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

[Comparison of kinesthesia in patients with anterior cruciate ligament tears before and after reconstructive surgery at acute phase]

Recognition of kinesthesia impairs after anterior cruciate ligament [ACL] tear and reconstruction surgery can significantly improve the situation. The objective of the present study was to compare the Kinesthesia in patients with ACL tear before and after reconstruction surgery at acute phase. In this Quasi- experimental study, 30 patients with ACL tear were recruited. The patients included 16 males and 14 females selected in a non probability sampling manner. The C.P.M, as a dependent variable, was used to test the Kinesthesia motion sense. Data were analyzed using paired t-test, ICC, SEM, and K-S tests. The kinesthesia in the affected knee and at the speed of 0.5 m/s before and after surgery was 5.02 +/- 0.36 and 3.23 +/- 0.25 and at the speed of 2 m/s 1.95 +/- 0.16 and 0.85 +/- 0.04, respectively. The difference between the pre- and post-surgery was significant at both speeds employed [p<0.05]. It seems that the reconstructive surgery in patients with ACL tears at the acute phase is of high value in improving the kinesthesia

[Effect of functional brace on threshold of motion sense in patients with Anterior Aruciate Ligament tear]

Anterior Cruciate Ligament [ACL] tear is one of the most common injuries at knee joint. Threshold of motion sense included inputs that are received by mechanical receptors at dynamic position. The objection of present study was to find the effect of functional brace on the Kinesthesia motion sense in patients with ACL rupture. In this Quasi- experimental study, 20 patients with ACL tear, with aging range between 18 to 44 years old were recruited. Patients were selected in a simple non probability sampling manner. Using Continuous passive motion for testing the Kinesthesia motion sense, as a dependent variable. Data was analyzed with Paired t-test and Colmogrof-Smirnof tests. Threshold of motion sense at affected knee before and after bracing was 3.93 +/- 1.67, 4.45 +/- 1.86 in open eyes and 3.82 +/- 1.61, 4.13 +/- 1.96 in closed eyes [P<0.05]. This study showed that the functional brace did not play in important role in the improvement of threshold of motion sense in patients with ACL tear

[Comparison the effect of corticosteroid injection with physiotherapy in treatment of painful arch of shoulder]

Painful arch of shoulder is treated using both surgical and non-surgical methods. In the latter one, steroidal and non-steroidal analgesic drugs and/or physiotherapy are used. The aim of this study was to compare the effects of corticosteroid injection and physiotherapy in the treatment of disease. In this double-blinded clinical trial, 124 patients who referred to Shahrekord Kashani hospital and suffered from shoulder pain or with having limitation in its movement were considered as the patients with painful arch of shoulder. They were divided in two equal groups of 62. In the first group, 40 mg of prednisolone was locally injected in the painful site. The second one was subjected to ten sessions of physiotherapy for two weeks. The outcomes of these treatments were assessed using a questionnaire including shoulder disability and the amount of pain in the patients, 2, 6, and 11 weeks after the treatment. Data were analyzed using statistical analysis [X[2], t and repeated measures ANOVA]. The mean age of the patients was 42.3 +/- 9.5 years. The two groups were age and sex matched. The pain was relapsed in one patient of the first and 3 patients of the second group. Pain and shoulder disability were significantly decreased in the two groups [P<0.05]. The amount of shoulder disability and pain in the group received corticosteroid was less than that in the group subjected to physiotherapy [P<0.05]. Base on the results, injection of corticosteroid is more effective than using of physiotherapy in treatment of painful arch of shoulder. This cures pain and shoulder disability of the patients faster