scholarly journals THE EFFECT OF HIGH DOSE AND LOW DOSE PREGABALIN AS PREMEDICATION ON PREOPERATIVE ANXIETY AND SEDATION LEVELS

2021 ◽  
Vol 71 (5) ◽  
pp. 1759-63
Author(s):  
Ayman Zafar ◽  
Kulsoom Farhat ◽  
Mobasher Ahmed Saeed ◽  
Waqar Aslam Khan ◽  
Shabana Ali ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
General Anesthesia ◽  
Preoperative Anxiety ◽  
High Dose ◽  
Medical College ◽  
Preoperative Administration ◽  
Elective Laparoscopic Cholecystectomy ◽  
Group 3 ◽  
The Difference ◽  
Group 2

Objective: To assess the role of pregabalin as premedication for preoperative sedation & anxiolysis with two different doses in laparoscopic cholecystectomy patients. Study Design: Prospective, randomized control study Place and Duration of Study: Department of Pharmacology and Therapeutics, Army Medical College, Rawalpindi in collaboration with Department of Anesthesiology, CMH, Rawalpindi from February 2019 to July 2019. Patients & Methods: 96 patients of either gender, aged between 18 to 60 years with ASA grade I-II, undergoing elective laparoscopic cholecystectomy were enrolled in this study. They were randomly divided into three groups having 32 patients each. Group 1 received oral placebo drug, Group 2 received oral pregabalin 150 mg, whereas Group 3 received oral pregabalin 300mg with sip of water 90 mins before the induction of general anesthesia. The effects of drugs on the patient’s level of sedation and anxiety were evaluated at baseline and before the induction of anesthesia using Ramsay Sedation Score and Beck Anxiety Inventory respectively. Results: Premedication with pregabalin 150mg and 300mg significantly produced sedation as compared to placebo. Though, pregabalin 300mg exhibited more sedation than pregabalin 150mg but the difference between them was statistically insignificant (p >0.05). Preoperative administration of pregabalin was related with anxiolysis, with the most prominent results shown by pregabalin 300mg (p <0.05) whereas pregabalin 150mg couldn’t alleviate anxiety and the results were statistically insignificant (p >0.05). Conclusions: Premedication with pregabalin 300mg, 90 mins before the induction of general anesthesia is an effective regimen to alleviate preoperative anxiety and sedation.

Epidural Clonidine or Bupivacaine as the Sole Analgesic Agent during and after Abdominal Surgery 

1999 ◽  
Vol 90 (5) ◽  
pp. 1354-1362 ◽  
Author(s):  
Marc De Kock ◽  
Philippe Gautier ◽  
Athanassia Pavlopoulou ◽  
Marc Jonniaux ◽  
Patricia Lavand'homme
Keyword(s):  
High Dose ◽  
General Anesthetics ◽  
Visual Analogue Pain ◽  
Pain Scores ◽  
Arterial Blood ◽  
Sedation Scores ◽  
Group 3 ◽  
Group 2 ◽  
High Doses ◽  
Group 1

Background The rationale of this study was to compare high-dose epidural clonidine with a more commonly used agent, such as bupivacaine. This was performed to give a more objective idea of the relative analgesic potency of epidural clonidine. Methods Sixty patients undergoing intestinal surgery during propofol anesthesia were studied. At induction, the patients received epidurally a dose of 10 micrograms/kg [corrected] clonidine in 7 ml saline followed by an infusion of 6 micrograms [corrected] x kg(-1) x h(-1) (7 ml/h) (group 1, n = 20), a dose of 7 ml bupivacaine, 0.5%, followed by 7 ml/h bupivacaine, 0.25% (group 2, n = 20), or a dose of 7 ml bupivacaine, 0.25%, followed by 7 ml/h bupivacaine, 0.125% (group 3, n = 20). Intraoperatively, increases in arterial blood pressure or heart rate not responding to propofol (0.5 mg/kg) were treated with intravenous alfentanil (0.05 mg/kg). Additional doses of propofol were given to maintain an adequate bispectral index. The epidural infusions were maintained for 12 h. In cases of subjective visual analogue pain scores up to 5 cm at rest or up to 8 cm during coughing, the patients were given access to a patient-controlled analgesia device. Results During anesthesia, patients in group 1 required less propofol than those in groups 2 and 3 (78 [36-142] mg vs. 229 [184-252] mg and 362 [295-458] mg; P &lt; 0.05) and less alfentanil than patients in group 3 (0 [0-0] mg vs. 11 [6-20] mg; P &lt; 0.05). Analgesia lasted 380 min (range, 180-645 min) in group 1 versus 30 min (range, 25-40 min) in group 2 and 22 min (range, 12.5-42 min) in group 3 (P &lt; 0.05). There was no suggestion of a hemodynamic difference among the three groups except for heart rates that were significantly reduced in patients in group 1. Sedation scores were significantly higher in this group during the first 2 h postoperatively. Conclusion Our results show that high doses of epidural clonidine potentiate general anesthetics and provide more efficient postoperative analgesia than the two bupivacaine dosage regimens investigated.

