ABSTRACT
Objective To evaluate the effect of methylprednisolone sodium succinate combined with tropisetron on postoperative nausea and vomiting(PONV)under microvascular decompression of hemifacial spasm.Methods From January to June 2019,485 patients undergoing microvascular decompression for facial spasm at Department of Neurosurgery,Peking University People's Hospital were randomly assigned into two groups with random number table method.For group A(n=242),2 ml saline was administrated by intravenous drip before induction and 5 mg tropisetron after operation.For group B(n=243),40 mg methylprednisolone sodium succinate was administrated by intravenous drip before induction and 5 mg tropisetron after operation.The anesthesia time,operation time,and incidence of PONV in 0-24 h and 24-48 h were recorded for the comparison of the remedial treatment rate of nausea and vomiting between the two groups.Results There was no significant difference in age,gender,smoking history,body mass index value,American Society of Anesthesiologists score,medical history,surgical side,PONV history,operation time or anesthesia time between the two groups(all P > 0.05).The incidence of PONV in group A was 35.5% and 18.2% during 0-24 h and 24-48 h,respectively,which was significantly higher than that(18.5%,χ
Subject(s)
Humans , Antiemetics , Double-Blind Method , Hemifacial Spasm/surgery , Indoles , Methylprednisolone Hemisuccinate/therapeutic use , Microvascular Decompression Surgery , TropisetronABSTRACT
Foi realizado o estudo comparativo do efeito imunossupressor de três tratamentos, utilizando-se a combinação de ciclosporina A e metilprednisolona, um ciclo curto e um ciclo longo de FK506 por 12 semanas no transplante de membro inferior entre ratos Sprague-Dawley e Wistar. O tempo médio de instalação da rejeição foi de 6,6 dias nos animais que não receberam imunossupressão, 34 dias nos que receberam ciclosporina A e metilprednisolona, 58 dias para os que receberam FK506 em ciclo curto e 77.75 para os que receberam FK506 em ciclo longo. Os grupos que receberam FK506 apresentaram tempo prolongado de sobrevivência do transplante. /The immunosuppressive effect of combined therapy using cyclosporine A and metilprednisolone, a short course and a long course of FK506 for 12 weeks in a Sprague-Dawley/Wistar rat limb allotransplantation model was tested. 36 right hindlimb transplantations were performed. Median time for onset of rejection was 6,6 days in animals without immunosuppression, 34 days receiving cyclosporine A and metilprednisolone, 58 days receiving FK506 short course and 77.75 days in the long course group. The FK506 groups presented survival time of the allograft longer than the cyclosporine A and metilprednisolone, and the FK506 long course was the most efficient among the three treatments preventing rejection. The mortality of the animal was increased in the cyclosporine A and metilprednisolone compared to the FK506 groups...
Subject(s)
Animals , Male , Adult , Hindlimb/transplantation , Transplantation, Homologous/statistics & numerical data , Cyclosporine/adverse effects , Cyclosporine/therapeutic use , Disease Models, Animal , Methylprednisolone Hemisuccinate/therapeutic use , Rats, Sprague-Dawley , Rats, Wistar , Graft Rejection/drug therapy , Transplantation, Homologous/adverse effects , Transplantation, Homologous/mortalityABSTRACT
Recent clinical trials have reported that methylprednisolone sodium succinate administered within 8 hours improves neurological recovery in human spinal cord injury (SCI). Methylprednisolone, however, was ineffective and possibly even deleterious when given more than 8 hours after injury. This finding suggests that a therapeutic time window exists in spinal cord injury. In order to determine the doses, durations and timing of methylprednisolone treatment for optimal neuroprotection, a single or two bolus dose of methylprednisolone (30 mg/kg) was administered at 10, 30, 120, 150 and 240 min. after three graded spinal cord injury. The primary outcome measure was 24-hour spinal cord lesion volumes estimated from spinal cord Na+ and K+ shifts. A single 30 mg/kg dose of methylprednisolone at 10 min. after injury significantly reduced 24-hour lesion volumes in injured rat spinal cords. However, any other methylprednisolone treatment starting 30 min. or more after injury had no effect on 24-hour lesion volumes compared to the vehicle control group. Moreover, delayed treatment increased lesion volumes in some cases. These results suggest that the NYU SCI model has a very short therapeutic window.