Publications by authors named "Reza Akhondzadeh"

15 Publications

  • Page 1 of 1

Comparison of Sedation with Dexmedetomidine Alfentanil Versus Ketamine-Alfentanil in Patients Undergoing Closed Reduction of Nasal Fractures.

Anesth Pain Med 2020 Aug 25;10(4):e102946. Epub 2020 Aug 25.

Department of Anesthesiology and Pain Medicine, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Objectives: To compare the sedative effects of dexmedetomidine alfentanil versus ketamine-alfentanil in patients undergoing closed reduction of nasal fractures on the basis of intraoperative hemodynamic changes, satisfaction of patients and surgeons, and the adverse effects.

Methods: Sixty patients with ASA class 1 or 2 were randomized to either of two groups, a dexmedetomidine alfentanil group (DA group; n = 30) or a ketamine-alfentanil group (KA group; n = 30). Hemodynamic parameters, oxygenation status, adverse events, the satisfaction of patients and surgeons, and postoperative pain scores by visual analog scale (VAS) were recorded at specific time intervals during the trial.

Results: Systolic blood pressure was significantly lower in the DA group than in the KA group from T1 min to T15 min. The duration of the recovery ward stay was longer in the DA group; however, two groups were similar in terms of total anesthesia time and awakening time. Likewise, two groups were similar in terms of the patient and surgeon's satisfaction, pain scores, and the occurrence of adverse effects.

Conclusions: Both sedation methods were safely performed, and dexmedetomidine-alfentanil is as effective as ketamine-alfentanil in patients undergoing short-term operations such as nasal fracture corrections.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5812/aapm.102946DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7539046PMC
August 2020

Comparing the Effect of Bupivacaine and Ropivacaine in Cesarean Delivery with Spinal Anesthesia.

Anesth Pain Med 2020 Feb 18;10(1):e94155. Epub 2020 Jan 18.

Department of Anesthesiology, Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Background: Spinal anesthesia is the most common technique used for cesarean delivery due to some advantages compared to regional anesthesia. It is easily performed and provides a rapid onset of block. Though bupivacaine is a generally used long-acting amide type local anesthetic drug for spinal anesthesia, ropivacaine may sometimes be selected.

Objectives: This prospective, randomized, double-blinded study was aimed at comparing clinical efficacy and safety between ropivacaine and bupivacaine during cesarean section.

Methods: After getting ethical committee approval and written informed consent, 65 women who referred to Imam Khomeini Hospital of Ahvaz, Iran in 2018 were chosen for elective cesarean delivery under spinal anesthesia. They were randomly allocated to receive either ropivacaine 1% (n = 33) or bupivacaine 0.5% (n = 32). Afterwards, the differences in the anesthetic efficacy, vital signs, and hemodynamics of participants between the two groups were recorded.

Results: Duration of sensory block was shorter in the ropivacaine group than bupivacaine group (132.5 ± 21.6 min vs. 175.8 ± 26.2 min; P < 0.001). Ropivacaine also produced a shorter duration of motor blockade than bupivacaine (124.8 ± 20.2 min vs. 168.2 ± 21.7 min; P < 0.001). There is no difference between the two groups in terms of systolic and diastolic blood pressure, but the heart rate of patients in the bupivacaine group is significantly higher than the ropivacaine group.

Conclusions: The results suggest that ropivacaine and bupivacaine are two efficient drugs in anesthesia in the cesarean section, ropivacaine is a better choice due to little influence on the hemodynamics and shorter duration of sensory block and motor block which are useful for the recovery and also safe to the patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5812/aapm.94155DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7144247PMC
February 2020

Comparison of the Ketamine-Lidocaine and Fentanyl-Lidocaine in Postoperative Analgesia in Axillary Block in Upper Limb Fractures By Ultrasound Guidance.

Anesth Pain Med 2019 Dec 1;9(6):e92695. Epub 2019 Dec 1.

Department of Anesthesiology, Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Background: Regional anesthesia provides safe anesthesia for upper extremity surgery. Axillary plexus block approach for hand and forearm surgery is commonly used. The use of adjuvants in combination with local anesthetics for peripheral nerve blocks enhances the quality and duration of anesthesia and postoperative analgesia.

