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Mahmood Saghaei

Publications and source records attributed to Mahmood Saghaei.

10 recordsLinked to original sources
PubMed2005

Evaluation of relationship between arterial and venous blood gas values in the patients with tricyclic antidepressant poisoning.

INTRODUCTION: Determination of arterial blood gas (ABG) values is essential in the evaluation of patients with TCA poisoning. The relationship between arterial and venous blood gas pH has not been established in TCA poisoning. In TCA poisoning, blood vessels vasodilatation due to antidepressant-induced alpha-blockade and also metabolic acidosis may lead to arterialization of venous blood, which in turn enhances the relationship between ABG and VBG parameters. Therefore this study was designed to evaluate the relationship between ABG and VBG pH values in TCA poisoned patients. METHODS: This prospective study was performed in the Poisoning Emergency Department of Noor Hospital, Isfahan, Iran. Samples for arterial and venous blood gas analysis were obtained during initial evaluation of TCA-poisoned patients and 30 min after treatment with sodium bicarbonate. The venous blood gas samples were collected with samples for other blood tests at the time of intravenous line insertion. Laboratory data were recorded on a database form initiated in the emergency department and analyzed by paired student t-test. The degree of agreement between the arterial and venous pH measurements was evaluated by Bland and Altman method. RESULTS: Data from 50 TCA-poisoned patients were analyzed. There were significant differences between mean differences of ABG and VBG parameter values on the initial evaluation. There was also a relationship between arterial and venous pH on the initial evaluation. CONCLUSION: In TCA poisoning, the peripheral venous pH measurement is a valid and reliable substitute for arterial pH.

Acid-Base Equilibrium↗
PubMed2005

Clinical trial of nitroglycerin-induced controlled hypotension with or without acupoint electrical stimulation in microscopic middle ear surgery under general anesthesia with halothane.

BACKGROUND: Transcutaneous electrical stimulation (ES) has been shown to produce long-lasting fall of arterial blood pressure in animal or human models. Previous reports have shown that ES of acupuncture points (acupoints) enhances the hypotensive effect of isoflurane anesthesia. This study was designed to investigate the combined effect of acupoint ES and different infusion rates of nitroglycerin on controlled hypotension. METHODS: Fifty-one adult ASA I patients undergoing elective mastoeidectomy were randomly divided into two groups, to receive either true or sham ES of ST36 (Zusanli) and ST38 (Tiaokou) acupoints. Each group was further subdivided into four groups to receive four different rates of nitroglycerin infusion (1.5, 2, 2.5 and 3 microg/kg/min). Steady state mean arterial blood pressure (MAP) and time to reach it were compared between two groups. The amount of bleeding in microscopic surgical field was quantitatively assessed and compared between two groups. RESULTS: Steady state MAP was significantly lower in true ES group compared with sham ES group (60 +/- 4 mmHg in true ES vs. 66 +/- 5 mmHg in sham ES, P = 0.000) and the difference was significantly greater in lower dosage of nitroglycerin compared with higher dosage. In addition time to reach steady state MAP was significantly shorter in true ES compared with sham group (10 +/- 3 min in true ES vs. 15.8 +/- 4 min in sham ES, P = 0.000). Heart rate decreased significantly in true ES compared with sham ES group after commencement of ES and nitroglycerin infusion. Quality of operative ischemia was excellent in 20 (83.3%) patients of true ES compared with 6 (25%) patients in sham ES group (P = 0.000). CONCLUSIONS: The result of this study shows that ES of ST36 combined with nitroglycerin infusion facilitates lowering of blood pressure and produces a bloodless surgical field. The mechanism of blood pressure lowering effect of acupoint ES may be reducing of norepinephrine and other sympathomimetic substances in the blood.

Acupuncture Points↗
PubMed2004

Random allocation software for parallel group randomized trials.

BACKGROUND: Typically, randomization software should allow users to exert control over the different aspects of randomization including block design, provision of unique identifiers and control over the format and type of program output. While some of these characteristics have been addressed by available software, none of them have all of these capabilities integrated into one package. The main objective of the Random Allocation Software project was to enhance the user's control over different aspects of randomization in parallel group trials, including output type and format, structure and ordering of generated unique identifiers and enabling users to specify group names for more than two groups. RESULTS: The program has different settings for: simple and blocked randomizations; length, format and ordering of generated unique identifiers; type and format of program output; and saving sessions for future use. A formatted random list generated by this program can be used directly (without further formatting) by the coordinator of the research team to prepare and encode different drugs or instruments necessary for the parallel group trial. CONCLUSIONS: Random Allocation Software enables users to control different attributes of the random allocation sequence and produce qualified lists for parallel group trials.

