Anesthesiology and Pain Medicine最新文献

{"title":"Double-Blind, Randomized, Controlled Pilot Trial to Specify Collateral Effect and Safety of Perioperative Dexmedetomidine in Patients Undergoing Open Heart Surgery.","authors":"Bassim Mohammed Jabbar Hatemi, Ayesheh Enayati, Somayeh Ghorbani, Fatemeh Tahmasebi, Hadi Abo Aljadayel, Ali Jabbari, Ali Movafegh","doi":"10.5812/aapm-157117","DOIUrl":"10.5812/aapm-157117","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to assess the collateral effects and safety of dexmedetomidine (Dex) during and one day after surgery in Iranian patients undergoing open heart surgery, to expand the clinical applications of Dex in Iran.</p><p><strong>Methods: </strong>This pilot study was conducted in Gorgan, Golestan province, Iran, in 2024. Both male and female participants undergoing open heart surgery were randomly assigned to either the Dex group (n = 10), receiving 0.5 µg/kg/h along with standard anesthesia management, or the control group (n = 10). The primary outcome was the percentage of patients experiencing adverse events. Secondary outcomes included the stability of hemodynamic and respiratory parameters, the occurrence of arrhythmias, and biological changes assessed during and 24 hours after surgery.</p><p><strong>Results: </strong>Out of 45 participants, 20 were enrolled and analyzed. The comparison between groups showed that observed adverse effects were higher in the control group (4 patients) compared to the Dex group (1 patient), with common events being hypotension, bradycardia, and tachycardia. Biological markers, such as lactate and blood sugar (BS), increased in both groups, with the control group showing a greater increase in both lactate and BS levels (P = 0.012 and P = 0.009, respectively) compared to the Dex group (P = 0.017 and P = 0.093, respectively). Additionally, there were no significant differences in hemodynamic and respiratory markers between the groups (P > 0.05); however, Dex improved and preserved hemodynamic and respiratory stability more effectively.</p><p><strong>Conclusions: </strong>The addition of Dex to the anesthesia protocol was safe and without adverse events, showing a promising role in improving cardiac function in patients undergoing open heart surgery.</p>","PeriodicalId":7841,"journal":{"name":"Anesthesiology and Pain Medicine","volume":"15 1","pages":"e157117"},"PeriodicalIF":0.0,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12125658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198126","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":"Effect of Two Different Doses of Neostigmine on the Gastric Residual Volume and Aspiration in Critically Ill Patients Under Enteral Feeding; A Comparative Controlled Randomized Trial.","authors":"Sameh Hamdy Abdelhamid Seyam, Ibrahim Elabd Hassan, Abdallah Elabd Hassan, Mostafa Mohamad Elsayed","doi":"10.5812/aapm-158019","DOIUrl":"10.5812/aapm-158019","url":null,"abstract":"<p><strong>Background: </strong>Delayed gastric emptying increases the risk of patient morbidity in the ICU. Intensive care researchers have exerted considerable effort to measure and regulate gastric residual volumes (GRV) in ventilator-operated patients.</p><p><strong>Objectives: </strong>This study examines a cross-sectional, double-blind clinical trial designed to assess the effect of the addition of neostigmine to metoclopramide GRV in ICU patients and the risk of aspiration in those patients.</p><p><strong>Methods: </strong>Participants were categorized into three groups: Group I (n = 41) and group II (n = 43) received neostigmine 1 mg and 2 mg, respectively, and a control group (group III, n = 40) received 10 mL of normal saline. All participants received an intravenous administration of 10 mg of metoclopramide. The GRV was measured every 3 hours before enteral feeding. Aspiration through nasogastric (NG) or orogastric (OG) tubes was done before the next due bolus of feeding. The study did not receive any external funding support. The possessed data was interpreted using the PASS program, which set the alpha error at 5% and the power at 80%.</p><p><strong>Results: </strong>There was a significant variation among the three groups regarding the GRV. Metoclopramide used alone, did not profoundly alter the GRV at various time intervals. However, the administration of neostigmine resulted in a significant reduction in GRV at 3 and 6 hours post-injection. The GRV increased six hours post-injection, indicating that the drug combination resulted in a short-term effect. We did not observe any significant link between GRV and aspiration incidence, which happened even with low-volume aspirations. We used immunoassay to determine pepsin in the collected tracheal aspirations.</p><p><strong>Conclusions: </strong>Combining neostigmine and metoclopramide can effectively reduce GRV in ICU patients receiving enteral nutrition.