Eficacia del bloqueo femoral modificado en los pacientes con diagnóstico de fractura de cadera / Effectiveness of modified femoral block in patients with a diagnosis of hip fracture

Introducción: La evidencia demuestra que un inadecuado alivio del dolor preoperatorio tiene consecuencias fisiológicas y psicológicas nocivas en los pacientes, aumenta la morbilidad y la mortalidad. Objetivo: Evaluar la eficacia del bloqueo femoral modificado en los pacientes con el diagnóstico de fractura de cadera. Método: Se realizó un estudio cuasiexperimental en el Hospital Universitario Manuel Ascunce Domenech de la provincia Camagüey, en el periodo correspondiente de enero 2016 hasta enero 2018. Se constituyó el universo con 639 pacientes programados de urgencia y electivo con el diagnóstico de fractura de cadera, a través de un muestreo aleatorio simple de manera automática con el Statistical Package for the Social Sciences (SPSS) Versión 21 para Windows, error aceptable y nivel de confianza del 95 por ciento. Se conformó la muestra por 295 pacientes. Resultados: La mayor parte de los pacientes intervenidos por fractura de cadera están por encima de la quinta década de la vida. Se diagnosticó la fractura extracapsular en 174 pacientes, en la evaluación del dolor a través del Cuestionario de dolor de McGill se constata dolor terrible de 4 con intervalo de confianza (2,00912-6,23110) antes del bloqueo y analgesia después del bloqueo de 1 con intervalo de confianza (0,73102 - 1,48209). Conclusiones: El bloqueo femoral modificado proporcionó analgesia en la totalidad de los casos(AU)

Introduction: Evidence shows that inadequate control of preoperative pain has harmful physiological and psychological consequences in patients, and increases morbidity and mortality. Objective: To evaluate the efficacy of modified femoral block in patients with a diagnosis of hip fracture. Method: A quasi-experimental study was carried out at Manuel Ascunce Domenech University Hospital in Camagüey Province, from January 2016 to January 2018. The study population was made up of 639 emergency and elective surgical patients with the diagnosis of hip fracture of hip, through simple random sampling automatically with the Statistical Package for the Social Sciences (SPSS) Version 21 for Windows, acceptable error and 95% confidence level. The sample was made up of 295 patients. Results: Most of the patients operated on for hip fracture are above their fifth decade of life. Extracapsular fracture was diagnosed in 174 patients. Regarding pain evaluation through McGill's Pain Questionnaire, terrible pain of 4 was perceived, with confidence interval (2.00912-6.23110) before block; and also analgesia of 1 after blockage, with confidence interval (0.73102-1.48209). Conclusions: The modified femoral block provided analgesia in all cases(AU)

Analgesic effects of Marasmius androsaceus mycelia ethanol extract and possible mechanisms in mice

Marasmius androsaceus is a medicinal fungus mainly used to treat various forms of pain in China. This study investigated the analgesic effects of an ethanol extract of M. androsaceus (MAE) and its potential molecular mechanisms. Oral administration of MAE (50, 200, and 1000 mg/kg) had significant analgesic effects in an acid-induced writhing test, a formalin test, and a hot-plate test, with effectiveness similar to tramadol (the positive control drug). The autonomic activity test showed that MAE had no harmful effects on the central nervous system in mice. MAE resulted in significantly enhanced levels of noradrenalin and 5-hydroxytryptamine in serum but suppressed both of these neurotransmitters in the hypothalamus after 30 s of hot-plate stimulation. Co-administration with nimodipine (10 mg/kg; a Ca2+ channel blocker) strongly enhanced the analgesic effect in the hot-plate test compared to MAE alone. Moreover, MAE down-regulated the expression of calmodulin-dependent protein kinase II (CaMKII) in the hypothalamus after a 30-s thermal stimulus. These results suggested that the analgesic ability of MAE is related to the regulation of metabolism by monoamine neurotransmitters and Ca2+/CaMKII-mediated signaling, which can potentially aid the development of peripheral neuropathic pain treatments obtained from M. androsaceus.

