scholarly journals Η αποτελεσματικότητα της ενδοπεριτοναϊκής έγχυσης τοπικού αναισθητικού στη μετεγχειρητική αναλγησία και το stress μετά από λαπαροσκοπική χολοκυστεοκτομή

2016 ◽  
Author(s):  
Ελένη Μελίδη
Keyword(s):  
Normal Saline ◽  
Λαπαροσκοπική Χολοκυστεκτομή

Σκοπός της παρούσας μελέτης ήταν η αξιολόγηση της αποτελεσματικότητας της ενδοπεριτοναϊκής έγχυσης λεβοβουπιβακαΐνης στο μετεγχειρητικό πόνο και το stress μετά από προγραμματισμένη λαπαροσκοπική χολοκυστεκτομή.Στην παρούσα προοπτική, τυχαιοποιημένη, διπλή-τυφλή μελέτη, 73 ασθενείς, κατόπιν έγγραφης συγκατάθεσης, τυχαιοποιήθηκαν σε δύο ομάδες. Μετά την ολοκλήρωση της χολοκυστεκτομής, τοποθετήθηκε ένας καθετήρας nelaton 10Fr στη δεξιά άνω οπή των Trocar σε όλους τους ασθενείς. Στην ομάδα του τοπικού αναισθητικού (ΤΑ), 36 ασθενείς έλαβαν ενδοπεριτοναϊκά 10 ml Λεβοβουπιβακαΐνης 0.5% στο τέλος της επέμβασης και 4 ώρες μετεγχειρητικά. Αμέσως μετά το τέλος της 2ης έγχυσης ακολούθησε αφαίρεση του καθετήρα nelaton σε όλους τους ασθενείς. Στην ομάδα εικονικού φαρμάκου (placebo) 37 ασθενείς έλαβαν 10 ml normal saline 0.9%, αντίστοιχα. Πραγματοποιήθηκε καταγραφή του μετεγχειρητικού πόνου με την κλίμακα μέτρησης κατά VAS, της εντόπισης του πόνου, της κατανάλωσης αναλγητικών, των ζωτικών σημείων, καθώς και της εμφάνισης επιπλοκών στις 0, 2, 6, 12, 18 και 24 ώρες μετεγχειρητικά. Επίσης, λήφθηκαν δείγματα αίματος μισή ώρα πριν και 24 ώρες μετά το πέρας της επέμβασης και προσδιορίστηκαν τα επίπεδα δεικτών φλεγμονής στο πλάσμα (CRP, IL-6, κορτιζόλη και λευκά αιμοσφαίρια). Τέλος, αξιολογήθηκε ο βαθμός ικανοποίησης των ασθενών κατά την έξοδό τους.Οι δύο ομάδες είχαν συγκρίσιμα δημογραφικά χαρακτηριστικά. Η ομάδα ΤΑ εμφάνισε σημαντικά μειωμένο σκορ πόνου κατά VAS, σε σχέση με την ομάδα placebo, τόσο στην ηρεμία (p=0.012), όσο και στην κίνηση (p<0.001), καθ΄ όλη τη διάρκεια του πρώτου 24ώρου. Επιπλέον, στην ομάδα ΤΑ σημειώθηκε σημαντικά μικρότερη κατανάλωση οπιοειδών στις 0 και 2 ώρες μετεγχειρητικά (p<0.001). Αναφορικά με τις μετρήσεις των λευκών αιμοσφαιρίων, της CRP, της IL-6 και της κορτιζόλης, τόσο προεγχειρητικά, όσο και μετεγχειρητικά, δεν αναδείχθηκε στατιστικά σημαντική διαφορά ανάμεσα στις δύο ομάδες. Μόνο σε κάθε ομάδα ξεχωριστά, σημειώθηκε σημαντική μεταβολή στα επίπεδα των λευκών αιμοσφαιρίων και της CRP, μεταξύ των τιμών πριν και 24 ώρες μετά την επέμβαση (p<0.001), κάτι που άλλωστε ήταν αναμενόμενο λόγω του χειρουργικού τραύματος.Συμπερασματικά, η ενδοπεριτοναϊκή έγχυση 10 ml λεβοβουπιβακαΐνης 0.5%, χορηγούμενης στο τέλος και 4 ώρες μετά από προγραμματισμένη λαπαροσκοπική χολοκυστεκτομή, συσχετίστηκε σημαντικά με μείωση του μετεγχειρητικού πόνου κατά τη διάρκεια του πρώτου 24ώρου, αλλά και με μείωση της κατανάλωσης οπιοειδών για τις πρώτες 2 μετεγχειρητικές ώρες. Σημαντικές μεταβολές στις τιμές των δεικτών φλεγμονής 24 ώρες μετά τη διενέργεια της λαπαροσκοπικής χολοκυστεκτομής, συγκριτικά με τις προεγχειρητικές τιμές δεν παρατηρήθηκε στον υπό μελέτη πληθυσμό.

