scholarly journals Efficacy of ultrasound-guided rectus sheath block, butorphanol for single-incision laparoscopic cholecystectomy: A prospective, randomized, clinical trial

2019 ◽  
Author(s):  
Huimin Fu ◽  
Chaochao Zhong ◽  
Yongtao Gao ◽  
Xingguo Xu
Keyword(s):  
General Anaesthesia ◽  
Visceral Pain ◽  
Rectus Sheath ◽  
Group Iv ◽  
Ultrasound Guided ◽  
Group I ◽  
Rectus Sheath Block ◽  
Vas Scores ◽  
Group Ii ◽  
Incisional Pain

Abstract Background: Whether rectus sheath block (RSB) combined with butorphanol can relieve incisional pain and visceral pain in patients undergoing single-incision laparoscopic cholecystectomy (SILC) remains unknown. The goal of this study was to assess the efficacy of ultrasound-guided bilateral RSB, and butorphanol for postoperative analgesia in patients undergoing SILC.Methods: All 116 patients who met the criteria were randomly divided into four groups: group I, (n=29) general anaesthesia combined with patient-controlled intravenous analgesia (PCIA) (sufentanil 1 µg/ml); group II, (n=29) general anaesthesia combined with PCIA (butorphanol 0. 08 µg/ml); group III, (n=29) ultrasound-guided RSB (ropivacaine 100 mg) combined with PCIA (sufentanil 1 µg/ml); and group IV, (n=29) ultrasound-guided RSB (ropivacaine 100 mg) combined with PCIA (butorphanol 0.08 µg/ml). Outcomes included visual analogue scale (VAS) scores (0-10) of incisional pain (defined as superficial pain on the abdominal wall) and visceral pain (defined as deep, dull pain within the abdomen) at rest and during cough at 2,6,12 and 24 h postoperatively, the dose of butorphanol and sufentanil, the number of PCIA presses, the length of hospital stay and the incidence of postoperative adverse events. Results: Both the rest and cough incisional pain scores were lower during the first 2 and 6 h in group Ⅲ than in group Ⅰ (P＜0.05). Similarly, scores in group Ⅳ were significantly lower than those in group II (P＜0.05). Patients in group I needed more butorphanol as a rescue analgesic for pain relief than did those in group III, and patients in group IV needed less butorphanol as a rescue analgesic for pain relief than did those in group II. From the above pairwise comparisons, it is clear that groups III and IV had lower VAS scores. The VAS scores for visceral pain were lower in group II at 2, 6 and 12 h after surgery than in group I and lower in group IV than in group Ⅲ. Overall, ultrasound-guided RSB combined with PCIA (butorphanol 0. 08 µg/ml) performed the best. Conclusions: Ultrasound-guided RSB combined with butorphanol can provide sufficient pain treatment after SILC than can general anaesthesia combined with sufentanil.

scholarly journals Efficacy of ultrasound-guided rectus sheath block, butorphanol for single-incision laparoscopic cholecystectomy: A prospective, randomized, clinical trial

2020 ◽  
Author(s):  
Huimin Fu ◽  
Chaochao Zhong ◽  
Yongtao Gao ◽  
Xingguo Xu
Keyword(s):  
Visceral Pain ◽  
Rectus Sheath ◽  
Group Iv ◽  
Ultrasound Guided ◽  
Group Iii ◽  
Group I ◽  
Rectus Sheath Block ◽  
Single Incision Laparoscopic Cholecystectomy ◽  
Group Ii ◽  
Incisional Pain