Economic assessment of postoperative pain control strategies for treatment of adult patients with cancer / Avaliação econômica de estratégias para controle da dor pós-operatória para tratamento de pacientes adultos com câncer

Summary Objective: The authors performed an economic assessment of opioids currently being used for control of postoperative pain relating to the surgical treatment of cancer (fentanyl and sufentanil) within the Brazilian Unified Health System (SUS, in the Portuguese acronym). Method: The assessment was based on the perspective of the government, in order to collaborate with the promotion of effectiveness in public policies of health, and to optimize the allocation of public resources into health. A cost-effectiveness analysis was performed using data collected from the Brazilian Unified Health System and information from literature review, in order to build a decision tree on the alternatives for control of postoperative pain related to cancer treatment among adult patients. The outcomes considered were: effectiveness of postoperative analgesia and occurrence of nausea and vomit in the 48 hour period after surgery, and additional 24-hour cycles in patient follow-up. A univariate sensitivity analysis was conducted in order to verify robustness of the model estimated. Results: Literature review showed a limited number of studies directly comparing fentanyl and sufentanil for control of postoperative pain. The adoption of sufentanil (cost = U$ 25.72 / outcome = 1.6 VAS points) was dominant in relation to the use of fentanyl (cost = U$ 32.58 / outcome = 2.6 VAS points). The estimated model showed robustness in relation to changes in the parameters analyzed. Conclusion: Sufentanil presented higher cost-effectiveness ratio in relation to fentanyl for control of postoperative pain in surgeries related to cancer treatment among adult patients in the Brazilian Unified Health System.

Resumo Objetivo: O artigo apresenta uma avaliação econômica de opioides atualmente utilizados no controle de dor pós-operatória relacionada ao tratamento cirúrgico do câncer (fentanil e sufentanil) no contexto do Sistema Único de Saúde. Método: A avaliação baseou-se na perspectiva do governo, de forma a colaborar na promoção da efetividade das políticas públicas de saúde e melhorar a alocação de recursos públicos em saúde. Uma análise custo-efetividade foi realizada a partir de dados coletados no Sistema Único de Saúde e de informações provenientes de revisão da literatura para construção de uma árvore de decisão contendo alternativas para controle de dor pós-operatória relacionada ao tratamento cirúrgico do câncer entre pacientes adultos. Os desfechos considerados foram: efetividade da analgesia pós-operatória e ocorrência de náusea e vômito no período de 48 horas após cirurgia e em ciclos adicionais de 24 horas de seguimento do paciente. Uma análise de sensibilidade univariada foi conduzida para verificar a robustez do modelo estimado. Resultados: Na revisão de literatura, um número limitado de estudos efetuou comparação direta entre fentanil e sufentanil no controle de dor pós-operatória. A adoção de sufentanil (custo = U$ 25,72 / desfecho = 1,6 pontos VAS) foi dominante em relação ao uso do fentanil (custo = U$ 32,58 / desfecho = 2,6 pontos VAS). O modelo estimado demonstrou robustez em relação a mudanças nos parâmetros analisados. Conclusão: O sufentanil apresentou razão custo-efetividade superior em relação ao fentanil no controle de dor pós-operatória em cirurgias relacionadas ao tratamento de câncer entre pacientes adultos no Sistema Único de Saúde.

Interaction between low level laser therapy and anesthesia in wistar rats / Interações entre laser de baixa potência e anestesia em ratos wistar

The aim was to assess whether the low level laser therapy (LLLT), 660 nm, can lower the effect of injectable anesthetics in rats. Wistar rats (n = 20) were used in two steps: 1) grip strength test and measuring the anesthesia time for control (G1A) and irradiated (G1AL) groups; 2) after 15 days, rats received new anesthesia injection and were evaluated for nociception (G2A - control; G2AL - laser). Anesthesia was induced by ketamine hydrochloride (75 mg kg-1) and xylazine (10 mg kg-1), by intraperitoneal injection, according to the body weight. LLLT used was 660 nm at four sites along the right hind limb. Anesthesia time was shorter for the G1AL (p = 0.0031). There were significant differences between pre- and post-intervention in the grip strength test (p < 0.001), but no differences were detected between groups (p = 0.459). For nociception, G2AL achieved higher values than G2A (p = 0.019 and p = 0.032), and also for the comparison between pre-injury values with the following values (p < 0.001) although no significant difference was found between 10 and 60 minutes (p > 0.05). It can be concluded that the LLLT caused no significant reduction on the effect of anesthesia.

