فصلنامه بیهوشی و درد
سال سیزدهم شماره 3 (پاییز 1401)

Chronic back pain is a common disease among men. The aim of this study was to investigate the effect of a Graston massage session on pain and range of motion of the lumbar and hip regions in men with chronic low back pain.

The present study was an experimental study with a pre-test-post-test design. Participants in this study were 56 men with chronic low back pain who were selected by purposive sampling method and randomly assigned to experimental (n = 28) and control (n = 28) groups. In this study, pain with VAS visual index and range of motion were evaluated with inclinometer along with Android smartphone application. In the experimental group, massage with Greston instrument was performed for one session for 20 minutes. The control group did not receive any intervention in this study. In order to test the research hypotheses under normal conditions, analysis of covariance (between groups) and correlated t (within groups) were used

The results of this study showed that applying a Graston massage session on constant pain during movement and range of motion of men with chronic low back pain was effective (P ≤ 0.05).

Due to the effect of Craston massage on back pain and range of motion of the joints, coaches and sports physicians are recommended to use this type of intervention to prevent injuries and treatment.

The aim of this study was to evaluate the effect of online yoga exercises on pain, functional disability and functional tests of the torso and lumbar in middle-aged women with nonspecific chronic low back pain in the Covid 19 pandemic.

The research was quasi-experimental and applied study. Thirty women with nonspecific chronic low back pain in the age range of 35 to 55 years were selected based on inclusion and exclusion criteria as a sample and its were randomly divided into experimental and control groups. In order to measure the variable of pain from the Visual Analog Scale, functional disability from the self-reported questionnaire of Oswestry, ITOO tests for functional tests of the torso and the functional scale of the lumbar were used. Eight weeks of yoga exercises were done online. Data were analyzed by paired t-test and analysis of covariance at the significant level of P≤0.05.

The results showed a significant effect of the online yoga exercises on the variables of pain intensity, functional disability, lumbar executive scale, endurance of flexor and extensor trunk muscles of the experimental group (P≤0.05) and also there was a significant difference on the results of post-test research variables between the two groups (P≤0.05).

According to the results of this study, in relation to the effect of online yoga exercises in improving non-specific chronic low back pain, the use of this type of exercises is recommended in corrective exercises and movement therapy clinics.

Glenohumeral internal rotation deficit (GIRD) is one of the most important risk factors for overhead-throwing athletes and adversely affects the biomechanics of the Glenohumeral joint during overhead-throwing motions. The aim of this study was to review all the articles performed in the field on the effect of corrective exercises on pain, function, proprioception, and muscle activity in people with GIRD

Reputable domestic and external electronic databases such as Sid, Magiran, Noormags, Science Direct, Google Scholar, PubMed, Trip Database, and Scopus were searched in all years through relevant keywords. A total of 444 studies were reviewed, of which 7 articles were accepted based on inclusion and exclusion criteria’s. The PEDro scale was used to evaluate the quality of selected articles.

2 examined the effect of stretching exercises, 2 examined the effect of rotator cuff exercises, 1 examined the effect of throwing exercises augmented, 1 examined the effect of facial manipulation, and 1 compared the effects of Kinesio Taping and stretching in people with GIRD. The results suggested that corrective exercises were effective in reducing pain and improving function, proprioception, and muscle activity in people with GIRD.

A corrective exercises proposed to improve muscle activity, function, and proprioception and reduce pain in people with GIRD.

Non-specific chronic low back pain (LBP) is the most common problem of spinal column disorder and musculoskeletal problems. Many evidence has demonstrated that exercise and corrective exercise is a positive intervention on decrease pain; but according to the relationship between increased lumbar lordosis angle and low back pain; it seems to be very important to implement the study about pain changes and lumbar lordosis angle. Furthermore, movement control impairment is one of the most problem related with low back pain. The aim of current systematic review was to evaluate the effect of exercise on pain, lumbar lordosis angle and movement control in participants with non-specific chronic low back pain.

A data base search within the all of times was performed, using Google Scholar, PubMed, The PEDro, CINAHL, Cochrane Library, Trip Database and Web of Science systems. Studies investigating the effect of types of exercise in pain, lumbar lordosis angle and movement control in patient with LBP were included. PEDro quality scale was used for the assessment of included studies.