Kinetics of Various 99mTc-Sn-Pyrophosphate Compounds in the Rat

1977 ◽  
Vol 16 (04) ◽  
pp. 157-162 ◽  
Author(s):  
C. Schümichen ◽  
B. Mackenbrock ◽  
G. Hoffmann
Keyword(s):  
Normal Saline ◽  
Half Life ◽  
Compound A ◽  
Short Half Life ◽  
Low Concentrations ◽  
The Stability ◽  
Kinetics Of ◽  
In Vitro Stability

SummaryThe bone-seeking 99mTc-Sn-pyrophosphate compound (compound A) was diluted both in vitro and in vivo and proved to be unstable both in vitro and in vivo. However, stability was much better in vivo than in vitro and thus the in vitro stability of compound A after dilution in various mediums could be followed up by a consecutive evaluation of the in vivo distribution in the rat. After dilution in neutral normal saline compound A is metastable and after a short half-life it is transformed into the other 99mTc-Sn-pyrophosphate compound A is metastable and after a short half-life in bone but in the kidneys. After dilution in normal saline of low pH and in buffering solutions the stability of compound A is increased. In human plasma compound A is relatively stable but not in plasma water. When compound B is formed in a buffering solution, uptake in the kidneys and excretion in urine is lowered and blood concentration increased.It is assumed that the association of protons to compound A will increase its stability at low concentrations while that to compound B will lead to a strong protein bond in plasma. It is concluded that compound A will not be stable in vivo because of a lack of stability in the extravascular space, and that the protein bond in plasma will be a measure of its in vivo stability.

The role of intracanal medicaments in inhibition of bacteria isolated from root canals of infected primary molars

2019 ◽  
Vol 14 (1) ◽  
pp. 92
Author(s):  
Dr. Maha Abdul- Kareem Mahmood ◽  
Dr. Huda Elias Ali ◽  
Dr. Haraa Khairi Abdul-Kadher
Keyword(s):  
Antimicrobial Activity ◽  
Streptococcus Mutans ◽  
Normal Saline ◽  
Root Canal ◽  
Primary Teeth ◽  
Primary Molars ◽  
Root Canals ◽  
Etiologic Agents ◽  
Micro Organisms

Microbes are considered as the primary etiologic agents in endodontic diseases.Disinfection of the root canal is obtained by the combined effect of biomechanicalpreparation, irrigation and intra canal medicament. The aim of the present study wasto assess the antimicrobial activity of intracanal medicaments (formocresol andEndosepton) against two micro organisms (Streptococcus mutans and staphylococcusaureus) isolated from 15 necrotic pulps of primary molars indicated for pulpectomyprocedure. The samples were cultured, and purified using microbiological evaluation.Broth dilution test was performed in our study by preparing test tubes containing10 ml of BHI broth (pH. 7) which then inoculated with strains of the tested bacteriaand incubated at 37 C° for 24 h. After over night incubaction, ten fold dilution weremade in test tubes containing 9 ml of normal saline by adding 1 ml of the inoculum tothe first tube . Then from dilution 10-1 , 0.1 ml of cell suspension was added to 9.9 mlof formocresol and endosepton, then 0.1 ml was taken and spread on duplicates ofBHI agar plates at different intervals and incubated aerobically for 24 h. at 37 C°.Colonies on the plates were counted after incubation and CFU/mL (colony formingunit) was calculated. Our results indicating that there were no significant differencesbetween the intracanal medicaments, but there were high significant differencesbetween the intervals time of the study. We concluded that both materials had greatantibacterial effect against the pathogens commonly isolated from necrotic pulpaltissue of primary teeth.