Abstract Background: Whether rectus sheath block (RSB) combined with butorphanol can relieve incisional pain and visceral pain in patients undergoing single-incision laparoscopic cholecystectomy (SILC) remains unknown. The goal of this study was to assess the efficacy of ultrasound-guided bilateral RSB, and butorphanol for postoperative analgesia in patients undergoing SILC.Methods: All patients who met the criteria were randomly divided into four groups: group I, (n=29) patient-controlled intravenous analgesia (PCIA) (sufentanil 1 µg/ml); group II, (n=29) PCIA (butorphanol 0. 08 µg/ml); group III, (n=29) ultrasound-guided RSB (ropivacaine 100 mg) combined with PCIA (sufentanil 1 µg/ml); and group IV, (n=29) ultrasound-guided RSB (ropivacaine 100 mg) combined with PCIA (butorphanol 0.08 µg/ml). General anesthesia in all groups, It's noteworthy that we only use general anesthesia, not ultrasound-guided RSB in group I and II. The primary outcome were numeric rating scale (NRS) scores (0-10) of incisional pain and visceral pain. Secondary outcomes were the dose of butorphanol and sufentanil, the number of PCIA presses, the length of hospital stay and the incidence of postoperative adverse events. Results: Both the rest and cough incisional pain scores were lower during the first 2, 6 and 12 h in group Ⅲ than in group Ⅰ (P＜0.05). Similarly, scores in group Ⅳ were significantly lower than those in group II (P＜0.05). The NRS scores for visceral pain were lower in group II at 2, 6 and 12 h after surgery than in group I (P＜0.05) and lower in group IV than in group Ⅲ (P＜0.05). Patients in group I needed more butorphanol as a rescue analgesic for pain relief than did those in group III, and patients in group IV needed less butorphanol as a rescue analgesic for pain relief than did those in group II. From the above pairwise comparisons, it is clear that groups III and IV had lower NRS scores. Overall, ultrasound-guided RSB combined with PCIA (butorphanol 0. 08 µg/ml) performed the best. Conclusions: Ultrasound-guided RSB combined with butorphanol can provide sufficient pain treatment after SILC than can general anaesthesia combined with sufentanil.

scholarly journals Efficacy of ultrasound-guided rectus sheath block, butorphanol for single-incision laparoscopic cholecystectomy: A prospective, randomized, clinical trial

2019 ◽  
Author(s):  
Huimin Fu ◽  
Chaochao Zhong ◽  
Yongtao Gao ◽  
Xingguo Xu
Keyword(s):  
Clinical Trial ◽  
Laparoscopic Cholecystectomy ◽  
General Anesthesia ◽  
Visceral Pain ◽  
Single Incision ◽  
Rectus Sheath ◽  
Ultrasound Guided ◽  
Rectus Sheath Block ◽  
Single Incision Laparoscopic Cholecystectomy ◽  
Vas Scores

Abstract Background: Whether rectus sheath block (RSB) combined with butorphanol can relieve incision pain and visceral pain in patients undergoing single-incision laparoscopic cholecystectomy (SILC) remains unknown. The goal of this study was to assess the efficacy of ultrasound-guided bilateral RSB, butorphanol on postoperative analgesia in patients undergoing SILC. Methods: All 116 patients who met the criteria were randomly divided into four groups: (Ⅰ) (n=29) general anesthesia combined with patient controlled intravenous analgesia (PCIA) (sufentanil 100ug); (Ⅱ) (n=29) general anesthesia combined with PCIA (butorphanol 8mg); (Ⅲ) (n=29) ultrasound-guided RSB combined with PCIA (sufentanil 100ug). (Ⅳ) (n=29) RSB combined with PCIA (butorphanol 8mg). Outcomes included visual analog scale (VAS) scores of incisional and visceral pain at rest and cough at 2,6,12 and 24h postoperatively, if a patient’s pain score＞3, then butorphanol 2mg was administered intravenously. the dose of butorphanol and opioids, the pressing numbers of PCIA, the length of hospital stay and the incidence of postoperative adverse events. Results: Both rest and cough pain scores were lower during first 2,6 hours in group Ⅲ than groupⅠ, similarly, group Ⅳwas significantly lower than groupⅡ. GroupⅠneeded more butorphanol as rescue analgesic for pain relief than group Ⅲ, group Ⅳ was better than group Ⅱ. In the above pairwise comparisons, it was clear that group Ⅲ and group Ⅳ had lower VAS scores. VAS scores of visceral pain was lower in groupⅡ at 2, 6 and 12 h after surgery compared with the groupⅠ. In the both groups Ⅲ and Ⅳ, the group Ⅳ was also lower than groupⅢ. Overall, RSB combined with PCIA (butorphanol 8mg) is the best match. Conclusions: Ultrasound-guided RSB combined with butorphanol can provide sufficient pain treatment after SILC. Trial registration: The study was registered prospectively with the Chinese Clinical Trial Registry（reg no.ChiCTR1900020738), obtained ethics committee of Affiliated Hospital of Nantong University approval (approved number: 2018-K067).

scholarly journals The Effect of Rectus Sheath Block as a Supplement of General Anesthesia on Postoperative Analgesia in Adult Patient Undergoing Umbilical Hernia Repair

