Journal of Anesthesiology and Pain

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Aims and Background: The aim of the present study is prediction of depression in elderly patients with rheumatoid arthritis based on perception of pain and quality of sleep and it examines the mediating role of pain catastrophizing as a model. Few investigations have been reported regarding this subject. Also some limited results are still uncertain. Methods and materials: Research design was Correlation and study population including all elderly patients with rheumatoid arthritis in Hafez rheumatology clinic at Shiraz. For this purpose, 150 patients participated in the study via convenient sampling. Research Tools included Geriatric Depression Scale, the McGill pain questionnaire, the Pittsburgh Sleep Quality Index and Pain Catastrophizing Scale. In order to analyze the data, the path analysis by AMOS and the stepwise multiple regressions by SPSS were used. Findings: The results indicated that perception of pain and quality of sleep significantly predict pain catastrophizing and depression. The proposed model shows that perception of pain and quality of sleep with mediating role of pain catastrophizing can significantly predict depression. Conclusions: The finding of this study showed that we can prevent depression by special therapies such as: Cognitive- Behavior Therapy and Acceptance- Commitment Therapy for improving quality of sleep, reducing pain and controlling catastrophizing thought in these patients. Keywords: Perception of pain, Quality of sleep, Pain catastrophizing, Depression, Rheumatoid Arthritis.

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Aims and Background: Opiate addiction, is one of the most prominent health problem in diverse communities

which may lead to anxiety during treatment and relapse. This study investigates the efficacy of transcranial

direct current stimulation (TDCS) on anxiety during treatment of opiate addiction via the ultra rapid opioid

detoxification approach (UROD).

Methods and materials: It is a randomized, double blind controlled survey which was conducted on forty

scheduled subjects for UROD. TDCS was applied at 24 hour intervals for two sessions by the researcher. The

anxiety scores were recorded before the intervention, immediately before UROD, and 24 hours afterwards using

Beck questionnaire. Data were analyzed via repeated measure ANOVA using SPSS software.

Findings: All the participants were male with mean drug abuse duration of 8.37 ±2.4 and 7.37 ± 2.4 years in

intervention and control groups, respectively. According to statistical analysis, anxiety was less in the intervention

group and the difference was significant at all time intervals (P-value&le0.008). We observed about 90% decline

for anxiety in intervention group one hour after UROD (p-value&le 0.01) while it was about 25%for control group

(P-value=0.163) and it increased in the control group within 24 hours.

Conclusions: Generally speaking, TDCS is an effective approach to alleviate anxiety due to pre-anesthesia and

withdrawal syndromes during UROD.

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Abstract

Aims and Background: The term of opiate refers to natural and synthetic materials that have morphine-like activity. Opiates have central nervous system depressant and analgesic effects .They can lead to pleasure and euphoric sensations. So subsequent to therapy , the probability of relapse is high. The aim of this study is to determine the effect of transcranial direct current stimulation on the recurrence of drug abuse following ultra rapid opioid detoxification (UROD).

Materials and methods: It is a randomized, double blind, sham controlled survey which has been conducted for forty scheduled subjects undergoing UROD. Transcranial direct current stimulation was applied at 24 hour intervals for three sessions. The relapse rate was assessed within two weeks, one and three months after detoxification using addiction strip test and psychiatric visit. The acquired data was  analyzed via ordinal logistic regression model while selecting group therapy as a predictor variable, with other variables using SPSS software.

Findings: All the participants were male with mean ages of 25 ±2.11 and 26 ± 1.71 years in intervention and control groups, respectively. Although the intervention was shown to be   effective for a short time and the relapse rate within the first two weeks was decreased,  no significant difference was shown between the groups  finally(P-value=0.931) .Considering  other important factors influencing the relapse rate, only the marital status was effective (P-value<0.05).

Conclusion: The findings showed no long-term effects of transcranial electrical stimulation on the relapse rate following UROD approach.

