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Inoue S, Miyoshi H, Hieda K, Hayashi T, Tsutsumi YM, Teishima J. Postoperative around-the-clock administration of intravenous acetaminophen for pain control following robot-assisted radical prostatectomy. Sci Rep 2021; 11:5174. [PMID: 33664398 PMCID: PMC7933238 DOI: 10.1038/s41598-021-84866-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 02/19/2021] [Indexed: 11/09/2022] Open
Abstract
The objective of this study was to examine the impact of around-the-clock (ATC) administration of intravenous (IV) acetaminophen following robot-assisted radical prostatectomy (RARP). Intravenous infusion of acetaminophen was started on the day of the operation at 1000 mg/dose every 6 h, and the infusion was continued on a fixed schedule until postoperative day 2 a.m. In a retrospective observational study, we compared 127 patients who were administered IV acetaminophen on a fixed schedule (ATC group) with 485 patients who were administered analgesic drugs only as needed (PRN group). We investigated postoperative pain intensity and additional analgesic consumption on postoperative day 0, 1, 2, 3, and 5 between the two groups. Postoperative pain scores were significantly lower in the ATC group than in the PRN group at 1 and 2 days, and this period matched the duration of ATC administration of IV acetaminophen. Postoperative frequency of rescue analgesia was significantly lower in the ATC group than in the PRN group at postoperative 0, 1, and 2 days. ATC administration of IV acetaminophen has the potential to be a very versatile and valuable additional dose to achieve appropriate postoperative analgesia in patients with RARP.
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Affiliation(s)
- Shogo Inoue
- Department of Urology, Hiroshima University Graduate School of Biomedical Sciences, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
| | - Hirotsugu Miyoshi
- Department of Anesthesiology and Critical Care, Hiroshima University Hospital, Hiroshima, Japan
| | - Keisuke Hieda
- Department of Urology, Hiroshima University Graduate School of Biomedical Sciences, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Tetsutaro Hayashi
- Department of Urology, Hiroshima University Graduate School of Biomedical Sciences, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Yasuo M Tsutsumi
- Department of Anesthesiology and Critical Care, Hiroshima University Hospital, Hiroshima, Japan
| | - Jun Teishima
- Department of Urology, Hiroshima University Graduate School of Biomedical Sciences, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
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Effect of Preoperative Patient Education on Opioid Consumption and Well-Being in Breast Augmentation. Plast Reconstr Surg 2020; 145:316e-323e. [DOI: 10.1097/prs.0000000000006467] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Gol MK, Dorosti A, Montazer M. Design and psychometrics cultural competence questionnaire for health promotion of Iranian nurses. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2019; 8:155. [PMID: 31544120 PMCID: PMC6745883 DOI: 10.4103/jehp.jehp_367_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 03/16/2019] [Indexed: 06/10/2023]
Abstract
INTRODUCTION As an important factor in the quality of nursing care, cultural competence of nurses should be assessed to improve the quality of care provided. Nursing care is sensitive to culture; therefore, it is necessary to design a tool for evaluation of cultural competence. In this regard, the present study intended to develop a cultural competence questionnaire for Iranian nurses. MATERIALS AND METHODS In this methodological study, 350 nurses working in all educational hospitals affiliated to Tabriz University of Medical Sciences were selected through convenience sampling. Questions related to cultural care were selected by experts of this field, and a questionnaire was designed and its validity and reliability were examined. RESULTS A 20-item questionnaire was developed which assessed the three areas of learning and education, awareness and knowledge, and skills. Cronbach's alpha of the whole questionnaire was 0.912, and its validity based on the Kaiser-Mayer-Olkin Index was 0.891. CONCLUSION This study provides proper evidence regarding the strength of factor structure and the reliability of the developed questionnaire; therefore, it can be considered as a scientific tool for research, educational, and practical purposes in Iranian nurses.
