What is the most effective method of pain reduction during intravenous cannulation in children? A systematic review and meta-analysis study

Introduction: Pain is one of the various outcomes of intravenous cannulation. There are various methods of pain reduction during intravenous cannulation. Still there is not any agreement about the most effective analgesic method. For this reason, the aim of this study was to determine the most effective method of pain reduction during intravenous cannulation in childrenn. Materials and methods: All previous relevant studies in the databases were reviewed using Cochrane protocol and sensitive and standard keywords such as pain, children and intravenous cannulation, from 1995 to 2013. The extraction and evaluation of studies were performed by two individuals. CONSORT checklist was used to evaluate the quality of the studies. Samples homogeneity was assessed using the tau-square estimates. The random effects model was used to report the pooled average estimates for the most effective method on pain reduction during intravenous cannulation. Results: systematic review of 14409 studies determined that only 30 studies had the inclusion criteria. Nineteen studies were entered the meta-analysis. Meta-analysis study showed that EMLA was the most effective method in comparing control/ placebo among the other various ones. Among the treatments comparison, IontophoresisLidocaine was the most effective in compare with EMLA. Conclusion: EMLA cream was the most effective treatment in reducing the pain of intravenous cannulation. Although lidocaine injection methods such as Iontophoresis, as a new method, can produce more rapid, effective and satisfying pain reduction than other alternatives. © 2016, Semnan University of Medical Sciences. All rights reserved

Association of regional cerebral perfusion impairment with gait and balance performance in dizzy patients using brain perfusion spect: Voxel-based analysis of a pilot sample

Objective(s): The purpose of this study was to investigate regional cerebral blood flow (rCBF) reduction in patients with dizziness and perfusion-related clinical impairment using brain perfusion single photon emission tomography (SPECT). Methods: Thirty-four patients with subjective dizziness and 13 age-and sexmatched healthy controls were studied. Dizziness-related impairments were assessed using the Dizziness Handicap Inventory (DHI) and Short Physical Performance Battery (SPPB). Brain perfusion SPECT scan was acquired from all participants. The carotid intima-media thickness (CIMT) was also measured. Brain perfusion data were qualitatively interpreted in all cases. Voxel-wise analysis was also conducted in 11 patients compared to healthy controls. Results: Thirty-four patients (mean age=53.8±13.4 years, m/f: 19/15) and 13 ageand sex-matched controls (mean age=51.5±13.1, m/f: 7/6) were included. The dizziness severity was mild in 58.8% (n=20), moderate in 26.5% (n=9), and severe in 14.7% (n=5). Qualitative interpretation of SPECT images showed normal scans in 4 (11.2%) patients and abnormal scans in 30 (88.2%) patients. Patients with dizziness showed a significantly decreased brain perfusion in the precuneus, cuneus, occipital lobe (superior and inferior parts), frontal lobe (inferior and middle parts), temporal lobe, parietal lobe (inferior and superior parts), cerebellum, insula, and putamen nucleus. Based on both qualitative SPECT interpretation and voxel-wise analysis, perfusion defect had a significant association with the total SPPB score and the scores of two sub-domains (p[removed]0.05) score . Conclusion: The perfusion-and atherosclerosis-related impairments of gait and balance were largely independent of subjective dizziness and dizziness severity. Moreover, this study provided support for contribution of perfusion impairment to the disturbance of gait and balance in older populations along with other pathologic processes. © 2021 mums.ac.ir All rights reserved