Showing 7 results for Deylami
Seyedeh Roya Mousavi , Parvaneh Ebrahimzadeh, Sepideh Yazdanpanah , Nasim Alsadat Mousavi, Mansour Deylami ,
Volume 82, Issue 4 (July 2024)
Abstract
Background: Today, addiction is a major problem in modern society, which affects the management of patients during anesthesia. In patients with long-term use of opioids, higher doses of opioids are needed to create analgesia and control pain during and after surgery. Also, addicted patients have more resistance to local anesthetic drugs when they are used to perform peripheral and central nerve blocks. Therefore, many drugs are added to local anesthetics to enhance their analgesic properties, one of the most common of which is narcotic compounds. Itching caused by opium may be generalized and often occurs shortly after injection. Therefore, this study aims to investigate the amount of itching caused by intrathecal injection of fentanyl in opium addicts who undergo elective orthopedic surgeries of the lower limbs with spinal anesthesia. have been taken, designed and established.
Methods: This study was a double-blind clinical trial conducted on 68 patients who were candidates for elective lower limb orthopedic surgeries under spinal anesthesia and referred to 5 Azar Hospital in Gorgan in 2023. Patients were divided into two groups using random numbers table, Intervention (a group of addicted patients who received intrathecal marcaine together with fentanyl for spinal anesthesia) and control (a group of addicted patients who received only intrathecal marcaine for spinal anesthesia). Pruritus, nausea and vomiting were measured in both groups. Data analysis was done using descriptive statistics and inferential statistical tests.
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Results: In terms of age, gender, and BMI, there was no statistically significant difference between the intervention and control groups. There was no statistically significant difference in the incidence of nausea and vomiting between the two groups. The incidence of itching was zero in the bupivacaine group and 17.6% in the fentanyl and bupivacaine group, of which 3% required anti-itch medication for treatment.
Conclusion: The results of this study showed that due to the low incidence of pruritus in the group using fentanyl along with bupivacaine, its use is beneficial in people with drug addiction.
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Kazem Kazemnejad, Parvaneh Ebrahimzadeh, Seyedeh Roya Mosavi, Mansour Deylami ,
Volume 82, Issue 6 (September 2024)
Abstract
Background: Shivering is one of the side effects of anesthesia that occurs both in general anesthesia and regional anesthesia. Ketamine, as an N-methyldiaspartate receptor antagonist, may prevent shivering after spinal anesthesia by reducing central heat distribution to the environment. Therefore, the purpose of this study is to investigate the effect of ketamine in preventing tremors after spinal anesthesia in lower limb orthopedic surgeries.
Methods: This randomized, single-blind clinical trial study was conducted on 60 patients who were candidates for orthopedic surgery of the lower limb referred to 5 Azar Hospital in Gorgan. Patients were randomly divided into two equal groups of ketamine (0.25 mg/kg) and control (placebo). The data collection tool includes a checklist containing information; Age, gender, mean arterial pressure, percentage of arterial oxygen saturation, heart rate, tremors and hallucinations. Data analysis was performed using descriptive statistics and inferential statistical tests at a significance level of P<0.05.
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Results: There was no statistically significant difference in gender between the control and intervention groups. The mean age of the study subjects in the control group was 36.13±12.53 and in the intervention group was 40.30±11.96. There was no statistically significant difference in age between the control and intervention groups. There is no statistically significant difference in mean arterial pressure (MAP) between the control and intervention groups. The incidence of shivering after spinal anesthesia was 13.33% in patients receiving prophylactic ketamine and 40% in patients receiving placebo. The incidence of hallucinations in the ketamine group was 26.67%. The rate of nausea and vomiting was similar in both groups. According to this study, between the two groups in terms of hemodynamic parameters, including mean arterial pressure, heart rate, percentage of arterial oxygen saturation; There was no significant difference.
Conclusion: The incidence of shivering in spinal anesthesia in the preventive use of ketamine has been more effective than placebo. Considering the effectiveness of ketamine in reducing the incidence of shivering, its use as a prevention is suggested to reduce the incidence of shivering.
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Sara Rezapour , Mehrab Deylami, Marjan Kazeminia,
Volume 82, Issue 7 (October 2024)
Abstract
Background: The mandibular first molar teeth are the most common teeth that undergo endodontic treatment and are anatomically very challenging. Adequate knowledge of the danger zone in the mesial root of the first mandibular molars helps reduce the risk of misdiagnosis of perforation during treatment. The aim of this study was to compare the dentin thickness of the danger zone in the mesial canals of the mandibular first molar in CBCT(Cone Beam Coomputed Tomography) images at intervals of 3, 4, 5 mm below the orifice canal.
Methods: In this study, CBCT images of 144 mandibular first molars from 74 patients aged 18 to 66 years were examined. Mean orifice to Furcation was calculated and mean distal dentin thickness of mesiobuccal and mesiolingual canals was measured at 3, 4 and 5 mm below the orifice. The mean thickness of the distal dentin was examined in terms of age, sex and maxillary side.
