Journal of Anesthesiology and Pain
Year:2016 | Volume:6 | Issue:4|Papers Count:9

causes physiological effects on body systems. The aim of this study was to compare the effect of Apotel-Morphine and ketorolac for post-operative pain reduction with Patient Controlled Analgesia (PCA) method.Methods and Materials: This double-blind clinical trial was carried out on 110 Patients, aged 18 to 50 and with lower extremity fracture, who were candidate for plating surgery. Patients were randomized to Morphine-Apotel or Ketorolac Group. Intravenous PCA was administered for patients 15 minutes after entry in the recovery. A Questionnaire containing demographic information, drug groups and degree of pain measured with “Visual Analogue Scale” at 0, 6 and 12 hours after surgery, was recorded for all patients.Findings: According to our findings mean levels of pain significantly decreased from the first hour to 12 hours after surgery, in both groups (P<0.05). The mean levels of pain in Morphine-Apotel and Ketorolac groups at 0, 6, and 12 hours after surgery showed no significant difference in comparison either.Conclusions: Our findings revealed that administration of non-opioid drugs has no advantage compared to opioids in controlling post-operative pain.

Aim and Background: Low Back Pain (LBP) is one of the most common and main musculoskeletal pain syndromes. Previous studies have reported different movement patterns in low back patients. This is may be due to the inclusion of subjects with widely varying movement patterns in a single LBP group. Nowadays, several studies have proposed that there are subgroups of people with LBP. So the aim of this study was to compare the range of motion and patterns of lumbar and hip movement between LBP patient (active extension pattern) and people with no history of LBP.Methods and Materials: Two angles (Lumbar and Hip) and also lumbar to hip ratio were measured during forward bending test in 9 non-specific LBP patients and 10 asymptomatic subjects using a motion analysis system.Findings: The mean range of motion in forward bending test was more in the LBP group than asymptomatic subjects. There were no group differences for lumbar to hip ratio for each 25 percent of movements.Conclusions: Results of this study showed that people with LBP (active extension pattern) display different patterns of posture and movement.

Aim and Background: The correct management of delivery and anesthesia is important for maternal and fetal health outcome during cesarean section. The aim of this study was to compare the effect of spinal anesthesia with plain bupivacaine, bupivacaine+25 mg fentanyl and bupivacaine+12.5 mg fentanyl on the newborn Apgar score during elective cesarean section.Methods and Materials: This study was a randomized double blinded clinical trial on 120 women aged 20-40 years, ASA 1& 2 who were admitted for elective cesarean section. Patients were allocated into three equal groups (n=40). Spinal anesthesia was applied by plain bupivacaine (group 1), bupivacaine+12.5 mg fentanyl (group 2), bupivacaine+25 mg fentanyl (group 3). The 1stand 5thminute Apgar scores, demographic variables and other variables were recorded during the operation. The statistical analysis was applied by ANOVA using SPSS 16.00 software.Findings: The three groups were similar regarding age, weight and height. Apgar scores at 1 and 5 minutes were not significantly different between the three groups. The incidences of side effects were not significantly different among the three groups.Conclusions: Adding doses of 12.5 and 25 microgram fentanyl to intrathecal bupivacaine did not have any significant effect on the neonates’ Apgar scores. Additionally it did not significantly increase spinal anesthesia side effects in the parturient.

Aim and Background: This study aimed at investigating the effectiveness of dialectical behavior therapy techniques in reducing catastrophizing, fear of movement, pain disability, and pain intensity in musculoskeletal chronic pain sufferers.Methods and Materials: This study is a single subject investigation based on multiple baseline design which is one of quasi-experimental research methods. The participants were two women suffering chronic back pain who were selected through purposive non-random sampling method among clients of Pain Clinic of Tabriz, based on pain specialist diagnosis, clinical interview and screening tools. The protocol was conducted in 12 and 60-minute sessions. Also two baseline sessions and one month follow up session were added. Catastrophizing, fear of movement, pain disability and pain intensity questionnaires were filled by subjects in 5th, 7th, 9th, 11th, 14th baseline sessions and the follow up session. Treatment results were investigated through visual inspection method.Findings: According to our results, Dialectical Behavior Therapy was effective in reducing catastrophizing, fear of movement, pain disability and pain intensity. Also these effects were maintained in patients to a large extent in the follow up session.Conclusions: Psychological as well as medical treatment can be helpful in patients with chronic musculoskeletal pain.

