فصلنامه بیهوشی و درد
سال نهم شماره 2 (تابستان 1397)

Pain is universally understood as a signal of disease and is the most common symptom about a disease. Modern clinical medicine and traditional medicine share common goals of alleviating pain and eliminating the causes of pain. Unfortunately, pharmaceutical drugs especially opioid analgesics often cause serious short- and long-term side-effects. As a result, more and more patients are turning to herbal medicine as their primary, complementary or alternative treatment for pain. Rosmarinus officinalis (Rosemary) possesses phenolic diterpenes, such as carnosic acid, carnosol, rosmanol, epi- and isorosmanol and the phenolic rosmarinic acid for its pharmacological effects,including antiinflammatory and analgesic activity. Thus, the antinociceptive effects of Rosemary may be mediated by its phenolic component,especially rosmarinic acid and the antinociceptive activity of it acts on both central and peripheral nervous system. Results indicate that the antinociceptive effect of Rosemary may be mediated by opioidergic, glutamatergic and GABAergic mechanisms; γ-Aminobutyric acid (GABA) is the primary inhibitory neurotransmitter in the mammalian central nervous system (CNS). Rosemary by suppressing the formation of prostaglandins has anti-inflammatory effects. Antinociceptive action of Nigella sativa (Black cumin) is mediated by mechanisms of direct stimulation of opioid receptors located in the central nervous system and its inhibitory effect on the inflammatory mediators. the analgesic activity of Black cumin might be due to the presence of tannins and flavanoids in the extract as these are also believed to possess analgesic properties.

Aims and Attending to mental health in cancer patients because of expanded damage and mortality in these patients is important. The present study investigated the mediating role of concern in the relationship between uncertainty of intolerance and illness perception with mental health in cancer patients.
This research is a cross-sectional descriptive study. In this study, 300 patients with cancer who attended Imam Hossein Hospital in Tehran were selected by convenience sampling method from May to September, 2017. Data was collected by using instruments including Demographic Questionnaire, Concern questionnaire, intolerance uncertainty Questionnaire, Illness Perception Questionnaire and Mental Health Questionnaire. For data analysis, descriptive and inferential statistics with spss-19 software was used.
Findings: Analysis of the findings showed that there is a significant positive relationship in the prediction of mental health according to the psychological distress component based on perceived disease with mediating role of concern. There is also a significant negative relationship between mental health prediction and the psychological well-being component based on the perception of disease with mediating role of concern. In addition, there is a significant positive relationship between mental health prediction and psychological distress based on intolerance of uncertainty with mediating role of concern. In the prediction of mental health, there is a significant negative relationship with the psychological well-being component based on the uncertainty intolerance with the mediating role of concern.
In order to the results of this study, it can be suggested that in order to improve the mental health of these patients, attention should be paid to the variables of concern, uncertainty and perception of the disease during clinical trials with the aim of designing appropriate intervention models or modifying existing interventions.

Aims and Postoperative pain is a common side effect following surgery that can postpone patient’s discharge from hospital. Pain control in orthopedic patients can significantly reduce joint movement problems and patients can easily get back to normal life. In this study we aimed to study the efficacy of sublingual Buprenorphine in postoperative pain control following orthopedic surgery of the lower limbs.
This double blind clinical trial was conducted on 60 patients referred for orthopedic surgery of the lower limbs. They were in classes I and II of the American Society of Anesthesiologists (ASA( and they were under spinal anesthesia. Patients were divided into two groups of Buprenorphine (0.4mg, every 8h hours( and control group (Morphine 20mg in 100cc(. This trial was practiced after surgery and in the recovery room. Amount of meperidine usage, pain score and side effects including nausea and vomiting, level of sedation and pruritis were recorded at 1, 8, 16 and 24 hours after surgery.
Findings: 60 Patients in the control (Morphine) and Buprenorphine groups were studied. There was no significant difference between the two groups in terms of gender distribution (p=0.766(, average age (p=0.350(, weight (p=0.195(, ASA score (p=0.519( and operation time (p=0.510(. Average pain score in the Buprenorphine group was significantly lower than the control (Morphine) group at 8 (p=0.025), 16 (p This study showed that Sublingual Buprenorphine administration after orthopedic surgery of the lower limbs can lead to better postoperative pain control in comparison to control group (Morphine PCA pump(. Also it has minimal side effects and is compatible with Morphine in this field.

