scholarly journals A comparative study of serotonin and norepinephrine as adjuncts to improve cutaneous antinociception of mexiletine in response to skin pinpricks in rats

2021 ◽  
Vol 35 ◽  
pp. 205873842110161
Author(s):  
Mingming Han ◽  
Fang Kang ◽  
Chengwei Yang ◽  
Mingyu Zhai ◽  
Kesong Zheng ◽  
...  
Keyword(s):  
Comparative Study ◽  
Local Anesthetics ◽  
Subcutaneous Injection ◽  
Sensory Block ◽  
Subcutaneous Injections ◽  
Injection Dose ◽  
The Difference

As adrenaline, serotonin and norepinephrine are two other vasoconstrictors and both of which have been proved to increase the quality and duration of local anesthetics when added as adjuvants. However, the difference in the improvement of the nociception of local anesthetics between the two adjuvants remains unclear. The purpose of this study was to assess the cutaneous nociception of mexiletine by coadministration with serotonin and norepinephrine. Subcutaneous injection of drugs or combinations includes mexiletine 0.6, 1.8, 6.0 μmol, serotonin 1.6500 μmol, noradrenaline 0.8895 nmol, saline, mexiletine 1.8 and 6.0 μmol, respectively combined with serotonin 0.4125, 0.8250, 1.6500 μmol and noradrenaline 0.0356, 0.1779, 0.8895 nmol, with each injection dose of 0.6 ml. The nociception of mexiletine alone and mexiletine coadministered with serotonin and norepinephrine was assessed after subcutaneous injection. Subcutaneous injections of mexiletine elicited dose-related cutaneous antinociception ( P < 0.05, 0.01, or 0.001). Compared with mexiletine (1.8 μmol), adding norepinephrine (except for lowest dose) and serotonin to mexiletine (1.8 μmol) solutions for skin nociceptive block potentiated and prolonged the action ( P < 0.01 or 0.001). Mexiletine (6.0 μmol) combined with norepinephrine and serotonin extended the duration of cutaneous antinociception when compared with mexiletine (6.0 μmol) alone ( P < 0.05, 0.01, or 0.001). Both serotonin and norepinephrine improve the sensory block and enhances the nociceptive block duration of mexiletine, and serotonin is superior to that of norepinephrine.

Comparison of Adrenaline and Dexmedetomidine in Improving the Cutaneous Analgesia of Mexiletine in Response to Skin Pinpricks in Rats

Pharmacology ◽  
2020 ◽  
Vol 105 (11-12) ◽  
pp. 662-668
Author(s):  
Mingming Han ◽  
Fang Kang ◽  
Chengwei Yang ◽  
Ziyou Liu ◽  
Ting Wang ◽  
...  
Keyword(s):  
Experimental Research ◽  
Local Anesthetics ◽  
Analgesic Effect ◽  
Sensory Block ◽  
Mechanisms Of Action ◽  
High Dose ◽  
Low Doses ◽  
Subcutaneous Injections ◽  
Injection Dose ◽  
The Difference

<b><i>Background:</i></b> Adrenaline (Adr) and dexmedetomidine (Dex) are commonly used adjuvants of local anesthetics; however, the difference in the improvement of analgesia of local anesthetics between the 2 adjuvants remains unclear. <b><i>Objective:</i></b> The objective of this experimental research was to evaluate the cutaneous analgesic effect of mexiletine (Mex) by coadministration with Dex or Adr. <b><i>Methods:</i></b> The effect of a nociceptive block was assessed based on the inhibition of the cutaneous trunci muscle reflex in response to skin pinpricks in rats. The analgesic activity of Mex alone and Mex coadministered with Dex or Adr was evaluated after subcutaneous injections. Subcutaneous injections of drugs or combinations include Mex 0.6, 1.8, and 6.0 μmol; Adr 13.66 nmol; Dex 1.05600 nmol; saline; and Mex 1.8 and 6.0 μmol, respectively, combined with Dex 0.01056, 0.10560, and 1.05600 nmol or Adr 0.55, 2.73, and 13.66 nmol, with each injection dose of 0.6 mL. <b><i>Results:</i></b> Subcutaneous injections of Mex elicited dose-related cutaneous analgesia. Compared with Mex (1.8 μmol), adding Dex or Adr to Mex (1.8 μmol) solutions for skin nociceptive block potentiated and prolonged the action. Mex (6.0 μmol) combined with Dex or Adr extended the duration of cutaneous analgesia when compared with Mex (6.0 μmol) alone. A high dose of Adr is more effective with Mex 1.8 μmol than that of Dex, whereas medium and low doses were less effective. Mex 6.0 μmol combined with any dose of Adr is superior to that of Dex. <b><i>Conclusions:</i></b> Both Dex and Adr improve the sensory block and enhance the nociceptive block duration of Mex. But in most cases, Adr is superior to Dex. It may be that different mechanisms of action of the 2 adjuvants lead to the differences.