O objetivo deste estudo é avaliar se o laser de baixa potência (LBP) pode desempenhar algum efeito na diminuição da ação de anestésicos injetáveis. Foram utilizados 20 ratos Wistar, em duas etapas: 1) realizado teste de força de preensão e contagem de tempo de anestesia para animais controle (G1A) e irradiados (G1AL); 2) após 15 dias, novo procedimento anestésico e avaliada a nocicepção (G2A ­ controle; G2AL ­ laser). Foram utilizados os anestésicos Quetamina (75 mg kg-1) e Xilazina (10 mg kg- 1), de acordo com o peso corporal, com injeção intraperitoneal. O laser utilizado foi 660 nm, em 4 locais, ao longo do membro pélvico direito. O tempo cronometrado de anestesia foi menor para G1AL (p = 0,0031). Na avaliação da força de preensão, houve diferenças significativas (p < 0,001) entre o momento pré x pós, mas não entre os grupos (p = 0,459). Para a nocicepção, G2AL obteve valores maiores do que G2A (p = 0,019 e p = 0,032), bem como ao comparar os valores pré-lesão com os seguintes (p < 0,001), mas sem diferenças entre 10 e 60 minutos (p > 0,05). Conclui-se que o LBP não apresentou grandes interações com relação à diminuição do efeito da anestesia.

Resultados a 10 años en trasplantes renales con donantes vivos no relacionados: Experiencia de 22 años / Survival among renal allograft recipients from non related living donors

Background: There is a gap between the number of patients requiring a renal allograft and the number of potential deceased donors (DD). One alternative is using allografts from non-related living donors (NRLD). Aim: To compare survival and complications of renal allograft recipients from DD, related living donors (RLD) and NRLD. Material and Methods: Observational study of a cohort of renal allograft recipients. Of 253 transplants performed in a Chilean region between 1981 and 2003, 20 patients received and allograft from a NRLD. Graft and patient survival of these patients were compared with those of 93 patients receiving an allograft from a related living donor and 140 receiving it from a DD. Patients were followed for 10 years or until death or dialysis requirement. Results: No significant differences between groups in graft and patient survival, deaths with a functioning graft or return to dialysis were observed. Receptors of DD had more hospital admissions during the first years after receiving the graft, usually due to infections. Also a delayed graft function was more common among them. Glomerular filtration rate ten years after the graft was similar among the three groups. Conclusions: No differences in graft or patient survival was observed between patients receiving a renal allograft from NRLD, RLD or DD.

Mechanical Antiallodynic Effect of Intrathecal Nefopam in a Rat Neuropathic Pain Model

Nefopam has a pharmacologic profile distinct from that of opioids or other anti-inflammatory drugs. Several recent studies demonstrate that nefopam has a mechanism of action similar to those of anti-depressants and anticonvulsants for treating neuropathic pain. The present study investigates the mechanical antiallodynic effect of nefopam using immunohistochemical study and western blot analysis in a rat neuropathic pain model. Twenty-eight male Sprague-Dawley rats were subjected to left fifth lumbar (L5) spinal nerve ligation and intrathecal catheter implantation, procedures which were not performed on the 7 male Sprague-Dawley rats in the sham surgery group (group S). Nefopam, either 10 or 100 microg/kg (group N10 or N100, respectively), and normal saline (group C) were intrathecally administered into the catheter every day for 14 days. The mechanical allodynic threshold of intrathecal nefopam was measured using a dynamic plantar aesthesiometer. Immunohistochemistry targeting cluster of differentiation molecule 11b (CD11b) and glial fibrillary acidic protein (GFAP) was performed on the harvested spinal cord at the level of L5. Extracellular signal-regulated kinase 1/2 (ERK 1/2) and cyclic adenosine monophosphate response element binding protein (CREB) were measured using western blot analysis. The N10 and N100 groups showed improved mechanical allodynic threshold, reduced CD11b and GFAP expression, and attenuated ERK 1/2 and CREB in the affected L5 spinal cord. In conclusion, intrathecal nefopam reduced mechanical allodynia in a rat neuropathic pain model. Its mechanical antiallodynic effect is associated with inhibition of glial activation and suppression of the transcription factors' mitogen-activated protein kinases in the spinal cord.

