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Stress responses have been excited by the painful stimuli, after induction of anesthesia and during the operation. In order to reduce these responses, it will be useful to select the type of anesthesia. Based on this fact, two groups of patients (Every group had 50 patients) were selected randomly. All patients are older than 18 years old and were chosen according to America Society of Anesthesiologist, class I, II, and were candidated for cataract surgery. Propofol were used for induction and maintenance of anesthesia In group 1 (TIVA group). In group 2 (Balance anesthesia), Sodium Thiopental induced anesthesia and the combination of N2O and Halothane were used for maintenance of anesthesia, respectively. Blood Glucose in two groups was measured before induction of anesthesia that all were in normal range (80-120 mg/d). Then after induction, incision and 30 minutes after start of surgery, blood Glucose was measured again and deviation from basal level were classified in three categories as: <10%, 10-20%, >20%. The results demonstrated meaningful difference between two groups, statistically (Chi-square, P<0.001). Increasing the blood Glucose in group 2, in three stages, was more than group 1. Blood Glucose level was increased about 20% from its basal level, in the majority of group 2 (32% after induction, 64% after incision, 62% 30 minutes after start of surgery). But, this amount of increasing in group 1 was detected as follow. 16% after induction, 16% after incision, 12% 30 minutes after start of surgery. It is possible that in TIVA group’s, control of blood Glucose and stress responses better than balance anesthesia group’s. The comparative measurements of catecholamine level in both groups would be the next investigations.

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One of the major determinative of the outcome of the ophthalmologic surgeries, is how efficiency the anesthesiologist can lower the intraocular pressure (IOP) and prevent it from rising in response to such maneuvers as laryngoscopy and tracheal intubation. In our study, we have chosen Midazolam and Propofol for comparing their effects on IOP during induction of anesthesia, laryngoscopy and tracheal intubation, with the purpose of identifying the drug which can more effectively decrease IOP and prevent it’s during laryngoscopy and tracheal intubation. 100 patients were selected randomly and received either Midazolam 0.2 mg/kg, Sufentanil 0.2 microgram/kg, Atracurium 0.5 mg/kg (Group 1) or Propofol 2.5 mg/kg, Sufentanil 0.2 microgram/kg, Atracurium 0.5 mg/kg (Group 2). The IOP was measured before and after induction and immediately after intubation. Both groups showed a meaningful decrease in IOP following induction of anesthesia (P?0.0001). Laryngoscopy and intubation, increased IOP in group 1, however not significantly and still lower than the base line IOP (P=0.09). Group 2 showed no such increase (P<0.0001). We concluded that Propofol in comparison to Midazolam is more effective in prevention of IOP rise in response to laryngoscopy and tracheal intubation.

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Background & Objective: Propofol is one of the latest anesthetic agent which has many advantages with few side effects in patients. One of the application problems of this drug is pain at the time of injection. Several methods are investigated to reduce the pain, and one of them is the application of Lidocaine together with Propofol.

Materials & Methods: This randomized clinical trial study was done in 5th Azar teaching during 2007. 272 patients were selected randomly between age of 15-55 years with ASA Class I,II who were the candidates of elective surgery. We injected  Fresenius %1 to the first group with 91 patients, Lipuro %1 to the second group with 90 patients and Propofol drug Lipuro %1 mixed with 20 mg Lidocaine (2 ml of Lidocaine %1) to the third group with 91 patients. Injections was carid out on the supenlial vein of dorsal hand. Patients were asked about the severity of pain at the time of injection, 5-10 seconds after %25 of anesthetic induction doze. Data analyzed with using SPSS software and Chi-Squre test.

Results: The rate (incidence) of pain (Score 1-3) has been 63.91 (%69.2) in the first group, 50.90 (%55.6), and 22.9 (24.2%) in the third group in which there is a significant difference (P<0.001). Moderate and sever intensity of pain (Score 2.3) was 42.91 (46%) For the first group, 18.90 (20%) for the second group and 2.91 (2.2%) for the third group (P<0.001).

Conclusion: On the basis of this study, it is recommended to use lidocaine, at the time of injection, to reduce pain.

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Background and Objective: In particular medical situation administration of muscle relaxants following intravenous anesthetics for tracheal intubation may be unnecessary or hazardous. The aim of this study was the comparison of larengoscopy and intubation conditions after induction of anesthesia with propofol or thiopental with remifentanil in the absence of muscle relaxants. Materials and Methods: In a randomized, and double – blind clinical trails, 42 ASA class 1 and 2 patients assigned randomly to propofol 2mg/kg group or thiopental 5mg/kg group. All patients received lidocaine 1.5mg/kg and remifentanil 2.5 µg/kg 30 second before anesthetics administration. Ninety second after administration of the hypnotic agent's, larengoscopy and intubation were attempted. Intubating conditions were assessed as excellent, good, suitable or poor on the basis of mask ventilation, jaw relaxation, vocal cords position and patient's response to intubations and indotracheal tube cuff inflation. The mean arterial pressure and heart rate were measured before and after anesthetic administration, and immidately, 2 and 5 minutes after intubations. Results: 40% of patients in thiopental group and 80% of patients in propofol group showed either excellent or good conditions for larengoscopy and tracheal intubation (P<0.05). Mean arterial pressure and heart rate were decreased more significantly in propofol group in respect to thiopental group (P<0.05). Conclusion: This investigation showed that propofol in combination with remifentanil is better than thiopental for tracheal intubation without muscle relaxants. However, it induces more homodynamic changes.

