Journal of Anesthesiology and Pain
Year:2017 | Volume:8 | Issue:1 |Papers Count:8

Aim and Background: This study was performed with the purpose to determine the role of alexithymia and emotion dysregulation in quality of life in patients with chronic pain.Materials and methods: This research is descriptive and correlational. The research sample consisted of 150 patients (90female and 60male) with chronic pain who referred to Gilan pain clinic in march-June 2017. They were selected by available sampling method. Toronto’s Alexithymia scale, Gratz and Roemer emotion dysregulation Scale and Quality of Life Scale were used for their evaluation. Data was analyzed by using Pearson correlation coefficient and stepwise regression.Findings: The results showed a negative significant relationship between Alexithymia and emotion dysregulation with quality of life (p<0.01), and the difficulty in identifying emotions and emotion dysregulation predict about 32% of the quality of life changes in patients with chronic pain (P<0.01).Conclusion: Alexithymia and emotion dysregulation are involved in the quality of life in chronic pain patients and the need to pay attention to emotional responses can improve the quality of life in patients.

Aims and background: Exercise-related transient abdominal pain (ETAP) or side stitch is a well known injury in many sport activities. The purpose of this study was to compare vertical displacement of the body and body angles during running in people with side stitch and healthy people.Materials and Methods: Twenty six subjects (male students) in Ferdowsi University of Mashhad were selected through non-probability inconvenient sampling and based on the pain during running, they were divided in to two groups; stitch group and control group (13 subjects with stitch and 13 healthy subjects). After the formation of the marker motion model, vertical displacement and angles of the neck, trunk, hip, knee and ankle in both groups were measured during treadmill running by using Motion Analysis system and theyvwere compared. To analyze the data, independent t-test was used.Findings: Significant differences in Neck angles (P=0.04), trunk (P=0.01) and hip (P=0.02) were observed between the two groups and these angles were significantly higher in control group than stitch group. But no difference between the two groups was observed at angles of knee and ankle (P>0.05). The results also have shown that vertical displacement in stitch group was significantly higher than control group (P=0.02).Conclusion: Increased vertical displacement of the body and reduced angle of the neck, trunk and hips may be factors affecting the incidence of stitch. Therefore, by modifying these factors in people with stitch, perhaps we can reduce their pain.

Aims and background: The aim of this study was to compare peak pressure and time to peak pressure during normal walking between females with idiopathic chronic low back pain (LBP) and healthy controls.Materials and Methods: 10 females with chronic LBP and 11 healthy female participated in this study. LBP was measured using Quebec questionnaire. Plantar pressure was measured using emed platform during barefoot walking. After dividing foot into 10 parts, peak pressures and time to peak pressures were calculated. Repeated measure and MANOVA were used for statistical analysis and significance level was set at 0.05.Findings: This study showed that peak pressure of LBP subjects were significantly greater than healthy subjects on right (p=0.001) and left (p=0.001) medial midfoot parts; and they were significantly smaller than healthy subjects on left lateral midfoot (p=0.03), right hallux (0.04) and left 3rd, 4th and 5th finger (p=0.003) parts. Also, LPB patients showed significantly increased time to peak pressure in the parts of medial (0=0.002) and lateral heel (p=0.003), medial (0=0.005) and lateral midfoot (0=0.01) in the right foot and in the meidal (0=0.002) and lateral heel (p=0.004), medial (0=0.002) and lateral midfoot (p=0.003), second metatarsal (0=0.002) and 3rd, 4th and 5th metatarsals (p=0.001) in the left foot.Conclusion: plantar pressure is affected by LBP; So the assessment of plantar pressure distribution and prescribing the appropriate insole should be considered in treatment planning and pain management of chronic LBP patients.

Aims and Background: Post operative pain is the most common problem after surgeries. In the meanwhile, post operative pain in children is very important because tolerance to pain in children is lower; also use of opioid in children is limited. As using acetaminophen is increasing for pain relief, this study aimed to compare the effect of Acetaminophen with Morphine in decreasing post opearative pain in children undergoing laparoscopic apandectomy.Materials and Methods: In a clinical trial 80 children, candidate for apandectomy, were selected and randomly divided into two groups. The first group recevied 15 mg/kg acetaminophen in 100 ml normal saline and the second group received 0.01 mg/kg morphine intravenously and post operative pain and other complications such as nausea and vomitting and hemodynamic parameters during surgery and recovery were compared between the two groups. Data were analyzed by SPSS soft ware.Findings: According to Cheopsis score the mean post operative pain in the enterance to recovery in acetaminophen and morphine groups were 10.4±0.9 and 8.93±2, respectively and the difference between the two groups was statisticallysignificant (P<0.001). After 15 minutes in recovery the pain intensity in the two groups were 10.58±1.06 and 8.1±1.72, respectively and the difference was statisticallysignificant (P<0.001). The mean post operative painat the time of exit from recovery in acetaminophen and morphine groups were 10.28±1.2 and 8.03±1.8, respectively and the difference was again statistically significant (P<0.001). According to repeated measures ANOVA the trend of pain in the recovery was different between the two groups (P<0.001).Conclusion: According to the results of the study, injection of acetaminophen before laparascopic apandectomy led to decreased post operative pain, decreased length of stay in recovery and decreased other post operative events such as nausea and vomitting. Therefore acetaminophen is a suitable replacement for control of post operative pain in children under laparoscopic apandectomy and this recommended except in the case of contraindication.

