Group Pl Research Articles

Intravenous dexmedetomidine versus clonidine for prolongation of bupivacaine spinal anesthesia and analgesia: A randomized double-blind study.

Background:Alpha2-adrenergic agonists have synergistic action with local anesthetics and may prolong the duration of sensory, motor blockade and postoperative analgesia obtained with spinal anesthesia.Aim:The objectives of this study are to compare and evaluate the efficacy of intravenous dexmedetomidine premedication with clonidine and placebo on spinal blockade duration, postoperative analgesia and sedation in patients undergoing surgery under bupivacaine intrathecal block.Materials and Methods:In this prospective, randomized, double-blind placebo-controlled study, 75 patients of the American Society of Anesthesiologists status I or II, scheduled for orthopedic lower limb surgery under spinal anesthesia, were randomly allocated into three groups of 25 each. Group DE received dexmedetomidine 0.5 μgkg−1, group CL received clonidine 1.0 μgkg−1 and placebo group PL received 10 ml of normal saline intravenously before subarachnoid anesthesia with 15 mg of 0.5% hyperbaric bupivacaine. Onset time and regression times of sensory and motor blockade, the maximum upper level of sensory blockade were recorded. Duration of postoperative analgesia and sedation scores along with side effects were also recorded. Data was analyzed using analysis of variance or Chi-square test, and the value of P < 0.05 was considered statistically significant.Results:The sensory block level was higher with dexmedetomidine (T4 ± 1) than clonidine (T6 ± 1) or placebo (T6 ± 2). Dexmedetomidine also increased the time (243.35 ± 56.82 min) to first postoperative analgesic request compared with clonidine (190.93 ± 42.38 min, P < 0.0001) and placebo (140.75 ± 28.52 min, P < 0.0001). The maximum Ramsay sedation score was greater in the dexmedetomidine group than other two groups (P < 0.0001).Conclusion:Premedication with intravenous dexmedetomidine is better than intravenous clonidine to provide intraoperative sedation and postoperative analgesia during bupivacaine spinal anesthesia.

Effect of penehyclidine hydrochloride on acute lung injury induced by cardiopuimonary bypass in rats

Objective To investigate the effect of penehyclidine hydrochloride on acute lung injury induced by cardiopulmonary bypass (CPB) in rats.Methods Forty adult male SD rats aged 4-6 months weighing 330-420 g were randomly divided into4 groups ( n =10 each): sham operation group (group S),acute lung injury group (group ALI) and low and high dose of penehyclidine hydrochloride groups (groups PL and PH ).Penehyclidine hydrochloride 0.6 and 2.0 mg/kg were added to the priming solution in groups PL and PH,while the equal volume of normal saline was added in group ALI instead.The rats of groups ALI,PL and PH were underwent 1 h of CPB.Arterial blood samples were collected before CPB and at 2 h after CPB for blood gas analysis.The superior vera cava blood samples and lung tissues were collected at 2 h after CPB for determination of concentrations of TNF-α and IL-6,lung tissue contents of water and malondialdehyde (MDA) and activity of glutathione peroxidase (GSH-px).The pathological change of lung tissue was also examined.Results Compared with group S,PaO2 was significantly decreased at 2 h after CPB,plasma concentrations of TNF-α and IL-6 and contents of water and MDA in lung tissues were increased,while activity of GSH-px in lung tissues was decreased in groups ALI,PL and PH ( R ＜ 0.05).Compared with group ALI,PaO2 was significantly increased at 2 h after CPB,plasma concentrations of TNF-α and IL-6 and contents of water and MDA in lung tissues were decreased,activity of GSH-px in lung tissues was increased (P ＜ 0.05),and the pathological change was reduced in groups PL and PH.Compared with group PL,PaO2 was significantly increased at 2 h after CPB,plasma concentrations of TNF-α and IL-6 and contents of water and MDA in lung tissues were decreased,activity of GSH-px in lung tissues was increased ( P ＜0.05),and the pathological change was reduced more obviously in group PH.Conclusion Penehyclidine hydrochloride 0.6 or 2.0 mg/kg can reduce the CPB-induced lung injury in a dose-dependent manner by antioxidant and anti-inflammatory mechanism in rats. Key words: Cholinergic antagonists; Cardiopulmonary bypass; Respiratory distress syndrome, adult