PRILOZI ◽  
2017 ◽  
Vol 38 (3) ◽  
pp. 135-142 ◽  
Author(s):  
Andrijan Kartalov ◽  
Nikola Jankulovski ◽  
Biljana Kuzmanovska ◽  
Milka Zdravkovska ◽  
Mirjana Shosholcheva ◽  
...  
Keyword(s):  
Hernia Repair ◽  
General Anesthesia ◽  
Umbilical Hernia ◽  
Rectus Sheath ◽  
Morphine Consumption ◽  
Ultrasound Guided ◽  
Group I ◽  
Umbilical Hernia Repair ◽  
Rectus Sheath Block ◽  
Group Ii

Abstract Background: Ultrasound guided rectus sheath block can block the ventral rami of the 7th to 12th thoracolumbar nerves by injection of local anesthetic into the space between the rectus muscle and posterior rectus sheath. The aim of this randomized double-blind study was to evaluate the analgesic effect of the bilateral ultrasound guided rectus sheath block as supplement of general anesthesia on patents undergoing elective umbilical hernia repair. Methods: After the hospital ethics committee approval, 60 (ASA I–II) adult patients scheduled for umbilical hernia repair were included in this study. The group I (n=30) patents received only general anesthesia. In the group II (n = 30) patents after induction of general anesthesia received a bilateral ultrasound guided rectus sheath block with 40 ml of 0.25% bupivacaine. In this study we assessed demographic and clinical characteristics, pain score - VAS at rest at 2, 4, 6, 12 and 24 hours after operation and total analgesic consumption of morphine dose over 24-hours. Results: There were statistically significant differences in VAS scores between the groups I and II at all postoperative time points - 2hr, 4 hr, 6 hr, 12 hr and 24 hr. (P < 0.00001). The cumulative 24 hours morphine consumption after the operation was significantly lower in the group II (mean = 3.73 ± 1. 41) than the group I (mean = 8.76 ± 2.41). This difference was statistically significant (p = 0.00076). Conclusion: The ultrasound guided rectus sheath block used for umbilical hernia repair could reduce postoperative pain scores and the amount of morphine consumption in 24 hours postoperative period.

scholarly journals Efficacy of ultrasound-guided rectus sheath block, butorphanol for single-incision laparoscopic cholecystectomy: A prospective, randomized, clinical trial

2019 ◽  
Author(s):  
Huimin Fu ◽  
Chaochao Zhong ◽  
Yongtao Gao ◽  
Xingguo Xu
Keyword(s):  
Clinical Trial ◽  
Laparoscopic Cholecystectomy ◽  
General Anesthesia ◽  
Visceral Pain ◽  
Single Incision ◽  
Rectus Sheath ◽  
Ultrasound Guided ◽  
Rectus Sheath Block ◽  
Single Incision Laparoscopic Cholecystectomy ◽  
Vas Scores

Abstract Background: Whether rectus sheath block (RSB) combined with butorphanol can relieve incision pain and visceral pain in patients undergoing single-incision laparoscopic cholecystectomy (SILC) remains unknown. The goal of this study was to assess the efficacy of ultrasound-guided bilateral RSB, butorphanol on postoperative analgesia in patients undergoing SILC. Methods: All 116 patients who met the criteria were randomly divided into four groups: (Ⅰ) (n=29) general anesthesia combined with patient controlled intravenous analgesia (PCIA) (sufentanil 100ug); (Ⅱ) (n=29) general anesthesia combined with PCIA (butorphanol 8mg); (Ⅲ) (n=29) ultrasound-guided RSB combined with PCIA (sufentanil 100ug). (Ⅳ) (n=29) RSB combined with PCIA (butorphanol 8mg). Outcomes included visual analog scale (VAS) scores of incisional and visceral pain at rest and cough at 2,6,12 and 24h postoperatively, if a patient’s pain score＞3, then butorphanol 2mg was administered intravenously. the dose of butorphanol and opioids, the pressing numbers of PCIA, the length of hospital stay and the incidence of postoperative adverse events. Results: Both rest and cough pain scores were lower during first 2,6 hours in group Ⅲ than groupⅠ, similarly, group Ⅳwas significantly lower than groupⅡ. GroupⅠneeded more butorphanol as rescue analgesic for pain relief than group Ⅲ, group Ⅳ was better than group Ⅱ. In the above pairwise comparisons, it was clear that group Ⅲ and group Ⅳ had lower VAS scores. VAS scores of visceral pain was lower in groupⅡ at 2, 6 and 12 h after surgery compared with the groupⅠ. In the both groups Ⅲ and Ⅳ, the group Ⅳ was also lower than groupⅢ. Overall, RSB combined with PCIA (butorphanol 8mg) is the best match. Conclusions: Ultrasound-guided RSB combined with butorphanol can provide sufficient pain treatment after SILC. Trial registration: The study was registered prospectively with the Chinese Clinical Trial Registry（reg no.ChiCTR1900020738), obtained ethics committee of Affiliated Hospital of Nantong University approval (approved number: 2018-K067).

