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Imani F, Emami A, Alimian M, Nikoubakht N, Khosravi N, Rajabi M, Hertling AC. Comparison of Perioperative Pregabalin and Duloxetine for Pain Management After Total Knee Arthroplasty: A Double-Blind Clinical Trial. Anesth Pain Med 2023; 13:e127017. [PMID: 37529346 PMCID: PMC10389034 DOI: 10.5812/aapm-127017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 01/01/2023] [Accepted: 01/08/2023] [Indexed: 08/03/2023] Open
Abstract
Background Chronic residual pain after total knee arthroplasty (TKA) is one of the challenges of postoperative pain management. Duloxetine, by controlling neuropathic pain, and pregabalin, by affecting nociceptors, can effectively manage postoperative pain. Objectives This study aimed to compare the effect of perioperative oral duloxetine and pregabalin in pain management after knee arthroplasty. Methods In this clinical trial, 60 patients scheduled for TKA under spinal anesthesia were randomly assigned to one of three groups A (pregabalin 75 mg), B (duloxetine 30 mg), and C (placebo). Drugs were administered 90 minutes before, 12, and 24 hours after surgery. The visual analog scale (VAS) score for pain, the first analgesic request time, postoperative analgesic consumption (i.v. paracetamol), and WOMAC score six months after surgery were recorded. Results The VAS score and analgesic consumption 48 hours after TKA in groups A and B significantly decreased compared to the placebo (P < 0.05). The first analgesic request time was longer in groups A and B than in group C (P < 0.05). While the differences were statistically significant, they are most likely not clinically significant. The WOMAC score before and six months after arthroplasty did not differ between the groups (P > 0.05). Conclusions Perioperative oral pregabalin and duloxetine similarly reduce pain and the need for analgesic consumption within 48 hours after TKA but do not affect knee mobility status.
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Affiliation(s)
- Farnad Imani
- Pain Research Center, Department of Anesthesiology and Pain Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Azadeh Emami
- Pain Research Center, Department of Anesthesiology and Pain Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mahzad Alimian
- Pain Research Center, Department of Anesthesiology and Pain Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Nasim Nikoubakht
- Pain Research Center, Department of Anesthesiology and Pain Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Niloofar Khosravi
- Pain Research Center, Department of Anesthesiology and Pain Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mehdi Rajabi
- Department of Anesthesiology, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Arthur Christopher Hertling
- Department of Anesthesiology, Perioperative Care and Pain Medicine, School of Medicine, New York University, New York, USA
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Shafeinia A, Rahimi M, Nikoubakht N, Ghaed MA. The Effect of Painless Delivery with Intrathecal Sufentanil on Labor Progress and Neonatal Outcomes: A Single Center Study on Pregnant Women. Anesth Pain Med 2022; 12:e121297. [PMID: 36938112 PMCID: PMC10016133 DOI: 10.5812/aapm-121297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 05/21/2022] [Accepted: 10/26/2022] [Indexed: 11/30/2022] Open
Abstract
Background Delivery pain is the most unbearable pain and can be relieved with intrathecal opioids. This study aimed to investigate the effect of intrathecal sufentanil for painless delivery on labor progress and neonatal outcomes in pregnant women. Methods This was a single-arm observational cohort study on 1055 pregnant women candidates for vaginal delivery with spinal analgesia referred to the Akbarabadi Hospital. First, 0.1 µg/kg of intrathecal sufentanil was used, and maternal blood pressure and maternal and fetal heart rates were recorded after analgesia. During delivery, the mothers were monitored for nausea, pruritus, motor block, apnea, urinary retention, or the possibility of an emergency cesarean section. The duration of the analgesia, the duration of the second stages of labor, and the mother's pain scores were recorded based on the Visual Analogue Scale (VAS). 1- and 5-minute Apgar scores and arterial blood gas (ABG) of the umbilical cord were also recorded. Results The most common station was -3 for 723 women, followed by -2 for 229 women. Fifty-two women underwent cesarean section, and fetal distress was the most common reason for cesarean section (57.7%). The mean time for initiating analgesia was 5.93 ± 2.87 minutes, and the mean visual analog scale was 1.08 ± 0.16. The mean Apgar was 9.0 ± 0.47; the mean weight at birth was 2917.39 ± 449.90 gr; PH was 7.31 ± 2.03; HCO3 was 22.67 ± 3.08mEq/liter, and PaCo2 was 43.36 ± 7.06 mmHg. Regarding complications, the patients just developed itching (n = 78), and hypotension, bradycardia, apnea, and decreased consciousness were overlooked. Conclusions Intrathecal sufentanil is safe and efficient in painless delivery, resulting in normal Apgar and normal PH with no specific side-effect.
