ABSTRACT
Local anesthetics (LA) belong to a class of pharmacological compounds that attenuate or eliminate pain by binding to the sodium channel of excitable membranes, blocking the influx of sodium ions and the propagation of the nerve impulse. S (-) bupivacaine (S(-)bvc) is a local anesthetic of amino-amide type, widely used in surgery and obstetrics for sustained peripheraland central nerve blockade. This article focuses on the characterization of an inclusion complex of S(-) bvc in2-hydroxypropyl- beta-cyclodextrin (HP-beta -CD). Differential scanning calorimetry, scanning electron microscopy andX-Ray diffraction analysis showed structural changes inthe complex. In preliminary toxicity studies, the cellviability tests revealed that the inclusion complex decreased the toxic effect (p smaller that 0.001) produced by S(-) bvc.These results suggest that the S(-) bvc:HP- beta-CD inclusion complex represents a promising agent for the treatment of regional pain.
Subject(s)
Bupivacaine/toxicity , Calorimetry, Differential Scanning , Pain/drug therapy , Inclusion Bodies , Microscopy, Electron, Scanning/methods , beta-Cyclodextrins/toxicityABSTRACT
118 patients (79 mean and 39 women, mean age of 50.7 years) who underwent cardiovascular surgery and extracorporeal oxygenation were prospectively evaluated for neurologic complication and its correlation with risk factors. 71 were submitted to coronary artery graft by-pass (RM), 18 to valve replacement (TV), 6 to prosthetic valve replacement (RV), 11 to commissurotomy(Co), 5 to thoracic aortic aneurysm correction (An Ao T) and 7 to other surgeries (OT). All of them received extracorporeal oxygenation. No deaths were registered; 14 (11.9%) patients had neurologic abnormalities: delirium in 7 cases, ischemic stroke in 6, epileptic seizure in 3. Patients with systemic arterial hypertension and older patients exhibited a statistically significant (p < 0.05) higher risk of complication. Compared to data of the literature, we had a lower index of morbidity and mortality.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Cardiovascular Diseases/surgery , Nervous System Diseases/etiology , Postoperative Complications , Extracorporeal Circulation , Postoperative Period , Prospective Studies , Risk FactorsABSTRACT
1. The dyslipoproteinemia commonly occurring in the hepatosplenic forms of schistosomiais mansoni in Brazilian patients is characterized by low plasma levels of choleteryl esters and of the cholesterol-esterifying enzyme, lecithin:cholesterol acyltransferase (LCATase, EC.2.3.1.43). 2. In the present study, normal helathy individual and patients sufferin from hepatosplenic schistosomiasis mansoni were comapred for the fatty acyl compositons of circulating plasma cholesteryl esters and of those formed in vitro by the action of LCATase on a) the endogenous plasma lipoprotins and b) an excess of lipoprotein substrate composed of heat-inactivated plasma. 3. In patient palsma the proportions of saturated and monounsaturated cholesteryl esters were higher and those of diunsaturated and polyunsaturated esters were lower than in the control group. 4. Similar differences were observed between patients and controls in the proportions of the cholesteryl ester subclasses formed in vitro by the action of LCATase on endogenous plasma lipoprotins. 5. Incubation of fresh normal or patient plasma with escess heat-inactivated plasma as substrate for LCATase produced proportions of cholesteryl ester subclasses similar to those formed dduring incubation of nonheated aliquots of the appropriate plasma. 6. We conclude that the alterations in fatty acyl composition of palsma cholesteryl estes in patients with hepatosplenic schistosomiasis mansoni do not appear to be direct consequence of the low levels of LCATase acivity in patient plasma