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Showing 46 results for Pain

Ali Akbar Abdollahi, Bijhan Arya, Mohammad Jafar Gol Alipour, Mohammad Ali Vakili,
Volume 6, Issue 3 (10-2003)
Abstract

Introduction: Pain is one of the main complaints of many postoperative patients. Narcotic and NSAID drugs are used to control postoperative pain.
Recent studies suggest different results of pain relief by NSAID group. We compared analgesic effects of intramucular Pethedine to Didofenac Sodium and Indomethacin suppositories due to inguinal hernioplasty.
Materials and Methods: This study was a clinical trial study over 55 patients of 17-60 years old who underWent unilateral inguinal hernioplasty.
These patients divided into 3 groups. The first group included 17 patients who received 100 mg Indomethacin suppository every 8 hours to relief postoperative pain. The second group of 18 patients who received 100 mg Diclofenac Sodium suppository every 8 hours and the third group induded 20 patients who received 0.5 mg/kg body weight Pethedine intramuscularly every 8 hours. The first dose of each drug started 2 hours after termination of operation. Tue sevrity of pain was checked by visual analogue scale method every 2 hours for 24 hours. Mean pain severity recoded and compared in 6 hours intervals.
Results: The averages of pain severity in the first 24 hours were 23±12 for Indomethacin, 31±9 for Pthedine and 27±12 hours for Diclofenac Sodium groups. There was no significant difference in whole 24 hours.
Conclusion: We concluded that Indomethacin and Diclofenac Sodium suppositories are good substitutes for intramuscular Pethedine to relief postoperation pain during the first postoperation day.
Bijhan Forough, Mahmoud Bahrami, Hassan Saiidi, Feridoun Rahimi,
Volume 9, Issue 3 (9-2006)
Abstract

Introduction: Plantar fasciitis is one of the common complications in adults. It can be treated by surgical and nonsurgical interventions. Nonsurgical treatments (functional foot orthosis, heel pad, night splint and wedge) are emphasized as the main option in management of plantar fasciitis. Wedge can be used effectively because of its low weight, low price, easy making and availability to the patient. In this study the effect of medial heel wedge on managing pain in patients suffering from plantar fasciitis was examined. Materials and Methods: In this before and after clinical trial, 15 patients with plantar fasciitis including 6 male and 9 female with 18 involved extremities were selected by non probability sampling.Variables including pain, ADL, sport and recreational activity, quality of life, stride length and step length were measured in three stages: once before intervention and then two and four weeks after intervension. For evaluating the variables, FAOS questionnaire was used. Data was analyzed using ANOVA. Results: The improvement of variables such as pain, ADL, quality of life, sport and recreational activity, step length and stride length was significant (p=0.05). Conclusion: Medial heel wedge reduced pain by shifing the center of force into lateral border of heel in addition to reduce the tension of plantar fascia.
Hamid Reza Kohestani, Nayereh Baghcheghi, Jila Abedsaiidi, Ali Ghezelbash, Dr Hamid Alavimajd,
Volume 9, Issue 3 (9-2006)
Abstract

Introduction: The reported 12 months prevalence of low back pain in nurses ranges from 43% to 76%. In most researches physical factors were only a part of high prevalence of low back pain in nurses. This study was conducted to determine the association between occupational stress and low back pain in nurses. Materials and Methods: In this case-control study, 80 nurses as case group and 80 nurses as control group were selected via convenience sampling. Case group were defined as those subjects who had experienced low back pain in the last 12 months. Control group were defined as those subjects who had not experienced low back pain in the last 12 months. A questionnaire was used for data collection which consistsed of 3 sections: demographic information, history of low back pain and occupational stress. Data was analyzed using paired T, Mann-Whitney, and Chi-square tests, correlation coefficient and one way ANOVA Results: Results indicated that, there was an association between low back pain and occupational stress (p<0/01).Also an association existed between low back pain and working hours per month (p<0/05). Statistical tests showed no significant difference between the two groups in terms of age, gender, marital status, number of childbirth, number of pregnancy, smoking, sport, work shift, number of years spent in the hospital (nursing experience). Conclusion: Results indicated that occupational stress in case group was more than control group. Since there was not any significant difference between other factors and low back pain, it can be concluded that there is an association between low back pain and occupational stress.
Nasud Nazem, Parvin Sajedi, Vahid Goharian, Mohamadreza Shirvani,
Volume 9, Issue 3 (9-2006)
Abstract

