Effect of sequential sedation and analgesia in preventing delirium and withdrawal symptoms in children after ventilator weaning / 中国当代儿科杂志

OBJECTIVES@#To investigate the effect of sequential sedative and analgesic drugs in preventing delirium and withdrawal symptoms in children after ventilator weaning.@*METHODS@#A retrospective analysis was performed on 61 children who were admitted and received mechanical ventilation support for ≥5 days in the Pediatric Intensive Care Unit of Dongguan Children's Hospital Affiliated to Guangdong Medical University from December 2019 to September 2021. The children were divided into a control group (30 children with no maintenance of analgesic and sedative drugs after ventilator weaning) and an observation group (31 children with sequential sedative and analgesic drugs maintained for 48 hours after ventilator weaning). The two groups were compared in terms of the Sophia Observation Withdrawal Symptoms Scale (SOS) score, the Pediatric Delirium Scale (PD) score, the Richmond Agitation-Sedation Scale (RASS) score, and the incidence rates of delirium or withdrawal symptoms at 24 and 72 hours after ventilator weaning.@*RESULTS@#There was no significant difference in the incidence rate of delirium at 24 hours and 72 hours after ventilator weaning between the two groups (P>0.05). Compared with the control group, the observation group had significantly lower incidence rate of withdrawal symptoms and scores of SOS, PD, and RASS scales at 24 hours and 72 hours after ventilator weaning (P<0.01).@*CONCLUSIONS@#Sequential sedation and analgesia after ventilator weaning can reduce the incidence of withdrawal symptoms within 72 hours after ventilator weaning, but it cannot reduce the incidence rate of delirium.

Effects of sinomenine and acupuncture on amygdala in heroin-withdrawal rats / 中国药理学通报

Aim To explore the effects of acupuncture and sinomenine on the withdrawal symptoms,on the spontaneous discharge and synaptophysin expression of amygdala of heroin-addicted rats.Methods 75 SD rats were randomly and equally divided into 5 groups consisted of control,heroin-addicted,acupuncture,sinomenine and combined treatment group.The model of heroin-addicted rats were established with heroin subcutaneous injection,which in acupuncture,sinomenine and combined group were subsequently punctured at 3 acupoint(Neiguan,Baihui and Zusanli),intramuscular injected with sinomenine and treated with combined methods(acupuncture and sinomenine)respectively.The withdrawal symptoms of rats in different group were evaluated,and then the spontaneous discharges and synaptophysin expression of amygdala were detected with electrophysiological and immunohistochemical technology respectively.Results The heroin-addicted rats were successfully established,being suggested by typical withdrawal symptoms induced by naloxone(P<0.01 vs control),which were alleviated in the 3 treatment groups(acupuncture,sinomenine and combined ) with varying degree(P<0.01 vs heroin group).The electrophysiological results suggest that the forms of low-frequency and single irregular discharges in amygdala were increase,bunchy/cluster and complex discharges were decreased(P<0.05 vs control),which were reversed apparently in sinomenine and combined treatment groups(P<0.05 vs heroin group),closed to control.The immunohistochemical results show that expression of synaptophysin in amygdala was increased obviously(P<0.01 vs control),which was decreased in the 3 treatment groups(acupuncture,sinomenine and combined),P<0.01 vs addicted group.Conclusion Treatments of acupuncture and sinomenine administration can alleviate withdrawal symptoms of heroin-addicted,and rectify the abnormal spontaneous discharges and expression of synaptophysin in amygdala of heroin-addicted rats for certain degree,especially with combined treatments.

Fixed-dose schedule and symptom-triggered regimen for alcohol withdrawal: a before-after study

Objectives: To evaluate the efficacy, safety, benefits and cost of alcohol detoxification after switching from a fixed-dose schedule (FDS) to a symptom-triggered regimen (STR). Methods: This retrospective study was carried out in inpatients receiving alcohol detoxification. The data of alcohol dependent patients receiving STR during March – September 2006 were compared with those of patients treated with FDS between August 2005 and February 2006. Results: The mean age, alcohol use and history of delirium tremens were not significantly different between groups. The mean dosage of benzodiazepines in the STR group (91.3 mg equivalent to diazepam) was lower than that of FDS (465.3 mg equivalent to diazepam), (p<.001). The mean length of hospitalization was shorter in the STR group (10.6 vs. 16.8 days, p=.003). There was no significant difference in major complications. Oversedation was significantly less frequent in the STR group (p <.001). The treatment cost was significantly lower in the STR group (p<.05). Conclusions: Despite the limitations of the study design, STR is as effective as FDS with less frequent complications, shorter length of hospitalization and decreased cost of treatment.