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Affiliation(s)
- Mehdi Khanbabayi Gol
- Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Abasali Dorosti
- Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Majid Montazer
- Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Wang VC, Preston MA, Kibel AS, Xu X, Gosnell J, Yong RJ, Urman RD. A Prospective, Randomized, Double-Blind, Placebo-Controlled Trial to Evaluate Intravenous Acetaminophen Versus Placebo in Patients Undergoing Robotic-Assisted Laparoscopic Prostatectomy. J Pain Palliat Care Pharmacother 2019; 32:82-89. [DOI: 10.1080/15360288.2018.1513436] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Kalani N, Sanie MS, Zabetian H, Radmehr M, Sahraei R, Kargar Jahromi H, Zare Marzouni H. Comparison of the Analgesic Effect of Paracetamol and Magnesium Sulfate during Surgeries. World J Plast Surg 2016; 5:280-286. [PMID: 27853692 PMCID: PMC5109390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND New drugs are increasingly used to induce analgesia during surgeries. This study compared the analgesic effects of paracetamol and magnesium sulfate. METHODS Sixty patients with American Society of Anesthesiologists (ASA) class I or II patients who were candidates for surgery of the lower limbs were randomly divided into three equal groups who were age and gender matched. Group 1 received paracetamol, and group 2, the magnesium sulfate during surgery and group 3 as the control. Pain intensities were measured and recorded using the Visual Analog Scale before surgery, in the recovery room, and 6, 12, and 18 hours after surgery. RESULTS Pain intensities (7.10, 5.80, and 4.10) were higher in the control group; 6, 12, and 18 hours after surgery compared to the paracetamol (6.45, 4.15, 2.50) and the magnesium groups (7.25, 4.55, and 2.05), but the difference was not statistically significant. CONCLUSION Paracetamol and magnesium sulfate were shown to have postoperative analgesic effects and reduce the quantity of narcotic use after surgery.
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Affiliation(s)
- Navid Kalani
- Medical Ethic Research Center, Jahrom University of Medical Sciences, Jahrom, Iran;,Department of Anaesthesiology, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Mohammad Sadegh Sanie
- Department of Anaesthesiology, Jahrom University of Medical Sciences, Jahrom, Iran;,Research Center For Social Determinants Of Health, Jahrom University of Medical Sciences, Jahrom, Iran;,Corresponding Author: Mohammad Sadegh Sanie, MD, Department of Anesthesiology, Jahrom University of Medical Sciences, Jahrom, Iran. Tel: 98-917-700-2599 ,
| | - Hasan Zabetian
- Department of Anaesthesiology, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Mohammad Radmehr
- Department of Anaesthesiology, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Reza Sahraei
- Department of Anaesthesiology, Jahrom University of Medical Sciences, Jahrom, Iran
| | | | - Hadi Zare Marzouni
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
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Movassaghi R, Peirovifar A, Aghamohammadi D, Mohammadipour Anvari H, EJ Golzari S, Kourehpaz Z. Premedication With Single Dose of Acetazolamide for the Control of Referral Shoulder Pain After Laparoscopic Cholecystectomy. Anesth Pain Med 2015; 5:e29366. [PMID: 26705522 PMCID: PMC4688810 DOI: 10.5812/aapm.29366] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Revised: 08/22/2015] [Accepted: 08/31/2015] [Indexed: 01/04/2023] Open
Abstract
Background: The use of laparoscopic surgeries is escalating thanks to their advantages over the open surgeries. However, several complications can be observed following laparoscopy operation. Postoperative pain is a major concern in cholecystectomy surgeries. Pain can be both experienced in operated areas and radiated to the right shoulder. Acetazolamide is used for glaucoma, acute mountain sickness prophylaxis, and epilepsy in few patients with recurrent epilepsy. It seems that patients’ pain can be reduced by preventing carbonic acid production in abdomen after operation. Objectives: We aimed at evaluating if administration of acetazolamide preoperatively could affect early or late postoperative pain following laparoscopic surgery. Patients and Methods: In a randomized-controlled clinical trial study, 70 subjects (30 - 60 years) scheduled for laparoscopic cholecystectomy were included after obtaining a written informed consent. Patients were divided into two groups randomly (intervention and control). The intervention group received 5 mg/kg oral acetazolamide one hour before the operation. The control group did not receive any further medication. Results: Administration of a single dose of acetazolamide did not have any statistically significant impact on sleep quality (P = 1.000). Moreover, there was no statistically significant difference between groups regarding nausea and vomiting on single dose administration of acetazolamide (P = 1.000). Single dose of acetazolamide was associated with statistically significant decrease in shoulder pain immediately after laparoscopy (P = 0.017). However, there was no statistically significant difference regarding shoulder pain between the studied groups 2, 4, 6, 8, 10, 12, and 24 hours after laparoscopy. Single dose of acetazolamide did not significantly affect analgesic administration in 2, 4, 6, 8, 10, 12, and 24 hours after laparoscopy. Conclusions: Single dose of acetazolamide was associated with statistically significant decrease in shoulder pain immediately after laparoscopy. However, this effect was limited to the first postoperative hours and it failed to reduce postoperative pain of right shoulder during 24 hours after the operation.
