Postoperative Morphine Use and Hyperalgesia Are Reduced by Preoperative but Not Intraoperative Epidural Analgesia

2003 ◽  
Vol 98 (6) ◽  
pp. 1449-1460 ◽  
Author(s):  
Joel Katz ◽  
Lorenzo Cohen ◽  
Roger Schmid ◽  
Vincent W.S. Chan ◽  
Adarose Wowk

Background The aim of this study was to evaluate the postoperative morphine-sparing effects and reduction in pain and secondary mechanical hyperalgesia after preincisional or postincisional epidural administration of a local anesthetic and an opioid compared with a sham epidural control. Methods Patients undergoing major gynecologic surgery by laparotomy were randomly assigned to three groups and studied in a double-blinded manner. Group 1 received epidural lidocaine and fentanyl before incision and epidural saline 40 min after incision. Group 2 received epidural saline before incision and epidural lidocaine and fentanyl 40 min after incision. Group 3 received a sham epidural control (with saline injected into a catheter taped to the back) before and 40 min after incision. All patients underwent surgery with general anesthesia. Results One hundred forty-one patients completed the study (group 1, n = 45; group 2, n = 49; group 3, n = 47). Cumulative patient-controlled analgesia morphine consumption at 48 h was significantly lower (P = 0.04) in group 1 (89.8 +/- 43.3 mg) than group 3 (112.5 +/- 71.5 mg) but not group 2 (95.4 +/- 60.2 mg), although the hourly rate of morphine consumption between 24 and 48 h after surgery was significantly lower (P < 0.0009) in group 1 (1.25 +/- 0.02 mg/h) than group 2 (1.41 +/- 0.02 mg/h). Twenty-four hours after surgery, the visual analog scale pain score on movement was significantly less intense (P = 0.005) in group 1 (4.9 +/- 2.2 cm) than group 3 (6.0 +/- 2.6 cm) but not group 2 (5.3 +/- 2.5 cm), and the von Frey pain threshold near the wound was significantly higher (P = 0.03) in group 1 (6.4 +/- 0.6 log mg) than in group 3 (6.1 +/- 0.8 log mg) but not group 2 (6.2 +/- 0.7 log mg). Conclusions Preincisional administration of epidural lidocaine and fentanyl was associated with a significantly lower rate of morphine use, lower cumulative morphine consumption, and reduced hyperalgesia compared with a sham epidural condition. These results highlight the importance of including a standard treatment control group to avoid the problems of interpretation that arise when two-group studies of preemptive analgesia (preincisional vs. postsurgery) fail to find the anticipated effects.

Author(s):  
Ramyathilagam Raju ◽  
Angeline Divya ◽  
Ganesh Rajendran ◽  
James Rufus John

Background: The aim of the study was to compare the efficiency of green tea mouthwash, Listerine mouthwash and Chlorhexidine mouthwash in plaque reduction among orthodontic patients. Methods: The study employed a double blinded, simple randomized, cross over design with a control group consisting of 30 orthodontic patients undergoing fixed appliance therapy. All the subjects were divided into group 1 (Green tea), group 2 (Listerine) and group 3 (Chlorhexidine) as 10 subjects per group. Gingival status was assessed using Sulcus Bleeding Index and plaque accumulation was assessed using Turesky-Gilmore-Glickman modification of Quigley Hein Index. After a relapse period of 15 days, group 1 and 2 were crossed over, however, group 3 remained the same. Indices were again recorded at baseline and 15th day. Results: The mean gingival and plaque score was reduced in all the three groups. However, green tea mouthwash was estimated to have the highest mean difference from 2.17 ± 0.610 at baseline to 1.48 ± 0.474 on the 15th day. Conclusions: Effective use of mouthwashes as supplements for tooth brushing has proved to be beneficial in oral hygiene and maintenance. The findings of this study provide useful insights on the effectiveness of different compositions of mouthwashes. 


2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Lyudmil Terziev ◽  
Violeta Dancheva ◽  
Veneta Shopova ◽  
Galya Stavreva

Aim. To investigate the effects of MnTE-2-PyP on some markers of antioxidant defence system in asthma mice model.Material and Methods. The animals were divided into four groups: group 1, controls; group 2, injected with ovalbumin, group 3, treated with MnTE-2-PyP, and group 4, treated with ovalbumin and MnTE-2-PyP. The activities of superoxide dismutase, catalase, glutathione peroxidase and nonprotein sulfhydryl groups content (NPSH) were determined in lung homogenate.Results. The activities of superoxide dismutase and catalase in group 2 decreased significantly as compared to control group. The decrease of the same enzymes in group 4 was lower and significant as compared to group 2. Changes in the glutathione peroxidase activity showed a similar dynamics. The NPSH groups content decreased in group 2. In group 4 this decrease was relatively lower as compared to group 2.Conclusions. The application of MnTE-2-PyP mitigated the effects of oxidative stress in asthma mice model.


