Anesthesiology and Pain Medicine最新文献

{"title":"Effectiveness of Chamomile in Reducing the Incidence and Severity of Nausea and Vomiting After Middle Ear Surgery: A Triple-Blind Randomized Study.","authors":"Maryam Sarkhosh, Ehsan Rajabi Visroodi, Hamidreza Samaee, Motahareh Farhadi, Parisa Moradimajd","doi":"10.5812/aapm-153566","DOIUrl":"https://doi.org/10.5812/aapm-153566","url":null,"abstract":"<p><strong>Background: </strong>Nausea and vomiting are among the most common complications after surgery.</p><p><strong>Objectives: </strong>The aim of this study was to investigate the effectiveness of chamomile in reducing the incidence and severity of nausea and vomiting after middle ear surgery.</p><p><strong>Methods: </strong>A total of 110 patients who met the inclusion criteria were randomly assigned to either the chamomile or placebo group. Group A consumed chamomile drops (500 mg), while group B consumed cornstarch with 30 mL of water, one hour before surgery. The severity of nausea and frequency of vomiting were recorded at recovery (time of zero), 1, 2, 4, and 6 hours after surgery using the Rhodes Index. Data were analyzed using SPSS v.21 software, paired <i>t</i>-tests, and chi-square tests.</p><p><strong>Results: </strong>A total of 110 patients were included, with an average age of 36.14 ± 10.3 years (group A) and 34.28 ± 13.3 years (group B). There was no statistically significant difference between the chamomile and placebo groups in terms of the severity of nausea and the frequency of vomiting immediately after recovery (time of zero), 1, 2, and 6 hours after surgery (P > 0.05). However, 4 hours post-surgery, the severity of nausea in the chamomile group was lower than in the placebo group, and a statistically significant difference was observed between the two groups (P = 0.03). No gastrointestinal side effects were reported.</p><p><strong>Conclusions: </strong>Based on the results of this study, chamomile can be used to reduce nausea and vomiting after middle ear surgery, given its availability and low cost.</p>","PeriodicalId":7841,"journal":{"name":"Anesthesiology and Pain Medicine","volume":"14 6","pages":"e153566"},"PeriodicalIF":0.0,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11910166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the Preemptive/Preventive Effect of Dexmedetomidine and Ketorolac on Post-operative Pain of Appendectomy Patients: A Randomized Clinical Trial.","authors":"Sepideh Pakniyat, Ghasem Mousavi, Hashem Jarineshin, Fereydoon Fekrat, Narjes Sabet, Alireza Abdullahzadeh-Baghaei","doi":"10.5812/aapm-146868","DOIUrl":"10.5812/aapm-146868","url":null,"abstract":"<p><strong>Objectives: </strong>The primary objective was to test the hypothesis that the preemptive/preventive effect of Dexmedetomidine would attenuate the post-operative pain more effectively compared to ketorolac and control groups.</p><p><strong>Methods: </strong>This study was conducted in Shahid Mohamadi Hospital. Sixty patients undergoing appendectomy operations were randomized in 3 groups. Group A received intravenous Dexmedetomidine bolus (1 μg/kg) and infusion (0.5 μg/kg/h). Group B received slow intravenous bolus ketorolac 30 mg. Group C was the control group. Post-operatively fentanyl (5µg/mL) as patient control analgesia (PCA) was provided only on demand. The primary outcome was the Visual Analogue Scale (VAS) pain scores recorded at 1, 3, 6, 12 and 24 hours postoperatively. The secondary outcome was the 24-hour cumulative fentanyl PCA dose. Tertiary outcomes; changes in blood pressure, heart rate, body temperature, SpO₂ perioperatively. Quaternary outcomes were PONV, shivering.</p><p><strong>Results: </strong>In the Dexmedetomidine group the mean ± SD pain VAS scores 1.15 ± 1.98 and 0.95 ± 1.76 were significantly lower at 12 and 24 hours after operation (P = 0.004 and P = 0.003) compared to the other two (ketorolac and control) groups. The cumulative volume dose of fentanyl PCA 21.35 ± 11.77 mL was less in the Dexmedetomidine group compared to ketorolac (28.35 ± 9.82 mL, P = 0.629) and control (40.35 ± 12.90 mL, P = 0.003) groups.</p><p><strong>Conclusions: </strong>Preemptive/preventive effects of Dexmedetomidine were greatest after operation compared to the ketorolac and control groups in the terms of pain scores and amount of analgesia needed postoperatively.</p>","PeriodicalId":7841,"journal":{"name":"Anesthesiology and Pain Medicine","volume":"14 6","pages":"e146868"},"PeriodicalIF":0.0,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11895797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143612886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opioid-Free Anesthesia for Upper Limb Surgery in Obese Patients as a Day Case Surgery: A Prospective Observational Study.","authors":"Rana Ahmed Abdelghaffar, Mohamed Ahmed Hamed, Mohammed Magdy Basiony, Mohammad Fouad Algyar, Omar Sayed Fargaly, Mohamed Ahmed Shawky","doi":"10.5812/aapm-150997","DOIUrl":"10.5812/aapm-150997","url":null,"abstract":"<p><strong>Background: </strong>Opioid-free anesthesia (OFA) is a relatively new approach, and many studies are still needed to assess its effectiveness and compare it to opioid-based anesthesia (OBA).