Effects Of Continuous Intravenous Infusion Research Articles

Effects of continuous intravenous infusion with propofol on intestinal metabolites in rats.

Microbial metabolites play an important role in regulating intestinal homeostasis and immune responses. Propofol is a common anesthetic in clinic, but it is not clear whether it affects intestinal metabolites in rats. Tail vein puncture was performed after adaptive feeding for 1 month in eight 2-month-old rats and they were given continuous intravenous infusion of propofol for 3 h. The feces of rats were divided into different groups based on time periods, with before and after anesthesia with propofol on days 1, 3 and 7 labeled as groups P, A1, A3 and A7, respectively. The effect of continuous intravenous infusion with propofol on rat fecal metabolites was determined using the non-targeted metabolomics technique gas chromatography coupled with a time-of-flight mass spectrometer analysis. The types and contents of metabolites in rat feces were changed after continuous intravenous infusion with propofol, but the changes were not statistically significant. The contents of the metabolites 3-hydroxyphenylacetic acid and palmitic acid increased from day 3 to 7, and it was shown that the two metabolites were positively correlated at a statistically significant level. Linoleic acid decreased to its lowest level on day 3, and it returned to pre-anesthesia level on day 7. At the same time, linoleic acid metabolism was a metabolic pathway that was co-enriched 7 days after infusion with propofol. Spearman correlation analysis showed that there was significant correlation between some differential metabolites and differential microorganisms. It was observed that zymosterol 1, cytosin and elaidic acid were negatively correlated with Alloprevotella in the A3 vs. P group. In the A7 vs. P group, cortexolone 3 and coprostan-3-one were positively correlated with Faecalibacterium, whilst aconitic acid was negatively correlated with it. In conclusion, the present study revealed statistically insignificant effects of continuous intravenous propofol on the intestinal metabolites in rats.

Influence of alprostadil on the dynamics of blood flow resistance index and renal graft function in the early postoperative period

Aim . To evaluate the effect of continuous intravenous infusion of alprostadil solution on the dynamics of the peripheral resistance to arterial blood flow and renal graft function in the early postoperative period. Material and methods . From June 2018 to May 2022, 278 kidney transplants from a deceased donor were performed at the City Clinical Hospital n.a. S.P. Botkin. In 179 recipients operated from June 2018 to May 2021, we evaluated the significance of the intraoperatively determined resistance index of blood flow in the segmental arteries of the renal graft as a predictor of the development of its delayed function. The study of the effect of alprostadil included 32 patients divided into 2 groups comparable in patient age, gender, body mass index. The resistance index in both groups was more than 0.85. In the second group patients received a continuous intravenous infusion of alprostadil solution in the first 3 days after surgery. Results . Retrospectively we found that in patients with a high resistance index (more than 0.85), the risk of developing delayed graft function was 6.9 times higher, that was statistically significant (p=0.001). In the alprostadil group, a delayed graft function developed in 5 of 18 patients (27.8%), compared with the control group, where delayed graft function developed in 9 of 14 (64.3%) patients, however, without reaching the level of statistical significance (p=0.072). The median time to normalization of graft function in group II was 4 (interquartile range: 3–4) days, while in group I it was 7 (interquartile range: 5–8) days (p=0.05). The median hospital length of stay in the alprostadil group was significantly lower than in the control group and amounted to 13 (interquartile range: 8–15) versus 17 (interquartile range: 15–19) days (p=0.032). Conclusion . The use of continuous intravenous infusion of alprostadil solution after kidney transplantation in patients with a high intraoperative resistance index can safely and effectively lead to a decrease in resistance index to normal rates, accelerate the recovery of graft function and significantly reduce the incidence of delayed graft function. However, further research is needed.

[Effects of subanesthetic dose of esketamine on opioid consumption after thoracoscopic surgery].