scholarly journals Selecting the ideal adjuvant to improve neuraxial and regional analgesia: A narrative review

2020 ◽  
Vol 24 (6) ◽  
Author(s):  
Dmytriiev Dmytro ◽  
Nazarchuk Oleksandr ◽  
Dmytriiev Kostiantyn ◽  
Lysak Evgenii ◽  
Zaletska Olesya
Keyword(s):  
Local Anesthetics ◽  
Sensory Block ◽  
Narrative Review ◽  
Regional Analgesia ◽  
Effect Duration ◽  
The Difference ◽  
Time To Onset ◽  
Crucial Part ◽  
Better Than ◽  
The Ideal

Introduction: The aim of this review was to systematize known facts about the effects of adjuvants to local anesthetics for neuraxial and regional analgesia in order to determine the adjuvant with the best effect among all others. More precisely to consider the time to onset, the strength of the effect, duration of the motor and sensory block and some additional effects such as ‘marker of intravascular injection’, safety and toxicity profile. We aimed to find an ideal adjuvant which has all these properties to a good degree. Methodology: For this narrative review we searched the information in Medline, PubMed, Scopus, and Embase databases. 105 articles were identified regarding the topic, published since 1989 to 2020. Data from 105 articles about adjuvants to local anesthetics was analyzed and synthesized in this review. Results: Regional methods of analgesia are becoming a crucial part of anesthesiologists’ practice and the knowledge about adjuvants is developing alongside with it, so there are more and more studies devoted to it. All of them try to find the “ideal” adjuvant, having sufficient necessary effects, but we think that due to the difference in various classes of adjuvants, some may be better than others. However, use of combination of adjuvants is not desirable at all times. Conclusion: A variety of adjuvants to local anesthetics are available now, yet the data about most of them remains inconclusive, so more studies are required to found out the best adjuvants with the most desirable profile and the least adverse effects Key words: Local anesthetic; Adjuvants; Pain management; Regional anesthesia. Citation: Dmytro D, Oleksandr N, Kostiantyn D, Evgenii L, Olesya Z. Selecting the ideal adjuvant to improve neuraxial and regional analgesia: A narrative review. Anaesth. pain intensive care 2020;24(6):---; DOI: 10.35975/apic.v24i6.1209 Received: 24 March 2020, Reviewed: 23 April, 25 June 2020, Revised: 18 October 2020, Accepted: 27 October 2020

Blinded, Randomized, Multicenter Study to Evaluate Single Administration Pegfilgrastim Once per Cycle Versus Daily Filgrastim as an Adjunct to Chemotherapy in Patients With High-Risk Stage II or Stage III/IV Breast Cancer

2002 ◽  
Vol 20 (3) ◽  
pp. 727-731 ◽  
Author(s):  
F.A. Holmes ◽  
J.A. O’Shaughnessy ◽  
S. Vukelja ◽  
S.E. Jones ◽  
J. Shogan ◽  
...  
Keyword(s):  
Subcutaneous Injection ◽  
Chemotherapy Cycle ◽  
Severe Neutropenia ◽  
Double Blind ◽  
Subcutaneous Injections ◽  
Single Subcutaneous Injection ◽  
Treatment Groups ◽  
Safety Parameters ◽  
The Difference ◽  
To Receive

