جراحی ارتوپدی

Total hip arthroplasty is one of the most successful and cost-benefit interventions in health care. The present study was designed and performed to determine the factors affecting the long-term survival of patients after total hip arthroplasty.

In this retrospective cross-sectional study, 100 patients who underwent hip arthroplasty from September 2017 to March 2019 were included in the study. Patients who underwent hip arthroplasty reoperation or bilateral hip arthroplasty surgery were excluded from the study.

The mean duration of hospitalization was 5.91± 1.8 days. The mean age of patients in the study was 56.37± 14.79 years and the mean duration of surgery was 2.76 ± 0.36 hours. There was no significant relationship between length of hospital stay and age and duration of surgery. Women made up 42.0% of the study population and 46.0% of patients had a history of at least one underlying disease. There was no significant difference between men and women (5.88 vs. 5.93 days) and individuals with and without underlying disease (5.88 vs. 5.93 days) in of length of hospital stay. Individuals who received blood during surgery had significantly longer hospital stays (6.63 vs. 5.57 days). Also, the type of anesthesia (general 5.76 days and spinal 6.22 days) and the type of surgery (emergency 6.48 days and elective 5.79 days) had no effect on the duration of hospitalization.

The results of this study showed that blood transfusion is associated with increased length of hospital stay in patients. There was no significant relationship between length of hospital stay and gender, age, past medical history, type of anesthesia, type of surgery and duration of surgery.

 Postoperative pain, anxiety and sleep disturbances are common among patients undergoing orthopedic surgery, often leading to increased physical complications and substantial healthcare costs. Given the rising interest in non-pharmacological methods such as aromatherapy, this study aims to investigate the effectiveness of lavender inhalation aromatherapy in alleviating pain, anxiety and enhancing sleep quality in patients post-orthopedic surgery. 

This randomized clinical trial was conducted in 2022 at a trauma center in Isfahan, involving 80 patients undergoing orthopedic surgery. Eligible patients were recruited through consecutive sampling and were randomly assigned to either the intervention group (n=40) or the control group (n=40). The intervention included inhalation of 100% pure lavender essential oil over a period of three days, while the control group received standard postoperative care. The study employed the Standard Spielberger anxiety questionnaires, the St. Marry’s Hospital Sleep Questionnaire (SMHSQ), and the Visual Analog Scale (VAS) for data collection. Data were analyzed using paired t-tests, independent t-tests, chi-square tests, and one-way repeated measures analysis of variance, utilizing SPSS software version 26.

Post-intervention analysis revealed statistically significant differences in the average scores of anxiety and sleep quality between the intervention and control groups (P<0.001). Additionally, the average pain scores exhibited significant differences at all time points across both groups (P<0.001).

The findings show that lavender aromatherapy significantly reduces pain and anxiety while improving sleep quality in patients following orthopedic surgery. Given these positive effects, the integration of this cost-effective and easily accessible intervention is recommended as a complementary treatment, alongside conventional methods.

For over 50 years, bone cement has been used to strengthen artificial joints like hip, knee, shoulder, and elbow joints. The main purpose of bone cement is to fill the space between the prosthesis and the bone. This absorbs the forces on the joint by creating an elastic area. Besides ensuring the long-term stability of the artificial implant, it also improves the damaged bone. Polymeric bone cement consists of a polymer matrix known as polymethyl methacrylate (PMMA) and a liquid monomer called methyl methacrylate (MMA). When these two components are mixed, a free radical polymerization reaction occurs, leading to the cement's hardening at the place of use. The properties of bone cement, such as mechanical strength, biocompatibility, and handling characteristics, can be adjusted by combining the effective polymerization parameters. However, there are some challenges, such as heat generation during polymerization.
Ceramic bone cement is a composite material of ceramic particles dispersed in a polymer matrix, including calcium phosphate and calcium sulfate. The ceramic particles provide strength and bioactivity, while the polymer matrix enhances the transport properties of the cement. This combination results in a mechanically stable, bone-conductive, and biocompatible cement. Moreover, ceramic bone cement can be engineered to release therapeutic agents, such as antibiotics or growth factors, to prevent infection and foster bone regeneration. Ceramic bone cement is a promising alternative material for bone cement in joint replacement. However, more research and development are required to optimize the properties of bone cement and overcome the challenges associated with its use. With continued advancements in biomaterials, ceramic and polymer bone cement could revolutionize the field of orthopedic surgery and improve patient outcomes. Recent research has focused on developing new bone cement with improved properties like bioactivity, antibacterial activity, and drug delivery capabilities. These developments aim to enhance the performance of bone cement and remove the current limitations in orthopedic applications. In this review study, we will focus on the types of bone cement, their mechanical, biological, and structural properties, and how to optimize them.

