@article{ author = {Moshtaghion, Seyyed-hossein and Mohsenpour, Amir-mohammad and HashemianP, Zahra and Faiz, Hamid-rez}, title = {Comparison of the efficacy of intravenous Lidocaine and Remifentanil on hemodynamic responses at the time of extubation}, abstract ={Background and aimsWe have compared the effects of lidocaine, remifentanil and placebo on the hoemodynamicresponses to tracheal extubation.MethodsThis was a prospective, randomized clinical trial, double-blind study in 18 to 50 years old adultswith ASA I - II, undergoing an orthopedic surgery. Anesthesia was induced with fentanyl 2 μg/kgIV and propofol 1.5 mg/kg and atracurium 0.6 mg/kg, and maintained with propofol 100μg/kg/min and repeated doses of atracurium 0.2 mg/kg. Ten and 50 minutes before the end ofsurgery, propofol and fentanyl were discontinued respectively. At the end of surgery a bolusdose of Remifentanil 0.25 μg/kg or Lidocaine 1.5 mg/kg or 5 ml normal saline was given andtracheal extubation was performed after standard criteria acheivement. Arterial pressure andheart rate were recorded at the time of 1,5,10 intervals from the end of surgery.ResultsThere were statistically significant differences between the lidocaine and remifentanil groupwith respect to hemodynamic parameters (heart rate, diastolic blood pressure) at 5, 10 minintervals from the end of surgery. Systolic blood pressure at three times was significantlydifferent in three groups.ConclusionsRemifentanil is more effective than lidocaine on cardiovascular response control duringemergence from anesthesia and extubation.}, Keywords = {hemodynamic responses, remifentanil, lidocaine, extubation}, volume = {1}, Number = {3}, pages = {7-14}, publisher = { Iranian Society Of Regional Anesthesia And Pain Medicine}, url = {http://jap.iums.ac.ir/article-1-96-en.html}, eprint = {http://jap.iums.ac.ir/article-1-96-en.pdf}, journal = {Anesthesiology and Pain}, issn = {2228-6659}, eissn = {2322-3324}, year = {2010} } @article{ author = {Madineh, Hossain and Abedin-zadeh, Mohammad-reza and Jafari, Fatemeh}, title = {Comparison the Effect of Propofol and Thiopental on Patient Prognosis after Severe Traumatic Brain Injury}, abstract ={Background and aimsSecondary brain damage due to head trauma is one of the causes of death especially in young victims. Prolonged disability and death happen in most severe head trauma cases. Use of hypnotic drugs such as benzodiazeapine, barbiturates and propofol plus opioids cause sedation for respiratory support by mechanical ventilation. This study investigated the efficacy of thiopental in compare with propofol in mortality rate and prognosis of patients with severe head trauma.Material and methods130 patients suffering from head injury with GCS =8 randomly divided to two groups. They were treated with infusion of thiopental or propofol for 48 hours. Then their clinical signs improvement, mortality rate and remained of clinical symptoms evaluated for 3 months.ResultsPatients under propofol treatment had better prognosis than the other group.ConclusionsPropofol better protects brain tissue from hydrogen peroxide and reduces metabolic rate at early hours of injuries with better brain perfusion. These reduce secondary brain injury and secondary disability.}, Keywords = {Propofol,prognosis,thiopental,brain injury}, volume = {1}, Number = {3}, pages = {15-22}, publisher = { Iranian Society Of Regional Anesthesia And Pain Medicine}, url = {http://jap.iums.ac.ir/article-1-97-en.html}, eprint = {http://jap.iums.ac.ir/article-1-97-en.pdf}, journal = {Anesthesiology and Pain}, issn = {2228-6659}, eissn = {2322-3324}, year = {2010} } @article{ author = {Mosaffa, Faramarz and Karimi, Khoda-morad and Khoshnevis, Seyed-hass}, title = {Comparison the incidence of PDPH after median and paramedian spinal anesthesia technique in patients undergoing orthopedic surgery}, abstract ={Background and aimsSpinal Anesthesia is one of the safest Anesthesia methods with lower complications. The most common complication