Methods: This double-blind clinical trial was performed on 60 patients who were candidates for the surgery of upper extremity fractures with ASA I and II classes. The patients were randomly divided into two equal groups (n = 30). The intervention group 1 received 4 mg/kg lidocaine 1% and 50 µg fentanyl and the intervention group 2 received 4 mg/kg lidocaine 1% and 30 mg ketamine during the axillary block. After the necessary monitoring, a pinprick test was performed to evaluate sensory block, and a three-point scale test for the motor block was performed for median, ulnar, radial and musculocutaneous nerves. The duration of postoperative analgesia, the time of the first request for a painkiller, and the amount of opioid received were compared in the two groups.

Results: Onset of sensory and motor block was shorter in the fentanyl group but did not differ significantly. The sensory and motor block length was slightly higher in the fentanyl group, but no significant difference was observed. The severity of pain (VAS) and the mean of received opioid (pethidine) were significantly lower in the fentanyl group 24 hours after the surgery (P < 0.0001). The duration of postoperative analgesia and the time of the first request for painkiller were longer in the fentanyl group, but there was no significant difference.

Conclusions: The severity of pain and analgesic intake in the fentanyl group decreased significantly. Therefore, fentanyl is a better drug than ketamine for using as an adjuvant in the axillary block.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5812/aapm.92695DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7118445PMC
December 2019

Comparison of Dexmedetomidine and Morphine as Adjuvants to Bupivacaine for Epidural Anesthesia in Leg Fracture Surgery: A Randomized Clinical Trial.

Anesth Pain Med 2019 Aug 27;9(4):e91480. Epub 2019 Aug 27.

Department of Anesthesiology, Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Background: Epidural block approach and drugs are common options for improving the sensory and motor block duration and postoperative pain management.

Objectives: The study aimed to compare the analgesic effects of dexmedetomidine and morphine as adjuvants to bupivacaine for epidural anesthesia in leg fracture surgery.

Methods: This prospective clinical trial was conducted on patients (n = 80, age range: 18 - 60 years) categorized as ASA class I or II. After a clinical examination, the patients were allocated to receive either lumbar epidural bupivacaine + morphine (BM) (12 mL bupivacaine 0.5% + morphine 2 mg) or bupivacaine + dexmedetomidine (BD) (12 mL bupivacaine 0.5% + dexmedetomidine 1 µg/kg). After drug administration, the sensory block level was assessed at 2-min intervals using the Cold Swab method until it reached the T12 level. At the T12 level of sensory block, the surgery began when motor block reached grade 3 of the modified Bromage scale.

Results: The BD group had a significantly shorter time to reach the sensory and motor block than the BM group (P < 0.001). The duration of sensory and motor block was significantly longer in the group BD than in the BM group (P < 0.001). Moreover, the BD group showed lower VAS scores (P < 0.0001) and longer time to first analgesia demand than the BM group.

Conclusions: Combined bupivacaine + dexmedetomidine prolongs the sensory and motor block duration and controls postoperative pain more effectively, indicating that it is an appropriate combination for epidural anesthesia.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5812/aapm.91480DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6829178PMC
August 2019

The Effect of Different Doses of Isoflurane on Hemodynamic Changes and Bleeding in Patients Undergoing Endoscopic Sinus Surgery under General Anesthesia.

Anesth Pain Med 2019 Feb 18;9(1):e57864. Epub 2019 Feb 18.

Department of Anesthesiology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Background: Nowadays, endoscopic sinus surgery is one of the most common surgeries in the field of ear, nose, and throat. This surgery has always been followed by bleeding and can cause hemodynamic disorders due to the direct effect of the endoscopic sinus surgery.

Objectives: This study aimed to investigate the hemodynamic changes with different doses of isoflurane during endoscopic sinus surgery.

Methods: In a randomized clinical trial, 90 patients were selected based on ASA class I and II, and divided into three groups of 30 people. The method of anesthesia induction in groups was alike. After induction anesthesia, isoflurane with percentages of 1%, 1.2%, and 1.5% was used in the groups of 1, 2, and 3, respectively and remifentanil was fixed and used in the groups in a dose of 0.1 g/kg/min during the surgery.

