میرمحمد تقی مرتضوی

Since sevoflurane is one of the most effective anesthetic gases in the occurrence of nausea and vomiting after anesthesia in children, and on the other hand, due to the lack of a systematic review study regarding the effective role of dexmedetomidine in preventing this complication, the aim of Conducting this study was the effectiveness of dexmedetomidine on the occurrence of vomiting after surgery in children with sevoflurane.

The current study is a systematic review and meta-analysis, which was designed and implemented based on the steps of the PRISMA statement, randomized controlled trials that were published before the beginning of 2022, from Web of Science, Embase, PubMed, and Cochrane Library, Mag Iran and SID were searched and selected. Search keywords were "dexmedetomidine", "children", "anaesthesia", "vomiting" and "sevoflurane". Meta-analysis was performed using Stata software. The statistical results of the two-category data comparison were presented in the form of odds ratios (RRs) and 95% confidence intervals. Statistical results for continuous data were presented as standardized mean difference (SMD). Heterogeneity between included studies was checked using the χ2 test (significance level of the test α = 0.1) and the I2 index was used to quantify the heterogeneity of the results.

A total of 672 participants from 10 randomized clinical trial articles were reviewed; the results were P = 0.898 and I = 0%. It was shown that dexmedetomidine is associated with a decrease in the incidence of vomiting compared to placebo (CI = 0.24-0.60-OR 0.40: P = 0.001).

Nausea and vomiting after anesthesia is one of the common and unpleasant side effects that may endanger the patient's safety. Knowledge of the effects of different drugs effective in the occurrence of this complication can change the occurrence of nausea and vomiting after anesthesia; the results of this meta-analysis showed that dexmedetomidine reduces vomiting after anesthesia of children with soflurane.

Acute pain after arthroplasty of the lower limb has adverse effects on the patient's treatment aspects, and also considering that acute pain (within the first 24 hours) after surgery is the basis of chronic pain and disability after surgery. and on the other hand, due to the lack of a meta-analysis study regarding the effects of pregabalin on the intensity of acute pain after lower limb surgeries, the present study aimed at the preventive effects of pregabalin on the intensity of acute pain during the first 24 hours after orthopedic surgeries The bottom is done.

This meta-analysis was performed following the guidelines of the PRISMA statement; Studies were selected based on the PICO criteria. Keywords pain, pain intensity, acute pain, pregabalin, lower limb, lower limb orthopedics and analgesia were searched in PubMed, EMBASE and Cochrane Library, Web of Science, Scopus, Mag Iran and SID databases; Statistical analyzes were performed using RevMan 5.4 software.

Pain intensity in the second (MD = -0.26 - CI95% = -0.02 to -0.50 and P = 0.04) and sixth (MD = -0.30 -CI95% = -0.29 to -0.30 and P = 0.00001) and the twelfth (MD = -0.53 -CI95% = -0.29
to -0.78 and P = 0.0001) after surgery was significantly lower in the intervention group than in the control group.

This meta-analysis supports the use of pregabalin before surgery in patients undergoing lower extremity orthopedic surgery and by reducing the intensity of acute pain (pain during the first 12 hours after surgery).

Mastectomy results in damage to the nerves of chest, also inappropriate long-term positioning during surgery leads to upper cross syndrome. Stretching exercise can be effective in treating this syndrome that there is consensus in the type of exercise; therefore, this study was performed with aim to investigate the effects of eight weeks of stretching exercise on upper cross syndrome in mastectomized women.

This randomized controlled clinical trial study was performed in 2018 on 30 women after mastectomy in Imam Reza Hospital. The subjects were divided into two groups of intervention (performing 24-hour stretching sessions) and control (without any intervention). Frontal, kyphosis, shoulder, and pain angles were measured before and after the intervention. Data were analyzed by SPSS software (version 20) and the ANCOVA and T-test. p < 0.05 was considered statistically significant.

Intervention led to positive and significant effects in the variables of kyphosis (P=0.003 -Control group=39.01±03.41- Intervention group=43.51±03.90), head forward (P=0.041-Control group=32.13±03.25- Intervention group=29.91±02.98) and pain (P=0.00001-Control group=65.02±11.93- Intervention group=30.14±06.13) between the two groups. According to the results of ANCOVA, there was a significant difference between the two groups in kyphosis angle (P=0.003), head forward angle (P=0.019) and pain (P=0.003) after exercise.

The variables of pain, head angle and kyphosis, which are disabling variables following upper transverse syndrome, were improved by eight weeks of stretching exercises, and the intervention in this study could be useful.