مجله علوم پزشکی پارس
ا ثر ملاتونین و تیزانیدین برپارامترهای همودینامیک و اضطراب دربیماران تحت عمل جراحی کاتاراکت: یک مطالعه کارآزمایی بالینی تصادفی شده دوسویه کور
نوع مقاله : مقاله پژوهشی
نویسندگان
1 گروه ببهوشی، مرکز تحقیقات بیهوشی، مراقبت های ویژه و کنترل درد، دانشگاه علوم پزشکی هرمزگان، بندرعباس، ایران
2 کمیته تحقیقات دانشجویی، دانشگاه علوم پزشکی هرمزگان، بندرعباس، ایران.
3 گروه بیهوشی، مرکز تحقیقات بیهوشی، مراقبت های ویژه و کنترل درد، دانشگاه علوم پزشکی هرمزگان، بندرعباس، ایران.
چکیده
مقدمه: کاتاراکت از بیماری های رایج دنیا و شایع ترین عامل بروز کاهش دید و نابینایی در جهان است و تثبیت پارامترهای همودینامیک در طول عمل جراحی آن بسیار مهم است. بنابراین، مطالعه حاضر با هدف بررسی اثر دو داروی ملاتونین و تیزانیدین بر پارامترهای همودینامیک و اضطراب در بیماران تحت عمل جراحی کاتاراکت انجام شد.
روش کار: این مطالعه کارآزمایی بالینی تصادفی شده دوسویه کور روی 90 بیمار کاندیدای عمل جراحی کاتاراکت در سال 1402 در بیمارستان شهید محمدی بندرعباس انجام شد. بیماران به سه گروه مساوی شامل گروه ملاتونین، گروه تیزانیدین و گروه کنترل (دارونما) تقسیم شدند. پارامترهای همودینامیک شامل فشارخون سیستولیک، دیاستولیک و ضربان قلب، در زمان پایه و هر 5 دقیقه در طول جراحی ثبت شد. پس از اتمام عمل و انتقال بیماران به اتاق ریکاوری، اضطراب پس از عمل در ریکاوری و 24 ساعت پس از عمل به وسیله ابزارهای RASS بررسی شد. تجزیه و تحلیل داده ها با کمک نرم افزار SPSS نسخه21 و با استفاده از آزمون های آماری تحلیل واریانس یک طرفه، مربع کای، بونفرونی و آزمون تعقیبی توکی انجام شد.
یافته ها: ضربان قلب، فشارخون دیاستولیک و سیستولیک با گذشت زمان در هر سه گروه کاهش پیدا کرد. فشارخون دیاستولیک در دقیقه 10جراحی (اواخر جراحی) در گروه تیزانیدین به طور چشمگیری کمتر از گروه کنترل بود (p<0.05). در اتاق ریکاوری، میزان اضطراب در افراد دریافت کننده ملاتونین یا تیزانیدین به طور معناداری کمتر از گروه کنترل بود (p<0.05). هیچ تفاوتی بین میزان اضطراب گروه ملاتونین و گروه تیزانیدین وجود نداشت (p=0.904).
نتیجه گیری: نتایج مطالعه حاضر نشان داد که ملاتونین و تیزانیدین می توانند اضطراب بیماران در فاز حاد پس از جراحی را کاهش دهند. از آنجایی که تیزانیدین ممکن است باعث افت فشار خون شود، به نظر می رسد پیش داروی ملاتونین گزینه بهتری برای کاهش درد و اضطراب بیماران تحت جراحی کاتاراکت باشد.
کلیدواژه‌ها
عنوان مقاله [English]
Investigating the effect of melatonin and tizanidine on hemodynamic parameters and anxiety in patients undergoing cataract surgery: A double- blind randomized clinical trial study
نویسندگان [English]
- Mehrdad Malekshoar 1
- Najla Tahmoresi 2
- Porua Adibi 3
- Tayebe Zarei 3
- Majid Vatankhah 1
1 Department of Anesthesiology, Anesthesiology, Critical Care and Pain Management Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
2 Student Research Committee, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
3 Department of Anesthesiology, Anesthesiology, Critical Care and Pain Management Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
چکیده [English]
Introduction: Cataract is one of the most common diseases in the world and the most common cause of vision loss
and blindness in the world. Stability of hemodynamic symptoms is one of the most important factors during cataract surgery. Therefore, the aim of this study is to investigate the effect of melatonin and tizanidine on hemodynamic parameters and anxiety in patients undergoing cataract surgery.
Materials & Methods: This prospective clinical trial study was conducted on 90 patient's candidates for cataract surgery.
Patients into three equal groups; Melatonin, tizanidine and placebo were divided. Hemodynamic parameters were recorded at baseline and every 5 minutes during surgery. After the operation was completed and the patients were transferred to the recovery room, postoperative anxiety in the recovery room and 24 hours after the operation (calling the patient) was checked by means of RASS tools.
Results: There was no difference in the variables of age, sex, weight between the studied groups. Heart rate, diastolic and systolic blood pressure decreased over time in all three groups. Diastolic blood pressure in the 10th minute of surgery (late surgery) in the tizanidine group was significantly lower than the control group (P<0.05). Tukey's post hoc test showed that in the recovery room, the level of anxiety in people who received melatonin or tizanidine was significantly lower than the control group (P<0.05). There was no difference between the anxiety levels of the melatonin group and the tizanidine group (P=0.904).
Conclusion: The results of this study showed that melatonin and tizanidine can reduce the anxiety of patients in the
acute phase after surgery. Since tizanidine may lower blood pressure, melatonin prodrug seems to be a better option for reducing pain and anxiety in patients undergoing cataract surgery.
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- Melatonin
- Tizanidine
- Hemodynamic Symptoms
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