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Affiliation(s)
- Reza Movassaghi
- Department of Anesthesiology, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ali Peirovifar
- Department of Anesthesiology, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Davood Aghamohammadi
- Department of Anesthesiology, Tabriz University of Medical Sciences, Tabriz, Iran
- Corresponding author: Davood Aghamohammadi, Department of Anesthesiology, Tabriz University of Medical Sciences, Tabriz, Iran. Tel: +98-9141150785, Fax: +98-4135566449, E-mail:
| | | | - Samad EJ Golzari
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zohreh Kourehpaz
- Department of Anesthesiology, Tabriz University of Medical Sciences, Tabriz, Iran
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Hashemi SM, Esmaeelijah A, Golzari S, Keyhani S, Maserrat A, Mohseni G, Ardehali SH. Intravenous Paracetamol Versus Patient-Controlled Analgesia With Morphine for the Pain Management Following Diagnostic Knee Arthroscopy in Trauma Patients: A Randomized Clinical Trial. ARCHIVES OF TRAUMA RESEARCH 2015; 4:e30788. [PMID: 26848478 PMCID: PMC4733531 DOI: 10.5812/atr.30788] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 08/19/2015] [Accepted: 09/02/2015] [Indexed: 02/07/2023]
Abstract
Background: Most patients undergoing outpatient surgeries have the unpleasant experience of high level pain after surgery. Compared with open surgeries, arthroscopic procedures are less painful; however, inadequate pain management could be associated with significant concerns. Opioids alone or in combination with local anesthetics are frequently used for diminishing postoperative pain using intravenous or epidural infusion pumps. Despite morphine various disadvantages, it is commonly used for controlling pain after surgery. Objectives: The aim of this study was to compare intravenous paracetamol and patient-controlled analgesia (PCA) with morphine for the pain management following diagnostic knee arthroscopy in trauma patients. Patients and Methods: Sixty trauma patients who were scheduled to undergo knee arthroscopy were randomly divided into two groups. Patients immediately received intravenous infusion of 1 g paracetamol within 15 minutes after surgery and every 6 hours to 24 hours in the paracetamol group. The patient-controlled analgesia group received morphine through PCA infusion pump at 2 mL/h base rate and 1mL bolus every 15 minutes. Pain level, nausea and vomiting, and sedation were measured and recorded during entering the recovery, 15 and 30 minutes after entering the recovery, 2, 6, and 24 hours after starting morphine pump infusion in the morphine and paracetamol in the paracetamol groups. Results: There was no significant difference regarding the pain level at different times after entering the recovery between the two groups. No one from the paracetamol group developed drug complications. However, 22.3% in the PCA morphine suffered from postoperative nausea; there was a statistically significant difference regarding the sedation level, nausea, and vomiting at various times between the two groups. Conclusions: Intravenous administration of paracetamol immediately after knee arthroscopy improved postoperative pain, decreased analgesic administration, maintained stable hemodynamic parameters, had no complications related to opiates, no nausea and vomiting, and increased patient satisfaction and comfort in comparison to PCA with morphine.
