Journal of Anesthesiology and Pain
Year:2018 | Volume:8 | Issue:3 |Papers Count:8

Aim and Background: The effect of music on decreasing anxiety and pain has been shiwn indifferent studies, although the results have been controversial upto now. This study aimed to investigate the effect of music on anxiety and vital signs (systolic and diastolic blood pressure, heart rate and respiratory rate) in Iranian patients.Materials and methods: This study was a clinical trial, in which 70 patients were randomly assigned in a selected manner. They were divided into two groups. Instrumental music was played for 30 minutes for patients in experimental group and for the control group just routine care alone was done. Tools included demographic questionnaire, and an anxiety questionnaire (Czech Aspylbergru) that used vital signs data before and after the intervention. Data was analyzed using SPSS version 21, and p value was considered significant when less than 0.05.Findings: The two groups were the same in terms of demographic and clinical data. Anxiety score after the intervention in the intervention group significantly decreased (p<0.05). Average systolic blood pressure before and after the intervention showed no significant difference (p>0.05). Diastolic blood pressure before and after the intervention was not significantly different (p>0.05). Average heart rate before and after the intervention showed a significant difference (p<0.05). The average number of breathing before and after the intervention was not significantly different (p<0.05).conclusion: The results suggest that music therapy can be used to reduce anxiety and to normalize heart symptoms in patients undergoing transesophageal echocardiography.

Aims and background: Airway management is one of the key skills in managing and treating of critical patients. In hospital departments before reaching an anesthesiologist or experienced team, this task lies with the nurses who have not been trained enough in this field. This study was conducted to evaluate the ability of nurses before and after a manikin-based workshop for securing the airway with laryngeal mask insertion and tracheal intubation.Materials and Methods: In this semi-experimental study, 68 nurses working in a university hospital with record of service of 1 to 12 years were enrolled. First, nurses were evaluated in terms of familiarity with the correct method of oral airway insertion, mask ventilation, laryngeal mask insertion, and intubation with the tracheal tube, using an oral questionnaire. In the next step, their ability to perform the above items on the educational model was evaluated. After completing a total of 10 minutes of theoretical and practical training on a manikin for each nurse, the ability to perform the above tasks with a maximum of two attempts for each task was measured again.Findings: Most nurses said that they were familiar with airway insertion and mask ventilation, but only about 20% of them were able to correctly ventilate the manikin in the pre-test assessment. After a 10-minute training, more than 90% of the participants put the laryngeal mask successfully. The ability for endotracheal intubation was only 13%.Conclusion: Adding laryngeal mask to resuscitation trolley and periodic short-term training of nurses might be an effective way to secure the patients’ airway in emergency situations.

Aims and background: Postoperative nausea and vomiting is a distressing situation with a prevalence of 10 - 30%. As dexamethasone and metoclopramide are inexpensive drugs and cause little complications, and ondasetron in turn is a good and high quality drug for relieving patients ftom nausea and vomiting, we compared the effect of dexamethasone and metoclopramide versus dexamethasone and ondasetron on nausea - vomiting and shivering in patients undergoing laparoscopic cholecystectomy, in the study.Materials and methods: The present study is a randomized, double - blind clinical trial. After obtaining consent from pations, study was performed on 88 patients allocated with sampling and blocking method. The first group received the combination of dexamethasone and ondasetron, and the second group received the combination of dexamethasone and metoclopramide. The anesthetist injecting drugs, was unaware of the type of injectable medicine. The anesthetic method and the drugs used for anesthesia were the same in both groups. After the operation, the questionair asked questions about nausea - vomiting and shivering for up to 24 hours (at intervals of 1 - 6 -12 and 24 hours), and all the answers were recorded for each participant. Finally all findings were analyzed statistically using spss version 20.Findings: In this study 88 patients were divided into 2 groups. the first group received the combination of dexamethasone and ondasetron, and the second group received combination of dexamethasone and metoclopramide. the mean average age in the D+O group was 41.07 years and in the D+M group was 42.16 years. The result of this study showed that there was insignificant decrease in nausea and vomiting after laparoscopic cholecystectomy; also none of the patients in the study groups showed any shivering.Conclusion: The result of this study showed that the combination of ondasetron and dexamethasone could not significantly reduce the incidance of post operative nausea and vomiting compared to combination of dexamethasone and metoclopramide. No patients in the study groups had shivering.