scholarly journals The Effectiveness of Endoscopic Surgery of Juvenile Angiofibroma Using Surgical Glue

2020 ◽  
Vol 8 (B) ◽  
pp. 150-154
Author(s):  
Seyed-Hadyi Samimi Ardesan ◽  
Mojtaba Mohammadi Ardehali ◽  
Najmeh Doustmohammadian
Keyword(s):  
Blood Loss ◽  
Endoscopic Surgery ◽  
Tumor Staging ◽  
Low Cost ◽  
Tumor Stage ◽  
Nasopharyngeal Angiofibroma ◽  
Group 3 ◽  
The Difference ◽  
Group 2 ◽  
Group 1

AIM: The current study aimed to provide a method for juvenile nasopharyngeal angiofibroma embolization using Glubran glue in patients with low stage tumor. This method not only has less blood loss and good visualization but also impose a low cost, where no pre-operative embolization complications were found for this procedure. METHODS: Between 2012 and 2014, 30 patients with angiofibroma undergoing endoscopic surgery. Age, sex, tumor stage, average blood loss, complications, length of hospitalization, and recurrence rate of the tumor were the main measured outcomes. Furthermore, 30 patients were divided into three groups with matched age, sex, and tumor staging. Group 1 received glue (Glubran), while Group 2 selected for study without glue and embolization and pre-operative embolization was considered for Group 3. RESULTS: Based on the amount bleeding, the mean blood hemorrhage in Groups 1, 2, and 3 was 510, 1655, and 800 ml, respectively, the difference of hemorrhage between Groups 1 and 2 was found to be statistically significant (p = 0.007). Blood loss in Group 1 was found to be less than Group 3, but the difference of hemorrhage between Group 1 and 3 was not statistically significant (p = 0.678). No blood transfusion and complication were recorded for individuals in Group 1. The recurrence was found in 1 patient (10%) in both groups of 2 and 3, and no patient (0%) in Group 1. CONCLUSIONS: The direct intraoperative embolization technique with glue was capable of providing a more complete and targeted embolization of the tumor. Some advantages can be mentioned for this technique, including decreased blood loss, less radiation exposure, lower rates of complications, and recurrence, as well as shorter hospitalization time, the ease of procedure with a spinal needle and low cost.

scholarly journals LAPAROSCOPIC CHOLECYSTECTOMY;

2013 ◽  
Vol 20 (05) ◽  
pp. 699-706
Author(s):  
HEMMATPOOR BEHZAD ◽  
MAHVAR TAYEBEH ◽  
MAKHSOSI BEHNAM REZA ◽  
Saeb Morteza
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Shoulder Pain ◽  
Rating Scale ◽  
Controlled Study ◽  
P Value ◽  
Medical Sciences ◽  
Preoperative Administration ◽  
Elective Laparoscopic Cholecystectomy ◽  
Double Blinded ◽  
To Receive

Background: shoulder pain after laparoscopic procedure is a frequent complication encountered in surgery ward. Severaltreatments have been proposed to reduce it. This study aimed to evaluate the efficacy of preoperative administration of gabapentin inpreventing and attenuating Post Laparoscpoic Shoulder Pain (PLSP) after laparoscopic cholecystectomy. Design: In a randomised,double blinded placebo controlled study. Setting: Woman's Hospital, Kermanshah University of Medical Sciences. Period: April 2011 toMarch 2012. Material and methods: 90 patients of ASA physical status I-II undergoing elective laparoscopic cholecystectomy wererandomly allocated to receive gabapentin 600 mg or placebo ,half an hour before surgery. The presence analgesia and side effects wererecorded for 12h postoperatively in same times. Results: Incidence Verbal Rating Scale (VRS) ≥ 4 at different times after arrival to PACUwere significantly lower in gabapentin group in arrival (P Value= 0.003) and then after 30 miniute (P Value= 0.02) and 2 (P Value=0.003), 4 (P Value= 0.03) and 6 (P Value= 0.04) hours after arrival to Post Anesthesia Care Unit (PACU). But this sigificancy lost at 12hours (P Value= 0.07) after arrival to PACU. Also there was a reduction in amounts of postoperative in ward analgesic consumption. Sideeffects were not different between two groups. Conclusions: 600 mg gabapentin as premedication is effective and safe for reducing postlaparoscopicshoulder pain intensity after general laparoscopy compared with placebo.