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Affiliation(s)
- Amineh Shafeinia
- Department of Anesthesiology, School of Medicine, Shahid Akbar-Abadi Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Rahimi
- Department of Obstetrics and Gynecology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Nasim Nikoubakht
- Department of Anesthesiology, School of Medicine, Rasool Akram Medical Complex, Iran University of Medical Sciences, Tehran, Iran
- Department of Anesthesiology and Pain Medicine, Pain Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Ghaed
- Endourology Fellowship, Labbafi Nejad Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Urology, Rasool Akram Medical Complex, Iran University of Medical Sciences, Tehran, Iran
- Corresponding Author: Endourology Fellowship, Labbafi Nejad Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Nikoubakht N, Faiz SHR, Mousavie SH, Shafeinia A, Borhani Zonoz L. Effect of bupivacaine intraperitoneal and intra-abdominal bicarbonate in reducing postoperative pain in laparoscopic cholecystectomy: a double-blind randomized clinical trial study. BMC Res Notes 2022; 15:191. [PMID: 35659713 PMCID: PMC9166522 DOI: 10.1186/s13104-022-06083-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 05/24/2022] [Indexed: 11/23/2022] Open
Abstract
Objective We aimed to compare the effect of bupivacaine intraperitoneal with intra-abdominal bicarbonate in reducing postoperative pain in laparoscopic cholecystectomy. Results In this double-blind randomized clinical trial study, 58 patients underwent laparoscopic cholecystectomy referred to a hospital in Tehran, Iran (2019), were assigned into three groups: at the end of the surgery, spraying 50 cc of bupivacaine 0.2% through the laparoscopic port; or rinsing the abdomen with 5.7% bicarbonate dissolved in 1000 cc of normal saline; or abdominal lavage with normal saline. Pain of patients was evaluated according to visual analogue scale criteria and means Ramsay score in recovery times, 2, 8 and 24 h and post-operative analgesia satisfaction score at 2 and 24 h were also evaluated. The mean age of range was 44.26 ± 13.13 years, 44 female patients and 14 male patients. The mean Ramsay score in recovery, 2, 8 and 24 h postoperative times was not significantly different among the groups. Comparing post-operative analgesic satisfaction scores in recovery, 2 and 24 h revealed no significant difference among the groups. We found that use of bupivacaine intraperitoneal and intra-abdominal bicarbonate decreased pain after laparoscopic cholecystectomy but the decrease was more in bupivacaine group than bicarbonate group. Trial Registration: Retrospectively registered, IRCT20180723040570N1; date of registration: 2019-06-24.
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Affiliation(s)
- Nasim Nikoubakht
- Department of Anesthesiology and Pain Medicine, Rasool Akram Medical Complex, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Hamid Reza Faiz
- Minimally Invasive Surgery Research Center, Department of Anesthesiology and Pain Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Hamzeh Mousavie
- Department of General Surgery, School of Medicine, Rasool Akram Medical Complex, Iran University of Medical Sciences, Tehran, Iran
| | - Amineh Shafeinia
- Department of Anesthesiology and Pain Medicine, Shahid Akbarabadi Hospital, Iran University of Medical Sciences, Tehran, Iran.