scholarly journals Analgesic effect of combined transversus abdominis plane block and rectus sheath block in laparoscopic cholecystectomy: prospective randomized study

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Ibrahim Hakki Tor ◽  
Erkan Cem Çelik ◽  
Muhammed Enes Aydın
Keyword(s):  
Rectus Sheath ◽  
Transversus Abdominis ◽  
Transversus Abdominis Plane ◽  
Time Intervals ◽  
Wound Infiltration ◽  
Pain Scores ◽  
Group I ◽  
Rectus Sheath Block ◽  
Significant Difference ◽  
Vas Scores

Abstract Background We aimed to investigate the combination of the subcostal transversus abdominis plane block and rectus sheath block (ScTAP-RS) versus wound infiltration on opioid consumption and assess effects on pain scores in laparoscopic cholecystectomy (LC). One hundred patients scheduled for LC were included in this study following the local ethics committee approval. Patients were randomized and divided into two groups as group ScTAP-RS and wound infiltration group (group I). After the surgical intervention, in group ScTAP-RS, ScTAP-RS block with 30 ml 0.25% bupivacaine solution was administered by ultrasound, and in group I, 20 ml 0.25% bupivacaine solution was injected in three port incision sites. Patient-controlled analgesia with tramadol was programmed for 24 h postoperatively. Tramadol consumptions and visual analog scale (VAS) scores were evaluated. Results Compared to the infiltration group, total tramadol consumption was significantly lower in the ScTAP-RS group between 4 and 12 h. There was no statistically significant difference between the groups in other time intervals. VAS scores were significantly lower in the ScTAP-RS group in the 4th and 8th hours at rest and ambulation. There was no statistically significant difference between the groups for VAS scores at other time intervals. Conclusion ScTAP-RS blocks decrease the opioid consumption and pain scores compared to the local infiltration after LC.

Different Treatment Protocols of Retained Fetal Membranes and its Effect on Serum Profile, Uterine Involution and Postpartum Fertility in Cows

2019 ◽  
Vol 14 (04) ◽  
Author(s):  
A. I. Shah ◽  
D. M. Patel ◽  
N. P. Sarvaiya ◽  
S. P. Madhira
Keyword(s):  
Group Iv ◽  
Fetal Membranes ◽  
Serum Progesterone ◽  
Group V ◽  
Manual Removal ◽  
Uterine Involution ◽  
Group I ◽  
Medicinal Treatment ◽  
Group Ii ◽  
Postpartum Estrus