Objective: To investigate the effect of continuous intravenous infusion of subanesthetic dose of esketamine intraoperatively on postoperative opioid consumption in patients undergoing thoracoscopic surgery. Methods: A total of 71 patients with elective thoracoscopic lung surgery in the First Affiliated Hospital of Zhengzhou University from December 2020 to December 2021 were selected. Patients who were classified as grade Ⅰ or Ⅱ by the American Society of Anesthesiologists (ASA) and aged 18-70 years were included, including 32 males and 39 females, with a body mass index (BMI) of 18.5-30.0 kg/m2. The patients were randomly divided into three groups: (1) Control group (group C, n=24): continuous intravenous infusion of normal saline at the same rate during surgery; (2) Subanesthetic dose of esketamine 0.125 mg·kg-1·h-1 group (group ES1, n=23): continuous intravenous infusion of esketamine at a rate of 0.125 mg·kg-1·h-1 during surgery; (3) Subanesthetic dose of esketamine 0.250 mg·kg-1·h-1 group (group ES2, n=24): continuous intravenous infusion of esketamine at a rate of 0.250 mg·kg-1·h-1 during surgery. The main outcome measures were the total consumptions of hydromorphone of 3 groups within 24 and 48 hours after surgery. The secondary outcome measures were the extubation time, length of postanesthesia care unit (PACU) stay, the time of first feeding, and the incidences of adverse effects within 24 h after surgery in 3 groups. Results: The 24 h postoperative consumption of hydromorphone in group C, ES1 and ES2 was (5.4±1.0) mg, (4.5±1.5) mg and (4.0±0.8) mg, respectively. Likewise, the 48 h postoperative consumption of hydromorphone was (9.7±2.2) mg, (9.0±3.0) mg and (7.7±1.8) mg, respectively. Compared with group C, the 24 h postoperative hydromorphone consumptions were significantly reduced in group ES1 and ES2 (both P<0.05). The extubation time, length of PACU stay and the time of first feeding after surgery in group C were (23±10) min,(70±12) min,(17±3) h,in group ES1 were (22±4) min,(69±11) min,(14±5) h,in group ES2 were (16±8) min,(58±12) min,(14±3) h, respectively. Compared with group C and group ES1, both of the extubation time and length of PACU stay were shortened in group ES2 (both P<0.05). Compared with group C, the first postoperative feeding time of group ES1 and ES2 was shortened (both P<0.05). There were no differences in the incidences of adverse effects at postoperative 24 h among 3 groups (all P>0.05). Conclusion: Continuously intravenous infusion of subanesthetic esketamine at a rate of 0.250 mg·kg-1·h-1 can significantly reduce the postoperative opioid consumption and improve the patient's outcomes.

Antinociceptive and analgesic effect of continuous intravenous infusion of maropitant, lidocaine and ketamine alone or in combination in cats undergoing ovariohysterectomy

BackgroundMultimodal analgesia consists of the combination of analgesic drugs at low doses to act in different places along the path of pain. Studies with continuous infusion of analgesic drugs in cats are not common. This study aimed to evaluate the analgesic effect of maropitant, lidocaine and ketamine alone or in combination (intravenous bolus + subsequent continuous intravenous infusion) in the management of acute postoperative pain in cats undergoing ovariohysterectomy. Seventy healthy cats undergoing an ovariohysterectomy received a standard anesthetic protocol consisting of acepromazine and morphine, propofol (anesthesia induction), and isoflurane (anesthesia maintenance). The animals were stratified into seven groups (n = 10 in each group): control (CG), maropitant (MG), lidocaine (LG), ketamine (KG), maropitant + lidocaine (LMG), maropitant + ketamine (KMG), and maropitant + lidocaine + ketamine (LKMG). All drugs were injected first as an intravenous bolus and then by continuous intravenous infusion. During surgery, esophageal temperature, respiratory rate, heart rate, oxygen saturation, expired isoflurane concentration, and partial pressure of carbon dioxide at the end of expiration were evaluated at 7 time points. Postoperative pain was evaluated for 6 h after extubation using the visual analogue scale and the UNESP-Botucatu multidimensional composite pain scale for assessing postoperative pain in cats.ResultsAdverse effects related to maropitant, lidocaine and ketamine infusion were not observed. Pain scores were lower in the MG, KG and LG groups when compared to the CG group using both scales. Although pain scores were also lower in all combination groups than CG, more animals in these groups required rescue analgesia compared to MG. This indicates that the postoperative analgesic effect of all drugs, either alone or in combination, confers analgesia, although the combinations did not promote greater analgesia.ConclusionsContinuous intravenous infusion of maropitant, lidocaine, and ketamine alone induces postoperative analgesic effect in cats undergoing ovariohysterectomy, but combinations of these drugs did not increase the analgesic effect. No adverse effect was observed with any drug or their combination.