2018 ◽  
Vol 24 (1) ◽  
pp. 37
Author(s):  
Annisa Trissatharra ◽  
Sri Ratna Dwiningsih ◽  
Ratna Sofaria Munir

Objectives: To identify the effect of monoclonal antibody bZP3 at ovarian follicles that undergo atresia and diameter of various ovarian follicles.Materials and Methods: This is a true experimental research with post only control group design. Samples were 36 female mices (Mus musculus) which is divided into 6 groups, there are 3 control groups (group 1, 2, and 3) injected by Phospatase Buffer Saline (PBS) 50µl and 3 treatment groups (group 4, 5, and 6) injected by Mab bZP3 50µl. Group 1 and 4 terminated at 5th day, group 2 and 5 terminated at 10th day, and group 3 and 6 terminated at 20th day. Evaluation of atretic ovarian follicles and diameter of ovarian follicles performed by hematoxylin eosin (HE) and the data processed by parametric statistic.Results: There are no significant in different among groups in the aspect of atretic follicles and diameter of folicles (p>0.05), but descriptively, number of follicles undergo atresia of the follicle primary, secondary, and tertiary treatment group was higher than the control group, except on the 20th day of observation time.Conclusion: administration of Mab bZP3 had no effect to amount of atretic follicles and diameter of folicles during observation time.


2020 ◽  
Vol 11 (1) ◽  
pp. 280-284 ◽  
Author(s):  
Julietpoornamathy J ◽  
Parameswari C.S.

In medical sciences, toxicity is an area wherein extensive studies have been carried to improve the diseases as well as to prevent. So, there is a high requirement for novel and improved alternative therapeutic strategies to manage diseases. The liver is the largest gland in the body, which executes several important mechanisms; it stores minerals and vitamins and releases them in periods of need. The main aim of this study was to give a closer insight into potent non- toxic compounds that is capable of modifying the responses. Animals were divided into five equal groups viz control (Group 1), administered with food and water ad libitum, (Group 2) administered with olive oil, (Group 3) administered with zingerone, (Group 4) administered with concanavalin A, (Group 5) administered with cyclosporine A followed by zingerone. Our results revealed significant changes in liver marker enzymes and liver histology of zingerone treated rats when compared to control rats.  A corollary, zingerone has no toxic effect on hepatocytes and was found to be safe at a dose of 10mg/kg b wt and also ameliorates hepatotoxicity.


2016 ◽  
Vol 4 (2) ◽  
pp. 228
Author(s):  
Hend A. El-Taweel ◽  
Mona H. El-Sayad ◽  
Sahar A. Abu Helw ◽  
Mohammad A. Al-Kazzaz

This study was designed to evaluate antischistosomal activity of Nitazoxanide (NTZ) in Schistosoma mansoni-infected mice compared to Praziquantel (PZQ). Fifty four infected mice were recruited into 3 groups, each of 18 mice. Group 1 was infected non-treated control. Group 2 was infected and then treated with PZQ 500 mg for two days, and group 3 was infected and treated with NTZ 100 mg/kg for seven days. Efficacy of drugs was assessed by Parasitological, and scanning electron microscopic studies. PZQ reduced (4.9%, 22.5% and 50.7%) of faecal eggs, (22%, 22.6% and 55.1%) of intestinal eggs, (20.4%, 44.3% and 46.7%) of hepatic egg counts and (27%, 45.1% and 64.9%) of total worm load whereas, NTZ reduced (4.9%, 22.5% and 50.7%),of faecal eggs, (22%, 22.6% and 55.1%) of intestinal eggs ,(20.4%, 44.3% and 46.7%) of hepatic egg counts and (27%, 45.1% and 64.9%) of total worm load at 1, 2 and 4 WPT, respectively. The percentages of dead eggs were more than 80% after PZQ treatment and only 30% after NTZ at 4 WPT. PZQ showed extensive tegumental damages in male and female worms more than NTZ at 2 WPT. Our findings concluded that Nitazoxanide showed weaker antischistosomal activity in animal models than praziquantel.


Zygote ◽  
2009 ◽  
Vol 18 (1) ◽  
pp. 27-32 ◽  
Author(s):  
J. Wang ◽  
L. Cong ◽  
Z.G. Zhang ◽  
Y.X. Cao ◽  
Z.L. Wei ◽  
...  

