Archives of Anesthesiology and Critical Care

The rapid expansion of a novel human infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has evolved into a pandemic, affecting thousands of people world wild. Some patients with coronavirus disease 2019 (COVID-19) develop severe infection, which may progress to acute respiratory distress syndrome, multiple organ failure, and death. Increasing studies indicate that abnormal elevation of cytokine levels in response to SARS-CoV-2 may contribute to the pathological process that leads mortality of COVID-19. Thus, application of extracorporeal hemoperfusion (HP) for removal of excessive cytokines from the blood can potentially mitigate or reverse cytokine storm related complications of COVID-19.&#x0D; Here, we presented series of COVID-19 patients, who were treated with HP (HA 380 cartridge, Jafron Biomedocal Co, China). The medical records were evaluated retrospectively to determine the effect of HP on patients’ clinical outcome. Our results showed that HP improvee PO2 and O2 saturation in patients with severe COVID-19. After the last courses of HP, 5 out of 6 patients were extubated and transferred to the general ward with an acceptable medical condition. The following case series demonstrate the promising role of HP in controlling the consequential effect of cytokine storm following a COVID-19 infection, which could facilitate patient survival.

Ali Amirsavadkouhi

Alireza Jahangirifard

Reza Shahrami

Saeid Safari

Faezeh Feizabadi

Zahra Mirshafiei Langari

Alireza Dastan

Seyed Bashir Mirtajani

Shayan Ghaznavi

Farzaneh Dastan

Archives of Anesthesia and Critical Care

The Role of Hemoperfusion in COVID-19 Infection: A Case Series

血液灌流在COVID-19感染中的作用：病例系列研究

Background: Oculocardiac reflex is a trigeminovagal reflex that occurs following mechanical manipulation of the orbital cavity. The current study evaluated the preventive effect of atropine and hyoscine on the Oculocardiac reflex in scleral buckling surgery. Methods: In this triple-blinded randomized controlled clinical trial, a total of 75 patients candidated for scleral buckling surgery were divided into three groups. Intravenous atropine (0.02 mg/kg up to a maximum of 0.5 mg), hyoscine (0.2 mg/kg), and distilled water were injected after intubation for each group respectively with standard monitoring. Heart rate, blood pressure and/or cardiac dysrrythmia were recorded immediately before/after injection and every 10 minutes. Decrease of heart rate more than 20%, or any cardiac dysrrythmia were defined as OCR. P-value &lt;0.05 was significant. Results: Demographic parameters were not different in three groups. Oculocardiac reflex was observed in hyoscine (34.8%), atropine (31.6%) and control (35.3%) groups (p=0.27). Additive atropine was injected only in two patients of control group. Oculocardiac reflex occurred more in the first ten minutes (35%) and in 30 minutes (55%), and was not observed after 90 minutes. Moreover, atropine and hyoscine increased the heart rate of patients more than control group (P=0.02), but in atropine group was longer than hyoscine group (P=0.03). Systolic blood pressure was not significantly different among the groups. Conclusion: In this study had been showed that in scleral buckling surgery, atropine is more effective than hyoscine in heart rate increase, but did not reduce oculocardiac reflex more significant than hyoscine and control group. And also oculocardiac reflex was more in first 30 minutes.

Mehryar Taghavi Gilani

Babak Dabbaghi

Shima Sheybani

Leila Mashhadi

Comparison of the Effect of Intravenous Atropine and Hyoscine on the Frequency of Oculocardiac Reflex in Scleral Buckling Surgery: A Triple-Blinded Randomized Clinical Trial

比较静脉注射阿托品和东莨菪碱对巩膜扣带手术中眼心反射频率的影响：一项三盲随机对照临床试验

Background: The University of Washington quality of life questionnaire (UW-QOL) is widely used to evaluate the quality of life for head and neck cancer patients. The purpose of this study is translation of the UW-QOL questionnaire's into Persian. Methods: After translation and cultural adaptation of the UW-QOL, the questionnaire was distributed among 100 head and neck cancer patients. Internal reliability of the translated UW-QOL was determined using Cronbach's alpha coefficient. The validity was determined by Spearman correlation coefficient between UW-QOL and 12-Item Short Form Survey (SF-12). The test – retest reliability was measured by Intraclass Correlation Coefficient (ICC) after one week. Results: Cronbach's alpha coefficient was more than 0.75 and ICC coefficient was more than 0.80 in all variables. The UW-QOL questionnaire composite score had a positive significant association with SF-12 questionnaire total score (Spearman's Correlation Coefficient= 0.70, P&lt; 0.0001). Conclusion: In conclusion Persian translation of the UW-QOL questionnaire has acceptable reliability and validity and is as valid as the original English version in evaluating the quality of life for patients with head and neck cancer.

