Background: Propofol is commonly used for providing sedation in endoscopic retrograde cholangiopancreatography (ERCP). It’s simple to use and effective but presents cardiovascular and respiratory adverse effects. Recently, dexmedetomidine has been tried but very little evidence exists to support its use. The aim of this study was to compare the efficacy and safety of combination of dexmedetomidine and lidocaine (DL) with the standard propofol-fentanyl (PF) regimen.Materials and Methods: After approval of the hospital ethics committee, 63 patients (18-60 years of age) were randomly divided into

سال انتشار: 1396
نوع سند: مقاله ژورنالی
زبان: انگلیسی
مشاهده: 461

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شناسه ملی سند علمی:

JR_SBMU-2-4_005

تاریخ نمایه سازی: 6 اسفند 1398

چکیده مقاله:

Background: The aim of the current study was to compare the effects of normal saline solution and 6% hydroxyethyl starch (HES/HAES) solution on hemodynamic changes after spinal anesthesia in patients undergoing lower limb orthopedic surgery.Materials and Methods: This randomized clinical trial was performed on 50 patients undergoing surgery, aged 20-60, with physical status of ASA I, II.Before surgery, the hemodynamic status of each patient including systolic and diastolic blood pressure, heart rate, and central venous pressure was measured. Then, the patients were randomly divided into two groups and for the control group, 7 ml/kg 9% (or normal) saline and for the experimental group 6% hydroxyethyl starch were administered. Hemodynamic indices were re-measured after the completion of infusion, and then spinal anesthesia was performed. After anesthesia, hemodynamic indices were measured every 5 minutes for 1 hour and then every 10 minutes for 2 hours. The analysis of variance (ANOVA) for repeated measures was used to evaluate the significant changes in hemodynamic indices.Results: The mean and standard deviation of systolic and diastolic blood pressure, heart rate, and central venous pressure in the control group were 113.0 (7.3), 73.0 (6.0), 95.6 (5.7), and 5.8 (0.9), respectively, and in the intervention group were 104.8 (5.5), 66.1 (4.2), 95.8 (8.2), and 4.3 (0.9(. ANOVA for repeated measures showed that the incidence of decreasing changes in systolic and diastolic blood pressure, heart rate, and central venous pressure of the patients for whom hydroxyethyl starch was prescribed was significantly less than that of the patients for whom normal saline was prescribed.Conclusion: Hydroxyethyl starch has a more effective role in controlling hemodynamic changes before spinal anesthesia than normal saline.

نویسندگان

Siamak Yaghobi

Department of Anesthesiology, School of Medicine, Qazvin University of Medical Sciences, Iran

Amir Hesam Alirezaei

Clinical Research Development Center at Shahid Modarres Hospital, Department of Nephrology, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Mahmood Bakhtiyari

PhD, Department of Community Medicine, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

Marzieh-Beigom Khezri

Department of Anesthesiology, School of Medicine, Qazvin University of Medical Sciences, Iran

Nilofar Massoudi

Clinical Research Development Center at Shahid Modarres Hospital, Department of Anesthesiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran