gabapentin effective on pain management after ar-throscopic anterior cruciate ligament reconstruction? a triple blinded randomized controlled trial

Acute pain is common after arthroscopic surgeries and it is one of the most important causes of patient dissatisfaction, admission time and increased morbidity, Gabapentin with anti-hyperalgesic effects can play a critical role in pre-emptive analgesia methods. The aim of this study was to assess the efficacy of gabapentin in pain management after surgery and the rate of drug consumption in patients who are candidate for anterior cruciate ligament [ACL] reconstruction arthroscopic surgery. In this randomized, triple blind clinical trial, 114 patients who were candidate for arthroscopic ACL reconstruction were divided into two groups of gabapentin [G] and placebo [p], with 57 patients in each group. The intervention group received gabapentin 600 mg and a placebo was administered in control group. Patients received on-demand pethedine for pain management. The primary outcome was pain intensity according to the visual analogue scale [VAS] and the secondary outcome was the amount of opioid consumption and incidence of side effects [including: dizziness, sedation, nausea and vomiting] at 6 and 24 h visits. The mean pain intensity in G group at both the 6 and 24 hour visits was significantly lower than the control group [Both p<0.0001]. Also, patients in the gabapentin group consumed less opioid at both visits in comparison to the placebo group [p<0.001, p=0.032]. The incidence rate of sedation, dizziness, nausea and vomiting was similar in both groups. In arthroscopic ACL reconstruction, administering a preoperative single dose of 600mg gabapentin may decrease both pain intensity and opioid consumption

Systemic effects of experimental spinal cord injury on bone healing in rabbit

loss after spinal cord injury leads to increased fragility of bone and subsequent risk for low-trauma fractures in the sublesional parts of the body. Although in such injuries upper limbs are normally innervated, bone loss may occur in the upper extremities. The present study was designed to de-termine the systemic effects of spinal cord injury on the fracture healing of upper limbs in rabbits. Twenty nine skeletally mature New Zealand white rabbits received a transverse mid-humeral open osteotomy in the left upper limb with the use of a standardized technique and spinal cord injury was done using forceps model at T8 level. The animals were divided into three groups: experimental [laminectomy, spinal cord injury, and osteotomy], sham [laminectomy and osteotomy], and control [osteotomy alone]. The bone healing score was calculated using modified Sandhu system by two independent pathologists. The mean ['SD] of healing scores in experimental, control, and sham groups were 7.22 [ +/- 3.6], 8.6 [ +/- 3.3], and 8.5 [ +/- 4.3] respectively [P = 0.68]. The percentage of mesenchymal [20%] and cartilaginous tissue [35%] showed a slightly higher value in the experimental group compared with the sham group [15% and 20% respectively]. A reverse pattern was seen concerning the percentage of trabecular bone, though as a whole there was no significant difference regarding the percentage of selected components of bone healing between the three trial groups. Fracture healing in innervated upper limbs is not influenced by the systemic effects of spinal cord injury

[Variations of palmaris longus tendon: a cadaver study in Kerman city]

Since palmaris longus tendon is the first choice for grafting, its anatomical variation is important. This study was designed to find the anatomical variations of this tendon in Iranian population by performing a study on cadaver. In this study, 150 forearms belonged to 75 cadavers were studied. After exploring the proximal end of tendon, tendon width was measured at its proximal end by caliper. The presence or absence of tendon in left and right, width of tendon in males and females, crown to heel height and the relationship between tendon width and height were determined. Statistical analysis was done by SPSS, and using exact Fischer test, Student t-test, Pearson's correlation coefficient and chi-square. Unilateral absence was seen in 24% and bilateral absence in 10.7% of 32 females. The tendon was absent in 4 cases [12.5%] in left side, in 6 cases [18.8%] in right side, and in 3 cases [9.4%] in both sides. Of 43 males, in 3 [7%] the tendon was absent in left side, in 5 [11.6%] in right side and in 5 [11.6%] in both sides. The mean width of tendon in males was 4.07 +/- 2.05 mm in right and 3.97 +/- 2.16 mm in left side and in women it was 3.77 +/- 2.07 mm in right and 3.41 +/- 2.20 mm in left side. The prevalence rate of unilateral and bilateral absence of PL in this study was 24% and 10.7% respectively that differs with the reported rates in studies of Asian countries such as China and Japan. There was not statistical difference between men and women in tendon width, unilateral and bilateral absence and side of absence. There was also no correlation between tendon width and individual height

Variation, length and width of tendinous portion of palmaris longus and forearm length and height: Is there a link? A cadaver study of adult Iranians

Palmaris longus [PL] is a muscle with marked variations. It is harvested as a tendon graft in many surgical procedures in which a certain length of tendon is required. The aims of the present study were to determine the variations of this tendon in Iranian population and to find whether the length of PL tendon could be estimated by measuring the forearm length and height. We examined 128 forearms of 64 cadavers. We dissected out the tendons to measure their lengths and widths. The width of the tendon was measured at its proximal end. The forearm length and height were measured from the styloid process of the ulna to the tip of the olecranon with the forearm in neutral rotation. The height of cadavers were measured from crown to the heel in supine position. The palmaris longus muscles were absent bilaterally in 5 [7.8%] and unilaterally in 14 [21.8%] cadavers. The overall prevalence of the absence of PL [unilateral or bilateral] was 29.6% [24 forearms of 19 cadavers]. The mean length and width of the PL were 14.2 +/- 6.3 mm and 12.8 +/- 7.2 mm in males and 4.00 +/- 1.9 mm and 4 +/- 2.1 mm in females, respectively. The mean forearms length and cadavers' height were 29 +/- 1.6 cm and 172.6 +/- 9.1 cm in males and 28 +/- 1.2 cm and 166.5 +/- 8.9 cm in females, respectively. A significant correlation was found between the length of the tendon and forearm in both males [P<0.001] and females [P<0.001]. In contrast, there was not statistically significant correlation between the forearm length and width of the tendon in either males or females [P=0.007 in males and females]. The results of this study indicate that the length of palmaris longus tendon can be estimated based on forearm length. This estimation might be useful for surgical intervention