Journal of Anesthesiology and Pain
Year:2022 | Volume:12 | Issue:4|Papers Count:9

Aims and background: This study aimed to evaluate the effects of scapular-focused treatment with (SFTF) and without (SFT) feedback on pain, function, and scapular kinematics in patients with Shoulder Impingement Syndrome (SIS). Materials and Methods: 36 males and females with SIS (age of 37 ±,6. 3 years) were randomly assigned into SFTF (n=12), SFT (n=12) and control (n=12) groups. The primary outcome was pain, assessed by Visual Analog Scale (VAS). The secondary outcomes were function and scapular kinematics, assessed by DASH Questionnaire and a 3-D motion capture, respectively. All outcomes were measured at the baseline and after the 8-week interventions. results: A post-hoc analysis performed to show significant differences between groups after the 8-week interventions. For pain, there were significant differences between SFTF vs. SFT (ES (95%CI) =-0. 3(-0. 4 to-0. 1),P= 0. 04), SFTF vs. control (ES (95%CI) = 1. 3(0. 7 to 1. 9),P= 0. 01). For DASH, also, there were significant differences between SFTF vs. SFT (ES (95%CI) = 1. 8(1. 1 to 2. 4),P= 0. 03), SFTF vs. control (ES (95%CI) = 4. 4(3. 3 to 5. 4),P= 0. 01), and SFT vs. control (ES (95%CI) = 2. 6(1. 8 to 3. 4),P= 0. 01). For scapular internal rotation (the sagittal or scapular planes), scapular upward rotation, and the scapular tilt, however, there weren’, t differences between SFTF vs. SFT. Conclusions: Based on the study results, rehabilitation program integrated with verbal feedbacks is effective to relieve pain, and improve function and scapular kinematics in patients with SIS. Adding feedback to an exercise therapy could clinically enhance outcomes in patients with SIS.

Aims and background: Knee osteoarthritis (OA) is a serious health issue and economic burden worldwide. Several treatment modalities have been proposed, each with its own limitations. Systematic reviews advocate the use of acupuncture for knee OA. Regarding the anti-inflammatory effects of gold, it was assumed that acupuncture with gold needles may have added value compared with the conventional stainless steel needles. Material and Methods: In a randomized controlled trial, 45 patients with knee OA grade two or three according to the Kellgren Lawrence criteria were enrolled. Pain severity score was evaluated at baseline. Patients were randomly allocated into three groups of acupuncture with gold, steel, or placebo needles for ten sessions over a period of 4 weeks. Participants were followed for 12 weeks after the end of treatment sessions. results: The pain score was lower in the acupuncture groups than in the placebo group, but the difference between gold and steel acupuncture groups was not statistically significant. Conclusions: Acupuncture with conventional needling is an effective and well-tolerated method for the management of knee OA.

Aims and background: Anterior knee pain is pain that occurs in the front and center of the knee and has a high prevalence, which is necessary to study the therapeutic effect of different methods on the pain of this disease. the aim of this study was to investigate the effect of treadmill use on pain in patients with anterior knee pain syndrome. Material and Methods: This study was performed on 136 patients with anterior knee pain syndrome (68 patients in the treadmill group and 68 patients in the control group). After recording demographic information and clinical notes, patients were randomly assigned to two groups and pain was recorded after intervention in both groups. The statistical test of Kai Square, Mann-Whitney and independent t was used to compare the data. results: The results of our study showed that the difference between mean pain score before the intervention and in the first week was not statistically significant among patients with patellofemoral pain syndrome in both treadmill and control groups, but in the fourth and eighth week in patients with treadmill group it was less significance than the control group, and this difference remained significant in people under the age of 25 with a BMI greater than 25. Conclusion: Due to the prevalence of patellofemoral pain syndrome, especially in young people, additional treadmill treatment should be done along with standard treatment for patients to improve the patients’,pain in short term and increase the quality of life of them.