Effect of short-term creatine monohydrate supplementation on indirect markers of cellular damage in young soccer players

Summary Purpose In recent years, creatine (Cr) supplementation has received great attention in both popular and scientific media. Nevertheless, there is anecdotal information on the side effects of this supplement. Hence, we hypothesized that Cr monohydrate (CrM) loading would induce increase in serum enzymes activity as indirect markers of cellular damage. Therefore, the present study was conducted to identify the effect of short-term Cr supplementation on serum lactate dehydrogenase (LDH), creatine phosphokinase (CK), and myocardial CK isoform (CK MB ) in young male soccer players. Methods Eighteen volunteer young male soccer players in a randomized and double-blind design were divided into two equal groups (Cr & Placebo groups). Creatine (CrM) group was ingested Cr supplementation (0.3 g/kg/d for 7 days), but placebo group (Pl) was not took any supplements. All subjects were participated in circuit weight training (eight exercises, three sets, 15 repetitions, and 60% one repetition maximum [1RM]). To identify enzymes activity (IU/L), venous blood samples were obtained before Cr loading and 24 h after last session of weight training, Moreover, VO 2 max each of subjects were obtained with 20 m Shuttle Run test. Data were expressed as mean (±SD) and analyzed by paired and independent t -tests using SPSS15 at P ≤ 0.05. Results The modest elevation of LDH activity in both groups were not significant following the short-term Cr supplementation, whereas, mean and changes range of CK ( P = 0.0004, t CK = 5.13) and CK MB ( P CKMB = 2.10) activities in CrM group were significantly higher than in Pl group ( P Conclusion The present results suggest that serum CK and CK MB activity as indirect markers of cellular damage increases by the oral short-term CrM supplementation in young male soccer players. Therefore, it can be concluded that CrM loading probably have significant adverse effects on serum indirect markers of cellular damage. Nevertheless, more research will be needed to determine effect of the short and long-term Cr supplementation on the other indirect markers of cellular damages in the future.

A Comparative Efficacy of Amitriptyline, Gabapentin, and Pregabalin in Neuropathic Cancer Pain

Neuropathic pain is difficult to diagnose and difficult to treat with certainty. So the aim of the study was to evaluate comparative clinical efficacy of pregabaline with amitriptyline and gabapentin in neuropathic cancer pain. A total of 120 patients with cancer having severe neuropathic cancer pain were enrolled in the study after taking approval from Institutional Ethics Committee and divided in to 4 groups: group AT-amitriptyline, group GB-gabapentin, group PG-pregabalin, and group PL-placebo. Oral morphine was used for rescue analgesic for continued pain. Pain score (Visual Analogue scale) and secondary outcome measures such as intensity of lancinating, dysesthesia, and burning on numerical rating scale, Global satisfaction score (GSS), Eastern Co-operative Oncology Group scoring (ECOG), and adverse effects were assessed. At the end of study there was significant decrease in pain score in group PG as compared to the other groups; group AT (P = .003), group GB (P = .042), and group PL (P = .024). Percentage of patients with lancinating pain and dysesthesia were significantly less in group PG as compared to groups GB and PL. All the patients in group PL needed rescue morphine. After 4 visits, maximum improvement in ECOG scoring and GSS scoring was observed in group PG patients. Our results suggested that all antineuropathic drugs are effective in relieving cancer-related neuropathic pain. There was statistically and clinically significant morphine sparing effect of pregabaline in relieving neuropathic cancer pain and neuropathic symptoms as compared to other antineuropathic drugs.