Calendario de inicio sexual en México: Comparación entre encuestas nacionales y tendencias en el tiempo / Sexual debut in Mexico: a comparison of household national surveys

Objetivo. Estimar el calendario de inicio sexual en México y sus tendencias a partir de encuestas poblacionales. Material y métodos. Se analizaron cinco cohortes de nacimiento con cuatro encuestas nacionales (Encuesta Nacional de Salud 2000, Encuesta Nacional de la Dinámica Demográfica 2009, Encuesta Nacional de Juventud 2010 y Encuesta Nacional de Salud y Nutrición 2012) y se identificaron las proporciones de individuos que iniciaron actividad sexual antes de los 16 y antes de los 20 años. Resultados. Las distintas encuestas son, en general, consistentes, pero difieren entre ellas en algunas cohortes. En las cohortes más jóvenes, se identificó una proporción algo mayor de individuos que iniciaron antes de los 20 años; no se advierten cambios en el inicio sexual antes de los 16 años. Conclusiones. La falta de grandes cambios en la edad de inicio de vida sexual con tendencia al adelanto del calendario en México llama a fortalecer la educación sexual integral y la oferta de servicios de salud sexual y reproductiva accesibles a los adolescentes.

Objective. To estimate calendar of sexual debut in Mexico and its trends using national representative household surveys. Materials and methods. Analysis of five birth cohorts extracted from four national population based household surveys in Mexico (National Health Survey 2000, National Survey on Demographic Dynamics 2009, National Youth Survey 2010, and National Health & Nutrition Survey 2012), using as outcome the proportion of individuals that reported sexual debut before the age of 16 and before the age of 20. Results. Overall, the four analyzed surveys produce consistent results, although some differences were found. While a larger proportion among younger cohorts reported sexual debut before the age of 20, that was not the case for sexual debut before 16 years. Conclusions. While data seems to reflect a relative stable age of sexual debut in Mexico, there is a recent trend to prepone sexual initiation that highlights the need to strengthen comprehensive sexual education and the supply of sexual & reproductive health services that are accessible and friendly to adolescents thus responding to the growing demand from this age group.

Cleansing the world of the germ of laziness: hygiene, sanitation, and the Javanese population in Suriname / Limpando o mundo do germe da preguiça: higiene, saneamento e população javanesa no Suriname

In 1915 the Rockefeller Foundation took its hookworm eradication campaign to Suriname, but was soon disappointed because of opposition from its main target group: the Javanese. Moreover, authorities and planters objected to the construction of latrines because of the costs and their belief that the Javanese were “unhygienic”. In describing the labor migration from Java to Suriname, I show that this “lack of hygiene” was closely related to the system’s organization. I argue that uncleanliness was the consequence of harmful socio-economic and ecological conditions. Secondly I suggest that even though the Foundation did not manage to cleanse Suriname of hookworm, its educational efforts, its emphasis on prevention, and its training of local health workers probably had more impact than Rockefeller officials thought.

Em 1915, a Fundação Rockefeller levou sua campanha de erradicação da ancilostomíase ao Suriname, logo sofrendo a oposição de seu principal alvo, os javaneses. Autoridades e proprietários rurais também reagiram à instalação de latrinas devido aos custos implicados e à crença de que os javaneses eram “anti-higiênicos”. Ao descrever a migração de trabalhadores de Java para o Suriname, mostro que a “falta de higiene” ligava-se à organização do sistema. Argumento que a sujeira era consequência de condições ecológicas e socioeconômicas danosas. Sugiro ainda que, embora a Fundação não tenha livrado o Suriname da anciolostomíase, seus esforços educacionais, sua ênfase na prevenção e o treinamento de profissionais de saúde locais tiveram maior impacto do que o imaginado pelos funcionários da agência norte-americana.

Percutaneous sciatic nerve block with tramadol induces analgesia and motor blockade in two animal pain models

