1 2228-6659 Iranian Society Of Regional Anesthesia And Pain Medicine 5288 Geriatric Anesthesia Comparison of the effect of Melatonin and Gabapentin on pain and anexiety in patients undergoing cataract surgery with Phacoemulsification with topical anesthesia marzban shideh b haddadi soudabeh c taheri fard pegah d atrkar roshan zahra e parvizi arman f panjtan panah mohamadreza g b Guilan University of Medical Sciences-Anesthesia research center c Guilan University of Medical Sciences-Anesthesia research center d Guilan University of Medical Sciences-Anesthesia research center e Guilan University of Medical Sciences-Anesthesia research center f Guilan University of Medical Sciences-Anesthesia research center g Guilan University of Medical Sciences-Anesthesia research center 1 12 2016 7 3 1 10 04 05 2016 13 08 2016 Background : The main purpose of sedation in patients under ocular surgery  is patients' preparing to stay calm during surgery .Inadequate or deep sedation  may lead to patient's  sudden movement  and subsequently serious complications . Objectives : The main purpose of  this study is  compare the effects of Melatonin and Gabapentin on pain and anxiety  during cataract surgery under topical anesthesia. Methods : This study was  a single  blinded  clinical trial conducted on 81 patients undergoing cataract surgery with topical anesthesia  in Amir-al-Momenin  Academic Hospital in 2014. Patients were randomly assigned into 3 groups:27 patients receiving 6 mg of melatonin tablet,27 patients receiving 600 mg of Gabapentin capsule, and 27 patients receiving placebo(control) 90 minutes pre -operative .In operation room, placebo group received 1 mg Midazolam intravenous, all  patients received 0.5 mic/kg Fentanyl .  The pain and anxiety were evaluated on premedication time(T1), in the operating room (T2), and post operative (T5).The sedation was evaluated at T1, T2, at the time topical anesthesia(T3), 15 minutes after the start of surgery (T4) and T5. Results: In our study, there was not statistically significant difference in demographic variables )age, sex and coexisting disease ), the intensity of anxiety and pain in 90 minutes before surgery among the three groups of patients undergoing cataract surgery in the time intervals. It was found that in entering operating room and discharge from recovery, there was a statistically significant difference between mean pain intensity  among three groups (p=0.001 and p=0.0001).. In each of the time periods, studying the difference between the intensity of anxiety among the three groups of patients showed a significant difference at the time of entering the operating room between mean anxiety in the three groups (p=0.034). However, there was no significant difference among the mean anxiety of the three groups in recovery discharge time ( p=0.316). Conclusion: The results show that pretreatment with Melatonin and Gabapentin  Midazolam decreased anxiety scores to the same extent of Midazolam. In addition, a single dose of Gabapentin or melatonin administered as pre- medication reduce pain intensity in the patients.
5296 Regional anesthesia Comparison of changes in serum interleukin, in patients with morbid obesity under laparoscopic gastric bypass surgery, before and after general anesthesia with isoflurane and propofol 1 12 2016 7 3 11 20 11 06 2016 14 09 2016 Introduction: Anesthesia can change the balance between proinflammatory and                anti-inflammatory cytokine factors during surgery. As a result of interference in the balance of these factors, increase the risk of cardiac and pulmonary disorders, blood glucose levels with insulin resistance, impaired function and damage to the patient's anesthesia. The aim of this study was to investigate the pattern of IL-10 and TNF-α with two type of anesthesia in surgery of Roux-en-Y laparoscopic gastric. Material: 64 patients undergoing laparoscopic gastric bypass referring to Hazrat Rasoul Hospital as a random and using block randomization and parallel divided into two groups. After pre-oxygenation, anesthesia induction and patient intubation, as the maintenance of anesthesia during the operation, in first group isoflurane 1.2% is used and in second group propofol 100 μ / kg/ min is used intravenously. Then in groups, interluekin 10 and TNFα by ELISA method is measured. Result: According to the results, the amount of IL-10 in both types of anesthesia increased, but increasing the amount of IL-10 in the propofol group showed unprecedented high. The amount of TNF-alpha in the isoflurane group; a little high, but decreased in the propofol group. The results of the statistical confidence level p <0.05 was significant. Conclusion: Intraoperative stress factors responsible for the increase inflammation factor such as TNF-α. The use of drugs, such as propofol, may be helpful for reduce inflammation during surgery. 