ABSTRACT
Abstract In the hospital environment, postoperative pain is a common occurrence that impairs patient recovery and rehabilitation and lengthens hospitalization time. Racemic bupivacaine hydrochloride (CBV) and Novabupi® (NBV) (S (-) 75% R (+) 25% bupivacaine hydrochloride) are two examples of local anesthetics used in pain management, the latter being an alternative with less deleterious effects. In the present study, biodegradable implants were developed using Poly(L-lactide-co-glycolide) through a hot molding technique, evaluating their physicochemical properties and their in vitro drug release. Different proportions of drugs and polymer were tested, and the proportion of 25%:75% was the most stable for molding the implants. Thermal and spectrometric analyses were performed, and they revealed no unwanted chemical interactions between drugs and polymer. They also confirmed that heating and freeze-drying used for manufacturing did not interfere with stability. The in vitro release results revealed drugs sustained release, reaching 64% for NBV-PLGA and 52% for CBV-PLGA up to 30 days. The drug release mechanism was confirmed by microscopy, which involved pores formation and polymeric erosion, visualized in the first 72 h of the in vitro release test. These findings suggest that the developed implants are interesting alternatives to control postoperative pain efficiently.
Subject(s)
Pain, Postoperative/classification , Bupivacaine/analysis , Absorbable Implants/classification , Anesthetics, Local/administration & dosage , In Vitro Techniques/methods , Pharmaceutical Preparations/analysis , Hospitals/classificationABSTRACT
Con un diseño descriptivo longitudinal se incluyeron 105 pacientes de ambos sexos, ASA I - III, a quienes se realizó bloqueo de plexo braquial con bupivacaína, lidocaína o la mezcla de ambas con la ayuda de un neuroestimulador (Stimuplex Dig-RC de Braun) para ser sometidos a cirugía de miembro superior en el Hospital Vicente Corral de Cuenca, Ecuador, en un período de dos años, se alcanzó un 97,2% de bloqueos exitosos y de éstos el 86.7% fueron completos y el 10,5% parciales. La edad promedio de la muestra fue de 29,4 ± 19,8 años con un rango entre 5 y 75 años. Los varones fueron el 71,4%. Artesanos y pacientes sin ocupación (estudiantes y preescolares) fueron el 76,1% del grupo, el 62.9% (n = 66) de las intervenciones fueron electivas. El acceso supraclavicular se utilizó en el 42,9% (n = 45), el interescalénico en el 41.% (n = 43) y el axilar en el 16.2% (n = 17),el tiempo quirúrgico tuvo una mediana de 90 min (rango 10 a 240), el tiempo anestésico de 120 min (rango 30 a 420) y el tiempo de analgesia de 250 min (rango 30 a 640), dos pacientes (1.9%) presentaron desorientación, ansiedad y diaforesis transitorias que se normalizaron en 20 30 min.
With a longitudinal descriptive design 105 patients of both sexes included themselves, ASA I - III, to those who blockade of brachial plexus with bupivacaine, lidocaine or mixture of both with aid of a neuroestimulator was made (Stimuplex Dig-RC Braun) to be undergoing surgery of superior member in Vicente Corral Hospital of Cuenca, Ecuador, in a period of two years, a 97.2% of successful blockades were reached and of these the 86,7% were complete and 10.5% partisans. The age average of the sample was of 29.4 ± 19.8 years with a rank between 5 and 75 years. The men were 71.4%. Craftsmen and patients without occupation (students and prestudents) were 76.1% of the group, the 62,9% (n = 66) of the interventions were elective. The access to supraclavicular was used in 42.9% (n = 45), the interescalénico in (the 41,% n = 43) and the axillary one in the 16,2% (n = 17), the surgical time min had a medium one of 90 (rank 10 to 240), anesthetic time of 120 min (rank 30 to 420) and time of analgesia of 250 min (rank 30 to 640).Two patients (1,9%) showed transitory disorientation, anxiety and diaphoresis that were normalized in 20 - 30 min.
Subject(s)
Brachial Plexus , Bupivacaine/analysis , Lidocaine/analysis , Upper Extremity/surgeryABSTRACT
O objetivo deste estudo foi avaliar a eficácia e segurança da associaçao bupivacaína com sufentanil para a analgesia no trabalho de parto e do parto por meio de um bloqueio peridural contínuo. Realizou-se um ensaio clínico duplo-cego, prospectivo e aleatório, incluindo sessenta mulheres nulíparas da Maternidade do CAISM/UNICAMP. No momento da analgesia, as mulheres foram aleatoriamente alocadas em dois grupos: BS, recebendo 12,5 mg de bupivacaína com adrenalina mais 30 mug de sufentanil e BP, recebendo 12,5 mg de bupivacaína com adrenalina mais placebo. Foram avaliados os parametros relativos à qualidade e duraçao da analgesia, duraçao do trabalho de parto e também possíveis efeitos sobre o recém-nascido. Os resultados mostraram a superioridade da adiçao do sufentanil sobre o grau de analgesia durante o tempo de açao da primeira dose de anestésico local. Nao houve aumento na duraçao do trabalho de parto depois do início da analgesia quando se compararam ambos os grupos, nem qualquer diferença quanto à via de parto. Nao houve também diferenças entre os grupos com relaçao à avaliaçao dos recém-nascidos. Conclui-se que a associaçao de 30 mug de sufentanil à primeira dose de bupivacaína é segura e eficaz, melhorando a qualidade da analgesia, sua duraçao e nao afetando a progressao do trabalho de parto e o resultado neonatal.
Subject(s)
Humans , Female , Adult , Analgesia, Epidural , Analgesia, Obstetrical , Anesthesia, Epidural , Labor, Obstetric , Bupivacaine/analysis , Double-Blind Method , Epinephrine/analysis , Placebos/analysis , Sufentanil/analysisABSTRACT
O alívio da dor pós-operatória é uma exigência cada vez mais frequente. As cirurgias oftálmicas que manipulam os músculos extra-oftálmicos que manipulam os músculos extra-oculares provocam intensa dor. Os resultados da irrigaçäo ou da injeçäo subconjuntival de bupivacaina. 0,75 por cento ao término de cirurgias de descolamento de retina, estrabismos e enucleaçäo de globo permitiram analgesias significativas em 102 pacientes