Comparison of the effect of continuous intravenous infusion of sodium valproate and midazolam on management of status epilepticus in children

Background and ObjectivesStatus epilepticus as a pediatric emergency requires rapid seizure control in order to prevent subsequent disabilities. Therefore, the present study was conducted to compare the efficacy and side effects of continuous intravenous infusion of sodium valproate versus midazolam as a third-line treatment of status epilepticus in children. MethodologyThis randomized clinical trial study included all children with convulsive and non-convulsive status epilepticus admitted to the pediatric intensive care unit (PICU) of the Bu-Ali Sina Hospital in Sari City (Mazandaran Province, Iran) who had not responded to first-line treatment with diazepam and second-line treatment with phenytoin or phenobarbital. They were consequently treated with continuous intravenous infusion of sodium valproate or midazolam to control persistent seizures. ResultsThe study comprised 70 patients who were randomly assigned to two equal groups of sodium valproate or midazolam treatment. The mean age of patients in group A (sodium valproate) and group B (midazolam) was 3.97 ± 3.33 and 3.84 ± 2.93 years, respectively. In the present study, the most common etiology of status epilepticus was remote symptomatic, accounting for 35% of cases in the two groups. Sodium valproate was effective in controlling status epilepticus in 91.4% of patients, while midazolam was found to be effective in 85.7% of patients (p > 0.05). Patients who received sodium valproate had shorter seizure duration after administration of the drug compared to those who received midazolam (p = 0.01). Eight patients in the midazolam group and two patients in the sodium valproate group were intubated (p = 0.023). The mean duration of stay in the PICU was 3.2 ± 1.4 and 5.6 ± 2.8 days in groups A and B, respectively, showing a significant difference (p = 0.001). ConclusionAccording to our findings, intravenous infusion of sodium valproate can be used as an effective and relatively safe treatment in children with all types of status epilepticus, especially in challenging situations such as lack of intensive care units or respiratory problems.

Effects of continuous intravenous infusion of propofol on intestinal flora in rats

Under normal circumstances, the gut microbiota, host, and external environment establish a dynamic ecological balance and maintain human health. Once this balance is broken, the intestinal flora dysregulation will form, manifested by changes in the diversity, richness, proportion, location and biological characteristics of the gut microbiota. The hypothesis that propofol alters gut microbes was tested in a rat model with continuous intravenous infusion of propofol. Eight male wistar rats underwent tail vein puncture and catheterization respectively, and were continuously pumped with propofol for 3 h. Feces were collected from each rat before and on the 1 st, 3rd, 7th and 14th days after intervention. Finally, the effect of continuous intravenous infusion of propofol on the intestinal flora of rats was analyzed by high-throughput 16S rRNA gene amplification sequencing. Through high-throughput 16S rRNA gene amplicon sequencing analysis, we found that continuous intravenous infusion of propofol had little effect on intestinal flora in rats. Analysis of Alpha (shannon diversity index) showed that group A-7 was different from group P and group A-1 (P = 0.034), and recovered on the 14th day. Although the species diversity analysis showed a significant difference among the five groups (P = 0.049), the distribution of most fecal samples in the PCoA showed a clustered distribution, indicating similarity. In addition, no significant difference was found in the statistical KEGG difference pathway through LEfSe analysis.

Anesthetic quality and cardiovascular and respiratory effects of continuous intravenous infusion of tiletamine-zolazepam in bitches

ABSTRACT: The objective of this study was to evaluate the quality and recovery from anesthesia promoted by the tiletamine-zolazepam (TZ) combination administered intravenously (IV) continuously in bitches pre-medicated with acepromazine. Eight cross-bred, clinically healthy bitches weighing 13.7 ±1.9kg on average were used in this study. After a food fast of 12 h and a water fast of four hours, the animals were treated with acepromazine (0.1mg/kg, intramuscular) and, after 15 minutes, anesthesia was induced with a combination of tiletamine-zolazepam (2mg/kg, IV) immediately followed by continuous IV infusion thereof at a dose of 2mg/kg/h for 60 min. The following parameters were measured in all animals immediately before administration of acepromazine (M15), immediately before anesthetic induction (M0), and at 5, 10, 20, 30, 40, 50, and 60 min after initiation of continuous infusion (M5, M10, M20, M30, M40, M50, and M60): electrocardiography (ECG), heart rate (HR), mean arterial pressure (MAP), respiratory rate (RR), body temperature (BT), and arterial hemogasometry, with the last performed only at experimental times M15, M0, M30, and M60. A subcutaneous electrical stimulator was used to evaluate the degree of analgesia. Myorelaxation and quality of anesthetic recovery were also assessed, classifying these parameters as excellent, good, and poor. Anesthetic recovery time was recorded in minutes. HR increased significantly at time M10 in relation to that at M-15, and at times M5, M10, M40, and M50 in relation to that at M0. MAP decreased significantly at M20 and M30 compared with the baseline. BT decreased significantly at M50 compared with that at M0, but no hypothermia was observed. RR showed significant reduction at M5, M10, and M20 in relation to that at M-15, and at M5 and M10 in relation to that at M0, and bradypnoea was observed during the first 20 min after anesthetic induction. Significant decreases in the PR interval at times M10, M40, and M50 were observed in relation to that at M15. Amplitude of the R wave showed significant decrease at M20 compared with that at M-15. In the other ECG parameters, no significant difference was observed between the times evaluated. Hemogasometric parameters and analgesia did not show significant alterations. Myorelaxation and quality of anesthetic recovery were considered excellent. Recovery time was 15.1±7.7 min for positioning of sternal decubitus and 45.5±23.1 minutes for return of ambulation. Continuous IV administration of TZ combination does not produce satisfactory analgesia and does not cause severe cardiorespiratory and hemogasometric effects in bitches pre-medicated with acepromazine.

