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The effect of menstrual cycle phase on the meperidine and metoclopramide consumption rate for controlling postoperative pain, nausea and vomiting
Sepideh Vahabi , Masoume Ghafarzade , Nahid Lorzade , Mahmood Reza Moradkhani , Behroz Frazan , Parisa Geranghadr ,
Volume 9, Issue 1 (Yafteh 2007)
Abstract

Vahabi S1, Ghafarzade M2, Lorzade N2, Moradkhani MR1, Frazan B1, Geranghadr P3

1. Assistant professor, Department of anesthesiology, Faculty of medicine, Lorestan University of medical sciences

2. Assistant professor, Department of gynecology, Faculty of medicine, Lorestan University of medical sciences

3. General practitioner

Abstract

Background: Postoperative nausea, vomiting (PONV) and pain are common causes of postoperative morbidity. Menstrual cycle may be one of the several factors that influence the incidence of them. This study was done to evaluate the effect of menstrual cycle phase on the on the Meperidine and Metoclopramide consumption rate for controlling postoperative pain, nausea and vomiting.

Materials and methods: On the basis of the menstrual cycle {pre ± menstrual (PD 25-6) follicular phase (PD 8-12) ovulatory phase (PD 13-15) and luteal (PD 20-24)}, 63 patients enrolled in this blinded, prospective study. All patients underwent a standardized surgery. Meperidine 1mg/kg was given to patients who had pain intensity more than 5 on Visual Analog Scale (VAS) intravascularly in recovery, and intramuscularly in the ward. Metoclopramide 0.3mg/kg was administered intravascularly to patients who had vomiting. A blinded person recorded PONV and pain score as well as required amount of Meperidine and Metoclopramide in the recovery and ward arrival time, 6, 12, 18 and 24 hours postoperatively.

Results: At the first 24 h post gynecological operation, PONV score was higher in luteal and follicular phase and lowest in pre ± menstrual phase (P< 0.001, X²= 41.64). The need for Metoclopramide in luteal phase was more than other phases (P < 0.001, X² =32.9). The highest pain score was in luteal phase (P< 0.001, X² =4.6) and the required dose of Meperidine was higher in luteal and follicular phase (P< 0.001, X² = 22.2).

Conclusion: We suggest that scheduling of surgery according to the menstrual phase may reduce the incidence of PONV and postoperative pain intensity as well as the required dose of Meperidine and Metoclopramide and hospitalization costs.


Investigation of arbitrary drug use and factors influencing it in patients admitted to Shahid Rahimi Hospital, Khorramabad in 2021
Ali Kharazmkia, Mahmoudreza Moradkhani, Abbas Asadi, Shahram Ahmadi Somaghian,
Volume 25, Issue 4 (2-2024)
Abstract
Background: Arbitrary use of drugs not only leads to failure to treat  the disease but also leads to drug complications, inconsistency of prevalence of diseases in the country with the amount of drug consumption and the problem of indiscriminate drug consumption in the pharmaceutical system of the country. Therefore, this study was conducted with the aim of investigating self-inflicted medication use factors influencing it among patients admitted to Shahid Rahimi Hospital, Khorramabad.
Materials and Methods: This study was conducted on 381 patients of Shahid Rahimi Hospital, Khorramabad in winter 2021. A simple random sample was drawn and the information of the individuals was collected using a questionnaire. Descriptive statistics were used to summarize the demographic information and a t-test was conducted using SPSS 23 software for comparisons.
Results: According to the results of this study, the average age of people was 34.322±11.438 years. The percentage of arbitrary drug use was 25.3%. The percentage of self -administered medication was 56.8% for painkillers and 56.2% for multivitamins, 71.2% for cold and flu patients and 38% for chronic and acute headaches. The most important reasons for self-medication are, in this order, the higher quality of foreign medicines compared to Iranian medicines and the use of medicinal plants, and the least important reasons for self-medication are fear and shame of medical examinations, lack of trust in doctors' medicine, taking medicines during illness on the advice of acquaintances and the use of previous doctors' prescriptions were mentioned.
Conclusion: Given the high prevalence of self-inflicted drug use, it is suggested that various educational programs be implemented by appropriate organizations, including the Ministry of Health, Treatment and Medical Education, medical centers, and mass media to reduce the factors identified in this study.

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