Eleven out of 128 relevant articles had our search entrance criterions, which were chosen for this review (score higher than 5 on the PEDro scale). There was a large difference between various studies base on their methodology, outcome measures, simple size, procedure, etc. However, results from studies have verified that exercise causes decrease pain, decrease lumbar lordosis angle and increase movement control in patient with LBP; and exercise effective on decrease pain in pregnant women, but was not effect on lumbar lordosis angle in pregnant women. Also studies that shown decreased lumbar lordosis angle after exercises, was more effectively on more decreased LBP in patient.

It is likely that exercise decrease pain, lumbar lordosis angle and increase movement control in patient with low back pain; also exercise can decrease LBP in pregnant women, especially in the last months of pregnancy.

Changes in bone position and scapular movements affect shoulder function and can lead to scapular dyskinesia. The purpose of this validity review article was to evaluate the effect of scapular stabilization exercises on pain and motor function in patients with scapular dyskinesia.

Search with related keywords in all years and in Magiran, Google Scholar, Elmnet and PEDRO websites with keywords Scapular Stabilization exercise, Scapular-focused exercise, Scapular Dyskinesia, Motor function, Pain, Kinematics and scapular position was performed. Studies investigating the effect of scapular stabilization exercises on scapular dyskinesia were included in the study. PEDro scale was used to evaluate the quality of imported articles.

Thirty studies were reviewed, of which five studies that had inclusion criteria (score higher than 5 on the Pedro scale) were selected for review. There were many differences in the methodology, the main index to be evaluated, the number of samples, the method of implementation, the method of evaluating the variables, etc. in the studies. In people with dyskinesia, stabilizing exercise reduces pain and improves motor function.

The results of previous studies showed that scapular stabilization exercises improve scapular dyskinesia.

 Examining fear of negative evaluation as one of psychological causes in headaches is important. The aim of the present study was to investigate validation and psychometric properties of the Brief Fear of Negative Evaluation Scale (BFNES, Leary, 1983) in a group of women with tension-type headaches.

Methods and Materials: 

A total of 110 women with tension-type headaches in Isfahan in the year of 2019 were selected through purposeful sampling method, and responded to BFNES.‌‌‌ To examine validity and reliability of the scale, convergent validity and confirmatory factor analysis and internal consistency method, the split-half validity and mixed validity were used, respectively‌‌.‌‌‌ Data were analyzed using SPSS and AMOS software‌‌.

 Cronbach's alpha, mixed and split-half coefficients for BFNES were 0‌‌.97, 0‌‌.94 and 0‌‌.86, respectively. The index of convergent validity of the scale was obtained as 0‌‌. 81. Furthermore, the results of factor analysis showed that all items had a high factor load more than 0‌‌.40, and the single-factor structure of BFNES fitted well with the data.

Conclusions‌‌: 

The Brief Fear of Negative Evaluation Scale showed good psychometric properties clinical and research purposes in women with tension-type headaches‌‌.

Propofol is commonly used in anesthesia practice because of its rapid recovery time, but pain upon injection is one of the unfavorable complications of this drug, which can cause both physical and mental discomfort for patients. Therefore, it is important to lower the pain on injection of Propofol in patients undergoing anesthesia. As a result, the current study was conducted in order to compare the effects of lidocaine, lidocaine, and the Valsalva maneuver, and the Valsalva maneuver on decreasing the pain of Propofol injection.

 This study is a clinical trial with 111 patients. The patients were allocated into 3 groups with one group receiving lidocaine, the second group receiving lidocaine and the Valsalva maneuver , and Valsalva maneuver. The pain resulting from injecting Propofol based upon the Visual Analog Scale (VAS) score was evaluated (with 1 being no pain and 10 the most severe imaginable pain). Data were compared and analysed using proper statistical tests using SPSS version 23.

 The mean pain score in the combination group of lidocaine and Valsalva maneuver was lower than the other two groups and was equal to 0.5 ± 0.33. In addition, the mean pain scores in the lidocaine group and the Valsalva maneuver group were 4.6 ± 1.41 and7.81±1/91, respectively. The mean pain intensity in the age groups and the sexes did not show a significant difference with each other.

 The current study showed that the injection of Propofol in the three groups of the study was reduced in a similar fashion, however in the group which combined lidocaine, Valsalva, and the Valsalva maneuver, pain was lowest, but the overall score in the three groups was not statistically different.

Backgrund: 

Nowadays, core stability exercises are very important for performance enhancement, injury prevention and post-injury rehabilitation. The aim of this study was to investigate the effect of six weeks of selected core stability exercises on lumbar curvature and functional movement screening test of women with lower crossed syndrome in Covid Pandemic 19.

