Shahram Shafa, Mehrdad Sayadinia, Bibi Mona Razavi, Tayyebeh Zarei , Maryam Ziyaei , Mansour Deylami,
Volume 83, Issue 2 (5-2025)
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.
Reza Saeidi , Mahboobe Gholami,
Volume 83, Issue 4 (7-2025)
Abstract
Background: Neonatal circumcision is one of the most common surgical procedures worldwide, performed for cultural, religious, and health-related reasons. The two primary methods for neonatal circumcision are the classic surgical method (using sutures or clamps such as Gomco or Mogen) and the plastic ring method (e.g., Plastibell). This systematic review and meta-analysis aimed to compare the benefits and complications of these two methods in neonates.
Methods: A systematic search was conducted in PubMed, Scopus, Web of Science, and Google Scholar databases for articles published between 2000 and 2024. Inclusion and exclusion criteria: Included studies included randomized controlled trials (RCTs), cohort studies, and cross-sectional studies that compared the benefits and harms of classical surgery and plastic ring in infants (<28 days). Studies without a comparison group, studies conducted in older children or adults, and articles that did not provide sufficient data were excluded. Keywords included "neonatal circumcision", "plastic ring", "Plastibell", "classical surgery", "Gomco clamp", "Mogen clamp", "benefits", "complications" and their English equivalents.
Studies comparing the benefits and complications of the classic surgical method and the plastic ring method in neonates were included. Data were meta-analyzed using a random-effects model, and risk ratios (RR) with 95% confidence intervals (CI) were calculated.
Results: From a total of 12 included studies (involving 5,342 neonates), the plastic ring method was associated with a significant reduction in bleeding (RR: 0.45; 95% CI: 0.32-0.64) and healing time (mean difference: -2.3 days; 95% CI: -3.1 to -1.5) compared to the classic surgical method. However, the risk of skin adhesion was higher with the plastic ring method (RR: 1.32; 95% CI: 1.05-1.66). Serious complications, such as urethral injury, were rare in both methods (less than 0.2%).
Conclusion: The plastic ring method is a suitable option for neonatal circumcision due to its ease of use, reduced bleeding, and faster healing time. However, careful post-procedural care is essential to minimize the risk of skin adhesion. The choice of method should consider the operator’s expertise and parental preferences.
