جستجوی مقالات مرتبط با کلیدواژه « preoperative period » در نشریات گروه « پزشکی »
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Background
Patients undergoing orthopedics surgery experience the most severe postoperative pain. The fasting time is a factor that affects this complication. The aim of this study was to investigate the impact of fasting time reduction by using oral carbohydrate on postoperative pain and analgesic consumption in orthopedic patients.
Materials and MethodsThis randomized control trial was conducted between November 2017 and December 2018. Sixty‑four patients were randomly assigned into the intervention (which consumed 200 mL of the 12.50% carbohydrate, 2 h before the surgery) and the control group (which was fasted from midnight). Postoperative pain was measured by visual analog scale; the amount of the consumed analgesics was also recorded. The data were analyzed by using Chi‑square and t‑test.
ResultsThe mean (SD) of the pain scores in the control group immediately and 2, 4, 6, 12 and 24 h after consciousness were 7.19 (2.64), 6.69 (2.17), 6.31 (2.05), 6.16 (2.08), 6.06 (2.24), and 5.38 (1.86), respectively. These scores for the intervention group were 7.44 (1.48), 6.31 (1.25), 5.72 (1.17), 5.59 (1.43), 5.25 (1.13), and 4.97 (1.57). The mean of the pain scores between two groups was not different (p </em>> 0.05). The amount of the consumed morphine (t61 = ‑2.10, p </em>= 0.039), pethidine (t62 = ‑2.25, p </em>= 0.028), and diclofenac (t62 = ‑2.51, p </em>= 0.015) were significantly different between the two groups.
ConclusionsThe pain intensity in the patients with shortened fasting time was lower, but it was not statistically significant. Moreover, reducing fasting time by using carbohydrate significantly reduced the use of analgesics.
Keywords: Fasting, orthopedics, pain, postoperative, preoperative period} -
مجله مراقبت پرستاری و مامایی ابن سینا، سال بیست و هفتم شماره 6 (پیاپی 72، بهمن و اسفند 1398)، صص 405 -414مقدمه
بیماران تحت جراحی ستون فقرات، بعد از عمل با درد شدیدی مواجه می شوند. یکی از روش های ویژه کنترل درد، استفاده از پمپ کنترل درد از سوی بیمار است. مطالعات نشان می دهد با وجود این پمپ، بیماران از درد متوسط تا شدید رنج می برند؛ بنابراین آموزش استفاده از پمپ از سوی پرستاران ضروری است؛ مطالعه حاضر با هدف تعیین تاثیر آموزش پمپ کنترل درد از سوی بیمار قبل از جراحی بر شدت درد، تهوع و استفراغ بعد از جراحی ستون فقرات انجام شد.
روش کارمطالعه حاضر از نوع کارآزمایی بالینی است که طی آن 60 بیمار کاندید جراحی ستون فقرات بستری در بیمارستان شهید فاطمی اردبیل به روش دردسترس انتخاب و به شکل تصادفی به دو گروه 30 نفره مداخله و کنترل تقسیم شدند. هر دو گروه آموزش روتین استفاده از پمپ را در بخش ریکاوری دریافت کردند، اما گروه مداخله شب قبل از جراحی، یک جلسه 15 دقیقه ای آموزش انفرادی چهره به چهره با استفاده از نمونه ای از پمپ کنترل درد دریافت کردند. بعد جراحی، متغیر شدت درد، تهوع و استفراغ در سه زمان 2، 4، 24 ساعت بعد از جراحی بررسی و مقایسه شد. به منظور تجزیه و تحلیل داده ها از SPSS نسخه 16 استفاده شده است.
یافته ها:
یافته ها نشان می دهد 2، 4 و 24 ساعت بعد از عمل از نظر شدت درد تفاوت معنی داری (0/001<P) بین دو گروه وجود داشت؛ به طوری که شدت درد گروه مداخله نسبت به گروه کنترل کاهش یافته بود؛ در حالی که از نظر شدت تهوع و فراوانی استفراغ تفاوت معنی داری بین دو گروه در این زمان ها مشاهده نشد (0/05>P).