Local anesthetic efficacy of tramadol has been reported following intradermal application. Our aim was to investigate the effect of perineural tramadol as the sole analgesic in two pain models. Male Wistar rats (280-380 g; N = 5/group) were used in these experiments. A neurostimulation-guided sciatic nerve block was performed and 2 percent lidocaine or tramadol (1.25 and 5 mg) was perineurally injected in two different animal pain models. In the flinching behavior test, the number of flinches was evaluated and in the plantar incision model, mechanical and heat thresholds were measured. Motor effects of lidocaine and tramadol were quantified and a motor block score elaborated. Tramadol, 1.25 mg, completely blocked the first and reduced the second phase of the flinching behavior test. In the plantar incision model, tramadol (1.25 mg) increased both paw withdrawal latency in response to radiant heat (8.3 ± 1.1, 12.7 ± 1.8, 8.4 ± 0.8, and 11.1 ± 3.3 s) and mechanical threshold in response to von Frey filaments (459 ± 82.8, 447.5 ± 91.7, 320.1 ± 120, 126.43 ± 92.8 mN) at 5, 15, 30, and 60 min, respectively. Sham block or contralateral sciatic nerve block did not differ from perineural saline injection throughout the study in either model. The effect of tramadol was not antagonized by intraperitoneal naloxone. High dose tramadol (5 mg) blocked motor function as well as 2 percent lidocaine. In conclusion, tramadol blocks nociception and motor function in vivo similar to local anesthetics.

Sertraline inhibits formalin-induced nociception and cardiovascular responses

The objective of the present study was to determine the antihyperalgesic effect of sertraline, measured indirectly by the changes of sciatic afferent nerve activity, and its effects on cardiorespiratory parameters, using the model of formalin-induced inflammatory nociception in anesthetized rats. Serum serotonin (5-HT) levels were measured in order to test their correlation with the analgesic effect. Male Wistar rats (250-300 g) were divided into 4 groups (N = 8/per group): sertraline-treated group (Sert + Saline (Sal) and Sert + Formalin (Form); 3 mg·kg-1·day-1, ip, for 7 days) and saline-treated group (Sal + Sal and Sal + Form). The rats were injected with 5 percent (50 µL) formalin or saline into the right hind paw. Sciatic nerve activity was recorded using a silver electrode connected to a NeuroLog apparatus, and cardiopulmonary parameters (mean arterial pressure, heart rate and respiratory frequency), assessed after arterial cannulation and tracheotomy, were monitored using a Data Acquisition System. Blood samples were collected from the animals and serum 5-HT levels were determined by ELISA. Formalin injection induced the following changes: sciatic afferent nerve activity (+50.8 ± 14.7 percent), mean arterial pressure (+1.4 ± 3 mmHg), heart rate (+13 ± 6.8 bpm), respiratory frequency (+4.6 ± 5 cpm) and serum 5-HT increased to 1162 ± 124.6 ng/mL. Treatment with sertraline significantly reduced all these parameters (respectively: +19.8 ± 6.9 percent, -3.3 ± 2 mmHg, -13.1 ± 10.8 bpm, -9.8 ± 5.7 cpm) and serum 5-HT level dropped to 634 ± 69 ng/mL (P < 0.05). These results suggest that sertraline plays an analgesic role in formalin-induced nociception probably through a serotonergic mechanism.

In vivo and in vitro anti-inflammatory and anti-nociceptive activities of lovastatin in rodents

Statins are among the most prescribed drugs in recent clinical practice. They are also known for their pleiotropic actions, which are independent of their lipid-lowering properties. The effect of lovastatin was investigated against carrageenan-induced paw edema in male Wistar rats (200-250 g) and on leukocyte migration, as measured by carrageenan-induced peritonitis in male Swiss mice (20-25 g), which are models of acute inflammation. Lovastatin (administered 1 h prior to carrageenan), at oral doses of 2, 5, and 10 mg/kg, markedly attenuated paw edema formation in rats at the 4th hour after carrageenan injection (25, 43, and 37 percent inhibition, respectively). Inhibitions of 20, 45 and 80 percent were observed in the leukocyte migration, as evaluated by carrageenan-induced peritonitis in mice with lovastatin doses of 0.5, 1 and 5 mg/kg, as compared to controls. Furthermore, lovastatin (administered 1 h before initiation) reduced the nociceptive effect of the formalin test in mice, at both phases, at doses of 2, 5, and 10 mg/kg: first phase (51, 65, and 70 percent, respectively) and second phase (73, 57, and 66 percent inhibition of licking time, respectively). The anti-nociceptive activity of lovastatin was inhibited by naloxone (3 mg/kg, sc). Lovastatin (0.01, 0.1, and 1 µg/mL) inhibited by 23, 79, and 86 percent, respectively, the release of myeloperoxidase from human neutrophils. Leukocyte (predominantly neutrophils) infiltration was almost completely reduced by lovastatin treatment, as observed in the model of acute paw edema with hematoxylin and eosin staining. In addition, lovastatin decreased the number of cells expressing tumor necrosis factor-α (TNF-α) and the inducible form of nitric oxide synthase (iNOS) activity. Therefore, the alterations in leukocyte activity and cytokine release could contribute to the anti-inflammatory activity of lovastatin.