</p><p><strong>Objectives: </strong>This study investigated the use of OFA in obese patients undergoing upper limb surgery and compares its outcomes with those of OBA.Methods:This prospective randomized clinical study included 76 obese patients with a Body Mass Index (BMI) ≥ 30 kg/m² who were scheduled for upper limb surgery. Patients were randomly assigned to receive either OFA (group A, n = 38) or OBA (group B, n = 38). The OBA group was administered propofol, fentanyl, and atracurium, while the OFA group received lidocaine, propofol, atracurium, and dexmedetomidine. All patients were mechanically ventilated, and anesthesia was maintained with isoflurane and atracurium. Primary outcomes monitored included postoperative pain [Visual Analog Scale (VAS) ≥ 4] and the number of rescue doses of tramadol. Secondary outcomes included extubation time, any cardiac events, hypoxia, postoperative nausea and vomiting (PONV), intensive care unit (ICU) admission rates, and duration of hospital stay.</p><p><strong>Results: </strong>The OFA group had significantly lower extubation time, mean arterial pressure (MAP), and heart rate (HR) compared to the OBA group. Additionally, VAS scores were significantly lower at the 30-minute and 2-hour marks after extubation (P < 0.001 and P < 0.001, respectively) in patients receiving OFA. The OFA group also experienced fewer adverse effects, required fewer rescue doses of tramadol, and had shorter hospital stays.</p><p><strong>Conclusions: </strong>Opioid-free anesthesia may result in better and safer outcomes for obese patients undergoing upper limb surgeries, with fewer postoperative complications and shorter hospital stays. However, further research is needed to fully understand the potential benefits of OFA compared to OBA.</p>","PeriodicalId":7841,"journal":{"name":"Anesthesiology and Pain Medicine","volume":"14 6","pages":"e150997"},"PeriodicalIF":0.0,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11895792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143612835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Pregabalin and Midazolam as Premedication in Children Undergoing General Anesthesia for Dental Treatment.","authors":"Maryam Hajiahmadi, Nasser Kaviani, Elahe Asnaashari Esfahani, Sanaz Rajaee","doi":"10.5812/aapm-149486","DOIUrl":"10.5812/aapm-149486","url":null,"abstract":"<p><strong>Background: </strong>Pediatric dentists employ both pharmacological and non-pharmacological behavior control methods. Despite the use of behavioral control techniques, some young children cannot undergo treatment in the office, making sedation or general anesthesia necessary. Premedication drugs can be used before general anesthesia to reduce anxiety, control pain, induce amnesia, prevent nausea, and avert potential complications. The search for the ideal premedication for children is ongoing.</p><p><strong>Objectives: </strong>This study aims to compare the effects of pregabalin and midazolam (MID) in children undergoing dental treatment under general anesthesia.</p><p><strong>Methods: </strong>This prospective, triple-blind study included 64 children aged 2 - 6 years who required dental treatment under general anesthesia. Participants who met the inclusion criteria were enrolled. One group of children received pregabalin syrup, while the other group received MID syrup. The comfort of the child during separation from the parents, ease of venous access, and degree of sedation upon entering the operating room were evaluated. Blood pressure, heart rate, and blood oxygen levels were measured at baseline and every 30 minutes thereafter. Additionally, the duration of the patient's stay in recovery until discharge was recorded and compared between the two groups. Statistical analyses were performed using chi-square, Mann-Whitney U, Fisher's exact test, and SPSS version 14 software.</p><p><strong>Results: </strong>No statistically significant differences were found between premedication with MID and pregabalin in terms of anxiety during venous access, parental separation anxiety, restlessness in recovery, duration of recovery stay, or changes in heart rate, blood pressure, and blood oxygen levels between the two groups. However, a statistically significant difference was observed between the two groups regarding the degree of sedation before entering the operating room.