Establishment of a rat self-control model with the bile duct deprived and the portal vein deprived hepatic lobe and the casting liver specimen scanned by Micro-CT

Objective To establish a rat self-control model with the bile duct deprived (BDD) and the portal vein deprived (PVD) hepatic lobe and to observe whether there were communicated branches between the two lobes.Methods Forty SD rats were divided into four groups: group S with sham operation as an undisposed blank control, group BL with the right lobe bile duct embolized and ligated, group PL with the quadrate lobe portal vein ligated, and group BPL with the right lobe bile duct embolized and ligated and meanwhile the quadrate lobe portal vein ligated. The right hepatic bile ducts were embolized with cyanoacrylate and then ligated to prepare the BDD lobe. The portal vein of quadrate hepatic lobes was ligated as the PVD lobes. The observation period was 1 month after the bile duct or portal vein ligated. The values of liver weight/body weight and the quadrate lobe weight/the right lobe weight were recorded. The bile duct and portal vein casting specimens of these four groups were prepared by a perfusion with barium and gelatin solution. Three-dimensional micro-computerized tomography (Micro-CT) data sets were acquired to observe the morphological changes of bile duct and portal vein of the livers and whether there were communicated branches between the right and quadrate lobes in order to estimate the feasibility of the model.Results (1) The survival rate of rats after operation was 100%. No jaundice was observed. The ratio of liver/body weight in groups S, BL and PL was about 3.5%, significantly lower than that in group BPL (P<0.01). The ratio of quadrate/right lobe weight in groups S and BL was about 60%-70%, while that was about 20% in groups PL and BPL (P<0.05, or P<0.01); (2) Micro-CT images exhibited directly the morphological changes of the hepatic bile duct and portal vein, and no communicated branches or side circulation situation were observed between the two lobes.Conclusion No collateral branches were found between the two lobes and the model was successfully established. The barium casting liver specimen scanned by micro-CT provided a useful method for the morphological observation of rat liver Glissons system. Key words: Bile duct embolization; Portal vein ligation; Model,animal; Liver casting specimen; CT scan

Afmite, Al3(OH)4 (H2O)3(PO4 )(PO3OH)· H2O, a new mineral from Fumade, Tarn, France: description and crystal structure

The new mineral afmite, Al_3(OH)_4(H_2O)_3(PO_4)(PO_3OH)·H_2O, is triclinic with space group Pl and cell parameters a = 7.386(3), b = 7.716(3), c = 11.345(4) A, a = 99.773(5), β = 91.141(6), y = 115.58(5)°, V = 571.6(3) A^3 and Z = 2. It occurs, sometimes in association with matulaite and variscite, in fractures and solution cavities in shale/siltstone at Fumade, Tarn, France. The formation is probably largely the result of remobilisation and crystallisation during low-temperature hydrothermal activity and/or weathering and ground water activity. Afmite forms in cockscomb aggregates of diamond-shaped tablets on {001}, ubiquitously contact-twinned on {001} and also commonly twinned by rotation on [010] with {010} and {110} composition planes, forming star-like sixlings. The streak of the mineral is white, the luster is pearly, and the Mohs hardness is about 11/2. The mineral is flexible, but not elastic, has an irregular fracture and three cleavage directions: {001} perfect, {010} and {1Formula 0} good. The measured density is 2.39(3) g/cm^3 and the calculated density is 2.391 g/cm^3 based upon the empirical formula. Optical properties (white light): biaxial (+), α = 1.554(1), β = 1.558(1), y = 1.566(1), 2V_(meas). = 70(5)° and 2V_(calc) = 71°. Electron microprobe analyses provided Al_2O_3 40.20 and P_2O_5 38.84 wt% and CHN analyses provided H_2O 25.64 wt%, total 103.68 wt%. Normalized EMP analyses and water based on the structure yield Al_2O_3 36.41, P_2O_5 35.17 and H_2O 28.42, total 100.00 wt%. Infrared and Raman spectra were consistent with the PO_3OH, OH and H_2O as indicated by the crystal-structure determination. The strongest powder X-ray diffraction lines are [d_(obs)(A),I_(obs),(hkl)]: 11.089,100,(001), 3.540,81,(013,112), 5.484,79,(002,101), 2.918,60(122), 3.089,33(113,201), 4.022,30,(102,112), 6.826,23,(010). The crystal structure, solved from twinned data, (R_1 = 10.4 % for 1262 F_o > 4σF reflections) consists of chains of AlO_6 octahedra parallel to [110] in which edge-sharing octahedral dimers share corners with individual octahedra. Both PO_4 and PO_3OH tetrahedra link the chains into sheets parallel to {001} and the PO_4 tetrahedra further serve to link two sheets together into a thick slab in which tetrahedral (T) and octahedral (O) layers alternate, forming a T-O-T-O-T sandwich. The linkage between these sandwiches in the c direction is via hydrogen bonding with isolated H_2O groups in the interlayer region. Afmite is closely related structurally to the turquoise-group minerals and specifically to planerite. The recently described mineral kobokoboite probably has a closely related sheet structure.

