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Abstract Introduction: Forearm distal fractures are of the most common Fractures in the upper organs. To fix such deformities, hematoma block approach can be applied. Less time, costs, and side effects are of the advantages of this approach, but in some cases a full paninlessness may not be achieved. Thus, The study was purposed to add intravenous phentanil to this approach to provide a better painlessness. Material & Methods: In a clinical experimentation, 40 candidates For surgical refixation of acate forearm under hematoma block aenesthesia were randomly investigated in two case and report groups. Lido caine 1% at 1 mg/kg in the hematoma site and 0.5 mg/kg round the osteoloied angle + intravenous Normal salin (plasbo) was used. Then the same lideocaine dose + 2µg/kg of intravenous Phentanil (5 minutes before the blockage) was injected. Afterward, the patient's tensity was assessed during the injection and fixation. Findings: Both the groups, were under the same condition regarding age and sex. The finds showed that the pain during blocking as well as fixation was significantly more intense in the report group than the case one (P= 0.001). Conclusion: It is concluded that applying the hematoma block method along with intravenous Phentanil decrease the pain all during the blocking as well as fixation process significantly, So more accepted by referring patients.

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Abstract Introduction: Intravenous (IV) administration of Fentanyl bolus elicits cough in more than one – third of the patients. Coughs may sometimes be explosive leading to hypoxia, vomiting, with increases in intracranial, intraocular and intraabdominal pressures. Materials & Methods: This double blind clinical trial included 360 patients below 60 years with ASA status I & II, who were scheduled for elective surgeries. They were randomized into 3 groups of 120. Group I received Normal Saline as placebo, 60 secounds late fentanyl was administred slowly over a period of 30 secounds. Group II was given fentanyl over 5 secounds, 1 minute after Lidocaine, (1.5 mg/kg IV). Group III also received Normal Salin, 60 secounds before the Fentanyl was given in 5 secounds. Fentanyl dose was 2 µg/kg. Then, incidence and severity of cough was recorded, and the results were analyzed using Chi square test. P.value of 0.05 was considered significant. Results: The incidence of cough was 2.5% in group I, 9.2% and 22.5% in groups II & III respectively. The finds showed that the incidence of cough was significantly higher in group III (P<0.001). Occurrence of cough in patients under 18 was more than those above 18 years of age in all the three groups (P=0.001). Conclusion: IV Lidocaine and, in particular,slow rate of Fentanyl administration, significantly minimize Fentanyl-Induced coughing. Also the incidence of evoked cough is much higher in young patients.

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Introduction: Pain due to cancer is one of the major problems of patients affected by malignancies. There are many methods applied for cancer pain management of which opioids consumption is the most important method. Fentanyl is a synthetic opioid represented as a trans- dermal patch used for cancer chronic pain relief. In this study, we evaluated effectiveness of trans-dermal fentanyl patch comparing with placebo in cancer pain. Materials & Methods: This study was designed and performed as a double-blind randomized clinical trial. Patients affected by soft tissue tumors with chronic pain referred to Imam Khomini Hospital during 1385-1386 were investigated and divided randomly into trans-dermal fentanyl patch and placebo groups. The patches appearance in both the groups were the same. Pain severity was measured by visual analogue scale (VAS) 24, 48 and 72 hours after beginning of treatment. Repeated measurement analysis of variances was used. Findings: A total number of 166 patients affected by cancer were divided into two groups–trans dermal group (86 patients) and placebo (80 patients). There was the same age and sex distribution. According to repeated measurement analyses, the pain severity was significantly reduced in trans-dermal fentanyl group more than that of the placebo group (p=0/07). The incidence of side effects was 62 cases (72%) in fentanyl patch group and 31 cases (39%) in placebo group which emphasized that the side effect in trans-dermal fentanyl patch group was more than placebo group significantly (p=./001). Discussion & Conclusion: The accomplished data suggest that trans-dermal fentanyl patch is an effective and safe method in reducing pain in patients affected by soft tissue tumors. Furthermore, trans-dermal fentanyl patch can improve the quality of life in patients affected by soft tissue tumors.

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Introduction: Eye movements during opht-halmic surgery cause irreparable complic-ations. So the aim of this study was to com-pare the combined use of fentanyl and pr-opofol versus alfentanil and propofol to limit patient´s eye movement during cataract surgery under topical anesthesia. Materials & Methods: In this double-blind clinical trial study, patients were randomly divided into two groups. The first Group received Fentanyl 1 µg/kg, and the second one received Alfentanyl 10 µg/kg. Then local anesthesia was done with Tetracaine drops, and cataract surgery was performed by the Phacoemulsification technique. Blood pres-sure and heart rate were measured at the time of injection of anesthesia, and minutes 10 and 30. The rate of eye movement was recorded by an observer surgeon who didn´t know anything about grouping. Findings: 246 patients were evaluated. There was no significant difference between blood pressure and heart rate at minutes 10 and 30. Movement of patients´s eye at minutes 10 (Chi-square=0.000001) and 30 (Chi-squ-are=0.000118) was significantly lower in Alfentanyl group than the other one. Discussion & Conclusion: The results of our study showed that Alfentanyl, in comparison with Fentanyl, causes more analgesia , less movments of the patient´s eye, and higher amount of surgeon´s satisfaction.