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Rezaei B, Salehi Zahabi S, darvishi F, Salehi A, Hemmatpour B. Evaluation of biochemical parameters in operating room staff exposed to radiation and anesthetic gases. Ann Med Surg (Lond) 2023; 85:5439-5444. [PMID: 37920652 PMCID: PMC10619581 DOI: 10.1097/ms9.0000000000001372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 09/21/2023] [Indexed: 11/04/2023] Open
Abstract
Background Exposure to ionizing radiations and other hazardous agents such as anesthetic gases pose serious risks to the health of healthcare workers. This study aimed to evaluate the changes in blood and biochemical parameters of the operating room staff exposed to ionizing radiations and remnants of anesthetic gas. Methods This cross-sectional study was performed at (Ayatollah Taleghani Hospital). The control group was selected from different parts of the hospital that were not exposed to ionizing radiations and anesthetics, including the office, services, and treatment. The case group included all operating room personnel. Hematopoietic parameters such as complete blood count and WBC differential, and parameters of liver function such as serum activity of liver enzymes (ALT, AST, ALP, LDH) and serum bilirubin levels, fasting blood sugar, serum lipid profile, level of vitamin D and magnesium were measured for the exposed and referent subjects. Additionally, a checklist was used to gather data regarding the occupational variables and medical histories of the studied subjects. Results The mean values of Hb, Hct, Vitamin D, and MCHC, as well as the RBC count, were significantly lower in the exposed individuals than in the referent subjects. In contrast, the proportion of smokers was significantly higher in the exposed group than in the referent group. No significant differences were noted between exposed and unexposed groups as far as other parameters were concerned. However, no significant differences were noted between the case and control groups as far as other measured parameters were concerned. Likewise, no significant differences were noted between exposed and referent groups as far as blood types, history of underlying diseases, work history, working hours per month, number of morning and evening shift hours, type of diet, consumption of a high-fat diet a day before blood sampling, X-ray in the recent year, history of radiotherapy, and therapeutic agents use was concerned. Conclusions Exposure of operating room staff to ionizing radiations and waste anesthetics gases is associated with subtle, subclinical prepathologic decreases in some hematopoietic parameters such as hemoglobin, hematocrit and MCHC levels, RBC count as well as vitamin D levels.
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Affiliation(s)
- Bareza Rezaei
- Clinical Research Development Center, Imam Reza Hospital
| | | | | | - Amir Salehi
- Clinical Research Development Center of Taleghani
| | - Behzad Hemmatpour
- Department of Emergency and Critical Care Nursing, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Hajilo P, Imani B, Zandi S, Mehrafshan A. Comparing the intraoperative and postoperative complications of the scalpel and electrocautery techniques for severing the inner layers of the lumbar disc during discectomy surgery. Front Surg 2023; 10:1264519. [PMID: 37841816 PMCID: PMC10568066 DOI: 10.3389/fsurg.2023.1264519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 08/21/2023] [Indexed: 10/17/2023] Open
Abstract
Background Due to the sensitivity of the surgical site and a higher probability of injury, the use of a scalpel and electrocautery to create an incision in the spine is discussed. In this study, we will compare the intraoperative and postoperative complications of the scalpel and electrocautery techniques for severing the inner layers of the lumbar disc during discectomy surgery. Materials and methods This study was conducted in Iran as a randomized controlled trial with double-blinding (1,401). Sixty candidates for spine surgery were randomly divided into two groups of 30 using electrocautery (A) and a scalpel (B) based on available sampling. The VAS scale was used to assess postoperative pain. The duration of the incision and intraoperative blood loss were recorded. The infection and fluid secretions were determined using the Southampton scoring scale. Utilizing the Manchester scar scale, the wound healing status was evaluated. The SPSS version 16 software was used for data analysis (t-test, Mann-Whitney U, ANOVA). Results The electrocautery group had substantially lower bleeding, pain, and wound healing rates than the scalpel group (P > 0.05). However, the electrocautery group had significantly longer surgical times, more secretions, and a higher infection rate than the scalpel group (P > 0.05). In terms of demographic and clinical characteristics, there was no significant difference between the two groups (P < 0.05). Conclusion Electrocautery reduces postoperative hemorrhage and, potentially, postoperative pain in patients. However, as the duration of surgery increases, so does the duration of anesthesia, and patient safety decreases. Additionally, the risk of infection increases in the electrocautery group compared to the scalpel group, and the rate of wound healing decreases. Clinical Trial Registration https://www.irct.ir/, identifier (IRCT20230222057496N1).