Aims and Background: Pain is one of the important factors in the acceptance of surgery in patients and may be the most important factor in the fear of surgery. The gold standard for controlling postoperative pain is the use of narcotic drugs, but its use is limited due to side effects. The present study was designed and performed with a comparative study betwwn the effect of infusion of ketorolac and acetaminophen on pain reduction and opioid use after surgery in patients undergoing orthopedic surgery of lower extremities.Materials and Methods: This study is a randomized double blind clinical trial. In this study, 100 patients undergoing orthopedic surgeries in the lower limbs with general anesthesia were randomly assigned to two groups of 50. The first group received 1 gr of acetaminophen every 6 hours intravenously, and the second group received 90 mg of ketorolac in 1 liter of normal saline serum for 24 hours. VAS system was used at 0, 12 and 24 hours to evaluate pain after surgery. In case of pain in patients, Meperidine was injected, and the dose of Meperidine consumed was measured and recorded at the end. Finally, the data was analyzed.Findings: In this study, intravenous administration of acetaminophen was initially less effective than ketorolac infusion, but after 12 hours it was observed that the effect of acetaminophen on pain relief was greater than that of ketorolac. Also, the level of Meperidine was initially lower in the ketorolac group than in the acetaminophen group, but after 12 hours, Meperidine levels increased in the ketorolac group. It was also observed that the rate of nausea and vomiting in the ketorolac infusion group was significantly lower than that of the intravenous acetaminophen recipient group. However, the patient’s satisfaction with acetaminophen was more than that of the ketorolac infusion.Conclusion: The results of this study showed that the effect of acetaminophen and ketorolac is different at different times. The pain reduction in the first 12 hours in the ketorolac group and the second 12 hours in the acetaminophen group significantly changed.

Aims and background: Neck related dysfunction, especially chronic neck pain, has become considerably prevalent in society. Neck pain is the most prevalent pain in middle-aged women and is more common in women than men. The purpose of this study was to evaluate the effect of respiratory exercises on pain, disability, proprioception and forward head posture in female patients with chronic neck pain.Material and Methods: Thirty-six women with mean age of 35±3.4 years old with chronic neck pain were recruited. Pain, disability, proprioception and forward head posture angle were measured via visual analog scale, neck disability index, craniocervical joint repositioning (degree) test and craniovertebral angle, respectively before and after 8-weeks of respiratory exercise program.Findings: Significant changes were observed in pain (P=0.014), disability (P=0.009), proprioception (P=0.016) and forward head posture (P=0.026) in women with chronic neck pain after an 8-week respiratory exercise program.Conclusion: The results of this study showed that respiratory exercise is effective on pain and disability reduction and also on increasing proprioception accuracy and improvement of forward head posture in women with chronic neck pain. Therefore, as an exercise therapy supplement, using the respiratory exercises in order to help for treatment of signs and problems in patients with chronic neck pain is recommended.

Aim and Background: Differences in attachment styles have been linked to cognitive variables in patients with chronic pain, but mechanisms through which attachment styles might impact cognitive factors are unclear. The aim of the present study was to examine the effect of predicting attachment styles on pain self-efficacy and acceptance in patients with chronic pain.Materials and Methods: In a descriptive-correlational study, convenience sampling was used to select 120 chronic pain patients from pain clinic of Akhtar hospital in Tehran, Iran during three months. The participants completed a demographic questionnaire, Adult Attachment Inventory, Pain Self-Efficacy Questionnaire and Chronic Pain Acceptance Questionnaire. Data was analyzed using Pearson’s correlation and step by step regression models.Findings: The correlations between attachment styles & depending variables in this study were significant (P<0.01). Based on the results of regression analysis, secure and ambivalent attachment styles were able to predict pain self-efficacy and acceptance in patients with chronic pain.Conclusion: According to the results of the present study, it can be concluded that secure and ambivalent attachment styles can predict pain self-efficacy and acceptance. Considering these variables may be important in the processes of prevention, diagnosis and treatment reparation of attachment, as well as promoting mental health in patients with chronic pain.

Aims and background: Pain is one of the most important complications in postoperative Orthopedic Patients. Today, various non-pharmacological methods are used for pain relief after surgeries. The aim of this study was to compare the effects of Allah recitation and rhythmic breathing on postoperative pain in Orthopedic Patients.Materials and methods: This is a three-group randomized clinical trial in which 90 patients were selected by available sampling and then randomized into 3 groups of Allah’s recitation, rhythmic breathing and control. In the group of Allah’s recitation, honorable recitation of “In the Name of the Merciful God, There is no power but from God, O Allah send blessings on Muhammad and his family “ was repeated calmly for 100 times, . In rhythmic group, rhythmic breathing was performed after training by “Hey-Hu” method. Intervention in each group was performed for approximately 20 minutes. Pain intensity was measured by Numeric Rating Scale (NRS). Data analysis was performed by One-way repeated ANOVA tests and repeated measures with SPSS software version 20.Findings: 21 patients (70%) were males and 23 (76.6%) were married and they had the average age of 36.4±13.6 years. There eas a significant relationship between the average of pain intensity in stages of postoperative period (p<0.009), and patients in Allah’s recitation group and then in the group of rhythmic breathing experienced less pain.Conclusion: Allah’s recitation and rhythmic breathing are effective and can be used to reduce the pain after orthopedic surgery.

Epidural space is a favorite anatomic target for several pain and anesthesia interventions. There are several practical techniques to access and localize the epidural space in routine pain or anesthesia practice. However, high prevalence of false positive results in routine anesthesia techniques, and probability of catastrophic events, in the case of performing pain procedures in false anatomic location, mandates additional application of more sophisticated and accurate radiological approval techniques in epidural space pain interventions.