Results: The lowest mean distal wall thickness of mesiobuccal and mesiolingual canals was 5 mm below the orifice of the canal. The mean distal wall thickness of mesiobuccal and mesiolingual canals were higher in men than women (P <0.05). The mean distal wall thickness did not show a significant relationship with age. (P=0.745) except in the area of 3 and 5 mm below the orifice in the mesiobuccal canal which was significantly associated with age (P=0.01). No statistically significant difference was observed between the two mandibular sides (P=0.543) except in the 4 mm area below the orifice in the mesiolingual canal (P <0.05).
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Conclusion: The present study showed that the danger zone is observed in the distal dentin of the mesiobuccal and mesiolingual canals of the mandibular first molar teeth in men and women 5 mm below the orifice of the canal. The mean dentin thickness of the distal wall was lower in women than in men.
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Reza Sahraei, Anahita Haghjoo , Hasan Zabetian, Mansour Deylami, Rahil Haghjoo, Fatemeh Khadempir, Navid Kalani ,
Volume 83, Issue 1 (April 2025)
Abstract
Background: Spinal anesthesia is a common method for elective cesarean sections; however, complications such as shivering and nausea may affect postoperative recovery quality. Bupivacaine is a standard drug used in this procedure, but its combination with opioids like sufentanil may have beneficial effects in reducing these complications. This study aimed to compare the incidence of shivering and nausea in women undergoing elective cesarean section who received either bupivacaine alone or a bupivacaine-sufentanil combination.
Methods: The present study was a double-blind randomized clinical trial conducted over a 6-month period from April 2021 to October 2021 on 30 patients undergoing elective cesarean section with spinal anesthesia at Motahari Hospital in Jahrom city. Patients were randomly assigned using a random number table into two groups: bupivacaine alone and bupivacaine-sufentanil combination. The frequency of nausea, vomiting, and shivering was recorded at different time points: before spinal anesthesia, after spinal anesthesia, 3 minutes before delivery, immediately after delivery, at 15, 30, and 45 minutes, upon recovery room admission, and upon discharge from recovery. The data analysis was performed using descriptive statistics indicators (frequency, percentage, mean, and standard deviation) and inferential statistical tests (t-test, Mann-Whitney, chi-square and Friedman) using SPSS software version 21. A significance level of p < 0.05 was considered.
Results: In the bupivacaine-sufentanil group, the highest frequency of shivering occurred at 30 minutes post-spinal anesthesia (20%) and upon recovery room admission (26.7%). In the bupivacaine-alone group, the highest frequency was observed upon recovery room admission (33.3%) and at discharge from recovery (26.7%). The highest nausea frequency was 33.3% in the bupivacaine-sufentanil group and 40% in the bupivacaine group at 3 minutes before delivery. However, no statistically significant difference was found between the two groups at different time points.
Conclusion: The present study showed that adding low-dose sufentanil to bupivacaine in spinal anesthesia protocols, while potentially having minor clinical effects on certain complications, did not lead to a significant difference in the incidence of shivering and nausea. Therefore, for more precise clinical decision-making regarding drug combinations in regional anesthesia, further studies with larger sample sizes and different drug dosages are recommended.
Shahram Shafa, Mehrdad Sayadinia, Bibi Mona Razavi, Tayyebeh Zarei , Maryam Ziyaei , Mansour Deylami,
Volume 83, Issue 2 (May 2025)
Abstract
Background: Controlling patients' anxiety before surgery reduces the possibility of postoperative problems and increases the possibility of patient participation and cooperation in the postoperative care and treatment plan.
Methods: This study uses a review approach to investigate non-pharmacological methods of anxiety management in patients undergoing orthopedic surgery. The systematic search involves several key steps. Literature search: A thorough search was conducted in PubMed, Sciences Direct, Scopus, Magiran, Sid, and Google Scholar databases. The search was refined using keywords such as “aromatherapy,” “music therapy,” “massage,” “educational intervention,” “educational film,” and “sound of the Quran” and their English equivalents to identify relevant studies published in the past ten years. Inclusion criteria included studies on orthopedic surgery, Persian and English articles, and original articles. Exclusion criteria included studies outside the specified time frame or studies that deviated from the defined focus. In this review, we conclude by summarizing key aspects of the review process, emphasizing the rigorous approach applied in study selection, data extraction, and synthesis.
Results: The results of the present study showed that the non-pharmacological methods used to control or reduce anxiety in orthopedic surgery include methods; Music therapy, the sound of the Quran, relaxation techniques, back massage, educational intervention, educational video, awareness and training before surgery and aromatherapy (chamomile, lemon, rose, valerian, cardamom, cinnamon, calendula, lavender, lemon sour).
Conclusion: The results of numerous and reputable research findings clearly show that the use of non-pharmacological methods plays an effective role in reducing the level of anxiety of patients before, during and after orthopedic surgery. These methods, which are generally low-cost, low-complication, and applicable in various clinical settings, include techniques such as preoperative education, music therapy, breathing and relaxation techniques, mindfulness-based interventions, psychological support, and the creation of a calm and reassuring environment. Since anxiety is a known factor in weakening the immune system, increasing postoperative pain, prolonging the recovery period, and reducing overall patient satisfaction, its management is of great importance. Therefore, by integrating and utilizing such non-invasive methods into nursing care protocols and holistic patient care programs, the detrimental and undesirable effects of anxiety after orthopedic surgery can be significantly reduced and faster recovery, a better patient experience, and more favorable clinical outcomes can be achieved.