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Affiliation(s)
- Seyed Masoud Hashemi
- Department of Pain Management, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Aliakbar Esmaeelijah
- Department of Orthopedics, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Samad Golzari
- Department of Anesthesiology, Tabriz University of Medical Sciences, Tabriz, IR Iran
| | - Sohrab Keyhani
- Department of Orthopedics, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Azita Maserrat
- Department of Anesthesiology, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Gholamreza Mohseni
- Department of Anesthesiology, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
- Corresponding author: Gholamreza Mohseni, Department of Anesthesiology, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran. Tel: +98-9375347941, E-mail:
| | - Seyed Hosein Ardehali
- Department of Anesthesiology, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
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Moslemi F, Rasooli S, Baybordi A, Golzari SE. A Comparison of Patient Controlled Epidural Analgesia With Intravenous Patient Controlled Analgesia for Postoperative Pain Management After Major Gynecologic Oncologic Surgeries: A Randomized Controlled Clinical Trial. Anesth Pain Med 2015; 5:e29540. [PMID: 26587406 PMCID: PMC4644303 DOI: 10.5812/aapm.29540] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2015] [Revised: 06/27/2015] [Accepted: 07/05/2015] [Indexed: 01/14/2023] Open
Abstract
Background: Postoperative pain after major open gynecologic surgeries requires appropriate pain management. Objectives: This study aimed at comparing perioperative patient controlled epidural analgesia (PCEA) and patient controlled intravenous analgesia (PCA) after gynecologic oncology surgeries. Patients and Methods: In this clinical trial study, 90 patients with American society of anesthesiologists (ASA) class I or II scheduled for gynecologic oncologic surgeries were randomly allocated to two groups (45 patients each group) to receive: patient-controlled epidural analgesia with bupivacaine and fentanyl (PCEA group), or patient controlled intravenous analgesia (IV PCA group) with fentanyl, pethidine and ondansetron. Postoperative pain was assessed over 48 hours using the visual analog scale (VAS). The frequency of rescue analgesia was recorded. Occurrence of any concomitant events such as nausea, vomiting, ileus, purities, sedation and respiratory complications were recorded postoperatively. Results: There were no statistically significant differences in demographic data including; age, weight, ASA physical status, duration of surgery, intraoperative bleeding, and the amount of blood transfusion (P > 0.05), between the two studied groups. Severity of postoperative pain was not significantly different between the two groups (P > 0.05); however, after first patient mobilization, pain was significantly lower in the epidural group than the IV group (P < 0.001). There was no significant difference between the two groups regarding the incidence of complications such as nausea, vomiting, purities or ileus (P > 0.05). Nevertheless, the incidence and severity of sedation was significantly higher in the IV group (P < 0.001). Respiratory depression was higher in the IV group than the epidural group; this difference, however, was not significant (P = 0.11). In the epidural group, only 10 patients (22.2%) had mild and transient lower extremities parenthesis. Conclusions: Both intravenous and epidural analgesic techniques with combination of analgesics provide proper postoperative pain control after major gynecologic cancer surgeries without any significant complications. Regarding lower sedative and respiratory depressant effects of epidural analgesia, it seems that this method is a safer technique for postoperative pain relief in these patients.
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Affiliation(s)
- Farnaz Moslemi
- Department of Anesthesiology, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sousan Rasooli
- Department of Anesthesiology, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ali Baybordi
- Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Samad E.J. Golzari
- Drug Applied Research Center, Tabriz Univesity of Medical Sciences, Tabriz, Iran
- Corresponding author: Samad E.J. Golzari, Tabriz University of Medical Sciences, Tabriz, Iran. Tel: +98-9141151894, Fax: +98-4135566449, E-mail:
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