ABSTRACT
Brain ischemia modulates endogenous opioids production and the expression of opioid receptors. The present investigations aim to determine the neuroprotective effect of Spiradoline and Naloxone, administered intraperitoneally, against carotid artery occlusion induced cerebral ischemia in adult male Wistar rats. The ischemic assessment was carried out by evaluation of behavioral (cognitive and sensorimotor), and biochemical (antioxidants, acetylcholinesterase, brain swelling and hemispheric water content) parameters. The groups included sham-operated control, vehicle control, spiradoline-treated and naloxone-treated rats. Carotid artery occlusion induced behavioral impairment as per 8-arm radial maze, elevated plus maze, sensorimotor deficits, free radical production and biochemical changes. The results revealed that spiradoline significantly (p<0.05) antagonized the cognitive and sensorimotor deficits, indicated by reduced working memory errors, increased transfer latency time, and neurologic scores on 24 h and day 7 after ischemia, while naloxone produced transient improvement. The drugs significantly (p<0.05) restored the levels of antioxidants, and acetylcholinesterase on day 7. The brain edema development was significantly antagonized by spiradoline while naloxone showed lesser improvement. The results implied that the opioid agonist spiradoline has better efficacy than opioid antagonist naloxone for brain stroke therapy at tested doses, and spiradoline may be used in future combination therapies as a neuroprotective drug.
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Heart Diseases/microbiology , Humans , Leptospirosis/complications , Male , Middle AgedABSTRACT
Cost containment and efficient resource utilization are motivating anaesthesiologists to early tracheal extubation of cardiac surgical patients. Fast track cardiac anaesthesia is both safe and cost-effective. We studied 45 patients with LVEF = 40% who underwent coronary revascularization and were put on the same fast track principle as those with normal ventricular function. Of these 31 patients (68.8%) had recent (<2 weeks) cardiac events requiring hospitalization. Acute myocardial infarction was documented in 8 patients (17.7%) and 23 (51.1%) had unstable angina. Congestive failure was present in 13 (28.9%) patients. Preoperative intravenous pharmacological support was needed in 17 (37.7%) patients, mechanical ventilation in 2 (4.5%) and IABP support in 1 (2.3%) patient. Anaesthetic management of these patients hinged on reduced usage of narcotics and muscle relaxants to facilitate early extubation. Operative strategy adopted was that of optimal revascularization. Beating heart surgery was adopted particularly in patients with low ejection fraction to avoid the attendant systemic and myocardial ill effects of cardiopulmonary bypass (CPB), especially in those who have had recent myocardial insults. Coronary surgery was performed on beating heart in 18 (40%) patients, while the other 27 (60%) patients were revascularised on CPB support. Of the 44 operative survivors, early extubation (<4 hours) was performed in 37 (84%) patients. Only 7 (16%) patients required ventilation for more than 24 hours. 3 out of these 7 patients were ventilated due to pulmonary reason and other 4 were ventilated since they were on IABP support. ICU stay was less than 24 hrs for 34/42 (80.9%) and hospital stay less than 6 days in 24/40 (60%). Fast tracking in cardiac surgery can be achieved with safety even in patients with impaired LV function.