</p>","PeriodicalId":7841,"journal":{"name":"Anesthesiology and Pain Medicine","volume":"15 1","pages":"e158019"},"PeriodicalIF":0.0,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12125657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198128","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":"Autologous Platelet Rich Fibrin Versus Steroid in Ultrasound-Guided Sacroiliac Joint Injection for Joint Dysfunction: Randomized Comparative Study.","authors":"Omar Sayed Fargaly, Mohamed Ahmed Hamed, Maged Labib Boules, Mohammed Awad Alsaied, Mohammed Magdy Basiony, Mohammad Omar Mostafa, Amr Hamdy Mahmoud, Mohamed Ahmed Shawky","doi":"10.5812/aapm-158219","DOIUrl":"10.5812/aapm-158219","url":null,"abstract":"<p><strong>Background: </strong>Sacroiliac joint (SIJ) discomfort is frequently treated with steroids, although the relief is often temporary. The use of platelet-rich fibrin (PRF) may aid in tissue healing and prolong pain relief.</p><p><strong>Objectives: </strong>This study aims to compare the analgesic effects of a single autologous PRF injection with the commonly used steroid in ultrasound-guided intra-articular SIJ injections.</p><p><strong>Methods: </strong>This randomized clinical trial was conducted in the Department of Anesthesiology and Pain Management at Fayoum University Hospitals. The study included 94 adult patients with SIJ dysfunction confirmed by positive diagnostic tests. All patients were randomly assigned into two equal groups to receive either an ultrasound-guided PRF injection (group P, n = 47) or a steroid injection (group S, n = 47).</p><p><strong>Results: </strong>The Visual Analog Scale (VAS) score immediately after injection in group P was 7.51 ± 0.78 (mean ± SD), while in sroup S, it was 5.91 ± 0.54, with a highly significant difference between the two groups (P < 0.001). At six months, the VAS score was 3.51 ± 0.78 in group P compared to 4.68 ± 0.63 in group S, again showing a highly significant difference (P < 0.001). There was no significant difference in the Oswestry Disability Index (ODI) between the groups at one and six months.</p><p><strong>Conclusions: </strong>Intra-articular PRF injection is an effective therapy option for SIJ-related low back pain, offering prolonged pain relief compared to steroid injections.</p>","PeriodicalId":7841,"journal":{"name":"Anesthesiology and Pain Medicine","volume":"15 1","pages":"e158219"},"PeriodicalIF":0.0,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144148861","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":"A Prospective Randomized Trial Comparing Effectiveness of Parasagittal and Midline Epidural Steroid Injection in Patients with Lumbar Canal Stenosis Pain.","authors":"Masoud Hashemi, Faranak Behnaz, Payman Dadkhah, Ali Alizadeh Ojoor, Sina Hassannasab, Seyed Sam Mehdi Hosseininasab, Sogol Asgari","doi":"10.5812/aapm-157791","DOIUrl":"10.5812/aapm-157791","url":null,"abstract":"<p><strong>Background: </strong>Low back pain (LBP) due to lumbar spinal stenosis presents a significant clinical challenge. Epidural steroid injections (ESIs) are a common treatment option; however, the optimal injection route remains debated.</p><p><strong>Objectives: </strong>To compare the clinical outcomes of parasagittal interlaminar (PIL) versus midline interlaminar (MIL) ESI in patients with LBP attributed to lumbar spinal stenosis.</p><p><strong>Methods: </strong>This prospective, randomized study included patients with LBP and lumbar stenosis. Participants were randomly assigned to receive ESI via either the PIL or MIL route. Clinical outcomes, including pain intensity (measured by the Numeric Rating Scale [NRS]) and functional disability (assessed using the Modified Oswestry Disability Index [MODQ]), were evaluated at 1- and 3-months post-injection.</p><p><strong>Results: </strong>Analysis revealed a significant reduction in pain intensity (NRS) at 3 months post-injection in the PIL group compared to the MIL group (P = 0.014). Additionally, the PIL group demonstrated significantly lower patient satisfaction scores at 3 months (P = 0.033) and higher MODQ scores at 3 months (P = 0.002) compared to the MIL group. No significant differences were observed between groups at baseline or at the 1-month follow-up for any of the assessed outcomes.</p><p><strong>Conclusions: </strong>This study suggests potential differences in efficacy between parasagittal and midline interlaminar ESIs for lumbar stenosis pain. These findings underscore the need for further research to optimize treatment strategies and improve pain management for patients with this condition.</p>","PeriodicalId":7841,"journal":{"name":"Anesthesiology and Pain Medicine","volume":"15 1","pages":"e157791"},"PeriodicalIF":0.0,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12125659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198123","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":"Evaluation of Ultrasound‑Guided Erector Spinae Plane Block Versus Oblique Subcostal Transversus Abdominis Plane Block in Laparoscopic Cholecystectomy: A Comparative Study.","authors":"Moataz Salah Khalil, Michael Fayez Yousef Metias, Maged Salah Mohamed, Ahmed Abd Elmohsen Bedewy, Tarek I Ismail","doi":"10.5812/aapm-157680","DOIUrl":"10.5812/aapm-157680","url":null,"abstract":"<p><strong>Background: </strong>Many inter-fascial plane blocks, including the oblique subcostal transversus abdominis plane (OSTAP) block and, more recently, the erector spinae plane (ESP) block, have been utilized as part of multimodal analgesia in numerous abdominal surgeries.</p><p><strong>Objectives: </strong>This study aimed to evaluate the impact of using the OSTAP block and the ESP block as components of a multimodal analgesic technique in individuals undergoing laparoscopic cholecystectomy (LC).</p><p><strong>Methods: </strong>This randomized, controlled, single-blinded clinical study was conducted on 50 individuals aged 20 to 60 years, of both genders, with American Society of Anesthesiology (ASA) grade I and II physical status, undergoing LC. Subjects were allocated using a computer-generated randomization table into two equal groups: Group A received an ultrasound (US)-guided ESP block, and group B received a US-guided OSTAP block.</p><p><strong>Results: </strong>The Visual Analog Scale (VAS), mean arterial pressure (MAP), heart rate (HR), and respiratory rate (RR) at 6, 8, and 10 hours were significantly higher in the OSTAP block group compared to the ESP block group (P < 0.05). The time to the first morphine dose was significantly longer in the ESP block group compared to the OSTAP block group (P = 0.001). The total amount of morphine used was significantly greater in the OSTAP block group compared to the ESP block group. The incidence of nausea and vomiting did not differ significantly between the groups.</p><p><strong>Conclusions: </strong>Bilateral US-guided ESP blocks provide superior and prolonged postoperative analgesia and require less morphine use compared to OSTAP blocks following LC.</p>","PeriodicalId":7841,"journal":{"name":"Anesthesiology and Pain Medicine","volume":"15 1","pages":"e157680"},"PeriodicalIF":0.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12132070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214642","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":"Effect of Position Change After Induction of Spinal Anesthesia with Hyperbaric 0.5% Bupivacaine on Duration of Analgesia and Opioid Demand in Percutaneous Nephrolithotomy Candidates.","authors":"Alireza Jaffari, Homayoun Aghamohammadi, Masoud Forouzmehr","doi":"10.5812/aapm-153617","DOIUrl":"10.5812/aapm-153617","url":null,"abstract":"<p><strong>Background: </strong>Post-induction positioning influences the onset speed of the sensory block by affecting anesthetic distribution. Techniques such as using opioids and extending recovery stays aim to enhance this process.</p><p><strong>Objectives: </strong>This study aimed to evaluate the impact of transitioning patients from a sitting to a lateral position immediately after the induction of 0.5% hyperbaric bupivacaine spinal anesthesia on postoperative pain and opioid consumption.</p><p><strong>Methods: </strong>In this prospective, randomized clinical trial, patients scheduled for percutaneous nephrolithotomy (PCNL) under spinal anesthesia at Shahid Labafinejad Hospital in 2023 were divided into intervention (lateral position) and control (supine position) groups. Blood pressure, mean arterial pressure (MAP), and heart rate were recorded upon entering recovery, then every 10 minutes up to 60 minutes, and every 15 minutes up to 120 minutes post-operation. Pain levels were assessed using the Visual Analogue Scale (VAS) at specified intervals. Patient satisfaction with analgesia quality was also evaluated.</p><p><strong>Results: </strong>The study included 35 patients in the lateral group and 34 in the supine group. Pain levels significantly differed between the groups over time (P = 0.0001). The lateral group had a longer analgesia duration (28.8 ± 10.0 minutes vs. 22.9 ± 2.9 minutes, P = 0.105) and lower total narcotic consumption (21.7 ± 5.8 mg vs. 30.4 ± 10.2 mg, P = 0.012). Mean arterial pressure changes showed no significant difference (P = 0.061). Patient satisfaction was significantly higher in the lateral group (P = 0.0001).</p><p><strong>Conclusions: </strong>Transitioning from the sitting to lateral position post-induction with hyperbaric bupivacaine enhances hemodynamic stability, improves drug distribution in the cerebrospinal fluid (CSF), and enhances sensory block quality. This approach increases postoperative analgesia duration, reduces opioid use and related complications, and decreases the duration of surgery.</p>","PeriodicalId":7841,"journal":{"name":"Anesthesiology and Pain Medicine","volume":"15 1","pages":"e153617"},"PeriodicalIF":0.0,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12125665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198127","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":"Design, Implementation, and Evaluation of Anesthesia Students' Clinical Competency Based on the Virtual Objective Structured Clinical Examination.","authors":"Arghavan Afra, Shima Seneysel Bachari, Maryam Ban","doi":"10.5812/aapm-155251","DOIUrl":"10.5812/aapm-155251","url":null,"abstract":"<p><strong>Background: </strong>The objective structured clinical examination (OSCE) is an appropriate method for assessing clinical competency among students in universities worldwide. With nowadays technological advances, there is a growing interest in virtual OSCEs (VOSCEs).