فهرست مطالب

  • Volume:9 Issue:4, 2019
  • تاریخ انتشار: 1398/06/03
  • تعداد عناوین: 7
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  • Siti Yuyun Rahayu *, Lely Lusmilasari, Mohammad Juffrie, Windy Rakhmawati Page 1
    Context
    The term pain in neonates is emerged in recent decades. However, studies on pain in neonates are still limited and have various indicators. In addition, the term pain still often overlaps with stress in various studies and clinical circumstances. The concepts of pain and stress in the neonates need to be clarified to be better understood and then applied to improve neonates’ quality of life. Therefore, the current study aimed at clarifying the concept of pain in neonates.
    Evidence Acquisition
     The current study employed the concept analysis approach developed by Walker and Avant. The authors reviewed articles from JSTOR, ScienceDirect, Proquest, Sage, Cochrane, and Springer databases from 1980 to 2016 using keywords pain, stress, neonatal, neonates, and quality of life.
    Results
    Pain had attributes such as tissue damage, physiological changes, metabolic changes, and behavioral changes. Stress had attributes such as physiological changes, metabolic changes, and behavioral changes.
    Conclusions
    Attributes of pain and stress have similarities and differences. The main difference is the stimulus that induces a response. Pain has an attribute of tissue damage, whereas stress is not always due to tissue damage. The attributes of physical, metabolic, and behavioral changes between pain and stress are similar.
    Keywords: Neonatal, Pain, Stress
  • Washington Aspilicueta Pinto *, Lara de Holanda Juca, Mariana Lima, Claudia Regina Fernandes, Josenilia Alves Page 2
    Background
    There are meta-analyzes in adults demonstrating the benefits of using gabapentin to improve postoperative pain in orthopedic surgeries. In pediatrics, it has never been studied.
    Objectives
    The aim of this study was to evaluate the use of gabapentin 10 mg/kg, orally, in postoperative analgesia, hemodynamic stability and its pre/postoperative anxiolytic effect in children subjected to unilateral inferior limb surgery.
    Methods
    We performed a double-blinded, randomized study. 84 patients in Albert Sabin Children’s Hospital were selected for elective surgery that were divided into 2 groups: gabapentin group, who received gabapentin 1 to 2 hours before the procedure and the control group. Both groups were submitted to the same general anesthesia protocol with 0.125% bupivacaine femoral and sciatic block. Patients received scheduled dipyrone and morphine was used as the rescue analgesic up to 2/2 h. Postoperative pain was assessed using a scale appropriate for age (CRIES, CHIPPS or Wong-Baker face scale). We registered hemodynamic parameters, analgesic consumption and pre/postoperative anxiolytics.
    Results
    A decrease in pain intensity in the 4th and 8th postoperative hours was observed in gabapentin group, both groups had the same opioid consumption. Children in the gabapentin group had an odds ratio of 25.6 for preoperative sedation and gabapentin promoted reduction of postoperative agitation. During orotracheal intubation the gabapentin group exhibited attenuation of the hemodynamic response.
    Conclusions
    Gabapentin was superior to placebo in reducing postoperative pain. Children who received gabapentin were more sedated in the operating room, less agitated in the postoperative period and the autonomic response to intubation was reduced.
    Keywords: Gabapentin, Pediatric, Postoperative Pain, Orthopedic
  • Tamer Mohamed Naguib, Sameh Abdelkhalik* Page 3
    Background
    Flexible laryngeal mask airway may be used instead of the endotracheal tube in children presented for elective repair of tongue trauma, as it may shorten the time for extubation and recovery with the amelioration of stress response to airway management.
    Objectives
    This study aimed to evaluate the extubation time and hemodynamic response to the endotracheal tube or flexible laryngeal mask airway in children presented for tongue trauma repair.
    Methods
    The study recruited 90 children presented for elective repair of tongue trauma that were randomly assigned into the following groups: the ETT group for which the airway was controlled by a cuffed endotracheal tube and the LMA group for which the airway was controlled by a flexible laryngeal mask. The intubation time, surgical time, total anesthesia time, extubation time, recovery time, changes in the hemodynamic parameters, and the incidence of complications were measured.
    Results
    The use of flexible laryngeal mask airway instead of endotracheal tube significantly decreased the extubation time to 7.47 ± 2.74 min (P < 0.0001) and the recovery time to 52.67 ± 11.16 min (P = 0.001) while no significant differences were observed in the intubation time (P = 0.874), surgical time (P = 0.411), and total anesthesia time (P = 0.725). In addition, the changes in the hemodynamic parameters were significantly lower with flexible laryngeal mask airway both during airway securing and at the start of the surgery (P < 0.05). Moreover, it significantly decreased the incidence of postoperative cough, stridor, and sore throat (P = 0.039, 0.006, and 0.027, respectively).
    Conclusions
    The flexible laryngeal mask airway can be used instead of the endotracheal tube in children undergoing the repair of tongue trauma, as it decreases the extubation time, recovery time, and hemodynamic changes to the airway control.
    Keywords: Endotracheal Tube, Extubation Time, Intubation Time, Laryngeal Mask Airway, Recovery Time
  • Mehdi Fathi, Amir Shahriar Ariamanesh *, Marjan Joudi, Mitra Joudi, Farhood Sadrossadati, Azra Izanloo Page 4
    Anterior cruciate ligament (ACL) reconstruction is an extremely common surgery in sports medicine and orthopedic surgery. This surgery requires creating tunnels in bones (femur and tibia), which is often associated with severe pain and thus general or neuraxial anesthesia should be applied to mitigate pain and anxiety. This paper follows our previous case report of hypnoanesthesia in hand surgery, discussing the application of hypnosis as a non-pharmacologic intervention for controlling intraoperative and postoperative pain and anxiety, which can contribute to postoperative recovery of patients with ACL surgery. According to the results of this study, it seems better to teach hypnosis as a pain control protocol to anesthesia residents and pain service staff. Also, hypnosis can be considered an anxiety reduction strategy in perioperative phases and also useful for postoperative pain management.
