Anesthesiology and Pain
بیهوشی و درد
JAP
Medical Sciences
http://jap.iums.ac.ir
1
admin
2228-6659
2322-3324
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fa
jalali
1392
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gregorian
2013
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fa
بررسی مقایسـه اثـر استامینوفن وریـدی با کتامین بر کنتـرل درد
Comparison between ketamine and acetaminophen administered at the end of anesthesia for pain management after hysterectomy
مدیریت درد حاد
Acute pain managment
پژوهشي
Original
<p align="right" class="BasicParagraph" style="LINE-HEIGHT: normal MARGIN: 0in 0in 0pt" dir="rtl"><font face="B Nazanin"><strong><span class="a"><span lang="FA" style="LETTER-SPACING: -0.1pt FONT-SIZE: 11pt">زمینه و هدف: </span></span><span class="a"><span style="LETTER-SPACING: -0.1pt FONT-SIZE: 11pt" dir="ltr"></span></span></strong></font><p></p><p align="right" class="BasicParagraph" style="LINE-HEIGHT: normal MARGIN: 0in 0in 0pt" dir="rtl"><font size="2"><span class="a0"><span lang="FA" style="LETTER-SPACING: -0.1pt FONT-SIZE: 11pt"><font face="B Nazanin">جراحی</font></span></span><span class="a0"><span style="FONT-FAMILY: " dir="ltr"></span></span><font face="B Nazanin"><span class="a0"><span lang="FA" style="LETTER-SPACING: -0.1pt FONT-SIZE: 11pt">های شکمی روندی دردناک است که کنترل درد و عوارض ناشی از آن موجب ترخیص زود</span></span><span dir="ltr"></span><span dir="ltr"></span><span class="a0"><span lang="FA" style="LETTER-SPACING: -0.1pt FONT-SIZE: 11pt" dir="ltr"><span dir="ltr"></span><span dir="ltr"></span> </span></span><span class="a0"><span lang="FA" style="LETTER-SPACING: -0.1pt FONT-SIZE: 11pt">هنگام بیماران می </span></span></font><span class="a0"><span style="FONT-FAMILY: " dir="ltr"></span></span></font><span class="a0"><span lang="FA" style="LETTER-SPACING: -0.1pt FONT-SIZE: 11pt"><font face="B Nazanin"><font size="2">شود</font> و لذا تسکین درد پس از عمل دارای اهمیت زیادی است. امروزه استامینوفن وریدی یکی از داروهای شایع در اتاق </font></span></span><span class="a0"><span style="FONT-FAMILY: " dir="ltr"></span></span><span class="a0"><span lang="FA" style="LETTER-SPACING: -0.1pt FONT-SIZE: 11pt"><font face="B Nazanin">های عمل جهت کنترل درد بیماران می</font></span></span><span class="a0"><span style="FONT-FAMILY: " dir="ltr"></span></span><span class="a0"><span lang="FA" style="LETTER-SPACING: -0.1pt FONT-SIZE: 11pt"><font face="B Nazanin">باشد. کتامین نیز یک داروی بیهوشی است که جهت بیهوشی و بی</font></span></span><span class="a0"><span style="FONT-FAMILY: " dir="ltr"></span></span><span class="a0"><span lang="FA" style="LETTER-SPACING: -0.1pt FONT-SIZE: 11pt"><font face="B Nazanin">دردی استفاده می</font></span></span><span class="a0"><span style="FONT-FAMILY: " dir="ltr"></span></span><span class="a0"><span lang="FA" style="LETTER-SPACING: -0.1pt FONT-SIZE: 11pt"><font face="B Nazanin">شود. کارآزمایی بالینی دوسوکور حاضر با هدف مقایسه اثرات تجویز استامینوفن وریدی در پایان عمل هیسترکتومی با کتامین بر درد پس از عمل جراحی هیسترکتومی شکمی انجام شده است.</font></span></span><p></p><p align="right" class="BasicParagraph" style="LINE-HEIGHT: normal MARGIN: 0in 0in 0pt" dir="rtl"><strong><span class="a"><span lang="FA" style="LETTER-SPACING: -0.1pt FONT-SIZE: 11pt"><font face="B Nazanin">مواد و روش</font></span></span><span class="a"><span style="FONT-FAMILY: " dir="ltr"></span></span><font face="B Nazanin"><span class="a"><span lang="FA" style="LETTER-SPACING: -0.1pt FONT-SIZE: 11pt">ها:</span></span><span class="a"><span style="LETTER-SPACING: -0.1pt FONT-SIZE: 11pt" dir="ltr"></span></span></font></strong><p></p><p align="right" class="BasicParagraph" style="LINE-HEIGHT: normal MARGIN: 0in 0in 0pt" dir="rtl"><span dir="rtl"></span><span dir="rtl"></span><span class="a"><span