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Background: Due to high prevalence of vitrectomy surgery, and the importance of anesthetic technique in conducting an uncomplicated surgery, we decided to do this study.

Materials and Methods: This prospective randomized study was conducted on 80 patients 40-80 years old candidating deep vitrectomy sugery under general anesthesia that were categorized into II and III Class by American Society of Anesthesiologist (ASA). Patients were randomly allocated to two groups of 40 members. Anesthesia was induced in both groups in the same manner. For maintaining anesthesia, patients from I group receiVed 1.2% isofluran with 50% O2 in air at 4L/min and infusion of remifentanil (0.1 mg.kg-1.min-1). But in the P group, we used propofol up to 10mg/kg /hr with infusion of remifentanyl. Propofol and isoflurane in fusion was discontinued with the last surgical stitches, but remifentanil infusion continued in both groups until the eye was covered with shield. Hemodynamic variables were recorded just before the induction of anesthesia and in different time intervals till discharging of the patients from the recovery room.  Then, data were compared.

Results: Results showed that there is a significant changes in propofol group compared to isofluran in deep vitrectomy surgery operations.

Conclusion: Hemodynamic changes are more significant in maintaining propofol anesthesia when compared with isoflurane.

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Background: The aim of this study was to compare the efficacy of ondansetron, Midazolam and metoclopramide with placebo in preventing PONV following strabismus surgery.

Material and Methods: 160 patients were allocated with simple randomization in 4 groups of 40: group ON received Ondansetrone 0.05mg/kg, MT group received Metoclopramide 0.15mg/kg, MD group received Midazolam 0.03mg/kg intravenously and group CT received the solution of NaCl 0.9% as placebo infused with the same volume and the same manner 30 minutes before the end of surgery. The patients were evaluated for nausea, vomiting, need and  dosage of anti-emetic drugs, time of liquid and solid diet tolerance, drug complications and satisfaction score for the initial 24 hours after anesthesia.

Results:  The frequency of nausea (p-value = 0.001< 0.05) and vomiting (p-value=0.084>0.05) was lower in ON group and both of these complications were lower in MD group compared with MT and CT group. Use of rescue antiemetic was higher in MT and CT group (p-value = 0.001 < 0.05). Patient satisfaction was higher in ON group compared with other 3 groups (p-value=0.001<0.05).

Conclusion:   Prophylactic use of Ondansetron is more effective with fewer side effects than Metoclopramide and Midazolam in the prevention of PONV following strabismus surgery. Furthermore, metoclopramide was less effective and was associated with more adverse effects.

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Abstract

Background: The aim of this study is to evaluate the impact of preemptive adding topical Ketorolac to Tetracaine drop on pain intensity and hemodynamic parameters during and after cataract surgery.

Materials and Methods: Eighty patients scheduled for elective cataract surgery under sedation and topical anesthesia, were randomly allocated to two equal groups: group T received Tetracaine 0.5%, and group TK received Tetracaine with ketorolac eye drops. One drop of each ophthalmic drug was applied every 10 minutes from 30 minutes before surgery. Pain intensity and hemodynamic parameters were assessed just before starting the operation and 5, 10, 15and 20 minutes during the operation, and then 0, 5, 10, 15 and 20 minutes after arrival of the patient to the recovery room.

Results: Mean pain intensity was significantly lower in TK group (1 ± 0.128) compared with T group (2 ± 1.54) during the surgery (p = 0.003), but there was no significant difference between the two groups in this regard during the recovery time (p =0.157). The number of patients requiring additional analgesic was not significantly different between the groups. There was no significant difference between the two groups regarding hemodynamic parameters except at 20th minutes and 15^th and 20^th minutes (heart rate and respiratory rate) after arrival to the recovery room.

Conclusion: Preemptive adding topical Ketorolac to Tetracaine drop is more effective than Tetracaine alone to reduce pain during cataract surgery.

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Background:
 
This study aimed to compare the effect of cold eye irrigation solution (BSS) and viscoelastic gel with their combination in room temperature on the dosage of sedative drugs which we use in Phacoemulsification cataract surgery.
 
Material and methods:
 
190 patients scheduled for cataract surgery under sedation were randomly divided into two equal groups. During surgery we used cold (4c) and warm (room temperature) BSS and viscoelastic gel in the first and second group respectively. For all patients we started sedation with Midazolam and Fentanyl and in case we needed additional drug we used Sodium Thiopental till we reached desired sedation level. Ramsay sedation scores (before, during and after surgery) and total sedative drug consumption   were evaluated   and compared between two groups and at the end of the surgery we checked the satisfaction score of patients and surgeon about the quality of sedation.
 
Results:
The average dosage of Midazolam wasn’t significantly different between the two groups, while the average dosage of Sodium Thiopental was significantly lower in Cold group. Also the average time of which we reached desired Ramsay sedation score and the level of Ramsay score were significantly different between the two groups.
 Conclusion:
Using cold BSS and viscoelastic gel in cataract surgery in comparison of their combination in room temperature will reduce the dosage of sedative drugs which we use during surgery and help us getting a more effective sedation and gaining both a satisfied patient and surgeon.
 

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