فصلنامه بیهوشی و درد
سال دوازدهم شماره 3 (پاییز 1400)

Migraine is a common, painful and debilitating in severe and chronic cases. Therefore, identifying migraine-related factors is essential to reduce the problems associated with it. Therefore, the aim of this study was to predict pain indices based on cognitive emotion regulation strategies and alexithymia in women with migraine in Isfahan.

The research design was descriptive and correlational. The statistical population of the study included all women who referred to the neurology clinic of Khorshid Hospital in Isfahan in the second half of 1397 and received a diagnosis of migraine based on the opinion of a neurologist. To conduct this study, 100 people were selected through purposive sampling method and asked them to complete the Headache Indices Scale, Cognitive Emotion Regulation Questionnaire (CERQ) and Toronto Alexithymia Scale (FTAS-20).

The results showed that there was a relationship between cognitive emotion regulation strategies and alexithymia with pain indices in women with migraine and subscales of cognitive emotion regulation strategies respectively with Beta coefficients 0.498, 0, 0.304, 0.383, 0.540, -0.581, -0.473, -0.525, -0.540 and -0.410; and alexithymia and its components, respectively, with Beta coefficients of 0.544, 0.55, 0.47, and 0.33 were significant predictors of pain symptoms in women with migraine (P <0.01).

According to the obtained results as the prediction of pain indicators based on cognitive emotion regulation strategies and alexithymia, it is possible to reduce pain symptoms in people with migraines by provide timely and appropriate interventions and training to improve cognitive emotion regulation strategies and reduction of alexithymia.

The prevalence of postoperative urinary retention is between 5% and 70%, depending on the type of surgery, the type and combination of anesthetics, and the patient's underlying conditions. Studies have shown that reducing the dose of local anesthetics in spinal anesthesia and the use of the drug combination reduces the incidence of urinary retention and the need for postoperative catheterization. This study was designed to evaluate the effect of adding fentanyl to spinal anesthesia on the incidence of postoperative urinary retention.

In a randomized clinical trial, patients who were candidates for lower limb orthopedic surgery or lower abdominal surgery under spinal anesthesia were enrolled. Patients with a history of urinary problems were not included. participants were excluded if a change in the method of anesthesia was intended, urinary catheterization required or urinary tract trauma occurred. Patients were randomly allocated to either spinal anesthesia with Bupivacaine 2-2.5 ml or spinal anesthesia with Bupivacaine 1.5-2 ml plus fentanyl 25 µg. Postoperative urinary retention was assessed based on the need for catheterization or a complaint of difficult or incomplete urination.

There was a significant borderline association between the complaints of incomplete (20 vs. 12 patients) or difficult urination (16 vs. 8 patients) after surgery and the addition of fentanyl to the spinal anesthesia. (P=0.05) There was no statistically significant relationship between the need for postoperative catheterization and the addition of fentanyl to the spinal anesthesia (20 vs. 13 patients; p=0.11). Logistic regression analysis showed that age and amount of fluid intake during surgery were independent predictors of difficult urination.

Adding fentanyl 25µg to local anesthetics in spinal anesthesia will increase the incidence of postoperative urinary retention. The use of lower doses of fentanyl in combination with various local anesthetic drugs in spinal anesthesia is recommended in future studies.

One of the most common causes of chronic back pain is spinal stenosis.This disorder is common in the elderly.Treatments for spinal stenosis include surgery, laser therapy, ozone therapy, physical therapy, and medication.Since no study has been done to compare laser therapy and ozone therapy, this study was performed to evaluate the effectiveness of intramuscular injection of ozone gas in paravertebral muscles compared to high-power laser in patients with lumbar spinal stenosis.

This study was a randomized clinical trial.Patients referred to the Physical Medicine and Rehabilitation Clinic with spinal canal stenosis were evaluated in three groups: laser therapy, ozone therapy, and drug & physical therapy.After treatment, a valid SSSQ questionnaire was used to collect and the outcome of treatment.After data collection, they were analyzed by spss25 software.

