Anesthesiology and Pain Medicine
Year:2013 | Volume:3 | Issue:1|Papers Count:6

It is an established fact that patients in the Intensive Care Unit (ICU) experience a plethora of events such as lack of sleep, anxiety, fear, disturbances caused by the continuous and menacing noises of the ventilators, machines, trolleys and above all, pain caused by innumerable reasons such as the underlying disease, suctioning of the endotracheal tube or invasive procedures including arterial punctures for blood gas analyses, cannulation of the central veins for fluid therapy, tracheostomies and insertion of chest tubes etcetra etcetra.

Background: Tonsillectomy with or without adenoidectomy is one of the most common surgical procedures performed worldwide, especially for children. Oral honey administration following tonsillectomy in pediatric cases may reduce the need for analgesics via relieving postoperative pain.Objectives: The aim of this study was to evaluate the effects of honey on the incidence and severity of postoperative pain in patients undergoing tonsillectomy.Patients and Methods: A randomized, double blind, placebo controlled study was performed. One hundred and four patients, who were older than eight, and were scheduled for tonsillectomy, were divided into two equal groups, honey and placebo. Standardized general anesthesia, and postoperative usual analgesic, and antibiotic regimen were administrated for all patients. Acetaminophen plus honey for the honey group, and acetaminophen plus placebo for the placebo group were given daily. They began to receive honey or placebo when the patients established oral intake.Results: The difference between acetaminophen and acetaminophen plus honey groups was statistically significant both for visual analogue scale (VAS), and number of painkillers taken within the first three postoperative days. The consumption of painkillers differed significantly in every five postoperative days. No significant difference was found between groups regarding the number of awaking at night.Conclusions: Postoperative honey administration reduces postoperative pain and analgesic requirements in patients after tonsillectomy. As the side effects of honey appear to be negligible, consideration of its routine usage seems to be beneficial along with routine analgesics.

Background: Colonoscopy is performed without preparing sedation in many countries. However, according to the current literature patients are more satisfied when appropriate sedation is prepared for them.Objectives: We hypothesize that propofol-ketamine may prepare more patient satisfaction compared to propofol-fentanyl combination.Patients and Methods: Sixty adult patients older than 18 with ASA physical status of I, II or III were enrolled in the present study after providing the informed consent. They were prospectively randomized into two equal groups: 1- Group PF: was scheduled to receive IV bolus dose of fentanyl 1mg/kg and propofol 0.5mg/kg. 2- Group PK: was scheduled to receive IV bolus dose of ketamine 0.5mg/ kg and propofol 0.5mg/kg. As a primary goal, patient’s satisfaction was assessed by the use a Likert five-item scoring system in the recovery. Comparisons of hemodynamic parameters (mean heart rate, mean systolic blood pressure, mean diastolic blood pressure), mean Spo2 values during the procedure and side effects such as nausea, vomiting, and psychological reactions during the recovery period were our secondary goals. Level of sedation during the colonoscopy was assessed with the Observer’s Assessment of Alertness/Sedation score (OAA/S).Results: Mean satisfaction scores in the group PK were significantly higher than the group PF (P= 0.005) while the level of sedation during the procedure was similar (P= 0.17). Hemodynamic parameters and SpO2 values were not significantly different (P>0.05). Incidence of nausea and vomiting was the same in both groups.Conclusions: IV bolus injection of propofol-ketamine can lead to more patients’ satisfaction than the other protocols during colonoscopy.

Background: Although opioids are the main choice for acute postoperative pain control, many side effects have been reported for them. NSAIDs and paracetamol have been used extensively as alternatives, and it seems that they are more effective for minor to moderate pain control postoperatively when have been used alone or in combination with opioids. As laparoscopic cholecystectomy poses moderate pain postoperatively, this study was planned to assess whether paracetamol is able to provide effective analgesia as a sole analgesic at least in the first few hours post operatively.Objectives: We evaluated the effect of intravenous Paracetamol on postoperative pain in patients undergoing laparoscopic cholecystectomy.Patients and Methods: This is a randomized double- blind clinical trial study. 30 patients ASA class I, aged 18 to 50 years, candidate for laparoscopic cholecystectomy were recruited, and randomly divided into two equal groups. Group A (paracetamol group) received 1 gr paracetamol and group B received placebo ten minutes after the induction of anesthesia. 0.1 mg/Kg Morphine was administered intravenously based on patients compliant and pain score>3. Pain score and the opioids consumption were recorded in the first six hours postoperative. Patient's pain was measured by the VAS (Visual Analog Scale).Results: The pain score was lower in group A (P= 0.01), but the morphine consumption showed no significant difference between the groups (P= 0.24) during the first 6 hours postoperatively.Conclusions: Although paracetamol (1gr) has caused a better pain relief quality but it is not a suitable analgesic for moderate pain control in acute phase after surgery alone.

It has been suggested that PRF might possibly have an effect on the immune cells. We considered using the intravenous route to apply PRF in conditions that are caused by an unresolved immune action or connected to allostatic load, implicating an abnormally reacting immune system to obtain a systemic effect that could possibly be an additional tool in treating some of these conditions. These manuscript reports four cases that illustrate the wide variety of conditions where this new technique might be helpful.

Dear Editor, Recognition as an author is an honor and credit for most researchers. In recent years, the number of authors has been increased along with the increase in the number of research articles (1). For instance, the mean number of authors per paper was 4.5 in 1980 and 6.9 in 2002 in biomedical journals (2).