Evaluation of the possibility of performing painful stimulations before endotracheal intubation based on insufflation Hemodynamic changes and monitoring of anesthesia depth in patients under general anesthesia

Determination of the possibility of painful movement before tracheal intubation

A clinical trial with a control group, with parallel groups, double-blind, randomized, phase 2 on the examined patients, and the RAND function of Excel software was used for randomization.

Patients in operation rom in Emam khomeni after the injection of fentanyl (2 mcg per kilogram of body weight) and midazolam (0.03 mg per kilogram of body weight) and sodium thiopental induction drug (at the rate of 5 mg per kilogram of body weight and Etracurium half milligram) grams per kilogram of body weight) blood pressure and heart rate were again measured and the depth of anesthesia was monitored. If the depth of anesthesia is between 40 and 60, the patient underwent Foley catheterization and after that all parameters were measured and recorded again, and then after 3 minutes tracheal intubation was performed and again blood pressure including systolic blood pressure and Diastole and mean arterial pressure were measured by monitoring the depth of anesthesia.

Inclusion criteria : 1. Laparotomy candidate patients 2. Completing and signing the informed consent form Exclusion criteria: 1. Concurrent participation in other studies 2. Dissatisfaction with the study 3. Patients with a history of heart disease, high blood pressure, diabetes and other systemic diseases 4. Patients who had previous problems with intubation.

Intervention (after monitoring and drug injection, they first underwent urethral catheterization and then tracheal intubation) Controls (they underwent tracheal intubation)

Systolic pressure, Diastole, mean arterial pressure, Heart rate and depth of anesthesia

Random allocation is done based on the block of four numbers prepared by Excel software. In this method, the numbers are divided into groups of four and then one number is randomly selected from each group. This method ensures that each group of numbers is randomly selected and ensures random assignment in the study.

Double-scored blinding in this study is as follows: The professor who guides the study knows how to perform the probing process (painful stimulation) and identifies the patients who have been probed. He is also responsible for investigating hemodynamic changes and monitoring the depth of anesthesia in patients under general anesthesia. The visiting nurse who is responsible for performing sounding in patients, acts completely unaware of the research and the main purpose of the study. He is only acting according to the therapist's orders and treatment plan, and is not aware that this action was taken to investigate the effect of painful stimuli before tracheal intubation. The patients who have been probed are also unaware of the probe and the main purpose of the study. They are treated only as patients under general anesthesia and do not know whether painful stimulation was performed before tracheal intubation. Only the supervisor (scientific consultant) who participates in the research is aware of the probing and the patients who have been subjected to these painful stimulations. He is responsible for supervising the correct implementation of the research and provides technical and scientific guidance. In this way, in this double-blind method, the main researcher, the patients, and the attending nurse act separately without knowing the details of the survey and research, and only the supervisor has complete information. This method is used in order to maintain blinding and the scientific validity of the study results.

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