PURPOSE: This multicenter, randomized, double-blind, active-control study was designed to determine whether a single subcutaneous injection of pegfilgrastim (SD/01, sustained-duration filgrastim; 100 μg/kg) is as safe and effective as daily filgrastim (5 μg/kg/d) for reducing neutropenia in patients who received four cycles of myelosuppressive chemotherapy. PATIENTS AND METHODS: Sixty-two centers enrolled 310 patients who received chemotherapy with docetaxel 75 mg/m2 and doxorubicin 60 mg/m2 on day 1 of each cycle for a maximum of four cycles. Patients were randomized to receive on day 2 either a single subcutaneous injection of pegfilgrastim 100 μg/kg per chemotherapy cycle (154 patients) or daily subcutaneous injections of filgrastim 5 μg/kg/d (156 patients). Absolute neutrophil count (ANC), duration of grade 4 neutropenia, and safety parameters were monitored. RESULTS: One dose of pegfilgrastim per chemotherapy cycle was comparable to daily subcutaneous injections of filgrastim with regard to all efficacy end points, including the duration of severe neutropenia and the depth of ANC nadir in all cycles. Febrile neutropenia across all cycles occurred less often in patients who received pegfilgrastim. The difference in the mean duration of severe neutropenia between the pegfilgrastim and filgrastim treatment groups was less than 1 day. Pegfilgrastim was safe and well tolerated, and it was similar to filgrastim. Adverse event profiles in the pegfilgrastim and filgrastim groups were similar. CONCLUSION: A single injection of pegfilgrastim 100 μg/kg per cycle was as safe and effective as daily injections of filgrastim 5 μg/kg/d in reducing neutropenia and its complications in patients who received four cycles of doxorubicin 60 mg/m2 and docetaxel 75 mg/m2.

Comparative Study of Size, Total Protein, Fibrinogen and 5-HT Content of Human and Canine Platelet Density Subpopulations

1986 ◽  
Vol 56 (03) ◽  
pp. 288-292 ◽  
Author(s):  
Diego Mezzano ◽  
Eduardo Aranda ◽  
Arnaldo Foradori
Keyword(s):  
Comparative Study ◽  
Protein Content ◽  
Cell Density ◽  
Total Protein ◽  
Unit Volume ◽  
Low Density ◽  
Dense Bodies ◽  
Artifactual Changes ◽  
Platelet Release ◽  
The Difference

SummaryThe size, total protein, fibrinogen and 5-HT content were evaluated in density subpopulations of human and canine platelets fractionated in linear arabinogalactan gradients. The methodology was assessed to ascertain that platelet separation was by density and to discard artifactual changes and platelet release during the procedure. EDTA or PGEi increased the size of human PRP-platelets, but not of dog platelets. In humans, high density (HD) platelets were 1.26 times larger and contained 1.88 times more fibrinogen, 2.23 times more 5-HT and 1.37 times more protein than low density (LD) platelets; in dogs, these density cohorts did not differ in protein content, but LD platelets were 1.29 times larger and had 1.33 times more fibrinogen and 5-HT than HD platelets. These findings suggest that cell density is mostly dependent on the protein content per unit volume of platelets (and not on dense bodies). The differences in fibrinogen and 5-HT content between HD and LD cohorts in humans and dogs may be related to platelet age. The difference in volume between HD and LD platelets in dogs is of uncertain interpretation.