نتیجه گیری:
آموزش استفاده از پمپ بی دردی از سوی بیمار قبل از عمل، بدون اینکه تغییری در شدت تهوع و استفراغ ایجاد کند، سبب کاهش درد بعد از عمل جراحی ستون فقرات می شود؛ بنابرین نحوه استفاده از پمپ قبل از عمل آموزش داده می شود.
کلید واژگان: درد, کنترل درد, مدیریت درد, دوره قبل از عمل, آموزش به بیمار, جراحی ستون فقرات}IntroductionPatients undergoing spinal column surgery, experience severe postoperative pain. One of the special methods of pain control is use of a patient-controlled analgesia (PCA) pump. Studies show that despite this pump, patients suffer from moderate to severe pain. Therefore, the teaching patients how to use the pump by nurses is essential. Therefore, the present study was conducted to determine the effect of patient education about patient-controlled analgesia pump preoperative on severity of pain, nausea and vomiting after spinal column surgery.
MethodsThe present study was a randomized controlled trial during which 60 candidate patients of Spinal column surgery hospitalized in Shahid Fatemi hospital in Ardebil, were selected by accessible method and randomly assigned into two groups of 30 individuals, intervention and control group. Both groups received routine training in the use of the pump in the recovery department, but the intervention group received a 15-minute face-to-face intervention session using a sample of the PCA pump. Postoperative pain intensity, nausea, and vomiting in three times, 2, 4, 24 hours after surgery were assessed and compared. SPSS 16 was used to analyze the data.
ResultsThe findings showed that there was a significant difference between the control and intervention groups regarding the severity of pain in times of 2, 4, and 24 hours postoperative (P<0.001). Pain severity in intervention group was decreased compared to control group. However, there was no significant difference in nausea and vomiting frequency between the two groups (P>0.05).
ConclusionTraining the use of patient-controlled analgesia pump before operation, without changing the severity of nausea and vomiting, reduces pain after spinal column surgery. Therefore, it is recommended that the way of using the pump, be taught before operation.
Keywords: Patient-Controlled Analgesia, Pain, Pain management, Preoperative period, Patient education, Spinal column surgery} -
زمینه و هدف
درد بعد از عمل جراحی یکی از چالش های بالینی برای پرستارانی است که مراقبت از بیماران را به عهده دارند. هدف از این مطالعه تعیین اثر آموزش های قبل از عمل بر درد بعد از عمل های جراحی انتخابی بوده است.
روش بررسیپایگاه های اطلاعاتی PubMed، CINAHL، Cochrane Library، Web of Science، Scopus و EMBASE به منظور بازیابی مقالات کارآزمایی بالینی که از تاریخ اول ژانویه 2012 تا اول جوئن 2018 به زبان انگلیسی منتشر شده بودند، جستجو شدند.
یافته هااز مجموع 153 مطالعه بازیابی شده، 13 مطالعه (2482 نفر) وارد مرور شد. به طور کلی، بیش تر مطالعات، آموزش قبل از عمل بر کاهش درد بعد از عمل را موثر دانسته اند (7 مطالعه، 1678=n). در بقیه مطالعات، تفاوت معناداری بین آموزش و میزان کاهش درد بیمار مشاهده نشده است. همچنین نتایج برخی مطالعات (204=n) نشان داد آموزش همراه با همدلی در نیمی از موارد می تواند میزان اضطراب را کاهش دهد.
نتیجه گیریآموزش قبل از عمل جراحی به عنوان یک مداخله پیچیده، می تواند میزان درد بعد از عمل را کاهش دهد. شیوه آموزش تعاملی همراه با همدلی موجب کاهش اضطراب بیمار و همچنین کاهش نیاز به داروهای ضد درد بعد از عمل می شود. بنابراین، آموزش و تربیت پرستاران ماهر و ارایه دهندگان چنین آموزش هایی برای مدیریت درد بیماران پیشنهاد می شود.
کلید واژگان: دوره قبل از عمل, آموزش, درد, پرستاری, مرور}Hayat, Volume:25 Issue: 3, 2019, PP 220 -236Background & AimPostoperative pain is one of the clinical challenges for nurses who care for patients. The objective of this review was to evaluate the effect of preoperative education on postoperative pain after elective surgery.