Aims and background: Pain is an unpleasant experience due to tissue damage. Postoperative pain control is one of the essential issues in postoperative care, and plays an important role in quick healing of general status of surgery patients. Appropriate control of the postoperative pain is particularly important in preventing tachycardia, hypertension, myocardial ischemia, decreased alveolar ventilation and poor wound healing. Therefore, in this study the efficacy and adverse effects of morphine and diclofenac suppositories are compared to injectable pethedine in controlling postoperative pain in appendectomy and inguinal hernia.Material and Methods: This study is a clinical trial. The patients were among the ones admitted to Doctor Fatemi Hospital of Ardabil city with appendicitis and inguinal hernia, aged between 18 to 70 years old during 1392.75 individuals, chosen in 3 groups of 25 patients by Systematic random allocation were chosen. The first group received 10 mg of morphine suppository after surgery, the second group received 100 mg of Diclofenac suppository after surgery, and in the third group 50 mg of intra muscular pethedine was used to control pain.Findings: The average scores of pain (VAS) in the Diclofenac receiving group at 2- 6-12- 24 hours after surgery were 4.56, 4.40, 3.68 and 3.36, respectively. The average scores in the morphine suppository group were 4.36, 3.84, 3.12, and 2.44, respectively; the scores were 6.52, 6.68, 6.28 and 5.84 in the control group (pethedine group). According to ANOVAS test, there was significant difference among patients’ pain relief in the three studied groups.Conclusion: Both morphine and diclofenac suppositories, cause significant pain relief in comparison to the group receiving IM pethedine to control pain after appendectomy and inguinal hernia surgery.

Aim and Background: Non-specific chronic low back pain is the most common type of chronic low back pain. Rehabilitation to achieve a more rapid improvement in patients with chronic low back pain has always been taken into account. The aim of this study was to evaluate the effect of 8 weeks core stabilization on pain control, Dynamic balance and proprioception of lumbo pelvic part in subjects with non-specific chronic low back pain.Materials and Methods: The present study was a quasi - experimental study with a pretest-posttest design and a control group. For this purpose, 30 male patients with non-specific chronic low back were selected by convenience sampling in 2 equal groups of 15. The experimental group performed core stability exercise for 8 weeks, every week in three sessions. In order to assess pain control, Dynamic balance and proprioception of subjects, Visual analog scale (VAS), Berg Balance Scale and manual goniometer were used. The data was analyzed using a paired t-test and independent t-test to determine the statistical significance (P£0.05).Findings: The research findings showed a significant improvement in pain control, Dynamic balance and proprioception of core stabilization group (P=0.001); whereas these changes were not significant in the control group.Conclusion: The results showed that the effect of eight week core stabilization on pain control, Dynamic balance and proprioception (lumbo pelvic) of subjects with non-specific chronic low back pain was significant. We recommend therapists to include Core stabilization in preparing their programs in order to enhance these variables.

Aims and background: This study develops a computational framework for the classification of different anesthesia states, including awake, moderate anesthesia, and general anesthesia, using electroencephalography (EEG) signals and peripheral parameters.Materials and Methods: The proposed method proposes data gathering; preprocessing; a new labeling process of EEG signal; appropriate selection of window length by genetic algorithm; feature extraction by Hjorth parameters, approximate entropy, Petrosian fractal dimension, Hurst exponent, largest Lyapunov exponent, Lempel-Ziv complexity, correlation dimension, and Daubechies wavelet coefficients; feature normalization; feature selection by non-negative sparse principal component analysis; and classification by radial basis function (RBF) neural network. Correct labeling process of EEG signals is performed by an expert opinion and also qualitative and quantitative analysis of the extracted parameters from peripheral nerve stimulator, pulse oximetry, blood pressure, and the time of drug injection.Findings: The results indicate that the proposed method would classify different anesthesia states including awake, moderate anesthesia, and general anesthesia, with the accuracy of 93.98%, 98.62, and 97.3, respectively. Therefore, the proposed method can classify different anesthesia states with the average accuracy of 97.3%.Conclusion: Finally, the proposed method provided a good representation of the brain behavior in different anesthesia states.

Aims and Background: Huntington’s chorea (HC) is a rare, autosomal, dominant hereditary disorder of the nervous system. This disease is characterized by progressive chorea movement, dementia and psychiatric disorders. In these patients, an abnormal response to many anesthetic drugs has been observed. The primary goal of general anesthesia in these patients is airway protection and a fast and safe recovery. In this study, a 30 year old male with huntington chorea undergoing elective cholecystectomy with general anesthesia is introduced.Case report: The patient was a 30 year old man, known case of Huntington’s chorea from 5 years ago with increased salivary secretions and advanced limb chorea movements underdrug treatment, candidate for elective cholecystectomy. After pre operative visit and necessary implementation, the patient underwent general anesthesia with endotracheal intubation and surgery was performed successfully without complications. After surgery the patient was transferred to recovery room with good general appearance and was discharged after three days.