Aims and Various studies have shown that chronic pain affects quality of life is n people, but the mechanism of this effect is not clear. Attachment theory is one of the theoretical frameworks explaining these effects.
In this correlational study a sample of 345 patients with chronic pain referred to pain, rheumatoid and acupuncture clinics (Mashhad-Iran) were selected. The patients completed these questionnaires: Quality of life(QOL-SF) and Relational questionnaire(RQ).
Findings: A stepwise regression analysis showed that secure and preoccupied style could predict social relationships, mental health, and physical health in patients. In addition to the two other styles, one of the most promising factors in terms of environmental health is the fearful style.
Attachment styles are effective variables in the quality of life among patients with chronic pain. Utilization of emotional interventions for health can also be effective in improving the quality of life of these patients.

Aims and The aim of this study was to investigate the effects of elastic gait training on the peak plantar pressure variables and peak forces of 10 regions of the foot, peak of vertical force, time to peak of vertical force and displacement of center of pressure in patients with low back pain during running.
The sample of this study included 29 men with low back pain. These subjects were divided into control (n=12) and experimental (n=17) groups. The experimental group did elastic gait training for 6 weeks. Peak plantar pressure variables during both pre and post-test were recorded by a foot scan system (sample rate: 300 Hz).
Findings: In the experimental group, findings demonstrated greater peak force on lateral part of the heel during posttest than in pre-test. Moreover, lower peak pressure in the fourth and fifth metatarsal regions were observed during post-test than in pre-test. In control group, greater peak forces in third metatarsal part, lateral, and medial parts of the heel were observed during post-test compared to pre-test.
Findings of this study demonstrated that elastic gait training did not have any significant effect on stance time. Also, elastic gait training increased peak force in lateral part of the heel and decreased peak pressure in fourth and fifth metatarsal parts.

Aims and The aim of the present study was prediction of quality of life promotion in female patients with fibromyalgia on the basis of emotion expression, and spiritual intelligence with mediating of pain acceptance as a model.
This research is descriptive and correlational. We used available sampling for selecting 300 female patients with fibromyalgia as the study population including female patients with fibromyalgia referred to Shiraz private clinics. Research Tools included Quality of Life questionnaire, Pain acceptance questionnaire, Emotion expression questionnaire and King spiritual intelligence scale.The data was analyzed by AMOS and with help of structural equation modeling.
Findings: The results indicated the influence of emotion expression on pain acceptance, spiritual intelligence on quality of life, and pain acceptance on quality of life ; however it did not indicate any influence of spiritual intelligence on pain acceptance.
Emotion expression, Spiritual intelligence and Pain acceptance are involved in quality of life in female patients with fibromyalgia and it is important to pay attention to use therapy on the basis of these variables.

Aims and Defensive styles play an important role in intrapersonal and interpersonal experiences. One of the most important experiences is experiencing pain. In previous researches, the relationship between different styles of defense with experience of chronic pain is not clear. So, the aim of this study was to examine the role of developed defense styles, undeveloped ones and neuroticism in predicting chronic pain.
In a retrospective, descriptive-correlation and cross-sectional study, 150 college students of Tabriz university, were selected with using available sampling method. Mc Gill’s psychological pain questionnaire and defense style questionnaire were used for data collection.
Findings: Pearson’s correlation and multiple-regression were used for data analysis. Results of the study showed that neuroticism and undeveloped variables predict chronic pain.Also, developed variable has decisive role to avoid pain experience.
According to the results, we can conclude that developed, undeveloped and neuroticism defense styles have a determining role in chronic pain. So it is suggested to use psychological treatment to correct defense styles in chronic pain patients.

Aims and The purpose of this study was to investigate the effect of lateral wedge insole on ground reaction forces and loading rate in patients with knee osteoarthritis.
Ten individuals with medial knee osteoarthritis and 10 healthy subjects with similar age, height and mass were studied. The kinetic variables and walking speed of the subjects were calculated in walking conditions with barefoot, 0, 5 and 11 degrees lateral wedge insole. For inter-group comparison, the repeated measure and for between group comparison the MANOVA test were used, the level of significance was p >0.05.
Findings: The results showed that using an insole, significantly increased the speed of walking in the osteoarthritis group )P >0.05(. Also, the GRF was lower in damaged foot than that of normal foot when walking barefoot;besides the symmetry of foot was improved when osteoarthritis group used an insole. In general, the use of lateral wedge insole increased all components of the ground reaction force in the osteoarthritis group.
According to the results of this study, the use of insole improves control in the anterior-posterior direction and symmetry in the foot performance for osteoarthritis patients. However the increase in the Fx component indicated a reduction in lateral control during walking. Therefore, the use of ankle support brace for controlling medial lateral deviations can make it more stable while walking.