Ali Pouresmaeil

Saeed Sohrabpour

Behnaz Aghaei

Reza Erfanian

Leyla Noury

Amirmohsen Asadi Kiapey

Anahit Shoormeij

Mina Abdolahi

Abolghasem Yousefi

Persian version of the University of Washington Quality of Life Questionnaire (UW-QOL): Reliability and Validity Study

华盛顿大学生存质量问卷波斯版（UW-QOL）：信度与效度研究

Frozen shoulder is a condition of varying severity characterized by the gradual development of global limitation of active and passive shoulder motion where radiographic findings are limited and associated with severe shoulder pain. Frozen shoulder is also referred to as adhesive capsulitis, painful stiff shoulder, and periarthritis. Treatment typically focuses on reducing shoulder pain and restoring joint mobilisation. In the context of shoulder mobilization, the predominant nerve blocks encompass the interscalene, supraclavicular upper trunk block collectively referred to as the SCUT block, as well as the axillary nerve block. These nerve blocks demonstrate high efficacy in delivering targeted analgesia. However, a notable limitation of these interventions is the concomitant motor blockade and phrenic nerve block induced by them. This motor blockade poses a significant impediment to the initiation of early rehabilitation, thereby delaying the commencement of rehabilitative exercises and intervention. Shoulder Anterior Capsular Block is a motor sparing block which can be effectively used in shoulder mobilisation.

Saravanakumar Sundaresan

Bhavani Vaidiyanathan

I.Joseph Raajesh

"Shoulder Anterior Capsular Block: An Effective Strategy for Alleviating Pain During Shoulder Mobilisation in Adhesive Capsulitis Patients": A Case Series

"肩关节前囊阻滞：粘连性肩关节囊炎患者缓解肩关节活动疼痛的有效策略"：病例系列

Background: Sufentanil is extensively used as a powerful painkiller for both initiating and sustaining general anesthesia, thanks to its advantages like potent prolonged action, analgesic effect, and hemodynamic stability. Nonetheless, it's important to consider sufentanil's negative side effects, such as postoperative nausea and vomiting (PONV), during the surgical period. Additionally, Naloxone, an antagonist for opioid receptors, is frequently utilized to counteract the lingering effects of opioids after surgery. Hence, we examined the preventative use of low-dose naloxone on PONV and studied its potential mechanism of action. Methods: After ethical approval and receiving IRCT code, 64 patients were evenly assigned to the naloxone and ondansetron groups prior to surgery. We also monitored the occurrence and intensity of PONV and the use of antiemetic medication within the first 24 hours after surgery. The main focus of our study was to analyze the PONV profile. Results: The mean age was 49.8±15.5 years, the mean weight 71.8±23 kg, and the mean BMI was 23.5±5.2 kg/m2. No significant difference was detected regarding mean oxygen saturation and arterial pressure between the groups at admission, 15, 30, 60, and 90 min after surgery (p&gt; 0.05). Adverse reactions showed no significant difference during the recovery time between the groups (p&gt; 0.05). The PONV severity and incidence are significantly higher in the naloxone group. Conclusion: Naloxone can be used as an antiemetic medicine, besides the ondansetron, and using this agent individually cannot prevent nausea and vomiting effectively.

Mehran Rezvani Habibabadii

Behzad Nazemroaya

Mahshad Soltanpoor

Comparison of Low-Dose Naloxone with Ondansetron for Prevention of Sufentanil-Postoperative/Postdischarge Nausea and Vomiting

低剂量纳洛酮与昂丹司琼预防舒芬太尼术后/出院后恶心呕吐的比较

Masoud Tarbiat

Mohammad Hossein Bakhshaei

Rohollah Abbasi

Mahmoud Rezaei

Anesthesia Management of a Child with Mosaic Trisomy 22 for Adenotonsillectomy Surgery

染色体22嵌合三体患儿腺样体切除术的麻醉管理

A 34-year-old woman was admitted for an emergency cesarean section at 38 weeks of pregnancy. She had no previous surgeries or illnesses. During the pre-operative evaluation, the anesthesia team noticed that the patient had not fasted. However, they decided to use spinal anesthesia for the emergency procedure. While preparing for the spinal examination, they discovered a large mass of hair covering the 3rd, 4th, and 5th lumbar vertebrae. Despite the emergency situation, the absence of fasting, and the risk of aspiration, the anesthesia team carefully considered all aspects of the patient's safety and decided to proceed with spinal anesthesia.