This study was undertaken on 36 freshly calved cows randomly divided into 6 equal groups under field conditions. Cows of group-VI that shed placenta within 8-12 hours postpartum naturally served as healthy control. The cows with retained fetal membranes (RFM, n = 18) for more than 12 hrs were managed either by manual removal of placenta without antibiotics (group-I), parenteral antibiotic (Ceftiofur 1 g i/m) for three consecutive days (group-II) or a combination of both (group-III). In group-IV and group-V, cows were administered with Inj. Oxytocin @ 50 IU i/m and Inj. Dinoprost tromethamine (PGF2α) @ 25 mg i/m, respectively, immediately after parturition and time of placental shedding was recorded. The overall prevalence of Brucellosis by RBPT was found to be 5.55 % amongst these 36 animals. The placental expulsion in groups following medicinal treatment was found to be 50 (3/6) % in Ceftiofur alone by 3 days (group-II), and 66.67 (4/6) % in Oxytocin (group-IV) and 100 (6/6) % in PGF2α inj. (group-V) groups within 12 hrs. The time of uterine involution in groups I to VI was found to be 42.00 ± 1.94, 39.50 ± 0.99, 40.67 ± 1.39, 38.33 ± 1.55, 37.50 ± 1.02 and 37.33 ± 1.76 days, respectively, while the interval for the appearance of first postpartum estrus was 54.83 ± 2.06, 51.00 ± 1.05, 52.17 ± 1.96, 50.17 ± 2.03, 48.67 ± 1.90 and 49.17 ± 1.55 days, respectively, which did not vary statistically. The mean serum progesterone profile obtained on day 0 and day 21 postpartum was statistically non-significant between groups. However, it was significantly (p less than 0.05) lower on day 0 as compared to day 21 in group-I, II and VI. The levels on day 0 coincided with the time of blood sampling after calving. The high level of serum P4 on day 0 in group-IV and V could be due to sampling immediately after calving. The serum calcium and phosphorus levels were significantly(p less than 0.05) lower on day 0 than on day 21, but not the magnesium. The group effect was however non-significant for any of three minerals. It was observed that manual removal of RFM without parenteral antibiotics, resulted in puerperal metritis, cervicitis, pyometra which ultimately resulted into delayed uterine involution, delayed first postpartum estrus and thus, reduced the postpartum reproductive efficiency. It was inferred that the PGF2α and Oxytocin injections could be used as a treatment of choice for prevention of RFMs in cattle.

scholarly journals Effect and mechanisms of reproductive tract infection on oxidative stress parameters, sperm DNA fragmentation, and semen quality in infertile males

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Kang-Sheng Liu ◽  
Xiao-Dong Mao ◽  
Feng Pan ◽  
Rui Fang An
Keyword(s):  
Reproductive Medicine ◽  
Reproductive Tract ◽  
Group Iv ◽  
Semen Parameters ◽  
Group Iii ◽  
Reproductive Tract Infection ◽  
Group I ◽  
Sperm Dna ◽  
Group Ii ◽  
Elastase Level

AbstractRecent years have seen a rising incidence of male infertility, mostly caused by the decline of sperm quality. The ratio of infertile males to infertile females has escalated from 3:7 in 2013 to current 5:5, which turns male infertility into the research focus of reproductive medicine. This study aimed to clarify the effect of reproductive tract infection by ureaplasma urealyticum (UU) and chlamydia trachomatis (CT) on the DNA integrity and routine semen parameters of infertile males. A retrospective study was performed. A total of 259 infertile males who were treated at the Andrological Laboratory Examination and Reproductive Medicine Center in our hospital were analyzed. qRT-PCR was used to examine the infection status of CT and UU. According to the eligibility criteria, we evaluated the semen parameters and biochemical data of 253 men. Based on the results of PCR, the subjects were divided into four groups: Group I (CT positive, 63 cases), Group II (UU positive, 60 cases), Group III (CT positive and UU positive, 62 cases), and Group IV (no infection, 68 cases). DNA fragmentation index (DFI), sperm count, vitality and morphology, elastase level, seminal plasma malondialdehyde (MDA), and total antioxidant capacity (TAC) were assessed. Compared to Group IV, three groups (Group I, Group II and Group III) showed difference in semen volume, proportion of sperm with normal morphology, sperm motility, progressive motility, and vitality (P < 0.05). Compared to Group IV, Group II and Group III showed difference in DFI (P < 0.05). Compared to Group IV, Group II and Group III showed difference in elastase level (P < 0.05). VCL, VSL, VAP, WOB, ROS, TM, HDS showed differences between groups of abnormal/normal WBC (*P < 0.01).UU infection significantly increased the level of seminal leukocytes only in Group II, but not in the other three groups, indicating that UU is a factor to increase the level of seminal leukocytes. Compared with the normal leukocyte group, there were significant differences in total motility, forward motility and normal sperm ratio between the two groups. The proportion of sperm with abnormal morphology (mostly in the head) showed obvious difference between groups of high and normal seminal leukocytic levels. At the same time, in this study, SCGE and SCD verified that leukocytes could damage sperm DNA by increasing ROS, which ultimately affects male fertility.

scholarly journals Recovery Status in Children after General Anaesthesia: Role of Pre-emptive Local Anaesthetic Infiltration

