Tehran University Medical Journal

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Introduction: Succinylcholine is a depolarizing muscle relaxant, which has been used extensively in anesthesia to produce muscle relaxation. The present study was done with the aim of comparing Fasciculation and postoperative myalgia after injection of two different doses of Succinylcholine (1.5 mg/kg and 3 mg/kg).

Materials and Methods: In this study which has been conducted in the form of Randomized double blind study in Tehran Shariati Hospital in the year 2000, 50 male patients in two groups (25 in each) with ASA I&II, age between 18 to 65, were candidate for an elective surgical repair of inguinal hernia received a standard anesthetic technique, including one of the two doses of Succinylcholine.

Results: After collecting data it has been considered that the average difference of two respective groups is meaningful in terms of fasciculation (P<0.05), but not in terms of myalgia (P>0.05).

Conclusion: we came to the conclusion that, firstly, the percentage of myalgia after the injection of succinylcholine is totally low and with the increase of the dose of medication from 1.5 mg/kg to 3 mg/kg the very percentage does not change considerably. Secondly, regarding fasciculation the increase of the dose of medication from 1.5 mg/kg to 3 mg/kg causes the decrease of the average limit of fasciculation. This decrease is very obvious in server fasciculation. As a matter of fact no relationship was found between decrease in fasciculation and change in myalgia.

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Background: Fibromyalgia has been defined as a constellation of complaints including diffuse chronic pain and the presence of tender points. Its frequency varies from 3% to 20%. This study was conducted to estimate the prevalence of fibromyalgia syndrome in patients who come to the general medical clinic of Dr. Shariati hospital.
Methods: Using a standard questionnaire, all patients who came to the general medical clinic were asked about their ages, presence of diffuse chronic pain, marital status, educational level, living place, number of children and presence of fatigue or sleep disorder by a physician, without any gender or age restriction and without considering their main complaints or their underground diseases. The same physician did a thorough physical examination with special attention to the tender points in order to diagnose fibromyalgia according to the ACR criteria. To rule out other differential diagnosis relevant tests would be ordered for suspected patients.
Results: Among 1004 patients who were assessed, the prevalence of diffuse chronic pain was 14.6% (95%CI: 12.4-16.8). Forty patients 4% (95%CI: 2.9-5.2) suffered from fibromyalgia syndrome, their mean age (±SD) was (48.4±14.9) years.92.5% of these cases were female and 7.5% (3 patients) were male.The prevalence of fibromyalgia among women was 5.98% (95% CI: 4.31-8.06) and among men was 0.78% (95% CI: 0.20- 2.11) (OR=8.1,95%CI:2.48-26.44). There was a meaningful statistical relation between the prevalence of fibromyalgia and gender (P=0.001). There was also a direct statistical relation between the prevalence of fibromyalgia and low educational level (P=0.003). But there was not any relation between fibromyalgia and living place or marital status.Also, there was no relationship between the prevalence of fibromyalgia and having more children (Logestic analysis).82.5% of patients with fibromyalgia suffered from sleep disorders and 92.5% of them complained of fatigue. There was remarkable statistical relations between fibromyalgia syndrome and sleep disorders or fatigue. (P<0.001)
Conclusion: Fibromyalgia syndrome is relatively prevalent among Iranian and in some extents its epidemiological aspects are comparable to those in developed countries. More extensive epidemiologic studies on fibromyalgia is recommended in general population

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Background: Stretching exercises and massage therapy are both suggested for pain relief in fibromyalgia syndrome. Previous studies have not proved their superiority over each other. This study compared the therapeutic effects of friction massage, stretching exercises, and analgesics on pain relief in patients with fibromyalgia syndrome.
Methods: We evaluated 129 female patients with the diagnosis of primary fibromyalgia visited at the physical medicine clinics of Baqiyatallah Hospital in Tehran, Iran during 2010- 2011. Patients were randomly divided into three groups: the first group received 400 mg ibuprofen P.O. (3 times per day) and 25 mg nortriptyline (daily) P.O. as analgesic, the second group was treated by friction massage and the third group performed stretching exercises. Patients were assessed three times (initially, after one and four weeks) by visual analogue scale (VAS).
Results: The mean age of participants was 60.46 years. The mean age in each treatment group was 46.66 years in medication group, 46.73 years in stretching group and 46.65 years in friction massage group. Changes in VAS score over 4 weeks were 2.4, 3.1 and 1.9, in the first, second, and third groups, respectively. The changes in VAS were significantly different in the first and second groups rather than the controls (P<0.05).
Conclusion: The effect of stretch exercise on pain relief was similar to analgesics, but it was more effective than friction massage. Moreover, the therapeutic effect of stretching exercise on pain relief upon four weeks was more permanent than friction massage but it was similar to analgesics.