Publications by authors named "Nasim Nikoubakht"

7 Publications

  • Page 1 of 1

Emergency Tracheostomy in Two Airway Trauma Patients Suspected of COVID-19: A Case Report.

Anesth Pain Med 2020 Aug 5;10(4):e104648. Epub 2020 Jul 5.

Pain Research Center, Iran University of Medical Sciences, Tehran, Iran.

Coronavirus disease 2019, known as COVID-19, was first identified in Wuhan, China, in December 2019 and became a pandemic on Mar 11, according to the World Health Organization report. In the epidemic of COVID-19, many patients admitted to hospitals for other reasons may be silent carriers of COVID-19 and have the risk of infecting medical personnel. Thus, meticulous personal protection measures should be considered in suspicious patients, especially when close contact with the patient's airway is anticipated. We introduce two airway trauma patients suspected of COVID-19 who required emergency tracheostomy. Patient one was a 29-year-old man who suffered facial trauma following a car accident. A chest CT scan showed peripheral ground-glass opacities suggestive for COVID-19. The second patient was a young elevator mechanic who experienced maxillofacial trauma after an elevator crash. The methods of anesthesia and airway protection and safety precautions are described.
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http://dx.doi.org/10.5812/aapm.104648DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7539045PMC
August 2020

Commentary: Remote electronic consultation for COVID-19 patients in teaching hospitals in Tehran, Iran.

Med J Islam Repub Iran 2020 8;34:31. Epub 2020 Apr 8.

Rasoul Akram Hospital Clinical Research Development Center (RCRDC), Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.

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http://dx.doi.org/10.34171/mjiri.34.31DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7320982PMC
April 2020

The Effect of Phenylephrine Infusion on Maternal Hemodynamic Changes During Spinal Anesthesia for Cesarean Delivery.

Anesth Pain Med 2020 Feb 12;10(1):e99094. Epub 2020 Feb 12.

Pain Research Center, Department of Anesthesiology, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.

Background: Spinal anesthesia is used as a common anesthetic technique in many routine and outpatient surgeries.

Objectives: The aim of this study was to determine the effect of phenylephrine on maternal hemodynamic changes during spinal anesthesia for cesarean delivery.

Methods: This double-blind randomized controlled trial was conducted on 116 pregnant women candidate for the elective cesarean section through spinal anesthesia in the Shahid Akbarabadi Hospital, Tehran in 2019. The eligible women were randomly divided into the intervention (phenylephrine; n = 58) and control (normal saline; n = 58) groups. The data collection tool was a checklist, including the demographic and clinical variables, such as age, height, weight, body mass index, gravid, gestational age, Apgar score of 1 and 5, systolic blood pressure, diastolic blood pressure, heart rate, mean arterial pressure, SPO2, PH of the umbilical cord, PCO2, HCO3, base excess, nausea, and vomiting. Data were analyzed using SPSS 24 software and P value < 0.05 was considered as significant.

Results: The intervention and control groups showed a significant difference in terms of the PH of the umbilical cord, PCO2, and nausea and vomiting (P value < 0.05). The results of the repeated measure ANOVA test showed a significant statistical difference between the intervention and control groups at different time points in terms of arterial pressure, systolic and diastolic blood pressures (P value < 0.05).

Conclusions: Phenylephrine is effective in the prevention of some complications, like reducing mean arterial pressure, systolic and diastolic blood pressures, nausea, and vomiting during spinal anesthesia for cesarean delivery. Therefore, these drugs can be used based on maternal hemodynamic status during spinal anesthesia for cesarean delivery.
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http://dx.doi.org/10.5812/aapm.99094DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7144416PMC
February 2020

Comparison of Two Acupuncture Protocols (K1, DU25 or K1, DU26) Efficacy on Recovery Time of Patients After General Anesthesia, a Randomized Control Clinical Trial.

Anesth Pain Med 2019 Oct 28;9(5):e96172. Epub 2019 Oct 28.

Pain Research Center, Rasoul Akram Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran.

Background: Acupuncture has been used for more than two thousand years as part of traditional Chinese medicine.

Objectives: This randomized prospective clinical trial aimed to compare the effect of acupuncture on K1 (Yongquan) and DU26 (Renghong) with acupuncture on K1 (Yongquan) and DU25 (Suliao), with sham acupuncture on the recovery time of general anesthesia.

Methods: The patients (51) were randomly assigned to three groups: (A) acupuncture on K1 and DU26, (B) acupuncture on K1 and DU25, and (C) sham acupuncture. In each group, at the end of surgery acupuncture was performed accordingly for twenty minutes and the Bispectral Index (BIS) values at end of surgery, 5th minute, 10th minute, 15th minute and 20th minute as well as time of extubation and time of eye opening after the end of surgery were evaluated.

Results: BIS study at 5th minute, 10th minute and 15th minute after the end of surgery in the groups revealed a significant difference between sham acupuncture group and both A and B acupuncture groups, which was higher in groups A and B in comparison with sham acupuncture group. Time of opening eyes and time of extubation after the end of surgery between group A and sham acupuncture group differed significantly, which was earlier in group A. There was no significant difference between group B and sham acupuncture group in terms of eye opening and extubation time.