Introduction: Using one subcutaneous infiltration of Bopivacaine can cause a good pain relief in pediatric surgery, so the child may no longer need rectal Acetaminophen after surgery. In this study, we compared the efficacy of the two drugs. Materials and Methods: This was a clinical trial, performed on 141 pediatric patients between 6 months to 3 years old with unilateral or bilateral inguinal hernia or undescending testis. Patients were divided randomly into two groups. The first group received infiltration of Bopivacaine preoperatively and the second received the routine rectal Acetaminophen after surgery. In both groups pain score was measured with FPRS score 3,6,12 and 24 hours after surgery. After collecting data they were analyzed with T-student and Friedman tests. P<0/05 was considered significant. Results: Global FPRS pain score was lower in the group treated with Bupivacaine infiltration on 3 and 6 hours after surgery (p<0/05), but in 12 and 24 hours after surgery no significant difference was seen in the two groups. Conclusion: This study showed that, infiltration of Bupivacaine reduces pain better than Acetaminophen, especially during the first 6 hours after surgery. So because of better pain control and also single administration, we suggest using infiltralition of Bupivacaine preoperatively.
Abolghasem Zare-Zadeh, Masaud Samavarzade, Vahid Noorian, Beheshte Padidar,
Volume 9, Issue 4 (12-2006)
Abstract

Introduction: Flexor tendon entrapment of the digits (FTED) is a disorder characterized by snapping or locking of the thumb or fingers (with or without pain) and called trigger finger. Corticosteroid injections are one of the most commonly used treatments for chronic tendon disorders. Despite their popularity, the systematic evidence for their benefits are largely lacking. This study tries to determine the efficacy of local corticosteroid injection in treatment of trigger finger. Materials and Methods: This is a clinical trial research. Variables including local tenderness, trigerring stage, pain during isometric flexion and passive stretching of the tendon (based on VAS) were evaluated before local injection of corticosteroid and then 3 weeks, 3 months and 6 months after the injection. Data was collected by special forms and analyzed using Chi square and ANOVA Tests. Results: The difference between persence of A1 pulley tenderness in 4 examinations was significant (p<0.0001). The difference between pain induced by isometric flexion and pain induced by stretching the tendon passively in extension was also significant (both p<0.0001). The difference between frequency distribution of triggering was significant (p<0.0001). Patients satisfaction was 90% . Conclusion: The rate of success in local corticosteroid injection was 90% (only with one injection). The high rate of success and low side effects, make this method a suitable treatment for trigger finger.
Afsaneh Norouzi, Leila Haji-Beigi, Maryam Abbasi Talarposhti, Esmat Mashhadi, Mehri Jamilian, ,
Volume 9, Issue 4 (12-2006)
Abstract

Introduction: Pain relief has been received the highest level of medical attempts continuously but still many patients suffer from it. Narcotics' side-effects have led investigators to apply other techniques for controling acute postoperative pain to reduce narcotics requirements. Recently, some concepts have been presented implying that Metoclopramide does have analgesic effects and this led us to conduct the present study in order to determine Metoclopramide's effect on alleviating pain after cesarean section. Materials and Methods: In this clinical trial, 80 patients who were candidates of elective cesarean section were studied in two groups. 10 minutes before the cesarean section's ending time, the control group was given 25 mg Pethidine accompanied by 10 mg Metoclopramide and control group 25 mg Pethidine and distilled water. Then when patients were conscious after cesarean section, for a period of 6 hours received after-care for their vital signs and side-effects of prescribed drugs. Their pain score (VAS) and nausea rate was measured and if necessary, Pethidine was injected with certain dose. Injection time for first dose of Pethidine and its required amount were recorded in a checklist within first 6 hours after cesarean section. Data was analyzed using ANOVA and T tests. Results: Prescription of Metoclopramide inhaunced analgesic effect of narcotics and a meaningful decrease was found in pain score (p=0.002) and nausea rate (p<0.005). Injection time for the first dose of Pethidine was also prolonged in the group who received Metoclopramide compared to control group (p=0.019) and an obvious decrease was occurred in received Pethidine's amount within the first hours after cesarean section (p<0.005). Drugs side-effects were not found in patients. Conclusion: The results indicate that use of Metoclopramide accompanied by Pethidine in ending time of cesarean section, does have considerable effects in controlling acute pain after surgery and increasing analgesic effect of narcotic drugs. Therefore, use of Metoclopramide as a proper supplement drug with low side-effects is recommended.
Parsa Yousefi, Ali Cyrous, Fatemeh Dorre, Shadi Pirasteh,
Volume 10, Issue 2 (6-2007)
Abstract

