@article{ author = {Entezari, Saiedrez}, title = {Pain control and ACTH changes in postoperative intravenous analgesia versus epidural analgesia in limb orthopedic surgery patients}, abstract ={Background: The aim of this study is comparing ACTH changes in epidural and intravenous analgesia technique after lower limb orthopedic surgery.Methods: In a randomized clinical trial in Hazrat Rasool  Akram Hospital during 1387-88 , 60 patients candidate for surgery on the lower extremities were randomly allocated to receive either postoperative analgesia  with epidural analgesia (PCEA) or IV analgesia (PCIA). Measurement of ACTH levels and Visual analogue scale (VAS) was performed in four relief phases including at the time of arrival to the operating room, immediately after surgery and 12 hours after intravenous pump functionary and 24 hours after surgery were recorded.Results: The mean level of ACTH and VAS, 24 hours and 12 hours after surgery in the PCEA group were less than PCIA. Ramsey Sedation Score (RSS) in PCEA group at these intervals was more than PCIA cases.Conclusion: It seems that PCEA relieves pain more effectively than PCIA method. However, the proper method of anesthesia for each patient as well as patients;apos preferences should be considered in selecting the method of postoperative analgesia.}, Keywords = {ACTH,orthopedic surgery,intravenous analgesia,epidural analgesia,patient-controlled,pain}, volume = {2}, Number = {4}, pages = {1-2}, publisher = { Iranian Society Of Regional Anesthesia And Pain Medicine}, url = {http://jap.iums.ac.ir/article-1-50-en.html}, eprint = {http://jap.iums.ac.ir/article-1-50-en.pdf}, journal = {Anesthesiology and Pain}, issn = {2228-6659}, eissn = {2322-3324}, year = {2012} } @article{ author = {Entezari, Saiedreza and Alebouyeh, Mahmoudreza and Mohseni, Masood and Faiz, Hamidreza and Rahimzadeh, Poupak and safari, saee}, title = {Pain control and ACTH changes in postoperative intravenous analgesia versus epidural analgesia in limb orthopedic surgery patients}, abstract ={Background: The aim of this study is comparing ACTH changes in epidural and intravenous analgesia technique after lower limb orthopedic surgery.Methods: In a randomized clinical trial in Hazrat Rasool  Akram Hospital during 1387-88 , 60 patients candidate for surgery on the lower extremities were randomly allocated to receive either postoperative analgesia  with epidural analgesia (PCEA) or IV analgesia (PCIA). Measurement of ACTH levels and Visual analogue scale (VAS) was performed in four relief phases including at the time of arrival to the operating room, immediately after surgery and 12 hours after intravenous pump functionary and 24 hours after surgery were recorded.Results: The mean level of ACTH and VAS, 24 hours and 12 hours after surgery in the PCEA group were less than PCIA. Ramsey Sedation Score (RSS) in PCEA group at these intervals was more than PCIA cases.Conclusion: It seems that PCEA relieves pain more effectively than PCIA method. However, the proper method of anesthesia for each patient as well as patients' preferences should be considered in selecting the method of postoperative analgesia.}, Keywords = {ACTH,orthopedic surgery,intravenous analgesia,epidural analgesia,patient-controlled,pain}, volume = {2}, Number = {4}, pages = {3-10}, publisher = { Iranian Society Of Regional Anesthesia And Pain Medicine}, url = {http://jap.iums.ac.ir/article-1-51-en.html}, eprint = {http://jap.iums.ac.ir/article-1-51-en.pdf}, journal = {Anesthesiology and Pain}, issn = {2228-6659}, eissn = {2322-3324}, year = {2012} } @article{ author = {Alebouyeh, Mahmoudreza and Entezari, Saeidreza and Feiz, Hamidreza and Alaee, Atefe}, title = {Comparison of propofol with thiopental in hemodynamic changes and apnea duration in intensive care units for intubation of trachea}, abstract ={Background:Use of drugs with short apnea duration and less hemodynamic changes for intubation of trachea in intensive care units is necessary. This study compares the effects of propofol and sodium thiopental on hemodynamic changes and apnea duration after tracheal intubation in patients admitted to intensive care units. Methods:In this double blind clinical trial, 25 ICU-admitted patients were evaluated. They were intubated two times with 72 hours interval, once received 1.5mg/kg sodium thiopental, and the other time 0.75 mg/kg propofol, while the drug used for intubation in the first time was randomly selected. Hemodynamic variables include systolic and diastolic BP, heart rate, MAP, RPP, MAP/HR and apnea duration in two times, during pre intubation, intubation and after intubation were measured.Data were analysed with statistical tests of independent's t and ANOVA repeated test.Results: In comparison with pre-intubation, hemodynamic variables such as systolic and diastolic BP, MAP and MAP/HR were decresed during tracheal intubation in both groups, but range of changes in propofol group is less than those of thiopental group and the difference is statistically significant (P<0.0001).Conclusion:In comparison with thiopental, Propofol has fewer changes in hemodynamics in patients who needed tracheal intubation, and also has short er apnea period. Accordingly use of propofol over thiopental is recommended for tracheal intubation in ICU patients.}, Keywords = {propofol,sodium thiopental,hemodynamic changes,apnea duration,tracheal intubation}, volume = {2}, Number = {4}, pages = {11-19}, publisher = { Iranian Society Of Regional Anesthesia And Pain Medicine}, url = {http://jap.iums.ac.ir/article-1-52-en.html}, eprint = {http://jap.iums.ac.ir/article-1-52-en.pdf}, journal = {Anesthesiology and Pain}, issn = {2228-6659}, eissn = {2322-3324}, year = {2012} } @article{ author = {Hasani, Valiollah and Faiz, S.Hamid Reza and Seifi, Shahram and MoradiMoghadam, Omid and Niakan, Mohammad and Latifi, Shahrbanoo}, title = {Comparing the effect of continuous and intermittent feeding on the Ventilator-Associated Pneumonia in Intensive Care Unit Patients}, abstract ={background: Ventilator-Associated pneumonia (VAP) is the second common infections with high mortality (24-40%).In this study designed to determined effect of continuous(infusion) and intermittent(bolus) feeding on the Ventilator-associated Pneumonia in ICU Patient.Methods: This randomized controlled trial was performed on 76 patients admitted in ICU. They were randomly allocated to equal two groups (n=38). In case group, continuous feeding and in controlled group intermittent feeding was performed during the first five days. The incidences of early pneumonia(the first 3 to 5 days)and increase WBC (White Blood Cell) and PMN (Poly Morph Nuclear) in both groups were compared during the first 5 days. Results: The rate of increase in WBC(>11000/ml) and PMN(band cell>50%) in continuous group was 8 patients (10.5%) and in intermittent group were 7 patients (9.2%)  (pv=0.32). The incidences of early pneumonia(CPIS >or=6) in case group were 4 patients (5.3%) and in control group were 7 patients (9.2%)(pv=0.77). Conclusion: The results of this study showed that incidence of early VAP in case group was lesser, but this difference was not significant.Also, there was no significant difference in increase of WBC and PMN in both groups. }, Keywords = {Intermittent ventilator-associated pneumonia,continuous feeding,intermittent feeding,endotracheal tube,prevention}, volume = {2}, Number = {4}, pages = {19-24}, publisher = { Iranian Society Of Regional Anesthesia And Pain Medicine}, url = {http://jap.iums.ac.ir/article-1-53-en.html}, eprint = {http://jap.iums.ac.ir/article-1-53-en.pdf}, journal = {Anesthesiology and Pain}, issn = {2228-6659}, eissn = {2322-3324}, year = {2012} } @article{ author = {Talebi, Houshang and Kamali, Alireza and yazdi, Bijan and Salehjafari, Neda and Reihani, Zohre and Hendodari, Nasrin and Mehrabi, Maryam}, title = {Comparing the efficacy of low dose ketamine versus pethidine in controlling shivering after tonsillectomy surgery}, abstract ={Background:Postoperative shivering is one of the most common problems after general and local anesthesia. We compared the efficacy of low dose ketamine versus pethidine in controlling shivering after surgery.Methods : In a double-blind randomized Clinical trial, 132 ASA I,II patients candidate for tonsillectomy were randomized to receive either pethidine and ketamine.  