قدرت اخوان اکبری

دانشیار گروه بیهوشی

مقالات در کنفرانس ها

اخوان اکبری, قدرت, پلاسمای غنی از پلاکت در درمان درد مزمن, 4th International Congress of pain israpm, 2013- ایران- تهران,

A new treatment for pain is becoming popular among orthopedic and pain specialists: the injection of platelet rich plasma (PRP). Most everyone thinks of blood platelets as being responsible for blood clotting after injury which is true. What many people do not know is that blood platelets serve two other important functions. Blood platelets are responsible for bringing white blood cells to the injured area to clean up the remains of dead and injured cells. Most importantly to this discussion, blood platelets release growth factors that are directly responsible for tissue regeneration. These substances are called cytokins and include platelet derived growth factor, epithelial growth factor, and other important growth factors. PRP has been used for years in surgical centers around the US and abroad to improve the success of bone grafting (especially in dental surgery) and also by cosmetic surgeons for speeding healing time and decreasing the risk of infection after surgery. Only in the last few years have doctors and surgeons been experimenting with injecting PRP for the treatment of chronic pain. Tennis elbow, Plantar Fasciitis, Achilles tendonitis/tendonosis, Rotator Cuff Tears, meniscal tears, Osteoarthritis and chronic low back and neck pain are all being treated with the injection of PRP with the goal of regenerating degenerated connective tissue with reports of success. A PRP treatment looks like this: a patient’s blood is drawn and placed into a special collection kit. Using the person’s own blood eliminates the risk of transmission of any blood-borne disease. This kit is placed in a centrifuge for 15 minutes and the platelets and plasma are separated the red and white blood cells. Two thirds of the plasma is removed and discarded and the remaining plasma is mixed with the platelets. This higher than normal concentration of platelets is what gives us platelet rich plasma. The PRP is drawn into a syringe. The area to be treated is injected with a local anesthetic and after waiting five minutes for the anesthetic to take effect, the PRP is injected. The injection technique is identical to Prolotherapy/regenerative injection therapy, only the solution injected is different. Same instrument, different sheet music. Patient generally report two days of being sore and then usually pain relief occurs within the first week and continues to improve over a period of months. To date, one PRP treatment is the therapeutic equivalent of three or four prolotherapy/regenerative injection therapy treatments using dextrose.

 

مقالات در نشریات

اخوان اکبری, قدرت ، محمدیان اردی, علی ، انتظاری, مسعود, ارزیابی اثرات اضافه کردن کتامین به مرفین در بیدردی وریدی با کنترل بیمار بعد از جراحی ارتوپدی, Perspectives in Clinical Research, 5, 2013, Intravenous patient-controlled analgesia , ketamine , morphine , orthopedic surgery


خلاصه مقاله:

Background: Intravenous patient-controlled analgesia (PCA) with morphine is commonly used for post-operative pain after major surgery. Ketamine has analgesic property at lower doses, and in combination with opioids it could have synergistic effect. The aim of this study is to determine effects of the addition of ketamine to morphine for PCA after orthopedic surgery. Materials and Methods: In this double-blind randomized clinical trial, 60 patients were randomly allocated to receive PCA consisting: Group 1 (morphine 0.2 mg/ml), Group 2 (morphine 0.2 mg/ml ketamine 1 mg/ml), and Group 3 (morphine 0.1 mg/ml ketamine 2 mg/ml). In this, anesthesiologists managed study, patients had orthopedic surgery. Assessments were made at 24 h and 48 h post-operatively. Visual analog scale (VAS) was used for recording pain score. PCA morphine use was recorded at 24 h and 48 h. VAS scores over 48 h were analyzed with analysis of variance for repeated measures. Significance level was taken as 0.05. Results: There is no significant difference between demographic information of the three groups ( P > 0.05). Control of pain in Group 2 and Group 3 was better than in Group 1 (only morphine) ( P = 0.001) but there was no significant difference between Group 2 and Group 3 ( P > 0.05). Rate of narcotic consumption in groups 2 and 3 was significantly lower than Group 1 ( P < 0.05). Conclusion: After orthopedic surgery, the addition of ketamine to morphine for intravenous PCA was superior to Intravenous PCA opioid alone. The combination induces a significant reduction in pain score and cumulative morphine consumption.