Aim and Background: The majorities of neonates admitted to intensive care units are preterm and undergo painful procedures including blood draw and phlebotomy. Ignoring the pain of these procedures can cause changes in respiratory rate, heart rate, blood pressure and oxygen saturation. So using non-pharmacological pain management methods like nonnutritive sucking can impede transferring the pain impulse to the brain based on gate control theory. The purpose of this study was to determine the effect of combined use of nonnutritive sucking and sucrose on cardio-respiratory indices and pain behaviors during blood drawing-phlebotomy in preterm infants in Neonatal Intensive Care Unit (NICU).Methods and Materials: This study was performed in a quasi-experimental method with two groups of nonnutritive sucking plus sucrose 24% and control in three stages. The study included 52 preterm infants (26 per group) who were randomly divided into two groups. The neonatal specific pain assessment tool and intensive care monitor system were used to determine the aforementioned indices.Findings: The mean pain scores were the same in two groups within 5minutes before intervention (p>0.05).However, pain scores showed a significant difference during and 5minutes after blood drawing-phlebotomy procedures among two groups (p<0.05), but the mean cardio-respiratory indices didn’t show any significant difference in 5minutes before, during and 5minutes after procedure between two groups (p>0.05) by using the independent t-test.Conclusions: The results of this study indicate that combination of nonnutritive sucking with sucrose result in pain relief in preterm infants during and after blood drawing-phlebotomy procedures.

Aim and Background: Several studies have shown that operating room and anesthesia nurses should have adequate knowledge in the field of cardiopulmonary resuscitation (CPR). The purpose of this study was to evaluate the knowledge of operating room and anesthesia students regarding accurate performance of CPR.Methods and Materials: This research was a cross sectional study including all 97 senior students of the operating room and anesthesia care in their second semester in Yazd University of Medical Sciences during 2012 – 2013. A two-part questionnaire was used to measure the knowledge of students. The first section included questions about age, gender and field and the second part was about correctly performing the cardiopulmonary resuscitation. The data analysis was done by descriptive (frequency table, the percentage index of mean, median and standard deviation) and Mann–Whitney test using SPSS-19 software.Findings: The students’ knowledge when confronting a patient with cardiopulmonary arrest and about basic life support was well enough, while it was intermediate regarding advanced CPR and post-CPR management.Conclusions: Generally speaking, the knowledge of the participants about CPR was intermediate and diverse necessary courses have been suggested.

Aims and background: Aging comes with muscle weakness and musculoskeletal-related pain. This study aimed to examine the effects of core stabilization exercise on ultrasonic changes of multifidus muscle and chronic low back pain of aged-women.Methods and Materials: Twenty-nine aged-women (69±3.4 years old) with chronic low back pain were allocated into core stabilization exercise (9 women) and control (20 women) groups according to needed calculation indices (statistic power test). Exercise training was performed for 10 weeks (3days/week) and consisted of eight core stabilization exercises. Ultrasonic characteristics of lumbar multifidus muscle (lumbar forth vertebrate) of both groups were measured before and after 10 weeks. Multifidus cross sectional area, anterio-posterior border, and Lateral border were also measured. Moreover, pain status was examined with visual analogue scale in three times (pre-, middle, and post-intervention).Findings: Ten weeks core stabilization exercise led to a significant increase in lumbar multifidus anterioposterior and lateral borders (p<0.05). It significantly increased multifidus cross sectional area as well (-1.98±1.31, confidence interval=-3.36 to -0.59). Also, pain significantly decreased in the two middle and post-intervention phases compared to pre-intervention in core stabilization exercise group (p<0.05).Conclusions: Core stabilization exercise not only increased cross sectional area of Multifidus, but also decreased chronic low back pain of aged women. Also, at least five weeks core stabilization exercise lead to low back pain reduction.

Aims and background: Nausea-vomiting after surgery takes place in 20-30% of patients and they together constitute the second most common complaint of patients after surgery. We performed this study hoping that use of proper intravascular fluids could have a role in decreasing nausea and vomiting after surgery.Methods and Materials: This clinical trial study was performed on 60 female patients aged between 20 to 60 years old and with ASA scores of 1 or 2, who underwent diagnostic laparoscopy under general anesthesia.Fluids were injected 15 minutes before general anesthesia in all patients. We used 10ml/kg of ringer lactate in crystalloid group, and 10ml/kg voluven in colloid group. The frequency of nausea and vomiting during recovery was recorded and collected in special forms.Findings: According to p-value=0.121 in Chi-square test, nausea variant was not significantly different among the two groups. The two study groups were assessed also regarding vomiting, which was not either statically significant according to p-value=0.136. Also there was no statistical difference between the groups regarding the mean arterial blood pressure and heart rate at the measured time intervals.Conclusion: In this study we used voluven to increase intravascular volume but it had no significant effect on prevalence of nausea, vomiting and hemodynamic variables, compared to the other group which received ringer lactate instead.

Aims and background: The most common causes of difficult intubation are anatomical disorders such as micrognathia, head and neck deformities, and cervical spine disorders. Most of post-anesthetic harmful complications are due to airway management problems and hypoxemia. Therefore one of the most important points in airway management is the appropriate selection of safe policy.Case report: In this study we introduce a 79 years old man, who is candidate for elective endoscopic dacryocystorhinostomy. He has congenital spastic torticollis. Therefore we perform a successful awake fiber optic-guided tracheal intubation with sedation.Conclusion: In neck deformities and torticollis in which airway anatomy is distorted, it seems reasonable to intubate trachea with sedation and preservation of spontaneous breathing by fiber optic bronchoscope.