Background: Carpal tunnel syndrome is a prevalent disease with significant morbidity. The current treatments range from oral medication and local corticosteroid injection to surgical carpal tunnel release (CTR). In this study, we tried to assess the results of Carpal Tunnel Release surgery in combination with the anti-inflammatory effect of local corticosteroid injection. Methods: 65 patients were enrolled by clinical and electrodiagnostic tests and randomly divided into two groups, 32 in group one which underwent surgery with Dexamethasone injection and 33 in group 2 which intervened with carpal tunnel release surgery alone. Data on Boston questionnaire of patients were conducted before and two weeks after surgery. Distal motor and sensory latencies of patients were recorded before and two months after surgery. Mean values were compared between groups before and after surgery. Results: The mean preoperative Boston index was 35.83 in group one and 37.7 in group two, these data postoperative were 15.83 and 19.15 respectively. The mean preoperative distal sensory latency was 54.8 in group one and 47.6 in group two, these data postoperative were 34.1 and 35.1 respectively. The mean preoperative distal motor latency was 63.2 in group one and 62.3 in group two, these data postoperative were 44.5 and 46.55 respectively. Conclusions: CTR surgery plus local corticosteroid injection did not significantly change in results of Electrodiagnostic test or Boston index compared to the non-injection group.
Transdermal fentanyl patches provide effective pain relief and decrease total rescue morphine consumption during the first 72 h after operation without additive side effects in patients undergoing TKA surgery.
Background: One of the most important factors in the fracture healing is the intracellular production of prostaglandins by osteoblast cells. Nonsteroidal anti-inflammatory drugs (NSAIDs) exert their effects through inhibition of prostaglandin synthesis. NSAIDs are widely used in orthopedic practices and their effect on bone healing is not fully understood yet. Objectives: The current study aimed at examining the effects of indomethacin and meloxicam on tibia fracture union in rats. Methods: The current study was conducted on 60 male rats. Mid-shaft tibia fracture was induced in rats using bone-breaker device. The animals were randomly divided into 3 groups; a control group that received distilled water and 2 other groups that received indomethacin and meloxicam respectively for 28 days. At the end of weeks 1, 2, 4, 8 and 12, four rats were randomly sacrificed from each group, and histological evaluation, measurement of the calcium, phosphorus, and alkaline phosphatase plasma levels, as well as radiographic examinations were performed on them. Results: After 4 weeks, a thin layer of woven bone was observed in the vast spaces of the bone marrow in the fracture area in the control group. In the meloxicam group in the week 4, the formation of immature blades of bone was observed, which were less organized and more irregular. In the indomethacin group in the week 4, new bone formation was less immature and more areas of cartilage were still observed. In the radiographic evaluations, delayed union in indomethacin and meloxicam groups was observed, which was more significant in the indomethacin group. Conclusions: Indomethacin and meloxicam had impact on the process of bone repair and delayed union in both groups of drugs. This delayed union was more significant in non-selective NSAIDs (COX-I and = II inhibitors) rather than selective NSAIDs (COX-II inhibitor).
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