فهرست مطالب سعید انتظاری

One of disadvantages of axillary block is a long time gap between the performing the block and the appearance of the anesthesia required for surgery. This study aimed to to examine the effectiveness of adding 0.5% dextrose water (DW) to bupivacaine in brachial plexus block under the guide of a nerve stimulator and ultrasonography in hand and forearm surgeries.
A total of 60 candidates for an axillary block were studied. In both groups bupivacaine 0.5% was used to achieve anesthesia with 0.9% normal saline (NS) in the first group and 0.5% DW in the second group as solvents. Sensory and motor blocks were documented after local anesthesia every 5 minutes within the first 30 minutes, every 10 minutes within the second 30 minutes, and every 15 minutes thereafter.
The time interval between the drug injection and anesthesia between the two groups was different statistically only for the median nerve (p=0.03), whereas the difference for the remaining nerves was not significant.
In the present study adding 5% DW was only effective in the sensory block of the median nerve, with no significant difference with NS for the other nerves.

Aim and Arterial tourniquets are used widely for extremity orthopedic surgeries with regional or general anesthesia to reduce blood loss، but the harmful effect of ischemia and reperfusion is not clear yet. In this clinical trial 40 patients scheduled for lower extremity surgery with pneumatic tourniquet were randomized into 2 groups: a remote ischemic preconditioning (RIP group، n=20)، in which patients received three “5 minutes” cycles of ischemia، alternating with 5 minutes of reperfusion before extended use of tourniquet and a control group (n=19). Hemodynamic variables prior to inflation of tourniquet and every 30 minutes during the surgery and 10 minutes after tourniquet deflation and arterial blood gas sample prior to and after surgery were compared between groups. In comparison with the baseline values، systemic blood pressure was increased in all patients، however in control group it was significantly more than baseline values and also higher than the RIP group (p=0. 03 and p=0. 032 respectively). There was no significant change in heart rate and O2 saturation and Spontaneous respiratory rate between the groups and in comparison with baseline values. Tourniquet application in limb surgery can cause hemodynamic changes and remote ischemic preconditioning can not attenuate these effects such as variation of blood pressure، heart rate and changes of respiatory rate and arterial O2 saturation. However RIP can reduce inceases in systolic blood pressure and acidosis.