style="LETTER-SPACING: -0.1pt FONT-SIZE: 11pt"><span dir="rtl"></span><span dir="rtl"></span><span style="mso-spacerun: yes"><strong><font face="B Nazanin" size="3"> </font></strong></span></span></span><span class="a0"><span lang="FA" style="LETTER-SPACING: -0.1pt FONT-SIZE: 11pt"><font face="B Nazanin">بیماران با توجه به معیارهای ورود و خروج، به</font></span></span><span class="a0"><span style="FONT-FAMILY: " dir="ltr"></span></span><font face="B Nazanin"><span class="a0"><span style="LETTER-SPACING: -0.1pt FONT-SIZE: 11pt" dir="ltr"> </span></span><span class="a0"><span lang="FA" style="LETTER-SPACING: -0.1pt FONT-SIZE: 11pt">طور تصادفی در یکی از گروه</span></span></font><span class="a0"><span style="FONT-FAMILY: " dir="ltr"></span></span><font face="B Nazanin"><span class="a0"><span lang="FA" style="LETTER-SPACING: -0.1pt FONT-SIZE: 11pt">های مداخله با 1 گرم استامینوفن وریدی(40 نفر) یا </span></span><span class="a1"><span lang="FA" style="LETTER-SPACING: -0.05pt"><font size="3">15/0</font></span></span><span class="a0"><span lang="FA" style="LETTER-SPACING: -0.1pt FONT-SIZE: 11pt"> میلی</span></span></font><span class="a0"><span style="FONT-FAMILY: " dir="ltr"></span></span><span class="a0"><span lang="FA" style="LETTER-SPACING: -0.1pt FONT-SIZE: 11pt"><font face="B Nazanin">گرم کتامین(40 نفر) قرار گرفتند. درد بیماران بر اساس معیار </font></span></span><font face="Times New Roman"><span class="a2"><span style="LETTER-SPACING: -0.1pt FONT-SIZE: 11pt" dir="ltr">VAS</span></span><span dir="rtl"></span><span dir="rtl"></span></font><span class="a0"><span lang="FA" style="LETTER-SPACING: -0.1pt FONT-SIZE: 11pt"><span dir="rtl"></span><span dir="rtl"></span><font face="B Nazanin">، تغییرات ضربان قلب، فشارخون و همچنین نمره آرام</font></span></span><span class="a0"><span style="FONT-FAMILY: " dir="ltr"></span></span><span class="a0"><span lang="FA" style="LETTER-SPACING: -0.1pt FONT-SIZE: 11pt"><font face="B Nazanin">بخشی بیماران توسط معیار رامسی در ریکاوری و در زمان</font></span></span><span class="a0"><span style="FONT-FAMILY: " dir="ltr"></span></span><font face="B Nazanin"><span class="a0"><span lang="FA" style="LETTER-SPACING: -0.1pt FONT-SIZE: 11pt">های 4 ، 6 ، 12 ، 24 </span></span><span class="a0"><span lang="FA" style="LETTER-SPACING: -0.1pt FONT-SIZE: 11pt">ساعت پس از عمل جراحی ثبت گردید. تهوع و استفراغ و همچنین میزان مصرف مسکن اضافی در هر دو گروه ثبت و مقایسه شد. </span></span></font><p></p><p align="right" class="BasicParagraph" style="LINE-HEIGHT: normal MARGIN: 0in 0in 0pt" dir="rtl"><strong><span class="a"><span lang="FA" style="LETTER-SPACING: -0.1pt FONT-SIZE: 11pt"><font face="B Nazanin">یافته</font></span></span><span class="a"><span style="FONT-FAMILY: " dir="ltr"></span></span><font face="B Nazanin"><span class="a"><span lang="FA" style="LETTER-SPACING: -0.1pt FONT-SIZE: 11pt">ها: </span></span><span class="a"><span style="LETTER-SPACING: -0.1pt FONT-SIZE: 11pt" dir="ltr"></span></span></font></strong><p></p><p align="right" class="BasicParagraph" style="LINE-HEIGHT: normal MARGIN: 0in 0in 0pt" dir="rtl"><span class="a0"><span lang="FA" style="LETTER-SPACING: -0.1pt FONT-SIZE: 11pt"><font face="B Nazanin">در مطالعه حاضر </font></span></span><font face="Times New Roman"><span class="a2"><span style="LETTER-SPACING: -0.1pt FONT-SIZE: 11pt" dir="ltr">VAS</span></span><span dir="rtl"></span><span dir="rtl"></span></font><span class="a0"><span style="LETTER-SPACING: -0.1pt FONT-SIZE: 11pt"><span dir="rtl"></span><span dir="rtl"></span><font face="B Nazanin"> <span lang="FA"><font size="3">بیماران همچنین میزان مصرف مسکن اضافی جهت کنترل درد تا حد مورد رضایت بیمار که هدف </font></span></font></span></span><span dir="ltr"></span><span dir="ltr"></span><span class="a0"><span lang="FA" style="LETTER-SPACING: -0.1pt FONT-SIZE: 11pt" dir="ltr"><span dir="ltr"></span><span dir="ltr"></span><span style="mso-spacerun: yes"><font face="B Nazanin" size="3"> </font></span></span></span><font face="Times New Roman"><span class="a2"><span style="LETTER-SPACING: -0.1pt FONT-SIZE: 11pt" dir="ltr">VAS<</span></span><span dir="rtl"></span><span dir="rtl"></span></font><span class="a0"><span lang="FA" style="LETTER-SPACING: -0.1pt FONT-SIZE: 11pt"><span dir="rtl"></span><span dir="rtl"></span><font face="B Nazanin">3 بود در گروه استامینوفن نسبت به گروه کتامین کمتر بوده است. عوارض جانبی همانند تهوع و استفراغ، مشکلات تنفسی و خواب آلودگی دو گروه تفاوت معنی</font></span></span><span class="a0"><span style="FONT-FAMILY: " dir="ltr"></span></span><span class="a0"><span lang="FA" style="LETTER-SPACING: -0.1pt FONT-SIZE: 11pt"><font face="B Nazanin">داری با هم نداشتند(05/0</font></span></span><span class="a0"><span lang="FA" style="FONT-FAMILY: "><</span></span><span class="a0"><span style="FONT-FAMILY: " dir="ltr">P</span></span><span dir="rtl"></span><span dir="rtl"></span><span class="a0"><span lang="FA" style="LETTER-SPACING: -0.1pt FONT-SIZE: 11pt"><span dir="rtl"></span><span dir="rtl"></span><font face="B Nazanin">). </font></span></span><p></p><p align="right" class="BasicParagraph" style="LINE-HEIGHT: normal MARGIN: 0in 0in 0pt" dir="rtl"><font size="1"><strong><span class="a"><span lang="FA" style="LETTER-SPACING: -0.1pt FONT-SIZE: 11pt"><font face="B Nazanin">نتیجه</font></span></span><span class="a"><span style="FONT-FAMILY: " dir="ltr"></span></span><font face="B Nazanin"><span class="a"><span lang="FA" style="LETTER-SPACING: -0.1pt FONT-SIZE: 11pt">گیری: </span></span><span class="a"><span style="LETTER-SPACING: -0.1pt FONT-SIZE: 11pt" dir="ltr"></span></span></font></strong></font><p></p><p align="right" style="DIRECTION: rtl"><span class="a0"><span lang="FA" style="LINE-HEIGHT: 115% LETTER-SPACING: -0.1pt FONT-SIZE: 11pt mso-fareast-font-family: Calibri mso-hansi-font-family: Calibri mso-ansi-language: EN-US mso-fareast-language: EN-US mso-fareast-theme-font: minor-latin mso-hansi-theme-font: minor-latin" dir="rtl"><font face="B Nazanin">تجویز استامینوفن وریدی در پایان عمل بیش از کتامین در کنترل درد پس از هیسترکتومی شکمی موثر می</font></span></span><span class="a0"><span style="LINE-HEIGHT: 115% FONT-FAMILY: "> <font face="B Nazanin">باشد.</font></span></span></p></p><p></p></p><p></p></p><p></p></p><p></p></p><p></p></p><p></p></p><p></p>
<p class="BasicParagraph" style="TEXT-ALIGN: justify LINE-HEIGHT: 200% MARGIN: 0in 0in 0pt unicode-bidi: embed DIRECTION: ltr mso-hyphenate: none"><font face="Times New Roman"><span class="abbold"><span style="LINE-HEIGHT: 200% FONT-SIZE: 11.5pt"><strong>Aim and Background: </strong></span></span></font></p><p class="BasicParagraph" style="TEXT-ALIGN: justify LINE-HEIGHT: 200% MARGIN: 0in 0in 0pt unicode-bidi: embed DIRECTION: ltr mso-hyphenate: none"><font face="Times New Roman"><span class="abbold"><span style="LINE-HEIGHT: 200% FONT-SIZE: 11.5pt"></span></span><span class="ab"><span style="LINE-HEIGHT: 200% FONT-SIZE: 11pt">Abdominal surgeries are usually very painful post-operatively for the patients consequently pain control would lead to a more rapid recovery period in patient and it would lower the complication rate.Nowadays intravenous Acetaminophen is one of the most prevalent drugs used in operating rooms to control pain.Ketamine also is an anesthetic drug, being a reasonable analgesic agent.This double blinded RCT has been done to compare the analgesic effect of paracetamol in comparison with ketamine on postoperative pain control after hysterectomy.