Double promontofixation laparoscopique versus laparoscopique robot-assistée : morbidité, résultats anatomiques et fonctionnels à court terme

The purpose of our study was to compare the morbidity and the short-term anatomical and functional outcome of the double promontofixation according to the surgical access laparoscopic versus laparoscopic robot-assisted. Forty-six patients were operated for anterior and posterior promontofixation with two mesh between March 2008 and February 2010, 19 were robot-assisted (PR) and 27 laparoscopic (PL). All the patients were contacted again by telephone to answer a questionnaire estimating the functional results. Both groups (PR vs PL) were comparable in terms of age, score ASA and of surgical histories. There was no difference in terms of hospital stay nor per- and postoperative complications. The mean operating time was significantly more important in the group PR (P=0.049). With a mean follow-up of 10,7±7,8 months (PL) versus 8,8±5,9 months (PR), the anatomical result was good without recurrence in 93,5% of the cases. The rate of recurrence was similar in both groups with three patients who had a cystocele grade 2, two in the group PR and one in the group PL (P=0.411). The urinary and sexual functional results were comparable between both groups with an improvement of the rate of dyspareunia and dysuria. However we observed more postoperative constipation in the group PR (10/19 vs 6/27, P=0.033). The robot-assisted laparoscopic promontofixation is a reproducible technique with a morbidity and anatomical and functional results comparable to the laparoscopic way.

Accuracy of sonographic criteria in the decision for surgical treatment in infantile hypertrophic pyloric stenosis

IntroductionAbdominal ultrasonography has replaced barium studies in establishing the diagnosis in difficult cases of infantile hypertrophic pyloric stenosis (IHPS). The aim of this retrospective study was to establish sonographic criteria of qualification for surgical treatment in children with IHPS.Material and methodsHundred and fifteen infants (98 boys and 17 girls) with suspected IHPS were treated between 2000 and 2009. Pyloric muscle thickness, pyloric diameter and pyloric length were measured in US scans in all patients. Results were compared with US results of 19 infants with negative diagnosis and 29 children of the reference group.ResultsDiagnosis of IHPS was confirmed by US examination in 96 children (83.5%). There were 86 boys in the group with male prevalence 8.6 : 1. The remaining 19 infants (16.5%) had a negative ultrasound. The mean PL (20.89 vs. 12.73), PMT (5.41 vs. 2.24), and PD (14.1 vs. 7.42) differed significantly between patients with and without pyloric stenosis (p < 0.0001). The mean PL (12.34), PMT (2.2), and PD (7.48) in the reference group did not differ statistically from values obtained in patients with negative IHPS diagnosis and were significantly lower than in children from the IHPS group (p < 0.0001). US imaging had a sensitivity of 98%, specificity of 100%, with a positive and negative predictive value of 100% and 90% respectively.ConclusionsThis study confirmed that ultrasonography is the first choice of diagnostic method in an infant with suspected hypertrophic pyloric stenosis. In cases with an uncertain clinical diagnosis of IHPS the examination can be easily repeated.