Methods & Materials: A literature search was done on PubMed, CINAHL, Cochrane Library, Web of Science, Scopus and EMBASE to find the articles published in English on clinical trials from January 2012 to June 2018.ResultsOut of 153 studies retrieved, 13 studies (2482 people) were reviewed. Generally, most studies indicated the effectiveness of preoperative education on postoperative pain relief (7 studies, n=1678). In other studies, there was no significant difference between education and the degree of pain reduction in the patient. Also, the results of some studies (n=204) showed that education with empathy could reduce anxiety in half of the cases.
ConclusionPreoperative education as a complex intervention can reduce postoperative pain. Interactive education with empathy reduces patient’s anxiety and the need for postoperative analgesics. Therefore, training skilled nurses and the providers of such education is suggested for managing pain in patients.
Keywords: preoperative period, education, pain, nursing, review} -
BackgroundPostoperative nausea and vomiting (PONV), as one of the complications after laparoscopic cholecystectomy, occurs in over 40% - 77% of cases. Considering the numerous complications of synthetic drugs, there is a growing tendency towards the use of herbal medicines due to their unique features. Ginger root is one of the herbal compounds effective on nausea and vomiting.ObjectivesThe aim of this study was to evaluate the effect of preoperative Zintoma capsules on PONV after laparoscopic cholecystectomy.MethodsIn this quasi-experimental study, 130 eligible patients were randomly assigned to intervention (n = 65) and control (n = 65) groups using the four-block method. The intervention group received two capsules of 500 mg and one of 250 mg Zintoma. The control group received three placebo capsules. The severity of patients’ PONV was recorded at 0, 2, 6, 12, and 24 hours after surgery using a checklist and a standard VAS instrument. Data were analyzed using t-test, Chi-square test, and LSD Post Hoc test (ANOVA) in SPSS 19.ResultsThe severity of PONV and vomiting was significantly different between the two groups (P = 0.001) at the above time points. The mean severity of nausea (by VAS) changed in the intervention group from 7.92 ± 1.28 to 0.33 ± 0.67 and in the control group from 8.00 ± 1.20 to 2.11 ± 1.55. The postoperative vomiting was less frequent in the group receiving the Zintoma capsules. The postoperative use of chemical anti-vomiting and nausea drugs was significantly lower in the intervention group than in the placebo group (P = 0.001).ConclusionsZintoma capsules can be used as a supportive treatment in the prevention of nausea and vomiting by reducing the incidence rate of PONVKeywords: Ginger, Preoperative Period, Postoperative Nausea, Vomiting, Laparoscopic Cholecystectomy}
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اهدافاضطراب قبل از جراحی، یک حالت ناخوشایند است که به واسطه ترس از جراحی ایجاد می شود. هدف این مطالعه، مقایسه تاثیر مصرف سافرانال (زعفران) و قرص دیازپام بر کاهش اضطراب و بهبود علایم حیاتی قبل از عمل جراحی بود.مواد و روش هادر این مطالعه کارآزمایی بالینی تصادفی دوسوکور، 54 بیمار کاندید جراحی اورولوژی (واریکوسل) در بیمارستان 15خرداد شهرستان گناباد در سال 1392 به روش نمونه گیری مبتنی بر هدف انتخاب شده و با استفاده از جدول اعداد تصادفی، به دو گروه مداخله (29 نفر) و کنترل (25 نفر) تخصیص یافتند. 3 ساعت قبل از جراحی، گروه مداخله mg15 سافرانال و گروه کنترل mg5 دیازپام دریافت کردند. پرسش نامه اضطراب اسپیلبرگر (STAI) قبل از مداخله و در بدو ورود به اتاق عمل توسط بیماران تکمیل شد و علایم حیاتی آنها نیز مورد سنجش قرار گرفت. تحلیل داده ها با نرم افزار SPSS 11.5 و توسط آزمون های مجذور کای و T مستقل صورت گرفت.یافته هاپس از مداخله، اضطراب پنهان در گروه سافرانال نسبت به قبل از مداخله (002/0=p) و نیز نسبت به گروه دیازپام (007/0=p) کاهش معنی دار داشت. همچنین فشار خون دیاستولیک در گروه سافرانال نسبت به گروه دیازپام کاهش معنی داری یافت (049/0=p).نتیجه گیریمصرف سافرانال قبل از عمل جراحی بیشتر از مصرف دیازپام بر کاهش اضطراب پنهان تاثیر دارد، اما بر اضطراب آشکار تاثیری ندارد. همچنین مصرف سافرانال باعث کاهش بیشتر فشار خون دیاستولیک نسبت به مصرف دیازپام می شود، درحالی که بر فشار خون سیستولیک و ضربان قلب تاثیری ندارد.کلید واژگان: سافرانال, دیازپام, زمان قبل از عمل, اض, طراب}Aim: Preoperative anxiety is an unpleasant manner created by fear of surgery. The aim of the present study was to compare the effects of diazepam pill with Safranal in reducing preoperative anxiety and improving vital symptoms.
