جستجوی مقالات مرتبط با کلیدواژه « بی هوشی » در نشریات گروه « پزشکی »

Delirium is a clinical syndrome characterizedby acute changes in awareness and consciousness, and disturbances and fluctuations in attention. This study evaluated the frequency of postoperative delirium in patients undergoing general anesthesia for dental procedures and the relevant risk factors. Materials &

In this cross-sectional study, 103 patients who were candidates for dental procedures under general anesthesia in Isfahan Dental School were randomly selected. General anesthesia was induced with thiopental sodium-fentanyl-atracurium in all the patients and maintained with propofol. Dental anxiety was evaluated in all the patients using the DAS-R (Dental Anxiety Score-Revised) questionnairebefore the procedure. In addition, the MMSE (Mini Mental State Examination) questionnaire was completed 48 hours after the procedure. Statistical analysis was performed with SPSS 25, using independent t-test and regression analysis (α = 0.05).

The results showed that the incidence of delirium in 103 patients undergoing general anesthesia was22 cases (21.4%). The results of linear regression analysis indicated that age was an important and influential factor in the mental status, and orientation to place (p value = 0.002) and time (p value = 0.001) after general anesthesia. The severity of anxiety before anesthesia significantly affected the duration of general anesthesia (p value = 0.01) and orientation to place after general anesthesia (p value = 0.005). Anxiety itself was affected by the age of the patient (p value = 0.01).

Delirium is highly prevalent in patients undergoing general anesthesia for dental procedures. It is critical to identify the risk factors associated with this disorder in order to reduce the incidence of delirium.

Auriculotherapy (also auricular therapy, ear acupuncture, and auriculoacupuncture) is a health care procedure based on the idea that auricle is a microsystem reflecting the entire body. In this microsystem, a point is considered for each part of the body in the auricle. By manipulating any specific point in the auricle, the corresponding part of the body is stimulated. The physical, mental, or emotional health of individuals is affected by exclusive stimulation of the given points. This therapeutic approach can contribute to the treatment of various diseases. The Holy Quran is a comprehensive source of various sciences, where a great deal of knowledge can be obtained by contemplating its holy verses. The authors of this study put forward the view that this therapeutic approach is initially introduced in chapter 18 of the Holy Quran (verses 10-11 and 18), called “al-Kahf” or“The Cave”. In these verses, it read; “when the youths sought refuge in the cave, they said: 'Lord give us from your mercy and furnish us with rectitude in our affair” (10) “for many years we sealed up their hearing in the cave” (11) and “You might have thought them awake, though they were sleeping” (18). The phrase “sealed up their hearing” has been translated “we stamped their ears and they became anesthetized”. Accordingly, the authors of this study believe that the phrase “sealed up their hearing" in the second verse denotes what is now considered as the basis of the auricular therapy. Also, auriculotherapy can be regarded as one of the interpretations of these verses.

Pain management is an important key point to surmount multi-injured peoples in an overcrowding emergency setting. Its role would be more apparent when the physician encounters a mass casualty in a war zone or even a military prehospital. Proper pain management could prevent a hypercatabolic state and subsequent shock in an injured patient. Having sedative and analgesic properties, rapid onset and offset effects, maintaining the cardiovascular and respiratory contain are the main reason for the selection of ketamine as a good choice in the war zone.

In a prospective interventional study in a war zone, we have selected and followed two groups of casualties for pain management. All were men with an average age of 26.6+8 y/o and 27.5 +7 y/o at groups A and B respectively. Group A received only Ketamine and Group B, received ketamine and diazepam, too.

This study showed that all of the injured patients who received ketamine have experienced some degrees of agitation and they may finally need benzodiazepines for sedation but at group B that received benzodiazepine before or concomitant with ketamine, the agitation significantly reduced. (P-Value 50.05)

Various factors may affect pain score and pain perception; patient's culture, mental health, previous drug usage, and addiction could alter the pain score in similar situations. It seems that the significant agitation is due to catecholamine release in the rough situation of the war zone that is exacerbated with the ketamine properties, nonetheless, as a good choice, ketamine is now recommended to use with benzodiazepines in the critical condition such as war zone for procedural sedation and analgesia.