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Background and Objective: From 1942 when Griffith & Johnson suggested that muscle relaxants are safe drugs for better laryngoscopy & intubation and good for skeletal muscle relaxation during surgery, many of muscle relaxants discovered with different effect, side effect and potency. Some of the muscle relaxants properties include rapid onset, short-acting, fast recovery, stability of hemodynamic, lock of histamine release and etc. Hemodynamic stability is one of the important properties of this drug. In this research we wanted to see effect of Rocuronium, which is an intermediate muscle relaxant on systolic, diastolic BP and HR of patients who is candidate for elective surgery. Patients and Methods: This research is an experimental study. We wanted to see the effects of Rocuronium that is an intermediate muscle relaxant on mean avierial pressure and heart rate of the patient who is coming to the hospital of Iran medical university hospitals for elective orthopedic surgery. The sample size calculated 30 patients. We choose our patients with simple randomized method. All of them were ASA1 and in the age of 20 to 50 years old. The patients didn’t receive any pre-medication until coming to operating room. In the OR they received 7 cc/kg ringer solution and then 70 µg/kg thalamonal was administered intravenously. 5 minute latter their BP and PR was checked, which considered baseline measurement. Induction of anesthesia was with Thiopental 5 mg/kg and Rocuronium 0.9 mg/kg. After 60 sec patients were intubated with direct laryngoscopy. The maintenance of anesthesia for first 10 minutes was with O2 50% and N2O 50% and for continue of anesthesia MR and Opioid depend on need. Results: We analyzed our data with paired to T-test and green house test. Systolic and diastolic blood pressure and heart rate changes was 5% lowest than baseline hemodynamic parameter. Conclusion: With attention to previous studies and observation of hemodynamic changes with muscle relaxants which uses in Iran, this drug (Rocuronium) have good effect on stability of hemodynamic parameters. Beside other properties of Rocuronium include: Rapid onset, lack of histamine release, intermediate acting and etc. We can said this drug is a good and safe muscle relaxant for use during anesthesia and surgery.

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Background and Objective: Control of postoperative pain is one of the most important stages in the recovery of patients after surgery. This study was done to compare the effectiveness of combined Ondansetron and Apotel on the post-operative pain after surgery of upper limb fractures.
Methods: This double blind clinical trial study was done on 50 individual (41 male and 9 female) with upper limb fractures referring to 5 Azar hospital in Gorgan northern Iran during 2017. Patients were assigned (block randomization) into control and intervention groups. After the end of operation in the recovery phase, both groups received pain PCA (Patient Controlled Analgesia). In control group, the pain pump consisted of 2 grams of Apotel and in the intervention group; the pain pump consisted of 2 grams Apotel and 8 mg of ondansetron. Visual Analogue Score (VAS) was evaluated in both groups after surgery for 24 hours. Pain score of patients compared in the 2 groups during the 3 time intervals after surgery.
Results: 4 hours after upper limb fracture surgery, the mean pain was significantly decreased in the intervention group (3.20±0.707) compared to control group (3.64±0.569) (P<0.05). 12 hours after upper limb fracture surgery The Mean pain, in the intervention group (1.88±0.927) was significantly reduced in compare to control group (2.64±1.186) (P<0.05). 24 hours after upper limb fracture surgery, The Mean pain was significantly reduced in the intervention group (1.40±0.645) in compare to control group (2.08±0.997) (P<0.05).
Conclusion: This study showed that administration of compination of Apotele and Ondansetron in post-operative pain of upper limb fractures is effective than apotele alone.