Background: Delivery is an experience with full of stress, with pain, fatigue and fear. The fear of labor pain causes their tendency to cesarean section. It is believed that labor pain is the most painful pain experienced by human beings. This pain occurs at different stages of delivery. Labor duration is a factor affecting pregnancy outcomes and contributing to damages inflicted on mothers and their fetus. Present study was performed with aim of comparing effects of transcutaneous electrical nerve stimulation (TENS) with those of pharmaceutical hyoscinepromethazine compound on duration of the first phase of labor in 2015.Methods: This research was done by clinical ergometric method on 84 eligible pregnant women (42 in TENS group; 42 in hyoscinepromethazine group) referring to the Martyr Chamran Hospital of Kangavar division. At the onset of active phase, medication group were injected once with 20 mg of hyoscine and 25 mg of promethazine intramuscularly simultaneously. For nonmedication group, TENS device was employed, with a pair of upper electrodes being placed between L1-T10 and a pair of lower ones being placed between S2-S4 on both sides of spinal column. Two groups were tested for duration of the first phase of labor.Results: Variables of age, body mass index(BMI), pregnancy age, dilatation of the second phase of labor and infant weight were tasted in both groups showing no significant differences in this regard (p>0.05). In the first phase of labor, no statistically significant difference was observed between 2 groups in terms of the means of contraction number means (p=0.23). But during of the first phase of labor exhibited some significant difference between 2 groups (p=0.002); in TENS group, mean duration of the first phase was shorter than hyoscine-promethazine group.Conclusion: compared to pharmaceutical hyoscine-promethazine compound, TENS further shortened duration of the first phase of labor; therefore, it is recommended that TENS be used to shorten labor duration.
Background:Most patients experience some degree of pain during extracorporeal shock waves lithotripsy (ESWL).Aim:The aim of this study was to evaluate the effect of target-controlled infusion (TCI) of remifentanil or sufentanil and patient-controlled analgesia (PCA) with sufentanil or morphine for pain relief during ESWL.Materials and Methods:In a double blind, randomized clinical trial, a total of 60 patients who were scheduled for elective ESWL, randomly assigned into four groups (A, B, C and D). Patients in group A and B received remifentanil and sufentanil with TCI, respectively. Also, patients in group C and D received sufentanil and morphine with PCA, respectively. All patients in four groups were assessed about the intensity of their pain with Visual Analogue Scale (VAS) in three phases; the discharge of the waves (phase A), during breaking the stones (phase B) and the end of the procedure (phase C).Results:Patients in morphine PCA group experienced highest pain intensity in all stages, but patients in remifentanil TCI group experienced lowest pain intensity during lithotripsy. Remifentanil/TCI group experienced the lowest pain in B and C phases and the sufentanil/TCI group had the lowest pain only in the phase A. There was no significant difference in the occurrence of complications in all four groups.Conclusion:The current study demonstrates that efficacy of TCI pump in the reduction of pain during ESWL is superior to the PCA pump. Among the drugs that used in this study, remifentanil has more effective in pain management in the all phases during ESWL. We believe that using remifentanil/TCI should strongly be considered to clinicians in ESWL units.
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