Acta medica Iranica
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Acta medica Iranica · Jan 2013
Randomized Controlled Trial Comparative StudyComparison of two nomograms of unfractionated heparin in patients with acute coronary syndrome.
Heparin has an unpredictable pharmacokinetics and the responses of individuals may vary distinctly. Therefore, different dosing nomograms have been proposed. The aim of this study was to compare two prevalent nomograms to adjust heparin doses in hospitalized patients with acute coronary syndrome. One hundred and forty patients received heparin infusions based on one of two nomograms. ⋯ At 48 hours, the proportion of patients in the therapeutic range in group 1 was higher (72.86% vs 45.71%). The time patients stayed at the desired levels was significantly higher in nomogram 1 and they also required fewer heparin rate adjustments (3.41±1.55 vs 4.53±1.63). This study indicated that using nomogram 1 facilitated a more rapid achievement of the therapeutic threshold, higher proportion of patients in the therapeutic range for a longer time, and fewer changes of in the heparin rate.
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Acta medica Iranica · Jan 2012
Randomized Controlled Trial Comparative StudyThe effect of ondansetron and meperedin on preventing shivering after off-pump coronary artery bypass graft.
One of the most common complications of operation and anesthesia is shivering. The purpose of this study was to compare the effectiveness of Ondanseton and Meperedine in preventing shivering after off-pump coronary artery bypass graft (OPCAB). In this double-blind randomized clinical trial, the sample consisted of 90 patients, who were candidates of CABG under general anesthesia. ⋯ Bradycardia was 3.3% in group (A) and 0.0 % in group (B). Other variables (myoclonus, seizure and rash) showed no statistically significant difference (P=0.353). According to the findings, it was demonstrated that ondansetron is more effective in preventing shivering after Off-pump CABG than meperedine.
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Acta medica Iranica · Jan 2012
Randomized Controlled Trial Comparative StudyComparison of effects of ephedrine, lidocaine and ketamine with placebo on injection pain, hypotension and bradycardia due to propofol injection: a randomized placebo controlled clinical trial.
Propofol is a widely used anesthetic drug because of its minor complication and also its fast effect. One of most popular complication in using this drug is pain during injection that is more sever in new generation of its components (lipid-free microemulsion). Other complications of propofol are bradycardia and hypotension. ⋯ Our data shows that in pain management all tested drugs can decrease pain significantly comparing with placebo (P=0.017). In control of hemodynamic parameters ephedrine could efficiently control SBP, DBP, MAP at the time 1 min after intubation. Based on our study ephedrine can be an appropriate suggestion for control of both pain and hemodynamic changes induced by propofol, although because of inconsistent result in other studies it is recommended to design a systematic review to draw a broader view on this issue.
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Acta medica Iranica · Jan 2012
Randomized Controlled Trial Comparative StudyOndansetron pretreatment reduces pain on injection of propofol.
To assess the effectiveness of ondansetron pretreatment in alleviating propofol injection pain, 135 patients were randomly assigned to one of following three groups. Group 1 who received up to 2 mL pretreatment 50 mg tramadol in the saline, group 2 cases who received up to 2 mL pretreatment 4 mg ondansetron in saline, and group 3 who received up to 2 mL solution saline. A 20 gauge cannula was placed into the largest vein on the dorsum of the hand. Tourniquet was closed to the arm above the cannula and inflates to 70 mmHg, and then drug was injected. After 20 seconds, the tourniquet deflated, and propofol 2mg/kg injected over 10 seconds and pain assessment was made. ⋯ Tramadol and ondansetron significantly reduced the incidence and severity of propofol injection pain more than placebo (P=0.001). The efficacy of ondansetron in alleviating the pain on injection of propofol was no different from tramadol (P=0.330). Ondansetron pretreatment may be used to reduce the incidence of pain on injection of propofol, an advantage added to the useful prevention of postoperative nausea and vomiting.
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Acta medica Iranica · Jan 2011
Randomized Controlled Trial Comparative StudyComparison of the efficacy of nifedipine and hydralazine in hypertensive crisis in pregnancy.
Intravenous hydralazine is a commonly administered arteriolar vasodilator that is effective for hypertensive emergencies associated with pregnancy. Oral nifedipine is an alternative in management of these patients. In this study the efficacy of nifedipine and hydralazine in pregnancy was compared in a group of Iranian patients. ⋯ Nifedipine and hydralazine are safe and effective antihypertensive drugs, showing a controlled and comparable blood pressure reduction in women with hypertensive emergencies in pregnancy. Both drugs reduce episodes of persistent severe hypertension. Considering pharmacokinetic properties of nifedipine such as rapid onset and long duration of action, the good oral bioavailability and less frequent side effects, it looks more preferable in hypertension emergencies of pregnancy than hydralazine.