Effect of glibenclamide on antinociceptive effects of antidepressants of different classes

OBJECTIVES: The purpose of this work was to determine whether the intraperitoneal administration of glibenclamide as a K ATP channel blocker could have an effect on the antinociceptive effects of antidepressants with different mechanisms of action. METHODS: Three antidepressant drugs, amitriptyline as a dual-action, nonselective inhibitor of noradrenaline and a serotonin reuptake inhibitor, fluvoxamine as a selective serotonin reuptake inhibitor and maprotiline as a selective noradrenaline reuptake inhibitor, were selected, and the effect of glibenclamide on their antinociceptive activities was assessed in male Swiss mice (25-30 g) using a formalin test. DISCUSSION: None of the drugs affected acute nociceptive responses during the first phase. Amitriptyline (5, 10 mg/ kg), maprotiline (10, 20 mg/kg) and fluvoxamine (20 and 30 mg/kg) effectively inhibited pain induction caused by the second phase of the formalin test. Glibenclamide (5 mg/kg) alone did not alter licking behaviors based on a comparison with the control group. However, the pretreatment of animals with glibenclamide (10 and 15 mg/kg) partially reversed the antinociceptive effects of fluvoxamine but not those of maprotiline. In addition, the highest dose of glibenclamide (15 mg/kg) partially prevented the analgesic effect of amitriptyline. CONCLUSION: Therefore, it seems that adenosine triphosphate-dependent potassium channels have a major role in the analgesic activity of amitriptyline and fluvoxamine.

[Study on the different dosages of Elaeagnus angustifolia aqueous extract with and without morphine on the antinociceptive rate in mice]

Elaeagnus angustifolia extract has been used for its antinociceptive effects. The present study was done to compare of different dosage of this plant extract with and without Morphine on the extent of the antinociceptive effect. This study was done on the 80 male NMRI mice with a mean weight of 28 +/- 3G. These animals were divided to 10 groups [8 mice in each group] including: control, positive control, group treated with morphine [2 mg/kg], group treated with E. angustifolia aqueous extract [62.5, 125 and 250 mg/kg] and group treated with the plant aqueous extract plus morphine. Study was done on the 80 mice in two stages: with and without morphine and with three dosages of E.angustifolia aqueous extract. The extract was injected through the intraperitoneal route, [i.p] 30 minutes before the writhing test. Normal saline was injected in the control group and indomethacin, [5 mg/kg] to the positive control group. Then, the increase in abdominal pulse was calculated for 30 minutes as a sign of visceral pain and the pulse rates were compared in the different groups. Pulse rate in the control group was 88.4 +/- 2.4. These rates were 39.6 +/- 2.4 when 62.5 mg/kg E. angustifolia was used without morphine and 9.3 +/- 1.4 with same dosage of extract with morphine [p<0.0001]. Moreover, our findings showed that antinociceptive effect increased with higher dosages of plant extract [p<0.001]. Elaeagnus angustifolia and morphine show evidence of synergistic effect for antinociception in mice

Pharmacological profile of salvadora persica

This work was conducted to investigate the various pharmacological activities of Salvadora. persica family Salvadoracea and that includes anti inflammatory, analgesic, CNS, bleeding and clotting time activity by oral administration at the dose of 300 and 500mg/kg of body weight in animal models. Acute oral toxicity results showed that crude extract of S. persica is safe up to the dose of 5g/kg body weight of animals. Carraganeen induced hind paw edema method for anti inflammatory activity, tail immersion test method for analgesic activity, Rota rod and grip strength test for CNS activity were carried out in animal models. The analgesic activity was compared with aspirin, 300mg/kg body weight, anti inflammatory activity was compared with indomethacine, lOmg/kg body weight, Transamin 250mg/kg and Vitamin K lOmg were used for bleeding and clotting time activity respectively while diazepam 5mg/kg were used as standard for behavior and CNS activities. In all activities S. persica showed prolonged and dose dependent effects. Phytochemical analysis was also carried out which showed the presence of certain phytoconstituents which possesses these properties. Therefore the results justified the traditional use of the plant

Flavonoids of enhydra fluctuans exhibits analgesic and anti-inflammatory activity in different animal models