The results showed that the mean score of pain and neuroischemic symptoms, physical activity and patients' satisfaction with the intervention performed immediately after treatment (p = 0.04), 4 weeks after the intervention (p = 0.001) and 8 weeks after the intervention (p = 0.001) Was statistically significant.

The results of the present study showed that laser therapy and ozone therapy versus drug and physical therapy alone were effective in reducing pain and neuroischemic symptoms in patients as well as improving patients' physical activity but there was no significant difference between laser therapy and ozone therapy during the time the patients were examined.

Chronic musculoskeletal pain was one of the most common disorders in human societies. Incidence and improving of this disorders In addition to medical reasons, its also very influential from psychological factors. The aim of the present study was to evaluate the structural model of the relationship between health promoting lifestyles, Distress tolerance, Helplessness and Chronic Pain acceptance in patients with Chronic musculoskeletal pain.

The present study was a descriptive correlational study using structural equation modeling. We used available sampling for selecting 384 patients with chronic musculoskeletal pain as the study population including patients with chronic musculoskeletal pain referred to Najafabad private clinics. Research Tools included health promoting lifestyle questionnaire (HPLQ, 1988), distress tolerance questionnaire (DTQ, 2005), chronic pain acceptance questionnaire (CPAQ, 2006) and learned helplessness questionnaire (LHS, 1988). The data was analyzed by SPSS, AMOS and with help of structural equation modeling.

The model of research was fit and the considered factor structure was optimal. The results indicated the health promoting lifestyles and distress tolerance had significant direct relationship with chronic pain acceptance. Learned helplessness had relative reverse relationship with chronic pain acceptance and had significant reverse relationship with health promoting lifestyles and distress tolerance. Also the mediatory role of learned helplessness in the relationship between health promoting lifestyle and distress tolerance were supported and relative reverse correlations were obtained (p<0/05).

Improving health promoting lifestyle and distress tolerance are involved in chronic pain acceptance In patients with chronic musculoskeletal pain. Learned helplessness was an important mediator, and associated with health promoting lifestyle and distress tolerance and it is important to pay attention to use therapy on the basis of these variables.

The ankle and knee joints position sense disrupted in diabetic patients with osteoarthritis of the knee. The aim of this study was to evaluate the effect of 8 sessions of balance exercises on position sense of knee and ankle joints in diabetic patients with knee osteoarthritis.

This study was performed on elderly diabetic patients with knee osteoarthritis. Subjects were divided into control and intervention groups. Passive and active joint angles reconstructed and balance times were recorded for both legs. In the intervention group, the balance training was done for 8 sessions. Paired sample t-test was used for statistical analysis.

The results showed that reconstruction of 45 ° flexion of the left knee (P = 0.007), 20 ° flexion of the right knee (P = 0.035), dorsiflexion of the right ankle (P = 0.008), dorsiflexion of the left ankle (P = 0.011), plantar flexion of the right ankle (P = 0.012) and plantar flexion of the left ankle (P = 0.001) were significantly reduced in posttest than that pretest.

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

Irritable bowel syndrome is one of the most common causes of chronic abdominal pain, therefore the aim was the effectiveness of behavioral cognitive intervention based uncertainty intolerance and acceptance and commitment intervention on anxiety, severity of gastrointestinal symptoms and cortisol level in patients with irritable bowel syndrome with generalized anxiety disorder.

This study was a quasi-experimental study with a pretest and posttest design with a control group and follow up for three months. The statistical population included patients with irritable bowel syndrome and generalized anxiety disorder who referred to Parsian Hospital between late winter 1398 to mid-summer 1399 and internal medicine in Tehran. 60 patients were selected through targeted sampling and randomly assigned in Behavioral Cognitive Intervention based Intolerance of uncertainty, acceptance and commitment Intervention and control (n= 20 each). Data were collected analyzed using the Irritable Bowel Syndrome, Severity of Gastrointestinal Symptoms, Anxiety and blood cortisol level test and by SPSS-25 and using analysis of variance were performed by repeated measures.

