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Background and Objective: Hemodynamic alteration and hypotension due to spinal anesthesia can reduce tissue perfusion and increase ischemic risk, myocardial infraction, renal failures spinal damages and even deep veins thrombosis. This study was designed to compare pharmaceutical effects of ephedrine, atropine and mucosal phenilephrin on hemodynamic alteration of women during spinal anesthesia in cesarean section. Materials and Methods: This randomized clinical and double blind study was done on 90 singleton pregnant women with ASA I and II class .the subjects gone elective cesarean section and allocated into three groups. subjects were received 500 ml ringer lactate before spinal anesthesia. Subjects in group I, II and III first received 0.1 mg/kg atropine (IV) 0.01mg/kg ephedrine and 100µgr phenilephrin (mucosal) prior spinal anesthesia, respectively. Hemodaynamic indexes including blood pressure, heart Rate, oxygen saturation and drug side effects were determined every 5 minutes interval through the surgery. Data was analyzed by using SPSS-11.5, Chi-Square and ANOVA tests. Results: Hemodaynamic indexes were changed during study, but three medicine showed similar effect on heart Rate, blood pressure and changes of oxygen saturation (P<0.05). There was a significant differences among three groups for dosage of extra ephedrine to control of blood pressure (P<0.05). This increase dosage of extra ephedrine was 56.7%,20% and in ephedrine, phenilephrin and atropine groups,respectively. Nosia rate was 6.7%, 50% and 46.7% in phenilephrin, atropine and ephedrine groups, respectively (P<0.05). Conclusion: This study showed that to prevent of blood pressure drop following spinal anestasia atropine, phenilephrin and ephedrine can be prescribed, but ephedrine is recommended for lowering the rate of nosia.

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Background and Objective: Electroconvulsive therapy (ECT) is one of the most common methods in treatment of different types of psychological disorder. The effectiveness of this therapy has a direct relation with the duration of convulsion. This study was conducted to assess the effect of lidocaine on duration of seizure and hemodynamic alterations in electroconvulsive therapy. Materials and Methods: This clinical trial study was conducted on 72 ASA-I, II patients with psychotic disorders in Hajar Medical Center in Shahrekord, Iran during 2010. The patients randomly divided into intervention and control group. The interventional group was received 1.5 mg/kg lidocaine and controls were received normal saline. For induction of anesthesia, all patients were received Sodium Thiopental (2mg/kg), Succinylcholine (1mg/kg) and Atropine (0.5mg) Propofol and Succinylcholine during 72 sessions of ECT. Duration of objective convulsion and hemodynamic alterations including blood pressure and heart rate were recorded (before, immediately and 3, 5 minutes after ECT). Data were analyzed using SPSS-11.5 and t-test. Results: Systolic and diastolic blood pressures and heart rate in 3rd minutes in interventional group following electroconvulsive therapy were 143.38±16 mmHg, 79.86±6.7 mmHg, 91.9±9.9 mmHg, respectively and in controls were 128.88±13.04 mmHg, 87.63±5.79 mmHg and 102.86±13 mmHg, respectively. These difference were significant (P<0.05). The above-mentioned indices for 5th minutes in intervention and controls were as follow: systolic (113.47±9.97 mmHg, 122.36±13 mmHg), diastolic (73.47±4.27 mmHg, 77.63±6.26 mmHg) heart rate (84.41±4.6 in minute, 93.19±12.53 in minute). These differences in above indices were significant (P<0.05). Conclusion: This study showed that lidocaine administration during electroconvulsive therapy increase the duration of convulsion and reduces heart rate and blood pressure.