of spinal anesthesia is postdural puncture headache (PDPH) and it is very important to know which factors may increase the incidence of it, some factors that have relationship among variable and postdural puncture headache are studied and demonstrated.Method and materialIn a clinical trial study 150 patients who matched by age and sex, entered in following groups: median and paramedian techniques, randomly. Spinal puncture after the preparation of the patient performed in sitting position (for median approach or lateral position (for para median approach), the study was carried out in a double blind fashion, patients were evaluated 1 st postoperative day by an other Resident whether they have a headache or any related problems.ResultsThere were no difference between the two groups by sex and age. 7 patients (9.3%) in median and 8 patients (10.7%) in paramedian groupe had PDPH (P=0.875 & Odds ratio: 0.862, CI95% 0.676-1.048)ConclusionsThere was no difference between the two methods in the incidence of PDPH.}, Keywords = {Spinal Anesthesia,median techniques,paramedian techniques,PDPH}, volume = {1}, Number = {3}, pages = {23-28}, publisher = { Iranian Society Of Regional Anesthesia And Pain Medicine}, url = {http://jap.iums.ac.ir/article-1-98-en.html}, eprint = {http://jap.iums.ac.ir/article-1-98-en.pdf}, journal = {Anesthesiology and Pain}, issn = {2228-6659}, eissn = {2322-3324}, year = {2010} } @article{ author = {Entezary, Saeid-reza and Imani, Farnad and Alebouyeh, Mahmoud-reza and Seif, Amir-aziz}, title = {Blockade and Hemodynamic effects of Verapamil and Sufentanil during Axillary Brachial Plexus Blockade with Lidocain 1.5 %:A randomized, double-blinded study}, abstract ={Background and aimsAlthough calcium channel blockers such az verpamile are added to local anesthetics for regional anesthesia,rarely they may cause undesirable hemodynamic side effects This study compared the hemodynamic and blockade effects of verapamile and sufentanile during axillary brachial plexus blockade with lidocaine 1.5% .MethodsForty five patients were divided randomly into 3 groups. Patients in group 1 received 1.5% lidocaine patients group 2 received 105% lidocaine mixed with 5 mg verapamilepatients in group 3 received 1.5% lidocaine mixed with 5 mg verapa,ile and 5 μg sufentanile . Hemodynamic data were measured four times. The duration time of anesthesia and sensory block was recorded.ResultsThe beginning time of anesthesia was similar in 3 groups, but analgesia duration was significantly longer in groups 3 and 2 than in group 1 (p<0.05) . There were no significant differences in Hemodynamic data between 3 groups.ConclusionsVerapamile offers more stable hemodynamics and similar blockade, and thus may be beneficial for ASA I patients undergoing forearm and hand surgery.}, Keywords = {Lidocaine,verapamil,sufentanil,brachial plexus blockade,anesthesia,hemodynamic changes}, volume = {1}, Number = {3}, pages = {29-37}, publisher = { Iranian Society Of Regional Anesthesia And Pain Medicine}, url = {http://jap.iums.ac.ir/article-1-99-en.html}, eprint = {http://jap.iums.ac.ir/article-1-99-en.pdf}, journal = {Anesthesiology and Pain}, issn = {2228-6659}, eissn = {2322-3324}, year = {2010} } @article{ author = {Movassaghi, Reza and Dorosty, Abbas-ali and Agha-mohammadi, Davoo}, title = {Effect of Epidural Morphine in Controlling the Post- operative Pain after Microdiscectomy}, abstract ={Background and aimsNarcotics are commonly used in controlling of the postoperative pain. But few studies are available about direct narcotic spillage into surgical field. The aim of this study was to check the efficacy of this method for analgesia in postoperative lumbar microdiscectomy.MethodsIn a randomized clinical trial, numbers of 100 patients were included into two equal groups due to low back radicular pain and, underwent microdiscectomy. Study group received direct morphine (2mg/5mL) spillage and control group received normal saline (5mL) spillage as a placebo. The main outcome