5282 Special Evaluation of comparison between Remifentanil infusion and single dose intravenous Hydralazine + Propranolol administration to provide controlled hypotension in patients undergoing Rhino plastic surgery in khalili hospital during the 1393-94. khamestan mahsa j sadeghi seyed ebrahim k samadi kazem l forozan mohsen m j shiraz university of medical sciences k shiraz university of medical sciences l shiraz university of medical sciences m shiraz university of medical sciences 1 12 2016 7 3 21 29 28 03 2016 11 09 2016 Introduction: Since the amount of  bleeding during surgery has significant effects on the result of rhino plastic surgery, then all of the actions which cause reduction in bleeding are very useful and important. This study is done to compare two different ways of causing controlled hypotension during rhino plastic surgery. Method: In this randomized clinical trial, 80 patients with ASA class one and two who were candidate for rhinoplasty,  has been studied. These patients were randomly divided into two groups of forty individuals. In group A, single dose of  Hydralazine and propranolol , and in group B remifentanil  were used as maintenance medication. Surgeon satisfaction during surgery, patient's blood pressure and heart rate during surgery were recorded. The result of data analysis by software SPSS is shown. Results: Context variables, surgery and anaesthiology features were equal in both groups. Surgeon satisfaction of operation field was higher in remifentanil group( p-value less than 0.001). Mean duration of surgery was higher in remifentanil group. Heart rate in two groups didn't have significant difference.(p-value 0.156). Blood pressure was significantly reduced  in remifentanil group .(p-value 0.036). Discussion and Conclusion: Generally, based on the results concluded that anesthesia by remifentanil Infusion prescription can reduce blood loss and increases surgeon satisfaction during rhinoplasty surgery, this is significantly more effective than a Single Dose Intravenous Hydralazine and Propranolol. 5286 Acute pain managment The effect of hydroalcoholic extract of Ferula gummosa on visceral pain in mice: Experimental study Keramati Keyvan n Asghari BaghKheirati Amir o abdollahi mostafa p yaghmaee Marziye abdollahi morteza n semnan university o semnan university p semnan university semnan university veterinary 1 12 2016 7 3 30 37 19 04 2016 14 09 2016 Abstract Background: Visceral pain is  unpleasant felling that Using synthetic drugs for treatment has some side effects, such as psychological dependence and blood dyscrasia and for decreasing these side effects, administration of herbal medicine can be appropriate approach. Based on existing information in traditional medicine and some recent scientific surveys, Ferula gummosa plant is one type of herbs that has different therapeutic effects of which it is possible to point to antibacterial, antifungal, antioxidant and anti-inflammatory effects.The aim of this study is evaluation of palliative effect of Ferula gummosa on visceral pain. Methods: This experimental study was done on 40 NMRI male mice. (36±4g). Mice were divided randomly into control group, positive group (flunixine), treatment 1 , treatment 2 ,treatment 3. Respectively Control group and positive group received normal salin and flunixine (2mg/kg) and also treatment groups respectively received 25, 50 ,100 mg/kg of Ferula gummosa intraperitoneally. 15minute after each injection , for visceral pain induction , mices were injected by acetic acid 0.6% (10mg/kg) and during  30 minutes, the analgesic effect was recorded by counting the number of Writing. Datas were analyzed by SPSS statistical software , One-Way ANOVA and Tukey test with the significant level of P< 0.05. Results: The extracts of Ferula gummosa with 25, 50, 100 mg/kg doses in compared with   negative control doesn’t induced a significant reduction in pain response (P<0.05). Conclusion: This study confirms that Ferula gummosa had no palliative properties on visceral pain. But further studies are necessary to find out an Analgesic effect of its components. 5278 Special The comparison of resilience, coping style and pain catastrophizing in cancer patients and normal people tajikzade fakhri sadeghi razieh raees karimian frahnaz shiraz university university of chamran shiraz university 1 12 2016 7 3 38 48 23 03 2016 08 10 2016 Background: According to individual differences, patients suffering from cancer show different reactions. So, the purpose of this study is the comparison of resilience, coping style and pain catastrophizing in cancer patients and normal people. Methods: This study is ex post facto method. The target society of the research included all of the cancer patients in the hospital of Shiraz city that coming for Chemotherapy, out of which a sample of 60 patients was selected convenient method. Also, we used caregivers of cancer patients for choosing normal samples and  out of which a sample of 61 normal people was randomly selected. They completed Resilience inventory (Conver & Davidson,2003), coping stressor situation inventory (Andler & Parker, 1995), Pain Catastrophizing Scale (Sulivan, et. al., 1995). The findings were analyzed through descriptive statistics, Multivariate variance analysis using SPSS version 22. Results: Results showed that patient groups in comparison with normal groups have a significant difference all variables concept control, spiritual effect and avoidant coping style. Also, results showed that men groups in comparison with women groups have no significant difference in variables. Conclusions: According to results, cancer can make difference between patient and normal groups in resilience, coping style and pain catastrophizing. Therefore, we suggest making comprehensive care plan in patients suffering from cancer for reinforcing resilience and coping style with decreasing  pain catastrophizing. 