F Eshghi, R.a Moohammadpour, R Izadi, R Rahmani,
Volume 18, Issue 65 (7-2008)
Abstract
Background and Purpose: One of the important problems of major abdominal surgery is post-operative pain control. There are different modalities to control the pain after surgery, such as oral, local or intravenous analgesic drugs, regional nerve block, epidural catheters and pain killer pumps with their own benefits and complications. The aim of this study was to evaluate the effect of continuous peritoneal infusion of lidocaine by a pain killer pump for post-operative pain management following laparotomy.
Materials and Methods: This double blind randomized clinical trial was performed on 76 patients (38 cases and 38 controls) who underwent laparotomy with midline incision, in Imam Hospital, Sari, Iran, in 2008. Two groups were matched in age and sex. After surgery a catheter infusion pump was prepared for all patients. In case group, 2% lidocaine (20mg/kg/day) and for control, normal saline infused for 24 hours. Pain score (Visual Analog Scale), blood pressure, heart rate, respiratory rate, temperature and analgesic requirement was evaluated in 4, 10, 16 and 24 hours after surgery. Results analyzed by means of SPSS (15) software and chi-square, t test and repeated measurement. The p value less than 0.05 was considered to be significant statistically.
Results: 76 patients, 39 (51.3%) females and 37 (48.7%) males, with mean age of 47.03±15.2 years were studied. There was no significant difference in age, sex and weight between two groups. The mean of admission days was 5.03±0.6 in case and 5.29±1.3 in control, with no significant difference between them. Mean of opiod consumption was 16.05±13.05 mg and 25.39±11.4 mg in case and control respectively (P= 0.002). Mean of VAS score, blood pressure, heart rate, respiratory rate and temperature in case group was less than control group and the difference was significant statistically. Pain severity changes during 4, 10, 16 and 24 hours following surgery were significantly different in two groups, with linear correlation between time and pain reduction.
Conclusion: Our study demonstrates that continuous infusion of 2% lidocaine by a pain killer pump can reduce pain and opioid requirements after abdominal surgeries.
Ebrahim Salehifar, Roza Hazeghpasand, Shahrbanou Keyhanian, Shahram Ala, Nematollah Ahangar,
Volume 27, Issue 150 (7-2017)
Abstract
Background and purpose: Considering the importance of pain management in cancer patients, this study aimed to assess the prevalence of pain, its severity, analgesics used to control pain, and the extent of pain control in cancer patients attending a medical center in North of Iran.
Materials and methods: One hundred cancer patients attending Ramsar Imam Sajjad Hospital (2015) were prospectively enrolled in the study. Clinical and demographic data and all analgesics used were recorded. Pain intensity were determined based on the Numeric Rating Scale from 0 (pain-free) to 10 (the most severe pain ever experienced) in two sequential visits, 3 weeks apart.
Results: The average age of participants was 54.7±3 years. NSAIDs (98 cases, 98%) and opioids (49 cases, 49%) were the most common analgesics prescribed. Among opioids, codeine (67.3%) and morphine (24.5%) were used more frequently. The pain score was 3.94±0.342 at first visit and 3.65±.316 following analgesic use (P=0.002). For opioid users, the pain scores were 4.29±0.53 and 3.84±0.506, respectively (P=0.007).
Conclusion: The pain scores statistically reduced, however, the decrease was not clinically prominent since the pain severity was between 3 and 4 in NRS scale. More attention to pain control is recommended in cancer patients while considering the standard pain management guidelines.
Said Reza Entezari, Pooya Derakhshan, Arezou Darvishi, Mahmoudreza Alebouyeh,
Volume 29, Issue 179 (12-2019)
Abstract
Background and purpose: Postoperative pain management would result in increased patient’s satisfaction and decreases their problems. This survey was performed to determine the efficacy of premedication with dextromethorphan and gabapentin alone or in combination, for postoperative pain management in anterior cruciate ligament and posterior cruciate ligament knee arthroscopy with general anesthesia.
Materials and methods: In a randomized clinical trial, 114 patients under anterior cruciate ligament and posterior cruciate ligament knee arthroscopy with general anesthesia were randomly assigned to receive either dextromethorphan or gabapentin alone or in combination. The intensity of pain was assessed by numeric rating scale (NRS). Analgesic use and Ramsay score were compared among the three groups.
Results: In this study, the pain (P=0.0001) and analgesic use (P=0.004) were significantly lower in patients who had received the combination of dextromethorphan and gabapentin.
Conclusion: According to current study, premedication with combination of dextromethorphan and gabapentin is superior to each one alone for postoperative pain management in anterior cruciate ligament and posterior cruciate ligament knee arthroscopy with general anesthesia.
(Clinical Trials Registry Number: IRCT20141127020112N9)
