Mehrnoush Toufan Tabrizi, Saeed Mohammadzadeh Gharebaghi, Leili Pourafkari, Afshin Habibzadeh, Parastoo Chaichi, Elham Delir Abdollahi,
Volume 17, Issue 12 (3-2015)
Abstract
Background: Heart failure with normal ejection fraction (HFNEF) is commonly seen in adults. It is possible that old patients with HFNEF have severe clinical status. The aim of current study is to evaluate clinical and echocardiographic findings in old patients compared to young patients with HFNEF.
Materials and Methods: In this cross-sectional analytical study, 126 patients with HFNEF were evaluated in two groups of patients &ge60 years old (n=52) and <60 years old (n=74) for demographic, clinical and echocardiographic findings.
Results: Patients &ge60 years old had significantly more hyperlipidemia, less hypertension and more FC II. Patients &ge60 years old also had significantly larger septal wall thickness, lower end diastolic and systolic volume, end systolic diameter, E/A ratio and septal E’, lower diastolic dysfunction grade, higher left ventricle ejection fraction, left atrial volume index, E/E’ ratio and deceleration time compared to patients <60 years old.
Conclusion: Old patients with HFNEF have different clinical and echocardiographic findings compared to younger patients which are indicative of the disease severity in some cases. So, exact evaluation of the patients could be helpful in early diagnosis of these patients and providing an adequate treatment.
Hesameddin Modir, Aidin Shakeri, Alireza Ghafouri, Gholamhassann Chaichi Nosrati, Shiva Alikhani, Ayda Khammari,
Volume 28, Issue 2 (4-2025)
Abstract
Background: Some intracranial surgeries must be performed while the patient is awake. Awake craniotomy is an intracranial surgical procedure in which the patient is kept in a state of relative consciousness while the surgery is performed. The aim of this study was to present a case of intracranial surgery to remove a tumor in the right frontal cortex by awake craniotomy.
Case: In this report, anesthesia in craniotomy surgery with full wakefulness was investigated in a 22-year-old man. This patient, who was the first to perform a craniotomy with the fully awake method (from the beginning to the end of the operation) at Arak University of Medical Sciences and Valiasr Hospital in Arak, after preparing the patient and interviewing before the operation, Cranial nerve blocks related to the skin and head muscles (scalp block) were performed in the desired locations, and after providing mild sedation, surgical excision was given. The lesion was examined while awake and the surgery was performed while fully awake from the beginning to the end, and the patient's brain tumor was removed safely. A combination of local and regional anesthesia and light intravenous anesthesia was used in the patient. Two types of local anesthetics, lidocaine 1.5% and bupivacaine 2.5%, were used for anesthesia, as well as intravenous sedatives and anesthetics such as propofol, remifentanil, and dexmedetomidine were used to relieve the patients. Throughout the operation, the patient was awake and breathing spontaneously, and the function of the brain nerves during the operation could be evaluated. Finally, the patient's surgery was performed without any complications and in completely favorable conditions, and the patient was transferred to the intensive care unit in a good general condition, awake and fully alert.
Conclusion: Although maintaining analgesia and hemodynamic and ventilation stability in fully awake craniotomy conditions is considered a challenge, but due to the necessity of performing this procedure due to the need to check the function of cranial nerves during the operation and to prevent any neurological and functional damage, using By carefully performing the desired nerve block in the scalp and prescribing a small amount of sedative medicine(propofol,remifentanil,dexmedetomidine), we were able to create a condition where the operation can be successfully performed while fully awake. In this method, the possible complications of surgery are prevented and a satisfactory analgesia is achieved for the patient. In this recent experience, both surgical complications are prevented and the patient and surgeon are satisfied during the operation. Performing this technique was satisfactory for our patient.