Planning for blood request and balancing supply and demand are still contentious issues in hospitals and blood transfusion centers. This study aimed to compare the safety and cost-effectiveness of two pre-transfusion tests for red blood cells in patients undergoing orthopedic surgery.

In this descriptive-analytical cross-sectional study, patients undergoing surgery who required blood transfusion during the operation were included via convenience sampling method. The necessary information for this study was collected using a researcher-made checklist consisting of two parts: background information, blood bag information, and information related to potential complications. The cost estimation of the tests was also extracted using the records. The findings were analyzed using descriptive and inferential statistics with SPSS software (version 18), and the significance level was set at 0.05.

A total of 212 patients with a mean age of 44.98 years were included in the study. Cross-match was performed for 108 patients (50.9%), and antibody screening test was used for 104 patients (49.1%). Regarding complications after blood transfusion, at least one sign was observed in 12 patients (5.7%). Jaundice, fever, and itching were the most common symptoms. The cross-match to transfusion (C/T) ratio was higher than international standard criteria (5.25 vs. 2.5).

The results of this study demonstrated that the safety and accuracy of both pre-transfusion methods were similar, and no significant difference was observed. However, the cross-match test was more cost-effective compared to the match antibody screening test.

Anxiety is one of the most important symptoms after orthopedic surgery which can have various side effects and negatively affect the process of recovery after surgery. The present study was conducted with the aim of evaluating the effect of Melissa Officinalis tea and Matricaria Chamomilla tea on anxiety of patients after lower limb orthopedic surgery.

This was a randomized controlled trial which was conducted on 96 patients after lower-limb orthopedic surgery in Ayatollah Kashani hospital in Shahrekord, Iran. Patients were selected with convenience sampling method and allocated to either Melissa Officinalis, Chamomile or control group. For Melissa Officinalis group, 1g of Melissa tea, for Chamomile group 1g chamomile tea and for control group black tea was prescribed 3 times a day. Anxiety of participants was evaluated before start of interventions and after each step of interventions using Spielberger’s state anxiety inventory. The mean score of anxiety before interventions and the mean changes of anxiety score after each step of interventions compared between groups. Data were analyzed with descriptive and analytical statistics using SPSS software.

the results of Tukey’s post-hoc test showed that after the second step of interventions till the last step, the mean change of anxiety score in Melissa Officinalis and Chamomile group was significantly greater than in the control group (P<0.05).   

The results of this study show that prescription of Melissa Officinalis and Chamomile tea is effective in reducing anxiety of patients after lower limb orthopedic surgery.

 Patients who undergo major orthopedic surgery are at risk of acute kidney injury (AKI) due to blood loss, electrolyte disorders, infection, and other co-morbidities. In this study, we aim to investigate the frequency of AKI and its risk factors in patients undergoing major orthopedic surgery in Rasht, Iran.

 This is an analytical cross-sectional study on 180 patients undergoing major orthopedic surgery. Those with a history of chronic kidney disease and dialysis were excluded. 

 The data including patients’ age, gender, drug history, history of underlying diseases, duration of surgery, mean arterial pressure during and after surgery, and use of inotrope during and after surgery, and creatinine level before and after the surgery. 

 The mean age of patients was 47.3±22.8 years. The incidence of AKI was 11.11%. The use of some drugs, duration of surgery, MAP, and inotrope use had no significant relationship. The occurrence of AKI had a significant relationship with the history of heart disease, diabetes, and kidney disease. Multiple linear regression analysis results showed that with the increase of one unit in preoperative creatinine level, the postoperative creatinine level increased by 0.3.

 The incidence of AKI after major orthopedic surgery in Rasht city is relatively high. Careful monitoring of kidney function before, during, and after major orthopedic surgery is important; it can prevent the occurrence of postoperative AKI.

Pain management of surgical patients is an important part of postoperative care. This issue is associated with various challenges in drug-addicted patients. The aim of this study was to determine the challenges of pain management after orthopedic surgery in drug-addicted patients from the patient's point of view and to determine the relationship between the variables.