EFFICACY OF FREQUENT NEBULIZED IPRATROPIUM BROMIDE ADDED TO FREQUENT HIGH-DOSE ALBUTEROL THERAPY IN SEVERE CHILDHOOD ASTHMA

PEDIATRICS ◽  
1996 ◽  
Vol 98 (2) ◽  
pp. 342-342
Author(s):  
Thad H. Joos
Keyword(s):  
Ipratropium Bromide ◽  
Treatment Protocol ◽  
Forced Expiratory Volume ◽  
High Dose ◽  
Entire Cohort ◽  
Asthmatic Children ◽  
Group 3 ◽  
Group 2 ◽  
Sick Children ◽  
Double Blinded

Purpose of the Study. High-dose nebulized albuterol has become the standard of treatment for the severely wheezing asthmatic child. The role, dose, and frequency of administration of ipratropium bromide in this same group of children requires further definition. Methods. From the Emergency Department of the Hospital for Sick Children in Toronto, Ontario, Canada, 120 children 5 to 17 years of age with severe asthma as determined by a forced expiratory volume in 1 second (FEV1) of less than 50% predicted normal were equally divided and entered into a double-blinded, placebo-controlled treatment protocol. All groups received 0.15 mg albuterol/kg/dose nebulized every 20 minutes χ3. Group 1 had 250 µg of ipratropium bromide added to each treatment. Group 2 had the same amount of ipratropium bromide added to only the initial aerosol with a like amount of saline added to aerosols 2 and 3. Group 3 had only saline added to each aerosol. No corticosteroids were administered to any patient in the first hour. The entire cohort was meticulously monitored for oxygen saturation, heart rate, respiratory rate, accessory muscle use, cyanosis, wheezing and pulmonary function test parameters by a skilled research nurse. Results. As expected, all patients improved to a degree but those with the lowest FEV1s who were treated with ipratropium in each aerosol responded the best and were admitted to the hospital less frequently. No serious untoward side effects were observed in any patient. Reviewer's Comment. I feel the article is a must read for all physicians caring for acutely wheezing asthmatic children.

Epiphora in patients after high-dose radioiodine therapy

2021 ◽  
pp. 54-55
Author(s):  
V.D. Yartsev ◽  
◽  
E.L. Atkova ◽  
Keyword(s):  
Radioiodine Therapy ◽  
Therapy Group ◽  
Nasolacrimal Duct ◽  
Positive Answer ◽  
Nasolacrimal Duct Obstruction ◽  
High Dose ◽  
Duct Obstruction ◽  
The Difference ◽  
Group 2 ◽  
Group 1

Purpose. To estimate the frequency of tearing in patients after high-dose radioiodine therapy. Materials and Methods. The survey was conducted in 500 patients after radioiodine therapy (group 1) and 654 volunteers (group 2). We asked whether the respondent noticed epiphora last month, in case of a positive answer we specified how many times during the day it was necessary to wipe the tear, comparing the result with Munk scale. Results. The patients of group 1 noticed tearing in 232 cases, the respondents of group 2 noticed it in 186 cases. Epiphora was more frequent in patients of group 1 (46 % of cases), rather than in volunteers of group 2 (27 % of cases). Excessive tearing was noticed in 8.8 % of patients of group 1 and 3.5 % of respondents of group 2. The difference was statistically significant. Conclusion. 8.8 % of patients complain about excessive tearing after high-dose radioiodine therapy, which is more frequent than in the general population. This may be related to secondary acquired nasolacrimal duct obstruction. Key words: epiphora, nasolacrimal duct obstruction, radioiodine therapy.

scholarly journals Plasma as an indicator of bone fluoride levels in rats chronically exposed to fluoride

