بررسی میزان شدت درد ناشي از تزريق اتومیدیت در دست غالب در مقایسه با دست غیر غالب در بيماران كانديد عمل جراحي الكتيوكوله سيستكتومي لاپاراسكوپيك در بيمارستان شريعتي در سال 94-95

بررسی میزان شدت درد ناشي از تزريق اتومیدیت در دست غالب در مقایسه با دست غیر غالب در بيماران كانديد عمل جراحي الكتيوكوله سيستكتومي لاپاراسكوپيك در بيمارستان شريعتي در سال 94-95

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اتومیدیت داروی داخل وریدی جهت خواب آورب و بیهوشی عمومیست که به علت عملکرد مناسب قلبی-عروقی بسیار پر استفاده است. یکی از عوارض شایع آن درد هنگام تزریق است، در این مطالعه درد هنگام تزریق اتومیدیت در دست غالب و غیر غالب ۳۰ بیمار ار هر دو جنس در محدوده‌ی سنی ۲۵-۵۰ سال که کاندید عمل جراحی الکتیو کوله‌سیستکتومی لاپاروسکوپیک بودند را با هم مقایسه کرده‌ایم . پس از ورود به اناق عمل برای همه بیماران دو گانولای شماره ۲۰ در ورید پشت هر دو دست تعبیه میشود. پس از اینفیوژن ۱۰۰ml نرمال سالین به مدت ۱۰ دقبقه، دو متخصص بیهوشی به طور همزمان ۲ml اتومیدیت با سرعت یکسان را در هر دو دست تزریق می‌کنند. از بیماران در خصوص درد یا احساس ناراحتی در محل تزریق واضحا سوال شدونمره از صفر تا ده به هر دست داده میشود كليد واژه ها : درد محل تزریق اتومیدیت   مشخصات دانشجو: نام:آیدا الهیاری رشته تحصيلي:پزشکی مقطع:دکتری حرفه‌ای            گروه آموزشي  بیهوشی          پست الكترونيك دانشجو: a-allahyari@student.tums.ac.ir اساتيد راهنما و داور: استاد راهنما دکتر علی موافق    اساتيد مشاور دکتر امید عظیم عراقی   اساتيد داور دکتر سلیمی‌نیا دکتریکتا, زمان دفاع :    روز  تاريخ  1395/7/12 ساعت10:30 مكان دفاع به آدرس: تهران، امیر اباد شمالی، بیمارستان دکتر شریعتی اطلاعات به زبان انگليسي Title: Effect of hand dominance on pain caused by injection of Etomidate in patients undergoing elective laparoscopic surgery   Abstract: Objective: Etomidate is an intravenous anaesthetic agent used to induce general anaesthesia. One of the adverse effects of this drug is pain on injection. The aim of the present study was to compare the injection pain of Etomidate between right and left hand in regards to handedness in candidates for elective surgery. Methods: This study is a double-blind, randomized clinical trial. 60 patients aged 25 to 50 years (31 males and 29 females) of American Society of Anaesthesiologists (ASA) physical status class I or II, whom were candidates for elective laparoscopic cholecystectomy surgery entered this study. 29 were right handed and 31 were left handed. After infusion of 100 ml of Normal Saline through 20 gauge cannulas which were placed into dorsum of both hands, 2 mg (1 ml) of Etomidate is injected by two anaesthesiologists with similar rates into the IV lines. The patient gave a score to each respective hand based on a Visual Analogue Scale. Results: Significant difference was found in pain perception between dominant and non-dominant hand. The subjects reported higher VAS score in the dominant hand. The mean VAS score in dominant hand was 6.03±0.80 versus 4.66±1.24 in non-dominant hand among either right handed or left handed individuals (P-value <0.05). VAS score was significantly higher in the dominant hand among left-handed individuals, with a mean of 6.52±0.6, while the mean VAS for dominant hand among right-handed subjects was 5.52±0.5, (p-value <0.05). There was no significant difference in the VAS score in the non-dominant hand among the right-handed versus left-handed individuals (4.51±1.5 vs. 4.80±0.8 respectively) (P= 0.37) Conclusion: This study points out the importance of handedness in pain on injection of Etomidate. This study illustrates the fact that the amount of pain imposed upon patients by injecting Etomidate could be somewhat lessened by using the non-dominant hand as the injection site. Keywords: Pain on injection, Etomidate   فهرست منابع و ماخذ فارسي و لاتين:     (1) Katzung, Bertram G., Susan B. 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Anaesth. 83:464–466.   (24) Klement W, Arndt JO. Pain on i.v. injection of some anaesthetic agents is evoked by the unphysiological osmolality or pH of their formulations. Br J Anaesth. 1991 Feb;66(2):189-95. (25) Holdcroft A, Morgan M, Whitwam JG, Lumley J. Effect of dose and premedication on complications with etomidate. Br J Anaesth 1976;48:199-205.   (26) Doenicke A, Roizen, Michael F. MD; Nebauer, Alexander E. MD; Kugler, A. MD; Hoernecke, Rainer MD; Beger-Hintzen, H. MD A Comparison of Two Formulations for Etomidate, 2-Hydroxypropyl-$bT-cyclodextrin (HPCD) and Propylene Glycol. Anesthesia & Analgesia: November 1994 - Volume 79 - Issue 5   (27) Brown P.M., MB, ChB, Reduction of pain on injection of etomidate Anaesthesia Volume 36, Issue 8, pages 814–816, August 1981 (28) Nyman Y1, Von Hofsten K, Etomidate-Lipuro is associated with considerably less injection pain in children compared with propofol with added lidocaine. Br J Anaesth. 2006 Oct;97(4):536-9. 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