Evaluating the effects of continuous intravenous infusions of tramadol and tramadol-lidocaine on sevoflurane minimum alveolar concentration (MAC) and entropy values in dogs.

The sparing effects of tramadol and tramadol-lidocaine infusion on the minimum alveolar concentration (MAC) of sevoflurane in dogs as well as the entropy indices were investigated. Anesthesia was induced in eight young, healthy German shepherds weighing 27.6 ± 3.2 kg (mean ± SD) and maintained with sevoflurane. A standard tail-clamp technique was used to determine sevoflurane MAC during infusion with: sevoflurane alone to measure baseline MAC (MACB); tramadol (intravenous loading dose of 1.5 mg/kg and constant rate infusion [CRI] of 2.6 mg/kg/hr; MACT); and tramadol-lidocaine (tramadol CRI of 2.6 mg/kg/hr; and lidocaine intravenous loading dose of 1.0 mg/kg and CRI of 6 mg/kg/hr; MACTL). The state entropy (SE), response entropy (RE), and RE-SE difference were recorded 5 min prior to and during tail clamping. MACB was 2.4 ± 0.2%. Tramadol and tramadol-lidocaine CRI decreased MAC to 2.2 ± 0.3% and 1.7 ± 0.3%, respectively. The MAC-sparing effect of tramadol-lidocaine was greater than that of tramadol alone (8.2 ± 8.9% vs. 30.1 ± 10.7%; P<0.01). SE and RE in all subjects, and RE-SE difference in most subjects, were increased (all P<0.05) when they responded purposefully to noxious stimulation. A tramadol-lidocaine combination infusion can reduce anesthetic requirements to a higher degree than tramadol alone. Furthermore, MACentropy, MAC required to prevent increased entropy in response to a painful stimulation, and MAC of sevoflurane were similar in dogs.

Effect of continuous furosemide infusion on outcome of acute kidney injury.

Objective:To evaluate the clinical effects of continuous intravenous infusion with high-dose furosemide on early acute kidney injury (AKI) complicated with acute lung edema.Methods:Ninety patients who had been treated by furosemide at routine dose for 12 hour but with unsatisfactory outcomes were selected and subjected to continuous intravenous infusion with high-dose furosemide. The dose was adjusted according to hourly urine output. Serum levels of urea nitrogen, creatinine and potassium, pH, oxygenation index and mechanical ventilation time before and 6, 12, 24, 48 and 72 hour after treatment were compared.Results:The urine outputs before and 6, 12, 24, 48 and 72 hour after treatment were (10.71 ± 1.81), (164.52 ± 21.42), (189.71 ± 29.61), (181.33 ± 23.52), (176.82 ± 24.80) and (164.52 ± 18.91) ml/h respectively. Compared with data before treatment, the serum levels of urea nitrogen, creatinine and potassium significantly decreased while pH and oxygenation index significantly increased after six hour of treatment (P<0.05). After treatment, the kidney functions of 80 patients (88.9%) were completely recovered, without obvious adverse reactions.Conclusion:For patients with early AKI complicated with acute pulmonary edema who cannot be cured by diuretic agent at routine dose, high-dose furosemide increases urine output and improves success rate.