Effect of penehyclidine hydrochloride on brain injury induced by cardiopulmonary bypass in rats

Objective To investigate the effect of penehyclidine hydrochloride on brain injury induced by cardiopulmonary bypass (CPB) in rats. Methods Thirty adult male SD rats were randomly divided into 5 groups ( n = 6 each): sham operation group (group S), CPB group, and low, median and high dose penehyclidine hydrochloride groups (group PL, PM , PH). Penehyclidine hydrochloride 0.2, 0.6 and 2.0 mg/kg were added to the priming solution in group PL, PM and PH respectively, while the equal volume of normal saline was added instead in group S. Blood samples were obtained at 2 h after termination of CPB to determine the plasma concentrations of neuron specific enolase (NSE) and S-100β protein. The brain tissues were taken to observe the ultrastructure of hippocampal neurons with electron microscope. Results The concentrations of NSE and S-100β protein were significantly higher in the other groups than in group S, while lower in group PM and PH than in group CPB and PL( P＜ 0.05). The S-100β protein concentration was significantly lower in group PH than in group PM( P ＜ 0.05). The damage to hippocampal neurons was significantly attenuated in group PM and Ps. Conclusion Penehyclidine hydrochloride 0.6 or 2.0 mg/kg can reduce the CPB-induced brain injury in a dose-dependent manner in rats. Key words: Cholinergic antagonists; Cardiopulmonary bypass; Brain

EFFECTS OF CONCURRENT PREGNANCY AND LACTATION IN RABBIT DOES ON THE GROWTH OF FOLLICLES IN DAUGHTERS' OVARIES

The aim of this experiment was to study the effects of concurrent pregnancy and lactation in the mother on follicular development in daughter rabbits. Young females from mothers lactating (group PL) or not (group P) during gestation were sacrificed on days 29 (nPL = np =5), 49 (nPL = np =5) or 70 (nPL = 4, np = 5) and one ovary was taken from each. Follicles were divided into size bands according to their diameter. The P and PL group counts in each band were similar at 29 and 49 days, but at 70 days the number of larger growing follicles (diameter > 241 µm) was lower in the PL than in the P does (83 vs. 155; P<0.05). A mathematical model for follicular development was fitted to the size-class frequencies for animals in both groups and showed that the duration of the first growth phase was longer in the PL than in the P group (26.6 days vs. 14.9 days; P<0.001). These results suggest that concurrent lactation during pregnancy in primiparous does significantly affects early follicular development and delays the appearance of larger ovarian follicles in the daughters.

Comparing efficacy of preemptively used lornoxicam and tramadol for postoperative pain in patients underwent laparoscopic cholecystectomy

Objectives: The management of postoperative pain is an important problem in Anesthesiology. This randomized double-blind study compared the analgesic efficacy of preemptively used lornoxicam and tramadol in patients underwent laparoscopic cholecystectomy. Methods: A total of 76 patients were randomly divided into four groups. All patients received tablets 4 hours before the operation. Preemptively Group PL received 4 mg lornoxicam, Group PT received 50 mg tramadol and Group L and T received placebo. After the operation Group PL received 0.8 mg/h infusion and 1 mg bolus lornoxicam; Group L 1.6 mg loading, 0.8 mg/h infusion and 1 mg bolus lornoxicam; Group PT 5 mg/h infusion and 10 mg bolus tramadol; Group T 20 mg loading, 5 mg/h infusion and 10 mg bolus tramadol for 24 hours. Pain intensity and pain relief at 0, 1st, 2nd, 3rd, 6th, 10th, 24th hours and overall assessment of pain relief was done at 24th hour. Results: Demographic features, operation time, heart rate and mean arterial blood pressure values were not different between four groups. Both Group PL and PT had lower pain intensity and higher pain relief values than Group L and T. Group PL and PT had lower total drug consumption and higher pain relief. Overall assessment of pain relief was highest in Group PL. Pain intensity was highest in Group T and lowest in Group PL at all time points. Conclusion: Onset of analgesia with lornoxicam was faster and greater patient-controlled analgesia (PCA) demand was observed with tramadol. Postoperative pain relief was similar with lornoxicam and tramadol administrated by PCA. This study suggests that preemptive administration of lornoksikam and tramadol may result in more postoperative pain relief.

