ABSTRACT
Stress and stressful situations can be a prelude to fatal diseases such as cardiovascular diseases and hypertension. The aim of this study was to investigate the relationship between perceived stress with five major characteristics of the heart disease in patients with myocardial infarction. In this cross sectional descriptive-analytical study that was conducted from May 2005 till October 2009, a total of 3,200 patients with myocardial infarction, from cardiovascular care unit of Gha'em and Imam Reza hospital, Mashhad, were randomly selected. A demographic questionnaire, an instrument for recording laboratory and electrocardiograph finding, and the Perceived Stress Scale were used for data collection. The results of this study show that while 35% of all cases suffer from moderate stress, 65% percent of them suffer from high level of stress. The level of perceived stress in different categories of variables such as gender, educational level, hypertension, history of hypertension, depression, cigarette smoking, exercising, job, level of incoming, location of living, and family history of cardiovascular disease was significantly different from each other. Considering the high levels of stress among patients with myocardial infarction, design and implementation of interventions for identifying stressors, as well as their management seem to be crucial
ABSTRACT
Background and Purpose: Use of intrathecal opioids causes an increase in the block depth of anesthetics and duration of analgesia. Intrathecal opioids are associated with side effects such as itching, nausea and vomiting. However, the use of NSAIDs reduces itching induced by intrathecal opioids. Therefore, the present study intends to determine and compare the effects of nanogram celecoxib on reducing the incidence and intensity of intrathecal meperidine-induced pruritus
Methods and Materials: This double-blind clinical trial was conducted on 90 patients undergoing caesarean section. Patients were randomly assigned into experimental and control groups. The experimental group received 25ng/kg or 100ng/kg celecoxib and the control group received oral placebo. Patients under spinal anesthesia received meperidine 10mg with intrathecal Bupivacaine 0.5%. Then, pruritus was assessed 0, 2, 6, 12 and 24 hours after surgery, and were recorded by scoring criteria. The obtained data were analyzed in SPSS using one-way ANOVA, chi-square and Fisher's exact test. Values below 5% were considered significant
Results: The difference of the two groups in their age, weight and oral intake was not significant [confidence interval 95%]. The incidence of itching in the experimental groups of 25ng/kg [p=0.049] or 100ng/kg celecoxib [p=0.001] in 0 and 2 hours after surgery were significantly lower than the control group; also, the intensity of itching 2 hours after surgery was significantly lower then the control group [p=0.001]
Conclusion: Nanogram doses of Celecoxib can be used for reducing the incidence and intensity of meperidine induced pruritus
ABSTRACT
Background and Purpose: Opioids are frequently added to local anesthetics in order to improve analgesia in neuraxial blocks, which may lead to - sometimes intolerable - pruritus in the patients. In this study, the effect of meperidine on pruritus following the prescription of opioids [in the scale and dose of mg] in regional anesthesia was investigated
Methods and Materials: This clinical trial was conducted on 54 patients in two groups of 27. The patients included those hospitalized fro cesarean section in the midwifery ward, as well as those in the surgical-orthopedic ward. Both groups received anesthetic and opioids [meperidine in mg doses]. The first group, i.e. the control group, received a certain volume of physiologic serum, and the second group, i.e. the experimental group, received the same volume of physiologic serum plus IV meperidine [nanogram dose]. Pruritus was measured in the conventional scale at hours 0, 6, 12, and 24 after surgery. In the statistical analysis, Mann Whitney U, Fisher's exact test, and chisquare were used
Results: in the experimental group, incidence and intensity of pruritus [in case of occurring] were significantly lower than the control group [intensity score being one]
Conclusion: Using nano-doses of opioids [meperidine] is effective in preventing pruritus