SummaryObjective: To investigate the effects of various activation methods on freeze–thawed rabbit oocytes developmental potential. Methods: Rabbit oocytes were vitrified by cryoleafs and cryoprotected with ethylene glycol and propanediol. After thawing, the oocytes were fertilized by intracytoplasmic sperm injection (ICSI). Surviving oocytes after ICSI were divided into five groups at random. Group 1: Oocytes (n = 30) activated 1 h after ICSI by calcium ionomycin (I0634); Group 2: Oocytes (n = 26) activated by strontium chloride an hour after ICSI; Group 3: Oocytes (n = 33) activated by I0634 twice; Group 4: Oocytes (n = 28) were activated by strontium chloride twice; Control Group: Inactivated oocytes (n = 39). Blastocysts derived from each group were transplanted to recipient rabbits. Results: Rates of fertilization, cleavage and blastocyst formation of Group 3 were higher than those of Group 1 and Group 2 (81.8% vs 33.3% vs 53.8%, 54.5% vs 16.7% vs 26.9%, p < 0.05; 15.2% vs 3.3% vs 7.7%, p > 0.05). The rabbit transplanted with embryos derived from Group 3 became pregnant. Embryos derived from double activation could implant into endometrium. Conclusion: Double activation may increase freeze–thawed oocytes developmental potential. After activation, oocytes cleavage velocity may be faster than that of oocytes without activation.


2020 ◽  
Author(s):  
Hacı Öztürk Şahin ◽  
Mehmet Nuri Duran ◽  
Fatma Sılan ◽  
Ece Sılan ◽  
Duygu Sıddıkoglu ◽  
...  

Abstract Background: Premature ovarian failure is among the most important side effects of chemotherapy during reproductive period. Preserving ovarian function is gradually gaining importance during oncologic treatment. The present study aims to investigate the potential of melatonin to protect from cisplatin-induced ovarian toxicity in rats. Twenty nine female rats were divided to three groups: Saline control group (Group 1), cisplatin group (Group 2), and cisplatin+melatonin group (Group 3). While the rats in Groups 2 and 3 were administered 5 mg/kg single dose of cisplatin via intra-peritoneal (IP) route, the rats in Group 3 were started on melatonin (20 mg/kg IP) before cisplatin administration and continued during 3 consecutive days. Ovaries were removed one week after cisplatin administration in all groups. Blood samples were obtained before the rats were decapited. Histological evaluation, follicle count, and classification were performed. TAp63 mRNA expression was evaluated using mRNA extraction and real-time polymerase chain reaction (PCR) method. Serum estradiol (E2) and anti-mullerian hormone (AMH) values were measured with enzyme immune-assay technology. Results: While primordial follicles were seen to decrease in Group 2 as compared to Group 1 (p:0.023), primordial follicle count was observed to be preserved significantly in melatonin group as compared to Group 2 (p:0.047). Moreover, cisplatin-induced histo-pathological morphology was preserved in favor of normal histology in melatonin group. A significant difference was not observed between groups with regard to mean serum AMH and E2 values (p:0.102 and p:0.411, respectively). While TAp63 gene expression significantly increased in Group 2 as compared to control group (p:0.001), we did not detect a statistically significant difference in cisplatin+melatonin group, although gene expression decreased (p:0.34). Conclusion: We conclude that concurrent administration of melatonin and cisplatin may protect from ovarian damage.


2020 ◽  
pp. bjophthalmol-2020-317953
Author(s):  
Miguel Ángel Zapata ◽  
Sandra Banderas García ◽  
Adrián Sánchez ◽  
Anna Falcó ◽  
Susana Otero-Romero ◽  
...  

BackgroundGlobal pandemic SARS-CoV-2 causes a prothrombotic state without fully elucidated effects. This study aims to analyse and quantify the possible retinal microvascular abnormalities.Materials and methodsCase–control study. Patients between 18 and 55 years old with PCR-confirmed SARS-CoV-2 infection within the last 3 months were included. Risk stratification: group 1—mild disease (asymptomatic/paucisymptomatic); group 2—moderate disease (required hospital admission with no acute respiratory distress) and group 3—severe disease (subjects who developed an acute respiratory distress were admitted in the intensive care unit and presented interleukin 6 values above 40 pg/mL). Age-matched volunteers with negative serology tests were enrolled to control group. A colour photograph, an optical coherence tomography (OCT) and an angiography using OCT centred on the fovea were performed.ResultsControl group included 27 subjects: group 1 included 24 patients, group 2 consisted of 24 patients and 21 participants were recruited for group 3. There were no funduscopic lesions, neither in the colour images nor in the structural OCT. Fovea-centred vascular density (VD) was reduced in group 2 and group 3 compared with group 1 and control group (control group vs group 2; 16.92 vs 13.37; p=0.009) (control group vs group 3; 16.92 vs .13.63; p=0.026) (group 1 vs group 2; 17.16 vs 13.37; p=0.006) (group 1 vs group 3; 17.16 vs 13.63 p=0.017).ConclusionPatients with moderate and severe SARS-CoV-2 pneumonia had decreased central retinal VD as compared with that of asymptomatic/paucisymptomatic cases or control subjects.