Effects of Rosuvastatin on serum IL-6 and hs-CRP and on treatment of unstable angina pectoris

Objective To observe the clinical effect of Rosuvastatin in the treatment of unstable anginapectoris(UAP) and the clinical efficacy of IL-6 and hs-CRP changes. Methods 98 cases of UAP patients were randomly divided into two groups. 48 cases of control group were were given conventional treatment; 50 cases of treatment group given oral rosuvastatin based on the control group treatment. Both groups were treated for 8weeks. Results After the treatment,the treatment group improvement of angina pectoris and ECG were significantly better than that of the control group(Pl ＜ 0.05). In treatment group, serum IL-6 and hs-CRP were significantly lower than those the control group(P ＜ 0.05 ). Treatment group had no obvious adverse reactions. Conclusion Rosuvastatin treatment of UAP can improve symptoms of angina and ischemic ECG changes, have a significant reduction in serum IL-6 and hs-CRP concentrations,and no significant adverse reactions. Key words: Rosuvastatin; Unstable angina pectoris; Interleukin-6 (IL-6); High-sensitivity C-reactive protein(hs-CRP)

An algebraic classification of some solvable groups of homeomorphisms

We produce two separate algebraic descriptions of the isomorphism classes of the solvable subgroups of the group PL o ( I ) of piecewise-linear orientation-preserving homeomorphisms of the unit interval under the operation of composition, and also of the generalized R. Thompson groups F n . The first description is as a set of isomorphism classes of groups which is closed under three algebraic operations, and the second is as the set of isomorphism classes of subgroups of a countable collection of easily described groups. We show the two descriptions are equivalent.

Hydration Status on Soccer Players During a Match

It is well established that fluid replacement during exercise will optimize performance and minimize the risk of heat illness. Depending on environmental conditions and fluid intake during the match, a soccer player can have a weight loss of 2 kg at least. As soccer do not have breaks that allows players to drink fluids during the match there is a great risk of developing dehydration and hyperthermia. PURPOSE: The purpose of this study was to evaluate hydration status on soccer player's during a match. METHODS: 20 players of the Military Organization of the Brazilian Army who were part of soccer team's corporation were studied. They formed 2 teams and, by chance, according to their positional rules were divided in three groups, depending on the hydration condition. All the players were submitted to the same conditions, so 3 soccer games were accomplished with those groups: 1) group CHO (ingested (150 ml), in intervals of 15 minutes, a drink with carbohydrate (6%) and electrolytes); 2) group Placebo (ingested (150 ml), in intervals of 15 minutes, with placebo solution) and; 3) group control (they did not ingest any fluid during the game). It was verified: density of the urine, body weight, hematocrit, hemoglobin, before and after each game. RESULTS: The loss of body weight (group CHO: 1,72 kg; group PL: 1,63 kg and control group: 2,25 kg), dehydration degree (group CHO: 2,31%; group PL: 2,24% and control group: 3,14%) and sweat rate (group CHO: 1,84 L/h; group PL: 1,79 L/h and control group: 1,72 L/h) were larger statistically significant in control group. The others variables were not statistically different among the groups. CONCLUSIONS: As general conclusion our data suggest that players had a better hydration status during the match when a drink was offered, despite the fact that the protocol adopted was not able to prevent dehydration.

Propofol injection pain in children: a prospective randomized double-blind trial of a new propofol formulation versus propofol with added lidocaine

The incidence of pain on injection of propofol remains unacceptably high in children, despite various strategies to reduce it. A new drug formulation of propofol has, in adult studies, been reported to cause less injection pain compared with other propofol solutions. The aim of the present prospective randomized double-blind clinical trial was to compare the incidence of pain-free injection following the use of this new formulation with that following the use of propofol with added lidocaine in children undergoing day case surgery. Eighty-three children (age range 2-18 yr) were randomized to receive 3 mg kg(-1) of either Propofol-Lipuro (propofol dissolved in a mixture of medium- and long-chain triglycerides [MCT-LCT]; group pL, n=42) or Diprivan (propofol dissolved in long-chain triglycerides [LCT]) with added lidocaine (0.3 mg kg(-1)) (group pD, n=41). A specially trained nurse anaesthetist assessed the occurrence of injection pain using a four-graded pain scale. Significantly fewer patients had an entirely pain-free propofol injection in group pL (33.3%) than in group pD (61.0%) (P=0.016). A new MCT-LCT propofol formulation as a plain solution was associated with a higher incidence of injection pain than LCT propofol with added lidocaine when used for induction of anaesthesia in children.