Effects of Continuous Intravenous Infusion of Dexmedetomidine on the Duration of Spinal Anesthesia: A Prospective, Double-Blind, Randomized, Controlled Trial

Background: Spinal anesthesia with sedation is a common anesthetic technique in infraumbilical surgeries. Dexmedetomidine has been widely used as a sedative during spinal anesthesia, and is recognized as an adjuvant that prolongs the duration of spinal anesthesia. We compared the effects of a continuous intravenous infusion of dexmedetomidine to provide intraoperative sedation on the duration of sensory and motor blockade induced by spinal anesthesia, with those of midazolam. Methods: A double-blind randomized controlled trial was performed on 40 patients, aged between 20 and 75 years, who requested intraoperative sedation, and were classified as American Society of Anesthesiologists (ASA) physical status I-II, and underwent elective surgeries under spinal anesthesia. After spinal anesthesia with 13 mg (2.6 ml) of 0.5% hyperbaric bupivacaine, patients were randomized to receive intravenous dexmedetomidine 3 μg/kg/h for 10 mins followed by an infusion of 0.5 μg/kg/h (Group D), or intravenous midazolam 0.15 mg/kg/h for 10 mins followed by an infusion of 0.025 mg/kg/h (Group M). Sedation was titrated to Observer’s Assessment of Alertness/Sedation (OAA/S) score of 3. Sensory and motor blockade was evaluated using the pinprick test and modified Bromage scale, respectively. Results: The time taken to achieve OAA/S score 3 was similar in the two groups. The maximal level of sensory blockade was 5.3 ± 1.3 min in group D and 4.1 ± 1.5 in group M (P = 0.03). No significant differences were observed in the time taken to achieve the maximal level or the two-segment regression time of sensory blockade between the two groups. The time to sensory regression to the L2 level was significantly longer in group D than in group M (234.6 ± 78.1 mins versus 172.4 ± 41.5 mins, respectively, P = 0.008). The time to motor regression to modified Bromage score 1 was significantly longer in group D than in group M (232.2 ± 79.3 versus 176.5 ± 48.8, respectively, P = 0.02). Conclusion: Continuous intravenous dexmedetomidine to provide sedation during spinal anesthesia significantly prolongs the duration of sensory and motor blockade induced by spinal anesthesia over that with midazolam.

Attenuation of Multiple Organ Damage by Continuous Low-Dose Solvent-Free Infusions of Resveratrol after Severe Hemorrhagic Shock in Rats.

Therapeutic effects of continuous intravenous infusions of solvent-free low doses of resveratrol on organ injury and systemic consequences resulting from severe hemorrhagic shock in rats were studied. Hemorrhagic shock was induced by withdrawing arterial blood until a mean arterial blood pressure (MAP) of 25–30 mmHg was reached. Following a shock phase of 60 min, rats were resuscitated with the withdrawn blood plus lactated Ringer’s. Resveratrol (20 or 60 μg/kg × h) was continuously infused intravenously starting with the resuscitation phase (30 min) and continued until the end of the experiment (total treatment time 180 min). Animals of the shock control group received 0.9% NaCl solution. After the observation phase (150 min), rats were sacrificed. Resveratrol significantly stabilized the MAP and peripheral oxygen saturation after hemorrhagic shock, decreased the macroscopic injury of the small intestine, significantly attenuated the shock-induced increase in tissue myeloperoxidase activity in the small intestine, liver, kidney and lung, and diminished tissue hemorrhages (particularly in the small intestine and liver) as well as the rate of hemolysis. Already very low doses of resveratrol, continuously infused during resuscitation after severe hemorrhagic shock, can significantly improve impaired systemic parameters and attenuate multiple organ damage in rats.

Pulse Oximetric and ECG changes during continuous infusion of propofol in medetomidine – pentazocine and midazolam – pentazocine premedicated buffalo calves

Twelve buffalo calves of either sex presented to the clinic with surgical conditions like umbilical hernia, urolithiasis and fractures were utilized to study the effect of continuous intravenous infusion of propofol after premedication with medetomidine – pentazocine and midazolam – pentazocine. The animals were divided into two groups of six animals each. Medetomidine (@ 2.5 μg/kg b.wt.) – pentazocine (@ 0.5 mg/kg b.wt.) and midazolam (@ 0.25 mg/kg b.wt.) – pentazocine (@ 0.5 mg/kg b.wt.) was given intravenously in group I and II respectively. Propofol was given intravenously (@ 4 mg/kg b.wt.) after pre-medication and maintained by continuous intravenous infusion of propofol (@ 0.4 mg/kg b.wt.) in 5 % dextrose normal saline in both groups. Pulse oximetric and electrocardographic changes were recorded at 0, 5,10,15,30 and 60 min. Saturation of oxygen percentage of haemoglobin showed significant (P £ 0.05) difference in both groups but the changes were within the normal range. Electrocardiographic studies did not reveal any abnormalities except slight variations in the amplitude of P wave, T wave and QRS complex in both groups. It is concluded that both anaesthetic drug combinations can be used safely in buffaloes as they did not alter the pulse oximetry and ECG values.

