Comparison of the effect of low-dose naloxone infusion on hemodynamic factors and surgical field bleeding in patients under general anesthesia with remifentanil and propofol infusion.

Comparison of the effect of low-dose naloxone infusion on hemodynamic factors and surgical field bleeding in patients under general anesthesia with remifentanil and propofol infusion.

This study is a controlled clinical trial with parallel, double-blind, randomized groups on 114 patients. Block randomization method is used for randomization.

This study is a randomized clinical trial and will be performed after the approval of the ethics committee of Tehran University of Medical Sciences. After prescribing premedication and standard monitoring, induction of anesthesia is performed. To maintain anesthesia, infusion of remifentanil (1 μg / kg / min) and propofol in a dose 150 μg / kg / min are used. In the intervention group, naloxone (0.25 g / kg / h) prepared in 10 ml of normal saline is infused during the operation using a syringe pump. In the control group, 10 ml of normal saline is infused using a syringe pump during the operation. Systolic and diastolic blood pressure, heart rate in the time before induction are recorded, then systolic and diastolic blood pressure, heart rate, cardiac output, stroke volume are recorded 15 minutes after induction and every 15 minutes until the end of the operation and in recovery. The surgeon's general satisfaction from the amount of bleeding during the operation at the surgical site is also evaluated and recorded.

Inclusion criteria: Patients undergoing head and neck surgery Exclusion criteria: Patients addicted to Narcotics, Patients with heart failure or advanced heart disease, Patients with asthma

Intervention group: Injection of low-dose naloxone infusion (0.25µg/kg/h) in 10 ml of normal saline Control group : injection of 10 ml normal saline infusion

Dose of narcotics.the surgeon's satisfaction with the surgical bleeding

In this study, we use the block randomization method so that after selecting patients according to the inclusion and exclusion criteria by selecting numbers from the table of random numbers and adapting to the blocks, patients are divided into study groups. To randomize the two treatment methods, we create 4 blocks in six different states, then select a number using the table of numbers, and determine the study groups by matching the numbers with the blocks. For example, if the first digit of our number is 1 to 6, select a block and the division is done, but if, for example, our number is 94071, the digit 9 is not valid and we select the next digit. Here, based on the block 4, we divide patients into groups. 1. TTCC 2. TCTC 3. TCCT 4. CCTT 5. CTCT 6. CTTC

In this study, people who are responsible for patient care and analysis of statistical data do not know about the treatment process and study groups, and information is provided to them in groups A and B