to be compared between trial and placebo groups were: Patient comfort rate in recovery room and ward, amount of analgesics used, postoperative ambulation time, post operative hospitalization days.ResultsMean Systolic blood pressure increment was lower in morphine group.The restlessness and agitation during recovery in study group was lower than control group. Only %6 of patients in study group compared to %98 in placebo group had either moderate or severe pain, six hours after operation.Mean morphine dose used for study group was 10.75 mg compared to 21.4 mg among control group patients (p<0.0001). Mean ambulation time was 2 days among study group patients compared to 2.6 days in control group. Mean hospitalization length was 4.7 and 7 days in study and control group respectively.ConclusionUsing epidural morphine spillage (EMS) during Lumbar microdiscectomy results in better control of postoperative pain, early ambulation of patients and decreased hospitalization length.}, Keywords = {Morphine,Epidural,Microdiscectomy,Postoperative pain}, volume = {1}, Number = {3}, pages = {38-44}, publisher = { Iranian Society Of Regional Anesthesia And Pain Medicine}, url = {http://jap.iums.ac.ir/article-1-100-en.html}, eprint = {http://jap.iums.ac.ir/article-1-100-en.pdf}, journal = {Anesthesiology and Pain}, issn = {2228-6659}, eissn = {2322-3324}, year = {2010} } @article{ author = {Alebouyeh, Mahmoud-reza and Iman, Farnad and Rahimzadeh, Poupak and Mohammadian-erdi, Ali and Faiz, Seyyed Hamid-rez}, title = {Evaluation the Efficacy of Intrathecal injection of Amitryptiline and Doxepin in Spinal Anesthesia and in comparison with Bupivacaine in Rats}, abstract ={Background and aimsNowadays tricyclic antidepressants (TCAs) are commonly used orally for treating chronic pain states, such as neuropathic pain. TCAs produce analgesia by various mechanisms involving Sodium channels, N-methyl-d-aspartate receptors, biogenic amines, opioids, inflammatory mediators, and substance P. Studies have shown that intrathecal tricyclic administration effectively attenuates pain and thermal hyperalgesia in inflammatory and neuropathic pain in rats.Materials and methodIn a double blind RCT study in animal lab intathecal injection of drugs performed in 30 Wistar male rats .They devided in 3 groupes. In G1, 90 μl Doxepine (50 mM), G2, 90 μl amitriptyline (60mM) and in G3, 90 μl bupivacaine(23 mM) was injected. Then sensory, motor and proprioceptive changes was measured in these hours: 1, 2, 3, 4, 6 and 12 by one examinerResultsThree rats died in G1 and G2. After adjusting the influences from different concentrations, amitriptyline had a similar potency but a longer duration of spinal blockade of motor, propioception, and nociception than did bupivacaine(p value<0.05). Whereas doxepine had a reasonable but lower efficacy and shorter duration of spinal blockade than did bupivacaine (P value<0.05). The full recovery times for G2 were significantly longer.ConclussionIt seems that tertiary amine drugs such as amitriptyline and doxepin, had reasonable potencies of spinal blockade when compared to bupivacaine. But amitriptyline has a more potent and long-acting spinal anesthetic effect. It may turn to be a clinical valuable local anesthetic.}, Keywords = {Doxepine,amitriptyline,bupivacaine,spinal blockade}, volume = {1}, Number = {3}, pages = {45-52}, publisher = { Iranian Society Of Regional Anesthesia And Pain Medicine}, url = {http://jap.iums.ac.ir/article-1-101-en.html}, eprint = {http://jap.iums.ac.ir/article-1-101-en.pdf}, journal = {Anesthesiology and Pain}, issn = {2228-6659}, eissn = {2322-3324}, year = {2010} } @article{ author = {Talebi, Houshang and Yazdi, Bijan and Alizadeh, Shabanali and Moshiry, Esmaleel and Nourozi, Afsaneh}, title = {Effects of adding two Doses of Midazolam to Lidocaine for Spinal Anesthesia on Post-operative Pain Severity in Patients undergoing Inguinal Herniorrhaphy}, abstract ={Background and aimsThe efficacy of adding midazolam to intrathecal