Background: Tizanidine is a clonidine derivative and 2-adrenoreceptor agonist that has the same effects (sedation, anxiolysis and analgesia) but lesser side effects (hypotension and bradycardia). In these study effects of oral tizanidine on post operative pain was evaluated.Materials and methods: In this clinical trial double blind study sixty patients (ASA I, II), aged 18-60yr, were randomly allocated into two groups. 90 minutes before induction of anesthesia both control and tizanidine group received placebo and 4mg oral tizanidine respectively. Pain severity and sedation score were assessed before and after receiving placebo or tizanidine and in the first 24hr post operative period, meperidine requirements were assessed.Results: Pain severity and meperidine requirements in the tizanidine group was significantly lower than that in the control group (p<0.001). Sedation score was significantly higher than that in the tizanidine group (p<0.001). Conclusion: It was possible to reduce the post operative pain by oral administration of 4 mg tizanidine as premedication. Therefore, we recommended premedication with tizanidine for patients undergoing surgery.

Background: Approximately 20% of patients undergoing laporotomy experience chronic post-prandial abdominal pain for months after operation. Most surgeons are wary of re-operation in this condition, and opt for conservative treatment with analgesics and sedatives. This study was performed to determine the cause of this chronic abdominal pain by means of laparoscopy.Methods: Elective laparoscopic surgery was performed on 76 patients suffering from chronic post-operative abdominal pain. They did not have any signs and/or symptoms of acute intestinal obstruction the most common complaints were: abdominal pain in 100%, nausea in 30%, vomiting in 10%. Diagnostic laparoscopy was performed and cases with positive findings were treated by laporoscopic surgery.Results: In 81% of patients the cause of pain was obvious intestinal adhesions, 10% had adhesions without any correlation to patient's symptoms and the remaining 9% did not have any positive finding on diagnostic laparoscopy. Adhesiolysis, (sharp release with scissors) is the treatment of choice.95% of those patients who underwent Adhesiolysis became pain free for a mean average of 11 months follow up (pre-operative average of pain episode was 4 time per week).Conclusion: Laparoscopic diagnosis and treatment of chronic post-laparotomy pain is the gold standard method, it is minimally invasive and has good results.

Introduction: Pain is the most common complaint of patients and therefore its treatment is the most ancient problem of human being. Since opioids have many side effects, morphine (MOR) are administrated limitedly. Recent studies have shown that cimetidine (CIM) induces analgesia in animals and humans. This study was designed to evaluate the effect of CIM in control of post operative pain.Materials and Methods: This study was a double-blind clinical trial. Following filling a consent form, one hundred and twenty patients (male & female) were randomly divided to four groups. The first three groups, as CIM groups, were received different doses of CIM (3mg/kg, 6mg/kg and 8mg/kg) and the last group given MOR (o.1 mg/kg). The drugs were injected (IV) in peak of pain during post operation period. Numeric rating pain scale (RPS) method was used for pain scaling. Pain was measured in 30 min, 60 min and 120 min after injection the drug and compared with pain score before injection of the drug.Results: Pain intensity was not significantly different prior to injection, 30 , 60 min and 120 min after drug injections in all four groups (MOR and CIM groups), but it was significantly lower when compared with pain score before injection of drug (P<0.05). In addition, there were no significant differences in duration of analgesia among four groups.Conclusions: The results of this study indicated that the analgesic effects (time and quality) of CIM (each three doses) are compatible with that those induced by MOR. Therefore, It seems that CIM is a safe drug in control of post operative pain.

Background: Considering the existence of pain in different levels in post anesthesia care unit (PACU), and incapability of other therapeutic methods, and with respect to the importance of music therapy in controlling the pain without any side effects, this study was conducted to evaluate the effect of music therapy in the pain level in PACU.Materials and methods: It was a single blind controlled clinical trial. Having completed an informed consent, 80 patients were assigned in 2 different groups of case and control randomly. Cases were received self preferred favorite music but controls did not. Pain level, blood pressure, pulse rate, existence of nausea and vomiting, and the time of being in P ACU was evaluated at the time of entrance to PACU and then 30, 60 and 90 minutes later.Results: Mean age of study population was 39.4±13.3 years, of those 47 (58.8%) were male. Pain level was similar in both groups at minute zero, however, at minute 30th it was decreased in 17.5% and increased in 15.4% of the control subjects (NS), meanwhile, it was decreased in 61 % and increased in 2.6% of the cases (p<0.001). At minute 60th, 5.1% of the controls and 30.8% of cases were pain-free (p<0.005). At the 90th minute, 20.5% of controls reported decreased and 15.4% reported increased level of pain (NS), however, these figures were 64.1 % and 2.6% among cases, respectively (p<0.001).Conclusion: Our results have revealed that music therapy during the PACU period reduce the pain level after surgery.