Introduction: Chronic and relapsing abdominal pain is one of the most common reasons that bring children to pediatric clinics. About 20% of these children are suffering from idiopathic hypercalciuria. Since Hydrochlorothiazide is effective in relieving hypercalciuria, we assessed its effects on reducing these relapsing pains in girls with idiopathic hypercalciuria. Materials and Methods:In this single blind clinical trial study, 100 girls, aged 5-12 years old, with chronic relapsing abdominal pain and hypercalciuria were divided to two groups by random block design. All children and their parents were trained about consuming plenty of liquids and decreasing salt in foods. In addition to these measures, Hydrochlorothiazide (1 mg/kg/day) was also administered to children in the case group. The control group was assessed for the number of abdominal pain episodes for 3 months following the commencement of the diet and the case group for 3 months after becoming normocaciuric. The results were analyzed by T-test. Results: The mean number of pain episodes in Hydrochlorothiazide group in the first, second, and third months were 0.38, 0.4, and 0.26 respectively much lower than the corresponding months in the control group which were 1.60,1.94, and 1.84 in that order (p<0.001). Conclusion: It seems that single dose daily Hydrochlorothiazide is a safe and effective drug in the treatment of chronic relapsing abdominal pain in children with idiopathic hypercalciuria.
Shahin Fateh, Mahmoud Amini, Somaie Daliri, Faeze Zahedian,
Volume 10, Issue 3 (6-2007)
Abstract

Introduction: Post operative pain, nausea and vomiting are common complications after hemorrhoidectomy and cause unpleasant expriences for patients. Today, scientists are increasingly moving forward to find new drugs with fewer side effects and costs to control these complications. So this study was planned to evaluate the effect of Dexamethasone on post operative pain, nausea and vomiting. Materials and Methods: This study was a double blind randomized controlled clinical trial that carried out on 112 patients scheduled for hemorrhoidectomy. Patients were diveded into two groups. Case group received 8mg Dexamethasone and control group received 2 ml normal saline intramuscularly 30 minutes before the operation. The method of surgery and general anesthesia were the same in all patients. Pain and nausea score were recorded using visual analog scale (VAS) and vomiting was recorded by asking of them at 0, 2, 4, 6 hours after operation. The patients were followed for 6 hours after the end of the operation and data was analyzed using t and chi square tests. Results: There was a significant difference between the two groups regarding prevention of post operative pain and nausea (p=0.00001). But there was no significant difference between the two groups regarding prevention of post operative vomiting. Conclusion: The result of this study suggested that injection of Dexamethasone before hemorrhoidectomy can decrease incidence of postoperative pain and nausea but dose not have any effects on postoperative vomiting. Therefore Dexamethasone is recommended before hemorrhoidectomy.
Monireh Motevaselian, Mostafa Shiryazdi, Khadije Nasriani,
Volume 10, Issue 3 (6-2007)
Abstract