At the time of arrival to the recovery and after 30 minutes, the occurrence of chills and possible complications were evaluated and compared between the two groups.Results : Two patients in the ketamin group (3%) experienced shivering while none of the patients in the pethidine group reported shivering (p>0.05). Other complications were more in the ketamin group (p<0.05)Conclusion :  Ketamin and pethidine are equally effective in controlling postoperative shivering, but regarding the lower incidence of other complications, pethidine is still the first choice of treatment.}, Keywords = {Shivering,Ketamin,Petedine,Tonsillectomy,general anesthesia}, volume = {2}, Number = {4}, pages = {25-29}, publisher = { Iranian Society Of Regional Anesthesia And Pain Medicine}, url = {http://jap.iums.ac.ir/article-1-54-en.html}, eprint = {http://jap.iums.ac.ir/article-1-54-en.pdf}, journal = {Anesthesiology and Pain}, issn = {2228-6659}, eissn = {2322-3324}, year = {2012} } @article{ author = {Hassani, Valiollah and imani, Farnad and Alimian, Mahzad and abdolalizadeh, Masoumeh}, title = {Comparing the analgesic effect Pregabalin and Gabapentin as premedication in laparoscopic procedures}, abstract ={Background: Laparascopic surgery is associated with post operative pain .optimal pain treatment with minimal side effects is essential for early recovery and mobility in patients undergoing laparoscopic surgery .we compaired the analgesic effect Pregabalin and Gabapentin with different doses in this surgical procedurs.Methods: In a randomized , double blind , ninety patients were  allocated to either Group A Pregabalin 300mg , GroupB Gabapentin 600mg and GroupC Gabapentin 900mg .these were administered 1 h before operation .General anesthesia was performed .we collected data on pain intensity through Visual Analogue Scale (VAS) in recovery , 6 , 24 h after operation. Consumption of supp Diclofenac were recorded . p<0.05  was considered statistically significant.Results:  Pregabalin 300 mg  was significantly more effective in reducing post operative pain up to 24 hours following  the surgery (p<0.001) . Furthermore , the amount of analgesic consumption was less in the  Pregabalin group (p<0.001). consumption analgesic and VAS were more than the other groups in patient who receive Gabapentin 600 mg.Conclusions: Our finding showed that single dose of  pregabalin 300mg oral  is more effective than Gabapatin on the management of postoperative pain following abdominal laparoscopic surgery. And Pregabalin resulted in reduction in 24 h postoperative analgesic requirements.Gabapentin 900mg decrease VAS and consumption of analgesic significantly.}, Keywords = {Gabapentin,Pregabalin,laparoscopic surgery,VAS}, volume = {2}, Number = {4}, pages = {30-37}, publisher = { Iranian Society Of Regional Anesthesia And Pain Medicine}, url = {http://jap.iums.ac.ir/article-1-55-en.html}, eprint = {http://jap.iums.ac.ir/article-1-55-en.pdf}, journal = {Anesthesiology and Pain}, issn = {2228-6659}, eissn = {2322-3324}, year = {2012} } @article{ author = {Mohseni, Masoud and Ebneshahidi, Seyed amin and Mobasherizadeh, Si}, title = {Bacterial colaonization of endotracheal tube connectors after 24,48 and 72 hours of  repeated intubation}, abstract ={Background: Colonization of bacteria on the equipments in touch with airway and respiratory mucosa may cause respiratory infections. According to available protocols, endotracheal tube connectors should be disposable, but because of financial issues many hospitals use it more than once. In the present study, the colonization rate of endotracheal tube connectors after 24, 48 and 72 hours of administration in multiple patients on mechanical ventilation in the operating room was assessed.Methods: In this study, 150 endotracheal tube connectors after repeated use in different patients have been sampled and cultured using standard microbiological methods. Samples were categorized in three groups based on the duration of administration (24, 48 or 72 hours). Colony counts were identified and compared among the three groups. Results: Colonization rate after 24, 48 and 72 hours of usage was 2%, 18% and 30%, respectively (p<0.05). Separated bacteria usually were in kinds of Streptococci, Bacillus SP, Coagulate negative staphylococci, Klebsiella SP and Mold.Conclusion:    Using endotracheal tube connector for more than 24 hours significantly increases the colonization rate. In hospitals with limited financial resources, repeated use of endotracheal tube connector up to twenty four hours maybe acceptable.  }, Keywords = {colonization,ventilator,endotracheal tube connector,bacteria}, volume = {2}, Number = {4}, pages = {38-42}, publisher = { Iranian Society Of Regional Anesthesia And Pain Medicine}, url = {http://jap.iums.ac.ir/article-1-56-en.html}, eprint = {http://jap.iums.ac.ir/article-1-56-en.pdf}, journal = {Anesthesiology and Pain}, issn = {2228-6659}, eissn = {2322-3324}, year = {2012} } @article{ author = {Sajedi, Parvin and Hosseini, Behnam and Ehsanpour, Elahe and Momenzade, Sirus}, title = {Evaluating the Efficacy of Extraplural versus Epidural Analgesia for post-thoracotomy pain }, abstract ={Background: Thoracotomy is a particularly painful surgery and good pain control is crucial to maximize the ability to cough and breath. The most common methods of post operative pain management are systemic narcotics and epidural adminstration of local anesthetic agents or narcotics. The purpose of the persent study was to compare postthoracotomy analgesia of extraplural and epidural catheters.Methods: This is a randomized clinical control trial study performed in Alzahra;aposs hospital of medical university of Isfahan. 64 patients were randomized in two groups.In group A, 15cc %0/125 bupivacaine before surgery and in group B, 10cc %0/5 bupivacaine at the end of surgery were injected and repeated every hour post operatively. Visual analog scale in two group collected and comparcd.Result: VAS in epidural catleter was better than extra plural catheter but this difference is not significant. (P<0/05). No significant respiratory complication wre reported in both group.Conclusion: Due to results this difference is related to position, drainage of chest tube, volume of local anesthetic and type of surgery in the extra plural groups. Because of no significant difference between them we can use this techniques based on experience and preference of anesthesiologist and surgeon.}, Keywords = {Thoracotomy,epidural,extrapleural,bupivacaine}, volume = {2}, Number = {4}, pages = {43-51}, publisher = { Iranian Society Of Regional Anesthesia And Pain Medicine}, url = {http://jap.iums.ac.ir/article-1-57-en.html}, eprint = {http://jap.iums.ac.ir/article-1-57-en.pdf}, journal = {Anesthesiology and Pain}, issn = {2228-6659}, eissn = {2322-3324}, year = {2012} } @article{ author = {Homaee, Mohammadmohsen and Ghodrati, Mohammadreza and Farazmehr, Kourosh and Soleimani, Masoud and Pournajafian, Alireza and abdaviazarsharbiani, maji}, title = {Blood loss and quality of controlled hypotension induced by Magnesium Sulfate versus Remifentanil in PSF surgery}, abstract ={Background: Blood loss is one of the most critical problems in major surgery. Spinal surgery usually associated with considerable blood loss and allogenic transfusions. Controlled hypotension is one of efficient methods for decreasing operative blood loss. The objective of this study was evaluation of the efficacy of magnesium sulfate in comparison with remifentanil for induction of relative hypotension in posterior fusion of spine surgery. Methods: In this double blind randomized clinical trial, 40 patients with ASA I & II physical status candidate for lumbar posterior spinal fusion surgery were enrolled and assigned in two groups (remifentanil and magnesium sulfate) randomly. After the induction of anesthesia and giving the prone position, relative controlled hypotension was induced for one group with 0.15 µg/kg remifentanil infusions and in second group with 50 mg/kg loading dose and then 15 mg/kg/hr magnesium sulfate infusion. All other aspects of anesthesia and surgery were similar in two groups. The target MAP range used in this study was 60-70 mmhg. In the course of surgery the hemodynamic variables, volume of blood loss, urine output, fluid intake and surgeon's satisfaction were recorded. Data was analyzed with SPSS version 13 software and P- value less than 0.05 was considered meaningful.   