Emergency medicine
Mustafa Mahmood Eid
Volume 7, Issue 1 , January 2021, , Pages 77-79
Abstract
Objective: Epidural anesthesia is one of the famous, generally safe, and most requestedpain relief measures in labor. Nevertheless, it can have some complications thoughpneumocephalus and subdural effusion are very rare complications.Case Presentation: A 32-year-old woman presented with a severe persistent ...
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Objective: Epidural anesthesia is one of the famous, generally safe, and most requestedpain relief measures in labor. Nevertheless, it can have some complications thoughpneumocephalus and subdural effusion are very rare complications.Case Presentation: A 32-year-old woman presented with a severe persistent headacheafter a vaginal delivery, where epidural anesthesia was used for pain control. Her braincomputerized tomography (CT) scan confirmed pneumocephalus and subdural effusionas a complication of the procedure.Conclusion: Although headache can be present in many women post-delivery,investigations should run in susceptible women with alerting signs.
Anesthesiology
Arman Taheri; Morteza Hashemian; Mehrdad Noroozi; Mohammad Bakhtiari; Mohammad Reza Doroodian; Shirin Salajegheh
Volume 4, Issue 2 , July 2018, , Pages 62-66
Abstract
Objective: In order to prolong the duration of intrathecal lidocaine, various drugs are used along with it. Due to the promising effects of tizanidine on central nervous system, it can be assumed that tizanidine can have a positive effect on increasing the anesthesia duration too. Thus, we aimed to investigate ...
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Objective: In order to prolong the duration of intrathecal lidocaine, various drugs are used along with it. Due to the promising effects of tizanidine on central nervous system, it can be assumed that tizanidine can have a positive effect on increasing the anesthesia duration too. Thus, we aimed to investigate the effect of oral tizanidine on the duration of lidocaine spinal anesthesia.Methods: This double blind clinical trial was conducted on 40 male patients waiting for elective leg surgery with the age range of 20-60 years in one of the educational hospitals of Kerman University of Medical Sciences, Iran. We used simple random sampling and our participants were assigned into 2 groups (placebo and oral tizanidine receivers). Spinal anesthesia with 1 mg/kg of hyperbaric lidocaine 5% was performed in both groups. In tizanidine group, patients received 4 mg of oral tizanidine one hour before spinal anesthesia. Sensory block was examined by pin prick test and all anesthetic duration including start block until reduction of sensory level was calculated at 2 lower dermatomes.Results: Findings showed that oral tizanidine compared to placebo can cause a 10-15 minute increase in patients’ lidocaine spinal anesthesia. Therefore, the average anesthesia time for tizanidine group increased meaningfully (P = 0.03). In addition, tizanidine can sedate patients during surgery (P = 0.00) or in recovery (P = 0.003).Conclusion: Based on the results, tizanidine increased the duration of lidocaine so oral tizanidine can be used to prolong the duration of lidocaine spinal anesthesia.
Critical Care
Akbar Fadaei Haghi; Rouya Shokri; Samad Shams Vahdati; Farid Eftekhar Milani; Shahrad Tajoddini
Volume 3, Issue 1 , January 2017, , Pages 30-31
Abstract
We report a 54-year-old woman with the history of end-stage renal disease (ESRD) who was admitted to our hospital because of volume overload. Due to long-term use of peripheral veins and arteriovenous fistula (AVF) failure, central venous catheterization was the only choice for hemodialysis. She developed ...
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We report a 54-year-old woman with the history of end-stage renal disease (ESRD) who was admitted to our hospital because of volume overload. Due to long-term use of peripheral veins and arteriovenous fistula (AVF) failure, central venous catheterization was the only choice for hemodialysis. She developed right upper extremiti’s pain and paresis during hemodialysis. A posteroanterior chest x-ray showed the catheter tip was accidently pushed from right internal jugular vein into right subclavian vein during hemodialysis by the dialysis center nurse. Therefore, we believe that the physician should be aware of any changes in the catheter size after insertion. And a chest x-ray should ensure the catheter’s correct position in any patient who develops complications.
Critical Care
Mahesh Chand Meena; Kuldeep Panchal; Mukta Rani
Volume 3, Issue 1 , January 2017, , Pages 34-37
Abstract
Oculocardiac reflex (OCR) sometimes occurs as a result of pressure on the eye or traction of the intraorbital surrounding structures during ophthalmic surgery. This can result in bradycardiac arrhythmia and cardiac arrest. A 45-year-old female was undergoing an elective squint correction surgery of one ...
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Oculocardiac reflex (OCR) sometimes occurs as a result of pressure on the eye or traction of the intraorbital surrounding structures during ophthalmic surgery. This can result in bradycardiac arrhythmia and cardiac arrest. A 45-year-old female was undergoing an elective squint correction surgery of one eye under local anaesthesia in a private hospital in December 2013. The patient was preoperatively examined, investigated and admitted to the hospital one day prior to operation. There was no previous history of any chronic illnesses. The patient collapsed during surgery and declared dead. Doctors attempting strabismus surgery under local anaesthesia should be familiar with this phenomenon.
Clinical Toxicology
Ali Taherinia; Soodeh Shahsavari; Azadeh Heidarpour; Seyyed Mohammad Tabatabaii; Afsson Vahdat
Volume 2, Issue 1 , January 2016, , Pages 3-6
Abstract
Objective: Renal colic is a common cause of emergency room visits. Due to the spontaneous passage of more than 90% of kidney stones, treatment in the emergency department (ED) is limited to pain control. Analgesics currently used are selected based on physician experiences and various theories from different ...
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Objective: Renal colic is a common cause of emergency room visits. Due to the spontaneous passage of more than 90% of kidney stones, treatment in the emergency department (ED) is limited to pain control. Analgesics currently used are selected based on physician experiences and various theories from different sources. The aim of this study was to compare the common drugs (pethidine and diclofenac) used for renal colic in Iran.
Methods: In this single-blinded randomized clinical trial, 90 patients with renal colic who referred to the ED of Imam Reza hospital in Kermanshah were randomly assigned to each of 3 treatments including pethidine suppository (50 mg, iv), diclofenac suppository (50 mg), and a combination of pethidine and diclofenac suppository. In this regard, the response to treatment and duration of hospitalization were compared.
Results: The best medicine to relieve pain intensity in patients under 25 years was diclofenac suppository. In patients in the age range of 25-45 years, pethidine and diclofenac were the best choice. Conversely, in patients older than 45 years, pethidine was the best treatment. We could also observe a decrease in the length of hospitalization in patients who received pethidine.
Conclusion: It can be concluded that morphine is more appropriate to control pain and reduce the length of hospitalization in patients with renal colic. Clinical Trial Registration: irct.ir Identifier: IRCT20101214538