Algorithms↗
PubMed2004

Paradoxical reaction following intravenous midazolam premedication in pediatric patients - a randomized placebo controlled trial of ketamine for rapid tranquilization.

BACKGROUND: Paradoxical reactions to benzodiazepines include restlessness, violent behavior, physical assault, act of self-injury and need for restraints. These may occur at variable times after administration. This study was designed to determine the incidence of paradoxical reactions following intravenous midazolam premedication in pediatric patients and to compare the efficacy of extra doses of midazolam with low-dose intravenous ketamine to rapidly tranquillize them. METHODS: A total of 706 ASA I, II children scheduled for elective surgery were given intravenous midazolam premedication. Children who developed a paradoxical reaction were randomly divided into three equal groups to receive: (i) extra midazolam, (ii) ketamine, or (iii) placebo as the test drug for treatment of paradoxical reaction. Ease of rapid tranquillization and need for a rescue tranquillizer (i.e. ketamine; irrespective of patient group) were compared among the three groups. RESULTS: Twenty-four (3.4%) children developed paradoxical reaction after midazolam premedication. Those who received ketamine as the test drug responded rapidly to ketamine. But the responses of the other two groups to their test drug were poor and the majority of them required ketamine as rescue tranquillizer (six in midazolam, seven in placebo, but no patient in the ketamine group; P < 0.05). CONCLUSIONS: The results of this study demonstrate that ketamine is an effective drug for the treatment of paradoxical reaction following intravenous midazolam premedication. The exact mechanisms of these reactions and how it is aborted by ketamine are not clear.

Analgesics↗
PubMed2004

Effect of intravenous midazolam premedication on postoperative nausea and vomiting after cholecystectomy.

BACKGROUND: Several drugs and techniques have been used to reduce the incidence of postoperative nausea and vomiting (PONV). However PONV continues to be a common postoperative complication. Midazolam premedication in pediatric patients has been reported to reduce the incidence of PONV. In the present study the effect of intravenous midazolam premedication on the incidence and severity of PONV was investigated in a sample of adult patients undergoing anesthesia for cholecystectomy. METHODS: Eighty-two adult patients undergoing general anesthesia for cholecystectomy were randomly divided into two groups to receive either midazolam 75 microg/kg or a same volume of normal saline intravenously fifteen minutes prior to induction of anesthesia. Incidence and severity of PONV together with the total amount of administered metoclopramide during the first postoperative day were compared between two groups. RESULTS: Severity of nausea was significantly lightened in midazolam group during the first six hours after recovery period compared with placebo group (3.7 +/- 1.6 of a ten point visual analog scale vs. 4.9 +/- 2.2 in placebo group; P < 0.05). Mean number of vomiting episodes was significantly lower in midazolam group (0.4 +/- 0.7 vs. 1.1 +/- 1.4 in placebo group; P < 0.05). Midazolam group received a significantly less amount of metoclopramide during the first postoperative day (2.1 +/- 3.7 mg vs. 5.3 +/- 6.8 mg in placebo group; P < 0.05). CONCLUSIONS: The results of this study suggest the effectiveness of prophylactic intravenous midazolam premedication to reduce the incidence and severity of postoperative nausea and vomiting. Possible mechanisms for this effect of midazolam may be GABA receptor antagonism, inhibition of dopamine release, and anxiolytic effects.

Adult↗
PubMed2003

Effect of controlled hyperventilation on the pressor response to laryngoscopy and tracheal intubation.

Pressor response to laryngoscopy and tracheal intubation includes rises in blood pressure and heart rate. This response may be harmful in the presence of cerebral or myocardial diseases. Although different preventive measures have been developed the choice of the agent or method has not been defined clearly. Hypocapnia is commonly used in anesthesia practice for different indications. It depresses the cardiovascular system and lowers the cardiac output. This study investigated the effect of controlled hyperventilation on the pressor response to laryngoscopy and tracheal intubation in three groups of healthy adult patients with different levels of end tidal CO2. The blood pressure and heart rate were recorded during induction of general anesthesia before and after laryngoscopy and tracheal intubation. The pressor responses to laryngoscopy and tracheal intubation in hypocapnic and normocapnic groups were comparable. Moderate degrees of controlled hyperventilation caused relatively more fluctuation in blood pressure during induction of anesthesia. It can be concluded that controlled hyperventilation has no beneficial effect upon the pressor response to laryngoscopy and tracheal intubation.

