Introduction & Objective: Inhalation gases that are used for general ANESTHESIA influence central nervous system. Headache is one of the most common complications of the patients in recovery room. The more basic and exact the pain control and monitoring of patients’ condition in recovery room is, the more practicable prevention of the next uncontrollable accidents is, and the more the rate of patient's satisfaction will be. This study was done with the goal of prevalence detection of headache after INHALATIONAL general ANESTHESIA with halothane and nitrous oxide in patients who referred to Yasuj training hospitals for being under the elective operation.Materials & Methods: Subjects of this study were 417 patients referred to Yasuj training hospitals for elective operation. All of the patients were under INHALATIONAL general ANESTHESIA. Before ANESTHESIA the patients were asked about previous chronic headache, age, sex and smoking. After the complete return of consciousness until the patients were in recovery room, they were monitored for headache.Results: In this study, most of the patients (66.7%) complained about headache. Rate of headache in men (80.9%) was more than women (53.1%). The most prevalence of headache was in the age between10-15 and the least was in the age between 26-40. Headache in the group who didn't have the history of chronic headache was more prevalent. There wasn't any meaningful relationship between headache appearing after operation of ANESTHESIA and the length of ANESTHESIA. The rate of headache in smokers (82.4%) was higher than in nonsmokers (63.3%). There wasn’t any meaningful relationship between headache and the method of oxygenation during ANESTHESIA.Conclusion: This study shows the high prevalence of headache in INHALATIONAL general ANESTHESIA which can be attributed to smoking, history of chronic headache, age and sex. With the recognition of disposing factors and their removal, patient's satisfaction will be more and the cure expenses will be less.

Background &Aim: For hernia surgery and to induce general ANESTHESIA in children, pediatric venipuncture is needed. The venipuncture process in the children can lead to damage (destroy) of the vein due to many reasons, including fear, restlessness and the child's excessive movements. The aim of this study was to compare the results of inhalation ANESTHESIA in children undergoing inguinal hernia repair surgery under general ANESTHESIA. Materials and Methods: In this randomized, single-blinded, prospective clinical trial study, 70 children aged 2 to 6 years who volunteered for inguinal herniorrhaphy were divided into two groups of 35 people in the children's operating room of Shahid Motahari Medical Training Center in Urmia. In the intervention group, peripheral venous catheterization was performed with induction of inhalation ANESTHESIA by 8% soflurane along with oxygen and nitrous oxide, but in the control group, peripheral venous catheterization was performed without induction of inhalation ANESTHESIA and awake. Randomization of intervention and control groups was done with Random Allocation software. Chi-square test was used to compare the frequency of studied variables between two groups. Independent t-test was used to compare the average intensity of restlessness between the two groups. Data analysis was done using SPSS 20 software and the significance level was considered less than 0. 05. Results: The average time of intravenous insertion in the group receiving soflurane was 25. 03 ± 21. 996 and in the group not receiving soflurane was 254. 21 ± 154. 913. The difference in the average time of intravenous insertion of the patients in the study between the two groups receiving soflurane and not receiving soflurane was statistically significant, and this average value was much higher in the group not receiving soflurane than in the group receiving soflurane. There was a significant difference between the two groups in the variable of intravenous insertion time (P=0. 0001). Conclusion: Children induced with soflurane need more sedative drugs such as midazolam or combination of midazolam with other drugs. In terms of nausea and vomiting, soflurane has little nausea-causing properties, although is more common in soflurane compared to some drugs such as propofol.

