Journal of North Khorasan

Background and Objectives: General anesthesia and surgery are the Cause of various physiological disorders in different organs of patients, giving rise to   different complications during recovery of the patient. Emergence from anesthesia and tracheal extubation may be associated with tracheal stimulation ,leading to  cough and hemodynamic changes. The objective of this study was to evaluate the effect of remifentanil infusion with maintenance dose on symptoms such as cough and hemodynamic changes after general anesthesia.

Methods and Materials: In a double-blind clinical trial study, 60 patients underwent discectomy surgery with general anesthesia,were divided into the control group and remifentanil receiving group during emergence from anesthesia. At the end of surgery, remifentanil infusion was discontinued in the control group and in remifentanil receiving group with /015μg/kg/min continued until extubation. Blood pressure, heart rate and oxygen saturation were measured.

Results: During the emergence, mean blood pressure and heart rate of remifentanil group 5 minutes after extubation, were significantly lower than those of control group. Oxygen saturation in remifentanil group was significantly higher at 5th minutes after extubation in the comparison with the control group. No significant difference was found in the incidence of cough in patients of both groups. Time awakening from anesthesia was significantly longer in the control group.

Conclusions: Maintain a low dose of remifentanil infusion during emergence from anesthesia decreased hemodynamic changes without delay of awakening time significantly.

Keywords: remifentanil, hemodynamic changes, extubation, discectomy

Background & Objectives: Post-operative shivering is a common problem following the increased oxygen consumption leading to some other problems such as intracranial and intraocular pressure, and post operation pain. The goal of this study was comparing the effect of Pethedine (Meperidine) and Dexamethasone on prevention of shivering during the simple urological surgeries.

Material and Methods: This double blind clinical trial study -was performed on 120 patients who were candidates for simple urologic surgery. The patients were randomly divided into two different groups including those who were received  Dexamethasone (D) and Pethedine (P). After pre medication using the Midazolam, Lidocaine, and Fentanyl, similar anesthetic induction was done by injection of   Dexamethasone (8mg) and Pethedine (25mg) to the groups D and P, respectively. All the patients were controlled for visible shivering in recovery.

Results: There were not any significant differences between two mentioned groups in the case of weight, age, and duration of surgery. Only nine cases (15%) in group D had post-operative shivering. Whereas, twenty six cases in group P (44.3%) had shivering and the difference between 2 groups was significant (P value =0.002).

Conclusion: Pethedine and Dexamethasone are effective drugs for the prevention of post-operative shivering in simple urologic surgery. The effect of Dexamethasone in preventing the post – operative shivering was better than Pethidine.