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Introduction & Objective: Low flow anesthesia technique in which the flow fresh gas is lower than minute volume of the patient results in improvement in the patient’s care such as reduction of operative hypothermia, reduction of postoperative shivering and leads to an increase in economical and enviornmental interests. The goal of the study was to investigate the patients’ operative hemodynamic variations using the high and low flow anesthesia techniques. Materials & Methods: This prospective, clincal and single blind study was carried out in Tbriz Emam Khomeini Hospital in 1384. In this study 97 patients in ASA class I or II after routine induction of G.A, during maintenance of anesthesia were randomly divided in two groups group I (high flow anesthesia) and group II (low flow anesthesia). For all patients ECG, HR, SPO2, BP, B.T, ETCO2 and inspiratory, expiratory percentage of O2, N2O, halothane, postoprative shievring and duration of oprations were recorded. 46 patients underwent high flow anesthesia and 51 patients underwent low flow anesthesia. Results: The average blood pressure in group I was as follow: preoperative, systol=13820 mmHg and diastol=7815 mmHg, intraoperative, systol=10531 mmHg and diastol=6410 mmHg and in recovery systol=11615 mmHg and diastol=7013 mmHg. In group II who had low flow anesthesia the blood pressure was found to be systol=13922 mmHg and diastol=7922 mmHg preoperative, systol=12221 mmHg and diastol=7517 mmHg intraoperative and systol=11815 mmHg and diastol=7717 mmHg in recovery. The differences in blood pressure in both group were statiscally significant (p=0.01). The average heart rate in group I was 9018 beat/min preoperative, 7014 intraoperative and 126 in recovery. The avrage heart rate in group II was 87.921 preoperative, 8616 intraoperative and 10417 in recovery. The differences were statiscally significant but there was no significant difference between the two groups with regard to sex, age and weight. Conclusion: Maintenance of anesthesia with low flow anesthesia gasses maintains more hemodynamic condition during operation.

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ABSTRACT: Introduction & Objective: Transurethral Resection of Prostate (TURP) is usually performed under regional or general anesthesia. An alternative to conventional anesthesia is performing of TURP under local anesthetic infiltration with sedation. The aim of this study was to evaluate the efficacy and complication of sedoanalgesia in TURP. Material & Methods: In a prospective clinical trial from September 2006 to December 2007, 60 patients (30 in each group) with prostate hypertrophy, candidate for TURP, were randomly assigned into two groups. In the first group, standard spinal anesthesia was done. In the second group, five minutes before the operation, 25 mgs of diazepam plus 25-50 mgs of pethedine was intravenously administered followed by injection of 10 ml lidocaine 2% gel in the urethra and the skin in the suprapubic area was anesthetized with 2 ml of 1% lidocaine. Using a 22 gauge nephrostomy needle, the suprapubic skin was punctured and the needle was directed toward prostate apex and 10-20ml of 1% lidocaine was injected at the serosal aspect of the rectal wall. For dorsal nerve block, 5-10ml of 1% lidocaine was injected at penopubic junction, and then a standard TURP was performed. Patients were switched to another anesthetic technique if the selected technique failed. Severity of pain was assessed by visual analogue scale. Results: The average prostate size was 25 grs (range10-50grs) in the local anesthetic group (group 1) and 27.5 grs (range 10-50 grs) in the spinal group (group2). In the local anesthetic group, 82.3% had no or mild pain while moderate to severe pain was reported in 16, 7% of the patients. In the group with spinal anesthesia, these were 93.1% and 6.9% respectively. Intolerable pain was observed in 23.3% and 13.8% of groups 1 and 2 respectively (p>0.05). Two patients in spinal group and 5 in local anesthetic group (3 due to severe pain and 2 for unsatisfaction) required conversion to general anesthesia or receiving additional drugs such as ketamine (p=0.06). Postoperatively, 2 patients experienced headach following spinal anesthesia otherwise there was no significant difference between two groups. Conclusion: local anesthetic TURP with sedation is safe, effective and suitable for patients with prostate glands below 50 gr who require TURP.

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Abstract:

Background and aim: Lack of physical activity increases the risk of cardiovascular disease, diabetes, pulmonary function and sleep quality, but with regular physical activity, may reduce many of these risk factors. The aim of this study was to find the effects of aerobic training on serum levels of nitric oxide, pulmonary function parameters and quality of sleep in women with type 2 diabetes.

 

Methods: In the present quasi-experimental study, 20 type 2diabetic women were selected and randomly assigned into two exercise (n = 12) and control (n = 8) groups. Aerobic training program was performed for six weeks (4 times a week, with 50% to 80% heart rate reserve) who receive the time and intensity of exercise (50 to 80 HRR) was added. Main aerobic exercises presented in the form of 6 chain, each chain includes 32 motion. FVC, FEV1 Indices and nitric oxide levels were measured before and after the intervention and Pittsburgh Sleep Quality Index questionnaires were used to assess sleep quality. Statistical analysis were analyzed using t-test, analysis of covariance and correlation coefficient.

 

Results: Six weeks of aerobic exercise indicated a significant reduction in sleep quality scores and but a significant increase in the concentration of nitric oxide and lung volumes (FVC and FEV1) compared to the control group (p≤ 0.05), but no significant relationship between lung volumes and a score of sleep quality was observed.

 

Conclusion: It seems that aerobic exercise training can have a considerable impact on serum nitric oxide pulmonary functions and thereby improve the sleep quality in patients with type 2 diabetes.