Continuous intravenous infusion of nicorandil for 4 hours before and 24 hours after percutaneous coronary intervention protects against contrast-induced nephropathy in patients with poor renal function

BackgroundWe conducted a prospective randomized trial to assess the protective effect of continuous intravenous infusion of nicorandil against contrast-induced nephropathy (CIN) in patients with poor renal function. Methods and resultsWe randomly assigned 213 patients who would subsequently undergo elective percutaneous coronary intervention (PCI) and who had a high serum cystatin C level to a saline group (n=107) or a nicorandil group (n=106, nicorandil infused in addition to saline for 4h before and 24h after PCI). There were no significant differences in baseline characteristics between the two groups. However, the average percent increases in serum creatinine and cystatin C following PCI were significantly smaller in the nicorandil group than the saline group. Likewise, the average percent decline in the estimated glomerular filtration rate was smaller in the nicorandil group. Correspondingly, the incidence of CIN was dramatically lower in the nicorandil group than the saline group (2.0% vs. 10.7%, p<0.02). Univariate regression analysis revealed nicorandil treatment to be the only significant predictor of CIN development (odds ratio: 0.173, 95% confidence interval: 0.037–0.812, p=0.026). ConclusionsNicorandil strongly prevents CIN in patients with poor renal function undergoing PCI.

Protective effect of continuous intravenous infusion of Isoproterenol on myocardial mitochondria of early septic rats and the corresponding mechanism

Objective To investigate the protective effect of continuous intravenous infusion of Isoproterenol (ISO)on myocardial mitochondria of early septic rats and the corresponding mechanism. Methods Thirty Sprague Dawley (SD)rats were randomly divided into 5 groups (6 cases per group): control group, endotoxin group, ISO small-dose group, ISO medium-dose group and ISO large-dose group.Endotoxin group and ISO intervene group received same management apart from drug intervention: receiving intravenous injection of lipopolysaccharide (LPS)10 mg/kg followed by an continuous intravenous infusion of 9 g/L saline 1 mL/h or ISO 0.06 μg/(kg·min), 0.30 μg/(kg·min)and 0.60 μg/(kg·min). Control group received intraperitoneal injection and continuous intravenous infusion with the same amount of 9 g/L saline.The primary endpoint of the study was 24 hours after injection of 9 g/L saline or LPS.Serum creatine kinase (CK)and creatine kinase isoenzyme (CK-MB), oxidative and nitrosative stress levels and swelling of isolated heart mitochondrion were detected.The pathological changes of the myocardium and morphologic changes of the heart mitochondria were observed through light microscope and scanning electron microscope, respectively. Results The levels of CK, CK-MB, nitric oxide (NO)content, inducible nitric oxide synthase (iNOS)activity and malondialdehyde (MDA)content in endotoxin group were increased compared with control group (all P<0.05), while the superoxide dismutase (SOD) activity decreased [(11.543±1.080) U/mg prot vs (9.892±0.815) U/mg prot, P<0.05]. The morphology of the heart mitochondria significantly changed (such as swelling, disordered arrangement, crest fracture, fusion and cavitations, and so on). ISO intervention significantly decreased the levels of CK, CK-MB and mitochondrial swelling (all P<0.05)and increased the SOD activity (all P<0.05). The levels of NO content, iNOS activity and MDA content were significantly decreased in small-dose group[(10.823±2.240) μmol/g prot vs (7.917±2.203) μmol/g prot, (0.045±0.008) U/mg prot vs (0.033±0.003) U/mg prot, (1.663±0.618) mmol/mg prot vs (0.768±0.312) mmol/mg prot, all P<0.05], while the levels of iNOS activity and MDA content were significantly increased in medium- and large-dose group (all P<0.05); compared with medium-dose group, the degree of mitochondrial swelling in large-dose group increased (1.160±0.186 vs 1.393±0.128, P<0.05). The pathological changes of the myocardium mitochondria significantly improved. Conclusions The myocardium and myocardial mitochondria of early septic rats were damaged, continuous intravenous infusion of low-dose ISO revealed protective effect on these damages, and the corresponding mechanism may relate to the decrease of the oxidative and nitrosative stress. Key words: Isoproterenol; Lipopolysaccharide; Sepsis; Oxidative stress; Mitochondrion