Background & Aim: Every surgery is followed by some changes in postoperative pulmonary function tests which can dramatically influence this period. Although the type of the surgery and its vicinity to diaphragm are the main determinants of these changes, anesthetic techniques are also responsible. Among different probable factors through which ANESTHESIA could influence postoperative pulmonary function tests, we planned to evaluate the effects of drugs used during the maintenance stage of ANESTHESIA on postoperative pulmonary function tests.Patients & Method: This is a single blind randomized clinical trial in which the patients ranged in age from 15 to 35 and presented with ASA I (American Society of Anesthesiology). All the operations were elective extremity or lower abdominal surgeries and their length was between one and two hours. All the patients had normal preoperative pulmonary function tests. The total number of the subjects was sixty and they were randomly divided into two equal groups (n=30).For the maintenance stage of ANESTHESIA, INHALATIONAL agents (N2O 50%, Halothane 0.5-1%) were used in one group and intravenous drugs in the other one (Midazolam 0.1mg/kg/h, Alfentanil 0.5mg/kg/min). 24 hours postoperatively, pulmonary function tests (PFT) were performed and the deviations of three indices (FEV1=Forced Expiratory Volume in 1 sec, FVC=Forced Vital Capacity, VC=Vital Capacity) from their preoperative values were measured and compared. Students’ t-test was used for statistical analysis. Results: FEV1, FVC and VC decreased by 16.3%, 13.5% and 12.5% in the INHALATIONAL group and by 12%, 12.9% and 12% in the intravenous group respectively. Comparing the results showed no significant difference between the two groups.Conclusion: Among the factors which are related to ANESTHESIA and can affect postoperative pulmonary indices, the above-mentioned drugs that we used for the maintenance stage, whether INHALATIONAL or intravenous, exert no significant influence on postoperative pulmonary function tests.

Introduction: Fentanyl, a synthetic opioid is a popular choice amongst anesthesiologists in the operating room. Preinduction IV fentanyl bolus is associated with coughing in 28-45% of patients. Coughing due to fentanyl is not always benign and at times maybe explosive requiring immediate intervention. The goal of this study was to compare the role of inhalation of salbutamol beclomethasone and IV lidocaine in preventing fentanyl induced coughing. Materials and Methods: This clinical trial study was performed in Ghaem Hospital in 2006. 320 patients aged 20-60 years, undergoing elective orthopedics surgery were randomized into four groups of 80. Group I served as control, while groups II, III, IV received an inhalation of salbutamol, beclomethasone or IV lidocaine before induction of ANESTHESIA. Following IV fentanyl (2 mg/kg) the incidence of cough was recorded and graded as mild (1-2), moderate (3-4) and severe (³5) depending on the number of coughs observed. Patients, characteristics and coughs, and the results of using different drugs were recorded in a questionnaire and analyzed by descriptive statistical methods. A p value of =< 0.05 was considered significant. Results: The incidence of cough was 40% in the control group, 6.25%, 1.25% and 11.25% in the salbutamol, beclomethasone and lidocaine groups, respectively. Occurrence of cough was significantly low in the treatment groups; however the difference among the groups was not significant. Conclusion: The use of inhalation salbutamol, beclomethasone or IV lidocaine prior to IV fentanyl administration minimizes fentanyl induced coughing, and in conditions like corneal rupture or increased intracranial pressure, which coughing is highly dangerous, they are beneficial.

Background: The severity of postoperative pain varies widely in the different types of ANESTHESIA. The aim of the present study was to compare the effect of isoflurane-nitrous oxide ANESTHESIA and propofolremifentanil ANESTHESIA on postoperative pain after foot and ankle surgery. Methods: In this double-blind clinical trial, 60 eligible patients were divided into two equal intervention and control groups; the first group inhaled ANESTHESIA with isoflurane-nitrous oxide and the control group were given intravenous ANESTHESIA with propofol-remifentanil using the quadruple random block model and postoperative pain intensity was measured and compared in the two groups. Data on pain severity were collected at different times and analyzed using SPSS statistical software and related tests. The significant level was set at 0. 05. Results: Of the 60 participants, 38 (52. 4%) were male and 22 (47. 6%) were female. The mean age of the participants was 33. 9± 15. 1 years. The intensity of pain in the recovery room and up to 4 hours after surgery was significantly (Pvalue<0. 001) lower in the intervention group but after 4 hours there was no significant difference between the two groups. So, it can be seen in the present study that there was a significant decrease (Pvalue<0. 036) in the number of cases requiring analgesics prescribed in the recovery room and up to 4 hours after surgery in the intervention group. Conclusions: According to the results, evaporation anesthetic isoflurane-nitrous oxide can be used in the stage of induction of ANESTHESIA in orthopedic surgeries, and has achieved good results in reducing pain, especially during the first 4 hours, postoperative.

