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In this study, we investigated the effect of local injection of ropivacaine and bupivacaine with magnesium sulfate on postoperative pain in vertebral laminectomy surgery. This randomized double-blind prospective study was conducted among 60 patients aged 18–65 years old with ASA class I and II. Group RM: (30 people) received 70 mg ropivacaine (14 ml) plus 1 ml magnesium sulfate (500 mg) volume up to 20 ml with normal saline. Group BM: (30 people) received 70 mg bupivacaine (14 ml) plus 1 ml magnesium sulfate (500 mg) volume up to 20 ml with normal saline. The results were analyzed by SPSS 23 software, and statistical analysis consisted of χ2 test and t-test, and a p value less than.05 was considered significant. Mean pain score based on VAS in 6 and 12 h after surgery in the RM group was lower in the BM group (p < 0.05). The analgesic request frequency in the RM group was lower than the BM group (p = 0.01). The mean morphine consumption in the RM group was 185 mg and in the BM group was 220 mg. According to the T-test, there was a significant difference between the two groups (p = 0.03). there was no significant difference between the mean arterial blood pressure and mean heart rate between the two groups at 6, 12, 24 and 24 h after surgery (p > 0.05). This study showed that wound infiltration with ropivacaine and magnesium sulfate compared to bupivacaine and magnesium sulfate provided better postoperative analgesia and significantly reduced postoperative opioid consumption in patients undergoing lumbar laminectomy. [ABSTRACT FROM AUTHOR]

Introduction: Emergence agitation (EA) is one of the common problems during recovery from general anesthesia, especially in children. In this study, we investigated the effect of dexmedetomidine on the control of agitation after anesthesia with sevoflurane in children., Method: This randomized control-placebo, double-blind prospective clinical trial was conducted on seventy-six children between 2 and 7 years with ASA (American Society of Anesthesiologists) class I who were candidates for elective adenoidectomy surgery and tonsillectomy. Participants were selected by an available sampling method. Patients were randomly placed in one of the two groups D (dexmedetomidine 0.5  μ g/kg infusion within ten minutes) or P (placebo: normal saline infusion within ten minutes). A four-point scale evaluated agitation. Pain evaluation was done by FLACC (faces, legs, activity, cry, and consolability). The statistical software was SPSS version 23. P < 0.05 was considered statistically significant., Results: The level of agitation was significantly lower in the intervention group ( P < 0.05), except after 40 minutes in the PACU (Post Anesthesia Care Unit) ( P =1.00). Patients in the control group experienced high pain scores when admitted at PACU, 10, 20, and 30 minutes after admission at PACU ( P < 0.05). Pethidine and metoclopramide prescriptions in the intervention group were lower than in the control group ( P < 0.05). Shivering occurred in five patients in the intervention group and nine in the control groups ( P =0.032). Hypotension that required intervention occurred in 3 patients in the intervention group and one in the control group ( P =0.024)., Conclusion: Our trial demonstrated that the prescription of 0.5  μ g/kg of dexmedetomidine within ten minutes after intubation significantly reduced the EA frequency, pain severity, analgesic consumption, and PONV (postoperative nausea and vomiting). However, it caused delays in the emergence from anesthesia. This trial is registered with IRCT20160430027677N14., Competing Interests: The authors declare that there are no conflicts of interest., (Copyright © 2024 Mitra Golmohammadi et al.)

Purpose: The use of perineural dexamethasone as an adjuvant drug to peripheral nerve block for postoperative pain is controversial. This systematic review aimed to determine the effectiveness of adding dexamethasone to lidocaine in upper limb nerve blocks., Design: Systematic review., Methods: This review used a comprehensive search strategy to retrieve relevant published randomized trial articles that fulfilled the inclusion and exclusion criteria, without time limits, (until December 2023) that assessed the effects of a combination of dexamethasone to lidocaine in upper limb nerve blocks. The databases used for the electronic literature search included PubMed, Embase, and Clinical Trials.gov, dbGaP, Cochrane library, and Google Scholar. There was no language, gender, or age limitation. This systematic review is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement., Findings: Of 3,926 articles identified by the initial search, 8 studies that met our inclusion criteria. All articles were original research studies. All eight articles were clinical trials. The sample size in the selected studies ranged from 30 to 90 people. Studies demonstrated that combining dexamethasone with lidocaine significantly improved the quality of peripheral nerve blocks, increased the analgesia period, and decreased analgesic consumption., Conclusions: This review supported that the combination of dexamethasone (dose of 4 to 10 mg) and lidocaine (concentration of 1.5% to 2%) for upper limb block was more effective and beneficial without any side effects. However, further clinical trials in this regard with more data, various regions, and larger sample sizes to support our hypothesis are recommended., Competing Interests: Declaration of Competing Interest None to report., (Copyright © 2024. Published by Elsevier Inc.)

Nowadays in the world, tuberculosis is the second largest killer of adults after HIV. Due to the location of presidios that is mostly located in hazardous zones soldiers and army personnel are considered high risk, therefore we decided to determine the prevalence of tuberculosis status in this group of people. This was a cross-sectional descriptive research that studied the prevalence of pulmonary tuberculosis in soldiers and military personnel in the last 15 years in tuberculosis and lung disease research center at Tabriz University of Medical Sciences. The statistical population consisted of all the soldiers and military personnel. The detection method in this study was based on microscopic examination following Ziehl-Neelsen Stain and in Leuven Stein Johnson culturing. Descriptive statistics was used for statistical analysis and statistical values less than 0.05 were considered significant. By review information in this center since the 1988-2013 with 72 military personnel suffering from tuberculosis, it was revealed that among them 30 women, 42 men, 14 soldiers, 29 family members, and 29 military personnel are pointed. A significant correlation was found between TB rates among military personnel and their families. Although in recent years, the national statistics indicate a decline of tuberculosis, but the results of our study showed that TB is still a serious disease that must comply with the first symptoms of tuberculosis in military personnel and their families that should be diagnosed as soon as possible.

Laryngeal mask is a supraglothic instrument for ventilation of patients who are under anesthesia. Insertion of laryngeal mask requires maintaining sufficient depth of anesthesia to avoid airway reflex (gagging, coughing and spasms). The present study investigated two techniques of anesthesia with propofol-atracurium and thiopental-atracurium to facilitate insertion of the laryngeal mask, term of recovery and postoperative nausea and vomiting. In this prospective, randomized and double-blinded clinical trial, 224 patients undergoing elective laparoscopic class ASA one and two were studied.  Patients were divided into two groups of 112 patients - one group with propofol anesthetic and thiopental-atracurium. Then after the induction of anesthesia neuromuscular hemodynamic changes, airway reflex (gagging, coughing and spasms), the ease of insertion of laryngeal mask and the frequency of patient movements' were recorded. The data were analyzed by SPSS V.18. Results indicated that anesthetic technique with propofol-atracurium provides better and more comfortable condition for insertion of laryngeal mask significantly (P<0.05). Hemodynamic changes during induction of anesthesia and five minutes after insertion of the laryngeal mask in first group was more than second one (P<0.05),  and nausea and vomiting during recovery in propofol group was significantly lower than  thiopental group (P<0.05). Using techniques of anesthesia with propofol - atracurium in inserting laryngeal mask airway in patients who have an indication for the use of this technique is better than anesthesia with thiopental -atracurium.