Effects of continuous intravenous infusion of morphine and morphine-tramadol on the minimum alveolar concentration of sevoflurane and electroencephalographic entropy indices in dogs

ObjectiveTo compare the effects of continuous rate infusions (CRIs) of intravenous (IV) morphine and morphine-tramadol on the minimum alveolar concentration (MAC) of sevoflurane, and on electroencephalographic entropy indices in dogs. DesignProspective study. AnimalsEight young, healthy German shepherds, weighing 26.3 ± 3.1 kg (mean ± SD). MethodsAnaesthesia was induced and maintained with sevoflurane. A standard tail-clamp technique was used for MAC determination. Within one anaesthetic period, MAC was first determined during sevoflurane anaesthesia alone (MACB); then during morphine infusion (MACM), (loading dose 0.5 mg kg−1IM; CRI, 0.2 mg kg−1hour−1) then finally during morphine-tramadol infusion (tramadol loading dose 1.5 mg kg−1IV; CRI, 2.6 mg kg−1 hour−1) (MACMT). At each change, periods of 45 minutes were allowed for equilibration. Stated entropy (SE), response entropy (RE), and RE-SE differences were measured five minutes prior to and during tail clamping. ResultsThe MACB was 2.1 ± 0.3vol%. The morphine and morphine-tramadol infusions reduced MAC to 1.6 ± 0.3vol% and 1.3 ± 0.3vol%, respectively. MAC was decreased below baseline more during morphine-tramadol than during morphine alone (39 ± 9% versus 25 ± 6%, respectively; p = 0.003). All SE and RE and most RE-SE differences were increased significantly (p < 0.05) over pre-stimulation in all groups when the dogs responded purposefully to noxious stimulation. When no response to noxious stimulation occurred, the entropy indices did not change. Conclusion and clinical relevanceIn dogs, combined morphine-tramadol CRI decreased sevoflurane MAC more than morphine CRI alone. Entropy indices changed during nociceptive responses in anaesthetized animals, suggesting that entropy measurements may be useful in determining anaesthetic depth in dogs.

Evaluation of Propofol Anaesthesia in Medetomidine-Pentazocine and Midazolam- Pentazocine Premedicated Buffalo Calves

Twelve buffalo calves of either sex presented to the college clinic with various surgical conditions were utilized to study the effect of continuous intravenous infusion of propofol after premedication with medetomidine – pentazocine and midazolam – pentazocine. The animals were divided into two groups of six animals each. Group I animals were premedicated with Medetomidine @ 2.5 μg/kg b.wt. – pentazocine @ 0.5 mg/kg b.wt IV and Group II animals received midazolam @ 0.25 mg/kg b.wt. – pentazocine @ 0.5 mg/kg b.wt. IV.. Propofol was given @ 4 mg/kg b.wt. IV after premedication and maintained by continuous intravenous infusion of propofol @ 0.4 mg/kg b.wt. in 5% dextrose normal saline in both groups. Induction quality was excellent, smooth and attained sternal recumbency rapidly without struggling in both groups. Anaesthetic character, Physiological & haematobiochemical parameters were studied at 0, 5,10,15,30 and 60 minutes following anaesthetic injections. No significant changes were recorded in both the groups. ECG studies did not reveal any abnormalities except slight variations in the amplitude of P wave, T wave and QRS complex in both groups. The study suggests that medetomidine – pentazocine premedication with continuous intravenous infusion of propofol provided better surgical anaesthesia and was compatable and safe in buffalo calves.

Effects of continuous intravenous infusion of methoxamine on the intraoperative hemodynamics of elderly patients undergoing total hip arthroplasty.

