فصلنامه بیهوشی و درد
سال دوازدهم شماره 1 (بهار 1400)

Low back pain is a common ailment that affects about 80% of the population at some point in their life time. Using a brace is a method to control pain that physiotherapists recommend it. However, the scientific evidence about the effects of different braces in low back pain patients is limited. Therefore, the aim of this study was to evaluate the effects of two thoracolumbosacral braces on electromyography activity) and pain index of low back pain patients during walking.

In this quasi-experimental study, 15 male and female subjects with low back pain volunteered to participate in this study. Subjects walked in three conditions (without braces, simple braces and sensor braces). An 8-channel wireless electromyography system was used to record the activity of the muscles of the back and lower limb during walking. Visual scale index was also used to record pain and comfort. Repeated measure ANOVA test was used for statistical analysis. Significance level was set at p=0.05.

Finding demonstrated that the pain value during using brace with sensor was lower than that simple brace (P<0.05). However, comfort value during using simple brace was the lowest (P<0.05). Frequency content of biceps femoris during push off while using brace with sensor was greater than that simple brace condition (p=0.007).

In general, it can be said that the use of tracholambosacral braces with sensor because of reduction in pain and increment in frequency content of biceps femoris muscle is more effective than that simple brace in patients with low back pain.

In recent years and recent studies have observed specific viewpoint about awareness and recall and complications of them e.g. postoperative psychological reactions. The purpose of this study was to investigate the relationship between different isoflurane MAC (1/2- 0/8) awareness and postoperative depression, anxiety and stress in patients undergoing cesarean section with general anesthesia.

In this study, in nine months, 70 mothers with ASA class I/II, randomly, were selected. After satisfaction and after induction of anesthesia, depends on the amount of uterus relaxation Isuflurane administered. One month after surgery, the questions of DASS examination orally asked from patients to measure the stress and anxiety and depression and the so recall examination asked to measure the awareness. Then the data were analyzed.

Four patients had awareness. 17% of patients had depression, 27% anxiety and 16% stress. There was a significant relationship between the Isuflurane concentration and postoperative psychological problems. In other words, if Isuflurane concentration decreases, the psychological problems would increase.

setting of Isoflurane MAC less than 0.7 lead to awareness/recall and postoperative depression, anxiety and stress after cesarean section. Therefore, it is recommended, when there is necessary to reduce the dose of inhaled anesthetics, administer alternative anesthetics as IV anesthetic drugs for maintaining the depth of anesthesia.

Rheumatoid arthritis is an inflammatory, autoimmune, chronic, and progressive connective tissue disease with an unknown cause that is associated with symptoms such as pain, swelling, tenderness, stiffness, and dryness in the joints and decreased energy, leading to muscle inactivity and atrophy. The aim of this study was to investigate the effect of Pilates exercises on pain and isometric torque of flexor muscles and knee extensors in women with rheumatoid arthritis.

Thirty female patients with rheumatoid arthritis (hip and knee joints) were randomly divided into two groups (15 experimental groups and 15 control groups). Evaluation of the pain performed with visual Analogue Scale (VAS) scale and Kin-com 125A isokinetic dynamometer were used to assess the isometric torque of the muscles. The experimental group performed Pilates exercises for eight weeks and three sessions a week. Paired t-test and analysis of covariance were used to interpret the data in two groups. (P≤0.05).

The findings showed that the pain of the experimental group after eight weeks of Pilates exercises was significantly lower than the control group (P <0.05). Also, the isometric torque of the knee flexor and extensor muscles of the experimental group is significantly better than the control group members (P <0.05).

According to the findings of this study, Pilates exercises can improve the pain and the knee flexor and extensor muscles isometric torque of patients with rheumatoid arthritis.

To have proper balance, proper communication between body systems and environment is essential. Disruption of these systems causes problems for the individual, which can be seen in diabetic patients with osteoarthritis. Therefore, the aim of this study was to investigate the effect of 8 sessions of balance exercises and traction loops on the joint position sense of the knee and ankle in Diabetic patients had osteoarthritis of the knee.

This study was performed on elderly diabetic patients with osteoarthritis. Subjects were divided into control and intervention groups and actively and passively reconstructed joint angles and balance time was recorded on both legs. The training phase was balanced. In the test phase, the amount of joint error and balance time on one leg were recorded twice. Correlated t-test was used to compare variables between different pre-training and post-training conditions. The significance level for all analyzes was 0.05.