<p></p></span></span></font></p><p class="BasicParagraph" style="TEXT-ALIGN: justify LINE-HEIGHT: 200% MARGIN: 0in 0in 0pt unicode-bidi: embed DIRECTION: ltr mso-hyphenate: none"><font face="Times New Roman"><span class="abbold"><span style="LINE-HEIGHT: 200% FONT-SIZE: 11.5pt"><strong>Methods and Materials:</strong></span></span></font></p><p class="BasicParagraph" style="TEXT-ALIGN: justify LINE-HEIGHT: 200% MARGIN: 0in 0in 0pt unicode-bidi: embed DIRECTION: ltr mso-hyphenate: none"><font face="Times New Roman"><span class="ab"><span style="LINE-HEIGHT: 200% FONT-SIZE: 11pt">Our patients were randomly allocated into two groups, according to the inclusion-exclusion criteria. The first group(40 patients) recieved 1 gram IV paracetamol and the second group (40 patients) recieved 0.15 mg per kg ketamine instead. The changes in blood pressure, heart rate, pain based on visual analogue score, and also the sedation Ramsay score were all evaluated at 4,6,12, and 24 hours after the operation. Moreover, nausea-vomiting and the amount of consumed analgesics were recorded and compared between the two groups<p></p></span></span></font></p><p class="BasicParagraph" style="TEXT-ALIGN: justify LINE-HEIGHT: 200% MARGIN: 0in 0in 0pt unicode-bidi: embed DIRECTION: ltr mso-hyphenate: none"><font face="Times New Roman"><span class="abbold"><span style="LINE-HEIGHT: 200% FONT-SIZE: 11.5pt"><strong>Findings:</strong></span></span></font></p><p class="BasicParagraph" style="TEXT-ALIGN: justify LINE-HEIGHT: 200% MARGIN: 0in 0in 0pt unicode-bidi: embed DIRECTION: ltr mso-hyphenate: none"><font face="Times New Roman"><span class="abbold"><span style="LINE-HEIGHT: 200% FONT-SIZE: 11.5pt"> A</span></span><span class="ab"><span style="LINE-HEIGHT: 200% FONT-SIZE: 11pt">ccording to our findings, the VAS scoreand the total analgesic use were both significantly less in the Acetaminophen group in comparison with the ketamine group. However there was no significant difference found in regards to sedation score, nausea-vomiting, and respiratory problems. (p> 0.05)<p></p></span></span></font></p><p class="BasicParagraph" style="TEXT-ALIGN: justify LINE-HEIGHT: 200% MARGIN: 0in 0in 0pt unicode-bidi: embed DIRECTION: ltr mso-hyphenate: none"><font face="Times New Roman"><span class="abbold"><span style="LINE-HEIGHT: 200% FONT-SIZE: 11.5pt"><strong>Conclusions:</strong></span></span></font></p><p class="BasicParagraph" style="TEXT-ALIGN: justify LINE-HEIGHT: 200% MARGIN: 0in 0in 0pt unicode-bidi: embed DIRECTION: ltr mso-hyphenate: none"><font face="Times New Roman"><span class="abbold"><span style="LINE-HEIGHT: 200% FONT-SIZE: 11.5pt"><strong> </strong></span></span><span class="ab"><span style="LINE-HEIGHT: 200% FONT-SIZE: 11pt">Prescribing paracetamol at the end of abdominal hysterectomy is significantly more effective for pain control than intravenous ketamine.<p></p></span></span></font></p><p style="DIRECTION: ltr" >
استامینوفن، هیسترکتومی شکمی، کتامین، بیدردی پس از عمل جراحی .
Acetaminophen, abdominal hysterectomy, ketamine, post-operative analgesia
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http://jap.iums.ac.ir/browse.php?a_code=A-10-1-4&slc_lang=fa&sid=1
Poupak
Rahimzadeh
پوپک
رحیم زاده
100319475328460010396
100319475328460010396
No
Iran University of Medical Sciences
دانشگاه علوم پزشکی ایران
Farnad
Imani
فرناد
ایمانی
100319475328460010397
100319475328460010397
No
Iran University of Medical Sciences
دانشگاه علوم پزشکی ایران
Mahzad
Alimian
مه زاد
علیمیان
100319475328460010398
100319475328460010398
No
Iran University of Medical Sciences
دانشگاه علوم پزشکی ایران
Behzad
Behzadi
بهزاد
بهزادی
100319475328460010399
100319475328460010399
No
Iran University of Medical Sciences
دانشگاه علوم پزشکی ایران
Seyed-Hamid-Reza
Faiz
سیدحمیدرضا
فیض
hrfaiz@hotmai8l.com
100319475328460010400
100319475328460010400
Yes
Iran University of Medical Sciences
دانشگاه علوم پزشکی ایران