Results: Twenty patients in Mg group and 19 patients in remifentanil group were studied. There was no statistical difference between two groups according to the hemodynamic variables, volume of blood loss, urine output, fluid intake and surgeon's satisfaction (p > 0.05). The target mean arterial pressure was achieved in 75% of Mg and 58% of remifentanil groups. Although, the frequency of TNG consumption was higher (42.1%) in remifentanil group than magnesium sulfate (25%), but this difference wasn't statistically significant (p= 0.320).Conclusions: Our finding showed that in patients undergoing lumbar posterior spinal fusion surgery, remifentanil and magnesium sulfate has the same hypotensive effect and the volume of blood loss without any significant side effects.}, Keywords = {Controlled hypotension,Magnesium sulfate,Remifentanil,Lumbar Posterior Spine Fusion (PSF),Blood loss,Clinical trial}, volume = {2}, Number = {4}, pages = {52-62}, publisher = { Iranian Society Of Regional Anesthesia And Pain Medicine}, url = {http://jap.iums.ac.ir/article-1-58-en.html}, eprint = {http://jap.iums.ac.ir/article-1-58-en.pdf}, journal = {Anesthesiology and Pain}, issn = {2228-6659}, eissn = {2322-3324}, year = {2012} } @article{ author = {Sedighinejad, Abbas and Haghighi, Mohammad and Ettehad, Hossein and Naderi-nabi, Bahram}, title = {Case report: Hereditary methemoglobinemia during general anesthesia, a diagnostic and therapeutic review}, abstract ={The case report that will be presented is an inherited methemoglobinemia , during general anesthesia of 36year old patient and was suspected by some clinical xamination such a decrease oxygen saturation in pulse oximetry and a normal finding in ABG sample that have been prepared at the preparation of patient for anesthesia .So we are going to write about this problem in the perioperative period and how to manage it.}, Keywords = {}, volume = {2}, Number = {4}, pages = {63-67}, publisher = { Iranian Society Of Regional Anesthesia And Pain Medicine}, url = {http://jap.iums.ac.ir/article-1-59-en.html}, eprint = {http://jap.iums.ac.ir/article-1-59-en.pdf}, journal = {Anesthesiology and Pain}, issn = {2228-6659}, eissn = {2322-3324}, year = {2012} } @article{ author = {Imani, Farnad and Abolhasan-gharehdaghi, Fari}, title = {Review articles: Efficacy of Low Level Laser Therapy in fibromyalgia and myofacial pain syndrome}, abstract ={Background: Myofacialpain syndrome and fibromyalgia are two painful  clinical disorders of soft tissues that encountered to pain specialists. Low level laser therapy is  one of the non-pharmacological treatment modalityseems controversial.  Aim of this review articles is to investigate of  the efficacy of low level laser therapy (LLLT) in fibromyalgia  and myofacial  pain patients in the literature.Methods: A comprehensive evaluation of the literature relating to LLLT in fibromyalgia and myofacial pain syndrome patients was performed. 34 articles allocated for this studyThe time frame covered was 2000 to 2010. Not only the journals of laser therapy allocated for this study, but alsovarieties of journals of medicine specialties selected for avoidance of bias error.Results: From 34 articles, 13 articles supported, the efficacy of low level  laser therapy in pain score, in 12 studies there was no difference between (LLLT) and placebo and did not study for pain criteria in  9 studies. In case of the number of trigger points, 2 studies supported, the efficacy of(LLLT), there was no difference  between (LLLT) and placebo in  5 studies and did not study for number of trigger points in 9 studies. For patient;aposs quality of life, (LLLT) significantly improved of this criteria in 10 studies,there was no difference between (LLLT) and placebo in 7 studies and did not study for patient;aposs quality of life in 7studies.  The increased levels of 5-hydroxy-tryptamine, 5-hydroxy-tryptophan and 5-hydroxy indol acetic acid, reported in one sudy.Conclusion: This study revealed that, application of LLLT was effective in pain relief, improvement of functional ability  and   patient;aposs quality of life and number of trigger points in 15 studies. However, no significant differences were obtained between placebo and LLLT in 6 studies. In conclusion, although the laser therapy has no superiority over placebo in few groups in this study, we cannot exclude the possibility of effectivity of LLLT in fibromyalgia and myofacialpian syndrome patients. We recommended another treatment regimen including different laser wavelengths and dosages (different intensity and density and/or treatment interval) for this aim.}, Keywords = {Low level laser therapy,fibromyalgia,myofacial pain syndrome,pain}, volume = {2}, Number = {3}, pages = {1-8}, publisher = { Iranian Society Of Regional Anesthesia And Pain Medicine}, url = {http://jap.iums.ac.ir/article-1-60-en.html}, eprint = {http://jap.iums.ac.ir/article-1-60-en.pdf}, journal = {Anesthesiology and Pain}, issn = {2228-6659}, eissn = {2322-3324}, year = {2011} } @article{ author = {Taghipor­anvari, Zahra and Sheibani, Shima and Imani, Farnad and Sheibani, Shadi}, title = {Comparison of three Oral Premedication Dextrometorphan, Diphenhydramine and Midazolam in Pediatric Eye Exam under Anesthesia}, abstract ={Background: The pre anesthetic management and separation anxiety of infants and children can be a challenge for the anesthesiologist. In this study we compared the effects of dextromethorphan, diphenhydramine and midazolam for this purpose.Methods: Ninety  1-6 year old patient candidate for Eye Examination Under Anesthesia (EUA) were randomly assigned into one of 3 groups receiving Diphenhydramine syrup(1mg/kg) , Dextromethorphan syrup (1mg/kg) or oral Midazolam (0.3mg/kg) 20 to 30 minutes before entering into the operating room, and were evaluated in a randomized clinical trial. Sedation score was evaluated 1)at 20 minutes after premedication and with the child untouched, 2)on separation from parents, 3)during mask induction and IV line insertion and 4)15 minutes from the beginning of recovery. Duration of anesthesia and recovery were considered too. One way ANOVA and repeated measurement of analysis was used for data analysis. Results: sedation scores before the child getting touched were significantly better for group dextromethorphan (p = o.o4). There was no statistically significant difference among groups on separation from parents (p=0.348). Sedation scores were significantly better in Dextromethorphan group during induction of anesthesia and in the recovery too (p=0.002 and p=0.001 respectively). There were no significant differences among groups in duration of anesthesia and recovery.Conclusions: Our finding showed that dextromethorphan can provide an acceptable level of sedation and anxiolysis in children without increasing the recovery time and is comparable to midazolam, as a routine premedication in this setting.  }, Keywords = {Premedication,pediatric anesthesia,midazolam,dextromethorphan HBR,diphenhydramine HCl}, volume = {2}, Number = {3}, pages = {9-17}, publisher = { Iranian Society Of Regional Anesthesia And Pain Medicine}, url = {http://jap.iums.ac.ir/article-1-61-en.html}, eprint = {http://jap.iums.ac.ir/article-1-61-en.pdf}, journal = {Anesthesiology and Pain}, issn = {2228-6659}, eissn = {2322-3324}, year = {2011} } @article{ author = {Abbasi, Hamid-reza and Ayatolahi, Vida and Behdad, Shekufeh and Zareh, Habib and Dehghan-­­­­­tazarjani, Mohamad and Heyranizadeh, Najmeh}, title = {Comparison of General Anesthesia and Spinal Anesthesia on Maternal and Neonatal Central Temperature during Cesarean Section}, abstract ={Background: Hypothermia is the most common complication of general and neuroaxial anesthesia. In previous studies, the effects of anesthesia on the temperature were assessed in different surgeries.  