Results: There was a significant difference in changes in mean of arterial pressure (MAP) after induction in the 3 groups (P < 0.001) that the reduction in mean of arterial pressure between 1 and 3 groups and between 2 and 3 groups were significantly different. There was a significant difference in heart rate per 30, 45, and 60 minutes between 1 and 2 groups (P < 0.001).

Conclusions: Isoflurane percentages of 1.5% versus 1.2% and 1% affected generally a considerable reduction rate of 1% in bleeding and better control of mean arterial blood pressure. In addition, the mean heart rate in several minutes in group 2 with 1.2% isoflurane was less than other groups.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5812/aapm.57864DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6413045PMC
February 2019

The Effect of Low-Level Laser on Postoperative Pain After Elective Cesarean Section.

Anesth Pain Med 2018 Dec 20;8(6):e84195. Epub 2018 Nov 20.

Canadian Optic and Laser Center, COL Center, Victoria, Canada.

Background: Postoperative pain is one of the major concerns about a cesarean in pregnant women that can lead to serious complications and delayed recovery for patients.

Objectives: The objective is to investigate the effect of low power laser on acute pain after elective cesarean.

Methods: In this randomized, double-blind clinical trial, 80 candidates for an elective cesarean were divided randomly into two groups, control and laser. The type of surgery was the same for both groups, which contained the spinal anesthesia technique. At the end of surgery, the surgical incision in patients who were treated with laser, (GaAlAs: 804 nm and GaAlInp: 650 nm) was irradiated by laser. The control group also received laser off by the same method. Patients were monitored for 24 hours to assess the severity of postoperative pain by VAS, the first request for analgesic and the total consumption of analgesic.

Results: The results demonstrated significant reduction of pain in the laser group 1, 4, 8, 12, 16, 24 hours after surgery, compared with the control group (P value < 0.05). Additionally, the average of total received analgesic in the group laser was less than the controls (P value = 0.006). The first request for analgesic in the laser received group was significantly longer than the controls (P value = 0.005).

Conclusions: Low power laser therapy is a good method to reduce postoperative pain due to the fact that it is a safe and non-invasive method which is also accepted by patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5812/aapm.84195DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6347730PMC
December 2018

The Effect of Adding Dexmedetomidine as an Adjuvant to Lidocaine in Forearm Fracture Surgeries by Supraclavicular Block Procedure Under Ultrasound-Guided.

Anesth Pain Med 2018 Aug 25;8(4):e74355. Epub 2018 Jul 25.

Department of Anesthesiology, Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Background: To improve the brachial plexus block (BPB) performance, different compounds have been used as adjuvants to local analgesics.

Objectives: The aim of the present study was to investigate the effects of adding DEX to lidocaine on effectiveness of nerve block, and postoperative pain in forearm fracture surgery by supraclavicular BPB undergoing ultrasound-guided.

Methods: This was a double-blinded randomized clinical trial conducted on 72 patients with ASA classes I and II, which were candidates for forearm fracture surgery. In group A, patients received 3 mg/kg of lidocaine 2%. In group B, patients received 3 mg/kg of lidocaine 2% and DEX (1 µg/kg). The ultrasound-guided supraclavicular BPB was performed in all patients. The onset of sensory and motor blocks were evaluated with pin prick test and modified Bromage scale, respectively. The sensory and motor block moment was recorded as the onset of the block. The first analgesic request time, total consumed analgesic, adverse effect, and hemodynamic parameters of patients were recorded. A visual analog scale (VAS) was used for recording the severity of pain.

Results: The two groups showed no significant difference in the demographic variables. The onset of sensory and motor block in the DEX groups was shorter. The duration of sensory and motor block, and analgesic request was significantly longer than the control groups. Total analgesic consumption 24 hours after surgery in the DEX groups was significantly lower. Moreover, hemodynamic status of patients in both groups was stable and no significant difference was observed between groups. This study showed that DEX, as an adjuvant to lidocaine, improve the characteristics of supraclavicular BPB and decrease the postoperative pain.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5812/aapm.74355DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6139532PMC
August 2018

The Effect of Intravenous Magnesium Sulfate Versus Intravenous Sufentanil on the Duration of Analgesia and Postoperative Pain in Patients with Tibia Fracture.

