فصلنامه بیهوشی و درد
سال نهم شماره 4 (زمستان 1397)

The purpose of this study was to investigate the effectiveness of positive psychotherapy on pain self-efficacy and psychosocial inflexibility in women with chronic pain. Semi-experimental research design was a pre-test and post-test type with control group. The statistical population included all women with chronic pain in Isfahan. The sample size of the study consisted of 30 women with chronic pain. They were selected by purposeful sampling and randomly assigned to two groups of experimental and control groups. The experimental group underwent a positive therapeutic educational intervention of 6 sessions weekly sessions while the control group received no training at all. The data collection tools were PES (Nicholas, 1989) and pain psychological inflexibility (PSEQ) (Wicksell et al., 2010). The results of covariance analysis indicated that there were significant differences between the scores of self-efficacy of pain and the dimensions of the psychological inflexibility of the pain in the experimental and control groups in the post-test stage. At the post-test stage, the experimental group in comparison with the control group, obtained more scores in the degree of self-efficacy and less scores in psychosocial disorder. Based on the findings, it could say that the treatment of positive psychology is an important factor in improving the self-efficacy and pain relief in patients with chronic pain.

One of the major challenges in women’s surgery, including cesarean section, is postoperative pain control. Postoperative pain as one of the most common problems in the postoperative phase and can lead to a significant reduction in the quality of surgical operations, along with other problems such as nausea and vomiting, hypotension and shivering. Therefore, the present study we aimed to study the efficacy of sublingual Buprenorphine in postoperative pain control following cesarean surgery and its effects among patients. The present study is a randomized, double-blind clinical trial. Patients aged 18_45years old and all candidates underwent cesarean section at Alavi Hospital in Ardabil in 2017. After obtaining consent from patients for inclusion in the study, 80 patients were selected using simple sampling method and divided into two groups of 40. In the first group,) control group) 40 patients received fentanyl and placebo tablets, and the pump was used to inject intravenous fentanyl and the drug lasted for up to 24 hours. the second group )40 patients) received normal saline pump and buprenorphine pills. In the second group (sublingual buprenorphine + placebo pump), it was repeated 6 and 12 hours after the first dose. Then, VRS pain scores, vomiting nausea, sedation )from Ramsay sedation scale), and the amount of analgesic demand for pain control at 2, 6, 12, and 24 hours, and postoperative analgesia (time to first need analgesia) were recorded. Finally, all patient information entered into a pre-designed checklist and all the data entered into the SPSS v20 statistical analysis program and we analyzed the data. In this study, 80 patients were evaluated in two groups The results of VRS pain score in patients showed that, except within 24 hours after surgery, in other hours of study, the pain score in the two groups did not show any significant difference. In the control group, the demand for analgesics was higher than the buprenorphine group. In the early hours after surgery (hours 2 and 6), the incidence of nausea and vomiting was significantly lower in the buprenorphine group than in the control group, but the rest of it, no difference was observed. The sedation score was also evaluated, but no significant difference was observed in the two groups. Also, the incidence of other side effects in the two groups did not differ significantly. The results of this study showed that buprenorphine is an effective drug in reducing postoperative pain in postoperative patients and, due to its very low side effects, can be routinely used in patients.

Living with chronic pain can cause a great deal of mental and emotional stress. The aim of this study is to explore the relationship between social support and the personality traits of extroversion and neuroticism and psychological well-being in patients with chronic pain referred to specialized clinics in the city of Rasht. The present study is descriptive and shows a correlation. The study sample included 150 women with pain chronic. They were selected from female and male patients with chronic pain that received treatment in the Clinic of Chronic Pain and Hospital in Rasht. To evaluate the variables, NEO personality traits, Filips social support and Riyf Psychological well-being questionnaires were employed. In order to analyze the data, the statistical methods of Spearman correlation and regression analysis were used. The results showed that there was a positive and significant correlation between psychological wellbeing in women with chronic pain and extroversion and social support (P<0/01). There is a reverse and significant correlation between neuroticism and psychological well-being (P>0/01). Also, the results of the regression analysis showed that the variables of neuroticism, extroversion and social support predicted 74% of the changes in psychological well-being (P>0/01). Therefore, with the planned curriculum in order to improve the psychological well-being and personality traits in these women with chronic pain we should work to improve their social support.

The Centrality of Pain Scale as a brief scale was developed to assess how pain is central, or dominant in the lives of individuals with chronic pain disorders. The aim of this study was to validate the reliability of the measurements of this scale among Iranian patient with chronic pain disorders. The current study was conducted in a correlation research context. A group of 150 patients with chronic pain disorders took part in this research. Participants answered the Centrality of Pain Scale )COPS(, the McGill pain questionnaire and the Toronto Alexithymia Scale. Data were analyzed using explanatory factor analysis, multiple analyses of variance and Pierson correlation coefficient. Two factor solutions were extracted using Principal Component Analysis that named pain dominance and pain control. The convergent validity was found to be high. According to the results, females had higher scores on total scale and pain dominance factor than males. The internal constancy and test retest reliabilities were found to be acceptable. Based on these results, it was concluded that Centrality of Pain Scale contain good validity and reliability in an Iranian population with chronic pain disorders.