In this study we evaluated the effects of general and spinal anesthesia on the core temperature of the mother and neonate in cesarean section. Methods: Eighty pregnant women were randomly assigned to receive general or spinal anesthesia. Maternal core temperature was measured five times with a digital ear thermometer just before anesthesia, at the beginning of surgery, after delivery, 30 and 60 minutes after the end of the operation. In addition, umbilical vein blood was sampled for pH. The rectal temperatures of the babies were recorded immediately after delivery by rectal probe, and Apgar scores were determined 1 and 5 min after birth.Results :There were no differences between maternal and newborn temperatures in different times in both groups, but, the umbilical vein pH value were lower in the spinal anesthesia group. Temperature of the operating room was 26 and recovery was 20.Conclusion: According to the results of this study, spinal and general anesthesia have similar effects on core temperatures in mothers underwent cesarean section.}, Keywords = {Spinal anesthesia,general anesthesia,caesarian,hypothermia}, volume = {2}, Number = {3}, pages = {18-26}, publisher = { Iranian Society Of Regional Anesthesia And Pain Medicine}, url = {http://jap.iums.ac.ir/article-1-62-en.html}, eprint = {http://jap.iums.ac.ir/article-1-62-en.pdf}, journal = {Anesthesiology and Pain}, issn = {2228-6659}, eissn = {2322-3324}, year = {2011} } @article{ author = {Mirkheshti, Ali-reza and Aryani, Mohammad-reza and Dabbagh, Ali and Jabbary-moghaddam, Morteza and Razavi, Seyyed-Sajjad and Elyasi, Hedayatollah and Mohammadi-tofigh, Arash}, title = {Comparison of Magnesium Sulfate and Paracetamol in Analgesic Effect and Venous Blood Gas Alterations during Intravenous Regional Anesthesia with Lidocaine}, abstract ={Background: Intravenous regional anesthesia (IVRA) is an efficient method for short-term procedures of the upper extremities. Some defects are associated with IVRA including tourniquet-related pain and insufficient duration of the anesthesia. The main purpose of the current study was to compare the effects of adding paracetamol or magnesium sulfate to lidocaine in IVRA on pain, venous blood gasses (VBG) and sensory and motor block.Methods: There were 90 patients contributed in the current study. Patients were divided into paracetamol (P), magnesium sulfate (Mg) and control (C) groups, randomly. Severity of the pain, time interval between the injection and onset of the sensory and motor block, duration of the sensory and motor block and the changes of VBG were measured.Results: The onset of the sensory and motor block was reduced significantly in Mg group (p<0.05). There was a meaningful increase in the motor block duration in Mg group in relation to C group (p<0.05), but no statistically significant difference between Mg and P groups. Also, there was no meaningful difference between C and P groups in the means of onset of block and block duration. Neither MgSO4 nor paracetamol decreased the tourniquet-related pain. The changes of VBG were significantly lesser in the P group.Conclusion:  Adding MgSO4 to lidocaine improves the sensory and motor block in the IVRA. In other hand, paracetamol prevents ischemic changes to occur. None of these drugs are helpful to relief the tourniquet-related pain.}, Keywords = {Intravenous regional anesthesia,lidocaine, paracetamol,magnesium sulfate,sensory block,motor block,venous blood gasses}, volume = {2}, Number = {3}, pages = {27-37}, publisher = { Iranian Society Of Regional Anesthesia And Pain Medicine}, url = {http://jap.iums.ac.ir/article-1-63-en.html}, eprint = {http://jap.iums.ac.ir/article-1-63-en.pdf}, journal = {Anesthesiology and Pain}, issn = {2228-6659}, eissn = {2322-3324}, year = {2011} } @article{ author = {Ebrahim-soltani, Ali-reza and Maleki, Anahid and Goodarzi, Mehrdad and Afkham, Khosro and Akhoondzadeh, Shahin and Kazemi, Hadi and Arbabi, Shahriar and Peyro, Abdollah}, title = {The Evaluation of Blood Glucose and Serum Electrolyte changes before and after Electroconvulsive Therapy under General Anesthesia}, abstract ={Background: Electroconvulsive therapy (ECT) is used in the treatment of various medicalconditions such as severe depression, mainly in situations where the patient does not respondeffectively to drug treatment and during pregnancy where drug intake can result in severecomplication for fetus. ECT  carried out under general anesthesia, therefore before ECT some physical exam and some lab data is necessary. Patients who are ECT candidates also include diabetic patients which renders the study of the effect of ECT on blood glucose and serum electrolyte level significantly important.Methods: Blood sample were taken from patients before induction of anesthesia. After 30 seconds preoxygenation anesthesia was induced by making use of sodium thiopental and succiniylcholine .20 minutes after ECT, the second blood samples were taken. The resulting data was gathered and then subjected to statistical analysis.Results: To investigate changes in blood sugar and serum electrolytes level in 70 patients who were subjected to ECT, significant changes were noted in pre and post ECT in glucose between men and  women and sodium in men and women and potassium in men. But no significant changes were noted in pre and post ECT calcium level and in potassium level in women.Conclusion: ECT carried out under general anesthesia therefore pre ECT physical exam andblood samples are required. Electrolytes change under ECT, therefore attention to theseelectrolytes specially sodium and potassium  are important}, Keywords = {Blood glucose change,serum electrolytes,electroconvulsion therapy}, volume = {2}, Number = {3}, pages = {38-42}, publisher = { Iranian Society Of Regional Anesthesia And Pain Medicine}, url = {http://jap.iums.ac.ir/article-1-64-en.html}, eprint = {http://jap.iums.ac.ir/article-1-64-en.pdf}, journal = {Anesthesiology and Pain}, issn = {2228-6659}, eissn = {2322-3324}, year = {2011} } @article{ author = {Dalili, Amir-reza and Mardani-­kivi, Mohsen and Alizadeh, Ahmad and Hatamian, Hamid-reza and Hoseininejad, Mozaffar and Peyrazm, Hamid and Saheb-ekhtiari, Khashayar and Hashemi-motlagh, Keyv}, title = {Comparison between Sonography and Electrodiagnostic Testing in the Diagnosis of Carpal Tunnel Syndrome }, abstract ={Background: Progress in high-contrast ultrasound technology in recent years brought more attention to its rule in the diagnosis of carpal tunnel syndrome (CTS). The aim of this study is to evaluate the diagnostic value of sonography in the diagnosis of CTS and its relationship with disease severity.Methods: In this prospective study, 100 patients who had unilateral upper extremity involvement were studied. All patients were initially undergone electro diagnostic test and the test was assumed as the gold standard. Afterwards the cross-sectional area and anteroposterior diameter of the median nerve in the carpal tunnel inlet and outlet and the thickness of the flexor retinaculum were measured by ultrasound in all patients. Relationships between ultrasound and electro diagnostic findings were evaluated using SPSS software ver. 19th.Results: Patients included 84 women and 16 men in the age range 19 to 72 years (mean age 44.43 ± 12.05 years). Among the criteria evaluated, the proximal and distal cross sectional area of the nerve showed significant correlation with disease diagnosis (P= 0.018 and P= 0.022 respectively). In addition, significant relationship was found between mentioned two criteria and the severity of the disease (P<0.05 both). The best cut-off point at the proximal cross sectional area was 9.45 mm2 in which the sensitivity was 78.9%, specificity was 82.8%, positive predictive value was 91.8% and negative predictive value was 61.5%.Conclusion: The present study indicated that evaluating the cross sectional area of the median nerve using ultrasound at the carpal tunnel inlet is useful in diagnosing CTS. According to its high sensitivity, specificity and positive predictive value, it is not only useful in diagnosing suspected patients but also can be useful in screening the population at risk.