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Background and Objective: A common complication after general anesthesia is nausea and vomiting followed by different problems such as spasm, hypoxia and pulmonary aspiration. This complication is more common in patients with full stomach, Eye injury, head trauma, cesarean and laparoscopy. Propofol and metoclopramide are two common drugs to prevent nausea and vomiting after operation. On the other hand adding dexamethasone to the above drug, has an important effect on decreasing nausea and vomiting. In this study, the effect propofol and metoclopramide associated with dexamethasone on nausea and vomiting after operation was investigated.

Materials and Methods: In this clinical trial study, 100 patients with ASA I, II classes, aged 16-60 years with selective orthopedic surgery randomly have divided into two groups. In group one, 48 patients received metoclopramide (10mg) with dexamethasone (8mg) and in group two, 52 patients received propofol (20mg) with dexamethasone (8mg), five minutes before the end of operation. Prevalence of nausea and vomiting in both groups was considered after 4 hours and results were analyzed by Chi-Square, t-student and Fisher exact tests.

Results: The rate of nausea in group 1 and 2 was 35.4% and 11.5% respectivly (P<0.05). The rate of vomiting was 27.7% and 7.7% in group 1 and 2 respectivly (P<0.05).

Conclusion: This study showed that the antiemetic effect of propofol with dexamethasone is more effective to prevent nausea and vomiting than metoclopromide with dexamethasone.

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Background and Objective: Electro convulsion therapy (ECT) is one of the most common ways for treatment of psychiatric disorders. The aim of this study was to compare the effect of Propofol, Etomidate, and Thiopental on seizure and recovery duration following ECT.
Methods: In this clinical trial study, 90 patients diagnosed with a psychiatric disorder by a psychiatrist, who need to be treated by ECT in 5 Azar hospital, Gorgan, north Iran. The patients were randomly divided into the three groups by simple random allocation method. Interventions included standard monitoring and pre-oxygenation with 100% FiO2 for 3 minutes for all patients in three groups. Anesthesia of the patients in the first, second, and third group was done with Thiopental (1.5 mg/kg), Propofol (0.6 mg/kg), and Etomidate (0.1 mg/kg), respectively. Administration of Succinyl Colin (0.5 mg/kg) as muscle relaxant and Atropine for prevention of bradycardia was uesd in all patients. Duration of seizure and recovery; changes in hemodynamic status including heart rate (HR) and mean arterial pressure (MAP); and amount of charge for ECT were recorded for each subject.
Results: Mean of seizure duration in Thiopental, Propofol, and Etomidate groups were 43.72±11.81, 35.74±10.58 and 45.81±17.26 seconds, respectively (P<0.05). Amount of charge for ECT in 3 sessions of treatment and changes of HR were not different between the 3 groups. Changes of MAP in the Propofol group was significantly less than other two groups (P<0.05). Recovery time following ECT was the least in Etomidate group in comparison with Thiopental and Propofol (P<0.05).
Conclusion: Ethomidate and Thiopental had the same effect on increasing seizure duration. However, due to the significant reduction in recovery time compared with Thiopental, Ethomidate may be considered as the best choice.

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Background and Objective: Propofol is one of the most commonly used drugs in anesthesia with the pain during an injection is a side effect of this drug. This study was conducted to compare the effect of Lidocaine, Magnesium Sulfate, and Ketamine on reducing pain caused by intravenous injection of Propofol in patients Undergoing surgery.
Methods: In this double-blind randomized clinical trial study, 80 patients aged 18 to 65 years were randomly blocked and assigned into four groups including Lidocaine, Ketamine, Magnesium Sulfate and Normal Saline. The pain was measured with the Ambesh Score. Hemodynamic changes of patients were evaluated in 1, 3, and 5 minutes.
Results: The patients in Lidocaine, Ketamine, and Magnesium Sulfate groups with 75%, 70%, and 55%, respectively, did not feel pain after Propofol injection compared to Normal Saline group (25%) (P<0.05). The mean time trend of Systolic and diastolic blood pressure and mean arterial blood pressure between the studied groups were significant (P<0.05).
Conclusion: The use of Lidocaine or Ketamine during Propofol injection can be effective in reducing pain during injection in patients undergo surgery.