[Comparing the effects of peritoneal and subcutaneous injections of bupivacaine on post-appendectomy pain]

This study aimed to compare the effects of peritoneal and subcutaneous injections of bupivacaine 0.5% on post-appendectomy pain and also the efficacy of local anaesthetic injection for postoperative pain relief in peritoneal inflammation with subcutaneous injection. This randomized-clinical trial was conducted on 126 participants [age range, 15-45 years] underwent appendectomy for acute appendicitis in Kashan Shahid-Beheshti hospital. Participants were divided into three groups: bupivacaine [0.5%, ip], bupivacaine [0.5% s.c], and control [no injection]. Pain intensity was evaluated using the visual analogue scale at 6, 12 and 24 hours after surgery. There was no significant difference among the three groups in age, sex, the duration of anesthesia and surgery. Pain intensity [6 h post-surgery] was significantly higher in the subcutaneous group than the peritoneal group, but no significant difference was seen between the two groups at 12 and 24 h post-surgery. Moreover, pain intensity in the peritoneal and subcutaneous groups was significantly lower than the control group at 6 and 12 h post-surgery [P<0.05]. There was a significant difference between the peritoneal and subcutaneous groups as well as between the peritoneal and control groups required analgesics, but the difference was not significant between the subcutaneous and control groups. Although both peritoneal and subcutaneous injections of bupivacaine can reduce postoperative pain in patients undergoing appendectomy, the peritoneal injection can significantly reduce the postoperative analgesic consumption

[ gabapentin effect on pain morphin consumption after total abdominal hysterectomy]

Post operative pain is one of the important factors affecting recovery from surgery and anesthesia. Gabapentin is used as an anticonvulsant drug that acts through voltage-dependent calcium channels. In some recent studies, oral gabapentin has been reported to reduce post operative pain and morphin consumption following mastectomy and hysterectomy. The aim of the present study was to determine the effect of gabapentin on postoperative pain after abdominal hysterectomy. In a double-blinded clinical trial design, 50 women aged 35- 50 years old, whom were candidate for hysterectomy referred to Shabih Khani Hospital in 1389, were signed up for the study. Patients received randomly either oral gabapentin 1200 or placebo 1 hr prior to the surgery. Pain was assessed on a visual analogue scale [VAS] at 2, 6, 12, and 24 hr intervals after the operation. Morphine consumption and drug-induced complications such as nausea and vomiting were recorded and compared between the two groups. Factors including age, mean operative time, mean anesthesia time, and BMI were not significantly different between the test and control groups. However, the mean pain scores at 2, 6, 12, and 24 hr after operation were significantly lower in the gabapentin group in comparison to the controls [P<0.0001]. The morphin consumption was also significantly lower in the gabapentin group [P<0.0001]. Furthermore, the average time before the first to walk following the operation was significantly shorter in the gabapentin group [P=0.002]. Preoperative oral gabapentin decreases the pain scores in the postoperative period and lowers the morphine consumption in patients following abdominal hysterectomy

[Remifentanil versus propofol on pain and hemodynamic in patients under phacoemulsification with topical anesthesia]

To evaluate the effect of propofol and remifentanil on pain and hemodynamic in patients under phacoemulsification with topical anesthesia. After Ethic's committee approval in a clinical trial study, 100 consecutive patients scheduled for phacoemulsification were randomized to 2 groups in a prospective manner. Each group received intravenous infusion 3 mg/kg/h propofol or 3 micro/kg/h remifentanil. Phaco time, blood pressure and heart rate before and after surgery, number of patients with respiratory depression [O2 sat < 90%] and vomiting, pain scores, ophthalmologist satisfaction and demographic data were recorded. Mean age, sex and phaco time were equal in the two groups. Systolic and diastolic blood pressure and heart rate were decreased significantly [p < 0.05] in propofol group but this difference in remifentanil was not significant. Patients had more pain in propofol group [p = 0.001] and the surgeon satisfaction was higher in remifentanil group [p = 0.01]. Two patients in the remifentanil group had respiratory depression but the difference was not statistically significant [p > 0.05]. Perioperative vomiting was not found in any groups. With the doses used in this study, it was shown that remifentanil was more effective than propofol in minimizing pain and hemodynamic stability without producing excessive, respiratory depression or perioperative nausea and vomiting

Preemptive effects of Lidocain on postoperative pain in patients undergoing disc operation: a Randomized, double blind, placebo-controlled trial

Postoperative pain is a major poorly managed problem in millions of operations performed all over the world each year. Since infiltration of the operative field with lidocain as a local anesthetic is very cheap, it is easily available, and there are few side effects, this study aimed to evaluate its efficacy on post-op-pain of patients undergoing open intervertebral disc surgery. In this double blind clinical trial on 188 patients undergoing elective open intervertebral disc operation, the surgical incision site was infiltrated with 2 ml of 1/500,000 epinephrine for each centimeter in the control group and the same solution with 20 mg lidocain for each centimeter of the incision in the case group. Post-oppain was measured with visual analog scale [VAS] in the 6[th], 12[th], 24[th], and 48[th] hours. The mean age was 41.8 +/- 12.4 for the study group, and 43.5 +/- 15.6 for the control one. Statistical analysis revealed no significant difference in pain severity in females, but for males it was significant at the 6th and 24th hours. Interestingly, it was more severe in those receiving lidocain. The amount of narcotics used postoperatively revealed no significant difference in the groups. Lidocain used locally before skin incision has no effect on reducing post-op-pain, post-op-narcotics demand, and duration of hospital stay