Aims and background: Distress tolerance is an important psychological phenomenon which affects self-regulation processes including cognitive appraisal of emotional or physical states. Given that individuals with tension-type headaches are most likely to have low levels of distress tolerance, the evaluation of this variable is, therefore, very essential as the initial step of treatment in this population. The present research aimed at evaluating the psychometric properties of the Persian version of Distress Tolerance Scale (DTS) in women suffering from tension-type headaches in Isfahan. Material & Methods: The research method was a cross-sectional validation study of 110 women with tension-type headaches in Isfahan in 2019. The research population was selected through purposful sampling method. In order to analyze the psychometric properties of DTS, Cronbach’, s alpha, composite reliability, convergent validity, and confirmatory factor analysis were used. Findings: The results showed that the overall Cronbach’, s alpha and composite reliability values for DTS were 0. 96 and 090, respectively. The convergent validity was obtained as 0. 590, suggesting a reasonably good convergent validity for DTS. Furthermore, the one-factor structure of DTS was supported by confirmatory factor analysis. Conclusions: The findings revealed acceptable validity and reliability of DTS. Thus, DTS can be used as a research and clinical tool among women with tension-type headaches.

Aims and background: The coronavirus 2019 pandemic has caused psychological disorders in many people around the world, especially in vulnerable groups such as people with chronic diseases. In this regard, the present review study was conducted to investigate the anxiety, depression and stress of patients with rheumatoid arthritis and migraine during the COVID-19 pandemic. Materials and methods: In this study, a systematic review of the keywords COVID-19, Arthritis, Migraine Depression, Stress, Anxiety, Mental Health, Pandemic in the titles and abstracts of articles published in Google Scholar, PubMed, Scopus and Science Direct databases in the period 2020 (From February) to 2021 (until July) searched. 408 English articles were retrieved in the electronic search. The abstracts of the published articles were reviewed and, in several stages, duplicate and unrelated items were removed from the study, and finally 22 final articles were selected for comprehensive review and data extraction. The PRISMA checklist was used to review and control the quality of articles. Findings: Studies have shown a high prevalence of depression, anxiety, stress, poor sleep quality, recurrence and fear in people with rheumatoid arthritis and migraine during the COVID-19 epidemic. Factors such as female gender, age, rumination, marital status, income, education and disease severity were significantly associated with patients’,psychological health. The results of the studies showed that receiving social support, having physical activity, job and proper lifestyle led to improve the quality of life and mental health of patients with rheumatoid arthritis and migraine during the COVID-19 pandemic. Conclusion: Given that Coronavirus 2019 is still mutating and the psychosocial health of patients has been severely damaged. It is necessary to take measures such as tele-mental health to improve the mental health of patients in order to prevent recurrence of the disease and progressive problems.

Aims and background: The correct management of delivery and anesthesia hs important for maternal and fetal health outcome during cesarean section. The aim of this study was to compare the effect of spinal anesthesia with bupivacaine and ropivacaine on the hemodynamic parameters of pregnant women during cesarean section. Material and Methods: This study was a randomized double blinded clinical trial on 76 women aged 18-40 years, ASA 1&2 were admitted for elective cesarean section. Patients allocated into two equal groups (n=38). Spinal anesthesia was applied by 12. 5 mg bupivacaine (group R) & 17. 5 mg ropivacaine (group B). The hemodynamic parameters, demographic variables and other variables were recorded during the operation. The statistical analysis was applied by ANOVA using SPSS 16. 00 software. Results: Two groups were similar regarding Age, ASA and cause of cesarean section. Mean of systolic blood pressure and Time of reach to adequate anesthesia (T4 level) in Bupivacaine group and Time of decrease of anesthesia level (T10), Rate of nausea&vomiting, Rate of hypotention and Use of ephedrine in Ropivacaine group were lower significantly (Pvalue<0. 05). The rate of surgeon’, s satisfaction was better in Bupivacaine group. Heart rate, MAP, Rate of bradycardia and Chilling were not significantly different among two groups. Conclusion: Intrathecal Ropivacaine provides stable blood pressure in Women undergoing cesarean section and Recovery time is shorter than Intrathecal Bupivacaine.

