Publications by authors named "Hossein A Khalili"

3 Publications

  • Page 1 of 1

Effect of high-dose intravenous dexamethasone on postlumbar discectomy pain.

Spine (Phila Pa 1976) 2006 Oct;31(21):2415-7

Department of Neurosurgery, Isfahan University of Medical Sciences, Isfahan, Iran.

Study Design: A prospective, randomized triple-blind clinical trial.

Objective: To evaluate the effect of 40 and 80 mg intravenous (IV) dexamethasone versus placebo to reduce postlumbar diskectomy pain.

Summary Of Background Data: Lumbar discectomy is a procedure to ablate radicular and low pack pain (LBP) in select patients. Unfortunately, some patients have radicular pain for several days after successful surgery, possibly caused by nerve root inflammation.

Methods: A total of 61 patients with single-level herniated lumbar disc at L4-L5 or L5-S1 were randomly assigned to 3 groups. After the skin incision, group 1 received 40 mg, group 2 received 80 mg IV dexamethasone, and group 3 received placebo. All patients also received 50 mg ranitidine IV at the same time. Preoperative and postoperative radicular and LBP were evaluated using the visual analog scale. Morphine was administered and recorded as a sole pain-killer during hospital admission if indicated. Collected data were analyzed using the 1-way analysis of variance test.

Results: A total of 61 consecutive patients entered the study. There were 19 patients who received 40 mg dexamethasone IV (group 1), 20 received 80 mg (group 2), and 22 received placebo (group 3). Preoperative data, including age, sex, level of disc herniation, and radicular and LBP, were statistically matched among groups. Postoperative LBP was decreased in all groups equally. Based on the visual analog scale, mean radicular pain was significantly decreased 4.26 points in group 1, 4.15 points in group 2 versus 2.73 points in group 3 (P = 0.006). Mean total morphine used was also significantly lower in group 1 versus group 3 (5.26 vs. 9 mg P = 0.012).

Conclusion: Intraoperative IV injection of 40 mg dexamethasone could effectively reduce postoperative radicular leg pain and narcotics usage in patients with single-level herniated lumbar disc.
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http://dx.doi.org/10.1097/01.brs.0000238668.49035.19DOI Listing
October 2006

Brown Séquard syndrome due to cervical pen assault.

J Clin Forensic Med 2006 Apr 13;13(3):144-5. Epub 2005 Dec 13.

Department of Neurosurgery, Isfahan University of Medical Sciences, Kashani Hospital, Kashani Street, Isfahan, Iran.

Brown Séquard syndrome is an uncommon incomplete spinal cord injury with ipsilateral motor and proprioception loss and contralateral pain and temperature loss. A 14-year-old student with classic Brown Séquard syndrome after pen assault injury by his classmate in posterior neck area presented here; with medical and supportive care, the patient was discharged with good outcome. Brown Séquard syndrome is mostly due to penetrating trauma. Several types of penetrating objects have been reported but this appears to be the first report of a pen or pencil injury.
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http://dx.doi.org/10.1016/j.jcfm.2005.10.003DOI Listing
April 2006

Effect of methylphenidate on ICU and hospital length of stay in patients with severe and moderate traumatic brain injury.

Clin Neurol Neurosurg 2006 Sep 13;108(6):539-42. Epub 2005 Oct 13.

Department of Neurosurgery, Isfahan University of Medical Sciences, Isfahan, Iran.

Objective: Traumatic brain injury is one of the major causes of death and disability among young people. Methylphenidate, a neural stimulant and protective drug, which has been mainly used for childhood attention deficit/hyperactivity disorder, has shown some benefits in late psychosocial problems in patients with traumatic brain injury. Its effect on arousal and consciousness has been also revealed in the sub-acute phase of traumatic brain injury. We studied its effect on the acute phase of moderate and severe traumatic brain injury (TBI) in relation to the length of ICU and hospital admission.

Patients And Methods: Severely and moderately TBI patients (according to inclusion and exclusion criteria) were randomized to treatment and control groups. The treatment group received methylphenidate 0.3mg/kg per dose PO BID by the second day of admission until the time of discharge, and the control group received a placebo. Admission information and daily Glasgow Coma Scale (GCS) were recorded. Medical, surgical, and discharge plans for patients were determined by the attending physician, blinded to the study.

Results: Forty patients with severe TBI (GCS = 5-8) and 40 moderately TBI patients (GCS = 9-12) were randomly divided into treatment and control groups on the day of admission. In the severely TBI patients, both hospital and ICU length of stay, on average, were shorter in the treatment group compared with the control group. In the moderately TBI patients while ICU stay was shorter in the treatment group, there was no significant reduction of the period of hospitalization.

Conclusion: There were no significant differences between the treatment and control groups in terms of age, sex, post resuscitation GCS, or brain CT scan findings, in either severely or moderately TBI patients. Methylphenidate was associated with reductions in ICU and hospital length of stay by 23% in severely TBI patients (P = 0.06 for ICU and P = 0.029 for hospital stay time). However, in the moderately TBI patients who received methylphenidate, there was 26% fall (P = 0.05) only in ICU length of stay.
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http://dx.doi.org/10.1016/j.clineuro.2005.09.003DOI Listing
September 2006