</p><p><strong>Conclusions: </strong>Both pregabalin and MID were effective for premedication in terms of sedation and anxiety reduction, with no significant difference between the two drugs in these outcomes.</p>","PeriodicalId":7841,"journal":{"name":"Anesthesiology and Pain Medicine","volume":"14 6","pages":"e149486"},"PeriodicalIF":0.0,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11895789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143612884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative Analgesia and Length of Hospital Stay After Surgery for Malignant Pleural Mesothelioma: A Retrospective Observational Study.","authors":"Mayuu Kobata, Kenta Takeda, Mana Taguchi, Hiroai Okutani, Takeshi Ide, Akane Kido, Kouichi Fujimoto, Masaki Hashimoto, Ryusuke Ueki, Munetaka Hirose","doi":"10.5812/aapm-150055","DOIUrl":"10.5812/aapm-150055","url":null,"abstract":"<p><strong>Background: </strong>Pleurectomy/decortication (P/D), a surgical procedure for malignant pleural mesothelioma (MPM), is a highly invasive surgery requiring prolonged hospitalization. Previous studies have reported that postoperative analgesia using regional anesthesia contributes to shorter hospital stays after surgery under general anesthesia by reducing acute postoperative pain. However, the association between postoperative analgesia and the length of hospital stay (LOHS) following P/D has not been evaluated.</p><p><strong>Objectives: </strong>To evaluate the association between postoperative analgesia and postoperative LOHS after P/D.</p><p><strong>Methods: </strong>This single-institution observational study enrolled consecutive adult patients undergoing P/D under general anesthesia, who postoperatively received either intertransverse process block (ITPB) or continuous intravenous (IV) fentanyl infusion as postoperative analgesia between March 2022 and February 2023.</p><p><strong>Results: </strong>Among all enrolled patients with ASA physical status II or III (n = 60), postoperative analgesia was administered using either continuous ITPB (n = 19) or continuous IV fentanyl infusion (n = 41). Multivariable logistic regression analysis revealed that postoperative analgesia with continuous ITPB (P = 0.007), a lower incidence of major complications after surgery (P = 0.034), and female sex (P = 0.033) were significantly associated with a shorter postoperative LOHS. In subgroup analysis, patients who received continuous ITPB had significantly lower postoperative LOHS, lower postoperative serum C-reactive protein levels on postoperative day (POD) 3, and reduced acute postoperative pain on POD3 compared to those who received continuous IV fentanyl infusion.</p><p><strong>Conclusions: </strong>Postoperative analgesia using continuous ITPB appears to be associated with a reduction in LOHS following P/D for MPM under general anesthesia.</p>","PeriodicalId":7841,"journal":{"name":"Anesthesiology and Pain Medicine","volume":"14 6","pages":"e150055"},"PeriodicalIF":0.0,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11895794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143612851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analyzing Patterns in Anesthesiology Residents' Exam Performance Using Data Mining Techniques.","authors":"Maedeh Karimian, Shahabedin Rahmatizadeh, Zeinab Kohzadi, Zahra Kohzadi, Firoozeh Madadi, Ali Dabbagh, Daccpm Department Of Anesthesiology Critical Care And Pain Medicine","doi":"10.5812/aapm-151686","DOIUrl":"10.5812/aapm-151686","url":null,"abstract":"<p><strong>Background: </strong>Residency is a critical period in the development of medical professionals. It provides hands-on training and exposure to various medical specialties, enabling residents to improve their skills and achieve expertise in their chosen field.</p><p><strong>Objectives: </strong>This study aimed to extract frequent patterns in annual and board examination performance among anesthesiology residents by analyzing results from the department's weekly exams.</p><p><strong>Methods: </strong>This cross-sectional study was conducted in the Department of Anesthesiology, Critical Care, and Pain Medicine (DACCPM) from September 2022 to June 2023. Weekly intra-group exams were administered at the university's electronic exam center for residents in their first to fourth years (CA-1 to CA-4), with a total of 61 participants. Learner grades were categorized as excellent (A), good (B), average (C), poor (D), and inferior (E). The Apriori algorithm was employed to extract frequently repeated patterns in these exams and compare them with results from the final national examination.