Computer search in projective planes for the sizes of complete arcs

The spectrum of possible sizes k of complete k-arcs in finite projective planes PG(2 ,q) is investigated by computer search. Backtracking algorithms that try to construct complete arcs joining the orbits of some subgroup of collineation group PL( 3 ,q) and randomized greedy algorithms are applied. New upper bounds on the smallest size of a complete arc are given for q = 41, 43, 47, 49, 53, 59, 64, 71 ≤ q ≤ 809 ,q � 529, 625, 729, and q = 821. New lower bounds on the second largest size of a complete arc are given for q = 31, 41, 43, 47, 53, 125. Also, many new sizes of complete arcs are obtained for 31 ≤ q ≤ 167.

Postoperative extradural analgesia with morphine and ropivacaine. A double‐blind comparison between placebo and ropivacaine 10 mg/h or 16 mg/h

Some controversy exists in the literature on the benefit of epidurals compared to patient-controlled intravenous analgesia (PCA). Also, the dose of ropivacaine for epidural analgesia when combined with morphine remains uncertain. The aim of this study was to compare the epidural vs. PCA technique and high-dose vs. low-dose ropivacaine combined with morphine during knee replacement surgery. In this prospective, randomized, double-blind study, postoperative pain relief with a combination of epidural ropivacaine (Group L: 10 mg h-1, Group H: 16 mg h-1) and morphine (0.16 mg h-1) was evaluated in 30 patients. A placebo group (Group PL) of 15 patients having PCA morphine served as the control. Visual analog pain (VAS), morphine consumption, sensory and motor block and side-effects were recorded during 48 h. VAS scores at rest were significantly lower in Groups L and H compared to Group PL. On movement, Group H had lower VAS scores than Group PL during 3-27 h (P<0.05) and Group L during 4-9 h (P<0.05), while Group L had lower a VAS than Group PL during 9-18 h (P<0.05). Morphine consumption after 48 h was greater in Group PL (64.6+/-36.3 mg) vs. Group L (23.3+/-33.9 mg) (P<0.001) and Group H (4.3+/-9.6 mg) (P<0.0001). Mild motor block was seen in Group H in 20% and 14% patients at 24 h and 48 h, respectively, but time to mobilization was similar between the groups. Pruritus was more common in the ropivacaine groups (P<0.05). Lumbar epidural analgesia using a combination of ropivacaine (16 mg h-1) and morphine (0.16 mg h-1) provides superior analgesia compared to the PCA technique or ropivacaine (10 mg h-1) and morphine (0.16 mg h-1). Although this resulted in a mild motor block during the first 12 h, patient mobilization was similar in all groups.

Epidemiology ofOestrus ovisinfection of sheep in Argentina's western Pampas

Seasonal population trends and effects of Oestrus ovis in naturally infected sheep were studied over 13 months, in the Western of the Pampeana region. At weaning, 140 growing lambs were randomly allocated to two groups: UG, untreated group and TG treated every 4 weeks with closantel (10 mg/kg). Successive Oestrus free tracer lambs (TL) by previous treatment (n = 65) were slaughtered after 20-30 exposition days for larval counts. Likewise, other group PL of 117 permanent untreated lambs was slaughtered from four to 17 months of age. Weighing and assessment of health signs of UG and TG and blood samples were monthly carried out. The prevalence of infection in permanent group varied from 33% to 100%. Mean number of larvae in PL was 6.1 with 3 L1, 1.4 L2 and 1.6 L3 during spring-summer and 17.9 with 16.9 L1, 0.5 L2 and 0.4 L3 during autumn-winter months. In PL the proportions of larvae in each of the different larval stages was similar during spring and summer, but a significant (P < 0.01) increase of L1 was detected during autumn and winter. The prevalence in tracer lambs was 100% during summer time and larvae were absent from 25-May to 25-October. Mean larval burdens of positive TL varied from 6.4 to one Oestrus and a significant peak (P < 0.05) of larvae was seen from December to March. Since March to November only L1 was recovered from TL. TG group showed a reduction in nasal discharge and in antibody ELISA levels, but no difference was observed in live weight gain between TG and UG. These results show a high prevalence during summer and that the perpetuation of Oestrus is ensured by an autumn period of arrested development and the over wintering larvae in the sheep heads.