}, Keywords = {Carpal Tunnel Syndrome,ultrasonography,electrodiagnosis}, volume = {2}, Number = {3}, pages = {43-51}, publisher = { Iranian Society Of Regional Anesthesia And Pain Medicine}, url = {http://jap.iums.ac.ir/article-1-65-en.html}, eprint = {http://jap.iums.ac.ir/article-1-65-en.pdf}, journal = {Anesthesiology and Pain}, issn = {2228-6659}, eissn = {2322-3324}, year = {2011} } @article{ author = {Mohammadzadeh, Ali and Haghighi, Mohammad and Amir-alavi, Sirous and Naderi-nabi, Bahram and Mohammadzadeh, Ali and Nekoofard, Majid and Abad, Mohse}, title = {A Comparison of Effects of Alfentanil, Magnesium Sulfate and Ketamin on Reduction the Pain during Propofol Injection}, abstract ={Background: Propofol is one of the most common drugs used in anesthesia induction and the pain during its intravenous injection is the most important and another side effect of it. Therefore a lot of methods and drugs are examined to reduce or eliminate this side effect. In this study the effects of Alfentanil, Magnesium sulfate and Ketamin drugs on reducing of pain during intravenous injection of propofol are investigated. Methods: This study was performed on 220 patients who were under orthopedic surgery in Poursina hospital in 2010. The intensity of propofol intravenous injection pain is measured after using premedication by VAS, result is analyzed by SPSS v16 software under Chi square and PostHoc exams.Results: According to data and variance analysis statistic exam ANOVA it is definded that after propofol injection there is a meaningful difference in quantity of VAS among studied groups (Chi square = 49.78 and df = 3 and P0.05).Conclusion: Despite reduction the propofol intravenous injection pain in three studies drugs in this thesis, there is no preference among them.}, Keywords = {Alfentanil,anesthesia,general,infusion,parenteral,ketamine,magnesium sulfate,pain,Propofol}, volume = {2}, Number = {3}, pages = {52-58}, publisher = { Iranian Society Of Regional Anesthesia And Pain Medicine}, url = {http://jap.iums.ac.ir/article-1-66-en.html}, eprint = {http://jap.iums.ac.ir/article-1-66-en.pdf}, journal = {Anesthesiology and Pain}, issn = {2228-6659}, eissn = {2322-3324}, year = {2011} } @article{ author = {Imani, Farnad and Entezary, Saeid-­­reza and Alebouyeh, Mahmoud­-reza and Faiz, Hamid­-reza and Nikpour, Karim}, title = {Comparing the Analgesic Effects of adding Ketamine to Morphine with Tramadol after Major Abdominal Surgery under General Anesthesia}, abstract ={Background: Postoperative pain control is one of the problems for these patients. Opioid agents are the most important analgesics which commonly used for postoperative pain control. There are several trials for reducing the doses of opioids. It seems addition of ketamine to the opioids other than postoperative pain relief, reduces the total opioid consumption. The goal of this study was evaluation of postoperative analgesic effects of adding ketamine to morphine and tramadol after major abdominal surgery. Methods: Eighty patients candidate for major abdominal surgery under similar general anesthesia were enrolled in this study. Postoperative pain was managed by iv patient controlled analgesia (PCA) for aal patients. After the end of surgery, they were randomly allocated into the 1) morphine (M), 2) tramadol (T), 3) ketamine and morphine (KM), and 4) ketamine and tramadol (KT) groups. Analgesic solution in PCA in M group was morphine (0.2 mg/ml), in T group was tramadol (2 mg/ml), in KM group was ketamine (2 mg/ml) and morphine (0.2 mg/ml), and in KT group was ketamine (2 mg/ml) and tramadol (2 mg/ml). Visual analogue scale (VAS), total opioid consumption, complications, and satisfaction were measured and recorded for during the first 24 hours after surgery. Results: Demographic data was not differences between groups. Pain score in early period (1st and 6th hours) was significantly lower in KM group than the others. Furthermore, addition of ketamine significantly reduced total morphine and tramadol consumption. No side effects were observed in the all groups. Conclusions: Our finding showed that addition of ketamine to morphine could reduce pain score and total opioid consumption after major abdominal surgery.}, Keywords = {Pain score,major abdominal surgery,ketamine,tramadol,morphine}, volume = {2}, Number = {3}, pages = {59-68}, publisher = { Iranian Society Of Regional Anesthesia And Pain Medicine}, url = {http://jap.iums.ac.ir/article-1-67-en.html}, eprint = {http://jap.iums.ac.ir/article-1-67-en.pdf}, journal = {Anesthesiology and Pain}, issn = {2228-6659}, eissn = {2322-3324}, year = {2011} } @article{ author = {Almasi-nokiani, Fariba and Rahimzadeh, Poupak and Faiz, Hamid-reza and Akbari, Hossein and Almasi, Ali-reza and Asadolah, Sar}, title = {Case Report: Anesthesia management for hysterotomy in a case of Morquio\'s syndrome }, abstract ={Morquio's syndrome is an autosomal recessive disease. It is from mucopolysacaridosis group disease and it's obvious clinical signs are severe skeletal dysplasia and normal intelligence. Deposition of keratan sulfate in different tissues is seen and with progression of the disease, connective tissue of cornea, airways, lung and heart valves will be involved. In this article we present a case of Morquio's rare syndrome that we terminated the pregnancy due to severe respiratory distress of mother and also we present the anesthesia management of this case.}, Keywords = {Anesthesia,pregnancy,Morquio syndrome}, volume = {2}, Number = {3}, pages = {69-74}, publisher = { Iranian Society Of Regional Anesthesia And Pain Medicine}, url = {http://jap.iums.ac.ir/article-1-68-en.html}, eprint = {http://jap.iums.ac.ir/article-1-68-en.pdf}, journal = {Anesthesiology and Pain}, issn = {2228-6659}, eissn = {2322-3324}, year = {2011} } @article{ author = {Imani, Farnad and Abolhasan-gharehdaghi, Fari}, title = {Review articles: Efficacy of Low Level Laser Therapy in fibromyalgia and myofacial pain syndrome}, abstract ={Background: Myofacialpain syndrome and fibromyalgia are two painful  clinical disorders of soft tissues that encountered to pain specialists. Low level laser therapy is  one of the non-pharmacological treatment modalityseems controversial.  Aim of this review articles is to investigate of  the efficacy of low level laser therapy (LLLT) in fibromyalgia  and myofacial  pain patients in the literature.Methods: A comprehensive evaluation of the literature relating to LLLT in fibromyalgia and myofacial pain syndrome patients was performed. 34 articles allocated for this studyThe time frame covered was 2000 to 2010. Not only the journals of laser therapy allocated for this study, but alsovarieties of journals of medicine specialties selected for avoidance of bias error.Results: From 34 articles, 13 articles supported, the efficacy of low level  laser therapy in pain score, in 12 studies there was no difference between (LLLT) and placebo and did not study for pain criteria in  9 studies. In case of the number of trigger points, 2 studies supported, the efficacy of(LLLT), there was no difference  between (LLLT) and placebo in  5 studies and did not study for number of trigger points in 9 studies. For patient's quality of life, (LLLT) significantly improved of this criteria in 10 studies,there was no difference between (LLLT) and placebo in 7 studies and did not study for patient's quality of life in 7studies.  The increased levels of 5-hydroxy-tryptamine, 5-hydroxy-tryptophan and 5-hydroxy indol acetic acid, reported in one sudy.Conclusion: This study revealed that, application of LLLT was effective in pain relief, improvement of functional ability  and   patient's quality of life and number of trigger points in 15 studies. However, no significant differences were obtained between placebo and LLLT in 6 studies. In conclusion, although the laser therapy has no superiority over placebo in few groups in this study, we cannot exclude the possibility of effectivity of LLLT in fibromyalgia and myofacialpian syndrome patients. We recommended another treatment regimen including different laser wavelengths and dosages (different intensity and density and/or treatment interval) for this aim.