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Article
Comparison of the Hemodynamic & Respiratory Parameters between Smokers & Non Smokers in Lower Abdominal Surgery Under General Anesthesia

Authors: Iyad Abbas Salman --- Musrey Younis Jahn
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2013 Volume: 12 Issue: 2 Pages: 202-207
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT: BACKGROUND:Smoking is a very widespread habit , it had been proved to affect adversely on many systems of the body especially the cardiovascular (CVS) & the respiratory system, and such effects wouldbe exaggerated perioperatively because of the effect of general anesthesia (GA) especially whenthere is no any period of abstinence from smoking (as when occurred during emergencyprocedures).OBJECTIVE: To assess the hemodynamic & respiratory effects of smoking perioperatively in patientsundergoing emergency lower abdominal operations. PATIENT AND METHODS: A prospective case control study carried on 80 patients in Baghdad teaching hospital/Medicalcity / Baghdad / Iraq, from September 2011 to March 2012, the 80 patients have been allocatedinto 2 groups, (each of 40 patients): group 1 who were non smoker patients, & group 2 thesmoker patients. The 2 groups were undergone emergency lower abdominal surgery under GA, all the patientsreceived similar pre. & intraoperative managements. Pulse rate (PR), systolic blood pressure(BPsys), diastolic blood pressure (BPdias),oxygene saturation (SPO2), and airway pressure(Paw) were monitored with the standard non invasive technique, at the baseline period(preoperative); immediate postintubation; 10, 20, 30, & 40 minutes intraoperatively; immediatepostextubation; & 10 minutes in the recovery period.RESULTS: Regarding the pulse rate, there were no statistically significant variations between the 2 groupsapart from the immediate postextubation period (105 ± 6.95 in smokers vs 100.3 ± 8.3 in nonsmokersRegarding the systolic blood pressure, there was statistically significant increase in the systolicBP especially at the immediate postintubation period in smoker patientsRegarding the diastolic BP, apart from the immediate postextubation period ,there wassignificant increase in the diastolic BP between the 2 groups especially at the immediatepostintubation Regarding the SPO2%, there were no statistically significant reduction in the SPO2 readingsbetween the 2 groups apart from the intraoperative period Regarding the P airway , there were no significant increase in the P airway perioperativelybetween the 2 groups CONCLUSION: There were statistically significant CVS derangements in the smoker group versus the nonsmokers especially around intubation period.

Keywords

smoking --- hemodynamic --- respiratory


Article
Comparison between Total Intravenous Anesthesia (TIVA) and Conventional General Anesthesia in Day Case Surgical Procedures

Authors: Iyad Abbas Salman --- Ali Yousif Mohammad
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2013 Volume: 12 Issue: supplement Pages: 700-705
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND: Day case surgery should be of short duration, rapid recovery, and with low incidence of postoperative complications. For long time was done with conventional inhalational based anesthesia, in last year's, TIVA began to be used in these surgeries.OBJECTIVE:To evaluate total intravenous anesthesia (TIVA), as an aesthetic technique for day case procedures and to compare it with conventional inhalational based technique in terms of intra and postoperative hemodynamic and respiratory changes, postoperative recovery and postoperative vomiting.PATIENTS AND METHODS: This is a prospective randomized study has been done on 100 patient who underwent general anesthesia for short duration surgical procedure in AL- Jumhory teaching hospital in Al-Mosul city in Iraq, during the period between Nov 1st, 2011 and March 1st, 2012 , All patients were allocated into either TIVA or inhalational (INH) groups, of 50 patient each. In TIVA group: induction and maintenance of anesthesia done by propofol. While in INH group: maintenance of anesthesia done by halothane. Blood pressure, pulse rate, respiratory rate were monitored at a specific time. Recovery time was recorded according to Aldrete score. Any episode of vomiting was recorded.RESULTS: Aldrete score of ≥ 9 was achieved earlier in the TIVA group than in the INH group. It was also observed that there was initial fall in HR, MAP and respiratory rate in the both group, and post operative vomiting was less in the TIVA group.CONCLUSION: The time needed for recovery and episodes of postoperative vomiting in TIVA is less than in inhalational anesthesia.KEYWORDS: TIVA, propofol, day case surgery.


Article
Comparison of the Effect of Dexamethasone and Metoclopramide in Prevention of Post-Operative Nausea and Vomiting in Laparoscopic Cholecystectomy

Authors: Iyad Abbas Salman --- Redha Mohamed Abdul Hussien Alkabee
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2013 Volume: 12 Issue: 3 Pages: 443-448
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ACKGROUND: Postoperative Nausea and vomiting is Common complication depending on the type of surgery, technique and duration of anesthesia.OBJECTIVE: To evaluate the effect of Dexamethasone as antiemetic in comparison with Metoclopramide.METHODS: Is aprospective study carried on (100) patients undergone elective cholecystectomy in a periodfrom Jan. 2009 to April. 2010 in Baghdad Teaching Hospital / Medical city/Baghdad/Iraq. The patients were allocated into two groups of 50 patients each. Group A received 8mgDexamethasone, group B received 10mg metoclopramide intravenously, both groups monitoredpostoperatively for nausea and vomitting for 24 hours every 4 hours.RESULT:Regarding Nausea, for 24 hrs the results were not significant except at 24th hr., in which nauseamore significant in metoclopramide group.Regarding Vomiting, there was no significant from postoperative period to 12hr, while from 16 hr.to 24 hr. there were significant fewer incidences in dexamethasone group.CONCLUSION: A single dose of Dexamethasone is effective same as Metoclopramide in prevention of PONV ,and it is better in late prevention postoperativel

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