The present study is a quasi-experimental study with pretest-posttest design. The statistical population of the study was women aged 20 to 30 years (12 people) and 40 to 50 years (12 people) in Mashhad. The subjects' lordosis arch was examined with a flexible ruler and angles greater than 30 degrees were selected as hyperlordosis. Then FMS test was performed. Both groups performed selected core stability exercises for 6 weeks. Lumbar curvature and FMS test were measured at the end of 6 weeks of training intervention. Paired t-test was used to evaluate the effect of central stability exercises on two groups of 20-30 and 40-50 years. Also, analysis of covariance was used to compare the effect of central stability exercises between the two groups of 20-30 and 40-50 years.

The results showed a significant reduction in the lordosis angle of women in both groups after six weeks of selected core stabilization exercises (P<0/05). Also, the results obtained from FMS test showed a significant improvement in this test in both groups after six weeks of training intervention (P<0/05). The effect of central stability exercises on both groups of 20-30 and 40-50 years of age was similar for both lordosis variables and FMS test.

According to the results of the present study, performing core stability exercises can play an important role in reducing lordosis angle and correcting dysfunctional movement patterns and improving performance. And because they do not require a long time in each training session, they can be used continuously throughout life, it can also be run at home due to the spread of the Corona virus. Therefore, this protocol can be used as an alternative to bulky and time-consuming exercises.

Pain relief after C/S is very important. Acetaminophen is one of the most common drugs to control post-operative pain. Due to the fact that Acetaminophen IV should be injected several times a day for patients, to save time, manpower and cost, it is recommended to inject intravenous Acetaminophen in 24-hour drip. Therefore, this study was designed and performed to compare Acetaminophen drip with routine IV injection on pain control after C/S surgery.

This interventional study was performed on 80 women who referred to Isfahan Family Hospital for C/S in 1396. Patients were divided into two groups of 24-hour drip and routine IV injection of Acetaminophen. Then postoperative pain and complications were evaluated in recovery and within 24 hours after surgery. Finally, the data were analyzed using SPSS.

The mean score of postoperative pain in both groups was statistically significant (P-Value <0.05). The mean pain score in the Acetaminophen drip group was significantly lower than the routine IV Acetaminophen group (P-Value = 0.014). Mean Diastolic Blood Pressure in routine IV Acetaminophen group was significantly higher than Acetaminophen drip group (P-Value = 0.004). Drug side effects were higher in the routine IV Acetaminophen group. 

 This study showed that 24-hour Acetaminophen drip had better analgesic effects with fewer side effects than routine IV Acetaminophen injection after C/S surgery.

review and comparison of the effect of therapy method of hinotherapy and short-term psychodynamic therapy on the quality of life of patients with chronic pain.

The current research is prospective, practical and experimental. The statistical population was all patients with chronic pain disorder in Tehran in 2019. Sampling was done in a purposive samplingand 60 people (20 people in each group (two experimental groups and one control group)) were selected from patients with chronic pain disorder and were randomly assigned into experimental and control groups. Short-term psychotherapy and hypnotherapy training was provided to the experimental group for 8 sessions; World Health Organization quality of life questionnaires,West Haven-Yale Multidimensional Pain Questionnaire, Waterloo Stanford Hypnotizability Questionnaire (1993), Dunlow's short-term psychodynamic therapy and Watson's hypnotherapy were used to collect information.

The average difference of the physical health, mental health, social health and environmental health components of the quality of life in the pre-test-post-test and pre-test-follow-up stages was significant, but the difference of those averages in the post-test follow-up stages was not significant. Both methods of intervention have led to an increase in the average of the four components of the quality of life in the post-test and follow-up stages. Also, compared to hypnotherapy, short-term Dynamic Psychotherapy has increased the physical health components of quality of life (p=0.021), environmental health (p=0.032) and mental health (p=0.007).

Both short-term Dynamic Psychotherapy and hypnotherapy increase the quality of life in patients with chronic pain, but ShortTerm Dynamic Psychotherapy is more effective compared to hypnotherapy.

two drugs, fentanyl and sufentanil, are drugs added to the anesthetic trial, which have been used more than other drugs, however, there is still no detailed information about the safety of adding these two drugs to the anesthetic drug in the event of urinary retention in Therefore, the present study was conducted with the aim of comparing the addition of fentanyl and sufentanil to the anesthetic drug and its effects on urinary retention after spinal anesthesia.