Anesth Pain Med 2017 Apr 21;7(2):e44035. Epub 2017 Feb 21.

Anesthesiologist, Department of Anesthesiology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Background: In the recent decades controlling postoperative pain has become a popular topic as it leads to the patients' wellbeing and improved life quality, while it reduces the costs for both patients and medical facilities.

Objectives: This study aimed at comparing intravenous magnesium sulfate versus intravenous sufentanil on the duration of analgesia and postoperative pain in patients undergoing tibia fracture surgery.

Methods: This double blind clinical trial study was performed on 70 candidates of tibia fractures between the ages of 18 and 55 years with American society of anesthesiologists (ASA) class I and II. The patients were randomly divided to 2 groups, 1 receiving magnesium sulfate (M) and another receiving sufentanil (S). Both of the groups underwent spinal anesthesia with 10 mg bupivacaine 0.5%. One hour after ensuring the sensorimotor blockade, in the S group 0.1 µg/kg/hour and in the M group 8 mg/kg/hour was diluted in 1 liter of Ringer's solution and infused. In this study, full weakness of the lower limb was considered as the sign of sensorimotor blockade initiation. The postoperative pain intensity was measured using the Visual Analog Scale (VAS), 0, 1, 4, 8, 16, and 24 hours after the end of anesthesia duration. In case of VAS ≥ 3, the patients received 0.3 mg/kg pethidine, intravenously. At last, the time of requesting the first narcotic drug and the total usage of pethidine were recorded.

Results And Conclusions: Sufentanil was found to be more effective than magnesium sulfate in reducing postoperative pain and the time of first narcotics request was later in patients receiving sufentanil (P < 0.05).
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5812/aapm.44035DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5594416PMC
April 2017

A comparison between the effects of propofol-fentanyl with propofol-ketamine for sedation in patients undergoing endoscopic retrograde cholangiopancreatography outside the operating room.

Biomed J 2016 Apr 21;39(2):145-9. Epub 2016 Jun 21.

Department of Anesthesiology, Pain Research Center, Razi Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Background: The efficient and secure techniques of anesthesia and sedation have always been needed for. One of these procedures is endoscopic retrograde cholangiopancreatography (ERCP), due to its painfulness and long duration, has high sensitivity. We compare the effects of propofol-fentanyl (PF) with propofol-ketamine (PK) to sedate patients undergoing ERCP.

Methods: In this clinical trial, patients were divided into two groups of 49 people. A group received a pharmaceutical combination of PK, and another group received a pharmaceutical combination of PF. Vital signs of patients, Ramsey Sedation Score, and pain of patients were assessed. The total dosage of used propofol was also recorded.

Results: There was no significant difference seen in the patients' hemodynamic characteristics in both groups. Pain at the end of surgery and an hour after it in the PK group was less that was not statistically significant. By Ramsey Sedation Score also significant differences were not seen between groups (p = 0.68). By using total dose of propofol used also a significant difference was not observed between the two groups (p = 0.36). Rate of apnea in PK group was 32% and in the PF group was 63%, which this difference was statistically significant (p < 0.05).

Conclusion: A comparison between the two drugs combination shows that although in terms of hemodynamic and sedation criteria both groups were similar, but because of the lower amount of pain and apnea in the PK group, this combination may generally in the ERCP procedure is more efficient and safer.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.bj.2015.11.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6138805PMC
April 2016

The effect of single-dose administration of dexamethasone on postoperative pain in patients undergoing laparoscopic cholecystectomy.

Anesth Pain Med 2014 Aug 13;4(3):e17872. Epub 2014 Aug 13.

Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran ; Department of Anesthesiology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Background: Postoperative pain is considered as a reason of patient's delay in discharge and disability aggravation. Therefore, multimodal approaches have been suggested in order to mitigate pain and decrease postoperative side effects.

Objectives: The aim of this study was to evaluate analgesic effect of a single dose injection of dexamethasone on reducing postoperative pain in laparoscopic cholecystectomy.