Introduction: Hemorrhoid is a common disorder causing pain, and its standard treatment is Hemorrhoidetomy. Also, pain is a common problem after surgery and control of it prevents physiologic and psychiatric complications. Kegel exercise is one of the relaxing and none invasive methods for reduction of pain. In this study the effect of kegel exercise on pain relief post hemorrhoidetomy is investigated. Materials and Methods: This study is a single blind randomized clinical trial. Samples were patients admitted for hemorrhoidetomy to Shahid Sadooghi hospital of Yazd. They were randomly divided in two experiment and control groups (each group 30 persons). Before operation, Kegel exercise was educated to experiment group and after surgery pain range were recorded. Data was analyzed using descriptive and analythic statistics (t and Pearson correlaton tests). Results: Findings showed that the mean score of post surgery pain in the first 48 hours after operation in experimental group was 26.50±5.82 and in control group 31.26±5.94, that have meaningful difference (P=0.003). Regarding the amount of analgesics, the mean use of analgesics after surgery in experimental group was 18.9±14.83 and in control group 52.83±29.89 which has meaningful difference (P=0.00001). Type of analgesics in the two groups 18, 24 and 48 hours after surgery with p=0.04, p=0.04 and p=0.05, had significant difference. There were not any correlations between pain intensity and numbers of Kegel exercise. Conclusion: Based on results, Kegel exercise decreased post hemorrhoidetomy pain and using analgesic drugs was decreased in experimental group. Preoperative education of this method is useful in pain management postoperatively.
Ali Cyrus, Shirin Pazoki, Davoud Goodarzi, Malihe Yavari, Esmat Babayee, Shadi Piraste,
Volume 11, Issue 2 (6-2008)
Abstract

Introduction: Oral Ketamine is used as a low side effect analgesic in comparison with opioids, in different pain syndromes. This study is designed to evaluate the effect of oral Ketamine in renal colic treatment. Materials and Methods: In this clinical trial study 104 patients with renal colic, hospitalized in emergency department, were divided in to two groups by Random block design. Group B received Pethidine (1 mg/kg up to 100 mg) and placebo, and group A received Pethidine with the same dose and Ketamine (0.5 mg/kg). All patients were assessed for pain by using VAS chart, for nausea by a 0-3 scale and for the number of vomiting at baseline and 1, 2 and 3 hours after taking drug. The results were analyzed by t-test. Results: Average pain score and vomiting in all times and nausea score in one and three hours after receiving drugs were reduced significantly in patients who took Pethidine and Ketamine comparing patients who took Pethidine and placcbo(p < 0.05). Conclusion: Regarding the significant effect of Ketamine in reduction of pain, nausea and vomiting without side effects, it is possible to use Ketamine as an adjuvant drug in treatment of renal colic and to reduce narcotic dosage.
Vahid Sheibani, Mohammad Ali Afarinesh Khaki, Zahra Hajizadeh, Mandana Jafari, Razeieh Arabnezhad, Ali Shamsizadeh,
Volume 11, Issue 3 (9-2008)
Abstract

Background: Pain is an unpleasant feeling which humans experience. It is a warning sign of the damaged tissue. Due to the awful sense of pain, scientists always attempt to relieve it. Retinoic acid (RT), an active metabolite of natural vitamin A has important roles in modulation of the inflammatory responses. The aim of the present study was to analyze the pain threshold of rats which had microinjections of RT, applying acute and chronic models. Methods and Materials: In this study, the tail flick and formalin tests were used to determine pain threshold. In each test, the acute and chronic pain thresholds of 252 Wistar male rats (275 ± 25 gr) were assayed. The druge were injected in the acute model one-dose30 minutes before behavioral testing and in chronic model two-dose for one or two-weeks. The rats of both models divided randomly into six groups (n=7). In four treatment groups retinoic acid (RT) intra cerebro ventricular (i.C.V) were injected as dosagc of 0.5, 3 and 6 (µg/kg) micrograms per kilogram. In control group, was microinjected by ACSF. In vehicle group injected RT solvent (DMSO+ Distil water). Results: The resuits Showed acute injection of RT did not change pain thresholds in the tail-flick methd, but the chronic administration of RT (0.5, 1, 3, 6 µg/kg) reduced tail-flick latencies of the rats (p<0.05) in compare to DMSO group. The threshold of pain in the first phase of formalin test was reduced after injection of 3µg/kg of RT for two weeks. Conclusion: It was concluded that chronic i.c.v. injections of RT can induce significant hyperalgesia in rat.
Bijan Yazdi, Jamshid Momeni, Alireza Akbari,
Volume 11, Issue 3 (9-2008)
Abstract