Chronic pain is a sensory and psychological experience of discomfort that usually affects the emotional state and quality of life of the individual. The aim of the present study was to compare the effectiveness of group positive psychotherapy and group psychodrama on spiritual attitude, distress tolerance, and quality of life in women with chronic pain. This research was a quasi-experimental study with pre-test, post-test and followup design with control group. The statistical population included all women with chronic pain visiting Pars Royal Clinic of Tehran, among them, forty-five women were selected by the convenience sampling method, and were divided into three groups of 15. The research tools included Simons & Gaher’s Distress Tolerance Scale, Shahidi & Farajnia’s Spiritual Attitude Scale, and Short Form Quality of Life Questionnaire; and Rashid’s group positive psychotherapy protocol, and psychodrama package were used for interventions. Data were analyzed using ANCOVA. the results of the study in the post-test confirmed that positive psychotherapy is more effective than psychodrama on spiritual attitude, distress tolerance, and quality of life in women with chronic pain (p<0.01). The results suggest that positive psychotherapy is a more effective intervention for strengthening spiritual attitude and distress tolerance, and finally improving the quality of life of women with chronic pain.

Jumping and landing are common exercises in sports activities which are associated with injury of the anterior cruciate ligament. The purpose of this study was to investigate the effect of using a knee brace on peak ground reaction forces amplitudes, vertical loading rate, impulses in three dimensions and peak free moment values during landing in athletes with anterior cruciate ligament injuries. 15 athletes with anterior cruciate ligament injuries )height: 1.75±0.02 m; weight: 70.00±6.54 kg; body mass index: 23.29 kg / m2) volunteered to participate in this study. The landing height was 30 cm. The 50K30 Xeleton knee brace was used to support the anterior cruciate ligament and Kistler force plates were used to record landing ground reaction forces. The results did not show any significant difference during the landing from a height of 30 cm with and without knee braces )P<0.05) in peak ground reaction force components and the time to peaking of ground reaction forces along the vertical, anterior-posterior, and medio-lateral directions. Also, the findings did not show any significant differences in loading rate, impulse and free moment during landing with a brace compared to landing without it )P<0.05). According to the results of this study, it can be concluded that using a brace in patients with anterior cruciate ligament injury did not have any significant effect on the improvement of ground reaction forces, free moment, impulse and loading rate values during landing. It is also suggested that in future studies, the effect of wearing a brace long term on these components should be considered.

Nausea and vomiting is one of the most common and most annoying post-operative complications, therefore, the aim of this study was to investigate the effect of oxygen therapy with Venturi mask and CPAP mask on nausea and vomiting after cesarean section. This quasi-experimental study was performed on two groups (control-intervention) on 90 candidates for elective cesarean section in Ahvaz Razi Hospital. Patients were divided into two groups: intervention (45) and control group (45). Patients in the intervention group received 100% oxygen concentration with CPAP mask and patients in the control group with concentration of 30% by Venturi mask during and up to 6 hours after the operation. Nausea rate was assessed based on the VAS criteria and the frequency of vomiting. Data were analyzed by SPSS19 software using t-test and chi-square test. The results showed that there was a significant difference between the severity of nausea and vomiting in both intervention and control groups at all postoperative times (p>0.05). The mean of severity of nausea and vomiting in the control group was more than the intervention group.It indicates the effectiveness of Cpap mask against Venturi mask on the severity of nausea and vomiting after cesarean section. Using oxygen at a concentration of 100% with a Cpap mask, compared to a venturi mask with a 30% delivery oxygen concentration, is able to reduce nausea and vomiting after cesarean section surgery.

The aim of this study was evaluation the kinematics of the hip, knee, ankle and pelvis in low back pain patients who had pronated foot before and after a selected training protocol during walking. 23 men (15 men with low back pain and pronated foot as a control group and 17 men with low back pain and pronated foot as experimental group) were volunteered to participate in this study. The experimental group didresistance training with Teraband for 12 weeks, 3 sessions per week. The kinematic data was recorded by 4 Vicon cameras during walking. The results of this study in the experimental group showed that during the post-test, the walking speed was higher than the pre-test )p>0.05(. The results showed that the effect of time factor on pelvic posterior tilt was significant (p=0.001). Also, increas in ankle planar flexion (about 6 degrees) and the ankle joint range of motion (about 4 degree) during the post-test in comparison with the pre-test in the experimental group were observed (p=0.000). Regarding the increase in walking speed in low back pain patients with pronated foot during post-test compared to the pre-test, the less of changes in the lower limb joints angles and the absence of absolute pelvic angle indicate better mechanical efficiency of walking after exercise program