| | - Leila Borhani Zonoz
- Nurse Anesthetist, Rasool Akram Medical Complex, Iran University of Medical Sciences, Tehran, Iran
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Rahimzadeh P, Nikoubakht N, Faiz SHR, Khodabandeh M. Effects of Different Doses of Dexamethasone on Blood Glucose Concentration in Patients Undergoing Elective Abdominal Surgery: A Double-Blind Randomized Clinical Trial. Med J Islam Repub Iran 2021. [DOI: 10.47176/mjiri.35.178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Alimian M, Zaman B, Seyed Siamdoust SA, Nikoubakht N, Rounasi R. Comparison of RAMP and New Modified RAMP Positioning in Laryngoscopic View During Intubation in Patients with Morbid Obesity: A Randomized Clinical Trial. Anesth Pain Med 2021; 11:e114508. [PMID: 34540638 PMCID: PMC8438731 DOI: 10.5812/aapm.114508] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 05/24/2021] [Accepted: 05/29/2021] [Indexed: 11/16/2022] Open
Abstract
Background The prevalence of obesity is increasing worldwide, and anesthesiologists are facing challenges in the airway management of such patients. Excessive adipose tissue influences pharyngeal spaces and affects the laryngoscopic grade. Standard ramp positioning is time-consuming and difficult to prepare, and requires expensive equipment. Objectives The aim of this study was to compare the standard ramp position with the proposed low-cost and easily accessible modified ramp position in laryngoscopic view during the intubation of patients with morbid obesity. Methods In this single-blind clinical trial, 84 patients candidate for bariatric surgery at Rasoul Akram Hospital in 2020 were assigned to the rapid airway management positioner (RAMP) (R) and new modified RAMP (MR) groups by the block randomization method. The laryngoscopic view of the glottis based on the Cormack-Lehane scale, ventilation quality, duration of intubation, intubation attempts, oxygen saturation at the end of intubation, and the need for backward, upward, rightward pressure (BURP) maneuver for successful intubation were recorded. Normal distribution tests and Mann-Whitney and Kruskal-Wallis tests were used to analyze the data. Results The results showed no significant differences between the two groups regarding ventilation score, laryngoscopy grade, number of intubation attempts, duration of intubation, and the need for BURP maneuvers during intubation (P > 0.05). Conclusions The two methods are not significantly different, and the new modified ramp position can be used with more ease and availability and less cost.
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Affiliation(s)
- Mahzad Alimian
- Pain Research Center, Department of Anesthesiology and Pain Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Behrooz Zaman
- Pain Research Center, Department of Anesthesiology and Pain Medicine, Iran University of Medical Sciences, Tehran, Iran
- Corresponding Author: Pain Research Center, Department of Anesthesiology and Pain Medicine, Iran University of Medical Sciences, Tehran, Iran.
| | - Seyed Alireza Seyed Siamdoust
- Pain Research Center, Department of Anesthesiology and Pain Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Nasim Nikoubakht
- Pain Research Center, Department of Anesthesiology and Pain Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ramin Rounasi
- Pain Research Center, Department of Anesthesiology and Pain Medicine, Iran University of Medical Sciences, Tehran, Iran
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Nikoubakht N, Alimian M, Faiz SHR, Derakhshan P, Sadri MS. Effects of ketamine versus dexmedetomidine maintenance infusion in posterior spinal fusion surgery on acute postoperative pain. Surg Neurol Int 2021; 12:192. [PMID: 34084620 PMCID: PMC8168657 DOI: 10.25259/sni_850_2020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 04/01/2021] [Indexed: 12/25/2022] Open
Abstract
Background: One of the most challenging issues after posterior spinal fusion (PSF) surgery is providing appropriate pain control measures to enhance recovery of the patients. We aimed to compare effects of ketamine versus dexmedetomidine infusion during maintenance of anesthesia on acute postoperative pain in PSF surgery. Methods: In a double-blinded randomized clinical trial, 87 patients candidates for PSF surgery were randomly assigned into three groups. Anesthesia protocol for all groups was the same except: the first group received 0.2 mcg/kg/h dexmedetomidine infusion, the second received 0.1 mg/kg/h ketamine infusion, and control group received normal saline infusion as a placebo. Pain intensity by VAS scale and level of sedation by Ramsey scale were assessed, and amount of opioid prescribed after surgery was measured and compared for patients during the recovery and at 2, 4, 6, 12, and 24 h after surgery in three groups, and hypotension and bradycardia during operation were reported. Results: There was a significant difference among the groups regarding pain intensity and amount of opioids during recovery and at 2, 4, 6, 12, and 24 h after surgery. Pain intensity and amount of opioids for ketamine and dexmedetomidine groups were significantly lower than those in the controls during recovery and at the hours after surgery. There was no significant difference regarding bradycardia and hypotension and level of sedation during recovery and at the hours after surgery. Conclusion: Both ketamine and dexmedetomidine infusions during maintenance of anesthesia are effective in reducing acute postoperative pain effectively after PSF surgery.
