Results of this study indicates a significant effect of concomitant use of intravenous acetaminophen and diclofenac suppository on pain severity reduction and reducing the need for repeated doses of narcotics and prolonging the postoperative analgesia.

Introduction: Ensuring the clinical competencies of nurse anesthetists is an essential professional standard. The key and primary step in the assessment of nurse anesthesia educational programs is to understand the essential competencies from the perspective of anesthesia service providers in response to the community needs. This study aimed to determine the clinical competencies of nurse anesthetists for meeting the needs of the community. Materials and Methods: This descriptive survey was based on the classical Delphi method. The study was conducted in three stages. In the first stage, 25 questions were prepared by a non-systematic literature review. In the second and third stages, a list of clinical competencies for nurse anesthetists was determined. For assessing the content validity, two indices of content validity ratio and content validity index were calculated. Data were analyzed by SPSS software (version 16) using descriptive statistics and consensus validity. Results: After analyzing the data in the first stage, one item was removed from the 25 selected items, and 11 items were added to the initial checklist. The maximum and minimum coefficient of agreement was 100 and 0.54, respectively. The findings of the second stage showed that the percentage of agreement in 35 items was at least 70.7 and maximum 95.1. A competence from the education dimension was removed with a percentage of agreement of 0.59 and a total of 34 items were approved. Conclusions: This study determined the clinical competencies of nurse anesthetists. The development of clinical competencies for these nurses could be the starting point for understating, analyzing and planning in order to improve the quality of services provided.

15(2):8-13. Relationship between knowledge toward anesthesia and Fear of anesthesia in the patients and their Companions in Teaching Hospitals of Golestan University of Medical Sciences , 2017Introduction: Surgery and anesthesia are the common practice for anesthetist on the one hand and very worrying for the patient and his family on the other. This fear can have potentially dangerous consequences. The aim of this study was to determine the relationship between the awareness and fear of patients and their companions towards anesthesia. Methods:The present study employed a descriptive-analytic design. The instrument was a questionnaire with 38 items consisting of 20 items for fear of anesthesia, 13 items for awareness of anesthesia, and 3 items for the role of anesthesia personnel. The research population included patients undergoing surgery and their companions. The sample population was selected using non-random sampling. Data was analyzed using SPSS software version 16.Results: In this study, 328 patients and 325 patients' companions (n = 653) were enrolled. The mean score of fear of anesthesia for patients and their companions was 77.56 ± 20.15 and 82.56 ± 20.51, respectively. The mean score of anesthesia awareness for patients and their companions was 6.27 ± 2.33, 33.6 ± 2.86, respectively. No significant correlation was found between fear and anesthesia awareness among patients. Conclusion:The results of the study showed that patients and their companions had a relatively high degree of fear towards anesthesia and did not have enough awareness about anesthesia and its related factors. Therefore, it seems that provision of educational and anesthetic counseling before surgery can be very helpful in order to improve the conditions.