Material andMethodsIn this double blind randomized clinical trial, 54 patients who were candidates of urology surgery (varicocele) in 15th Khordad Hospital, Gonabad, Iran, were selected by purposive sampling method, using a randomized numbers table; they were divided into intervention (n=29) and control group (n=25). The patients in intervention group received 15mg Safranal and the patients in control group received 5mg oral diazepam 3 hours before surgery. The State-Trait Anxiety Inventory (STAI) questionnaire was completed by the patients prior to the intervention and just at the entrance to the surgery room, and the vital symptoms of the patient were evaluated. The data were analyzed by SPSS 11.5 software, using of Chi-square and independent sample t-test.
Findings: After intervention, the trait anxiety in the Safranal group was significantly lower than diazepam group (p=0.007) and before the intervention (p=0.002). Also, diastolic blood pressure decreased significantly in the Safranal group compared with the diazepam group (p=0.049).ConclusionSaffranal consumption before surgery is more effective than diazepam consumption in reducing the trait anxiety, but it does not affect state anxiety. Also, compared to diazepam, Saffranal consumption leads to a more reduction in diastolic blood pressure, while it does not affect systolic blood pressure and heart rate.Keywords: Safranal, Diazepam, Preoperative Period, Anxiety} -
مقدمههدف از انجام مطالعه ی حاضر، بررسی عواملی بود که پیش از عمل جراحی، فرد را مستعد به افت درصد اشباع اکسیژن خون در Post-anesthesia care unit (PACU) می کند.روش هادر مطالعه ی مشاهده ای حاضر، 500 بیمار پیش از عمل جراحی از نظر سن، جنس، وزن، دور گردن، سابقه ی خروپف (Snoring)، اعتیاد، مصرف سیگار، بیماری زمینه ای، هموگلوبین، علایم حیاتی و درصد اشباع اکسیژن خون ارزیابی شدند. سپس، با توجه به افت یا عدم افت درصد اشباع اکسیژن خون (کمتر از 90 درصد) بیماران در ریکاوری، آنان به دو گروه دچار افت درصد اشباع اکسیژن خون و گروه بدون افت درصد اشباع اکسیژن خون تقسیم شدند. سپس، وجود یا عدم وجود عوامل مورد مطالعه در هر گروه مورد بررسی قرار گرفت.یافته هااز 500 بیمار تحت بررسی، 50 نفر (10 درصد) دچار افت درصد اشباع اکسیژن خون شدند و 445 نفر (89 درصد) مبتلابه افت درصد اشباع اکسیژن خون نشدند. در ارتباط با 5 بیمار (1 درصد) نیز وضعیت افت درصد اشباع اکسیژن خون مشخص نشد. در بیماران دچار افت درصد اشباع اکسیژن خون، میانگین سن (004/0 = P)، وزن (024/0 = P) و متوسط اندازه ی دور گردن (002/0 = P)، متوسط فشار خون سیستولیک (026/0 = P)، متوسط دمای محیطی (037/0 = P)، توزیع فراوانی مصرف سیگار (004/0/ = P) و توزیع فراوانی بیماری های دیابت (030/0 = P)، پرفشاری خون (006/0 = P) و مشکل تنفسی (020/0 = P) به طور معنی داری بیشتر از بیمارانی بود که دچار افت درصد اشباع خون شریانی نشدند. همچنین، متوسط درصد اشباع اکسیژن خون نیز در بیماران مبتلا به افت درصد اشباع اکسیژن خون، به طور معنی داری کمتر از بیماران بدون افت درصد اشباع اکسیژن خون بود (037/0 = P).نتیجه گیریبا بررسی عوامل مساعد کننده، می توان احتمال افت درصد اشباع اکسیژن خون را پیش بینی کرد و با کنترل عوامل، از میزان افت درصد اشباع اکسیژن کاست.کلید واژگان: اکسیژن خون, مراقبت پس از بیهوشی, دوره ی پیش از عمل جراحی}BackgroundWe aimed to investigate preoperative factors tend to decrease in oxygen saturation in post-anesthesia care unit (PACU).MethodsThis observational study evaluated 500 patients before operation for age, gender, weight, neck circumference, smoking, addiction, underlying diseases, hemoglobin level, vital signs, and oxygen saturation. After operation, patients were divided into two groups of those experienced oxygen desaturation and those did not experience this situation. All above-mentioned variables were compared between the two groups.