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Affiliation(s)
- Nasim Nikoubakht
- Department of Anesthesiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mahzad Alimian
- Department of Anesthesiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Hamid Reza Faiz
- Department of Anesthesiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Pooya Derakhshan
- Department of Anesthesiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Saleh Sadri
- Department of Anesthesiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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Faiz SHR, Riahi T, Rahimzadeh P, Nikoubakht N. Commentary: Remote electronic consultation for COVID-19 patients in teaching hospitals in Tehran, Iran. Med J Islam Repub Iran 2020. [DOI: 10.47176/mjiri.34.31] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Hassani V, Amniati S, Ahmadi A, Mohseni M, Sehat-Kashani S, Nikoubakht N, Derakhshan P, Farahmand Rad R, Habibi A. Emergency Tracheostomy in Two Airway Trauma Patients Suspected of COVID-19: A Case Report. Anesth Pain Med 2020; 10:e104648. [PMID: 33134149 PMCID: PMC7539045 DOI: 10.5812/aapm.104648] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 06/17/2020] [Accepted: 06/23/2020] [Indexed: 11/16/2022] Open
Abstract
Coronavirus disease 2019, known as COVID-19, was first identified in Wuhan, China, in December 2019 and became a pandemic on Mar 11, according to the World Health Organization report. In the epidemic of COVID-19, many patients admitted to hospitals for other reasons may be silent carriers of COVID-19 and have the risk of infecting medical personnel. Thus, meticulous personal protection measures should be considered in suspicious patients, especially when close contact with the patient’s airway is anticipated. We introduce two airway trauma patients suspected of COVID-19 who required emergency tracheostomy. Patient one was a 29-year-old man who suffered facial trauma following a car accident. A chest CT scan showed peripheral ground-glass opacities suggestive for COVID-19. The second patient was a young elevator mechanic who experienced maxillofacial trauma after an elevator crash. The methods of anesthesia and airway protection and safety precautions are described.
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Affiliation(s)
- Valiollah Hassani
- Pain Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Saied Amniati
- Pain Research Center, Iran University of Medical Sciences, Tehran, Iran
- Corresponding Author: Pain Research Center, Iran University of Medical Sciences, Tehran, Iran.
| | - Aslan Ahmadi
- ENt and Head and Neck Research Centerand Department, The Five Sences Institue, Hazrat Rasoul Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Masood Mohseni
- Pain Research Center, Iran University of Medical Sciences, Tehran, Iran
| | | | - Nasim Nikoubakht
- Pain Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Pooya Derakhshan
- Pain Research Center, Iran University of Medical Sciences, Tehran, Iran
| | | | - Azadeh Habibi
- Pain Research Center, Iran University of Medical Sciences, Tehran, Iran
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Faiz SHR, Riahi T, Rahimzadeh P, Nikoubakht N. Commentary: Remote electronic consultation for COVID-19 patients in teaching hospitals in Tehran, Iran. Med J Islam Repub Iran 2020; 34:31. [PMID: 32617270 PMCID: PMC7320982 DOI: 10.34171/mjiri.34.31] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Indexed: 12/04/2022] Open
Affiliation(s)
- Seyed Hamid Reza Faiz
- Rasoul Akram Hospital Clinical Research Development Center (RCRDC), Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Taghi Riahi
- Rasoul Akram Hospital Clinical Research Development Center (RCRDC), Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Poupak Rahimzadeh
- Pain Research Center, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Nasim Nikoubakht
- Rasoul Akram Hospital Clinical Research Development Center (RCRDC), Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
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Shafeinia A, Ghaed MA, Nikoubakht N. The Effect of Phenylephrine Infusion on Maternal Hemodynamic Changes During Spinal Anesthesia for Cesarean Delivery. Anesth Pain Med 2020; 10:e99094. [PMID: 32309198 PMCID: PMC7144416 DOI: 10.5812/aapm.99094] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 12/18/2019] [Accepted: 01/15/2020] [Indexed: 11/28/2022] Open
Abstract
Background Spinal anesthesia is used as a common anesthetic technique in many routine and outpatient surgeries. Objectives The aim of this study was to determine the effect of phenylephrine on maternal hemodynamic changes during spinal anesthesia for cesarean delivery. Methods This double-blind randomized controlled trial was conducted on 116 pregnant women candidate for the elective cesarean section through spinal anesthesia in the Shahid Akbarabadi Hospital, Tehran in 2019. The eligible women were randomly divided into the intervention (phenylephrine; n = 58) and control (normal saline; n = 58) groups. The data collection tool was a checklist, including the demographic and clinical variables, such as age, height, weight, body mass index, gravid, gestational age, Apgar score of 1 and 5, systolic blood pressure, diastolic blood pressure, heart rate, mean arterial pressure, SPO2, PH of the umbilical cord, PCO2, HCO3, base excess, nausea, and vomiting. Data were analyzed using SPSS 24 software and P value < 0.05 was considered as significant. Results The intervention and control groups showed a significant difference in terms of the PH of the umbilical cord, PCO2, and nausea and vomiting (P value < 0.05). The results of the repeated measure ANOVA test showed a significant statistical difference between the intervention and control groups at different time points in terms of arterial pressure, systolic and diastolic blood pressures (P value < 0.05). Conclusions Phenylephrine is effective in the prevention of some complications, like reducing mean arterial pressure, systolic and diastolic blood pressures, nausea, and vomiting during spinal anesthesia for cesarean delivery. Therefore, these drugs can be used based on maternal hemodynamic status during spinal anesthesia for cesarean delivery.
