RESUMO
Background and aim: Shock wave during extracorporeal lithotripsy causes pain for which analgesic drugs are prescribed most often. The aim of this study was to compare the efficacy and adverse effects of fentanyl and combination of pethedine and midazolam for pain control during extracorporeal shockwave lithotripsy [ESWL]
Methods: In this single blind clinical trial study, 89 patients older than 18 years with renal or upper urethral stones who were candidates for ESWL were randomly allocated into Intervention [45 patients] and control groups [44 patients]. First group [Intervention] was given I.V. fentanyl [1 mg/kg] and control group was given I.V. pethedine [0.7 mg/kg] and [0.02 mg/kg] midazolam before starting ESWL. Then ESWL was performed in two groups with guidance of fluoroscopy by standard technique. During operation every 20 minutes and 2 hours after operation severity of pain was checked according to visual analogue scale. Efficacy of operation was evaluated in two groups according to follow up KUB and ultrasonography. Data were analyzed by SPSS software using Chi square test
Results: Frequency of painless operation and mild pain in fentanyl group were found 26.6 and 24.4 percents, respectively. Although severe pain was more observed in the control group [32.5%], but it was not significantly different [P>0.05]. Efficacy of operation didn't show significant difference between two groups of patients [P>0.05]
Conclusion: Similar pethedine and midazolam lower dose of intravenous fentanyl provides adequate analgesia with minimal side effects and suitable efficacy for pain control during ESWL, which can be used in outpatients, without need to monitoring in adult patients
RESUMO
Understanding and influencing the determinants of physical activity is an important public health challenge. This study examines the application of key constructs of the transtheoretical model to physical activity behaviors for aged people. This study is a field trial with census sampling. Sixty healthy adult men at Kahrizak nursing home in 1386 completed a questionnaire including demographics and self-reported levels of physical activity, constructed from the Transtheoretical Model [TTM], before and after two months of intervention. The interventional program included tailored counseling and focus group. The data were then analyzed with T test, X[2], pair T test and Wilcoxon, using SPSS software. Statistical analysis showed a significant difference for the effect of health education program on increasing stage of change, self-efficacy, decisional balance and physical activity behavior in elderly people [p<0.0001]. Educational physical activity interventions can result in increased physical activity, thus, health education program based on TTM has had positive effect on promotion physical activity behavior. It can be recommended that health education be used on educational models