2006 ◽  
Vol 14 (4) ◽  
pp. 238-241 ◽  
Author(s):  
Juliane Guimarães de Carvalho ◽  
Rodrigo Cardoso de Oliveira ◽  
Marília Afonso Rabelo Buzalaf
Keyword(s):  
Wistar Rats ◽  
Direct Method ◽  
Facilitated Diffusion ◽  
Bone Surface ◽  
Male Wistar Rats ◽  
Group 3 ◽  
The Difference ◽  
Group 2 ◽  
Exposure Methods ◽  
Group 1

OBJECTIVE: This study evaluated the use of plasma, bone surface (periosteal) and whole bone as biomarkers of chronic fluoride (F) exposure. METHODS: Forty male Wistar rats were assigned to 4 groups (n=10/gr) that differed according to the F concentration they received in the drinking water. Groups 1, 2, 3 and 4 received water containing 0 (control), 5, 15, and 50 mg F/L, respectively. The rats were killed at 120 days of age. Plasma and femur were collected and analyzed for fluoride with the ion specific electrode by the direct method or after hexamethyldisiloxane-facilitated diffusion. Data were tested for statistically significant differences by ANOVA and linear regression (p<0.05). RESULTS: Mean (± SE) plasma F concentrations ranged from 0.030 ± 0.002 to 0.187 ± 0.013 (mg/mL). The concentrations in surface and whole bone ranged from 610 ± 32 to 4,693 222; and 647 ± 22 to 3,439 ± 134 µg/g, respectively. The surface/whole F concentration ratios were 0.941, 1.414, 1.173 and 1.377, for groups 1, 2, 3 and 4 respectively. For plasma and whole bone, the difference among all groups was statistically significant, except for group 2 compared to group 1. For bone surface, all groups differed from each other except for group 2 compared to group 3. A significant positive correlation was found between bone surface and whole bone F (r²=0.94), as well as between plasma and bone surface (r²=0.71) and plasma and whole bone (r²=0.74). CONCLUSIONS: Data suggest that both bone surface and whole bone are suitable biomarkers of chronic F exposure in rats and plasma may be used as indicator of bone fluoride levels.

scholarly journals Evaluation of the Clinical Efficacy of Using Thermal Camera for Cryotherapy in Patients with Total Knee Arthroplasty: A Prospective Study

Medicina ◽  
2019 ◽  
Vol 55 (10) ◽  
pp. 661 ◽  
Author(s):  
Zekeriya Okan Karaduman ◽  
Ozan Turhal ◽  
Yalçın Turhan ◽  
Zafer Orhan ◽  
Mehmet Arican ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Postoperative Period ◽  
Thermal Camera ◽  
Prosthesis Infection ◽  
Total Knee ◽  
Group 3 ◽  
The Difference ◽  
Group 2 ◽  
Group 1

Background and objectives: Cryotherapy is a method of treatment using cold application. This study aimed to evaluate postoperative clinical and hematological parameters and pain associated with total knee arthroplasty in patients and compared cryotherapy to the conventional method of cold ice pack compressions. Materials and Methods: Between January 2015 and January 2016, 90 patients who underwent total knee arthroplasty for grade 4 gonarthrosis were prospectively evaluated. The patients were divided into three groups (n = 30, each): Group 1, cryotherapy was applied in the pre- and postoperative periods; Group 2, cryotherapy was applied only in the postoperative period; and Group 3 (control group), only a cold pack (gel ice) was applied postoperatively. In all groups, pre- and postoperative evaluations at 6, 24, and 48 h, hemorrhage follow-up, knee circumference measurement, visual analog scale pain score, knee circumference, and temperature measured by thermal camera were recorded. Results: Of the 90 patients, 10% were men and 90% were women. The mean age was 64.3 ± 8.1 (range: 46–83) years. The patella upper end diameter values were significantly lower in the postoperative period in Groups 1 and 2 than in Group 3 (p = 0.003). Hemoglobin levels at 24 and 48 h postoperatively were significantly lower in Group 3 than in Group 1 (p < 0.001, each) and Group 2 (p = 0.038, p < 0.001). At 6, 24, and 48 h follow-ups, pain values were significantly lower in Group 2 than in Group 3 (p < 0.001). Preoperative 6, 24, and 48 h temperature values were significantly lower in Group 1 than in Group 3 (p < 0.001 for each). It was found that the difference between preoperative and postoperative knee flexion measurements was significantly different in both groups or the difference between the groups was changed in each period (p < 0.001). Conclusions: Postoperative cryotherapy is a potentially simple, noninvasive option and beneficial for the reduction of reducing pain, bleeding, length of stay, analgesic requirement and swelling after total knee arthroplasty. Moreover, there was no early or late prosthesis infection in cryotherapy groups, which may be considered as an additional measure to prevent prosthesis infection.

