Background:Postoperative pain is considered as a reason of patient’s delay in discharge and disability aggravation. Therefore, multimodal approaches have been suggested in order to mitigate pain and decrease postoperative side effects.Objectives:The aim of this study was to evaluate analgesic effect of a single dose injection of dexamethasone on reducing postoperative pain in laparoscopic cholecystectomy.Patients and Methods:In this double-blind, prospective study, 122 patients aged 18-60 years old, whom were selected for laparoscopic cholecystectomy, were classified into two case and control groups, and 61 patients were included in each group. The case (D) group underwent general anesthesia and a single- dose intravenous injection of dexamethasone. The Control (C) group received general anesthesia and intravenous injection of normal saline. Total dose of consumed meperidine and pain intensity during first 24 hours were evaluated in both groups.Results:No significant difference existed between two groups regarding age, sex, weight and operation time. Pain intensity in group D was significantly less than group C (P < 0.01) after two, six and 12 hoursof surgery. No significant difference existed in pain intensity between two groups at the beginning of and 24 hours after the surgery (P > 0.05). Meperidine consumption in group D was significantly less than group C (P < 0.05).Conclusions:Findings of present study showed that single dose of intravenous dexamethasone, led to less pain intensity and amounts of meperidine consumption, in comparison with placebo.

Background Discopathy is one of the most common spinal surgeries. Hemodynamic control is important in bleeding reduction during the surgery. Clonidine and dexmedetomidine both are α 2 agonists that help stabilize hemodynamics and prevent the increase of intraoperative bleeding. Objectives In this study, the effects of clonidine and dexmedetomidine were compared in bleeding reduction during spinal surgery. Methods This randomized, double-blind clinical trial was conducted in 120 patients aged 20 to 50 years with ASA class I or II, undergoing spinal surgery. Patients were randomly divided into three groups. Group C received oral clonidine 0.2 mg, 90 minutes before entering the room. Group D received dexmedetomidine 0.5 µ/kg 15 minutes before anesthesia induction and 0.25 µ/kg/h infusion during operation. Group P received placebo as the control group. Results There was a significant reduction in intraoperative blood loss in patients who received clonidine (289 ± 130) and dexmedetomidine (344 ± 145) compared to the control group (462 ± 15) (P < 0.05), with a more dramatic reduction in the clonidine group (P < 0. 001).

BackgroundPrevious studies have been conducted to evaluate the effect of different adjuvants on brachial plexus block.ObjectivesThis study investigated the effect of adding magnesium sulfate to lidocaine on postoperative pain in upper limb surgeries by supraclavicular brachial plexus block under ultrasound guidance.MethodsThis study was carried out on patients who were candidate for upper limb surgeries. This was a controlled double-blind study conducted on a number of 52 patients aged 18 - 75 years with ASA class I or II. The first group (M) received lidocaine 1% (4 mg/kg) plus fentanyl 50 micg and magnesium sulfate 20% (5 mL) while the second group (N) received lidocaine 1% (4 mg/kg) plus fentanyl 50 micg and normal saline (5 mL) to supraclavicular brachial plexus block under ultrasound guidance. Postoperative pain was evaluated by visual analog scale (VAS) until 24 hours. Sensory and motor blocks onset and duration, rescue analgesics, hemodynamic variables, and side effects were recorded for all the patients.ResultsPostoperative VAS values at 24 hours were significantly lower in group M than group N (P < 0.0001). Sensory and Motor blocks onset and duration were statistically longer in group M than group N (P < 0.0001).ConclusionsThe addition of magnesium sulfate to lidocaine decreased the postoperative pain and increased the onset and duration of sensory and motor blocks in supraclavicular brachial plexus block under ultrasound guidance in upper limb surgeries.

Background:Postoperative pain is a common complication that can lead to serious morbidities and delayed recovery.Objectives:The aim of this study was to investigate the effect of low-level laser therapy on acute pain after tibial fracture surgery.Patients and Methods:In this randomized clinical trial, 54 patients who were candidate for tibial fracture surgery were allocated randomly to two groups, namely, control and laser therapy. Both groups had the same type of surgery and technique of spinal anesthesia. Patients in laser group were treated with the combination of two lasers (GaALAs, 808 nm; and GaALInP, 650 nm) at the end of the surgery while control group received laser in turn-off mode with the same duration as laser group. Patients were evaluated for pain intensity according to the visual analogue scale (VAS) and the amount of analgesic use during 24 hours after surgery.Results:Laser group experienced less pain intensity in comparison with control group at second, fourth, eighth, 12th, and 24th hours after surgery (P Value < 0.05). In addition, the amount of consumed opioid in laser group was significantly less than the control group (51.62 ± 29.52 and 89.28 ± 35.54 mg, respectively; P Value, 0.008).Conclusions:Low Level Laser Therapy is a proper method to reduce postoperative pain because it is painless, safe, and noninvasive and is easily accepted by patients.

Background:Response to the surgical stress is an involuntary response to metabolic, autonomic as well as hormonal changes that leads to heart rate and blood pressure fluctuations.Objectives:This study aimed to investigate the effect of general versus spinal anesthesia on blood sugar level and hemodynamic changes in patients undergoing curettage surgery.Patients and Methods:In this randomized clinical trial, 50 patients who were candidate for elective curettage surgery were divided into two groups of general (n = 25) and spinal (n = 25) anesthesia. In both groups, blood glucose level was evaluated 10 minutes before, 20 and 60 minutes after initiation of anesthesia. Also, heart rate and mean arterial blood pressure were evaluated at 10 minutes before, 10, 20, 30, 40, 50 and 60 minutes after intiation of anesthesia.Results:There was not significantly difference between blood glucose level of both groups during 10 minutes before, 20 and 60 minutes after the intiation of anesthesia. Heart rate changes in the general and spinal groups compared to the baseline level were decreased up to maximum12.5% and 14.5%, respectively. The mean arterial pressure changes in the general and spinal groups compared to the baseline level were decreased up to maximum 5.4% and 8%, respectively.Conclusions:Blood glucose and hemodynamic changes caused by surgical stress were not significantly different between two groups.