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Affiliation(s)
- Parisa Hajilo
- Student Operating Room, Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Behzad Imani
- Department of Operating Room, School of Paramedicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Shirdel Zandi
- Department of Operating Room, School of Paramedicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ali Mehrafshan
- Department of Neurosurgery, Nekuii Forghani Hospital University of Medical Sciense Qom, Qom, Iran
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Ahmadinejad M, Pak H, Soltanian A, Pouryaghobi SM, Mohammadzadeh S, Ahmadi A, Ahmadinejad I. A retrospective study on the cardiac assessment of isolated sternal fracture patients based on radiographic and clinical outcomes. Ann Med Surg (Lond) 2021; 69:102762. [PMID: 34471533 PMCID: PMC8387903 DOI: 10.1016/j.amsu.2021.102762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 08/17/2021] [Accepted: 08/22/2021] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVE Sternal fracture may be associated with major and serious injuries. In this study, the complications associated with isolated sternal fracture in trauma patients are evaluated based on radiographic and cardiac findings. METHODS This retrospective study was performed on patients with isolated sternal fractures admitted to the emergency department of (XXX) Madani Educational-Medical. Data regarding demographic information, mechanism of trauma, length of hospitalization, electrocardiography (ECG), cardiac enzyme, and chest radiography were recorded in the questionnaire for each patient. RESULTS The mean age of patients 41.2 + 11.04 years and 63.9% were male. The most common cause of the trauma was car accidents in 41% (25 cases). The mean duration of hospitalization was 1.54 ± 0.90 days. The mechanism of trauma was not associated with x-ray and computed tomography findings, p = 0.53 and p = 0.86, respectively. ECG findings were significantly related to x-ray and computed tomography outcomes, p < 0.001, respectively. CONCLUSION Patients with isolated sternal fracture with displacement >0.5 cm and hematoma are likely to require cardiac consultation.
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Affiliation(s)
- Mojtaba Ahmadinejad
- Department of Surgery, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Haleh Pak
- Department of Surgery, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Ali Soltanian
- Department of Surgery, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Seyyed Mohsen Pouryaghobi
- Department of Anesthesiology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Sanaz Mohammadzadeh
- Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran
| | - Abtin Ahmadi
- Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran
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Pak H, Maghsoudi LH, Soltanian A, Jafarinia S. Evaluation of clinical manifestation and risk factors of idiopathic granulomatous mastitis. INTERNATIONAL JOURNAL OF SURGERY OPEN 2021. [DOI: 10.1016/j.ijso.2021.100380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Kiabi FH, Emadi SA, Jamkhaneh AE, Aezzi G, Ahmadi NS. Effects of preoperative melatonin on postoperative pain following cesarean section: A randomized clinical trial. Ann Med Surg (Lond) 2021; 66:102345. [PMID: 34040762 PMCID: PMC8141662 DOI: 10.1016/j.amsu.2021.102345] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 04/19/2021] [Accepted: 04/25/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Data regarding the analgesic effects of melatonin after the surgery is scare. So far, only one study has investigated the analgesic effect of melatonin during cesarean section. Objective: The present study was performed to investigate the effect of preoperative oral melatonin on pain intensity after cesarean section during spinal anesthesia. METHODS In a double-blind randomized controlled clinical trial study, 204 patients undergoing elective cesarean section with class 1 and 2 anesthesia (ASA) were enrolled. Patients were randomly divided into 3 groups of 68 patients. Patients in group A were given 5 mg melatonin tablets, patients in group B were given 10 mg melatonin tablets, and group C was given placebo. All patients underwent spinal anesthesia with the same anesthesia protocol. Pain intensity, nausea, vomiting, pruritus and headache were assessed and recorded 2, 6, 12 and 24 h after surgery. The time of first dose of analgesia, the amount of opioid consumed within 24 h, and the time to resume physical activity was also recorded. Statistical analysis of data was performed using SPSS 20 software. RESULTS Repeated measurements of pain intensity during the study showed that in all 3 groups pain intensity was significantly reduced during the study, p < 0.001, respectively. The intensity of pain was significantly different in groups B and C, groups B and A and groups A and C, P < 0.001, respectively. The pain reduction was greatest in group B, followed by group A and group C, respectively. The time interval between the end of surgery and the patient's need for analgesia was significant in group B compared to group A (P = 0.035) and C (P < 0.001) and also in group A compared to group C (P = 0.011). The mean dose of opioid was significantly least in group B, p < 0.001. The mean time to resume physical activity was also shortest in group B, p < 0.001 Headache and nausea/vomiting were observed in 7 patients (10.7%) group A and 7 patients (10.7%) in group C. None of the patients in group B developed complications. CONCLUSION The results of the present study showed that the use of 10 mg of melatonin before cesarean section with spinal anesthesia is not only safe, but also reduces the severity of patients' pain, increases the duration of postoperative analgesia, reduces the need for analgesics after surgery and resumption of physical activity.