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 Aims and background: Defensive styles play an important role in intrapersonal and interpersonal experiences. One of the most important experiences is experiencing pain. In previous researches, the relationship between different styles of defense with experience of chronic pain is not clear. So, the aim of this study was to examine the role of developed defense styles, undeveloped ones  and neuroticism in predicting chronic pain. Materials and methods: In a retrospective, descriptive-correlation and cross-sectional study, 150 college students of Tabriz university, were selected with using available sampling method. Mc Gill’s psychological pain questionnaire and defense style questionnaire were used for data collection. Findings: Pearson’s correlation and multiple-regression were used for data analysis. Results of the study showed that neuroticism and undeveloped variables predict chronic pain.Also, developed variable has decisive role to  avoid pain experience. Conclusion: According to the results, we can conclude that developed, undeveloped and neuroticism defense styles have a determining role in chronic pain. So it is suggested to use psychological treatment to correct defense styles in chronic pain patients.

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 Aims and background: Recognizing the variable mediating role of openness to experience in the relationship between pain self-efficacy predictors variables, pain management strategies and resiliency with variables of pain perception criteria in chronic pain patients. Materials and methods: In this fundamental and descriptive-correlational study, 340 chronic pain patients were hospitalized in all hospitals in Tehran, including public and private hospitals, general and specialized centers and clinics, as well as medical centers provided by the sampling method of access available. The tools used in the Big Five Personality Examination, NEO-PI R, Pain Self-Efficacy Test, Pain Management Strategies Test, Resiliency Test, Chest Pain Perception Test, West Yon Yale. The data obtained using the least squared structural equation Minority and path analysis were analyzed in the smart PLS software. Findings: The results of the study, openness to experience, have a full mediator role in the relationship between self-efficacy and perception of pain. Openness to experience has a mediator role in the relationship between pain management and pain perception. Openness to experience has a partial mediator role in the relationship between resilience and pain perception. The strongest mediator role in the above model relates to the role of mediating openness to experience in the relationship between self-efficacy and perception of pain. Conclusion: The openness of the experience, the strong mediator of pain self efficay, the pain management strategy, persistence with the perception of pain in chronic patients. Openness to experience in a person with chronic pain affects perception of a person’s pain.

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Background. Knee osteoarthritis (OA) is a serious health issue and economic burden worldwide. Several treatment modalities have been proposed, each with its own limitations. Systematic reviews advocate the use of acupuncture for knee OA. Regarding the anti-inflammatory effects of gold, it was assumed that acupuncture with gold needles may have added value compared with the conventional stainless steel needles.
Methods. In a randomized controlled trial, 45 patients with knee OA grade two or three according to the Kellgren Lawrence criteria were enrolled. Pain severity score was evaluated at baseline. Patients were randomly allocated into three groups of acupuncture with gold, steel, or placebo needles for ten sessions over a period of 4 weeks. Participants were followed for 12 weeks after the end of treatment sessions.
Results. The pain score was lower in the acupuncture groups than in the placebo group, but the difference between gold and steel acupuncture groups was not statistically significant.
Conclusions: Acupuncture with conventional needling is an effective and well-tolerated method for the management of knee OA.

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Introduction: During the last few years, the trend of using non-opioid drugs for the management of pain after surgery has been highly welcomed, and on the other hand, considering the contradictory results of the preventive use of intravenous ibuprofen before surgery, the present study aimed at the effect of a single dose of intravenous ibuprofen before surgery. A systematic review and meta-analysis was conducted on post-anesthesia pain surgery.
Methods: This study was conducted as a systematic review and meta-analysis in the first six months of 1401 based on the PRISMA statement. For this purpose, the keywords of ibuprofen, intravenous, post-surgical pain, analgesia, opioid and analgesia under patient control in the databases PubMed, Scopus, MEDLINE, Embase, Cochrane Center for Controlled Trials and Web of Science, Mag Iran and SID databases.
Results: Examining pain intensity at 12 hours (MD=-1.64 (-2.56, -0.72), 95%CI P=0.001 and I=95%) and 24 hours (-0.58) MD = (-0.18, -0.99) 95% CI- P = 0.001 and I = 90%) after surgery indicated that prophylactic administration of ibuprofen significantly reduced pain intensity.
Conclusion: The administration of a single prophylactic dose of intravenous ibuprofen leads to a decrease in pain intensity during the first 24 hours after surgery, however, its effects decrease over time.