Journal of Translational Medical Research

Background and Aim: Spinal anesthesia is the preferred method for cesarian section -because of minimal maternal and neonatal complications and low cost. Intrathecal sufentanil is used for augmentation of analgesic effect in spinal anesthesia. The aim of this study was to evaluate the effect of intrathecal sufentanil on hemodynamic measurements and other complications.
Materials and Methods: This randomized double-blinded clinical trial was done in Rasool-e-Akram hospital in Tehran and Niknafas maternity hospital in Rafsanjan on 100 full term pregnant women who were candidate for cesarean section. Lidocaine 5% was used for spinal anesthesia and participants were indicated to receive intrathecal administration of 5 mg sufentanil or placebo. For 50 patients, in addition to lidocaine, 5 micrograms (1 mL) intrathecal sufentanil was administered (case group). In the control group, instead of sufentanil, 1mL of normal saline was injected. The obtained data was analysed by SPSS using fisher exact tests, and independent t-tests at significant level P≤0.05.
Results: Decreased blood pressure of more than 10% in the case and control groups were observed in 32.6% (16 individuals) and 67.4% (31 cases), respectively. Decreased heart rate of lower than 10% were measured in 40.8% (20 cases) and 91.3% (42 cases) of the case and control groups, respectively. Both of the above complications were significantly lower in the case group compared with control group (P<0.0001). Regarding other complications such as nausea, vomiting, respiratory depression, and neonatal apgar, no significant differences were noted between the two groups. However, itching was observed in 11 patients (22%) of the case group but not in the controls.
Conclusion: Addition of 5 microgram sufentanil to lidocaine 5% for spinal anesthesia in cesarean section improved hemodynamic stability without causing important complication. The only noticeable side effect of sufentanil was mild pruritus.

Background and Aim: Hot flash is one of the most prevalent problems in postmenopausal period.Considering the controversies on hormonal replacement therapy, the aim of this study was to evaluate the effect of a nonhormonal drug ,i.e. flouxetine, on hot flash and to compare it with a placebo. Materials and Methods: In this randomized clinical trial, 80 Postmenopausal women were divided into two equal groups. One group (n=40) were treated with flouxetine (20mg per day) and the other with placebos for 8 weeks. Frequency and duration of baseline hot flashes were recorded one week before the start of the treatment and during the following eight weeks (2nd, 4th, and 8th week). The obtained data was statistically analyzed by means of SPSS, using 2, t-test and correlation analysis at the significant level P≤0.05. Results: The mean rate of frequency and duration of hot flash before treatment were matched in both groups. Positive clinical response was more in fluoxetine group (75%), but in the placebo group it was less (42.5%), (P=0.01). The incidence of side-effects was the same in both groups. Conclusion: Considering the effectiveness of flouxetine in the treatment of hot flash in postmenopausal period with few side-effects, inexpensiveness and availability, it can be used instead of hormonal replacement therapy.