Background and purpose: Pain relief is a basic need and right of any patient as well as a priority in nursing. However, postoperative pain control have been inadequate for years with no significant progress. This research was intended to deter mine the effect of nurses' pain management or reducing patients' abdominal postoperative pain.Methods and Materials: In this quasi-experimental study, deta collection instruments were pain and demographic information questionnaire and a visual scale for pain control (0-10). Samples were surgery candidates at Sabzevar Emdad Hospital in Sabzevar, Iran, selected in a one-month period by poisson distribution and their specifications. Control group sampling was done with 65 patients and demographic data were gathered. Before intervention, the vital signs charts were corrected in patients' recordings by adding "pain" as fifth vital sign so that it is measured every time other vital signs are controlled; for each pain scale, appropriate interrentions were considered. Interventions included 3 sessions of 45-60 minutes training and orientation for nurses to perform pain management program. Designed care giving was conducted for 60 experimental patients for one month. Then their pain scores were measured. The obtained data were analyzed using chi-square.Results: The findings revealed that patients experienced less pain 72 hours after surgery in comparison with the first 24 hours; so that within 72 hours of hospitalzation after intervention, 38.6% of the patients scaled 3-5 degrees of pain and in the first 24 hours after interrention, 41.7% of the patients expressed very severe pain scores of 8-10.Conclusion: The study findings indicated that, nurses ' pain management can lead to appropriate and timely pain control in postoperative abdominal patients.

Introduction: Antiemetics currently in use are not totally effective. Serotonin Receptor Antagonists are a new class of antiemetics that have shown promise for the treatment of nausea and vomiting in many situations. This study aims at evaluating the efficacy of Serotonin Receptor Antagonist, Ondansetron, for the prevention of postoperative nausea and vomiting.materials and methods: This randomized, double-blind study compared the efficacy of an intravenous dose of Ondansetron 4 mg. with Metoclopramide 10 mg. for the prevention of postoperative nausea and vomiting (PONV) in patients undergoing general anesthesia for open abdominal surgery. A total of 126 patients (63 Ondansetron group, 63 Metoclopramide group), ASA status I–II, aged 18–65 years, were included and received the study medication after the induction of anaesthesia. A standardized anesthetic technique and intraoperative analgesia were used for all the patients. Within a period of 24 hours after the surgery, the following data were gathered and recorded: the proportion of the patients experiencing no emesis or no nausea as well as those who were provided with rescue antiemetic medication, the duration of nausea and the number of emetic episodes.results: During the overall observation period (i.e.0-24 hours), more patients who had received Ondansetron had significantly no emetic episodes (87.3%) than those who had received Metoclopramide (73%, P=0.044). A higher proportion of patients receiving Ondansetron (71.4%) did not experience nausea (Metoclopramide 63.5%, P=0.342). Fewer patients in the Ondansetron group required rescue medication (P<0.05).conclusion: Ondansetron was superior to Metoclopramide for the prevention of vomiting in the first 24 hours after surgery and the total number of emetic episodes was significantly reduced, as compared with Metoclopramide, but no significant differences were observed between Ondansetron and Metoclopramide for either the prevention of nausea or the treatment failure.

Aim: The purpose of this study was to examine the effect of patient education on postoperative pain perception in patient undergoing Coronary Artery Bypass Graft (CABG).Background: Pain is a common complication after CABG surgery. Non-pharmacological methods are more favorable than pharmacological agents.Method: In this quasi-experimental study, 72 patients who were scheduled for elective CABG surgery were randomized to experimental (n=36) and control group (n=36). Experimental group received educational intervention about pain control, one day before surgery (20-30 minutes duration), while control group received no intervention. Following transferring to the ICU and 2 hours after extubation, patients’ pain intensity wasmeasured by Johnson’s numerical scale. The measurements wererepeated twice withanintervalof threehours. The type and dosage of pain medication administered during ICU stay were recorded. To analyse the data, descriptive(mean and standard deviation, frequency distribution and percentage) and analytical statistics (Chi-square and Mann-Whitneytest) were used.Findings: There was no statistically significant difference between two groups in terms of demographic characteristics. Two hours after extubation, there were no statistically significant difference between experimental and control group in the intensity of pain (P=0.313). Pain intensity was significantly lower in experimental group than control group, 5 hours (P=0.015) and 8 hours (P=0.006) after surgery. The results also showedthat the amount ofanalgesics used to relieve post-operativepain was significantly lower in experimental group than control group (P=0.046).Conclusion: Patient education about pain control may have positive effects on postoperative pain in patients undergoing CABG surgery. This intervention could serve as an effective strategy for nurses to improve pain management among these patients.