Intra-articular remifentanil on postoperative pain in knee arthroscopic surgery; a double blind randomized clinical trial

BACKGROUND

We aimed to assess the efficacy of intra-articular remifentanil in relieving postoperative pain after knee arthroscopy.

METHODS

We conducted a double-blind randomized clinical trial study on 60 patients. Patients were divided into two equal groups. The control group received 25 ml of intra-articular normal saline, and the intervention group received 200 μg of remifentanil dissolved in 25 ml of saline. We evaluated at rest postoperative pain at 1, 3, 6, 12, 18, and 24 h after the surgery using the Visual Analog Scale (VAS). Patients with VAS scores of 4 or more received meperidine (pethidine). The first time meperidine was requested and the total amount of meperidine consumed was recorded.

RESULTS

Out of 60 patients, 49 were male (81.6%), and the mean age of participants was 32.71 (7.02) years. An hour after the surgery, the control group showed a mean VAS score of 8.66 (1.26), and decreased to 2.53 (1.67) at the end of 24 h. The intervention group started with a mean VAS score of 2.23 (1.81) and ended at 0.10 (0.305). All patients in the control group and 11 (36.7%) patients in the intervention group asked for analgesics during follow-up. The mean total meperidine dose in the control and intervention groups was 108.33 (23.97) mg and 13.33 (19.40) mg, respectively (P < 0.001; 95% confidence interval of the difference 83.72 to 106.27).

CONCLUSIONS

Intra-articular remifentanil may decrease postoperative pain and analgesic requirements in patients undergoing knee arthroscopy.

The Relation between Academic Achievement and Emotional Intelligence in Iranian Students: A Meta-Analysis

Academic achievement is one of the most important concepts in the field of education. Although emotional intelligence, as a key factor in academic achievement, has been studied in various studies, yet the results obtained are not in harmony with each other and the topic is yet under debate. In order to fill in this informational vacuum, the present research was undergone using a meta-analysis method.

In order to make a thorough search to find articles within the Iranian context, key words such as “Emotional Intelligence” AND (Emotional OR Intelligence) AND “academic achievement” OR “academic status” AND “Student” AND “Iran”, were used without limitation in dates or language in the following sites: Medline, Scopus, ScienceDirect, Web of Knowledge, Ovid, Wiley, Google Scholar, and Persian databases such as SID, Irandoc and Magiran. The random effect model was utilized for statistical pooling.

A total of 23 articles were chosen to enter the meta-analysis. The pooled results showed a meaningful relationship between emotional intelligence and academic achievement (Pooled Correlation = 0.157; 95% CI, 0.081-0.231). The Cochran Q (Q = 145:126, p = 0.000) and I2 = 84.84% index indicated a high heterogeneity among the articles entering the meta-analysis. In subgroup analysis, the students in state universities had more summary effect (0.177; 95% CI, 0.085 - 0.267) compared to the ones studying in private ones (0.118; 95% CI, 0.024-0.255). No sign of publication bias was found.

A weak correlation was seen between emotional intelligence and educational achievement in the context of Iranian university students. It seems that the relationship of these concepts may be affected by other factors in this setting, so this calls for further studies in this field.

Development of a Minimum Data Set (MDS) for C-Section Anesthesia Information Management System (AIMS)

Background

Caesarean section, also known as C-section, is a very common procedure in the world. Minimum data set (MDS) is defined as a set of data elements holding information regarding a series of target entities to provide a basis for planning, management, and performance evaluation. MDS has found a great use in health care information systems. Also, it can be considered as a basis for medical information management and has shown a great potential for contributing to the provision of high quality care and disease control measures.

Objectives

The principal aim of this research was to determine MDS and required capabilities for Anesthesia information management system (AIMS) in C-section in Iran.

Methods

Data items collected from several selected AIMS were studied to establish an initial set of data. The population of this study composed of 115 anesthesiologists was asked to review the proposed data elements and score them in order of importance by using a five-point Likert scale. The items scored as important or highly important by at least 75% of the experts were included in the final list of minimum data set.

Results

Overall 8 classes of data (consisted of 81 key data elements) were determined as final set. Also, the most important required capabilities were related to airway management and hypertension and hypotension management.

Conclusions

In the development of information system (IS) based on MDS and identification, because of the broad involvement of users, IS capabilities must focus on the users’ needs to form a successful system. Therefore, it is essential to assess MDS watchfully by considering the planned uses of data. Also, IS should have essential capabilities to meet the needs of its users.

Hospital Information Systems Implementation: An Evaluation of Critical Success Factors in Northeast of Iran

<p><strong>INTRODUCTION:</strong> Implementation of hospital information systems (HIS) is considered as a difficult and sensitive task in terms of its scope and its mission to collect identity-related, demographic, clinical and managerial data of patients in an integrative manner as well as due to the changes it makes in users’ working practices. The purpose of the present study was to investigate users’ views and attitudes towards the key elements of successful implementation of HIS.</p><p><strong>METHODOLOGY:</strong> This applied study was conducted in a descriptive cross-sectional form. To this end, 248 users of HIS at teaching hospitals in the city of Mashhad (Northeast of Iran) were selected through stratified random sampling, and then a questionnaire was distributed to collect the required data. After collecting the questionnaires, data was entered into the SPSS software and the findings were examined by using descriptive statistics (frequency) and then illustrated in tables and diagrams.</p><p><strong>RESULTS:</strong> Functional factors, meeting users’ needs and ease of use had the highest prominence in successful implementation of a HIS. This mean that HIS considering demands of users is the first critical success factors in HIS implementation.</p><p><strong>CONCLUSION: </strong>The analysis of the research findings demonstrated that three groups including system users, technical operators (professionals) and managers have important role in implementation of HIS. Furthermore, successful implementation of HIS was required to be performed through a formulated program with specified time, costs, and manpower in which the employment and participation of various users of the system had been precisely defined. In this respect, financial supports and presence of hospital management team in meetings and decisions was also of utmost importance.</p>