5292 Chronic pain managment Predicting of chronic pain based on early maladaptive schema 1 12 2016 7 3 49 60 20 05 2016 14 09 2016 Background: There are many studies that examine the relationship between chronic pain and childhood traumatic experiences. However, there are little researches on pain and early maladaptive schemas and their relationship is not clear. The aim of this study was to examine the relationship between chronic pain and early maladaptive schemas. Materials and Methods: In a descriptive-correlation and cross-sectional study, 100 patients with chronic pain of college students  were selected based on cut-off point of McGill pain questionnaire and were selected voluntarily as the sample. For data collecting, Early Maladaptive Schema Questionnaire-Short Form (YSQ-SF) and McGill Pain Questionnaire were used. Results: The results of the stepwise regression showed that emotional deprivation schema has the most ability in predicting of chronic pain and then subjugation schema is able to predict chronic pain. Subjugation schema and abandonment/instability schema are able to predict the emotional pain respectively. Emotional deprivation schema and emotional inhibition are able to predict the neuropathic pain respectively. As well as, Emotional deprivation schema is able to predict intermittent pain and Subjugation schema and emotional inhibition are able to predict variant pain. Conclusion: according to the results, it conclude that Emotional deprivation, Subjugation, abandonment/instability and emotional inhibition schema from three schema domains of disconnection and rejection, other-directedness and over vigilance/inhibition  are the important determinants of chronic pain. It is necessary to use schema therapy in pain management of patients with chronic pain. 5305 Regional anesthesia Compare the effect of adding ketamine and Neostigmine to bupivacaine ‎‎0.25 % for epidural analgesiain patients candidate for elective surgery‎ 1 12 2016 7 3 61 67 21 09 2016 29 10 2016 Background:Pain is a complex medical problem that its inadequate control of postoperative has adverse effects onpatients physiological , metabolic and mentalstatus. Adding new supplements will lead to an increased duration of analgesia . The purpose of this study was to compare the addition of neostigmine and ketamine to bupivacaine 0.25% for epidural analgesiainincreasing duration ofpostoperative analgesia. Materials and Methods:In this double blind clinical trial, 90 patients over 50 years candidate for elective hip surgerywith ASA class I, II randomly divided to three groups: neostigmine , ketamine and control groups. All patients received epidural with bupivacaine 0.25% by 2cc/segment .Furthermore 60 micrograms neostigmineadded in first group and 40 mg ketamine ingroup II . Level of postoperative pain based on VAS and duration of analgesia and amount of analgesic determined and compared between the three groups . Results:The mean of  pain score at 6 and 12 hours after surgery was significantly lower in the ketamine group than the other groups and in neostigmine group was less than placebo( P ≤ 0.01). The mean of duration of postoperative analgesia in the ketamine group was significantly higher than the other groups and in neostigmine group was more than placebo(P ≤ 0.01). The mean dose of analgesic (pethedin)  wasthe least in the ketamine group (P ≤ 0.001). Conclusion:Neostigmine and ketamine with bupivacaine 0.25% for epidural anesthesia increased the duration of analgesia for postoperative and reduced analgesicconsumption that  about ketaminewas more than neostigmine . 5284 Acute pain managment Comparison between obturator nerve block and femoral nerve block to relieve pain after elective arthroscopic ACL reconstruction of the knee Faiz Hamid Reza Rahimzade Poupak Imani Farnad Alebuye Mahmood Reza Esfandiari Zahra 1 12 2016 7 3 68 74 16 04 2016 14 09 2016 Aim and Background: Femoral nerve block is the common method for controlling pain after knee surgery, but it is not the only knee nerve and so always does not provide successful block. Another innervation of the knee is from obturator nerve. Materials and Methods: In this double-blind study, 60 patients whom have undergone elective arthroscopic knee surgery randomly divided into 2 groups of equal number; The femoral nerve block group and obturator nerve block group that. Then after the block patients were evaluated for pain with VAS. Also satisfaction scale was inquired [based on the excellent (1), good (2) moderate (3) and dissatisfied (4)]. Data was analyzed with SPSS 20 software. Findings: Pain was measured at rest in the femoral block, which at all hours showed less scores than obturator block except for measuring at 24 hours. And at 0, 3 and 6 hours after block this difference was statistically significant (at time 0 P value = 0.048 and at 3 and 6 < 0.001). Femoral block group in 24 hours after block compared to the obturator block group showed better satisfaction scores, although this difference wasn’t statistically significant (P value = 0.034). Conclusion: The study showed that patients undergoing femoral nerve block have less pain and greater satisfaction scores compared with patients that were under obturator block. Although, VAS in both groups was in an acceptable level of analgesia after surgery. 5301 Regional anesthesia Case report: meningitis after spinal anesthesia for cesarean section delavar parvin garshasebi ahya afshin majd siamak 1 12 2016 7 3 75 80 23 07 2016 29 10 2016 Spinal anesthesia is the preferred technique for caesarean section. Although hypotension are common, but neurologic complications are rare.  Nevertheless, these side effects are serious and must be considered. The incidence of post dural puncture meningitis is very rare complication . In this paper we report a patient who had spinal anesthesia for cesarean section the three days ago and ensuing headache, neck stiffness and loss of consciousness and whit timely diagnosis  and treatment of meningitis, she found a full recovery and was discharged without any complications.