Findings: The prevalence of patients with oxygen desaturation was 10%; while 89% did not experience this condition and 1% was unkown for oxygen saturation. There were significant differences between the two groups in age (P = 0.004), weight (P = 0.024), neck circumference (P = 0.002), systolic blood pressure (P = 0.026), peripheral and central temperature (P = 0.037), smoking (P = 0.004), diabetes (P = 0.030), hypertension (P = 0.006), respiratory disease (P = 0.020), and preoperative oxygen saturation (P = 0.037).ConclusionBy evaluating predictive factors, oxygen desaturation can be predictable. We can improve respiratory complications in post-anesthesia care unit by controlling and monitoring these factors.Keywords: Oxygen, Post-anesthesia nursing, Preoperative period} -
BackgroundAnxiety is an emotional state characterized by apprehension and fear resulting from anticipation of a threatening event..ObjectivesThe present study aimed to analyze the incidence and level of preoperative anxiety in the patients scheduled for cardiac surgery by using a Visual Analogue Scale for Anxiety (VAS-A) and Amsterdam Preoperative Anxiety and Information Scale (APAIS) and to identify the influencing clinical factors..Patients andMethodsThis prospective, longitudinal study was performed on 300 cardiac surgery patients in a single university hospital. The patients were assessed regarding their preoperative anxiety level using VAS-A, APAIS, and a set of specific anxiety-related questions. Their demographic features as well as their anesthetic and surgical characteristics (ASA physical status, EuroSCORE, preoperative Length of Stay (LoS), and surgical history) were recorded, as well. Then, one-way ANOVA and t-test were applied along with odds ratio for risk assessment..ResultsAccording to the results, 94% of the patients presented preoperative anxiety, with 37% developing high anxiety (VAS-A ≥ 7). Preoperative LoS > 2 days was the only significant risk factor for preoperative anxiety (odds ratio = 2.5, CI 95%, 1.3 - 5.1, P = 0.009). Besides, a positive correlation was found between anxiety level (APAISa) and requirement of knowledge (APAISk). APAISa and APAISk scores were greater for surgery than for anesthesia. Moreover, the results showed that the most common anxieties resulted from the operation, waiting for surgery, not knowing what is happening, postoperative pain, awareness during anesthesia, and not awakening from anesthesia..ConclusionsAPAIS and VAS-A provided a quantitative assessment of anxiety and a specific qualitative questionnaire for preoperative anxiety in cardiac surgery. According to the results, preoperative LoS > 2 days and lack of information related to surgery were the risk factors for high anxiety levels..Keywords: Preoperative Period, Cardiac Surgery, Risk Factors, Anxiety Scale}
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BackgroundAdenotonsillectomy is a common otolaryngology surgery. Nausea and vomiting are the most common complications of this procedure with a prevalence ranging from 49% to 73 %.ObjectivesOur aim was to evaluate the effects of short time fasting protocol on decreasing postoperative pain, nausea and vomiting, and initiation of oral feeding after adenotonsillectomy.Patients andMethods120 children aged 4 to 14 years candidates for adenotonsillectomy were randomly divided into intervention and control groups (n = 120, 60 in each group). Each patient of the intervention group was given oral dextrose 10% as much volume as he could consume at 3 and 6 hours prior to the operation. All the data including pain severity, nausea and vomiting of the patients, the time of oral feeding initiation etc. were gathered in checklists after the operation. Statistical analyses were then performed using Statistical Package for the Social Sciences (SPSS) software version 16. Descriptive statistical methods and mean difference test for independent groups and chi square test or Fisher exact test, and if regression needed model test were applied. A P value of 0.05 or less was considered statistically significant.ResultsThe amount of Acetaminophen administered for the intervention group was significantly lower than the control group, and also the time of oral feeding initiation was significantly shorter in the intervention group than the control group (P < 0.005). Pain