This study was conducted as a systematic review and meta-analysis based on the PRISMA statement. Searching MEDLINE, CENTRAL and EMBASE, Web of Science, Scopus, Mag Iran and SID databases using the keywords anesthesia, spinal anesthesia, phenethyl, sufentanil, bupivacaine, ropicaine, levobopiva, regional anesthesia, urinary retention and after Anesthesia was performed with the help of Boleyn operatives.

There was no significant difference in urinary retention (RR=1.02 [0.70-1.49]; 95% CI) between the intervention and control groups; Also, there was no significant difference between fentanyl or sufentanil (Chi=0.13/I=0%).

Adding fentanyl or sufentanil to the anesthetic drug during spinal anesthesia has no effect on urinary retention after surgery

During the last few years, the trend of using non-opioid drugs for the management of pain after surgery has been highly welcomed, and on the other hand, considering the contradictory results of the preventive use of intravenous ibuprofen before surgery, the present study aimed at the effect of a single dose of intravenous ibuprofen before surgery. A systematic review and meta-analysis was conducted on post-anesthesia pain surgery.

This study was conducted as a systematic review and meta-analysis in the first six months of 1401 based on the PRISMA statement. For this purpose, the keywords of ibuprofen, intravenous, post-surgical pain, analgesia, opioid and analgesia under patient control in the databases PubMed, Scopus, MEDLINE, Embase, Cochrane Center for Controlled Trials and Web of Science, Mag Iran and SID databases.

Examining pain intensity at 12 hours (MD=-1.64 (-2.56, -0.72), 95%CI P=0.001 and I=95%) and 24 hours (-0.58) MD = (-0.18, -0.99) 95% CI- P = 0.001 and I = 90%) after surgery indicated that prophylactic administration of ibuprofen significantly reduced pain intensity.

The administration of a single prophylactic dose of intravenous ibuprofen leads to a decrease in pain intensity during the first 24 hours after surgery, however, its effects decrease over time.

spinal anesthesia is the preferred method of anesthesia in elective cesarean section. Preoperative anxiety is a very common problem in all surgeries. The purpose of the present study was to determine The effect of preoperative education on anxiety and acceptance of spinal anesthesia among mothers undergoing elective cesarean section.

This study was a quasi-experimental study. A total of 70 pregnant mothers who were candidates for elective cesarean section were randomly divided into two groups, A and B. Sampling was done by randomization method. The Hamilton Anxiety Questionnaire was used to assess anxiety. SPSS software version 24 was used for data analysis

Preoperative training increased the acceptance rate of spinal anesthesia in pregnant women elective cesarean section candidates compared to the control group (p=0.003). According to the Hamilton Anxiety Scale, the frequency of moderate to severe anxiety in the trained group was significantly lower than in the control group (p=0.001). Moderate and severe anxiety after training had a significant decrease (p=0.001). According to the Hamilton Anxiety Scale, the mean of post-training anxiety was significantly different from before training (p=0.001). Also, the level of anxiety based on the Hamilton Anxiety Scale in the trained group was significantly different from the control group (p= 0.001).

Referral of pregnant mothers who are candidates for elective cesarean section to the anesthesia clinic and provide training will reduce anxiety and general anesthesia.

 There are different methods for pain management after cesarean section. Due to the importance of proper pain management after cesarean section, this study was performed to provide alternative methods and main analgesic compounds that can be used in women undergoing cesarean section.

 This study was performed by non-systematic and narrative review method in the first quarter of 2022; In this study, search without any restrictions (time and type of study) in articles published in two databases, Medline and PubMed, using selected keywords based on mesh, which include: cesarean section, multidimensional analgesia, pain management, Complications, anesthesia, anesthesia, analgesia, elective cesarean section, treatment and intrathecal drugs were performed.

 Fifty articles were evaluated and topics such as the development of analgesia in cesarean section, intrathecal opioids, epidural opioids, associated neuroaxial non-narcotics, non-neuroaxial drugs (oral, intravenous, subcutaneous and lingual) including paracetamol , Nonsteroidal anti-inflammatory drugs, ketamine, dexamethasone, gabapentin, magnesium and opioids. After that, the side effects of drug use such as: respiratory depression, pruritus, urinary retention, nausea and vomiting were presented, and then peripheral nerve block, non-pharmacological methods were studied.

 The use of non-narcotic methods in the optimal management of pain after cesarean section is preferable to the old methods.