Background:Recently, the preemptive analgesic effects of subcutaneous infiltration of tramadol (T) in the site of incision have not been extensively studied. In this study, we investigated the effect of subcutaneous T infiltration before the incision of surgery on post-operative pain, in lower abdomen surgeries.Materials and Methods:This double-blind study was carried out on 90 patients (18-65 years) of American Society Anesthesiologists physical status I and II who were candidates for a lower abdomen surgery during 2011. They were randomly assigned to receive preemptive subcutaneous T or normal saline (NS). The visual analogue scale for pain (VAS) in rest and cough position and opium total dose consumption were compared between two groups in times 0, 15, 30, 60 min and 2, 4, 6, 12, 24 h after the surgery.Results:The VAS in cough and rest position in the first 24 h following the surgery was lower in group T (P < 0.05). Opium consumption was lower in group T (P < 0.05).Conclusion:Subcutaneous preemptive infiltration of T before surgical incision reduces post-operative opioid consumption.

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Objective: Patients with substance use disorders (SUD) under methadone maintenance therapy (MMT) are susceptible to a number of complications (psychological and metabolic disorders). Evidence studies have shown the roles of the glutamatergic system in addiction. N-Acetylcysteine (NAC) enhances extracellular glutamate, and is effective in the treatment of neuropsychiatric disorders. We assessed oral NAC as an add-on to MMT medication for the treatment of SUD. Methods:In the current randomized, double-blind, placebo-controlled clinical trial, outpatients with SUD under MMT who were 18-60 years old received 2400 mg/day NAC (n = 30) or placebo (n = 30) for 12 weeks. Psychological status and metabolic biomarkers were assessed at baseline and the end of the trial. Results:Compared with the placebo group, NAC treatment resulted in a significant improvement in depression score (β −2.36; 95% CI, −3.97, −0.76; p = .005), and anxiety score (β −1.82; 95% CI, −3.19, −0.44; p = .01). Furthermore, NAC treatment resultedThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.