Adult↗
PubMed2002

Evaluating the relationship between arterial blood pressure changes and indices of pulse oximetric plethysmography.

UNLABELLED: The finger plethysmographic waveform of pulse oximeters is a qualitative indicator of fingertip perfusion. This waveform has been used to assess the depth of anesthesia. Its cyclical changes associated with mechanical ventilation have also been used to detect changes in blood volume under normotensive conditions and has revealed that minimal normotensive hypovolemia can cause a significant increase in the delta-down component of this waveform. Hypovolemia may be associated with hypotension; the latter may be due to causes other than hypovolemia. Because the effects of the hypotension on plethysmographic waveform have not been evaluated, it may be difficult to detect hypovolemia in these conditions by inspecting a plethysmogram. Therefore, we performed this study to evaluate the effect of normovolemic hypotension on characteristics of plethysmographic waveform in 33 adult patients undergoing general anesthesia with controlled hypotension. The delta-down and ventilatory systolic variation components were increased significantly with decreases in systolic blood pressure. The result of this study shows that the effect of pharmacologic hypotension on the plethysmographic waveform of pulse oximeter is similar to that of minimal hypovolemia. Therefore, blood volume may be inaccurately assessed by the inspection of ventilatory-induced cyclical changes of pulse oximetric waveform in the presence of hypotension. IMPLICATIONS: The cyclical respiratory-induced changes in the amplitude of the pulse oximeter waveform can be used to detect normotensive hypovolemia. This study shows that hypotension produces the same effect. Therefore, in hypotensive conditions, we cannot determine the presence of hypovolemia.

Adult↗
PubMed2002

Blood pressure measurement by pulse oxymetric method and comparison with conventional technique.

BACKGROUND: Measurement of systolic arterial blood pressure using a pulse oxymeter involves the evaluation of plethysmographic waveform during inflation and/or deflation of a blood pressure cuff. The purpose of this study was to determine that during slow inflation and deflation of cuff, which one of the pulse oxymetry-based readings of blood pressure is in best agreement with the value obtained by conventional method. METHODS: Blood pressure was measured in a sample of 50 healthy adult volunteers with conventional and pulse oxymetric methods. The degree of agreement between two methods was calculated. RESULTS: The mean difference between systolic blood pressure and pulse oximetric blood pressure during inflation of the cuff was 0.06 +/- 1.75 mmHg which was not different from zero. The highest correlation was also between these two pressures (0.988). CONCLUSIONS: This study shows that the best agreement is between systolic blood pressure and pulse oxymetric blood pressure during inflation. We conclude that for accurate measurement of blood pressure by pulse oxymetric method it is necessary to inflate the blood pressure cuff at a slow speed for the pulse oxymeter to have enough time to reach equilibrium state.

Adult↗
PubMed2002

The effect of acupuncture on the acute withdrawal symptoms from rapid opiate detoxification.

BACKGROUND: Rapid Opiate Detoxification (ROD) is among the best treatments for substance abuse. Unfortunately this method is associated with severe withdrawal reaction. The effect of body acupuncture has not been clearly identified during ROD. This study was designed to evaluate the effect of acupuncture on the severity of withdrawal reaction during ROD. METHODS: Forty adult male subjects addicted to opioids and scheduled for ROD by naloxone were randomly divided into acupuncture and control groups. In the acupuncture group during three consecutive days immediately before induction of ROD, body acupuncture was performed while in the control group it was exempted. Severity of withdrawal reaction was assessed having recourse to Clinical Institute Narcotic Assessment (CINA) Score and compared between two groups. RESULTS: After induction of ROD, CINA score raised significantly during the consecutive days in both groups compared with baseline values but the rise was significantly lower in acupuncture group. CONCLUSIONS: The result of this study shows that body acupuncture reduces the severity of withdrawal symptoms associated with rapid opiate detoxification and it is recommended that this nonpharmacologic method of treatment should be included in ROD program.

Acupuncture↗