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Affiliation(s)
- Amineh Shafeinia
- Department of Anesthesiology, Shahid Akbarabadi Hospital, Iran University of Medical Sciences, Tehran, Iran
- Pain Research Center, Department of Anesthesiology, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Ghaed
- Department of Urology, Rasoul Akram Hospital, Iran university of Medical Sciences, Tehran, Iran
| | - Nasim Nikoubakht
- Pain Research Center, Department of Anesthesiology, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
- Corresponding Author: Pain Research Center, Department of Anesthesiology, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
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Faiz SHR, Nikoubakht N, Imani F, Ziyaeifard M, Sadegh H, Rahimzadeh P. Comparison of Two Acupuncture Protocols (K1, DU25 or K1, DU26) Efficacy on Recovery Time of Patients After General Anesthesia, a Randomized Control Clinical Trial. Anesth Pain Med 2019; 9:e96172. [PMID: 31903336 PMCID: PMC6935292 DOI: 10.5812/aapm.96172] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 08/21/2019] [Accepted: 08/27/2019] [Indexed: 12/16/2022] Open
Abstract
Background Acupuncture has been used for more than two thousand years as part of traditional Chinese medicine. Objectives This randomized prospective clinical trial aimed to compare the effect of acupuncture on K1 (Yongquan) and DU26 (Renghong) with acupuncture on K1 (Yongquan) and DU25 (Suliao), with sham acupuncture on the recovery time of general anesthesia. Methods The patients (51) were randomly assigned to three groups: (A) acupuncture on K1 and DU26, (B) acupuncture on K1 and DU25, and (C) sham acupuncture. In each group, at the end of surgery acupuncture was performed accordingly for twenty minutes and the Bispectral Index (BIS) values at end of surgery, 5th minute, 10th minute, 15th minute and 20th minute as well as time of extubation and time of eye opening after the end of surgery were evaluated. Results BIS study at 5th minute, 10th minute and 15th minute after the end of surgery in the groups revealed a significant difference between sham acupuncture group and both A and B acupuncture groups, which was higher in groups A and B in comparison with sham acupuncture group. Time of opening eyes and time of extubation after the end of surgery between group A and sham acupuncture group differed significantly, which was earlier in group A. There was no significant difference between group B and sham acupuncture group in terms of eye opening and extubation time. Conclusions Acupuncture on K1 and DU26 accelerates restoring of consciousness and shortens of eye opening and extubation after general anesthesia, but on K1 and DU25 only speeds up retrieving of consciousness without significant effect on time of eye opening or extubation after general anesthesia.
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Affiliation(s)
- Seyed Hamid Reza Faiz
- Pain Research Center, Rasoul Akram Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Nasim Nikoubakht
- Pain Research Center, Rasoul Akram Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Farnad Imani
- Pain Research Center, Rasoul Akram Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Mohsen Ziyaeifard
- Rajaie Cardiovascular Medical & Research Center, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Hossein Sadegh
- Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Poupak Rahimzadeh
- Pain Research Center, Rasoul Akram Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran
- Corresponding Author: Professor of Anesthesiology, Pain Research Center, Rasoul Akram Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran.