Patients And Methods: In this double-blind, prospective study, 122 patients aged 18-60 years old, whom were selected for laparoscopic cholecystectomy, were classified into two case and control groups, and 61 patients were included in each group. The case (D) group underwent general anesthesia and a single- dose intravenous injection of dexamethasone. The Control (C) group received general anesthesia and intravenous injection of normal saline. Total dose of consumed meperidine and pain intensity during first 24 hours were evaluated in both groups.

Results: No significant difference existed between two groups regarding age, sex, weight and operation time. Pain intensity in group D was significantly less than group C (P < 0.01) after two, six and 12 hoursof surgery. No significant difference existed in pain intensity between two groups at the beginning of and 24 hours after the surgery (P > 0.05). Meperidine consumption in group D was significantly less than group C (P < 0.05).

Conclusions: Findings of present study showed that single dose of intravenous dexamethasone, led to less pain intensity and amounts of meperidine consumption, in comparison with placebo.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5812/aapm.17872DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4165022PMC
August 2014

The effect of low-level laser on postoperative pain after tibial fracture surgery: a double-blind controlled randomized clinical trial.

Anesth Pain Med 2014 Aug 21;4(3):e17350. Epub 2014 Jun 21.

Department of Physical Education and Sport Science, Bu-Ali Sina University, Hamedan, Iran.

Background: Postoperative pain is a common complication that can lead to serious morbidities and delayed recovery.

Objectives: The aim of this study was to investigate the effect of low-level laser therapy on acute pain after tibial fracture surgery.

Patients And Methods: In this randomized clinical trial, 54 patients who were candidate for tibial fracture surgery were allocated randomly to two groups, namely, control and laser therapy. Both groups had the same type of surgery and technique of spinal anesthesia. Patients in laser group were treated with the combination of two lasers (GaALAs, 808 nm; and GaALInP, 650 nm) at the end of the surgery while control group received laser in turn-off mode with the same duration as laser group. Patients were evaluated for pain intensity according to the visual analogue scale (VAS) and the amount of analgesic use during 24 hours after surgery.

Results: Laser group experienced less pain intensity in comparison with control group at second, fourth, eighth, 12(th), and 24(th) hours after surgery (P Value < 0.05). In addition, the amount of consumed opioid in laser group was significantly less than the control group (51.62 ± 29.52 and 89.28 ± 35.54 mg, respectively; P Value, 0.008).

Conclusions: Low Level Laser Therapy is a proper method to reduce postoperative pain because it is painless, safe, and noninvasive and is easily accepted by patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5812/aapm.17350DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4165037PMC
August 2014

Comparison of low and standard pressure gas injection at abdominal cavity on postoperative nausea and vomiting in laparoscopic cholecystectomy.

Pak J Med Sci 2014 Sep;30(5):1083-7

Nader Hamoonpou MD, Anesthesiologist, Dept. of Anesthesiology, Ahvaz Jundishapur University of Medical Science, Pain Research Center, Ahvaz, Iran.

Unlabelled: Background and Objective : Postoperative nausea and vomiting (PONV) is the main concern for 40-70% of patients undergoing laparoscopic cholecystectomy. Our objective was to compare carbon dioxide gas at low pressure and standard pressure for the occurrence of PONV on patients undergoing laparoscopic cholecystectomy.

Methods: This double- blind trial was conducted on 50 women patients aged between 18 to 60 years with acute cholecystectomy. The patients were divided into two groups: low pressure (LP) (received LP gas, 7-9 mmHg) and standard pressure (SP) (received SP gas, 14-15 mmHg). Nausea and vomiting in patients at hours 0-4, 4-8, 8-12, 12-24 after the surgery were recorded.

Results: The frequency of PONV in the LP and SP groups did not demonstrate statistically significant different (P > 0.05). Nevertheless the frequency of shoulder pain after 4 hours at the LP group compared with SP group was significantly different (P < 0.023).