High-dose lidocaine does not affect defibrillation efficacy: implications for defibrillation mechanisms

1998 ◽  
Vol 274 (4) ◽  
pp. H1113-H1120 ◽  
Author(s):  
Michael R. Ujhelyi ◽  
J. Jason Sims ◽  
Allison Winecoff Miller
Keyword(s):  
Ventricular Fibrillation ◽  
Cycle Length ◽  
Low Dose ◽  
High Dose ◽  
Channel Blockade ◽  
Group 3 ◽  
Baseline Values ◽  
Group 2 ◽  
Very High ◽  
Group 1

This study assessed the effect of low (10 mg ⋅ kg−1 ⋅ h−1) and very high (18 mg ⋅ kg−1 ⋅ h−1) doses of lidocaine on defibrillation energy requirements (DER) to relate changes in indexes of sodium-channel blockade with changes in DER values using a dose-response study design. In group 1 (control; n = 6 pigs), DER values were determined at baseline and during treatment with 5% dextrose in water (D5W) and with D5W added to D5W. In group 2 ( n = 7), DER values were determined at baseline and during treatment with low-dose lidocaine followed by high-dose lidocaine. In group 3 ( n = 3), DER values were determined at baseline and high-dose lidocaine. Group 3 controlled for the order of lidocaine treatment with the addition of high-dose lidocaine after baseline. DER values in group 1 did not change during D5W. In group 2, low-dose lidocaine increased DER values by 51% ( P = 0.01), whereas high-dose lidocaine added to low-dose lidocaine reduced DER values back to within 6% of baseline values ( P = 0.02, low dose vs. high dose). DER values during high-dose lidocaine in group 3 also remained near baseline values (16.2 ± 2.7 to 12.9 ± 2.7 J), demonstrating that treatment order had no impact on group 2. Progressive sodium-channel blockade was evident as incremental reduction in ventricular conduction velocity as the lidocaine dose increased. Lidocaine also significantly increased ventricular fibrillation cycle length as the lidocaine dose increased. However, the greatest increase in DER occurred when ventricular fibrillation cycle length was minimally affected, demonstrating a negative correlation ( P = 0.04). In summary, lidocaine has an inverted U-shaped DER dose-response curve. At very high lidocaine doses, DER values are similar to baseline and tend to decrease rather than increase. Increased refractoriness during ventricular fibrillation may be the electrophysiological mechanism by which high-dose lidocaine limits the adverse effects that low-dose lidocaine has on DER values. However, there is a possibility that an unidentified action of lidocaine is responsible for these effects.

An outbreak of oriental theileriosis in dairy cattle imported to Vietnam from Australia

Parasitology ◽  
2016 ◽  
Vol 144 (6) ◽  
pp. 738-746 ◽  
Author(s):  
HAGOS GEBREKIDAN ◽  
LINDA NELSON ◽  
GREG SMITH ◽  
ROBIN B. GASSER ◽  
ABDUL JABBAR
Keyword(s):  
Dairy Cattle ◽  
Phylogenetic Analyses ◽  
Surface Protein ◽  
Theileria Orientalis ◽  
Group 3 ◽  
Cattle Blood ◽  
The Difference ◽  
Group 2 ◽  
Major Piroplasm Surface Protein ◽  
Group 1

SUMMARYThis study reports an outbreak of oriental theileriosis in dairy cattle imported to Vietnam from Australia. Following clinical and pathological diagnoses, a total of 112 cattle blood samples were divided into three groups and tested using multiplexed tandem PCR. Group 1 were from aborted heifers in Vietnam; group 2 were from cattle before shipment from group 1 cattle and group 3 were from the same batch of cattle but transported to Taiwan. Theileria orientalis DNA was detected in 72·3% cattle. The prevalences of T. orientalis in groups 1, 2 and 3 were 77·6, 86·9 and 57·5%, respectively, and the difference in prevalence was significant between groups 1 and 3 (P < 0·0001). The infection intensities of genotypes chitose and ikeda of T. orientalis were higher in groups 1 (57 721 and 33 709, respectively) and 3 (5897 and 61 766, respectively) than those in group 2 (2071 and 6331, respectively). Phylogenetic analyses of the major piroplasm surface protein sequences revealed that genotypes chitose and ikeda determined herein were closely related to those previously reported from Australia. This first report of an outbreak of oriental theileriosis in imported cattle emphasizes improved measures for the export and import of cattle infected with T. orientalis.

