Journal of Anesthesiology and Pain

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Aim and Background: Acute post-operative pain is the most frightening aspect of a surgical procedure. This study has been designed to evaluate post-operative pain after common abdominal surgeries, and also to assess patient satisfaction with pain management in the department of surgery in order to understand whether enough attention has been paid to this type of treatment. Methods and Materials: In a prospective cross-sectional study, a questionnaire with 20 items including kind of surgery, intensity of pain using a verbal analogue scale (VAS), type of consumed analgesics and patient satisfaction with post-operative pain management, was given to the patients within 24 hours after surgery. Findings: Participants were 390 patients (56% male and 44% female), with the age range between 10 and 85 years. The average maximum post-operative pain score was 8.2±2 using VAS. Most of the patients (92.3%) were partially or moderately satisfied with the pain relief method, while 7.7% had some degree of dissatisfaction. Methadone was the most commonly administered analgesic. Conclusions: To achieve higher levels of pain control and patient satisfaction we should pay more attention to pain relief and other effective factors such as kind of incision and analgesics.

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 Aims and Background: Hemodynamic changes during laparoscopy and postoperative pain after laparoscopic surgery are important issues. Therefore, in this study we examined the effect of oral clonidine on hemodynamics and postoperative pain control after laparoscopic cholecystectomy.

Materials and Methods: The study was a randomized clinical trial. 61 patients, candidate for laparoscopic cholecystectomy, were randomly assigned into two groups. The intervention group received 0.2 mg oral clonidine one hour before anesthesia, and the control group was given placebo instead. The hemodynamic changes and postoperative pain were compared between the two groups.

Findings: Variations of Mean Arterial blood Pressure (P= 0.18) and heart rate (P= 0.15) in the two groups were not statistically significant during surgery. Postoperative analgesic intake in the first 60 minutes of recovery (P=0.006), and 24 hours after surgery (P=0.005) were both significantly lower in the clonidine group.

Conclusion: Although oral clonidine had no significant effect on hemodynamic changes during laparoscopic cholecystectomy but it caused a significant reduction in postoperative pain and analgesic requirement.

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Abstract: Aims and Background: Open cholecystectomy has many complications like respiratory dysfunction and stress response because of pain. The aim of this study was to compare the efficacy of intercostal nerve block added to intravenous infusion of morphine with sole intravenous morphine infusion on pain control after open cholecystectomy. Methods and Materials: 100 patients, candidate for open cholecystectomy, were randomly divided into two groups of 50. The patients underwent elective cholecystectomy by Kocher’s (Subcostal) incision and were randomly allocated to any of the following two groups. The intervention group received intercostal nerve block with 0.25 milligram per kilogram of 0.25% bupivacaine which was infiltrated into the subcostal 6th to 10th rib margin. Then intravenous infusion of 0.5 milligram per kilogram morphine was also started for them. In the control Group, patients had intravenous infusion of 0.5 milligram per kilogram morphine. The infusion rate was 5 milliliter per hour in both group. When the patients were transferred to postoperative recovery room, intensity of pain was recorded by response from the patients using 100 mm linear visual analogue scale(VAS) ranging from 0 to 100. The pain scoring was done at 30 minutes, 6 hours, 12 hours, 18 hours and 24 hours postoperatively. Findings: In our study the severity of pain was lower at 30 minutes, 6 hours, 12 hours, and 18 hours in the intercostal nerve block group than the control group. But at 24 hours postoperatively no significant difference was shown between the groups. Conclusions: Adding Intercostal nerve block to intravenous infusion of morphine is better than sole intravenous infusion of morphine in controling pain severity after open cholecystectomy. Keywords: intercostal nerve block, pain, morphine, opens cholecystectomy.

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 Aims and background: To enhance the quality of surgical procedures and to prevent surgical complications, anesthesia and analgesia techniques should be effective. Stress during surgery can disrupt the hemodynamic and physiological conditions of the human body. Different drugs are used to reduce the stress and each has advantages and disadvantages. The aim of this study was to investigate the effect of Esmolol infusion on the need for narcotic drugs during and after laparoscopic cholecystectomy. Materials and Methods: In this study, 60 patients who were candidate for laparoscopic cholecystectomy between 30 to 60 years old, were randomly selected and assigned to either Esmolol )E( or Saline )S(groups. Total opioid usage was recorded and compared during the operation. Findings: There was no statistically significant difference between the groups in mean intraoperative drug use )P= 0.9( and postoperative opioid use )P= 0.8(. Comparing the sedation score of the patients after the operation, there was no significant difference between the two groups (P= 0.4). conclusion: According to the findings of this study, Esmolol injection with 0.5 mg/kg dosage has no effect on the amount of opioid consumption during surgery and in the recovery; also it has no effect on sedation score of patients undergoing laparoscopic cholecystectomy.

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Introduction and Problem Statement: Acute postoperative pain, especially within the first 24 hours after surgery following the effects of anesthesia drugs, is one of the most significant factors contributing to patient dissatisfaction with their treatment process. Various pharmacological and non-pharmacological methods are being studied to reduce and control postoperative pain. One of the proposed interventions in this regard is the prophylactic intravenous injection of vitamin C. This study aims to investigate the effect of a single intravenous dose of vitamin C administered before surgery on pain control within the first 24 hours after surgery in patients undergoing laparoscopic cholecystectomy.

Materials and Methods: This study is designed as a clinical trial. Based on this design, 86 randomly selected patients will be divided into two groups: the intervention group, which will receive a single intravenous dose of 1 gram of vitamin C one hour before anesthesia induction, and the control group, which will receive a single intravenous dose of normal saline with the same volume. The pain intensity, nausea, and itching experienced by patients in both groups will be assessed immediately after surgery, 2 hours post-surgery, 6 hours post-surgery, 12 hours post-surgery, and 24 hours post-surgery for comparison.

Results: According to the results obtained, there was no statistically significant difference in the pain levels experienced by patients in both the control and intervention groups at any of the examined time intervals. Additionally, the assessed severity of nausea and itching did not show any statistically significant differences between the two groups at all time intervals.

Discussion and Conclusion: Based on the results obtained, a single prophylactic dose of vitamin C did not have any significant effect on reducing pain in patients within the first 24 hours after laparoscopic cholecystectomy. This may be due to the small sample size in each group or other confounding factors. Conducting more extensive studies in this field could provide broader insights.