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In a randomized study we compared postoperative pain and analgesic requirement in patients who underwent elective cesarean section under general anesthesia induced with Thiopental 4 mg/kg (N=25) or Ketamin 1 mg/kg (N=25). Anesthesia was maintained with N2O and Halothane. Postoperative pain was measured with OPS scale and analgesia was provided with Morphine. Median time to first need of analgesic was greater in Ketamine group compared with Thiopental group. Median Morphine consumption over 24 hour was less in Ketamine group compared with Thiopental group. No patient had recall of intraoperative events in Ketamine group however in Thiopental group 12% of patients had such recalls. Apgar score was similar between groups. Induction of anesthesia for cesarean section using Ketamine is associated with a lower postoperative analgesic requirement compared with Thiopental. Patients who had anesthesia for cesarean section induced with Ketamine required less analgesic drugs in the first 24 hours postoperative period compared with patients who received Thiopental. Ketamin unlike Thiopental has analgesic properties that may reduce sensitization of pain pathways and extend into post-operative period.

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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: 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: 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.