Background and Aim. Aparallel, randomized, double blinded, placebo-controlled trial study was designed to assess the efficacy of single low dose of intravenous magnesium sulfate on post-total abdominal hysterectomy (TAH) pain relief under balanced general anesthesia. Subject and Methods. Forty women undergoing TAH surgery were assigned to two magnesium sulfate (N = 20) and normal saline (N = 20) groups randomly. The magnesium group received magnesium sulfate 50 mg·kg−1 in 100 mL of normal saline solution i.v as single-dose, just 15 minutes before induction of anesthesia whereas patients in control group received 100 mL of 0.9% sodium chloride solution at the same time. The same balanced general anesthesia was induced for two groups. Pethidine consumption was recorded over 24 hours precisely as postoperative analgesic. Pain score was evaluated with Numeric Rating Scale (NRS) at 0, 6, 12, and 24 hours after the surgeries. Results. Postoperative pain score was lower in magnesium group at 6, 12, and 24 hours after the operations significantly (P < 0.05). Pethidine requirement was significantly lower in magnesium group throughout 24 hours after the surgeries (P = 0.0001). Conclusion. Single dose of magnesium sulfate during balanced general anesthesia could be considered as effective and safe method to reduce postoperative pain and opioid consumption after TAH.

Background: Nowadays, the new coronavirus (SARS-CoV-2) and its complications are one of the main concerns of the world. One of the most severe complications of COVID-19 is hypoxemia. Objectives: This study aimed to assess the importance of happy hypoxemia in COVID-19. Methods: We systematically searched web of science, PubMed, and Google scholar databases to find articles related to COVID-19 and happy hypoxemia. Results: COVID-19 causes a type of hypoxemia named silent (happy) hypoxemia, which has an atypical clinical presentation. This type of hypoxemia has not been noted before in viral pneumonia, and there is no specific treatment for this serious complication. Patients with silent hypoxemia may develop severe hypoxemia without dyspnea and with near-normal lung compliance. These patients are awake, calm, and responsive. Although their lungs are not oxygenated efficiently, they are alert and cooperative. Their condition may be deteriorated rapidly without warning and causes death. Conclusions: According to the findings, paying attention to happy hypoxemia is important for improving the health status of COVID-19 patients.

Objectives: Recent guidelines of the World Health Organization (WHO) indicated administering tranexamic acid (TXA) in order to treat postpartum hemorrhage (PPH). Therefore, finding low-cost and low-risk alternative methods to control obstetric hemorrhage is of great importance. The present study aimed to evaluate the prophylactic effect of TXA on hemorrhage during and after the cesarean section (CS). In addition, it was attempted to explore the impact of TXA as a safe and inexpensive method for decreasing bleeding during and after CS so that to decrease the hazard of blood transfusion or hysterectomy in these patients. Materials and Methods: This randomized double-blind control trial was performed on 60 women who underwent CS using spinal anesthesia. These women were randomly assigned to two groups. The experimental group received 1 g of TXA 15 minutes before the incision while the control group received dextrose 5% in water as a placebo. The amount of bleeding was measured during and after the surgery. Data were entered into SPSS software version 21 and reported by descriptive statistics and analyzed using chi-square, t test, Mann-Whitney U test, paired t test, and ANCOVA and Wilcoxon tests. Results: Based on the results, no significant difference was found between the groups regarding the mean age, mean gestational age, and the prothrombin time (PT) and partial thromboplastin time (PTT) (P > 0.05). The mean of the total bleeding volume was 551.8 and 713.1 mL for experimental and control groups, respectively which means that a significant difference was observed between both groups in this respect (P = 0.006). However, no significant difference was noted between the groups regarding changes in hemoglobin (Hb) concentration, systolic and diastolic blood pressure (BP), and heart rate. Conclusions: Generally, administering 1 mg of TXA in CS significantly reduced the volume of PPH. However, it did not cause significant changes in hemodynamic state or Hb level. Therefore, it can be recommended as an appropriate treatment for these patients.

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