</p><p><strong>Objectives: </strong>The present study aimed to design, implement, and evaluate a VOSCE for assessing anesthesia students' clinical competency.</p><p><strong>Methods: </strong>This quasi-experiment study was conducted in six phases: (1) Defining the exam's specifications and design, (2) determining validity and reliability, (3) setting up and conducting a pilot VOSCE, (4) familiarizing students with the VOSCE, (5) administering the exam, and (6) evaluating and providing feedback. Seventy-five senior anesthesia students from Abadan University of Medical Sciences were selected by census and participated in this study between 2021 and 2023. The scores of virtual and in-person OSCEs were compared, and the correlation between the two exams was investigated. At the end of each semester, students participated in a survey related to the VOSCE. The exam results and survey data were presented at the faculty's educational development office meetings, and suggestions for amending and eliminating shortcomings were considered in the following semester. Data were analyzed using SPSS 20 by calculating means, standard deviations, and Pearson's correlation.</p><p><strong>Results: </strong>The students' mean scores in the virtual and in-person OSCEs were 17.68 and 16.75, respectively. No significant difference was observed between the scores of the two exams. The total score of the VOSCE had a direct and significant correlation with the in-person OSCE (r = 0.861, P < 0.001), and this correlation was also observed in all stations of both exams (P < 0.05). Student surveys indicated that the VOSCE fostered a sense of empowerment, self-confidence, and enhanced learning, causing students to express strong agreement with its continuation in the future.</p><p><strong>Conclusions: </strong>The VOSCE can be an appropriate substitute for or an integral part of the in-person OSCE. It is recommended that educational planners and instructors develop this exam as a new assessment method. Given advances in technology and the requirement for improving the quality of virtual exams, professors need to be empowered in the field of modern electronic assessment methods.</p>","PeriodicalId":7841,"journal":{"name":"Anesthesiology and Pain Medicine","volume":"15 1","pages":"e155251"},"PeriodicalIF":0.0,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12125663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198125","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 SAMPE and ALDERTE Checklists on the Incidence of Complications After Discharge of Radical Prostatectomy Patients from the Post-anesthesia Care Unit (PACU).","authors":"Alireza Zareie, Parisa Moradimajd, Azam Saei, Jamileh Abolghasemi","doi":"10.5812/aapm-156738","DOIUrl":"10.5812/aapm-156738","url":null,"abstract":"<p><strong>Background: </strong>Among the available tools, the SAMPE and ALDERTE checklists have been specifically designed to facilitate timely patient discharge, minimize human error, and optimize resource utilization. Given the complexities associated with surgical care, a comparative analysis of these two checklists is essential to evaluate their efficacy in improving discharge outcomes and preventing complications.</p><p><strong>Methods: </strong>This descriptive-analytical cross-sectional study assessed the distribution of complications following radical prostatectomy surgery by utilizing the SAMPE and ALDERTE checklists for discharge from the post-anesthesia care unit (PACU). A total of 156 participants, divided into three groups of 52 individuals each, were monitored for post-discharge complications 12 hours after their discharge from the PACU across three training centers. This methodology enabled a thorough evaluation of the roles of both checklists in mitigating adverse events during the critical post-operative period.</p><p><strong>Results: </strong>No significant differences in complication rates were observed among the groups; however, bleeding and vomiting were slightly more common in the SAMPE group.</p><p><strong>Conclusions: </strong>This study concluded that neither the SAMPE nor the ALDERTE checklist provided a distinct advantage over the control group, which comprised patients routinely discharged from the same treatment center. Both checklists demonstrated similar functionalities, with each showing relative strengths in specific aspects; however, neither was found to be universally superior to the other.</p>","PeriodicalId":7841,"journal":{"name":"Anesthesiology and Pain Medicine","volume":"15 1","pages":"e156738"},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144148863","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":"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}