}, Keywords = {Low level laser therapy,fibromyalgia,myofacial pain syndrome,pain}, volume = {2}, Number = {3}, pages = {75-86}, publisher = { Iranian Society Of Regional Anesthesia And Pain Medicine}, url = {http://jap.iums.ac.ir/article-1-69-en.html}, eprint = {http://jap.iums.ac.ir/article-1-69-en.pdf}, journal = {Anesthesiology and Pain}, issn = {2228-6659}, eissn = {2322-3324}, year = {2011} } @article{ author = {TaghipourAnvari1, Zahra and Afshar-Fereydouniyan, Nader and Imani, Farnad and Sakhaei, Mojgan and Alijani, Babak}, title = {Oral Clonidine PremedicationReduces Blood Loss in Lumbar Spinal Posterior Fusion Surgery}, abstract ={Background: Blood loss in spine surgery is an important issue, even though it has been understudied compared to hip and knee arthroplasty surgery. In this study we have evaluated the effect of oral clonidine as premedication on blood loss in lumbar spine fusion surgery under propofol and remifentanil anesthesia.Materials and Methods: In this prospective double-blinded randomized clinical trial, 30 patients undergoing lumbar spine posterior fusion surgery were randomly allocated into 2 groups. The study group (Clonidine group) received 200micg oral clonidine tablet 60-90 minutes before anesthesia and the control group received placebo at the same time. Induction and maintenance of anesthesia and the target mean arterial pressure for controlled hypotension with remifentanil were the same in the 2 groups. We compared the amount of blood loss, dose of remifentanil /hour administered, need for nitroglycerine to reach the target mean arterial pressure when remifentanil was not enough, duration of operation and surgeon's satisfaction of a bloodless field between the 2 groups.Results: There was no statistically significant difference between the study groups in demographic characteristics (age (p=0.115), sex (p=0.439), weight (p=0.899)) operation time (p=0.2) and American Society of Anesthesiologists physical status score of the patients (p=0.390).Intra-operative blood loss and remifentanil dosage administered per hour in the clonidine group were significantly less than the control group (p=0.002 and p=0.001 respectively). But there was no significant difference in surgeon's satisfaction between the two groups (p=0.169).Conclusion: Clonidine as an oral premedication can reduce surgical blood loss in lumbar spine posterior fusion surgery, even at the same levels of mean arterial pressure with the control group. Its use can be studied in more complicated spine surgeries such as scoliosis and spinal deformity surgeries.  }, Keywords = {Clonidine Premedication, Spine Surgery, Controlled Hypotension, Surgical blood Loss}, volume = {2}, Number = {2}, pages = {1-9}, publisher = { Iranian Society Of Regional Anesthesia And Pain Medicine}, url = {http://jap.iums.ac.ir/article-1-70-en.html}, eprint = {http://jap.iums.ac.ir/article-1-70-en.pdf}, journal = {Anesthesiology and Pain}, issn = {2228-6659}, eissn = {2322-3324}, year = {2011} } @article{ author = {Yazdi, Bijan and Khalili, Mohammad and Talebi, Houshang and Fotovat, Ali-reza and Nikaeen, Arezou}, title = {Effect of adding ketamine to propofol infusion on hemodynamics and recovery time of patients under cataract surgery}, abstract ={Introduction: According to the importance of hemodynamic stability during anesthesia, usage of drugs and technics which change the hemodynamic in a minimum rate has become one of the most important purposes.Widely spread usage of propofol for sedation in cataract surgery made us to evaluate the effect of ketamine,which in itself has sympathetic effects, in usage accompaning with propofol.Materials and Methods: In a double blinded clinical trial 110 patients whom were candidate for cataract surgery were divided in two groups accidentally. After dripping topical analgesic drop and intravenous fentanyl injection 1mcg/kg : In one of the groups 0.25 mg/kg ketamine and in the other one 2cc normal saline were injected. Propofol infusion was started up to reaching to Ramsy score 3. Blood pressure, pulse rate and arterial O2 saturation were measured before and after injection of drug or placebo and also every 2 minutes for 10 minutes and the every 5 minutes up to end of surgery and transportation to recovery. Recovery time and propofol prescribed dosage were also measured. The results were analyzed with SPSS software.Results: The average of systolic blood pressure and diastolic blood pressure was higher in 2 and 6 minutes and diastolic blood pressure was higher in minute 4 in ketamine group after injection. After injection and 2 minute later the average of pulse rate was higher in ketamine group. Also the usage of propofol in ketamine group was less and the recovery time was longer.Conclusion: Although the recovery time in ketamine - propofol usage is longer but it provides a better stability in patients hemodynamic and also reduces the propofol dosage.}, Keywords = {Hemodynamic,Anesthesia,Propofol, Ketamine,Cataract}, volume = {2}, Number = {2}, pages = {10-23}, publisher = { Iranian Society Of Regional Anesthesia And Pain Medicine}, url = {http://jap.iums.ac.ir/article-1-71-en.html}, eprint = {http://jap.iums.ac.ir/article-1-71-en.pdf}, journal = {Anesthesiology and Pain}, issn = {2228-6659}, eissn = {2322-3324}, year = {2011} } @article{ author = {Ahmadinezhad, Mehdi and Vatankhah, Majid and Shokohi, Mostafa and Ghahreman, Minoo and MoradiMoghadddam, Omi}, title = {Comparison effect of intravenous and epidural fentanyl on analgesia and consciousness level in patients with chest and abdominal trauma in intensive care unit}, abstract ={Background ;aim: Several reasons cause to pain in ICU patients. The pain brings some side effects in the patients so that different methods have been introduced for pain reduction. The aim of this study was comparison the effect of epidural fentanyl injection with intravenous fentanyl injection for analgesia and the effect of these two methods on ICU patients' continuousness level.Material and methods: This investigation was a single-blind clinical trial in ICU patients of Shahid Bahonar Hospital in Kerman. These patients suffered from abdominal and chest trauma that were mechanically ventilated. Sixty patients were assessed in two groups. Patients in Group A received intravenous fentanyl for first 24 hrs, and then get epidural fentanyl from epidural catheter. Patients in B group were injected by epidural fentanyl in first 24 hrs, and then by intravenous fentanyl in second 24 hrs. Levels of fentanyl were 1.5 mcg.kg-1 intravenous injection and 8 mcg.kg-1 for epidural injection that were regulated with injection pump. Glascow Coma Scale and Visual Analogue Pain Score were assessed in 0, 2, 6, 24, 50, 54 and 72 hours.Results: In both groups, pain score in 2 hours was significantly lower in intravenous injection than epidural way but after 6 hours, epidural way cause to relieve pain than intravenous way (P<0.05). In all items, fentanyl intravenous injection cause to decrease patients GCS than epidural way (P}, Keywords = {Epidural,fentanyl,pain,ICU}, volume = {2}, Number = {2}, pages = {24-33}, publisher = { Iranian Society Of Regional Anesthesia And Pain Medicine}, url = {http://jap.iums.ac.ir/article-1-72-en.html}, eprint = {http://jap.iums.ac.ir/article-1-72-en.pdf}, journal = {Anesthesiology and Pain}, issn = {2228-6659}, eissn = {2322-3324}, year = {2011} } @article{ author = {Motaghi, Kamran and Safari, Farhad and Khodabendelou, Leili and Salimi, Alirez}, title = {Evaluation the efficacy of IV dexamethasone on post puncture headache incidence after cesarian section}, abstract ={   Introduction: Although its prevalence has reduced since introduction of small size spinal needles, post dural puncture headache is a still a common problem in young women. Headache could appear several hours to seven days after dural puncture, and could be a cause for delayed hospital discharge. (There are several methods for prevention and treatment of this side effect such as complete bed rest, hydration, non-opioid analgesics, caffeine, codeine, which none of them proved to be totally effective. The last option would be epidural blood patch).Methods and Materials: Sixty parturients aged 18-45 years old in American Society of Anesthesiologist (ASA) class of I or II, who had no past history of headache, analgesic consumption, substance abuse and drug addiction, candidate for elective cesarean section, were randomly assigned into two groups of case (Dexamethasone) and control (Norman saline). The anesthesia method for both groups was precisely the same. After spinal anesthesia 8 mg of intravenous Dexamethasone and 2 ml of intravenous normal saline were infused for case and control groups respectively, then at 1st, 6th,18th and 24th hours and 2nd, 3rd, 4th, 5th,6th and 7th days post operative, patients were asked about headache.Results: There were no demographic differences between two groups. The differences of headache prevalence in all times post operative, were sot statistically meaningful between two groupsConclssion: This study showed that 8mg of intravenous Dexamethasone does not have any significant effect on headache prevalence in parturients after spinal anesthesia for elective cesarean section.