Effects of CCK-8 on the withdrawal symptoms and expression of c-jun protein in Cd of morphinomania rats / 中国药理学通报

Aim To investigate the effects of cholecys-tokinin octapeptide(CCK-8)on the withdrawal symp-toms of morphinistic rats by the observation of praxiology,and change of expression of proto-oncogene c-jun in caudate nucleus(Cd) after CCK-8 injected by immunohistochemistry.Methods Animal praxiology evaluation and immunohistochemistry were used.The influence of CCK-8(10 mg?L-1,1 ?l) on the withdrawal symptoms and the expression of c-jun of morphinistic rats was observed.Results Morphinistic rats had obvious praxiological changes in the withdrawal symptoms compared with normal saline rats;the scores of withdrawal symptoms decreased most obviously at withdrawal 40 h after Cd injection of CCK-8;the expression of c-jun protein in Cd decreased in morphinistic rats,but increased after Cd injection of CCK-8.Conclusions Models of morphinomania rats were successfully built.The Cd injection of CCK-8 could decrease the withdrawal symptoms of morphinomania rats.The CCK-8 could increase the expression of c-jun protein in Cd.These findings suggested that CCK-8 could regulate the production of withdrawal symptoms and the expression of c-jun protein in Cd of morphinomania rats.

Symptom Aggravation in an Elderly Schizophrenic due to Lorazepam Discontinuation of Long-term Use of Minimal Dosage: A Case Report / 신경정신의학

Withdrawal psychosis following long-term administration of benzodiazepine is relatively unclear and has rarely reported. Especially, there are few reports of lorazepam withdrawal characterized by psychotic aggravation in schizophrenia. We report a 64 years old chronic schizophreinc case who developed symptom aggravation and paroxysmal attack of severe psychotic symptom, following discontinuation of 1mg lorazepam, which has been used in combination with 100mg chlorpromazine for 13 years. It was suggested that long-term combination therapy with benzodiazepines in schizophrenia was strongly discouraged even if its dosage is minimal.

Effect of Salvia miltiorrhiza extracts on morphine physical dependence in mice / 中草药

Objective To investigate the effect of Salvia miltiorrhiza extracts on morphine physical dependence in mice. Methods The physical dependence model was induced by repeated sc morphine daily in mice and then withdrawal symptom was induced by ip naloxone. Different doses of S. miltiorrhiza extracts were administrated by ip during or after the induction phase of morphine dependence, and effects of S. miltiorrhiza extracts both by preventive and acute administration on naloxone-precipiated withdrawal symptom in mice were investigated. The potential physical dependence of S. miltiorrhiza extracts was studied. Results Compared to morphine model group, preventive administration of S. miltiorrhiza extracts (100—200 mg/kg) could reduce the number of naloxone-induced withdrawal jumps (P

A Case of Withdrawal Symptom after Injection of Nalbuphine in a Chronically Morphine-Dependent Patient / 대한마취과학회지

Nalbuphine, a mixed agonist-antagonist type opioid, can precipitate abstinence syndrome in opioid-dependent patients especially in large doses. We can prevent this syndrome by avoiding the injection of agonist-antagonist type opioid to the patient who already has used opioid for a long time, and the method of relatively small dose increments in its use. We experienced a case of opioid withdrawal symptom in chronically morphine-administered patient via epidural catheter after using intramuscular nalbuphine for analgesia. The symptom was promptly relieved by intravascular morphine injection without any problems.

Effect of Houxiangzhengqi Oral Liquid on the withdrawal syndromes in morphine dependent rats / 中成药

Objective: To explore the effects of Houxiangzhengqi Oral Liquid(HOL) on controlling withdrawal syndromes of morphine dependent rats and analgesia of mice. Methods: 60 rats were divided into group A、B、C and D randomly. Group A was injected equivalent 0.9%NaCl(0.2 mL, sc), group B、C and D were injected morphine increasingly(from 20mg?kg -1 to 100mg?kg -1, 5 days, sc) to form patterns of morphine dependent rats. When the 6th day, after group A and B were given 0.9% NaCl(0.5mL?(100g) -1, ig), group C and D were given HOL(100%0.2mL?(100g) -1 and 0.8mL?(100g) -1), respectively, 30 minutes later, by naloxone(4mg?kg -1, ip) withdrawal syndromes. And the withdrawal syndromes was observed and evaluated by the scores and weight lost. Results: The total of scores and their weight loss of group C and D were significantly different from group B(P