Conclusions: Acupuncture on K1 and DU26 accelerates restoring of consciousness and shortens of eye opening and extubation after general anesthesia, but on K1 and DU25 only speeds up retrieving of consciousness without significant effect on time of eye opening or extubation after general anesthesia.
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http://dx.doi.org/10.5812/aapm.96172DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6935292PMC
October 2019

A Comparative Study on the Efficacy of Oral Memantine and Placebo for Acute Postoperative Pain in Patients Undergoing Dacryocystorhinostomy (DCR).

Anesth Pain Med 2017 Jun 26;7(3):e45297. Epub 2017 Apr 26.

Center for Academic and Health Policy, Tehran University of Medical Sciences, Tehran, Iran.

Background: Memantine is an N-methyl-D-Aspartate (NMDA) antagonist. By transferring acute postoperative pain, the NMDA channels may lead to active excess and neuropathic pain. Objectives: This study attempted to investigate the effect of preoperative use of single oral dose of memantine in controlling Dacryocystorhinostomy (DCR) postoperative pain.

Methods: A double-blind clinical trial was conducted on 60 patients undergoing DCR. On arrival at the operating room, the memantine group received 20 mg of oral memantine and the control group received placebo. The severities of pain by visual analogue scale (VAS) and sedation by Ramsy Scale were measured immediately 1, 2, and 6 hours after the operation. The drug's side effects were recorded.

Results: The pain scores of patients in the recovery in 1, 2, and 6 hours after operation were significantly lower in the memantine group than the placebo group (P < 0.001). The sedation score, 1 hour after the operation, was significantly greater in the memantine group than the placebo (P < 0.001). The sedation scores did not have any statistically significant difference in recovery and 2 hours after surgery between the two groups. Moreover, the sedation scores in 6 hours after the surgery were identical in the two groups.

Conclusions: The oral single-dose 20 mg of memantine administered before DCR can reduce postoperative pain compared with placebo.
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http://dx.doi.org/10.5812/aapm.45297DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5561447PMC
June 2017

The effect of gabapentin on reducing pain after laparoscopic gastric bypass surgery in patients with morbid obesity: a randomized clinical trial.

Anesth Pain Med 2015 Feb 1;5(1):e22372. Epub 2015 Feb 1.

Department of Anesthesiology and Pain Medicine, Rasoul-Akram Medical Center, Iran University of Medical Sciences, Tehran, Iran.

Background: Pain after laparoscopic gastric bypass surgery (LGBP) is a major problem. Gabapentin is an anticonvulsant drug that can be effective in postoperative pain control.

Objectives: This study examined the effect of preoperative administration of gabapentin on reducing pain after LGBP in patients with morbid obesity.

Patients And Methods: This randomized clinical trial was performed in Hazrat Rasoul Akram Medical Center in Tehran. A total of 60 patients undergoing LGBP were randomly allocated into two groups; one group received 100 mg of oral gabapentin and the other group received placebo. Pain was evaluated at recovery time, and at the first, second, fourth and sixth hour of surgery by visual analog scale. The number and dose of opioid use after surgery and incidence of postoperative complications, such as nausea and vomiting, agitation, and headache, were also recorded.

Results: The mean pain score in the group receiving gabapentin was significantly lower than the placebo group (P < 0.001). Indications and dose of opioid consumption between the two groups were not statistically significant. Incidence of nausea/vomiting (P = 0.028) as well as agitation (P = 0.037) was significantly lower in the gabapentin group.

Conclusions: Administration of gabapentin before surgery can reduce pain after LGBP. Furthermore, it is not accompanied by significant short-term adverse effects.
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http://dx.doi.org/10.5812/aapm.22372DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4350186PMC
February 2015

Effect of intravenous methylprednisolone on pain after intertrochanteric femoral fracture surgery.

J Clin Diagn Res 2014 Apr 15;8(4):GC01-4. Epub 2014 Apr 15.

Assistant Professor, Preventive and Community Medicine Specialist, Community Based Participatory Research Center, Iranian Institute for Reduction of High-Risk Behaviors , Tehran University of Medical Sciences, Tehran, Iran .

Background: Pain after surgery is one of the major problems in patients with intertrochanteric fracture. This study investigates administration of single-dose Methylprednisolone prior to surgery with the goal of reducing Post-operative pain.

Materials And Methods: The study was a Double Blind Randomized Clinical Trial. Eighty two patients with stable intertrochanteric unilateral fracture were selected and divided into two groups: one received Methylprednisolone (MP) 125 mg and the other received placebo. Pain was evaluated at rest and 45° flexion of the hip in times 4, 6, 8, 12, 24, 36, and 48 hours and during walking in times 24, 36, and 48 hours after the surgery. Post-operative nausea, vomiting and fatigue and changes in C - reactive protein (CRP) levels before and after the surgery were also recorded.

Results: Pain at rest, 45° flexion of the hip and during walking after the surgery was significantly lower in the MP group compared to the control group (p < 0.001). Fatigue (p = 0.002) and changes in CRP (p=0.001) were significantly lower in MP group. Incidence of nausea, vomiting (p = 0.37) and opioid consumption (p = 0.49) were not significantly different between the two groups.

Conclusion: Single-dose methylprednisolone 125 mg (IV) can reduce Post-operative pain in patients with intertrochanteric fracture undergoing elective surgery.
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http://dx.doi.org/10.7860/JCDR/2014/8232.4305DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4064860PMC
April 2014