}, Keywords = {parturients,spinal anesthesia,post dural puncture headache,intravenous dexamethasone}, volume = {2}, Number = {2}, pages = {34-40}, publisher = { Iranian Society Of Regional Anesthesia And Pain Medicine}, url = {http://jap.iums.ac.ir/article-1-73-en.html}, eprint = {http://jap.iums.ac.ir/article-1-73-en.pdf}, journal = {Anesthesiology and Pain}, issn = {2228-6659}, eissn = {2322-3324}, year = {2011} } @article{ author = {Imani, Farnad and Radmehr, Mohammad and Mohammadian-erdi, Ali and Entezary, Saeid-reza and Alimian, Mahz}, title = {Evaluation of adding Acetaminophen to Fentanyl in Patient-Controlled IV Analgesia (PCIA) after Lower Limb Orthopedic Surgery}, abstract ={Background and aims: Postoperative analgesia is one of the most concerns of anesthesiologist and patients. Systemic opioids administration is the gold standard in reducing the severe pain after surgery but some side effects prevent the use of adequate doses of opioids. The aim of this study was evaluation of adding acetaminophen on fentanyl in patient-controlled iv analgesia (PCIA). Materials and Methods: In this randomized clinical trial, 120 patients candidate for lower limb orthopedic surgery (ASA I-II) were recruited in Rasoul-Akram Medical Center in a 12- month period. They randomly allocated  in two groups for postoperative pain, group F (Fentanyl)  (n=60)  and group AF (Acetaminophen/ Fentanyl) (n=60) by patient-controledl  intravenous analgesia (PCIA) groups. The pump has a continuous infusion of 5 ml per hour, bolus dose 2 ml and the lock out time 30 minutes was left. Each ml of solution in group F containing 10 mcg of fentanyl and in the group AF containing 5 mcg fentanyl and 20 mg acetaminophen. Pain score, sedation score, satisfaction, nausea and vomiting was evaluated for 48 hours after surgery.Results:The demographic characteristics of the two groups did not differ significantly. Pain scores beforpump  in F and AF groups were  6.8±1.6 and6.5±1.4, respectively. After 24 and 48 hours pain scores (2.4± 0.8, 1.7± 0.7) and (1.9± 0.6, 1.2± 0.5) decreased (P<0.001). Changes in pain scores were similar in both groups. Level of sedation, nausea and vomiting in the F group  and satisfaction in the AF group was higher.  Conclusion: This study showed adding iv acetaminophen to fentanyl through an PCIA is effective in controlling pain in patients undergoing lower limb orthopedic surgery. Moreover, acetaminophen and fentanyl combination and has fewer side effects such as nausea, vomiting and sedation and more satisfaction than fentanyl alone.}, Keywords = {Fentanyl,Acetaminophen,PCIA,lower limb orthopedic surgery}, volume = {2}, Number = {2}, pages = {41-47}, publisher = { Iranian Society Of Regional Anesthesia And Pain Medicine}, url = {http://jap.iums.ac.ir/article-1-5144-en.html}, eprint = {http://jap.iums.ac.ir/article-1-5144-en.pdf}, journal = {Anesthesiology and Pain}, issn = {2228-6659}, eissn = {2322-3324}, year = {2011} } @article{ author = {Ali-Asgarzadeh, Akbar and Agha-mohammadi, Dawood and Movasaghi, Reza and Shahsavari, Parvaneh}, title = {Effect of low-intensity laser on lower limb neuropathic pain in patients with diabetes mellitus}, abstract ={Introduction:Distal symmetric polyneuropathy was the most common diabetic neuropathy that caused to significant disability. Sever pain, decrease and absence of sense and increase risk of ulcer and amputation were the complication of diabetes. Several therapeutic modalities used for pain control in these patients but none of them didn't provide complete consensually of patients. The aim of this study was evaluation of the effect of low-intensity laser on limb neuropathic pain in patients with diabetes mellitus.Methods:In a Randomized Controlled Trial study with placebo, 30 patients with diabetic neuropathy, according to Electromyographic results, were included in two groups. In study group (15patients) irradiated from the Lumbosacral nerves to internal Maleous by infrared laser 980 nanometer, 200miliwaat, in 8 point. Each point applied 10 joule during 12 sessions. In control group (15patients) irradiated the same way with zero power. Effect of low-intensity laser on neuropathic lower limb pain were assessed and recorded by VAS scale at the end of every week.Results:Nine of patients were male and 21 of them were female. Mean base pain score of patient in low-intensity laser group was 9.53 ± 0.63 and Mean base pain score of patient in placebo low-intensity laser group w  9.53 ± 0.63(P=1). Mean pain score of patient after one week in low-intensity laser group was 7.26 ± 1.59 and Mean pain score of patient after one week in placebo low-intensity laser group was 8.40 ± 1.12(P=0.299). Mean pain score of patient after two week in low-intensity laser group was 5.80 ± 1.42 and Mean pain score of patient after two week in placebo low-intensity laser group was 8.47 ± 0.74. Mean pain score of patient after three weeks in low-intensity laser group was 3.80 ± 1.56 and Mean pain score of patient after three weeks in placebo low-intensity laser group was 8.06 ± 0.59. Mean pain score of patient after fore weeks in low-intensity laser group was 3.26 ± 2.40 and Mean pain score of patient after fore weeks in placebo low-intensity laser group was 8.46 ± 0.51.Conclusion:Mean pain score in end of two, three and four weeks in patients of low-intensity laser group were significantly lower than mean pain score in end of two, three and four weeks in patients of placebo low-intensity laser group (P<0.001).Significantly decrease was found in pain score in low-intensity laser group patients in weeks after treatment.}, Keywords = {Low-intensity laser,diabetic neuropathy,pain}, volume = {2}, Number = {2}, pages = {48-60}, publisher = { Iranian Society Of Regional Anesthesia And Pain Medicine}, url = {http://jap.iums.ac.ir/article-1-75-en.html}, eprint = {http://jap.iums.ac.ir/article-1-75-en.pdf}, journal = {Anesthesiology and Pain}, issn = {2228-6659}, eissn = {2322-3324}, year = {2011} } @article{ author = {Pournajafian, Ali-reza and Sehat, Malihe and Ghodrati, Mohammad-reza and Rokhtabnak, Faranak and Kholdbarin, Ali-rez}, title = {Comparison of post-operative pain in patients with leg fracture surgery with celecoxib administration in different preoperative times}, abstract ={Background: Efficacy of preoperative oral administration of celecoxib to prevent postoperative pain has been proved in several studies. Also some studies were done about efficient and enough dose to control postoperative pain but there is no agreement about administration in one single dose or administration in short divided doses. In this study, we conducted to evaluate the clinical efficacy of two different doses (200 mg and 400 mg) of celecoxib, as selective cyclooxygenase-2 inhibitors, on acute pain severity after orthopedic surgeries.  