Najmeh Zarei Jelyani; Razieh Sadat Mousavi-Roknabadi; Mohamad Javad Andalibi; Afsaneh Dehbozorgi; Faramarz Farahmand,
Abstract
Background: Several studies have been performed to evaluate the efficacy of different pain management techniques in patients with trauma, using different methods.Objectives: To compare Intravenous (IV) morphine vs. fentanyl for analgesic response, the time to reach lowest pain score, and adverse effects ...
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Background: Several studies have been performed to evaluate the efficacy of different pain management techniques in patients with trauma, using different methods.Objectives: To compare Intravenous (IV) morphine vs. fentanyl for analgesic response, the time to reach lowest pain score, and adverse effects in patients with trauma who were referred to Emergency Department (ED) was investigated.Methods: This double-blind randomized controlled trial (June-December 2017) was performed on adult traumatic patients, who were referred to the EDs of two main trauma centers (Affiliated to Shiraz University of Medical Sciences), in southern Iran. The inclusion criteria were acute pain >4 on a Numeric Rating Scale (NRS) 0-10 upon presentation. The patients were randomly allocated to receive a single dose of IV morphine (0.1 mg/kg) or IV fentanyl (2 µg/kg). The pain score was recorded at baseline, 5, 10, 30, and 120 minutes after administration of either morphine or fentanyl, as well as adverse effects. Then, the data were analyzed.Results: In order to carry out this study, 167 patients were enrolled. The initial NRS in both groups were similar. The mean ± SD of NRS at all times was higher in the fentanyl group, except in 10 minutes, but only in 120 minutes, this difference was statistically significant (p= 0.01). The mean ± SD of pain reduction in all times was similar in both groups. The incidence of adverse effects in both groups were not different (p = 0.18).Conclusion: According to findings, IV fentanyl had a similar analgesic effect to IV morphine in traumatic patients with acute pain. Also, there was no significant difference in terms of adverse effects between groups.
Tuba Erdem Sultanoğlu; Hasan Sultanoğlu
Abstract
Background: Overcrowding of emergency departments (EDs), which are not suitable places to treat chronic pain and are responsible for managing acute disorders, leads to prolonged waiting times, delays in treating conditions requiring rapid intervention, patient dissatisfaction, and chaos and exhaustion ...
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Background: Overcrowding of emergency departments (EDs), which are not suitable places to treat chronic pain and are responsible for managing acute disorders, leads to prolonged waiting times, delays in treating conditions requiring rapid intervention, patient dissatisfaction, and chaos and exhaustion in the ED.Objectives: Examine the characteristics of patients who presented to the ED with non-malignant chronic pain to determine the frequency of use and factors that caused ED use.Methods: This cross-sectional study was conducted in an ED. Three hundred ninety-two patients with chronic pain were included.Results: The mean age of the patients was 48.1 ± 15.3 years, 62.2% were female, and 37.8% were male. Of the patients, 59.2% were married, 42.6% had elementary school education, and 56.1% were unemployed. The most common cause of ED admission was low back pain (LBP), the 32.7% used non-steroidal anti-inflammatory drugs, 16.3% used opioid analgesics, 15.8% used anticonvulsants, 13.2% used anticonvulsants antidepressant drugs, 22% did not use any medication. The reasons for presenting to the ED for chronic pain were 13.3% for medication prescription, 74.5% for receiving analgesics, and 12.2% for a diagnosis. The mean Patient Health Questionnaire-9 (PHQ-9) scale score of the participants was 12.82 ± 3.98, which indicated moderate depressive symptoms. The mean Generalized Anxiety Disorder-7 scale score was 9.84 ± 3.23, which indicated mild generalized anxiety disorder.Conclusion: Instead of trying to suppress pain, emphasis should be put on preventing overcrowding in EDs, which are intended to manage acute conditions rather than chronic pai
Mehdi Torabi; Fahimeh Shojaee; Moghaddameh Mirzaee
Abstract
Background: Kidney calculi are the most common cause of kidney failure.Objectives: This study aimed to investigate the prevalence of renal colic and its risk factors in the patients referred to two emergency departments during a year.Methods: This was a descriptive cross-sectional study conducted in ...
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Background: Kidney calculi are the most common cause of kidney failure.Objectives: This study aimed to investigate the prevalence of renal colic and its risk factors in the patients referred to two emergency departments during a year.Methods: This was a descriptive cross-sectional study conducted in two hospitals in Kerman city, south-east of Iran, for one year from March 2019 to March 2020. All the archives of the two emergency departments were reviewed, and the required information was recorded in a checklist. The data was analyzed in SPSS 20 software.Results: A total of 504 patients were included in the study. The prevalence of renal colic was 0.5%. Most of the patients (58.5%) had an age between 19 and 39 years, and the majority (60.1%) were males and had a body mass index (BMI) above 25. A family history of renal colic was reported in 68.7% of the patients, and 63.9% had either hypertension or diabetes. Most of the patients consumed less than 3 liters of water per day. The highest referrals were seen in autumn (31.5%) and summer (27.4%).Conclusion: Considering the relationship between renal colic and age, sex, BMI, occupation, a family history of the disease, the presence of underlying diseases, the amount and type of drinking water, and the season of referral, it is recommended to control these risk factors to reduce the incidence of the disease.
Mohammad Javad Behzadnia