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Rahimzadeh P, Imani F, Nikoubakht N, Koleini Z, Faiz SHR, Sayarifard A. A Comparative Study on the Efficacy of Oral Memantine and Placebo for Acute Postoperative Pain in Patients Undergoing Dacryocystorhinostomy (DCR). Anesth Pain Med 2017; 7:e45297. [PMID: 28856113 PMCID: PMC5561447 DOI: 10.5812/aapm.45297] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 03/15/2017] [Accepted: 04/08/2017] [Indexed: 11/29/2022] Open
Abstract
Background Memantine is an N-methyl-D-Aspartate (NMDA) antagonist. By transferring acute postoperative pain, the NMDA channels may lead to active excess and neuropathic pain. Objectives: This study attempted to investigate the effect of preoperative use of single oral dose of memantine in controlling Dacryocystorhinostomy (DCR) postoperative pain. Methods A double-blind clinical trial was conducted on 60 patients undergoing DCR. On arrival at the operating room, the memantine group received 20 mg of oral memantine and the control group received placebo. The severities of pain by visual analogue scale (VAS) and sedation by Ramsy Scale were measured immediately 1, 2, and 6 hours after the operation. The drug’s side effects were recorded. Results The pain scores of patients in the recovery in 1, 2, and 6 hours after operation were significantly lower in the memantine group than the placebo group (P < 0.001). The sedation score, 1 hour after the operation, was significantly greater in the memantine group than the placebo (P < 0.001). The sedation scores did not have any statistically significant difference in recovery and 2 hours after surgery between the two groups. Moreover, the sedation scores in 6 hours after the surgery were identical in the two groups. Conclusions The oral single-dose 20 mg of memantine administered before DCR can reduce postoperative pain compared with placebo.
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Affiliation(s)
- Poupak Rahimzadeh
- Pain Research Center, Department of Anesthesiology and Pain Medicine, Rasoul-Akram Medical Center, Iran University of Medical Sciences, Tehran, Iran
| | - Farnad Imani
- Pain Research Center, Department of Anesthesiology and Pain Medicine, Rasoul-Akram Medical Center, Iran University of Medical Sciences, Tehran, Iran
| | - Nasim Nikoubakht
- Pain Research Center, Department of Anesthesiology and Pain Medicine, Rasoul-Akram Medical Center, Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Koleini
- Pain Research Center, Department of Anesthesiology and Pain Medicine, Rasoul-Akram Medical Center, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Hamid Reza Faiz
- Pain Research Center, Department of Anesthesiology and Pain Medicine, Rasoul-Akram Medical Center, Iran University of Medical Sciences, Tehran, Iran
- Corresponding author: Seyed Hamid Reza Faiz, Pain Research Center, Department of Anesthesiology and Pain Medicine, Rasoul-Akram Medical Center, Iran University of Medical Sciences, Tehran, Iran. Tel: +98-9121534811, Fax: +98-2166509059, E-mail:
| | - Azadeh Sayarifard
- Center for Academic and Health Policy, Tehran University of Medical Sciences, Tehran, Iran
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Hassani V, Pazouki A, Nikoubakht N, Chaichian S, Sayarifard A, Shakib Khankandi A. The effect of gabapentin on reducing pain after laparoscopic gastric bypass surgery in patients with morbid obesity: a randomized clinical trial. Anesth Pain Med 2015; 5:e22372. [PMID: 25789237 PMCID: PMC4350186 DOI: 10.5812/aapm.22372] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Revised: 11/26/2014] [Accepted: 12/13/2014] [Indexed: 01/09/2023] Open
Abstract
Background: Pain after laparoscopic gastric bypass surgery (LGBP) is a major problem. Gabapentin is an anticonvulsant drug that can be effective in postoperative pain control. Objectives: This study examined the effect of preoperative administration of gabapentin on reducing pain after LGBP in patients with morbid obesity. Patients and Methods: This randomized clinical trial was performed in Hazrat Rasoul Akram Medical Center in Tehran. A total of 60 patients undergoing LGBP were randomly allocated into two groups; one group received 100 mg of oral gabapentin and the other group received placebo. Pain was evaluated at recovery time, and at the first, second, fourth and sixth hour of surgery by visual analog scale. The number and dose of opioid use after surgery and incidence of postoperative complications, such as nausea and vomiting, agitation, and headache, were also recorded. Results: The mean pain score in the group receiving gabapentin was significantly lower than the placebo group (P < 0.001). Indications and dose of opioid consumption between the two groups were not statistically significant. Incidence of nausea/vomiting (P = 0.028) as well as agitation (P = 0.037) was significantly lower in the gabapentin group. Conclusions: Administration of gabapentin before surgery can reduce pain after LGBP. Furthermore, it is not accompanied by significant short-term adverse effects.
