Effects of Oral Gabapentin, Local Bupivacaine and Intravenous Pethidine on Post Tonsillectomy Pain

Introduction: Tonsillectomy is one of the most common surgeries performed worldwide. Post-operative pain arising from tonsillectomy is one of the earliest complications that can postpone oral nutrition and increase the hospitalization period. Administration of opioids via injection is usually preferred to relieve pain in these patients. However, the side effects of this approach prompted us to seek alternative treatments. In this study, the effectiveness of oral gabapentin is compared with an intravenous (IV) injection of pethidine and a local injection of bupivacaine in the control of pain after tonsillectomy. Materials and Methods: This clinical trial was performed on 7-15 year-old patients who were candidates for tonsillectomy at Shahrekord Kashani hospital from 2012–2013. The patients were divided into three groups at random. Group 1 was give 20 mg/kg oral gabapentin 1 hour before anesthesia. In Group 2, 2.5 ml bupivacaine 0.25% was injected into each tonsil bed by a surgeon. In Group 3,1 mg/kg pethidine was injected intravenously after intubation. To assess postoperative pain, the Oucher scale was used in recovery as well as 3,6,12, and 24 hours after surgery. Results: The pain score was lowest in the gabapentin group and highest in the bupivacaine group during the study. The pain score in the gabapentin group was significantly lower than that in the bupivacaine group (P<0.05). No statistically significant difference was found between the pain score of the Pethidine group and that of the Bupivacaine group (P>0.05). Conclusion: Gabapentin, with its antihyperalgesic properties and other unknown properties, is a convenient drug for controlling pain following tonsillectomy

Comparison of the effects of pethidine and diclofenac on post appendectomy pain

روش معمول کنترل دردهای پس از عمل استفاده از داروهای مخدر می باشد. استفاده از این داروها می تواند باعث بروز عوارض خطرناکی مثل ضعف تنفس یا حتی قطع تنفس و عوارض خطرناک دیگر شود. از طرفی کار برد این داروها خطر سوء مصرف هم دارد. بنا براین همیشه جایگزین کردن این داروها با داروهای کم خطرتر مد نظر بوده است. هدف از این مطالعه بررسی مقایسه ای اثر ضد درد دیکلوفناک سدیم (داروی مسکن با خواص ضد التهابی) با پتیدین (داروی مخدری که به طور معمول برای کنترل درد های پس از عمل به کار برده می شود) پس از جراحی آپاندکتومی بوده است. این مطالعه از نوع مداخله ای ـ مقایسه ای است که بر روی 72 بیمار پس از عمل آپاندکتومی، بالای 15 سال که به صورت تصادفی ساده انتخاب شدند انجام شد. به گروه مورد (p) آمپول پتیدین یک میلی گرم به ازاء هر کیلو گرم وزن به صورت داخل عضلانی در سه مرحله بلافاصله پس از هوشیاری کامل (مرحله یک)، 6 ساعت بعد (مرحله دو) و 12 ساعت بعد از هوشیاری (مرحله سه) و به گروه شاهد (D) آمپول دیکلوفناک سدیم 75-50 میلی گرم داخل عضلانی در زمان های مشابه تجویز شد. در مراحل مختلف تحقیق شدت درد بر حسب نوع مسکن در هر دو گروه، با استفاده از پرسشنامه مک گیل ارزیابی شد. مقایسه شدت درد مرحله 2 به 1 در گروه P (پتیدین)40/42 و در گروه D (دیکلوفناک سدیم)60/30 (05/0

Predicting Difficult Laryngoscopy and Intubation With Laryngoscopic Exam Test: A New Method.

Airway assessment is fundamental skill for anesthesiologists and failure to maintain a patient's airway is the tremendous cause of anesthesia-related morbidity and mortality. None of the tests which have recommended for predicting difficult intubation stands out to be the best clinical test or have high diagnostic accuracy. Our study aimed to determine the utility of a new test as "laryngoscopic exam test (LET)" in predicting difficult intubation. Three hundred and eleven patients aged 16-60 years participated and completed the study. Airway assessment was carried out with modified Mallampati test, upper lip bit test and LET preoperatively, and Cormack and Lehane's grading of laryngoscopy were assessed during intubation as a gold standard, and difficult laryngoscopy was considered as Cormack and Lehane's grade ΙΙΙ or ΙV of laryngoscopic view. The incidence of difficult intubation was 6.1%. The LET showed higher sensitivity, specificity, and accuracy (P<0.05), without revealing significant differences among three tests (P=0.375). The LET is a simple bedside test and an alternative method for predicting difficult intubation

Effect of naloxone on seizure duration after electroshock therapy (ECT

ECT is a process in which a generalized seizure is induced by passing electrical current for 25 to 150 seconds through the brain under general anesthesia. It is a highly effective treatment for major depression, mania and schizophrenia. Seizure is terminated by active inhibitory processes. The inhibition of seizure is due to the production of endogenous opioids. Naloxone, as an opioid antagonist, may lessen the effect of endogenous opioids. This clinical trial study was conducted to determine the effect of naloxone on length of the seizure. Sixty patients (30 male and 30 female), who met the diagnostic criteria were included in this study. The control group comprised of 30 patients, received ECT without naloxone, and the experimental group comprised of 30 patients, received ECT and 2 mg naloxone (i.v.). Duration of seizure was compared between two groups by t-test. The mean of seizure length was 21.3s in the control and 27.8s in the experimental group. Therefore naloxone can be used for lengthening of seizure and consequently for improving its treatment benefit