Alireza Babajani

Tina Mohebi

Mahnosh Ahmadi

Ahang Karimi

Selection Spinal Anesthesia Against an Unusual Finding: A Case Report Hairy Patch

选择性脊髓麻醉对抗异常发现：一例多毛斑病例报告

Background: Pre-anesthetic evaluation is the initial stage of anesthesia procedures for patients. This evaluation involves elucidating the patient's medical history, determining patient readiness, screening for undisclosed disorders, and identifying risk factors. Safety measures help mitigate patient-related risks within medical environments. The aim of this study is to investigate the role of Pre-anesthetic evaluation in patient safety. Methods: The present study was a review conducted in the year 2024. Databases including PubMed, Direct Science, MEDLINE, Proquest, SID, Scopus, Google Scholar, Magiran, and library resources were searched using keywords such as Pre-anesthetic evaluation, pre-anesthetic visit, anesthesia clinic, patient safety, and their English equivalents. A logical combination of these keywords was performed using "OR," "AND," and "NOT" operators. The search was conducted in relevant articles from the year 2000 to January 2024. Results: Initially, 22,000 articles were screened, and ultimately, 16 relevant articles were used for preparing this paper. In all the reviewed articles, pre-anesthetic evaluation played a key role in patient safety. Conclusions: Studies indicate that pre-anesthetic evaluation is a key improver of surgical outcomes. These measures not only mitigate potential risks but also enhance surgical outcomes. Overall, pre-anesthetic evaluation has a direct correlation with patient safety, playing a significant role in postoperative improvement and elevating the quality of medical care.

Shahnam Sedigh Maroufi

Behnam Shiri Zilan

Parisa Moradimajd

Jamileh Abolghasemi

The Importance of Pre-Anesthetic Evaluation in Patient Safety: A Systematic Review

麻醉前评估在患者安全中的重要性：一项系统综述

Gestational trophoblastic disease (GTD) is a cluster of tumors which often had a lethal outcome in the past. As the years have passed, with better understanding of the pathophysiology fatalities have reduced and patients have been cured. On an anesthetic stand point these cases can be challenging to manage due to the emergency nature of the surgery and various systemic complications they may present with. We present to you a case of a 29-year-old female with molar pregnancy managed by spinal anesthesia.

Jyoti P. Deshpande

Harsha Singhi

Molar Pregnancy- A Snowstorm Encounter: A Case Report

葡萄胎妊娠 - 一场暴风雪的遭遇：病例报告

Intraoperative Airway management of Pan facial fracture is always challenging due to difficult airway resulting from airway trauma and airway sharing between the anesthesiologist and maxillofacial surgeon. Submental intubation is considered a good alternative technique over tracheostomy for providing a clear field intraoperatively for maxillofacial fracture fixation. We want to discuss airway management maneuvers using Awake fiberoptic bronchoscope-assisted intubation and submental intubation technique and the challenges we faced in a patient presented with Pan- facial fracture with difficult airway posted for surgery.

Sumedha Mehta

Girish Saundattikar

Kiran.C. Valake

Swapnil. G.Kandukwar

Intraoperative Difficult Airway Management in Patient with Pan Facial Fracture Using Airway Manoeuvre Involving Fiberoptic Intubation and Submental Intubation

使用纤维镜插管和颏下插管技术对全面部骨折患者进行术中困难气道管理的策略

Publication Information	Publisher: Tehran University of Medical Sciences，Publishing cycle: ，Journal Type: journal，Open Access Journals: Yes
Basic data	Year of publication: 2023，Proportion of original research papers: 0.00%，Self Citation Rate:N.A.， Gold OA Rate: 0.00%
Average review cycle	网友分享经验：12 Weeks

Archives of Anesthesiology and Critical Care

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