2019 ◽  
pp. 014556131987431
Author(s):  
Burak Mustafa Taş ◽  
Gökçe Şimşek ◽  
Musa Azman ◽  
Rahmi Kılıç

Ototoxicity is the general name of cochlear and vestibular organ injury resulting from encountering various therapeutic agents and chemical substances. Cisplatin is commonly used in the treatment of many cancers. In this study, the efficacy of intratympanic steroids was compared for preventing cisplatin ototoxicity. In this study, 32 (64 ears) rats were used by separating into 4 groups. Cisplatin was administered intraperitoneally to the first group (n = 8). Methylprednisolone and then cisplatin were administered intratympanically to the second group (n = 8). On the third group (n = 8), dexamethasone and then cisplatin were administered intratympanically. To the fourth group (n = 8), 0.9% NaCl and then cisplatin were given intratympanically. Otoacoustic emission (OAE) measurements and auditory brainstem responses (ABRs) tests were performed on all groups before and 72 hours after the procedure. Pretreatment of ABR-IV values were 4.29 ± 0.19 milliseconds in group 2 and 4.27 ± 0.16 milliseconds in group 3, whereas posttreatment ABR-IV values were 4.95 ± 0.35 milliseconds in group 2 and 4.65 ± 0.26 milliseconds in group 3. The ABR-IV values were measured significantly shorter in the rats given dexamethasone and methylprednisolone, according to control and cisplatin groups ( P < .001). Pretreatment of ABR I-IV interval values were 2.98 ± 0.34 milliseconds and 3.03 ± 0.42 milliseconds in group 1 and group 4, respectively, and ABR I-IV interval values in group 1 and group 4 posttreatment were 3.49 ± 0.39 milliseconds and 3.5 ± 0.39 milliseconds in group 1 and group 4, respectively. Auditory brainstem responses I-IV interval was significantly longer in the cisplatin and control group than in the rats given dexamethasone and methylprednisolone ( P < .001). After cisplatin treatment, OAE amplitudes decreased significantly in group 1 and group 4 for all frequencies, while OAE values were protected in methylprednisolone and dexamethasone group ( P < .001). In conclusion, it has been shown that both agents have protective effects on cisplatin ototoxicity, with dexamethasone slightly more than methylprednisolone.


Phlebologie ◽  
2015 ◽  
Vol 44 (01) ◽  
pp. 13-17
Author(s):  
J. Duben ◽  
J. Gatek ◽  
T. Saha ◽  
G. Hnatkova ◽  
L. Hnatek

SummaryIntroduction: During the last years, many endovascular techniques have been developed in order to eliminate not only the reflux in stem veins but in perforating veins and their tributaries, too.Aim: The aim of this study was to use endo -vascular RFITT and the foam sclerotherapy for the occlusion of perforating veins as the prime source of reflux and their tributaries.Material and Methods: The Celon method was used for the thermal treatment. Polydocalon with the concentration 1% and 2% with DSS technique was used for the foam sclerotherapy. The RFITT was accomplished in 127 perforating veins in total. This group was divided into three subgroups. The first one consists of patients where only RFITT was carried out (n= 41), in the second, there were patients with RFITT realized with sclerotherapy during one session (n= 48), in the third, RFITT was completed with sclerotherapy in one month after the RFITT intervention (n= 38). The control group included perforating veins treated only with sclerotherapy (n= 81). The power setting 6W was used on the generator during the RFITT with CelonProSurge micro and 18W for usage of Celon ProCurve probe.Results: The effectiveness of the procedure in the group 1 was 8.8%, in the group two 93.7%, in the group three 92.1% and in the control group 76.5% in one year follow up. There was no significant difference between the effectiveness in groups 1, 2 and 3. The marginal difference was among all three groups with RFITT and the control group. Significant differences were in the parameter of the extinction of visible varicose veins with the reflux from perforators. The extinction was faster in group 3 than in group 2 and in the control group and the slowest was in group 1. The significant difference was observed between groups 2 and 3 compared with group 1 and the margin difference was between groups 2 and 3 compared with the control group. No significant difference was observed between groups 1 and the control group.Conclusions: All procedures are effective. The most important is the combination of RFITT and the sclerotherapy one month after thermal intervention. This is associated with a low risk of recanalization and the fastest extinction of visible varicose veins.


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