EFFECTS OF INCREASING DOSES OF PYROGLUTAMYL-HISTIDYL-PROLINE AMIDE ON SERUM THYROTROPHIN LEVELS IN NORMAL SUBJECTS

1972 ◽  
Vol 70 (1) ◽  
pp. 196-208 ◽  
Author(s):  
Bengt Karlberg ◽  
Sven Almqvist
Keyword(s):  
Normal Saline ◽  
Standard Dose ◽  
Normal Subjects ◽  
Response Curves ◽  
Clinical Observations ◽  
Trh Stimulation ◽  
Stimulation Tests ◽  
Serial Measurements ◽  
Serum Tsh ◽  
Stimulation Of

ABSTRACT The effects of the administration of normal saline in four normal subjects and the single iv injections of synthetic pyroglutamyl-histidyl-proline amide (TRH) in doses of 6.25, 12.5, 25, 50, 100, 200 and 400 μg in 12 healthy subjects were evaluated by clinical observations and serial measurements from −10 to + 360 minutes of serum TSH, PBI, STH, cholesterol, glucose and insulin. Normal saline and TRH 6.25 μg iv did not change the serum TSH level. The minimum iv dose of TRH increasing serum TSH within 10 minutes was 12.5 μg. Nine of 12 subjects gave maximal increases of serum TSH after TRH 100 μg and all after 200 and 400 μg. The time for the peak response varied with the dose from 15 to 60 minutes. The dose-response curves, average and individual, were complex and not linear. This was interpreted as a varying degree of stimulation of both pituitary synthesis and release of TSH by TRH. PBI changes were measured at 2 h and 6 h. Minimum dose for a significant increase of PBI was 12.5 μg and 6.25 μg of TRH for the respective times. No change in basal STH-levels occurred in 53 of 65 TRH-stimulation tests. Nine of the 12 changes in serum STH occurred in four subjects with varying basal STH-levels. No changes were found in serum cholesterol, glucose or insulin. Our results show that 50 μg of TRH can be used as a standard dose for the single iv stimulation of pituitary release of TSH. TRH stimulated both TSH and STH release in 18% of our tests.

Comparing the efficacy of nebulized morphine with intravenous morphine in traumatic musculoskeletal pain management

2020 ◽  
Vol 8 (1) ◽  
pp. 21-21
Author(s):  
Mani Mofidi ◽  
Ali Dashti ◽  
Mahdi Rezai ◽  
Niloufar Ghodrati ◽  
Hoorolnesa Ameli ◽  
...  
Keyword(s):  
Pain Management ◽  
Pain Relief ◽  
Musculoskeletal Pain ◽  
Normal Saline ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Vital Signs ◽  
Categorical Variables ◽  
Intravenous Morphine ◽  
Numerical Rating