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Affiliation(s)
- Valiollah Hassani
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
- Department of Anesthesiology and Pain Medicine, Rasoul-Akram Medical Center, Iran University of Medical Sciences, Tehran, Iran
| | - Abdolreza Pazouki
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Nasim Nikoubakht
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
- Department of Anesthesiology and Pain Medicine, Rasoul-Akram Medical Center, Iran University of Medical Sciences, Tehran, Iran
- Corresponding author: Nasim Nikoubakht, Department of Anesthesiology and Pain Medicine, Rasoul-Akram Medical Center, Iran University of Medical Sciences, Tehran, Iran. Tel/Fax: +98-2166509059, E-mail:
| | - Shahla Chaichian
- Minimally Invasive Techniques Research Center, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran
- Endometriosis Research Center, Iran University of Medical Sciences, Tehran, Iran
- Pars Advanced Medical Practice Research Center, Pars Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Azadeh Sayarifard
- Center for Academic and Health Policy, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Shakib Khankandi
- Department of Anesthesiology and Pain Medicine, Rasoul-Akram Medical Center, Iran University of Medical Sciences, Tehran, Iran
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14
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Rahimzadeh P, Imani F, Faiz SHR, Nikoubakht N, Sayarifard A. Effect of intravenous methylprednisolone on pain after intertrochanteric femoral fracture surgery. J Clin Diagn Res 2014; 8:GC01-4. [PMID: 24959459 DOI: 10.7860/jcdr/2014/8232.4305] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2013] [Accepted: 02/02/2014] [Indexed: 11/24/2022]
Abstract
BACKGROUND Pain after surgery is one of the major problems in patients with intertrochanteric fracture. This study investigates administration of single-dose Methylprednisolone prior to surgery with the goal of reducing Post-operative pain. MATERIALS AND METHODS The study was a Double Blind Randomized Clinical Trial. Eighty two patients with stable intertrochanteric unilateral fracture were selected and divided into two groups: one received Methylprednisolone (MP) 125 mg and the other received placebo. Pain was evaluated at rest and 45° flexion of the hip in times 4, 6, 8, 12, 24, 36, and 48 hours and during walking in times 24, 36, and 48 hours after the surgery. Post-operative nausea, vomiting and fatigue and changes in C - reactive protein (CRP) levels before and after the surgery were also recorded. RESULTS Pain at rest, 45° flexion of the hip and during walking after the surgery was significantly lower in the MP group compared to the control group (p < 0.001). Fatigue (p = 0.002) and changes in CRP (p=0.001) were significantly lower in MP group. Incidence of nausea, vomiting (p = 0.37) and opioid consumption (p = 0.49) were not significantly different between the two groups. CONCLUSION Single-dose methylprednisolone 125 mg (IV) can reduce Post-operative pain in patients with intertrochanteric fracture undergoing elective surgery.
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Affiliation(s)
- Poupak Rahimzadeh
- Assistant Professor, Anesthesiologist, Department of Anesthesiology and Pain Medicine, Rasoul-Akram Medical Center , Iran. University of Medical Sciences Tehran, Iran
| | - Farnad Imani
- Anesthesiologist, Department of Anesthesiology and Pain Medicine, Rasoul-Akram Medical Center , Iran. University of Medical Sciences, Tehran, Iran
| | - Seyed Hamid Reza Faiz
- Anesthesiologist, Department of Anesthesiology and Pain Medicine, Rasoul-Akram Medical Center , Iran. University of Medical Sciences, Tehran, Iran
| | - Nasim Nikoubakht
- Resident of Anesthesiology, Department of Anesthesiology and Pain Medicine, Rasoul-Akram Medical Center , Iran. University of Medical Sciences, Tehran, Iran
| | - Azadeh Sayarifard
- Assistant Professor, Preventive and Community Medicine Specialist, Community Based Participatory Research Center, Iranian Institute for Reduction of High-Risk Behaviors , Tehran University of Medical Sciences, Tehran, Iran
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