Evaluation of the Impact of Three Different Pre-Transplant Strategies On the Outcome of Myeloma Patients Candidates to High-Dose Therapy.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 1223-1223
Author(s):  
Alessandro Corso ◽  
Silvia Mangiacavalli ◽  
Luciana Barbarano ◽  
Annalisa Citro ◽  
Paola Brasca ◽  
...  
Keyword(s):  
Patient Flow ◽  
High Dose ◽  
High Dose Therapy ◽  
Dose Therapy ◽  
Oral Dexamethasone ◽  
Group 3 ◽  
Group 2 ◽  
The Impact ◽  
Group 1

Abstract Abstract 1223 Poster Board I-245 Introduction This study aimed at evaluating the impact of three different pre-transplant therapies on the outcome of patients (pts) eligible for high-dose therapy. Methods two-hundred sixty eight newly diagnosed MM pts aged £65 years, Durie-Salmon stage III, II, or I in progression, were consecutively enrolled from 2000 to 2007 in three different protocols, with three different pre-transplant therapy: Group 1: (145 pts) 3 pulse-VAD cycles; Group 2: (67 pts) 3 pulse-VAD cycles plus 3 Thal-Dex cycles (thalidomide at the dose of 100 mg/day orally at bedtime, continuously for 3 months, oral dexamethasone at the dose of 20 mg on days 1-4 and 14-17 every 28 days); Group 3: (57pts) 4 Vel-Dex courses (Bortezomib 1.3 mg/m2 i.v. on days 1, 4, 8, 11; oral Dexamethasone 40 mg on days 1-4 and 8-11 every 3 weeks). After induction all pts received two DCEP-short cycles as mobilization (oral Dexamethasone 40 mg/day on days 1-4 + Cyclophosphamide 700 mg/m2/day i.v., Etoposide 100 mg/ m2/day i.v., cisPlatin 25 mg/m2/day for 2 days) with peripheral blood stem-cell (PBSC) collection prompted by G-CSF followed by one or two transplants (Tx) with melphalan 200 mg/m2 as conditioning regimen. Response was defined according to IMWG uniform criteria. Pts were considered responsive when obtaining at least a PR. Results pts in the three group were similar for age, gender, Ig type, ISS stage. A significant higher percentage of Durie and Salmon stages III was found in group 3 (83% vs 68% in group 1 and 67% in group 2, p=0.0002). The median follow-up was 46 (1-150) months for group 1, 43 (1-68) months for group 2, and 29.7 (1-79) months for group 3. At the time of this analysis in the three groups 51%, 65%, 90% of transplanted pts respectively were still alive, and progression after transplant was registered in 84%, 80%, 50% respectively. Patient flow before Tx was similar (p=0.45): 19% in group 1, 27% in group 2, 23% in group 3. In group 1, 2% of pts went off-study after VAD, and 17% after mobilization phase. In group 2, patient flow was equally distributed: 7% after pulse VAD, 10% after thal-dex, 9% after DCEP. In group 3, 12% of the pts went off-study after Vel-Dex, 11% after DCEP. Table 1 summarized responses. In group 3 (Vel-Dex) response was better along all protocol phases with respect to group 1 or 2 (p<0.00001). The number of responsive pts progressively increased from 87% after Vel-Dex (CR 31%), to 96% after transplant (CR 38%). Response rates of group 1 and 2 patients were not significantly different either after induction (p=0.6), after DCEP (p=0.5), and after Tx (p=0.65). On intention to treat basis, vel-dex induction produced a better, although not significant, PFS (34.6 months vs 29 in group 1 and 26.8 in group 2, p=0.56). OS were not statistically different among the three groups, event though the different follow-up could affect the analysis (median OS 110 in group 1, 66 months in group 2, and not reached in group 3, p=0.37). In multivariate analysis PFS was improved only by the achievement of CR (p=0.001). No significant difference was observed between VGPR or PR (p=0.43). Conclusion In this study, only CR not VGPR impacts on the outcome. Vel-Dex producing a significant high CR rate after TX (38%), seems to improve survival of MM patients candidate to high-dose therapy with respect to conventional pre-transplant strategies. Disclosures Morra: Roche:.

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