Both interventions had a significant effect on reducing the severity of irritable bowel syndrome and gastrointestinal symptoms and blood cortisol levels (P <0.01, this effect was stable during follow-up period (P <0.01). Regarding anxiety, only cognitive-behavioral intervention had a significant effect (P <0.01)

Behavioral cognitive and acceptance and commitment interventions as an effective intervention can be used in medical centers to reduce severity of gastrointestinal symptoms and blood cortisol levels of patients with irritable bowel syndrome and generalized anxiety disorder.

The aim of the present study was to evaluate the effectiveness of meta cognitive interpersonal therapy on reduction of perceived pain and marital conflict among couples at  empty nest stage.

The present study was a quasi-experimental research method with pre-test and post-test, control. The statistical population consisted of couple experiencing empty nest stage in Isfahan in 2019. The sampling method was purposive and 16 couples were selected and randomly assigned into two groups (n=16). The experimental group participated in 8 sessions of  meta cognitive interpersonal therapy based training, once a week, for 120 minutes and the control group was on the waiting list. Research tools consisted of Perceived Pain Questionnaire of McGill of Melzack and Revised Marital Conflict Questionnaire (MCQ-R) of Bagher Sanaei   & et al. Univariate analysis of covariance was used to analyze the data.

The results showed that meta cognitive interpersonal therapy significantly improved the mean scores of perceived pain and marital conflict in the experimental group compared to the control group. Therefore, the results showed a reduction in perceived pain and marital conflict in couples in the empty nest stage

The using of meta cognitive interpersonal therapy would be useful for reducing perceived pain and marital conflict.

 This study aimed to investigate a chronic pain prediction model based on catastrophic fear by considering the mediating role of self-control in patients with knee pain. 

 The research method is descriptive and correlational and the structural equation modeling method. The present study  statistical population was all patients with knee pain who were referred to Milad Hospital in Tehran in 1398. The total sample size was 400 patients who were selected by purposive sampling method. The research instruments included Van Korf et al. (1990) chronic pain questionnaire, the Sullivan et al. (1995) catastrophic pain questionnaire, and the Tanji et al. (2004) self-control questionnaire. Data analysis was performed using AMOS software, and necessary calculations and fitting indices and path coefficients were extracted for the proposed model.

The results of the statistical test showed that the model fit indices are in good condition. 

 The findings showed that chronic pain is directly affected by catastrophic fear factors, and the relationship between catastrophic fear and chronic pain is direct. Catastrophic fear factors also have an indirect effect on chronic pain through self-control. Therefore, self-control can alleviate the catastrophic fear of patients with chronic pain.

Quality of spiritual life are influenced by emotional structures, cognitive and motivational, so the present study aims to provide a conceptual model of quality of spiritual life based on the symptoms and emotional schemas with the mediation of perfectionist cognitions of patients with chronic pain was performed.

This study was a descriptive correlational study. The statistical population included all men and women ‌(30-50 aged) ‌with chronic low back pain referred to pain clinics in Akhtar, Labbafinejad and Imam Hossein (AS) hospitals in Tehran in the year  99-98. The sample included 400 people considering the inclusion criteria were chosen. The instruments used in this study are: Mood/Anxiety Symptoms Questionnaire, Short Form of Emotional Schemas, Perfectionist Structures, Short Form Spiritual Quality of Life. Data were analyzed by SPSS21 and LISREL 8.8 software programs by structural equation modeling.

The results showed that the direct path of mood/anxiety Symptoms to increased Emotional Schemas (p<0.05), and direct path of Emotional Schemas to increased Perfectionism Cognitions (p<0.05), was significant. Also, indicated that the indirect path mood/anxiety Symptoms to Spiritual Quality of Life through Emotional Schemas and Perfectionism Cognitions was significant (p<0.01)

The findings of this study support the mediating role of Perfectionism Cognitions in the relationship between emotional Symptoms and Emotional Schemas with Spiritual Quality of Life, so the development of therapeutic interventions based on reduced emotional schemas and perfectionism can be useful in improving the quality of spiritual life of patients with chronic pain.