bupivacaine has been widely documented. The aim of this study was to assess the effects of combination of intrathecal midazolam and lidocaine on postoperative pain.MethodsIn a randomized controlled trial that was performed in 2007 in a teaching hospital of Arak University of Medical Sciences, forty five male patients who were candidates for elective inguinal herniorrhaphy entered and randomly divided into three groups of Control (lidocaine 5% plus Normal saline), M0.5 (lidocaine 5% and midazolam 0.5mg) and M1 (lidocaine 5% and midazolam 1 mg) according to intrathecal solution injected for spinal anesthesia. Mean arterial blood pressure, heart rate, post-operative pain, narcotic requirements, and complications (nausea, vomiting, pruritis, headache, hypotension and bradycardia) were recorded.ResultsThe severity of post-operative pain was lowest in M1 group in all postoperative measurements except at 2 hours after operation.There was significant difference in vomiting between three groups which had the highest frequency in M0.5 group. No severe hypotension was seen though, bradycardia occurred in one patient in M0.5 group which needed treatment.ConclusionsOur findings suggest that administration of intrathecal midazolam (especially 1mg) together with lidocaine is effective in reducing post-operative pain in patients undergoing open inguinal herniorrhaphy and is not associated with adverse effect.}, Keywords = {Intrathecal,midazolam,lidocaine,spinal anesthesia,postoperative pain,inguinal herniorrhaphy}, volume = {1}, Number = {3}, pages = {53-62}, publisher = { Iranian Society Of Regional Anesthesia And Pain Medicine}, url = {http://jap.iums.ac.ir/article-1-102-en.html}, eprint = {http://jap.iums.ac.ir/article-1-102-en.pdf}, journal = {Anesthesiology and Pain}, issn = {2228-6659}, eissn = {2322-3324}, year = {2010} } @article{ author = {Imani, Farnad and Alimian, Mahzad and Radmehr, Mohammad and Deljou, Atousa and Mirabi, Nazani}, title = {Comparison of Morphine and Lornoxicam following PCIA on Pain after Laparoscopic Gastric Bypass Surgery}, abstract ={Background and aimsThe objective of our study was so to show the efficacy of PCIA with morphine or lornoxicam on the attenuation of postoperative pain after laparoscopic gastric bypass surgery.MethodsIn this randomized clinical trial, 60 patients who were candidates for laparoscopic gastric bypass surgery were included. Patients were randomly receiving morphine (n=30) or lornoxicam (n=30) through PCIA for postoperative pain relief, at the end of the procedure. Visual analogue scale (VAS), sedation score, and nausea and vomiting score (N;V score) were used up to 24 hours after laparoscopy. A physician, who was not aware of the therapy undertaken, evaluated the patients.ResultsThere were no statistically significant differences between two groups according to age, gender, and body mass index. Before intervention, the means of pain intensity (VAS) in the morphine and lornoxicam groups were 6.3±1.7 and 6.6±1.5, respectively. After 24 hours, the means reduced to 1.6±0.8 and 1.7±0.5, respectively (p<0.001). The changes of pain score were the same in two groups. During 24 hours follow-up, the means of sedation and N;V scores in patients receiving morphine were higher than the patients receiving lornoxicam significantly.ConclusionOur finding suggests that administration of lornoxicam through PCIA is as effective as administration of morphine through PCIA with in management of post-operative pain in patients undergone laparoscopic surgery. In addition, lornoxicam has less side-effect such as sedation, nausea and vomiting than morphine.}, Keywords = {Mirabi,lornoxicam,PCIA,laparoscopic gastric bypass}, volume = {1}, Number = {3}, pages = {63-70}, publisher = { Iranian Society Of Regional Anesthesia And Pain Medicine}, url = {http://jap.iums.ac.ir/article-1-103-en.html}, eprint = {http://jap.iums.ac.ir/article-1-103-en.pdf}, journal = {Anesthesiology and Pain}, issn = {2228-6659}, eissn = {2322-3324}, year = {2010} }