Relationship between substance abuse and mental disorders of family (2001)

زمینه و هدف: یکی از آثار شوم مصرف مواد مخدر بهم ریختن بهداشت روانی جامعه و در محدوده کوچکتر آن سیستم خانواده است. هدف اصلی این پژوهش بررسی مصرف مواد (سوء مصرف یا وابستگی) توسط یک یا بیش از یک عضو خانواده و تأثیر روانی آن روی سایر اعضاء خانواده است. روش مطالعه: نوع پژوهش توصیفی – تحلیلی و تعداد نمونه ها 724 نفر از بیماران ارجاعی و مراجعه کننده به مراکز مشاوره و روانشناسی کلینیک ویژه آیت ا… کاشانی شهرکرد بود که طی مدت یک سال به صورت تصادفی انتخاب شدند. این افراد پس از آنکه از طرف سایر متخصصین جهت مشاوره به مرکز ارجاع داده می شدند، بوسیله چک لیست علائم اختلالات روانی و همچنین چک لیست سوء مصرف یا وابستگی به مواد مورد ارزیابی قرار می گرفتند. نتایج: از تعداد کل نمونه ها 514 نفر (71) زن و 210 نفر (29) مرد و محدوده سنی نمونه ها 61-6 سال با میانگین سنی 24 سال بود. از تعداد کل مراجعین 358 نفر (4/49) اذعان کردند که حداقل یکی از اعضاء خانواده دارای سوء مصرف یا وابسته به مواد است که این مسئله در بروز یا عود علائم بیماری آنها نقش اساسی داشته است. از این گروه تعداد 238 نفر (5/66) زنان و تعداد 120 نفر (2/32) مردان وجود سوء مصرف یا وابستگی به مواد را در همسر و فرزند خود گزارش و 5/33 زنان و 7/27 مردان چنین مسئله ای را در خانواده بیمارگزارش کردند. همچنین ارتباط معنی داری (05/0

Lazer Navigating System: A New System for Finding and Removing Forigner Bodies

Finding Foreign Bodies (FB) inside different parts of the body have been difficult for all of the surgeons. Although at first it seems easy to remove these FB but during operation many problem for their removing can occurs, the most important of them is that they can not be find. Many orthopedists, general surgeons and neurosurgeons had experienced with this problem. In this study we are trying to show the efficacy of Lazer Navigating System (LNS) a new system that we have designed for finding and removing FB inside different parts of ..

Neurologic complications in percutaneous nephrolithotomy

Percutaneous nephrolithotomy (PCNL) has been the preferred procedure for the removal of large renal stones in Iran since 1990. Recently, we encountered a series of devastating neurologic complications during PCNL, including paraplegia and hemiplegia. There are several reports of neurologic complications following PCNL owing to paradoxical air emboli, but there are no reports of paraplegia following PCNL. Materials and Methods: We retrospectively reviewed the medical records of patients who had undergone PCNL in 13 different endourologic centers and retrieved data related to neurologic complications after PCNL, including coma, paraplegia, hemiplegia, and quadriplegia. Results: The total number of PCNL procedures in these 13 centers was 30,666. Among these procedures, 11 cases were complicated by neurologic events, and four of these cases experienced paraplegia. All events happened with the patient in the prone position with the use of general anesthesia and in the presence of air injection. There were no reports of neurologic complications in PCNL procedures performed with the patient under general anesthesia and in the prone position and with contrast injection. Conclusions: It can be assumed that using room air to opacify the collecting system played a major role in the occurrence of these complications. Likewise, the prone position and general anesthesia may predispose to these events in the presence of air injectio

EFFICACY OF PROPHYLACTIC TRANEXAMIC ACID FOR PREVENTION OF HEMORRHAGE IN HEMOPHILIC PATIENTS

Hemophilia A and B are two type of coagulation disorders with specific complication due to disease and its treatment consequences. The prevention of truma and factor replacement are cornerstone of therapy in hemophilia. In this study, the efficacy of prophylactic tranexamic acid (TEA) in reducing bleeding episodes and factor replacement was evaluated. In this study, 28 hemophilic patients were divided into two groups, group 1: TEA was used for 2 months (20mg/kg, oral tablet). In groupe2 any adjunctive therapy not used. In-group 1 bleeding episode and need for factor replacement, were decreased significantly (p<0.05). But surprisingly PIT was increased significantly in-group 1, probably due to decreased factor replacement by the pts. In groups, 2 bleeding episode and need for factor replacement were not+ different prior and during study. Our experience would suggest that daily prophylactic use of TEA is effective in reducing bleeding episodes in hemophilia, but due to increased PTT (probably due to decreased factor replacement by the pts) the risk for life threatening bleeding would be high, and also complete block of fibrinolytic pathway during TEA therapy is a dangerous consequence. So we do not recommend the use of TEA as prophylaxis in hemophiliac patients