In this descriptive study that was conducted in Akhtar Hospital in Tehran in 2021, 105 patients participated with the available sampling method. The data collection tool was a researcher-made questionnaire which included the patient's demographic information and 16 statements about effective factors in pain management of drug-addicted patients. SPSS26 software, parametric independent t-tests, analysis of variance and Pearson's correlation coefficient were used for data analysis and the significance level of the tests was considered less than 0.05.

From their point of view, "the low amount of painkillers" and "the ineffectiveness of painkillers" were the most important factors in their inadequate pain control, and other challenges in pain management were of little importance in optimal pain control of patients.

Pain in drug-addicted patients is not properly controlled after orthopedic surgery, and there are unrecognized challenges that require further investigation.

The operating room environment is one of the stressful places. Listening to the Holy Quran can produce a comforting effect in this environment. In this study, the effect of listening to the Holy Quran on vital signs and physiological changes was investigated in the patients undergoing orthopedic surgery in Shahid Rajaee Hospital of Qazvin, Iran.

This study was conducted on 164 patients aged 20-65 years, who were candidates for undergoing lower limb orthopedic surgery. The samples were randomly assigned to three groups, namely Control (without playing the Holy Quran), Sham (with a headset without playing the Holy Quran), and Experimental (with a headset and playing the Holy Quran). The patient's vital signs and physiological parameters, such as systolic and diastolic blood pressure, heart rate, arterial oxygen saturation, end-expiratory carbon dioxide, and anesthetic depth, were monitored and recorded. All patients were treated equally in the premedication, induction and maintenance of anesthesia, and recovery. Data were analyzed in SPSS software (version 19) using statistical tests.

Diastolic blood pressure, heart rate, and end-expiratory carbon dioxide were lower and more stable in the anesthetic patient that listened to the Holy Quran, compare to those in the other groups.

Based on the results, listening to the Holy Quran during anesthesia stabilized the hemodynamic status of patients during surgery.

Based on the results, listening to the Quran during anesthesia stabilizes the hemodynamic status of patients during orthopedic surgery.

Aging is associated with several health threats, including fall and fear of fall, as well as psychological, physical and social issues. Therefore, the aim of this study was to determine the depression, anxiety and stress and related factors in the elderly after orthopedic surgery. Therefore, the aim of this study was to determine mental health status of the elderly with fall related orthopedic surgery.

The present study was a cross-sectional (correlation-descriptive) study that included 280 elderly people with fall related orthopedic surgery who were attended to selected educational centers of Iran University of Medical Sciences in 2018. The subjects were selected by Available sampling method. The data gathering tool was a short form of cognitive test (AMT), demographic profile form, and depression, anxiety and stress scale (DASS). The internal consistency coefficients of the three scales of depression, anxiety and stress were: 93.9, 90.9, and 92.9 respectively. The test-retest coefficients (with a three-week interval) of depression, anxiety and stress scales were: 0.88, 89.9, respectively. And 90. In addition, the intra-class correlation between two runs is equal to 87.78, 87.8. And 80. The conditions for entering the elderly were: age 60-75 years, cognitive capacity and ability to answer questions (AMT), lack of neurological disorders, communication ability and absence of mental illness. Data were analyzed using descriptive statistics and inferential statistics such as Independent T and Anova Unilateral in SPSS software version 20 at significance level P ≤ 0.05.

The mean age of the elderly participated in this study was 69.51 ± 4.29 (SD = 4.29), 65% female and 35% male. Nearly half of the elderly had a mild to moderate depression (41.6%), about 47.9% had moderate anxiety and 23% had mild to moderate stress. In addition, each variable "stress, depression and anxiety" had a significant relationship with gender, education level, marital status and history of chronic diseases (P <0.05).

Considering the unfavorable outcomes of depression, anxiety and stress in the elderly, counseling programs during discharging and also the promotion of family and social support can provide a platform for health promotion and achieving healthy, successful and active aging Brought up.

Kienbock's disease is an enigmatic entity that causes wrist pain and disability in young adults. This study aimed to assess clinical and radiological outcomes radial shortening as its most common treatment.

In a retrospective research, the data of medical records of 100 patients with Kienbock's disease were studied. They included 66 men and 34 women with mean age of 28.9 ± 7.6 years, who treated using radial shortening surgery. The wrist indexes and Disabilities of the Arm, Shoulder, and Hand Score (Quick DASH) were calculated and analyzed.