Pourya Adibi , Somayeh Mehrpour, Reza Sahraei , Samira Zanbagh, Majid Vatankhah, Mehrdad Malekshoar, Mansour Deylami, Bibi Mona Razavi, Tayyebeh Zarei ,
Volume 83, Issue 2 (May 2025)
Abstract
Background: Today, cesarean section is one of the most common surgeries performed in different countries. Shivering after surgery is one of the common complications of spinal anesthesia in cesarean surgery. Many drugs have been investigated to prevent or reduce shivering, but the ideal drug has not yet been finally approved. The purpose of this study is to investigate the effect of dexmedetomidine in preventing shivering after cesarean section surgery under spinal anesthesia in the form of a systematic review.
Methods: In this systematic review, the Persian keywords "dexmedetomidine", "spinal anesthesia", "caesarean" and dexmedetomidine" and the English keywords dexmedetomidine", "Caesarean section", "Spinal Anesthesia" "Dexmedetomidine and "C-Section" in databases PubMed, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, Clinical Trials.gov and Scopus, SID, Magiran, Medlib and Google Scholar search engine, without time limit Done. Data extraction was performed independently by two authors. Study name, year of study, country, study groups, and incidence of shivering were extracted from the studies. Our primary outcome was the severity of shivering in patients. All disagreements in data extraction were resolved through discussion between the reviewers or, if not possible, by a third reviewer. Data were entered into an Excel file.
Results: In this systematic review, 19 studies were examined. The total number of patients included in the study was 2001 patients. The study range was from 2016 to 2022. The age group of most patients was between 18-45. The drugs studied in combination with dexmedetomidine in the studies included: pethidine, dexamethasone, nalbuphine, ondansetron, and morphine. The most studied drugs were pethidine and dexamethasone in three studies. In 13 studies, dexmedetomidine was more effective in controlling shivering than the other groups studied. Also, in five studies, dexmedetomidine, along with three drugs: pethidine, dexamethasone, and ondansetron, had similar effects in controlling shivering in patients. In one study, dexmedetomidine produced less anti-tremor effects than nalbuphine.
Conclusion: In the review of the studies, the results indicated that dexmedomedin is effective in preventing post-operative shivering in patients undergoing caesarean section. Therefore, it seems that the use of dexmedetomidine to prevent shivering after surgery is useful in these patients.
Masoome Pourmokhtari , Shahram Shafa, Nasim Nabizadeh, Reza Sahraei, Hasan Zabetian, Mansour Deylami, Navid Kalani,
Volume 83, Issue 3 (June 2025)
Abstract
Background: Spinal anesthesia is an effective method for providing analgesia in surgery and a safe alternative to general analgesia; But despite its benefits, in many cases it is not free of side effects, including unwanted cardiovascular events such as hypotension and bradycardia. Ondansetron effectively reduces the incidence of nausea, vomiting, and bradycardia associated with spinal anesthesia Thus, the present study aimed to assess intravenous ondansetron's efficacy in preventing post-spinal hypotension among patients scheduled for lower extremity orthopedic surgery at Peymanieh Hospital in Jahrom, Iran.
Methods: This randomized double-blind clinical trial included 60 patients undergoing lower limb orthopedic surgery at Peymanieh Hospital, Jahrom, Iran, from March 2021 to February 2022. Patients were randomly allocated into two groups: the intervention group (receiving 8 mg intravenous ondansetron) and the control group (receiving distilled water). Systolic and diastolic blood pressure (SBP, DBP) and heart rate (HR) were measured before pre-spinal anesthesia, after spinal anesthesia and then every two minutes for the first ten minutes and at 15, 30, 45, 60 and 90 minutes after surgery. After spinal anesthesia, the patient was asked about pruritus every 10 minutes. Nausea and vomiting during surgery in case of incidence, recording and nausea after spinal anesthesia, the patient was asked every 10 minutes.
Results: The chi-square test indicated no significant differences between the study groups regarding age and sex distribution(P>0.05). Time before anesthesia, immediately after anesthesia, 10 minutes, 15 minutes, 30 minutes, 45 minutes, 60 minutes, 75 minutes, and 90 minutes after anesthesia, significant difference between ondansetron and placebo groups from There was no mean SBP and DBP and HR (P <0.05). No significant difference between ondansetron and placebo groups in the incidence of pruritus and nausea and vomiting at different times (p <0.05).
Conclusion: Dose of 8 mg of ondansetron in lower limb orthopedic surgery has no significant effect on hemodynamic symptoms as well as the prevention of postoperative nausea, vomiting and pruritus in these patients. Therefore, to achieve more results regarding the transient effect of this drug, it can be compared with other drugs in the class of HT3-5 receptor antagonists.