BackgroundHemodynamic disturbances are common during continuous epidural anesthesia in elderly patients undergoing total hip arthroplasty. This study aimed to investigate the effects of methoxamine on the intraoperative hemodynamics in elderly patients undergoing total hip arthroplasty under epidural anesthesia.Material/MethodsThis prospective study included 150 elderly patients undergoing elective total hip arthroplasty under epidural anesthesia. Patients were randomly assigned into 5 groups (n=30 per group): a control group receiving saline (Group C), a dopamine group receiving 7 μg/kg/min dopamine (Group D), and methoxamine groups receiving 1, 2, or 3 μg/kg/min methoxamine (Groups M1, M2, and M3, respectively). Hemodynamic parameters were assessed 10 min before anesthesia (T1); 10 min (T2), 20 min, (T3), 30 min (T4), and 60 min (T5) after anesthesia; and at the conclusion of surgery (T6).ResultsAt T2–T6, the mean arterial pressure, central venous pressure, cardiac output, stroke volume, stroke volume ratio, and pulmonary vascular resistance were higher in Groups D, M2, and M3 compared to Group C (p<0.05). Compared to Group D, the heart rate and rate pressure product were significantly lower in Groups M1–M3. Infusion volume, ephedrine dose, and postoperative 24-h urine volume were significantly lower and intraoperative urine volume was significantly greater in Groups D, M2, and M3 compared with Group C. Hypertension occurred more frequently in Group M3 than in any other group.ConclusionsContinuous intravenous infusion of 2 μg/kg/min methoxamine is safe and effective in maintaining hemodynamic stability in elderly patients undergoing total hip arthroplasty.

Ven İçi Deksmedetomidin veya Propofolün Devamlı İnfüzyonunun, Siyatik-Femoral Bloğun, Blok Özellikleri ve Postoperatif Analjezik Özellikleri Üzerine Etkileri

Ven İçi Deksmedetomidin veya Propofolün Devamlı İnfüzyonunun, Siyatik-Femoral Bloğun, Blok Özellikleri ve Postoperatif Analjezik Özellikleri Üzerine Etkileri

Effects of Continuous Intravenous Infusion of MCI-186 on Functional Recovery after Spinal Cord Injury in Rats

We investigated the effects of a free radical scavenger, MCI-186 (edaravone), on neuroprotection in the rat post-traumatic spinal cord using various doses and routes of administration. The injury was produced with a weight-drop device. Lipid peroxide formation in the spinal cord was measured using the thiobarbituric acid test for malonyldialdehyde (MDA). In the first experiment, MDA production in the untreated post-traumatic spinal cord reached peak values at 1 h post-trauma, and gradually decreased to control levels in 7 days. In the second experiment, rats received twice-daily injections (0, 1, 3, 5, 10, or 20 mg/kg) for 3 days. We found that 3 mg/kg was most effective functionally and histologically. In the third experiment, rats received a 3 mg/kg bolus + continuous infusion (0, 1.5, 2.4, or 3.0 mg/kg/h) for 1, 2, 4, and 8 h. We found that a 3 mg/kg bolus + infusion of 3.0 mg/kg/h was most effective for the inhibition of MDA production. In the fourth experiment, a 3 mg/kg bolus given once immediately after injury and twice daily for 3 days, a 3 mg/kg bolus + 3.0 mg/kg/h for 1 day, or a 3 mg/kg bolus + 3.0 mg/kg/h for 3 days were administered. The continuous infusion for 1 day showed significant improvement functionally and histologically, but continuous infusion at the same rate for another 2 days did not show any further improvement. To effectively reduce secondary neuronal damage, strong inhibition of free radical chain reactions at the early stage, particularly within the first 24 h post-trauma, is important.

Exenatide improves glucocorticoid-induced glucose intolerance in mice.

Exenatide is an incretin mimetic that is recently available in the US for the treatment of diabetes. There is a paucity of information on the effects of exenatide in glucocorticoid (GC)-induced diabetes. Although the effect of continuous intravenous infusion of exenatide on GC-induced glucose intolerance has been investigated before in healthy human males receiving oral prednisolone, we investigated the efficacy of a single subcutaneous dose of exenatide (3 μg/kg) in lowering blood glucose in GC-induced glucose intolerance in C57BL/6 mice. In a longitudinal experiment, the area under the curve (AUC) of oral glucose tolerance tests (OGTT) significantly increased after dexamethasone (P = 0.004), which was subsequently decreased by exenatide (P < 0.001). A cross-sectional experiment showed that exenatide improved glucose tolerance compared with placebo in a mouse model of dexamethasone-induced glucose intolerance. AUC of OGTT in the exenatide group were significantly (P < 0.001) lower than in the placebo group. Insulin tolerance tests (ITT) demonstrated that exenatide decreased the ability of the mice to tolerate insulin compared with placebo. The AUC of ITT in the exenatide group were also significantly (P = 0.006) lower than in the placebo group. In conclusion, a single dose of exenatide was able to decrease glucose intolerance and insulin resistance in these placebo-controlled experiments. Future clinical trials are justified to investigate the role of exenatide in the treatment of GC-induced glucose intolerance/diabetes.