Comparison of hyperbaric and plain ropivacaine 15 mg in spinal anaesthesia for lower limb surgery

Previously, plain ropivacaine 15 mg given intrathecally has been shown to be feasible for ambulatory surgery of lower-extremities. Hypothetically, hyperbaric solution could improve and shorten the block. This prospective, randomized, double-blind study included 56 patients undergoing surgery of lower extremities. They received intrathecally either 1.5 ml of ropivacaine 10 mg ml(-1) and 0.5 ml of glucose 300 mg ml(-1) (HYP) or 2 ml of ropivacaine 7.5 mg ml(-1) (PL). All patients in Group HYP achieved T(10) dermatome analgesia but only 64% (18/28) of Group PL. T(10) analgesia was reached in 5 min (median, range 5-20 min) in the HYP group vs 10 min (5-45 min) in the PL group (P=0.022), and full motor block in 10 min (5-45 min) vs 20 min (5-60 min) (P=0.003), respectively. Group HYP had a longer duration of analgesia at T(10); 83 min (5-145 min) vs 33 min (0-140 min) (P=0.004). Duration of sensory block from injection of the anesthetic to complete recovery was shorter in Group HYP than in Group PL, 210 min (120-270 min) vs 270 min (210-360 min) (P<0.001), as was duration of motor block, 120 min (5-150 min) vs 210 min (120-330 min) (P<0.001). Patients of Group HYP attained discharge criteria earlier than those of Group PL (P=0.009). In comparison with the plain solution, 15 mg of intrathecal hyperbaric ropivacaine produced a faster onset, greater success rate of analgesia at the level of T(10) dermatome, and faster recovery of the block.

Double-blind, randomized, placebo-controlled trial comparing rofecoxib with dexketoprofen trometamol in surgical dentistry

Rofecoxib, a selective cyclooxygenase-2 inhibitor, and dexketoprofen trometamol, a single isomer non-steroidal anti-inflammatory drug (NSAID), are available for the treatment of acute pain. Both are claimed to have fewer adverse effects than traditional NSAIDs. We have compared them in a clinical setting. We performed a double-blind randomized controlled trial involving 120 patients undergoing surgical removal of a single mandibular third molar at the Edinburgh Dental Institute. Those who developed moderate pain within 4 h of the procedure were allocated to one of three groups: rofecoxib 50 mg (Group RO, n=37); dexketoprofen trometamol 25 mg (Group DE, n=42); or placebo (Group PL, n=41). Participants monitored pain intensity and pain relief for 24 h using visual analogue scales (VAS) and verbal rating scales (VRS). The summed, time-weighted pain relief score to 8 h derived from the VRS (TOTPAR 8) was used as the primary outcome variable. No significant difference was demonstrated between Groups RO and DE using TOTPAR 8 as the primary outcome variable. Both drugs were significantly different compared with placebo. Rescue analgesia during the trial period was required by only 15 out of 37 subjects in Group RO, but 35 out of 42 subjects in Group DE. The median times to use of rescue medication were 150 (Group PL), 398 (Group DE) and 1440 min (Group RO). Both drugs were well tolerated and adverse events reported were mild to moderate in severity. Rofecoxib and dexketoprofen trometamol are effective treatments for acute pain using a dental pain model and are well tolerated. Rofecoxib has a longer duration of action as a single dose and gave adequate analgesia for over half of that study group; patients in the dexketoprofen trometamol group needed more rescue analgesia.