severity at all occasions following surgery was significantly lower in the intervention group than the control group (P < 0.001). Although frequency of nausea at recovery time was significantly lower in the intervention group than the control group (P < 0.002), there were no significant differences in frequency of nausea between the two groups at other postoperative occasions. Postoperative vomiting frequency was not significant between the two groups at any occasions.ConclusionsThe findings of this survey showed that shortening the duration of pre-adenotonsillectomy fasting period and hydration of patients several hours prior to the operation might be effective in decreasing postoperative pain and facilitating postoperative oral feeding initiation. Nevertheless this method does not seem to prevent postoperative nausea and vomiting.Keywords: Pain, Nausea, Vomiting, Children, Fasting, Preoperative Period}
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IntroductionHospital anxiety and surgery has an unpleasant and disturbing feeling for a child and his/her family. This study aimed to determine the effect of toys and visit in reducing children’s anxiety before the surgery and their mothers and satisfaction with the treatment process.MethodsThis was a quasi-experimental study in posttest design with a control group. 60 children aged 3 to 8 years, who were undergoing ear, nose and throat surgery in Tabriz Amiralmomenin hospital, were chosen, and regarding their age and gender, were recruited into the control or experiment group. For the experiment group, the interventions before surgery were applied. The level of anxiety in children and parents was evaluated by Observation Scale of Behavioral Distress (OSBD-R) and Spielberger State Anxiety Inventory (STAI). The level of parental satisfaction with the treatment process before being discharged from the hospital was evaluated by the process of treatment satisfaction questionnaire (PSQ-18). Data were analyzed by SPSS ver.13.ResultsMean anxiety scores of the children and mothers in the experimental group were lower than the control group. Mean maternal satisfaction score of the treatment process in the experimental group was higher than the mean scores of the control group. However, in the subscales of general satisfaction, interpersonal behavior, and financial aspects of satisfaction with treatment, no statistical significant difference was found between the experimental and control groups.ConclusionBased on the findings, providing toys for children and informing the parents about medical information has a major effect in reducing children’s and other’s anxiety and increasing maternal satisfaction with the treatment process.Keywords: Playthings, Preoperative Period, Anxiety, Patient Satisfaction, Child}
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BackgroundEarly stage gastric cancer diagnosis has ensued different approaches in resection strategies. In order to increase the proportion of cases which have undergone radical resection or have reduced the recurrence rate, different pre-operative treatments have introduced. Here, we have verified an active preoperative chemotherapeutic regimen in locally advanced gastric cancer patients.MethodsForty nine patients who have found eligible to enter this phase 2 trial have treated with oxaliplatin 100 mg/m2 IV, docetaxel 50 mg/m2 IV, plus capecitabine 625 mg/m2 PO (TOX). Clinical staging has been following the first 2 cycles of induction chemotherapy. Patients that have further undergone radical surgery, have evaluated for pathological response rate.ResultsAnemia (10.2%), nausea (10.2%) and vomiting (6.1%) were the most frequent grade 3 or 4 adverse effects. Regarding the pathologic staging, 6 patients (12.2%) had complete response (95% CI 3% to 21.4%), 18 of them (36.7%) had partial response (95% CI 23.2% to 50.2%), then 3 patients (6.1%) had stable disease (95% CI 0%-12.8%). Among the patients who had surgery, 22% had pathologic complete response.ConclusionPreoperative chemotherapeutic regimen of TOX seems to be an active and safe neoadjuvant therapy in non metastatic gastric cancer. It should further be considered with concurrent radiotherapy.Keywords: Preoperative period, Chemotherapy, Neoadjuvant Therapy, Stomach neoplasm}
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