ABSTRACT
Objective To compare the application effects of different drug administration modes under continuous epidural anesthesia in elderly patients undergoing total hip replacement.Methods One hundred and twelve ASA Ⅱ-Ⅲelderly patients undergoing elective total hip replacement,55 males and 57 females,aged 75-91 years old,were randomly divided into the group A and B,56 cases in each group.After continuous epidural puncture success at L2-L3,the test dose of 2 ％ lidocaine 3 mL was injected,according the anesthesia plane,additional 2 ％ lidocaine 3-5 mL was injected,the group A adjusted the anesthesia plane to T10,after fixation,epidural continuous infusionof 2 ％ lidocaine 3 5 mL/h was performed according to the patient's condition;the group B adjusted the anesthesia plane to T10,after fixation,according to patient's condition epidural injection of 2 ％ lidocaine 3-5 mL/h was injected by several times.The two groups were given vasoactive drugs dopamine when necessary during operation.Mean arterial pressure(MAP),heart rate (HR) and pulse oxygen saturation (SPO2) at entering the operation room,30 min after medication injection,skin incision,postoperative 1 h and end of operation were recorded in the two groups.The anesthesia plane,anesthetic drug dosage,anesthesia effect and fotal dosage of dopamine were recorded in the two groups.Results Blood pressure after epidural drug administration in the two groups were significantly reduced,while the blood pressure after intraoperatively administrating additional drug in the group B was significantly decreased compared with the group A(P＜0.05).The anesthesia plane in the group A was more stable than that in the group B (P＜0.01),moreover the dosage of anesthetic drug was decreased significantly (P＜0.05).The intraoperative total amount of dopamine in the group A was obviously less than that in the group B (P＜0.05).Conclusion Micropump continuous drug administration during continuous epidural anaesthesia has little influence on the patient's hemodynamics than discontinuous single drug administration.In the condition without affecting the anesthesia effect,the anesthesia plane is more stable,the anesthesia drug dose can be significantly decreased,which is conducive to maintain the circulation stable and increase perioperative safety.
ABSTRACT
In clinical settings, intravesical instillation of a drug bolus is often performed for the treatment of bladder diseases. However, it requires repeated instillations to extend drug efficacy, which may result in poor patient compliance. To alleviate this challenge, implantable devices have been developed for the purpose of sustained, intravesical drug delivery. In this review, we briefly summarize the current trend in the development of intravesical drug-delivery devices. We also introduce the most recently developed devices with strong potential for intravesical drug-delivery applications.
Subject(s)
Administration, Intravesical , Drug Delivery Systems , Patient Compliance , Urinary Bladder DiseasesABSTRACT
PURPOSE: In order to treat inflammatory and proliferative disorders of the posterior segment of the eye, the authors evaluated the use of a biodegradable intrascleral implant for slow release of triamcinolone acetonide (TA). METHODS: The intrascleral implant (1 mm thick and 3 mm in diameter) was made of alginic acid and PLA (poly (D, L-lactide)) containing 4 mg of TA. In vitro release of TA was evaluated by HPLC. To evaluate in vivo release of TA, the implant was placed into a scleral pocket in 18 rabbit eyes and the concentrations of TA in the aqueous humor, vitreous, and retina-choroid-sclera were measured by HPLC at 1, 2, 4, 8, and 12 weeks after implantation. The toxicity and biocompatibility of the implant were evaluated by slit lamp examination, IOP, electroretinogram, and light microscopy. RESULTS: In vitro study demonstrated that the implant released TA in controlled manner for at least 8 months. The TA detected in the vitreous after 8 to 12 weeks and was not detected in retina-choroid-sclera at 8 weeks after implantation. The TA was not detected in aqueous humor. No significant toxicity to the retina was observed. CONCLUSIONS: These results suggest that the intrascleral implant of TA could be a promising system for the delivery of steroids to the posterior segment of eye in cases of inflammatory or proliferative disorders of posterior segment.