60% of the patients were ulnar minus, 26% neutral, and 14% ulnar plus. Mean Quick DASH score was 11.34 ± 6.30 in patients in the Lichtman stages I and II, and 23.05 ± 10.40 in the Lichtman stage III. Delayed union after 5 months occurred in 3%, screw back out in 1%, and superficial infection in 1%. Mean duration of union was 16 weeks. Ulnar variance was the same amongst different Lichtman stages. At follow up, 29% had none, 39% mild, 23% moderate, 8% severe, and 1% extreme pain. Ulnar variance changed from -0.9 to +0.1. Bilateral involvement was noted in 4% and dominant arm involvement in 45%. In 26% of patients, radius was shortened less than 1 millimeter. No radiological progression or improvement occurred during follow up.

 After radial shortening surgery in Kienbock's disease, clinical improvement was commonly expected, even if the radius was not shortened to reach to neutral ulnar variance. This improvement was more obvious in patients in in the Lichtman stages I and II.</div>

During surgery, the surgery team is in contact with infectious and pathogenic microorganisms. Surgical gloves prevent the transmission of contamination between surgical team members and the patient, which is more important in orthopedic surgeries due to the presence of sharp and winning devices. The purpose of this study was to determine the frequency of damage of surgical gloves, and identify the factors involved in these damages in orthopedic surgeries. In this descriptive-analytical study, 384 surgical gloves (192 pairs) used in surgical procedures for palpation of the hands and feet were selected via simple sampling method. To determine the degree of damage of surgical gloves, a water leak test was used. The data-gathering tool was a researcher-made checklist. Descriptive and analytical statistics were used to analyze the data via SPSS software. The frequency of damage to surgical gloves was 26.8% (103/384). The frequency of damages was 18.8% (36/192) in hand surgeries, and 34.9% (67/192) in foot plating. 33.3% of gloves in hand surgeries and 34.3% in foot surgical procedures had hidden damage. The most common cause of obvious damage to surgical gloves was contact with thick and bone tissues during the procedure. Considering the high rate of gloves damages in orthopedic plating surgery, replacement of gloves during surgery can reduce the transmission of contamination among surgical team members and patients. Considering that the most common cause of damage in surgical gloves was thick and bony tissues, more cautious is suggested during surgical treatment of these tissues.

Old age is associated with several health threats, including falls, with fear of falling considered to be one of its major complications, especially after orthopedic surgeries, which may lead to limited daily activities, isolationism, and lack of social participation. The present study aimed to assess the fear of falling and its contributing factors in the elderly patients with the history of falls following orthopedic surgeries, who referred to the orthopedic clinics of selected hospitals affiliated to Iran University of Medical Sciences. This cross-sectional, descriptive-correlational study was conducted on 280 elderly patients referring to the clinics of the hospitals in Tehran, Iran. The patients were selected via convenience sampling. Data were collected using the abbreviated mental test (AMT), a demographic questionnaire, and the falls efficacy scale instrument (FES-I), which were completed via face-to-face interviews with the elderly. Data analysis was performed in SPSS version 20 using descriptive and inferential statistics, independent t-test, one-way analysis of variance (ANOVA), and linear regression analysis at the significance level of P≤0.05. The mean age of the elderly was 69.50±4.29 years, and 65% and 35% of the patients were female and male, respectively. The results of Pearson's correlation-coefficient indicated a direct correlation between the fear of falling and age (P=0.008; r=0.159). Direct, significant correlations were also observed between the fear of falling and hypertension, the number of the used medications, and pelvic fractures (P<0.05). In addition, 97.9% of the patients had more than one orthopedic surgery, which was directly correlated with the fear of falling. According to the results, the frequency of fear of falling in the elderly with the history of orthopedic surgeries was significantly high. Considering the adverse outcomes of the fear of falling in elderly patients, it is recommended that counseling training programs be planned for the elderly patients after orthopedic surgeries for the health promotion of these individuals and active old age, as well as the reduction of the fear of falling in elderly patients.

