Afshin Mansourian; Leila Malekmakan; Taraneh Tadayon; Narges Izadpanahi
Abstract
Background: This research evaluated the effects of propofol and midazolam/fentanyl on maternal blood pressure, heart rate, recall, and full satisfaction with spinal anesthesia. A double-blinded randomized controlled trial was designed.
Methods: The sample size was calculated as 100 patients (a type ...
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Background: This research evaluated the effects of propofol and midazolam/fentanyl on maternal blood pressure, heart rate, recall, and full satisfaction with spinal anesthesia. A double-blinded randomized controlled trial was designed.
Methods: The sample size was calculated as 100 patients (a type I error of 5% and statistical power of 80%) who were scheduled for elective cesarean delivery under spinal anesthesia. These patients were randomized into two equal groups by block randomization used for allocation sequence: midazolam/fentanyl and propofol groups. We measured the maternal heart rate (HR), systolic, and diastolic blood pressure (SBP and DBP) before induction, every three minutes in the operating room, and every five minutes until discharge from the recovery room. Data were analyzed by SPSS 18.0 and P value < 0.05 was considered as the significance level.
Results: 100 women (mean age: 29.7 ± 5.1 years and gestational age: 37.2 ± 1.2 weeks) were enrolled. The SBP and HR decreased during the study in both groups, but it was significant only in the midazolam/fentanyl group (SBP: from 120.0 ± 10.3 to 113.9 ± 4.8, P = 0.025; and HR: from 75.0 ± 7.6 to 65.3 ± 5.5, P = 0.046). DBP reduced in both groups, but it was only significant in the propofol group (from 68.5 ± 7.2 to 56.9 ± 2.1, P = 0.039). The maternal recall of the birth time, child weight, and full satisfaction were significantly better in the propofol group than in the midazolam/fentanyl group (P = 0.046, P = 0.009, and P = 0.039, respectively).
Conclusions: Propofol and midazolam/fentanyl could be useful in cesarean sections under spinal anesthesia thought propofol may induce more effective sedation with higher satisfaction. Accordingly, the propofol use during caesarian sections under spinal anesthesia is suggested due to its anti-stress effects, good delivery recall, and good sedation satisfaction.
Maryam Pakfetrat; Leila Malekmakan; Taraneh Tadayon; Amin Nikfar; Afshin Mansourian
Abstract
Background: Nephrolithiasis is a worldwide health problem. Objectives This study investigated the frequency of urinary and serum metabolic abnormalities and their association with demographic characteristics in patients with nephrolithiasis.
Methods: In this cross-sectional study, we assessed 376 patients ...
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Background: Nephrolithiasis is a worldwide health problem. Objectives This study investigated the frequency of urinary and serum metabolic abnormalities and their association with demographic characteristics in patients with nephrolithiasis.
Methods: In this cross-sectional study, we assessed 376 patients with nephrolithiasis who referred to Motahari Medical Center, Shiraz from March 2017 to June 2017. Patients’ history, 24-hour urine analysis (for volume, calcium, uric acid, sodium, citrate, phosphate, and oxalate), and serum tests (for calcium, uric acid, and parathyroid hormone) were recorded in a data gathering sheet. P value < 0.05 was considered statistically significant.
Results: The most common abnormality was a low volume of 24-hour urine (< 2000 mL), (73.7%), followed by hypercalciuria (23.9%), and hyperoxaluria (19.4%). Low 24-hour urine volume was more frequent in women (80.0% vs. 64.3%, P < 0.001), while hypercalciuria (37.0% vs. 18.3%, P < 0.001), and hyperphosphaturia (6.0% vs. 1.7%, P = 0.03) were more frequent in men. Moreover, hypercalciuria was more frequent in outdoor workers (39.7% vs. 21.1%, P = 0.003), whereas low urine volume was more frequent in indoor workers (79.0% vs. 61.1%, P = 0.006). Metabolic abnormalities were not different in terms of patients’ family history.
Conclusions: Multiple factors affect the frequency and type of nephrolithiasis. Since these parameters are also influenced by race, culture, and dietary habits; thus each region must determine its own demographic features of renal stone. Based on our results, women had lower urine volume and higher urine citrate than men. Moreover, water intake is one of the most important factors that correlate with renal stone formation.