The results showed that 45 ° flexion movements of the left knee (P = 0.001), 20 ° flexion of the right knee (P = 0.038), 20 ° flexion of the left knee (P = 0.001), dorsiflexion of the right ankle (P = 0.016) and plantar flexion of the left ankle (P = 0.001) was significantly reduced compared to the pre-exercise stage in the intervention group. Also, no significant difference was observed in the control group.

The results of this study showed that trapezoidal loops exercises have improved the reconstruction of joint angles and balance time in diabetic patients with osteoarthritis. Therefore, it is recommended that this type of exercise be included in the exercise program of diabetic patients with elderly osteoarthritis.

The choice of anesthesia for cesarean section depends on factors such as the cause of the operation, the degree of urgency of the operation and the patient’s desire. Following the choice of any of the methods either general anesthesia or spinal anesthesia for mother and baby will have consequences. The aim of this study was to compare maternal and neonatal outcomes after cesarean section with general and spinal anesthesia in teaching hospitals in Ahvaz in 1398.

This analytical study was performed in 1398 on 110 pregnant women aged 20-35 years who are candidates for repeat elective cesarean section in Ahvaz educational hospitals for termination of pregnancy. The research instruments included a three-part questionnaire related to demographic characteristics and pre-cesarean section information and post-cesarean section information. SPSS software version 22 and paired t-test and independent t-test and chi-square were used to describe and analyze the data.

The use of spinal anesthesia for cesarean section was associated with less pain, less analgesia, higher Apgar score, higher hematocrit and hemoglobin, no sore throat, and more satisfaction compared to general anesthesia. But the complications of nausea, vomiting and postoperative headache are more common in the group with spinal anesthesia.

Therefore, according to the results of the study, it is recommended to use spinal anesthesia as much as possible in cesarean delivery.

Living with the chronic pain of inflammatory bowel disease requires considerable emotional pressure, as pain reduces a person’s emotional abilities so the aim of this study was to explain the Structural model of relationships between family communication patterns and quality of life in patients with inflammatory bowel disease with the pain perception.

The research method is cross-sectional correlation using structural equation modeling. The statistical population of this study consisted of all people with inflammatory bowel disease in Isfahan in 1399, from which 331 people were selected by convenience sampling. In this study of family communication model tools, quality of life of inflammatory bowel patient, McGill pain perception were used. Lisrel-V8.8 software were used to analyze the data.

Findings showed that family communication patterns through pain perception have an indirect and significant effect on the quality of life of inflammatory bowel patients. The research findings also showed that the communication component of dialogue has a positive effect on quality of life and negative effect on pain perception and the compliance component has a negative effect on quality of life positive effect on pain perception.

Based on the findings it can be said that pain perception plays an important role in the quality of life of inflammatory bowel patients, therefore paying attention to the mentioned variables in prevention and designing more appropriate treatments helps researchers and therapists.

Chronic low back pain is one of the common causes of patients referring to specialized and general medical clinics. The positive effect of Epidural Steroid injection has been proven in relieving pain in these patients. In this study, the epidural effects of methylprednisolone acetate in these two methods of Caudal and Lumbar were compared.

In this study, 80 patients with radicular lower limb pain due to lumbar intervertebral disc protrusion who were referred to the pain clinic were divided into two groups of 40 patients. In the first group, steroids were injected into the epidural site by Lumbar method and in the second group by Caudal method. The effects of these two methods on reducing patients’ pain at 2-month intervals and at the end of 1 year were evaluated and compared.

According to this study, epidural steroid injection significantly reduced the mh pain in patients (P <0.001), but there was significant difference between Lumbar and Caudal methods. There was no reduction in pain. The rate of pain reduction in patients one year after epidural steroid injection in both lumbar and Caudal methods was not related to the level of discopathy. The rate of pain reduction after lumbar epidural steroid injection in patients with a history of lumbar spine surgery was less than caudal injection (P = 0.043). In Patients with a history of lumbar spine surgery the injection of caudal steroid would further reduce their pain (P = 0.336). Epidural steroid injection improves deep tendon reflexes (DTR) anesthesia of the lower extremities

Patients with radicular pain in the lower extremities who have not responded well to medication can benefit from epidural steroid injections. In reviewing the results of one year, the lumbar or caudal injection method is not preferable to another. Only in cases where the patient has a history of lumbar spine surgery, the caudal method will be preferred.