For evaluating the safety of pediatric ANESTHESIA in an outpatient setting, 100 cases were selected by convenient sampling method in Mofid children hospital. Information about postoperative complications (during 24h) were gathered by telephone interview.Most of patients were in the 1-4years age group (55%), 4-8years, 1 month to 1 year, above 8years and below 1 month were situated respectively. Four surgical procedures of inguinal hernia, hydrocele, circumcision and ectopy of testis consist 73% of all the surgeries. Ninety eight Percent of the surgeries were performed under general ANESTHESIA. In these patients, 25% received narcotics, and in 42% regional block were combined with general ANESTHESIA. Fifteen Percent of the patients were intubated. Complications that occurred at home were pain and restlessness (29%. most common), Nausea and vomiting (17%), sleep disturbances (11%), fever (7%), Anorexia (6%), Urinary retension (5.3%), hoarseness 4% and cough 3%.

Introduction: Direct laryngoscopy and biopsy are important procedures in otorhynolaryngology .There would be severe consequences due to the extensive manipulations during these procedures.Ideal condition for this type of surgery requires adequate depth of ANESTHESIA to prevent hemodynamic changes and short-term recovery. The effects of inhaled and intravenous ANESTHESIA (TIVA) on the hemodynamic changes and recovery time, is investigated in this study.Materials and Methods: sixty four patients entered the study and divided into two groups of inhaled and intravenous (TIVA) ANESTHESIA, thirty two patients each. Heart rate and blood pressure were recorded before induction and in defined intervals in both groups. At the end of surgery, recovery time recorded in both groups.Results: Average heart rate in 1st, 3rd, 5th, 10th, 15th, 20th and 30th minute post induction was 77.87, 74.38, 72.23, 68.83, 68.92, 69.03 and 69.55 beats/min in TIVA group respectively and 94.73, 93.26, 91.56, 86.97, 87.83, 87.12 and 87.75 beats/min in inhaled ANESTHESIA group respectively, which was statistically meaningful. Average Systolic BP in 1st, 3rd, 5th, 10th, 15th, 20th and 30th minute post induction was 118.83, 113.17, 108.33, 105.50, 102, 97 and 101.33 mmHg in TIVA group respectively and 127.50, 133.83, 131, 135.12, 127.83, 123.83 and 120.83 in inhaled ANESTHESIA group respectively, which was statistically meaningful. Average recovery time to respond to verbal stimulation was 12.13 minute and 22.43 minute in TIVA and inhalation group respectively which was statistically meaningfu l.Conclusion: Intravenous ANESTHESIA is a wise choice for d irect laryngoscopy and biopsy surgery, since exerts better control on hemodynamics and causes a short-term recovery.

Background: Two major complications of surgeries are postoperative nausea and vomiting (PONV) and also postoperative pain (POP). Several studies have compared total intravenous ANESTHESIA (TIVA) with INHALATIONAL ANESTHESIA regarding these two complications. Some results have shown a better postoperative recovery conditions, but other contradictory results can also be found. This study was performed to evaluate and compare the effect of INHALATIONAL and intravenous ANESTHESIA in patients undergoing elective laparoscopic surgery, on the incidence and the severity of PONV and POP. Methods: This study was performed as a single-blinded prospective clinical trial. All patients aged 18-65, with ASA class I and II who underwent elective laparoscopy were included. Patients were divided into two groups of intravenous ANESTHESIA and INHALATIONAL ANESTHESIA. The incidence and the severity of PONV and POP were examined in 5 separated times after the surgery. The use of a rescue antiemetic and analgesic medication were also evaluated. Results: Overall, 67 patients received INHALATIONAL ANESTHESIA and 55 patients received intravenous ANESTHESIA. It was revealed that 47. 8% of the patients in the inhalation group and 18. 2% of the patients in the intravenous group developed PONV (P<0. 001). The severity of PONV was significantly lower in the TIVA group (P<0. 001), however, no statistically significant difference was found regarding the severity of abdominal pain (P=0. 62). Conclusion: The incidence of PONV and the need for administration of an antiemetic rescue drug are significantly lower in the TIVA group.