    Keywords: Hypnosis, Anxiety, Meniscal Surgeries, Ligament Reconstruction
  • Sarah Namjoo *, Ahmad Borjali, Mohammadreza Seirafi, Farhad Assarzadegan Page 5
    Background
    Primary headaches are one of the most troubled chronic diseases. Headaches interfere within the various dimensions of the patient’s life. Coping strategies that aim to be attention focused (e.g., mindfulness) may moderate pain-related emotional and physical interference.
    Objectives
    This investigation examined the relationship between mindfulness and pain intensity with physical and emotional interference and the subsequent aim was to analyze the role of mindfulness and headache severity combination in the prediction of pain-related interference.
    Methods
    This correlational study was conducted during years 2017 to 2018 at Imam Hossein Hospital of Tehran province. Eighty-five patients (56 females and 29 males), who had one type of primary headache were selected through purposive sampling after the diagnosis by a neurologist. The data were collected through the brief pain inventory (BPI) and the mindful attention awareness scale (MAAS). All data were analyzed using descriptive statistics. Bivariate correlation matrix and hierarchical stepwise linear regression statistics were used.
    Results
    The correlational analysis of the results indicated significant association between mindfulness (MAAS) and pain severity (BPI) (P < 0.01) as well as the findings of the study point to the significant relationship between mindfulness and both physical and emotional pain-related interference (P < 0.01). The results of stepwise linear regression indicated that pain severity explains only 1% of the total score in emotional pain-related interference (P = 0.003 and ΔF (1 and 83) = 9.22, ΔR2 = 0.11). Adding mindfulness to the model led to a 43% increase of the explained variance (R2 Change = 0.34). In physical interference, although pain severity was able to predict pain interference (P = 0.01 and ΔF (1 and 83) = 7.09, ΔR2 = 0.07), a combination model justifies 10% of the interference variance that was not statistically meaningful (P = 0.08, ΔR2 = 0.103).
    Conclusions
    This result is a further support that Mindful Awareness contributed to emotional pain-related interference prediction. This result can explain the role of attention focused and mindful awareness in primary headache pain adjustment.
    Keywords: Primary Headache, Mindfulness, Physical Interference, Emotional Interference
  • Masoud Hatefi, Reza Parvizi, Milad Borji, Asma Tarjoman* Page 6
    Background
    Osteoarthritis (OA) is a progressive disease of the joints, leading to decreased function and disability.
    Objectives
    The study aimed to investigate the effect of self-management (SM) program on disability index and pain in aging men with knee OA.
    Methods
    The study included an SM group and a control group. Given the sample size of the previous studies, 83 patients were recruited. The study tools included a demographic profile questionnaire, visual analogue scale (VAS), and HAQ 8-item DI. The intervention included 10 SM sessions for patients in the SM group (8 sessions of in-person intervention and 2 sessions of telephone intervention). Patients were placed in groups of 7, and the sessions were held weekly each for a period of 45 to 60 minutes. Data were analyzed using descriptive and analytical tests by SPSS V. 16 software.
    Results
    The two groups(SM and control group) were homogeneous in terms of demographic characteristics (P > 0.05). The mean (SD) disability score was 19.12 (1.92) in the SM group before the intervention, which reduced to 14.70 (1.63) after the intervention (P = 0.000, T = 10.02). The mean (SD) pain score, was 9.19 (0.71) in the SM group before the intervention, which reduced to 6.48 (0.84) after the intervention (P = 0.000, T = 18.15).
    Conclusions
    Training can help patients perform SM measures and improve their health status by enhancing the information needed for the disease.
    Keywords: Pain, Disability, Aging, Knee Osteoarthritis
  • Abbas Sedighinejad, Soheil Soltanipour, Siamak Rimaz, Gelareh Biazar *, Yasamin Chaibakhsh, Mahan Badri Kouhi Page 7
    Background
    Recent articles about the topic of the anesthetic agents-related neurotoxicity have currently attracted the attention to the issue in the anesthesiology community. However, specialists in other fields should also be aware of this potential risk.
    Objectives
    This study aimed to evaluate the knowledge and practice of physicians at Guilan academic hospitals regarding general anesthesia-related neurotoxicity.
    Methods
    Firstly, the responsible anesthesia resident explained the purpose of this work to Guilan faculty and residents and if they agreed to participate a questionnaire containing 12 items was filled via a face to face interview.
    Results
    A response rate of 100% was achieved (271 responders from 271 eligible study responders). Also, 89 (33.1%) responders were attending, 180 (66.9%) were residents, 112 (41.6%) were female, and 157 (58.4%) were male. The mean years of experience was 8.8 ± 4.82 (2 - 28 years). According to the achieved data, the majority of the precipitants did not believe in GA toxicity.
    Conclusions
    This paper revealed that the current curriculum does not sufficiently address the anesthesia-related neurotoxicity problem. Indeed, the need for training and communication with non-anesthesia medical colleagues was highlighted.
    Keywords: General Anesthesia, Neurotoxicity, Knowledge, Practice, Guilan