---

Introduction: Wolff–Parkinson–White syndrome (WPW) is an uncommon cardiac disorder which occurs due to presence of an aberrant pathway between atria and ventricles. Owing to its life threatening complications like paroxysmal supra ventricular tachycardia (PSVT) and atrial fibrillation (AF), this syndrome has been considered a challenge for anesthesiologists. Case Report: We report a known case of WPW syndrome that had been scheduled for elective caesarean section and managed successfully under general anesthesia. Management of the present case includes important points in the management of WPW syndrome. Keywords: General Anesthesia, Wolff–Parkinson–White syndrome, Cardiac disorders Received: Oct 6, 2014 Accepted: Jan 6, 2015

---

Background and Aim: job involvement and intention to leave job are important feedbacks of work. The purpose of this study was to investigate the relationship between job involvement and intention to leave job among anesthetist employed in Sanandaj hospitals in 2017.
Material and Methods: In this descriptive-analytical study, 90 anesthetist working in Sanandaj hospitals were enrolled in the study. Data were collected from the Kanongo Job Anxiety Questionnaire, Attwod and Hinshaw Vacancy Forecasting Questionnaire and demographic and occupational information questionnaire. Version 23 of SPSS software was used for data analysis. Data were analyzed using descriptive statistics, independent t-test and chi-square test.
Results: The mean and standard deviation of job involvement and intention to leave job were 2±0.056 and 2±0.063, respectively. Also, the results showed that there is a significant relationship between job involvement and intention to leave job with all demographic and occupational variables (p <0.05).
Conclusion: Considering the low level of job involvement and the high intention to leave job in anesthetist, rooting and planning is recommended by the authorities.

---

Background and Aim: Choosing an appropriate anesthetic agent for induction and maintenance of anesthesia is very important in hemodynamic stability and pain control. The aim of this study was to compare the effects of ketamine-remifentanil combination with ketamine-propofol combination on pain, agitation and hemodynamic changes during closed reduction of nasal fracture.
 Material and Methods: This single-blind clinical trial included 80 patients between 16 and 18 years of age with ASA1 physical status who had undergone closed reduction for nasal fracture. Patients in the group 1 received 0.75 mg/kg ketamine and 2µ/kg remifentanil and group 2 received 0.75 mg/kg ketamine and 1.5 mg/kg propofol to induce anesthesia. Hemodynamic changes (heart rate, systolic and diastolic blood pressure), pain intensity, agitation, as well as nausea and vomiting and changes in arterial hemoglobin oxygen saturation during surgery were evaluated immediately after induction of anesthesia and after surgery every 15 minutes for 2 hours.
Results: Based on the statistical analysis of the patients' data, the mean heart rate and pain intensity scores in the ketamine-remifentanil group were significantly lower than those in the ketamine-propofol group (P <0.05). Mean systolic and diastolic blood pressure and RASS scores in the two groups did not show any statistically significant differences (P> 0.05). The incidence of nausea was higher in the ketamine-remifentanil group and the decrease in oxygen saturation was higher in the ketamine-propofol group (P <0.05). There was no statistically significant difference between the two groups in regard to incidence of vomiting (P> 0.05).
Conclusion: Based on the results of this study, it seems that use of ketamine-remifentanil combination in comparison to ketamine-propofol in closed reduction of nasal fracture is associated with greater hemodynamic stability, higher analgesic effect and fewer complications.