Background: Pain following propofol injection was reported between 28- 90 %. Ketamine have lesser cardiovascular depression effect and also local anesthetic effect. In this study effect of ketamin were analyzed when it given before propofol injection. Methods and Materials: In a randomized double blind clinical trial selected 120 ASA I, II Ptients with 15-65 years old. They were candidated for elective surgery, in half of the patients 100 µg/kg ketamine in 2 ml volume and in another half, 2 ml distilled water were given before propofol injection. Severity of injection pain was evaluated according to 4 scale criteria (none, mild, moderate, or severe) fifteen seconds after injection of 25% of the calculated dose of propofol. Heart rate (HR) and noninvasive blood pressure were recorded before and after propofol injection, immediately and 3 minutes after intubation. The data were analysed by Mann Whitney U, Pooled t-Test and the Chi-squared test. Results: Pain was not sensed in 51.56% and 75% of control and case groups respectively. In cases group showed little decrease in systolic and diastolic pressures after anesthetic induction (p=0.012 and p=0.005). There were upper diastolic pressures after intubation (p=0.00) and 3 minutes after intubation (p=0.000). During intervention heart rate changes had not significant difference between two groups. Conclusion: Ketamine pre-treatment was an effective method in reducing pain and providing hemodynamic stability after propofol induction.
Simin Taavoni, Shadab Shahali, Hamd Haghani, Leila Neisani Samani,
Volume 11, Issue 4 (12-2008)
Abstract

Background: Pain management is the challenging concepts in health workers. Since neonates have higher pain sensitivity in compare to childhood and adults. The objective of this study was to examine the pain relieving effect of breast feeding during immunization injections in healthy neonates. Methods and Materials: In this control randomized clinical trial, Samples were divided two groups (by age and sex) of 76 healthy 2- 4 months old term infants. In breast-fed group, 2 minutes before, during, and 15 seconds after the DPT immunization injection were in mother hug, and in control group as routine of clinic, were lied on the examining table during injection. Appearance of Neonates were observed and assessed by Modified Behavioral Pain Scale (MBPS) during 5 second before immunization to 15 second after it. Results: In breast fed and control group mean of age were 81.53±41.46 and 81.61±40.59 day and for weight were 6.65±1.17 and 6.70±1.14 kg for hight were 64.27±5.5 and 63.38±5.06 cm respectively. There were significant differences in Behavioral Pain Scores of two groups include: facial expression (4 items), cry (5 items), and movements (6 items). (P<0.0001). There is no statistically significant difference between the 2 groups for age, sex and the time of feeding prior to vaccination Conclusion: Regarding to significant difference in behavioral of pain responds in two groups, it is suggested, with simple and safe intervention method of straight breast feeding reduce pain during immunization and muscular injections too.
Khalilolah Nazem, Arsalan Mahmoudian,
Volume 12, Issue 4 (2-2010)
Abstract

Background: The effectivity of applying antiseptics in preparation of the operative site on the reduction of post-operative infections is not quite clear and controversies exist about the best method for doing this. The aim of this study is to compare the traditional two-stage method of first, washing the site with povidone iodine scrub and then painting with aqueous povidone iodine with the method of washing the site only with povidone iodine scrub. Materials and Methods: In this retrospective study, patients who had been under knee arthroscopy in 2 separate hospitals by the same surgeon were compared with regard to post operative infection. In one hospital, the operative site was only washed with povidone iodine scrub, while in the other hospital this same procedure was followed by painting with aqueous povidone iodine. The primary goal of this study was to identify the patients who had manifested clinical and laboratory signs of superficial or deep infection or septic arthritis one month postoperatively. Results: A total 300 patients were studied in two equal groups. All the patients had only been under diagnostic or curative non-bony operations. No superficial or deep infection or septic arthritis were seen in any of the patients in the two groups. Conclusion: Preoperative preparation of the knee with povidone iodine scrub is a safe method for prevention of infection and can be used instead of the common two-stage method of using povidone iodine scrub and then painting with aqueous povidone iodine since this can decrease the time and cost of surgery.
Simin Taavoni, Somayeh Abdolahian, Hamid Haghani,
Volume 13, Issue 1 (4-2010)
Abstract