Postoperative coughing and hoarseness are two of the most common complications occur following endotracheal intubation and pharyngitis, laryngitis, and tracheitis. Eucalyptus lozenges are used in the treatment of many sign of common colds, such as cough, sore throat, etc. Therefore, the aim of this research was to study the effect of sucking Eucalyptus lozenges on coughing and hoarseness following endotracheal intubation in patients undergoing orthopedic surgery under general anesthesia. In this clinical trial study, 134 patients undergoing orthopedic surgery under general anesthesia were selected using convenience sampling method, and were allocated into two equal groups of control and intervention via random assignment method. Following obtaining informed consent, half an hour before surgery and in intervals of six hours after the surgery, eucalyptus lozenges were administered to intervention group. Postoperative coughing and hoarseness were measured 2, 6, 12, and 24 hours following endotracheal intubation using coughing and hoarseness checklists. Data were analyzed using descriptive statistics, Fisher's exact, chi-square, and t test, and generalized estimating equation (GEE) measures in SPSS software. P values of less than 0.05 were considered significant. Findings: The severity of coughing (P = 0.004) and hoarseness (P < 0.001) during the time were significantly less in the intervention group compared to the control group. Eucalyptus lozenges are effective in reducing coughing and hoarseness caused by endotracheal intubation in patients undergoing orthopedic surgery under general anesthesia.

Postoperative shivering is a common complication of surgical procedures under spinal anesthesia. The aim of this study was to determine the preventive effect of different doses of tramadol injection on shivering during and after lumbar orthopedic surgery under spinal anesthesia as compared to control group.

In a clinical trial study, 128 patients underwent lower limb orthopedic surgery in 4 groups of 32 patients received 0.5, 0.75, and 1 mg/kg, tramadol and normal saline with equal volume, 5 minutes before spinal anesthesia. The incidence of postoperative shivering was compared in four groups. Findings: A total of 11 patients suffered from postoperative shivering, 1 (6.2%), 2 (1/5), and 1 (2.6%) received tramadol 0.5, 0.75, and 1 mg/kg, respectively, and 7 (17.9%) were of the control group. The incidence of shivering in the control group was significantly higher than other groups (P = 0.021).

In this study, all three doses of 0.5, 0.75, and 1 mg/kg of tramadol were effective in preventing postoperative shivering, but the dose of 1 mg/kg was more effective. Therefore, a dose of 1 mg/kg tramadol seems to be a more appropriate dose for controlling postoperative shivering.

Post-operative pain reduction is one of the problems in the patients with preoperative narcotic dependency. Morphine is the most common drugs to control postoperative pain. Due to resistance to morphine and its side effects in addict patients, using of adjuvant drugs such as ketamine has increased. The aim of this study was to evaluate the effect of adding ketamine to morphine in patients addicted to opioid with post orthopedic operation pain.
In a double blind clinical trial, 60 patients undergoing orthopedic operation with history of opioid consumption were randomly divided in 2 groups. Post operation, the first group received morphine 20 mg and the second group received morphine 20 mg ketamine 100 mg via IV patient-controlled analgesia (IPCA). The pain score as visual analogue scale (VAS), sedation score, and nausea and vomiting were evaluated at 1, 6, 12 and 24 hours post operation. SPSS v.20 was used for data analysis.
Results showed that dose of morphine consumption in morphine group was significantly increased compared to the morphine ketamine group (p 0.001). In addition, only at 12 hours after surgery the mean of pain score in the morphine group was significantly reduced compared to the second group (p = 0.02). The mean of sedation score at 1 (p 0.001), 6 (p = 0.002), 12 (p = 0.001) and 24 (p 0.001) hours after surgery in the morphine group was increased compared to the other group. At 1 hour, the mean of nausea and vomiting scores in the morphine group was significantly reduced compared to the morphine ketamine group (p = 0.024).
Addition of ketamine to morphine in the patients with history of opioid consumption reduced using of the morphine. But had no effect on pain and sedation score reduction.

Aims and Pain is one of the most important complications in postoperative Orthopedic Patients. Today, various non-pharmacological methods are used for pain relief after surgeries. The aim of this study was to compare the effects of Allah recitation and rhythmic breathing on postoperative pain in Orthopedic Patients.
This is a three-group randomized clinical trial in which 90 patients were selected by available sampling and then randomized into 3 groups of Allah’s recitation, rhythmic breathing and control. In the group of Allah’s recitation, honorable recitation of “In the Name of the Merciful God, There is no power but from God, O Allah send blessings on Muhammad and his family “ was repeated calmly for 100 times,. In rhythmic group, rhythmic breathing was performed after training by “Hey-Hu” method. Intervention in each group was performed for approximately 20 minutes. Pain intensity was measured by Numeric Rating Scale (NRS). Data analysis was performed by One-way repeated ANOVA tests and repeated measures with SPSS software version 20.
Findings: 21 patients (70%) were males and 23 (76.6%) were married and they had the average age of 36.4± 13.6 years. There eas a significant relationship between the average of pain intensity in stages of postoperative period (p Allah’s recitation and rhythmic breathing are effective and can be used to reduce the pain after orthopedic surgery.