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Affiliation(s)
- Farshad Hassanzadeh Kiabi
- Department of Anesthesiology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Seyed Abdollah Emadi
- Department of Anesthesiology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Aghdas Ebadi Jamkhaneh
- Department of Obstetrics and Gynecology., School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Goli Aezzi
- Department of Anesthesiology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
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Kiabi FH, Emadi SA, Shafizad M, Jelodar AG, Deylami H. The effect of preoperative sublingual buprenorphine on postoperative pain after lumbar discectomy: A randomized controlled trial. Ann Med Surg (Lond) 2021; 65:102347. [PMID: 34026096 PMCID: PMC8121872 DOI: 10.1016/j.amsu.2021.102347] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 04/19/2021] [Accepted: 04/25/2021] [Indexed: 12/20/2022] Open
Abstract
Background Lumbar discectomy is one of the most common surgical procedures performed to manage pain caused by the protrusion of an intervertebral disc. Postoperative pain management can be challenging and might lead to increased intake of opioids. Objective: The aim of this study was to determine the effect of preoperative sublingual buprenorphine on severity of pain after lumbar disc surgery and postoperative intake of morphine. Methods This Randomized clinical trial study was performed on 78 patients who were selected for lumbar discectomy surgery. Patients were randomly divided into two groups of 39 patients, each. Patients in the buprenorphine and placebo group received 2 mg buprenorphine sublingual, and placebo 1 h before surgery. Severity of pain, nausea, vomiting and pruritus and intake of opioids in the two groups were evaluated and recorded 1, 6, 12 and 24 h after surgery. Data were analyzed using SPSSv21. Results There was a significant difference in pain score in buprenorphine group at 1, 6, 12, and compared with placebo (P < 0.005). In the control group, the use of analgesics was more than the buprenorphine group. In the first hours after surgery (1–6 h), the incidence of nausea in the buprenorphine group was significantly lower than of the control group (P < 0.05). However, at 12 and 24 h, this difference was not observed, p > 0.05. There was no significant difference in incidence of side effects (nausea, vomiting, pruritus) in the two groups (P > 0.05). Conclusion Sublingual buprenorphine in postoperative pain management is an effective and low dose drug. Due to its simpler administration, it is recommended to relief postoperative pain after lumbar disc surgery. Lumbar discectomy is one of the most common surgical procedures performed to manage pain. Postoperative pain management can be challenging and might lead to increased intake of opioids. Sublingual buprenorphine in postoperative pain management is an effective and low dose drug. It is recommended to relief postoperative pain after lumbar disc surgery.
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Affiliation(s)
- Farshad Hassanzadeh Kiabi
- Department of Anesthesiology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Seyed Abdollah Emadi
- Department of Anesthesiology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Misagh Shafizad
- Department of Neurosurgery, School of Medicine, Orthopedic Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | | | - Hojat Deylami
- Student of Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
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Alipour S, Foroutan Z. A Local Random Glandular Flap for oncoplastic breast conserving surgery. INTERNATIONAL JOURNAL OF SURGERY OPEN 2021. [DOI: 10.1016/j.ijso.2021.100345] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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A randomized controlled trial evaluating inhalation and intravenous anesthesia for laparoscopic cholecystectomy. INTERNATIONAL JOURNAL OF SURGERY OPEN 2021. [DOI: 10.1016/j.ijso.2020.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Zarei F, Shahmoradi MK. Scalpel versus electrocautery for Herniorrhaphy Incision: A randomized controlled trail. INTERNATIONAL JOURNAL OF SURGERY OPEN 2021. [DOI: 10.1016/j.ijso.2020.12.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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