Methods: In this randomized clinical trial, 60 patients candidate leg fracture fixation under spinal anesthesia were enrolled. After taking informed consent, The patients were assigned randomly between three groups (group A: 400 mg at night before surgery, group B: 200 mg night before surgery and 200 mg in the morning and group C: no premedication). The severity of pain was evaluated by VAS(visual analogue scale),the time of anlgesic request by the patient and amounts of opioids administered during 24 hours after surgery was recorded and compared.Results: There was no statistically significant difference between three groups regarding to age, sex, and duration of operation time. The mean pain severity after 6 hours (post-operation) was the same in three groups. The mean of time of analgesic  request after operation was 196.5±121 minute in patients receiving 400 mg celecoxib in which it was significantly greater than the others (p=0.01). the mean of opioid consumption in patients receiving 400 mg celecoxib was less than the other groups but it didn't show any significant difference . Conclusion: Our study showed that administration of 400 mg celecoxib single dose was effective to postpone  time of opioid request after leg fracture operation under spinal anesthesia, but in comparison with two divided doses of  200 mg  celecoxib, it didn't have any significant difference on postoperative severity of pain. Also single dose (400mg) reduced the amounts of opioid consumption compared to two divided 200mg dose.}, Keywords = {Celecoxib,Post-operative pain,leg fracture,spinal anesthesia}, volume = {2}, Number = {2}, pages = {61-71}, publisher = { Iranian Society Of Regional Anesthesia And Pain Medicine}, url = {http://jap.iums.ac.ir/article-1-76-en.html}, eprint = {http://jap.iums.ac.ir/article-1-76-en.pdf}, journal = {Anesthesiology and Pain}, issn = {2228-6659}, eissn = {2322-3324}, year = {2011} } @article{ author = {imani, Farnad and Akhavan-akbari, Ghodrat and Mohammadian-erdi, Ali and Rahimzadeh, Puopak}, title = {An Evaluation of the Effects of adding oral pregabaline to Morphine sulfate in Patients Receiving Intravenous PCA after orthopedic Surgery}, abstract ={Background and aims: Although pregabalin shows efficacy against neuropathic pain, very limited evidence support postoperative analgesic efficacy. Our study objective to investigate analgesic efficacy of oral pregabalin in orthopedic surgery postoperative pain and opioid consumption.      Materials and methods: A randomized, double-blind, placebo-controlled was performed in . Patients received in first groupand in second group(30 patients) PCA morphine (10 mg/100ml) + oral pregabalin 300 mg daily for 48h after surgery. Pain score (VAS) and opioid consumption assessed in 48 hr after surgery. Results: There was not significant difference between groups for demographic data. Pain score and opioid consumption in pregabaline group was significantly lower than morphine group without any significant complications.  Conclusions: preoperative oral dose of 300 mg pregabalindailyfor 48h after surgery reduces post operative acute pain in orthopedic surgery.  }, Keywords = {pregabalin,morphine,orthopedic surgery,pain score}, volume = {2}, Number = {2}, pages = {72-78}, publisher = { Iranian Society Of Regional Anesthesia And Pain Medicine}, url = {http://jap.iums.ac.ir/article-1-77-en.html}, eprint = {http://jap.iums.ac.ir/article-1-77-en.pdf}, journal = {Anesthesiology and Pain}, issn = {2228-6659}, eissn = {2322-3324}, year = {2011} } @article{ author = {Fathi, Mehdi and Imani, Farnad and Joudi, Marjan and Goodarzi, Vahid and Shahhosseini, Gholam-rez}, title = {Ischemic Heart Disease Affected by Renal Failure in Postoperative Orthopedic Lower Surgery: A Case Report}, abstract ={Background: Renal dysfunction in the surgical patient is usually multifactorial: the most common cause is acute tubular necrosis (ATN) as a result of hypoxic damage to renal cells. Intra-operative events such as hypoxia and hypotension undoubtedly play an important role in this regards. Besides, among the peri-operative risk factors for ATN we can mention history of ischemic heart diseases and hypertension, age more than 65 years, diabetes mellitus, ACE inhibitor therapy, other comorbid illnesses, oliguria, sepsis, mechanical ventilation, and multiorgan failure.Results: In this special case, as we will discuss more, you would realize that our patient was an 89 years old woman with hypertension, ischemic heart disease, and diabet, with history of myocardial infarction. She had heart failure with ejection fraction of 30% and severe pulmonary hypertension who had also AF rhythm refractory to every kind of therapy. As she had to be operated due to falling down and her inter-trochanteric fracture, spinal anesthesia was chosen for her. However following the scenario which will be mentioned, she passed away unfortunately because of post -operative ATN in the ICU.  }, Keywords = {Acute tubular necrosis,ACE inhibitor,diabetes mellitus,ischemic heart disease,inter-trochantric fracture}, volume = {2}, Number = {2}, pages = {79-84}, publisher = { Iranian Society Of Regional Anesthesia And Pain Medicine}, url = {http://jap.iums.ac.ir/article-1-78-en.html}, eprint = {http://jap.iums.ac.ir/article-1-78-en.pdf}, journal = {Anesthesiology and Pain}, issn = {2228-6659}, eissn = {2322-3324}, year = {2011} } @article{ author = {}, title = {}, abstract ={}, Keywords = {}, volume = {2}, Number = {2}, pages = {85-96}, publisher = { Iranian Society Of Regional Anesthesia And Pain Medicine}, url = {http://jap.iums.ac.ir/article-1-79-en.html}, eprint = {http://jap.iums.ac.ir/article-1-79-en.pdf}, journal = {Anesthesiology and Pain}, issn = {2228-6659}, eissn = {2322-3324}, year = {2011} } @article{ author = {}, title = {}, abstract ={}, Keywords = {}, volume = {2}, Number = {1}, pages = {1-8}, publisher = { Iranian Society Of Regional Anesthesia And Pain Medicine}, url = {http://jap.iums.ac.ir/article-1-80-en.html}, eprint = {http://jap.iums.ac.ir/article-1-80-en.pdf}, journal = {Anesthesiology and Pain}, issn = {2228-6659}, eissn = {2322-3324}, year = {2011} } @article{ author = {}, title = {}, abstract ={}, Keywords = {}, volume = {2}, Number = {1}, pages = {9-16}, publisher = { Iranian Society Of Regional Anesthesia And Pain Medicine}, url = {http://jap.iums.ac.ir/article-1-81-en.html}, eprint = {http://jap.iums.ac.ir/article-1-81-en.pdf}, journal = {Anesthesiology and Pain}, issn = {2228-6659}, eissn = {2322-3324}, year = {2011} } @article{ author = {}, title = {}, abstract ={}, Keywords = {}, volume = {2}, Number = {1}, pages = {17-23}, publisher = { Iranian Society Of Regional Anesthesia And Pain Medicine}, url = {http://jap.iums.ac.ir/article-1-82-en.html}, eprint = {http://jap.iums.ac.ir/article-1-82-en.pdf}, journal = {Anesthesiology and Pain}, issn = {2228-6659}, eissn = {2322-3324}, year = {2011} } @article{ author = {}, title = {}, abstract ={}, Keywords = {}, volume = {2}, Number = {1}, pages = {24-31}, publisher = { Iranian Society Of Regional Anesthesia And Pain Medicine}, url = {http://jap.iums.ac.ir/article-1-83-en.html}, eprint = {http://jap.iums.ac.ir/article-1-83-en.pdf}, journal = {Anesthesiology and Pain}, issn = {2228-6659}, eissn = {2322-3324}, year = {2011} } @article{ author = {}, title = {}, abstract ={}, Keywords = {}, volume = {2}, Number = {1}, pages = {32-40}, publisher = { Iranian Society Of Regional Anesthesia And Pain Medicine}, url = {http://jap.iums.ac.ir/article-1-84-en.html}, eprint = {http://jap.iums.ac.ir/article-1-84-en.pdf}, journal = {Anesthesiology and Pain}, issn = {2228-6659}, eissn = {2322-3324}, year = {2011} } @article{ author = {}, title = {}, abstract ={}, Keywords = {}, volume = {2}, Number = {1}, pages = {41-47}, publisher = { Iranian Society Of Regional Anesthesia And Pain Medicine}, url = {http://jap.iums.ac.ir/article-1-85-en.html}, eprint = {http://jap.iums.ac.ir/article-1-85-en.pdf}, journal = {Anesthesiology and Pain}, issn = {2228-6659}, eissn = {2322-3324}, year = {2011} } @article{ author = {}, title = {}, abstract ={}, Keywords = {}, volume = {2}, Number = {1}, pages = {48-56}, publisher = { Iranian Society Of Regional Anesthesia And Pain Medicine}, url = {http://jap.iums.ac.ir/article-1-86-en.html}, eprint = {http://jap.iums.ac.ir/article-1-86-en.pdf}, journal = {Anesthesiology and Pain}, issn = {2228-6659}, eissn = {2322-3324}, year = {2011} } @article{ author = {}, title = {}, abstract ={}, Keywords = {}, volume = {2}, Number = {1}, pages = {57-63}, publisher = { Iranian Society Of Regional Anesthesia And Pain Medicine}, url = {http://jap.iums.ac.ir/article-1-87-en.html}, eprint = {http://jap.iums.ac.ir/article-1-87-en.pdf}, journal = {Anesthesiology and Pain}, issn = {2228-6659}, eissn = {2322-3324}, year = {2011} }