</p><p><strong>Results: </strong>A total of 24 exams were conducted, with all 61 residents participating. The most frequent patterns, identified with a minimum support of 0.41, revealed that residents generally achieved average scores in exam 7 and very poor scores in exams 1 and 5. The study found a statistically significant relationship between residents' scores in in-training examinations (ITEs) and their national examination performance.</p><p><strong>Conclusions: </strong>Analyzing residents' exam performance using frequent pattern recognition can help identify their strengths and weaknesses. Faculty members can utilize these insights to better plan curricula and enhance the quality of education.</p>","PeriodicalId":7841,"journal":{"name":"Anesthesiology and Pain Medicine","volume":"14 6","pages":"e151686"},"PeriodicalIF":0.0,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11895782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143612814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the Effect of High-Intensity Laser Therapy and Quadriceps Muscle Strengthening Exercises Using Biofeedback on Pain, Stiffness and Function of Patients with Knee Osteoarthritis: A Randomized Clinical Trial.","authors":"Maryam Sadat Rahimi, Amir Masoud Jafari-Nozad, Fatemeh Jazebi","doi":"10.5812/aapm-143642","DOIUrl":"10.5812/aapm-143642","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to compare the effects of high-intensity laser therapy (HILT) and quadriceps muscle strengthening exercises using biofeedback on pain and function in patients with knee osteoarthritis (KOA).</p><p><strong>Methods: </strong>This randomized, two-group clinical trial included patients with KOA (grades II - III of the Lawrence Kellgren classification) who met the inclusion criteria. Written informed consent was obtained from participants before they were randomly allocated into one of two groups: HILT + therapeutic exercise (group A) or quadriceps muscle strengthening exercises using biofeedback + therapeutic exercise (group B). Both groups followed the same therapeutic exercise regimen during the study.Knee pain severity was evaluated using the Visual Analogue Scale (VAS), and functional disability was assessed with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire before the intervention.For group A, HILT was performed using a BTL-6000 HIL device (wavelength 1064 nm, maximum power 12 W) following the manufacturer-recommended protocol. A pain relief program (10 W, 120 J/cm²) was administered for 120 seconds per session over ten sessions. Treatment protocol, laser positioning, and session duration were standardized. Two follow-up assessments (immediately and one-month post-intervention) were conducted to evaluate outcomes based on the VAS and WOMAC scores.</p><p><strong>Results: </strong>The study included 40 participants with KOA, divided evenly between the two groups (20 in each). The average age of the participants was 59.34 ± 6.92 years. High-intensity laser therapy group (group A): Visual analogue scale pain scores decreased significantly immediately after and one month post-intervention compared to baseline (P < 0.01). However, the VAS score one month after the intervention showed no significant difference compared to the immediate post-intervention score (P = 0.59). Biofeedback group (group B): VAS pain scores also decreased significantly both immediately after and one month post-intervention compared to baseline (P < 0.05). The difference in VAS pain reduction between the two groups was significant, with the HILT group showing greater improvement immediately after the intervention and one month later (P = 0.007).</p><p><strong>Conclusions: </strong>The study findings suggest that both quadriceps muscle strengthening exercises using biofeedback and HILT effectively reduce pain in KOA patients. However, HILT demonstrated superior efficacy compared to biofeedback exercises. These results support the use of HILT as a noninvasive therapeutic modality for KOA, particularly for patients with a higher risk of surgery due to preexisting comorbidities.</p>","PeriodicalId":7841,"journal":{"name":"Anesthesiology and Pain Medicine","volume":"14 6","pages":"e143642"},"PeriodicalIF":0.0,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11895785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143612885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the Optimal Dose of Mivacurium for Modified Rapid Sequence Intubation in Emergency Surgical Settings: A Randomized, Double-Blind Trial.","authors":"Saad Ahmed Moharam, Ismail Mohamed Abdelgawad Ahmed, Ahmed Mahmoud Elgarhy, Sameh Hamdy Abdelhamid Seyam, Mohammed Talal Almalki, Mohammed Said ElSharkawy","doi":"10.5812/aapm-153629","DOIUrl":"10.5812/aapm-153629","url":null,"abstract":"<p><strong>Background: </strong>Modified rapid sequence intubation (RSI) is crucial in emergency surgery, particularly for patients with a full stomach, as it allows for the administration of general anesthesia (GA).