Aims and background: With respect to the rising trend of chronic pain and demand for paying attention to the psychological dimensions of chronic pain, identifying practical strategies for psychological empowerment in chronic pain management process is high importance. So, the current study aimed to explore the psychological empowerment strategies in chronic pain management among health care providers and patients’, point of view. Materials and Methods: The grounded theory approach was applied in this qualitative study. Semi-structured interviews and observation of participants as the main methods for data collection was used. 15 members of the health care providers had a greater relationship with the psychotic dimensions of chronic pain management and 6 patients with chronic pain participated with purposive and theoretical sampling methods. Sampling was continued until data saturation and data analysis was performed concurrently with data gathering based on Corbin and Strauss’, s proposed method. Data validity was confirmed via Lincoln and Gubba’, s approach. results: The theme of “, facing pain”,was identified as the main approach in psychological empowerment, which consisted of two subthemes of pain experience and resilience. In this regard, the subthemes of pain experience were obtained from the subcategories of coping strategies and openness to pain. The two subcategories of ambiguity tolerance and self-efficacy also created the resilience sub theme. Interactions between experiencing pain and resilience could lead to facing pain. Conclusion: Identyfieng and using of applicable and appropriate strategies such as facing pain for psychological empowerment could improve chronic pain management and also reduce the challenges of health care providers, client and family in chronic pain management.

Aims and background: Migraine as one of the most common types of headaches with high prevalence has significant impact on the lives of patients. The current study aimed to compare the anxiety sensitivity, alexithymia and sleep quality in patients with migraine headache and normal people. Material and Method: The current study is casual-comparative research. The statistical population of this study was all patients with migraine headache, who were referred to the neurology clinic of Ardabil in 2020. 65 patients with migraine, who were referred to the neurology clinic of Ardabil and 65 people from normal people were selected by convenience sampling method. Data were collected by anxiety sensitivity inventory-revised, Toronto alexithymia scale-20 and Pittsburgh sleep quality index and were analyzed via multivariate analysis of variance analysis. results: Findings indicated that there is significant difference between the anxiety sensitivity, alexithymia and sleep quality in patients with migraine and normal people (P< 0/05). Conclusions: Based on the results of this study, it can be said that patients with migraine had more anxiety sensitivity and alexithymia and low sleep quality than normal ones. These findings indicate that physicians and psychotherapist should pay essential attention to the special psychological attributes of patients with migraine headache at the time of prevention and treatment.

Aims and background: Aim and Background: Continuous epidural analgesia (CEA) is the most common local anesthesia technique used to control pain after Total knee arthroplasty (TKA). CEA has many side effects. Continuous paravertebral block is an effective method with fewer side effects in controlling TKA pain. The aim of this study was to compare the effect of this two methods on post-TKA pain. Material and Method: TKA patients were randomly divided into two groups (N = 22): A) CEA: Bupivacaine 0. 25% was injected epiduraly by pump at 4 ml / hr during 24 hours after surgery. B) Continuous Lumbar Paravertebral Block (CLPB): all interventions were similar to group A, but by paravertebral catheter. Basic Mobility Scale (BMS) and the pain check. Visual Analogue Scale (VAS) ( static and dynamic) four times (4, 8, 16 and 24 hours after surgery) were measured and recorded. Use of opioids and their complications were measured and analyzed by SPSS 22th edition Results: Patients in the CLPB group experienced significantly less dynamic and static pain 4 and 8 hours after TKA than patients in the CEA group (p< 0. 05). There was no side effects in patients in the CLPB group to CEA group(Nausea and Vomiting in CEA group)No significant difference was observed for BMS and Muscular Strength in any of the follow-up stages between the two groups (P> 0. 05). Conclusion: Continuous paravertebral block has equal efficacy in controlling pain in patients undergoing TKA surgery compared to continuous epidural block. Due to, lack of complications it can be considered as a suitable alternative in TKA patients.