 




خوشیده, مریم ، میرزارحیمی, تیبا ، اخوان اکبری, قدرت, اثر زایمان فیزیولوژیک وزایمان تسهیل شده برپیامدهای مادری و نوزادی: یک بررسی مقایسه ای در مادران شکم اول, Journal of Family and Reproductive Health, 9, 2014, زایمان فیزیولوژیک،زایمان تسیهل شده،پیامدهای مادری،پیامدهای نوزادی


خلاصه مقاله:

Objective:To compare the effect of the physiologic and facilitated labor on the mother and neonate outcomes in the prim gravid women referring to Arash Hospital. Materials and methods:This clinical trial study was performed on 200 low risk pregnant women referring to Arash Women’s Hospital in 2012-2013. Mothers were divided into two groups of 100 patients using a simple random sampling method. The first group received the on-pregnancy and physiologic labor training and the second group was nominated for facilitated labor without training. The mother and neonate outcomes in these two delivery methods were then compared. Results:The rate of cesarean section in the physiologic group was significantly lower compared with the intervention group (p=0.001). Also in the first stage of labor, VAS was measured to be noticeably lower in the physiologic group in comparison with the intervention group (p=0.001), while the difference of VAS between the two studied groups was found not to be significant in the second stage of labor. In terms of duration of the labor and neonatal Apgar score two groups were not considerably different (p>0.05). Moreover, the laceration rate in the physiologic group was determined to be noticeably higher as compared to the intervention group (p=0.001). The groups were considerably different in terms of the vaginal bleeding and maternal satisfaction (p=0.001). Conclusion:This study revealed the lower rate of cesarean section, abnormal vaginal bleeding and pain score in the physiologic group compared with the facilitated group. Moreover, mothers of the first group were more content with the labor process.

 




پایان نامه ها

اخوان اکبری, قدرت ، انتظاری, مسعود ، فتحی, ندا, بررسی مقایسه ای اثر کتورولاک و پتیدین بر میزان لرز بعد از عمل, 1395, لرز بعد از عمل - پتیدین- کتورولاک

محدوده تاریخ انجام: 1395

سابقه و هدف: لرز بعد عمل جراحی یکی از عوارض شایع به دنبال بیهوشی عمومی است و می تواند منجر به عوارض متعددی شود. مطالعه حاضر جهت ارزیابی اثر تجویز پروفیلاکتیک کتورولاک وریدی بر لرز در مقایسه با پتیدین، طی دقایق اولیه بعد از جراحی در ریکاوری، طراحی شد. مواد و روش ها: در یک کارآزمایی بالینی تصادفی شده دوسو کور، شصت بیمار مطابق با شرایط فیزیکی 1 و 2 انجمن متخصصین بیهوشی آمریکا، در محدوده سنی 20 تا 60 سال که جهت انجام جراحی شکمی (کوله سیستکتومی و لاپاراتومی) تحت بیهوشی عمومی برنامه ریزی شده بودند، به صورت تصادفی به دو گروه تقسیم شدند، که 30 میلی گرم کتورولاک (یک مهار کننده سیکلواکسیژناز غیر انتخابی) وریدی یا mg/kg 5/0 پتیدین (مپریدین)، 20 تا 30 دقیقه قبل از اتمام عمل جراحی دریافت کردند. بعد از اتمام جراحی در ریکاوری بروز و درجه لرز بعد از عمل و نمره درد به ثبت رسید. یافته ها: اطلاعات دموگرافیک، مدت زمان عمل جراحی و نمره درد بعد عمل در دو گروه تفاوت معناداری نداشت. لرز بعد عمل جراحی در 4 نفر از گروه پتیدین مشاهده شد (13/33%) و این تعداد 7 نفر در گروه کتورولاک بود (23/33%) (36/0 = p). تهوع واستفراغ بعد عمل در ریکاوری در گروه پتیدین نسبت به گروه کتورولاک شایع تر بود (016/0 = p). نتیجه گیری: کتورولاک با دوز 30 میلی گرم وریدی، 20-30 دقیقه قبل از اتمام عمل جراحی به اندازه پتیدین با دوز mg/kg 5/0 وریدی به عنوان یک ضد لرز مؤثر است و با تهوع واستفراغ بعد از عمل کمتری همراه است.


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