Introduction: This study was designed to compare the effectiveness of intravenous morphine with nebulized morphine in pain relief of patients referring to the emergency setting with traumatic musculoskeletal pain. Methods: This randomized, placebo-controlled and double-blind clinical study evaluated 160 patients 18 to 65 years of age with acute traumatic pain, who attended the emergency department during 2019. Subjects were assessed with Numerical Rating Scale based on inclusion and exclusion criteria and randomly divided into two groups. In one group, 80 patients received IV morphine (0.1 mg/kg+5 mL normal saline) plus an equivalent volume of IV placebo. In the second group, 80 patients received nebulized morphine (0.2 mg/kg+5 mL normal saline) plus nebulized placebo. Pain score was monitored in all patients with Numerical Rating Scale before and after intervention at baseline, 15, 30, 45, and 60-minute intervals. Patients’ vital signs and possible adverse events were evaluated in each observation time points. Finally, all participants were assessed for their satisfaction with pain management. Data were analyzed using repeated measure analysis for continuous variables and Binomial test for categorical variables Results: There was no significant difference between the demographic characteristics of patients in study groups. Pain relief between the two groups was similar during the observation (0, 15, 30, 45, 60 min) (P>0.05). There were no changes in vital signs between two groups, although the nebulized group had lower systolic blood pressure at the time-point of 15 minutes after the treatment initiation (P=0.03). Conclusion: Although Nebulized morphine has similar efficacy in comparison with IV route, nebulization might be considered as the clinically efficacious route of morphine administration with minimal side effects, providing optimal pain relief in patients.

Evaluation of a New 99mTc-labeled GnRH Analogue as a Possible Imaging Agent for Prostate Cancer Detection

2020 ◽  
Vol 20 (14) ◽  
pp. 1695-1703
Author(s):  
Arezou Masteri Farahani ◽  
Fariba Maleki ◽  
Nourollah Sadeghzadeh ◽  
Saeid Abediankenari ◽  
Seyed Mohammad Abedi ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cell Lines ◽  
Cancer Cell ◽  
Nude Mice ◽  
Normal Saline ◽  
Radiochemical Purity ◽  
Prostate Cancer Cell ◽  
Gnrh Analogue ◽  
Tumor Uptake ◽  
Prostate Cancer Cell Lines

Introduction: Prostate cancer is a serious threat to men’s health so it is necessary to develop technics for early detection of this malignancy. The purpose of this research was the evaluation of a new99mTc-labeled GnRH analogue as an imaging probe for tumor targeting of prostate cancer. Methods: 99mTc-labeled-DLys6-GnRH analogue was prepared based on HYNIC as a chelating agent and tricine/ EDDA as coligands for labeling with 99mTc. HYNIC was coupled to epsilon amino group of DLys6 through aminobutyric acid (GABA) as a linker. Radiochemical purity and stability in normal saline and serum, were determined by TLC and HPLC methods. Furthermore, calculation of protein-binding and partition coefficient constant were carried out for 99mTc labeled peptide. The cellular experiments including receptor binding specificity and affinity were studied using three prostate cancer cell lines LN-CaP, DU-145 and PC-3. Finally, the animal assessment and SPECT imaging of radiolabeled GnRH analogue were evaluated on normal mice and nude mice bearing LN-CaP tumor. Results: The GnRH conjugate was labeled with high radiochemical purity (~97%). The radiolabeled peptide showed efficient stability in the presence of normal saline and human serum. The in vitro cellular assays on three prostate cancer cell lines indicated that the radiotracer was bound to LN-CaP cells with higher affinity compared to DU-145 and PC-3 cells. The Kd values of 99mTc- HYNIC (tricine/ EDDA)-Gaba-D-Lys6GnRH were 89.39±26.71, 93.57±30.49 and107.3±18.82 in LN-CaP, PC-3 and DU-145 cells respectively. The biodistribution studies in normal mice and LN-CaP tumor-bearing nude mice showed similar results including rapid blood clearance and low radioactivity accumulation in non-target organs. High kidney uptake proved that the main excretion route of radiopeptide was through the urinary system. The tumor uptake was 1.72±0.45 %ID/g at 1h p.i. decreasing to 0.70±0.06%ID/g at 4h p.i. for 99mTc-HYNIC-Gaba-D-Lys6GnRH. The maximum tumor/ muscle ratio was 2.30 at 1h p.i. Pre-saturation of receptor using an excess of unlabeled peptide revealed that the tumor uptake was receptor mediated. The results of the SPECT image of LN-CaP tumor were in agreement with the biodistribution data. Conclusion: Based on this study, we suggest LN-CaP as a favorable cell line for in vivo studies on GnRH analogues. Moreover, this report shows that 99mTc-HYNIC (tricine/EDDA)-Gaba-D-Lys6GnRH may be a suitable candidate for further evaluation of prostate cancer.