The aim of the present study was to compare the effectiveness of dialectical behavioral therapy and emotional schema therapy on sleep quality in people who suffering from tension headache. The present study was a quasiexperimental design that conducted in the form of pretest-posttest-2mounths follow up. In this study, 68 patients with chronic tension headache were referred from pain specific clinic of Imam Reza hospital (Tabriz medical university), and 30th of them with psychiatric recognition of tension headache were selected with purposive sampling method, they were randomly assigned to two experimental groups (15 students per group). The participants in each group completed the Pittsburgh sleep Quality as the pretest, posttest, and 2months follow-up. Twelve sessions of group emotional schema therapy, and Ten sessions of group Dialectical Behavioral therapy were held for the participants in the experimental groups. The collected data were analyzed using descriptive statistics (mean and standard deviation) and multivariate analysis of covariance. Based on the results of covariance analysis in posttest and follow- up, it was found that both emotional schema therapy, and dialectical behavior therapy were effective on sleep quality in patients with chronic tension headache (p=0/001). In addition, Bonferroni post hoc test results showed that emotional schema therapy had a greater effect on sleep quality than dialectical behavior therapy among people who suffering from tension headache (p=0/001). Therefor training of this therapeutic approach is recommended as an effective interventional method in recovery of sleep quality in people who suffering from tension headache.

Chronic nonspecific neck pain considered as a common problem which most of the time comes with changes in sensorimotor functions, beside high financial expense, its accompany with pain and personal concerns in society. The purpose of this research was to study and compare the effect and maintenance of breath training with and without yoga on Pain, range of motion and quality of life in women with chronic nonspecific neck pain.

The present study was a quasi - experimental study with a pretest-posttest design with a control group. For this purpose, 45 women (40 to 50 years old) with chronic non-specific neck pain and fulfilled the inclusion criteria has been selected by convenience sampling in 3 equal groups of 15 patients (randomly). Then two experimental groups performed the training protocol. The protocol was eight weeks of 45minute exercise program, three sessions per week, of breath training with yoga, breath training. In order to assess pain, range of motion and quality of life of subject, visual analogue scale, Universal Goniometer and whoqol-brief questionnaire was used. All variables were measured one week prior to the study, before, and immediately after the intervention and four weeks afterwards. After data collection, for data analysis Repeated measure ANOVA was applied at the significant level of (p≤0/05).

The findings of this study showed that both breath training with yoga and breath training has significant effect on pain, range of motion and quality of life of subject women with chronic non-specific neck pain(P≤0.05). Conducting a between-group comparison also showed that the pain, range of motion and quality of life variables had the highest variation, which was related to the breath training with yoga and breath training, respectively.

According to the results, breath training with yoga showed greater recuperation than breath training. The breath training with yoga are recommended as an adjunct method in treatment of subject with chronic nonspecific neck pain..

In any era of history, human beings have been afraid of a disease. Undoubtedly, cancer is one of the most worrisome diseases and cancer pain is one of the most painful pain. The purpose of this study was to compare the efficacy of cognitive-behavioral group therapy and mindfulness therapy on the reduction of physical disability and pain relief in cancer patients.

The present study is applied in terms of purpose and in terms of quasi-experimental method with pre-test, post-test and two-month follow-up and control group. The statistical population was all women with breast cancer referred to Tehran Cancer Research Center in 1397 who were selected by available sampling method consisting of 30 patients and randomly divided into two groups of intervention therapy (cognitive-behavioral and mindfulness), and The control group was placed. The research instrument was the Physical Disability Scale Questionnaire (Roland and Morris, 1984) to assess the physical condition and pain intensity. For data analysis, a mixed analysis of variance design with repeated measures was used.

The results of the analysis showed that there is a significant difference between the performance of the three groups in the physical disability and pain severity, but the effect of these two methods on the two groups was similar in reducing physical inability.

In this study, in addition to medical treatment, cognitive / behavioral group therapy and knowledge of the mind are effective methods to minimize physical disability and severity of pain in cancer patients.