fa مقایسه اثر بلوک فمورال توسط لیدوکائین و کتامین با لیدوکائین و دگزامتازون بر روی کاهش درد بعد از عمل جراحی شکستگی فمور مدیریت درد حاد Acute pain managment كاربردي Applicable <span style="font-size:11pt"><span style="tab-stops:227.0pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="line-height:107%"><span calibri="" style="font-family:"><b><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:107%"><span b="" style="font-family:" zar="">چکیده</span></span></span></b><b><span lang="FA" style="font-size:14.0pt"><span style="line-height:107%"><span style="font-family:"B Zar""></span></span></span></b></span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="line-height:107%"><span calibri="" style="font-family:"><b><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:107%"><span b="" nazanin="" style="font-family:">مقدمه</span></span></span></b><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:107%"><span b="" nazanin="" style="font-family:">: بلـوک عصـب فمـورال می توانـد جراحـی بـدون دردی را حیـن عمـل و کاهـش درد را بعـد از عمـل به همـراه داشـته باشـد. بنابراین این مطالعه با هدف </span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:107%"><span b="" nazanin="" style="font-family:">مقایسه اثر بلوک فمورال لیدوکائین و کتامین با لیدوکائین و دگزامتازون بر روی کاهش درد بعد از عمل جراحی شکستگی فمور انجام شد.</span></span></span><b><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:107%"><span style="font-family:"B Titr""></span></span></span></b></span></span></span></span></span><br> <span style="font-size:12pt"><span style="line-height:115%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span b="" lang="FA" nazanin="" style="font-family:">روش کار:</span></b><b> </b><span b="" lang="FA" nazanin="" style="font-family:">این مطالعه یک مطالعه کارآزمایی بالینی بوده است که جامعه آماری آن بیماران تحت عمل شکستگی فمور با کلاس بیهوشی </span>I<span b="" lang="FA" nazanin="" style="font-family:"> و </span>II<span b="" lang="FA" nazanin="" style="font-family:"> بود. بیماران در سه گروه </span>A<span b="" lang="FA" nazanin="" style="font-family:">:بلوک فمورال با لیدوکائین 1% (</span>kg/mg4<span b="" lang="FA" nazanin="" style="font-family:">) و کتامین (</span>mg50<span b="" lang="FA" nazanin="" style="font-family:">) ، گروه </span>B<span b="" lang="FA" nazanin="" style="font-family:">: بلوک فمورال با لیدوکائین 1% (</span>kg/mg4<span b="" lang="FA" nazanin="" style="font-family:">) و دگزامتارون (</span>mg8<span b="" lang="FA" nazanin="" style="font-family:">) و&nbsp; گروه </span>C<span b="" lang="FA" nazanin="" style="font-family:">: بلوک فمورال با لیدوکائین 1% (</span>kg/mg4<span b="" lang="FA" nazanin="" style="font-family:">) قرار گرفتند. با استفاده از دستگاه سونوگرافی و نیدل استریل (</span>mm90<span b="" lang="FA" nazanin="" style="font-family:"> و 26) تحت بلوک عصبی فمورال قرار گرفتند.</span>VAS<span b="" lang="FA" nazanin="" style="font-family:"> بیماران در 0 (بلافاصله بعد از، از بین رفتن بلوک اسپاینال) ،15 و 30 دقیقه و 1، 2، 3، 6، 9، 12، 24ساعت بعد از عمل چک شد. وقتی </span>VAS<span b="" lang="FA" nazanin="" style="font-family:"> بالای 3 بود،2/0 </span>kg/ mg<span b="" nazanin="" style="font-family:"> پتدین دریافت شد و در انتهای 24 ساعت مجموع دوز های دریافتی بیمار محاسبه گردید.</span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:115%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span calibri="" style="font-family:"><b><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:">یافته ها</span></span></span></b><b><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:">: </span></span></span></b>&nbsp;<span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:">نتایج مطالعه حاضر نشان داد که مقایسه</span></span></span> <span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:">اثر</span></span></span> <span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:">بلوک</span></span></span> <span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:">فمورال</span></span></span> <span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:">توسط</span></span></span> <span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:">لیدوکائین</span></span></span> <span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:">و</span></span></span> <span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:">کتامین</span></span></span> <span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:">با</span></span></span> <span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:">لیدوکائین</span></span></span> <span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:">و</span></span></span> <span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:">دگزامتازون</span></span></span> <span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:">بر روی</span></span></span> <span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:">کاهش</span></span></span> <span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:">درد</span></span></span> <span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:">بعد</span></span></span> <span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:">از</span></span></span> <span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:">عمل</span></span></span> <span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:">جراحی</span></span></span> <span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:">شکستگی</span></span></span> <span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:">فمور بر اساس شدت درد در دقیقه صفر، 15 و 30 وساعت 1، 2، 3، 24 بعد از عمل در گروه لیدوکائین وکتامین بیشترین میزان کاهش درد وجود داشت وکمترین میزان پتدین مصرفی بعد از عمل در گروه لیدوکائین و کتامین بود.