2009 ◽  
pp. 38-44
Author(s):  
Md Maqsud Isa ◽  
Rubina Yasmin ◽  
Nur Syeeda ◽  
Suraiya Enam ◽  
Md Manowarul Isiam ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
General Anaesthesia ◽  
Local Anaesthetic ◽  
Local Infiltration ◽  
Group I ◽  
Mean Pressure ◽  
Recovery Status ◽  
Group Ii ◽  
Operative Recovery ◽  
Group 1

This prospective clinical study was carried out in the dept. of Anaesthesia, Analgesia and Intensive Care Medicine, BSMMU. Dhaka during the period of January 04 to September 04. The study was done to emphasize the importance of giving analgesics preemptively instead of waiting for the child to complain or express their pain and to improve post operative recovery status and associated response by reducing the immediate post operative pain with simple local anaesthetic infiltration. The children scheduled for elective herniotomy operation through a hernial incision under general anaesthesia were recruited in this study. Immediate recovery status in children was compared with preemptive (group-1 and without preemptive (group-II) local infiltration of 0.25% bupivacaine in herniotomy operation. No. of patients was 20 in each group. Pulse, systolic, diastolic and mean pressure, oxygen saturation, pain (scored by TPPPS), anaesthetic recovery (scored by steward recovery system) and mental status if the children were observed postoperatively at different time interval up to one hour. Pulse, systolic, diastolic, mean pressure were stable in group-1 then group-II. Oxygen saturation in both the groups were in clinically acceptable range but in group-11 5 mins after extubation fall more than that of group- l and statistically significant. Pain score (TPPPS) in group-1 was lower all the time period but in group-II the score was high, all the children required rescue pethidine within 10 mins after extubation, mean dose reqd, in group-II was 23.6+3.6mg. Steward recovery score in both group was not significant at early period but after 10 mins. P value become significant The mental state of group-I was calm & quite only 3 were excited, on the other hand in group-11 all children were excited & irritable and required rescue pethidine. So preemptive local infiltration of 0.25 bupivacaine improved the recovery status in children by reducing the immediate postoperative pain and there by decrease in postoperative morbidity. Journal of BSA, Vol. 18, No. 1 & 2, 2005 p.38-44

Effect of amino acid infusion on renal hemodynamics in humans: a dose-response study

1994 ◽  
Vol 267 (5) ◽  
pp. F703-F708 ◽  
Author(s):  
M. Giordano ◽  
P. Castellino ◽  
E. L. McConnell ◽  
R. A. DeFronzo
Keyword(s):  
Amino Acid ◽  
Dose Response ◽  
Renal Hemodynamics ◽  
Group Iv ◽  
Group V ◽  
Group Iii ◽  
Amino Acid Infusion ◽  
Group I ◽  
Basal Plasma ◽  
Group Ii

We evaluated the dose-response relationship between the plasma amino acid (AA) concentration and renal hemodynamics in eight normal subjects. After an overnight fast, a balanced 10% AA solution was infused for 180 min at five separate infusion rates: 0.5 (group I), 1.0 (group II), 2.0 (group III), 4.0 (group IV), and 6.0 (group V) ml.kg-1.min-1 on separate days. Basal plasma AA concentration was 1.87 +/- 0.1 mmol/l and increased to 2.26 +/- 0.1 (group I), 2.66 +/- 0.2 (group II), 3.79 +/- 0.5 (group III), 5.81 +/- 0.4 (group IV), and 7.41 +/- 0.4 mmol/l (group V). Basal glomerular filtration rate (GFR) and renal plasma flow (RPF) averaged 95 +/- 4 and 476 +/- 29 ml.1.73 m-2.min-1, respectively, and rose to 98 +/- 5 and 506 +/- 40 (group I) [P = not significant (NS)], 102 +/- 3 and 533 +/- 30 (group II) (P < 0.05 vs. basal), 110 +/- 4 and 567 +/- 29 (group III), 115 +/- 7 and 610 +/- 55 (group IV), and 117 +/- 7 and 614 +/- 66 ml.1.73 m-2.min-1 (group V) (P = NS vs. group IV). Basal plasma glucagon concentration averaged 68 +/- 10 pg/ml and increased to 74 +/- 10 (group I), 83 +/- 11 (group II) (P < 0.05 vs. basal), 100 +/- 14 (group III), 121 +/- 14 (group IV), and 229 +/- 35 pg/ml (group V) (P < 0.01 vs. basal). Increases in plasma growth hormone (GH) and insulin levels were observed only during groups IV and V.(ABSTRACT TRUNCATED AT 250 WORDS)

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