Intraoperative hypothermia is a common problem with anesthesia. Spinal anesthesia, the same as general anesthesia, affects the process of temperature regulation. The aim of this study was to compare the prophylactic effect intrathecal sufentanil with meperidine on prevention of shivering during spinal anesthesia in patients underwent orthopedic surgery of the lower limb. Ninety patients were randomly recruited to receive either 3 ml of 0.5% hyperbaric bupivacaine plus 2μg of sufentanil (Group S), or 3 ml of 0.5% hyperbaric bupivacaine plus 0.2 mg/kg of meperidine (Group M), or 3 ml of 0.5% hyperbaric bupivacaine plus normal saline (Group C). The incidence and intensity of shivering, blood pressure, heart rate and total intravenous meperidine were compared in three groups.
Findings: Total incidence of shivering was lower in study groups during surgery and recovery was significantly different between three groups (P=0.03, P=0.001). Also the intensity of shivering during surgery and recovery was significantly different between three groups (P = 0.001, P=0.01). Total dose of intravenous meperidine was significantly lower in study groups versus control group (P=0.03). There is not significant different in hemodynamic parameters between three groups.

Concclusion: We concluded that intrathecal sufentanil and meperidine can decrease intensity and incidence of shivering compared to control group as well as decreasing the requirement to additional doses of meperidine for shivering the control without any hemodynamic side effect.

Aim: The purpose of this study is to review new achievements in prevention and treatment of venous thromboembolism (VTE) in orthopedic surgeries. Background. Method: This is a comprehensive review of literature published between 1998-2017 about prevention and treatment of VTE in orthopedic surgeries that was conducted through searching scientific databases and search engines Ovid, Science Direct, Medline, Google Scholar, and PubMed using the English and Persian forms of the words Apixaban, Dabigatran, Heparin, orthopedic procedures, venous thromboembolism, and Fondaparinux. In total, 35 English papers and 10 Persian papers were found, out of which 25 papers were included in the review. Findings: The risk of VTE is increased considerably during orthopedic surgeries. It is associated with important morbidities and also can increase mortality rate. Without prophylaxis, there is a noticeably increased risk of both venous and pulmonary embolism. Choosing a prophylactic pharmacologic agent depends on its efficacy and safety and also, on the presence of comorbidities and patient preferences. Conclusion: The features of primary preferred primary prophylactic method is easy management safety, effectiveness with limited or no need for laboratory observation, and cost effectiveness. The use of prophylactic anticoagulation in patient undergoing major orthopedic surgeries considerably reduces the risk of VTE, but does not completely exclude it.

Anxiety is the most prevalent feeling before surgery which could affect postoperative outcomes. Anti-anxiety properties of Passiflora incarnate have been reported in previous studies and this study was designed and conducted to determine properties of medicinal plant Passiflora incarnate on anxiety before orthopedic surgery in patients hospitalized in Ayatollah Kashani Hospital, Shahrekord.
In this experimental study, 60 patients aged 25-50 years candidate for orthopedic surgery referring Ayatollah Kashani Hospital, Shahrekord were randomly assigned into two 30-individual groups of case and control. At the night before surgery, case group received oral Passiflora caerulea drop (500 mg, Passipy) and control group received placebo. On the day of surgery, by Spielberger Anxiety Inventory, the level of trait anxiety (individual anxious property) and state anxiety (individual anxious state) was recorded, and the patient's demographic characteristics were gathered by questionnaire.
There was no significant difference between two groups regarding to age, sex, and marital status. Mean score of state anxiety in case group (40.86±7.25) was lower than control group (50.63±4.58) (P=0.001), but mean score of trait anxiety was not significantly different between the two groups (P=0.303).
Based on the results of this study, use of oral drop of Passiflora incarnate before orthopedic surgery helps to relieve patient's anxiety. Use of this extract is recommended for Anti-anxiety and sedative treatments.