مجله دانشکده پزشکی اصفهان
پیاپی 549 (هفته اول دی 1398)

The postoperative pain is one of the most common complications of laparoscopic cholecystectomy. To control this pain, analgesic drugs are commonly used. Therefore, considering the importance of this issue, the aim of this study was to determine the effect of pre-emptive intramuscular ketamine and methadone on postoperative pain after laparoscopic cholecystectomy.

In this double-blind clinical trial study, 90 patients undergoing laparoscopic cholecystectomy were included. Then, the patients were randomly divided into three equal groups. Preoperatively, the first group received 1.5 mg/kg ketamine, the second group received 0.15 mg/kg methadone, and the third group received normal saline intramuscularly. Hemodynamic changes, postoperative pain, rescue analgesia, and complications of the operation were investigated in the groups.

There was no significant difference between the groups based on hemodynamic changes, postoperative complications, and the rescue analgesia (P > 0.050). However, there was a significant difference between the groups according to the amount of pain after the operation; the postoperative pain was lower in methadone, ketamine, and placebo groups, respectively (P < 0.001).

Two drugs of ketamine and methadone are effective in reducing postoperative pain following laparoscopic cholecystectomy, but the effect of methadone is better than ketamine. Moreover, the use of these drugs is not associated with hemodynamic changes and postoperative complications.

Adipokine apelin plays an important role in regulating energy homeostasis and improving insulin resistance. The purpose of this study was to investigate the interactive effect of aerobic exercise and L-carnitine supplementation on serum levels of cardiac tissue apelin and insulin resistance in diabetic rats.

In this experimental study, 40 male rats were randomly divided into five groups of healthy control, diabetic control (placebo), diabetes + L-carnitine, diabetes + aerobic exercise, and diabetes + L-carnitine + exercise. After induction of diabetes in rats, aerobic exercise and L-carnitine supplementation were performed for six weeks and five sessions per week. Aerobic training in the active groups consisted of 10 minutes of treadmill exercise with 60% of maximal oxygen uptake, which increased by 20 minutes from the third week, with no control group training.

There was a significant increase in apelin in the diabetes + aerobic training group and the diabetes + aerobic training + L-carnitine group compared to the control and placebo groups (P = 0.001). There was no significant difference between the two active groups (P = 0.227). There was a significant decrease in insulin and glucose levels in the active groups compared to the control and placebo groups, too (P = 0.001).

Aerobic training and consumption of L-carnitine can increase cardiac tissue apelin and decrease insulin resistance.

Studies have shown that exercise stimulates cardiac proteins, and regular moderate-intensity aerobic exercise can have a significant effect on cardiac proteins. Therefore, the purpose of the present study was to investigate the effects of 8 weeks of aerobic training on expression of mRNA N-cadherin and β-catenin genes in left ventricle of cardiac muscle in male Wistar rats.

24 male Wistar rats (8 weeks old) with an average weight of 237 ± 33 g randomly divided to three equal groups of control, 8-weeks control, and aerobic training. Aerobic training group participated in an aerobic training for 8 weeks (5 sessions of 20-60 minutes each week, with an intensity of 65% of maximum oxygen consumption) running on animal treadmill (0% incline and 24 m/s), and there was no change in the normal activity cycle of the control group. 24 hours after the last training session, the heart tissue of rat was extracted, and the expression of mRNA β-catenin and N-cadherin genes was evaluated using real-time-polymerase chain reaction (RT-PCR). The data were statistically analyzed using one-way ANOVA and post-hoc Tukey methods.

Expression of mRNA β-catenin and N-cadherin gene proteins (P = 0.001) and maximal oxygen uptake (P = 0.001) increased significantly in aerobic exercise group.

It seems that significant changes in expression of mRNA β-catenin and N-cadherin gene, as well as an increase in VO2max may make a positive impact on optimal heart activity.