Background:The use of laparoscopic surgeries is escalating thanks to their advantages over the open surgeries. However, several complications can be observed following laparoscopy operation. Postoperative pain is a major concern in cholecystectomy surgeries. Pain can be both experienced in operated areas and radiated to the right shoulder. Acetazolamide is used for glaucoma, acute mountain sickness prophylaxis, and epilepsy in few patients with recurrent epilepsy. It seems that patients’ pain can be reduced by preventing carbonic acid production in abdomen after operation.Objectives:We aimed at evaluating if administration of acetazolamide preoperatively could affect early or late postoperative pain following laparoscopic surgery.Patients and Methods:In a randomized-controlled clinical trial study, 70 subjects (30 - 60 years) scheduled for laparoscopic cholecystectomy were included after obtaining a written informed consent. Patients were divided into two groups randomly (intervention and control). The intervention group received 5 mg/kg oral acetazolamide one hour before the operation. The control group did not receive any further medication.Results:Administration of a single dose of acetazolamide did not have any statistically significant impact on sleep quality (P = 1.000). Moreover, there was no statistically significant difference between groups regarding nausea and vomiting on single dose administration of acetazolamide (P = 1.000). Single dose of acetazolamide was associated with statistically significant decrease in shoulder pain immediately after laparoscopy (P = 0.017). However, there was no statistically significant difference regarding shoulder pain between the studied groups 2, 4, 6, 8, 10, 12, and 24 hours after laparoscopy. Single dose of acetazolamide did not significantly affect analgesic administration in 2, 4, 6, 8, 10, 12, and 24 hours after laparoscopy.Conclusions:Single dose of acetazolamide was associated with statistically significant decrease in shoulder pain immediately after laparoscopy. However, this effect was limited to the first postoperative hours and it failed to reduce postoperative pain of right shoulder during 24 hours after the operation.

Background: APACHE Score is an important criterion for determining the patient prognosis, especially in critically ill patients. According to significantly changes in the serum levels of thyroidal hormones in patients, especially in critically ill patients, the aim of the present study was to evaluate the relationship between thyroid function and APACHE 4 score in the prognosis of the traumatic patients admitted in surgery ICU. Method & Material: In a descriptive-analytical study, 90 patients with multiple trauma were studied. Thyroid hormones and APACHE 4 Score were evaluated on 1st, 5th and10th days of admission for each patient. Their clinical features and duration of hospitalization, either in trauma unit or ICU, elation between thyroidal hormones and APACHE 4 Score, duration of hospitalization, and survival of patients were evaluated. Results: This study included 90 patients. A statistically significant relation was detected between thyroid hormones (TT3) and APACHE 4 Score and duration of hospitalization. Conclusion: TT3 might be utilized as a prognostic factor in the traumatic patients admitted to ICU.

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Background & Objectives: Post-operative shivering is a common problem following the increased oxygen consumption leading to some other problems such as intracranial and intraocular pressure, and post operation pain. The goal of this study was comparing the effect of Pethedine (Meperidine) and Dexamethasone on prevention of shivering during the simple urological surgeries. Material and Methods: This double blind clinical trial study-was performed on 120 patients who were candidates for simple urologic surgery. The patients were randomly divided into two different groups including those who were received Dexamethasone (D) and Pethedine (P). After pre medication using the Midazolam, Lidocaine, and Fentanyl, similar anesthetic induction was done by injection of Dexamethasone (8mg) and Pethedine (25mg) to the groups D and P, respectively. All the patients were controlled for visible shivering in recovery. Results: There were not any significant differences between two mentioned groups in the case of weight, age, and duration of surgery. Only nine cases (15%) in group D had post-operative shivering. Whereas, twenty six cases in group P (44.3%) had shivering and the difference between 2 groups was significant (P value =0.002). Conclusion: Pethedine and Dexamethasone are effective drugs for the prevention of post-operative shivering in simple urologic surgery. The effect of Dexamethasone in preventing the post-operative shivering was better than Pethidine.