Background: Labor pain, which is a natural, unique and multi- factorial pain, is considereds a major part of women's anxiety at reproductive ages. There are two pharmacological and non-pharmacological approaches for reducing this pain. Since the pharmacological approach involves side effects, lots of attention has recently been given to the non-pharmacological methods. One of these methods, is use inc birth ball the, which includes sitting and rocking on the birth ball. The purpose of this study was to evaluate the effects of using birth ball on labor pain, the duration of active phase and contractions of physiologic labor. Materials and Methods: In this randomized control-clinical trial, sixty primiparous women (18-35 year old) were selected and randomly assighed into birth ball and control groups. The severity of pain was measured through Visual Analogue Scale (VAS) and the pain score, interval between contractions and duration of active phase were compared between the two groups. Results: The average pain score in the birth ball group was significantly lower than the control group (p<0.05). In terms of interval between the contractions, duration of active phase and uterine contractions, there were no significant differences between the two groups. Conclusion: Although use of birth ball did not have any effects on the duration of active phase, uterine contractions and interval between uterine contractions, this complementary therapy reduced the severity of pain during the active phase of delivery. Therefore, this safe method is suggested to be used during normal vaginal delivery and physiologic labor. Also, conducting a study, which examines the effects of using a combination of complementary methods, is recommended
Afsaneh Nourozi, Abolfazl Jafari, Reza Badei, Maryam Gadimi,
Volume 13, Issue 3 (9-2010)
Abstract

Background: Pain following tonsillectomy is common in children, and its elimination due to its subsequent complications is essential. Therefore, this study was conducted with the aim of obtaining the best method of administering ketamine for reducing pain following tonsillectomy with the greatest efficiency and the least side effects. Materials and Methods:This study was a double-blind clinical trial which was conducted on 92 children, aged 3-9, who had been admitted for tonsillectomy. The patients were randomly divided into oral ketamine and ketamine injection groups (each containing 46 patients). Thirty minutes before the operation, all the patients were given apple-juice ketamine injection group received normal apple juice without ketamine, whereas the oral ketamine group received 5mg/kg ketamine with the apple juice. Three minutes before tonsillectomy, 0.5 mg/kg ketamine was injected to the peritonsillar area in ketamine injection group while the same volume of saline was injected to the oral ketamine group. Data were registered, gathered, and, then, analyzed using Wilcoxon, Man Whitney, and t tests. Results: Demographic data and blood pressure before and after the operation did not have significant differences in the 2 groups. In terms of the duration of operation time, a significant difference was observed between the two groups the operation time in the ketamine injection group was shorter (p=0.006). Also, pain score in the ketamine injection group was less than the oral ketamine group. Conclusion: Ketamine is effective in reducing the pain after tonsillectomy operation. Peritonsillar injection of ketamine is more effective than its oral usage.
Fereshte Jahdi, Fatemeh Sheikhan, Effat Sadat Merghati Khoie, Hamid Haghani,
Volume 13, Issue 3 (9-2010)
Abstract

Background: Perineal pain following episiotomy affects mothers’ mental health and their quality of life. Using cooling gel pad is a new approach which is used for pain relief, but the pain related to episiotomy is still typically treated with oral analgesics. This study was conducted to investigate the effect of gel pad on post-episiotomy pain in primiparous women in Kamali Hospital of Karaj. Materials and Methods: This single-blind clinical trial was conducted on 60 primiparous women who referred for labor to Kamali Hospital of Karaj. The participants were randomly allocated to two groups: Those receiving gel pads (for 20 minutes four hours after labor and in case necessary, for up to 5 days) and the control (receiving the hospital routine). The two groups were evaluated in terms of episiotomy pain intensity through visual analogue scale (VAS) and analgesics usage. Results: The two groups did not show any significant differences in demographic features and other intervening variables. In terms of reduction in pain intensity, there were significant differences between the two groups 4 hours (p=0.002), 12 hours (p=0.009), and 5 days (p=0.000) after episiotomy. Analgesics usage, five days after delivery, in gel pad group was significantly lower than the control group (p<0.001) Conclusion: Using gel pad reduces the perineal pain intensity following episiotomy and decreases the need for using analgesics.
Zahra Ghodsi, Hakemzadeh,
Volume 14, Issue 1 (3-2011)
Abstract