</p><p><strong>Objectives: </strong>This work aimed to evaluate mivacurium effectiveness and optimal dose in modified RSI.</p><p><strong>Methods: </strong>This randomized double-blind study involved 100 patients, aged between 20 - 60 years, of both sexes, with the American Society of Anesthesiologists physical status classification of I - III, who were undergoing emergency surgery under GA. Patients were randomized into two equal groups and received mivacurium in a dose of 0.3 mg/kg in group M1 or 0.4 mg/kg in group muscarinic-2 (M2).</p><p><strong>Results: </strong>Intubating conditions were significantly better in group M2 than in group M1. The onset of adequate muscle relaxation was significantly earlier in group M2 than in group M1 (P < 0.001). At the third minute, mean arterial blood pressure recordings were significantly lower in group M2 (P = 0.04) than in group M1. The recovery time was significantly longer in group M2 than in group M1 (P < 0.001).</p><p><strong>Conclusions: </strong>Mivacurium in a 0.4 mg/kg dose resulted in more favorable intubating conditions during RSI and a more profound, earlier onset of muscle relaxation, but with a longer recovery time compared to the 0.3 mg/kg dose.</p>","PeriodicalId":7841,"journal":{"name":"Anesthesiology and Pain Medicine","volume":"14 5","pages":"e153629"},"PeriodicalIF":0.0,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11895783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143612794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Promoting a Patient Safety Culture in Anesthesia Practice.","authors":"Maryam Vosoughian, Sara Salarian, Mastaneh Dahi Taleghani","doi":"10.5812/aapm-154453","DOIUrl":"10.5812/aapm-154453","url":null,"abstract":"","PeriodicalId":7841,"journal":{"name":"Anesthesiology and Pain Medicine","volume":"14 5","pages":"e154453"},"PeriodicalIF":0.0,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11895779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143612798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing Analgesic Efficacy: Ropivacaine with Dexamethasone vs. Ropivacaine with Dexmedetomidine After Cesarean Section Using Transversus Abdominis Plane Block (2020 - 2021).","authors":"Mohammadreza Jamshidi, Mona Ghaderi, Mitra Hojatansari","doi":"10.5812/aapm-147872","DOIUrl":"10.5812/aapm-147872","url":null,"abstract":"<p><strong>Background: </strong>There are several methods for managing postpartum pain. The combined use of drugs with anesthetics can lead to effective pain management.</p><p><strong>Objectives: </strong>The present study aimed to compare the analgesic effects of ropivacaine (RPV) + dexamethasone (DEXA) and RPV + dexmedetomidine (DEX) on pain after cesarean section (CS) using the transversus abdominis plane (TAP) block.</p><p><strong>Methods: </strong>This double-blind, randomized clinical trial employed a quadruple block randomization method and included 40 participants scheduled for CS at Ayatollah Mousavi Hospital in Zanjan, Iran, during 2020 - 2021. The participants were divided into two groups: The first group received 15 mL of RPV 2% combined with 100 µg of DEX via the bilateral TAP block method, while the second group received 15 ml of RPV 2% combined with 8 mg of DEXA. The analgesic effects of the two drug combinations were evaluated at 0, 3-, 6-, 12-, and 24-hours post-CS using the visual analog scale (VAS) to measure pain intensity. Data analysis was conducted using SPSS software, version 24.</p><p><strong>Results: </strong>In the RPV + DEX group, the onset of pain was delayed, resulting in a longer duration before the administration of painkillers (P = 0.041 and P < 0.001). However, pain intensity between 3- and 24-hours post-surgery was significantly higher in the RPV + DEX group compared to the RPV + DEXA group (P = 0.028, P < 0.001). The RPV + DEX group experienced longer durations before the onset of pain and the need for painkillers (P = 0.041, P < 0.001). Hypotension was more frequently observed in the RPV + DEXA group at 0 hours (P = 0.068) and 3 hours post-surgery (P = 0.003). Additionally, bradycardia and sedation incidences were higher in the RPV + DEXA group at 3 hours post-surgery (P = 0.005, P = 0.048).</p><p><strong>Conclusions: </strong>The use of RPV + DEXA, unlike RPV + DEX, demonstrated positive and significant effects on pain management in female CS candidates using the TAP block method, despite its side effects.</p>","PeriodicalId":7841,"journal":{"name":"Anesthesiology and Pain Medicine","volume":"14 5","pages":"e147872"},"PeriodicalIF":0.0,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11895784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143612795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}