</span></span></span><span lang="AR-SA" style="font-size:18.0pt"><span style="line-height:115%"><span style="font-family:"B Nazanin""></span></span></span></span></span></span></span></span><br> <b><span dir="RTL" lang="AR-SA" style="font-size:12.0pt"><span style="line-height:107%"><span b="" nazanin="" style="font-family:">نتیجه‌گیری:</span></span></span><a name="_Hlk185510760"> </a></b><span dir="RTL" lang="FA" style="font-size:12.0pt"><span style="line-height:107%"><span b="" nazanin="" style="font-family:">میزان شدت درد و دوز مخدر مصرفی بعد عمل در گروه&nbsp; بلوک کننده فمورال با لیدوکائین و کتامین </span></span></span><span dir="RTL" lang="AR-SA" style="font-size:12.0pt"><span style="line-height:107%"><span b="" nazanin="" style="font-family:">نسبت به گروه های دیگر کمتر بود و تفاوت معناداری داشت.</span></span></span> <span style="font-size:8pt"><span style="line-height:115%"><span calibri="" style="font-family:"><b><span style="font-size:12.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times="">Abstract</span></span></span></b></span></span></span><br> <span style="font-size:8pt"><span style="line-height:115%"><span calibri="" style="font-family:"><b><span style="font-size:12.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times="">Introduction</span></span></span></b><span style="font-size:12.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times="">: Femoral nerve block can lead to painless surgery during the operation and pain reduction after the operation. Therefore, this study was conducted with the aim of comparing the effect of lidocaine and ketamine with lidocaine and dexamethasone in&nbsp; femoral block &nbsp;on reducing pain after femur fracture surgery.</span></span></span></span></span></span><br> <span style="font-size:8pt"><span style="line-height:115%"><span calibri="" style="font-family:"><b><span style="font-size:12.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times="">Methods</span></span></span></b><span style="font-size:12.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times="">: This study was a clinical trial study, the statistical population of which was patients undergoing femur fracture surgery with class I and II anesthesia. Patients in three groups A: with lidocaine 1% (kg/mg 4) and ketamine (50 mg), group B: with lidocaine 1% (kg/mg 4) and dexamethasone (8 mg) and group C: with lidocaine 1% (kg/mg 4 ) it placed. He was subjected to femoral nerve block using an ultrasound device and a sterile needle (26 G). The patient&#39;s VAS was checked and at 0 (immediately after the removal of the spinal block), 15 and 30 minute after surgery, and 1, 2, 3, 6, 9, 12 and 24 hours after the operation. When the VAS was above 3, 0.2 mg/kg of pethidine was intravenous injected. at the end of 24 hours, the total doses received by the patient were calculated.</span></span></span></span></span></span><br> <span style="font-size:8pt"><span style="line-height:115%"><span calibri="" style="font-family:"><b><span style="font-size:12.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times="">Findings</span></span></span></b><span style="font-size:12.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times="">: The results of the present study showed that comparing the effect of lidocaine and ketamine in femoral block with lidocaine and dexamethasone on pain reduction after femur fracture surgery based on pain intensity at 0, 15 and 30 minutes and 1,2,3,24 hours after surgery &nbsp;was dominant in lidocaine and ketamine group.</span></span></span></span></span></span><br> <span style="font-size:8pt"><span style="line-height:115%"><span calibri="" style="font-family:"><b><span style="font-size:12.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times="">Conclusion</span></span></span></b><span lang="EN" style="font-size:10.0pt"><span style="line-height:115%"><span courier="" new="" style="font-family:">: </span></span></span><span lang="EN" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:">The intensity of pain and the dose of narcotics used after the operation in the femoral blocker group with lidocaine and ketamine were lower than the other groups and there was a significant difference.</span></span></span><b><span lang="EN" style="font-size:12.0pt"><span style="line-height:115%"><span style="font-family:"Times New Roman Bold",serif"></span></span></span></b></span></span></span><br> &nbsp; واژگان کلیدی: بلوک فمورال, شکستگی فمور, کتامین,دگزامتازون Key words: femoral block, femoral fracture, ketamine 1 10 http://jap.iums.ac.ir/browse.php?a_code=A-10-879-1&slc_lang=fa&sid=1 Mahshid Vaziri مهشید وزیری drvaziri83@yahoo.com 100319475328460019701 100319475328460019701 No Department of Anesthesia, Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran گروه بیهوشی، مرکز تحقیقات درد، دانشگاه علوم پزشکی جندی شاپور اهواز، اهواز، ایران Ali Ghomeishi علی قمیشی dr.alighomeishi@gmail.com 100319475328460019702 100319475328460019702 Yes Department of Anesthesia, Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran گروه بیهوشی، مرکز تحقیقات درد، دانشگاه علوم پزشکی جندی شاپور اهواز، اهواز، ایران Sina Shariati سینا شریعتی sina.shariati.md1984@gmail.com 100319475328460019703 100319475328460019703 No Department of Orthopedic, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran گروه اورتوپدی، دانشگاه علوم پزشکی جندی شاپور اهواز، اهواز، ایران mohamadreza Mozafari محمدرضا مظفری اورگان mozafari.mv@ajums.ac.ir 100319475328460019704 100319475328460019704 No Department of Anesthesia, Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran گروه بیهوشی، مرکز تحقیقات درد، دانشگاه علوم پزشکی جندی شاپور اهواز، اهواز، ایران