Pandhawa Gubah sebagai Representasi Interaksi Metafisik Manusia Jawa dan Perbandingannya dengan Cheritera Pandawa Lima

Manuskripta ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. 67
Author(s):  
Novarina Novarina
Keyword(s):  
Comparative Study ◽  
Literary Theory ◽  
Research Method ◽  
Descriptive Analysis ◽  
Literary Study ◽  
Analysis Method ◽  
Research Objects ◽  
Similarities And Differences ◽  
The Difference ◽  
The Comparative Study

Abstract: This research is a comparative literary study that uses Malay and Javanese versions of Mahabarata text sources. The research objects used were the text edition of Pandhawa Gubah (PG) by Sudibjo Z. Hadisutjipto and the text of Cheritera Pandawa Lima (CPL) by Khalid Hussain. The research method used is descriptive-analysis method. In the comparative study used a comparative literary theory proposed by Endraswara (2011). The results of the text comparison reveal the similarities and differences in the image of Bima figures in the Javanese and Malay versions. The equation as a whole is that both texts contain the same heroic storyline and heroic character, Bima. In addition, Indian influence is still evident in the two texts seen from the nuances of Hinduism that exist in both texts. While the difference is seen in the events that accompany Bima's struggle in achieving his victory. Based on these similarities and differences, it can be seen that the authors attempt to represent the concept of metaphysical interactions vertically and horizontally expressed through PG text. --- Abstrak: Penelitian ini adalah satu kajian sastra bandingan yang menggunakan sumber teks Mahabarata versi Melayu dan Jawa. Objek penelitian yang digunakan adalah edisi teks Pandhawa Gubah (PG) karya Sudibjo Z. Hadisutjipto dan teks Cheritera Pandawa Lima (CPL) karya Khalid Hussain. Metode penelitian yang digunakan adalah metode deskriptif-analisis. Dalam telaah perbandingan digunakan teori sastra bandingan yang dikemukakan Endraswara (2011). Hasil perbandingan teks mengungkapkan adanya persamaan dan perbedaan citra tokoh Bima dalam versi Jawa maupun versi Melayu. Persamaan secara keseluruhan adalah kedua teks tersebut mengandung alur cerita kepahlawanan dan tokoh pahlawan yang sama yaitu Bima. Selain itu, pengaruh India masih tampak dalam kedua teks tersebut dilihat dari nuansa Hinduisme yang ada dalam kedua teks. Sementara perbedaannya tampak pada peristiwa-peristiwa yang menyertai perjuangan Bima dalam mencapai kemenangannya. Berdasarkan persamaan dan perbedaan tersebut tampak adanya upaya penulis untuk merepresentasikan konsep interaksi metafisik secara vertikal dan horizontal yang diungkapkan melalui teks PG.

Being Mother:Comparative Study of the Contested Motherhood between South Korea and Indonesia

2018 ◽  
Vol 1 (1) ◽  
pp. 22
Author(s):  
Desintha Asriani
Keyword(s):  
Political Economy ◽  
South Korea ◽  
Comparative Study ◽  
Cultural Issues ◽  
Family Routine ◽  
The Difference

This paper attempts to explain the discourse of motherhood in both South Korea and Indonesia. It is based on the interesting dynamic of being mother that is much influenced by the interrelated actions played by number of dominant actors around woman itself. By using a comparative study, it is found that the map or the trace of political economy in terms of developmental agenda, in fact drives the difference flows in shaping the notion of motherhood. In Indonesia, for being mother, women exist in the intersection of state intention, industrialization and culture pressure. Indonesian motherhood is interestingly in line with another analysis, such in their relation with housemaids. Meanwhile, in South Korea, the description of motherhood occurs in the middle of nationalism spirit, competition, ambience and family routine. Hence, this study concludes that being mother is highly contested and closely associated with the endless structural and cultural issues.

scholarly journals Effects of Dexmedetomidine as an Analgesic Adjuvant for Surgery of Femur Fracture: A Systematic Review and Meta-Analysis

Pharmacology ◽  
2021 ◽  
pp. 1-9
Author(s):  
Shan Deng ◽  
Yonghao Yu
Keyword(s):  
Femur Fracture ◽  
Meta Analysis ◽  
Sensory Block ◽  
Cochrane Library ◽  
Rescue Analgesia ◽  
Block Level ◽  
Block Time ◽  
Sedation Scores ◽  
The Difference ◽  
The Cochrane Library