Analgesic Effect of Nebulized Versus Intravenous Fentanyl for Pain Relief of Limb Fracture: A Double-Blind Clinical Trial

2017 ◽  
Vol 11 (1) ◽  
pp. 101-106
Author(s):  
Mohammadreza Maleki Verki ◽  
Kambiz Masoumi ◽  
Hassan Motamed ◽  
Meisam Moezi ◽  
Arash Forouzan ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Pain Relief ◽  
Normal Saline ◽  
Pain Level ◽  
Fentanyl Citrate ◽  
Double Blind ◽  
Intravenous Fentanyl ◽  
Limb Fracture ◽  
Double Blind Clinical Trial ◽  
Fentanyl Group

Background:More than half of the patients attending emergency centers need analgesics. Injectable analgesics are currently the most common pain control strategy, but entail complications. Fentanyl is one of the most commonly used pain-relief opiates available in various forms.Objective:The present study aims to compare analgesic effects of nebulized against intravenous fentanyl for controlling pain due to limb fracture.Method:The present double-blind clinical trial recruited 213 patients presenting with fractured limbs to emergency departments. The first group of patients received 1 micg/kg of intravenous fentanyl citrate from a solution of 50 micg/ml and 5 ml of normal saline in nebulized form (group A), and the second group intravenously received 5 ml of normal saline and 4 micg/kg of 50 micg/ml solution of fentanyl citrate in nebulized form, whose volume reached 5 ml with the addition of normal saline (group B). Then, pain level was frequently measured and compared in the two groups for 20 minutes.Results:The results obtained showed reduced pain level in both the groups. However, point-by-point comparison of pain in the two groups revealed significantly greater pain reduction in intravenous fentanyl group (P<0.001). The need for adjuvant pain relief medication was 8.3% in intravenous fentanyl group and 24% in nebulized fentanyl group, with a significant difference between the two groups (P=0.002).Conclusion:According to the results, although nebulized fentanyl is effective in controlling pain due to limb fracture, it was less effective than intravenous type, and unable to control pain in many cases.

The Effect of Prophylactic Ephedrine on Systemic Hypotension Caused by Induction of Anaesthesia with Propofol and Sufentanil in Elderly Hypertensive Patients: A Prospective Randomized, Double-blind Placebo-controlled Clinical Trial

2020 ◽  
Keyword(s):  
Blood Pressure ◽  
General Anesthesia ◽  
Normal Saline ◽  
Saline Group ◽  
Normal Saline Group ◽  
Hypertensive Patients ◽  
Group A ◽  
Elderly Hypertensive ◽  
Elderly Hypertensive Patients ◽  
Group B

Objective: To study the effectiveness of prophylactic ephedrine to prevent hypotension caused by induction of anesthesia with propofol and sufentanil in elderly hypertensive patients. Methodology: 70 elderly ASA grade II-III hypertensive patients undergoing elective general anesthesia were randomized into two groups to receive either intravenous ephedrine,100 ug/kg in 5ml normal saline (Group B), or an equal volume of normal saline (Group A) before induction. Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP) and Heart Rate (HR) were recorded at T0 (after entry to the operating room), T1 (1 min after induction), T2 (2 min after induction), T3 ( 3 min after induction), T4 (4 min after induction), T5 (when intubated), T6 (2 min after intubation), and T7 (at the start of the procedure), as well as the incidence of hypotension and bradycardia. Results: SBP, DBP and HR were not significantly different at T0 and were significantly different at T1 to T7 after anesthesia induction. There were statistically significant effect on hypotension and bradycardia between the two groups and group B have a lower risk of hypotension and bradycardia relative to group A. SBP and DBP decreased significantly after induction in both groups. HR decreased significantly in group A while increased in group B. Conclusion: Ephedrine pretreatment can minimize hypotension and bradycardia caused by propofol and sufentanil during the induction of general anesthesia in elderly patients with hypertension.

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