Conclusions: The use of low pressure gas compared to standard pressure gas to create pneumoperitoneum could not reduce the PONV whereas the frequency of shoulder pain in LP group was reduced. Low pressure gas was associated with reduction of surgeon visibility and subsequently more prolonged surgery duration.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.12669/pjms.305.5010DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4163237PMC
September 2014

Does low-level laser therapy enhance the efficacy of intravenous regional anesthesia?

Pain Res Manag 2014 Nov-Dec;19(6):e154-8. Epub 2014 Jun 19.

Background: The use of intravenous regional anesthesia (IVRA) is limited by pain resulting from the application of tourniquets and postoperative pain.

Objective: To assess the efficacy of low-level laser therapy added to IVRA for improving pain related to surgical fixation of distal radius fractures.

Methods: The present double-blinded, placebo-controlled, randomized clinical trial involved 48 patients who were undergoing surgical fixation of distal radius fractures. Participants were randomly assigned to either an intervention group (n=24), who received 808 nm laser irradiation as 4 J⁄point for 20 s over ipsilateral three nerve roots in the cervical region corresponding to C5-C8 vertebrae, and 808 nm laser irradiation as 0.1 J⁄cm2 for 5 min in a tangential scanning mode over the affected extremity; or a control group (n=24), who underwent the same protocol and timing of laser probe application with the laser switched off. Both groups received the same IVRA protocol using 2% lidocaine.

Results: The mean visual analogue scale scores were significantly lower in the laser-assisted group than in the lidocaine-only group on all measurements during and after operation (P<0.05). The mean time to the first need for fentanyl administration during the operation was longer in the laser group (P=0.04). The total amount of fentanyl administered to patients was significantly lower in the laser-assisted group (P=0.003). The laser group needed significantly less pethidine for pain relief (P=0.001) and at a later time (P=0.002) compared with the lidocaine-only group. There was no difference between the groups in terms of mean arterial pressure and heart rate.

Conclusion: The addition of gallium-aluminum-arsenide laser irradiation to intravenous regional anesthesia is safe, and reduces pain during and after the operation.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4273713PMC
http://dx.doi.org/10.1155/2014/314910DOI Listing
August 2015

Intravenous paracetamol for postoperative analgesia in laparoscopic cholecystectomy.

Anesth Pain Med 2013 1;3(1):214-8. Epub 2013 Jul 1.

Department of Anesthesiology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

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.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5812/aapm.9880DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3821153PMC
November 2013

The Effect of Inhalation of Aromatherapy Blend containing Lavender Essential Oil on Cesarean Postoperative Pain.

Anesth Pain Med 2013 1;3(1):203-7. Epub 2013 Jul 1.

Department of Anesthesiology, Golestan Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Background: Pain is a major problem in patients after cesarean and medication such as aromatherapy which is a complementary therapy, in which the essences of the plants oils are used to reduce such undesirable conditions.

Objectives: In this study, the effect of aromatherapy using Lavender (Lavandula) essential oil on cesarean postoperative pain was assessed.

Materials And Methods: In a triple blind, randomized placebo-controlled trial study, 60 pregnant women who were admitted to a general hospital for cesarean section, were divided randomly into two groups. After cesarean, the Lavender group inhaled about 3 drops of 10% Lavender oil essence and the placebo group inhaled 3 drops of placebo after the start of postoperative pain, four, eight and 12 hours later, for 5 minutes from the 10 cm distance. Patient's pain was measured by the VAS (Visual Analog Scale) score before and after each intervention, and vital sign, complications and level of satisfaction of every patient were recorded before and after aromatherapy.

Results: There was no statistically significant difference between groups in age, height, weight, and time to the first analgesic requirement. Patients in the Lavender group had less postoperative pain in four (P = 0.008), eight (P = 0.024) and 12 (P = 0.011) hours after first medication than the placebo group. The decreased heart rate and patients' level of satisfaction with analgesia were significantly higher in the Lavender group (P = 0.001). In the placebo group, the use of diclofenac suppositories for complete analgesia was also significantly higher than the Lavender group (P = 0.008).

Conclusions: The inhaled Lavender essence may be used as a part of the multidisciplinary treatment of pain after cesarean section, but it is not recommended as the sole pain management.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5812/aapm.9570DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3821145PMC
November 2013