ABSTRACT
Chest tube removal in the postcardiac surgical patients is a painful and distressful event. Fentanyl and sufentanil have not been used for pain control during chest tube removal in the postoperative period. We compared efficacy offentanyl and sufentanil in controlling pain due to chest tube removal. One hundred and forty one adult patients undergoing cardiac surgery were recruited in a prospective, randomized, double blind, placebo controlled study. Patients were randomized to receive either 2 microg/Kg fentanyl IV or 0.2 microg/Kg sufentanil IV or 2 ml isotonic normal saline, 10 min before removing chest tubes. Pain intensity was assessed by measuring visual analog scale pain score 10 minutes before removing chest tubes and 5 min and 20 min after removing chest tubes. Level of sedation, heart rate, arterial pressure, oxygen saturation, and respiratory rate were recorded by a blinded observer at the same time intervals. Mean pain intensity scores 10 minutes before removal of chest tubes infentanyl, sufentanil and control groups were 23.88+/-5.2, 25.10+/-5.39 and 23.64+/-6.10 respectively. The pain scores 5 minutes after chest tube removal were reduced to 20.11+/-6.9 (p<0.05) in the fentanyl group and 13.60+/-6.60 (p<0.05) in the sufentanil group, whereas in control group pain scores increased to 27.97+/-8.39 (p<O.05). The pain scores in sufentanil group were significantly lower compared with fentanyl or control group. Sedation scores remained low in all groups and patients remained alert and none of the patients showed any adverse effects of opioids. Heart rate, arterial pressure and respiratory rate had least variations in sufentanil group than fentanyl or control group.
Subject(s)
Adult , Aged , Analgesics, Opioid/therapeutic use , Analysis of Variance , Blood Pressure/drug effects , Cardiac Surgical Procedures , Chest Tubes/adverse effects , Conscious Sedation , Device Removal/adverse effects , Double-Blind Method , Female , Fentanyl/therapeutic use , Heart Rate/drug effects , Humans , Male , Middle Aged , Oxygen/analysis , Pain/etiology , Pain Measurement , Prospective Studies , Research Design , Respiration/drug effects , Sufentanil/therapeutic use , Treatment OutcomeABSTRACT
Oil obtained from stream distillate of V. negundo leaves was fractionated by column chromatography. Mosquito repellence activity, as evaluated against Aedes aegypti was mainly confined to the most polar fractions. The protection period against mosquito bites by polar fractions ranged between 1-3 h. However, the mean protection period values of these fractions did not show significant increase in the subsequent subfractions.
Subject(s)
Aedes , Animals , Female , Humans , Insect Bites and Stings/prevention & control , Insect Repellents , Male , Plant Extracts , Plant OilsABSTRACT
Five patients presented with severe mood disturbance and behaviour change during the premenstruum. Suspiciousness was an important feature in four of them. They were treated with carbamazepine 200-400 mg orally at bedtime for 7 days before the onset of menses. The follow-up period varied from 1 1/2 years to 2 menstrual cycles. Four patients showed remarkable improvement; one patient dropped out because of allergic rash.