Patients who undergo surgery of femur fracture suffer the excruciating pain. Dexmedetomidine (DEX) is a unique α2-adrenergic receptor agonist with sedative and analgesic properties, whose efficacy and safety are still unclear for surgery of femur fracture. Randomized controlled trials comparing the effects of addition of DEX to general or local anesthesia in surgery of femur fracture were searched from MEDLINE, EMBASE, and the Cochrane Library database. Patients who received DEX infusion had a significant longer time to rescue analgesia compared with those without DEX coadministration. DEX treatment seemed to reduce the visual analog score; however, the significance did not reach any statistical difference. DEX as an analgesic adjuvant did not reduce the onset of sensory block time, shorten the time to achieve maximum sensory block level, and provide a longer duration of sensory block. The difference in mean sedation scores between 2 groups was not statistically significant. As for adverse effects, DEX therapy significantly increased the rate of hypotension. In conclusion, dexmedetomidine as a local anesthetic adjuvant in femur fracture surgery had a longer duration of rescue analgesia. However, the incidence of hypotension was markedly increased in these patients. It was worth noting that the evidence was of low to moderate quality.

scholarly journals A comparative study between the effect of verapamil versus nalbuphine as an adjuvant in supraclavicular brachial plexus block

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Mohammed Ibrahim Khamis ◽  
Ahmed Saeed Mohamed ◽  
Hesham Mohamed El Azazy ◽  
Hala Salah El Ozairy ◽  
Mohamed Moien Mohamed
Keyword(s):  
Comparative Study ◽  
Brachial Plexus ◽  
Normal Saline ◽  
Motor Block ◽  
Brachial Plexus Block ◽  
Sensory Block ◽  
Motor Blockade ◽  
Group A ◽  
Group B ◽  
Plexus Block

Abstract Background Brachial plexus block has substituted general anesthesia in the majority of patients planned for upper limb surgeries as it avoids the undesired effects of the medications used in general anesthesia as well as the stress response associated with airway manipulation. Opioid agonist–antagonists such as nalbuphine are used as adjuvant to improve the anesthetic properties of bupivacaine. Verapamil has an additive effect in brachial plexus blockade in the form of decreasing the consumption of analgesics in the postoperative period with reducing onset time and extending the duration of motor and sensory blockade. The aim of this study is to investigate the adjuvant effect of verapamil versus nalbuphine to 0.5% bupivacaine in brachial plexus block as regards onset, duration of sensory and motor blockade and postoperative analgesic augmentation. The study is randomized, prospective, double-blinded, comparative study where 90 patients subjected to arm, forearm and hand surgeries were randomized into three groups, group A received 30 ml of plain bupivacaine 0.5% plus 2 ml of normal saline, group B received 30 ml of bupivacaine 0.5% plus 2 ml verapamil equivalent to 5 mg, group C received 30 ml of bupivacaine 0.5% plus 10 mg of nalbuphine diluted in 2 ml of normal saline. Results Results of this study showed that group C and group B sensory block time onset was 7.25 ± 1.5 vs. 10.92 ± 3.84 min, P < 0.001 and was shorter than that in group A (13.2 ± 2.66 min). In addition, the motor block onset was (11.10 ± 1.24 vs. 13.50 ± 3.77 min, P < 0.001) shorter than group A (17.16 ± 1.30 min). In group C and group B, sensory block duration was 396 ± 32.17 vs. 355.83 ± 18.48 min, P < 0.001, respectively and was longer than that in group A (321.13 ± 25.08 min). Also, there was prolonged motor block duration in group C and group B recording (338.92 ± 25.2 vs. 302.93 ± 15.24 min, P < 0.001) and was longer than that in group A (280.70 ± 32.35 min). Time of demand of rescue analgesia dose was significantly long in group C and group B (449.53 ± 52.45 vs. 418.13 ± 41.12 min, P < 0.001) and was longer than group A (361.31 ± 21.42 min). Both verapamil and nalbuphine have additive effect to bupivacaine improving the all anesthetic parameters of the block. Conclusion Both drugs produce favorable enhancement of time onset and effective prolongation of duration of sensory and motor blockade and extend the period of postoperative analgesia with superiority to nalbuphine over verapamil.

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