Background: Every year over 150 million pregnancies occur in developing countries however, delivery is not satisfactory for some mothers and, in fact, it is a painful and frightening experience. One solution for pain relief is using En2nox gas. Because of opposite stances of people and society on En2onox, this study was done to highlight the real experiences of people and describe mothers' experiences of pain relief using En2nox. Materials and Methods: In this qualitative, phenomenological study, deep interview is conducted with 30 pregnant women who chose painless delivery using En2nox at Taamin Ejtemaee Hospital. Data analysis was done via Collaizzi method. Validity and reliability were obtained noticing such measures as real value, applicability, continuity, and authenticity. Results: The reasons for choosing En2nox were being easy-to-use and having minimal side effects. Most mothers had a positive attitude towards self-administration of the method and their main satisfaction was with the reduction in pain without severe side effects following withdrawal from usage of the method. The mothers’ major complaint was with dizziness following the method. Conclusion: Based on the mothers’ positive experience of En2nox painless delivery, using this method with the aim of decreasing labor pain and elective cesarean is recommended. Furthermore, the use of this type of analgesia at other centers, with larger sample sizes, and in comparison with other analgesia methods is recommended.
Samane Abedi Dost, Majid Poya, Mohammad Shafe Shakouri,
Volume 14, Issue 2 (5-2011)
Abstract

Background: Hemorrhoidectomy is the basis of treatment for grades three and four hemorrhoid. One of the major post hemorrhoidectomy problems is pain that is usually due to the spasm of the internal sphincter. There are different methods for the management of postoperative hemorrhoidectomy pain. The aim of this study was to investigate the effect of sphincterotomy on post hemorrhoidectomy pain. Materials and Methods: This interventional clinical trial was conducted on 60 patients with 3rd and 4th grade hemorrhoid who had randomly been divided into hemorrhoidectomy and hemorrhoidectomy combined with sphincterotomy groups. The degree of pain was measured on visual analogue scale (VAS) and analyzed through Mann-Whitney, Friedman, and Chi square tests via SPSS version 14. Results: In terms of reduction in pain with sphincterotomy, there was a significant relationship between the two groups on the first, second, and fifth postoperative days (P=0.001). On the third and sixth postoperative days, a significant relationship was observed between the two groups (P=0.001). Days four and seven also indicated a significant relationship between the two groups (P=0.002). However, there were not any significant relationships between the two groups in terms of urinary and fecal incontinence and gas retention (P>0.05). A significant relationship existed between the two groups in terms of reduction in the need for sedation (P=0.006). Conclusion: Lateral internal sphincterotomy combined with hemorrhoidectomy can reduce the patients’ post hemorrhoidectomy pain and can reduce the use of analgesics, but it does not have any significant influences on the incidence of urinary retention and bleeding after the first defecation and does not increase the risk of fecal and gas incontinence in comparison with the hemorrhoidectomy group.
Esmail Moshiri, Afsane Norozi, Shirin Pazoki, Nafiseh Gazerani, Mostafa Choghayi,
Volume 14, Issue 2 (5-2011)
Abstract

Background: Postoperative pain brings about undesirable effects such as medical complications, increased healthcare costs, and the need for opioids administration. The aim of this study was to determine the effect of low dose (0.15 mg/kg) ketamine in comparison with the placebo on postoperative pain and analgesics consumption after cesarean section. Materials and Methods: In a randomized clinical trial, 120 women undergoing elective cesarean section were randomly divided into case and control groups. Ketamine (0.15 mgkg-1) or an equal volume of normal saline were administered intravenously immediately after initiating spinal anesthesia to the case and control groups, respectively. The anesthesia and surgery techniques were the same for both groups. Data were analyzed using SPSS version 11. Results: Means of age in the case and control groups were 28.85±4.81 and 28.87 ±5.62 years, respectively. Analgesics consumption, pain scores, homodynamic signs, drowsiness of the mothers, and the neonates’ Apgar scores after cesarean section were similar in both groups and no significant differences were found between them (P>0.05). The mean of postoperative arterial pressure in the early hours in the ketamine group showed a significant decrease compared to the placebo group (P>0.03). The means of the first time of request for analgesics after surgery in the ketamine and placebo groups were 99.75±68.88 and 96.1±52.59 minutes, respectively (P>0.05). Conclusion: It seems that the administration of 0.15 mg/kg dose of ketamine (0.15mg/kg) does not have a significant impact on decreasing the postoperative pain in cesarean section. Therefore, in order to obtain the desirable analgesic effects of this drug, further studies should be conducted with greater doses of this drug and its use in combination with other opioids.

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