Enhydra fluctuans [Compositae], an edible semi aquatic herbaceous vegetable plant, widely used in traditional system of Indian medicine. Total flavonoids of E. fluctuans [TFEF] were screened for analgesic and anti-inflammatory activity. Analgesic activity was studied in acetic acid induced writhing response and by hot plate method in Swiss albino mice. Anti-inflammatory activity was estimated by carrageenan and histamine induced acute inflammation and Freund's complete adjuvant [FCA] induced chronic inflammation in rats. Two flavonoids, baicalein 7-O-glucoside and baicalein 7-O-diglucoside, were isolated from the ethyl acetate fraction. Oral administration of TFEF at the doses of 200 and 400 mg/kg provide 27.05 and 55.49% protection respectively in acetic acid induced writhing method. It also increased the pain threshold in mice evidenced by hot plate method. TFEF showed more potent anti-inflammatory activity. The results of this study may be attributed to high free radical scavenging and antioxidant potential of the flavonoids present in ethyl acetate fraction of Enhydra fluctuans

Anti-inflammatory and analgesic activities of ethanolic extract of sphaeranthusindicus linn

The aim of the present study was to evaluate the intensity of the anti-inflammatory and analgesic activities of Sphaeranthus indicus on albino mice and rat of either sex. The flowers of S. indicus are an important herb used in folk eastern medicines. In this study, the ethanolic extract of S. indicus in doses of 300 and 500 mg/kg was used. Anti-inflammatory activity was evaluated by measuring the mean decrease in hind paw volume after the sub planter injection of carrageenan. The analgesic activity was tested against acetic acid induced writhing response using albino rats. Result of the study shows that at the end of one hour the inhibition of paw edema was 42.66 and 50.5% respectively and the percentage of protection from writhing was 62.79 and 68.21 respectively. S. indicus possesses several important pharmaceutical and pharmacological properties. The current study describes that flower of S. indicus has significant anti-inflammatory and analgesic properties. Conclusion of the study is that this herbal medicine can be used as an alternative therapy for the treatment of minor to moderate types of inflammation and as a painkiller

randomized controlled trial to compare pregabalin with gabapentin for postoperative pain in abdominal hysterectomy

Pregabalin is a potent ligand for alpha-2-delta subunit of voltage-gated calcium channels in the central nervous system, which exhibits potent anticonvulsant, analgesic and anxiolytic activity. The pharmacological activity of pregabalin is similar to that of gabapentin and shows possible advantages. Although it shows analgesic efficacy against neuropathic pain, very limited evidence supports its postoperative analgesic efficacy. We investigated its analgesic efficacy in patients experiencing acute pain after abdominal hysterectomy and compared it with gabapentin and placebo. A randomized, double-blind, placebo-controlled study was conducted in 90 women undergoing abdominal hysterectomy who were anaesthetized in a standardized fashion. Patients received 300 mg pregabalin, 900 mg gabapentin or placebo, 1-2 hours prior to surgery. Postoperative analgesia was administered at visual analogue scale [VAS] >/= 3. The primary outcome was analgesic consumption over 24 hours and patients were followed for pain scores, time to rescue analgesia and side effects as secondary outcomes. The diclofenac consumption was statistically significant between pregabalin and control groups, and gabapentin and control groups; however, pregabalin and gabapentin groups were comparable. Moreover, the consumption of tramadol was statistically significant among all the groups. Patients in pregabalin and gabapentin groups had lower pain scores in the initial hour of recovery. However, pain scores were subsequently similar in all the groups. Time to first request for analgesia was longer in pregabalin group followed by gabapentin and control groups. A single dose of 300 mg pregabalin given 1-2 hours prior to surgery is superior to 900 mg gabapentin and placebo after abdominal hysterectomy. Both the drugs are better than placebo

Anti-inflammatory effect of the ethanolic extract from Bowdichia virgilioides H.B.K stem bark

Bowdichia virgilioides H.B.K stem bark (Fabaceae), locally known as "sucupira-preta", is a reputed folk-remedy to treat some inflammatory disorders. To validate its traditional claim, the ethanolic extract from B. virgilioides was evaluated in several animal models of inflammation and nociception. The extract at oral doses of 100 to 1000 mg/kg body weight caused a significant inhibition of carrageenan-induced hind paw oedema, suppression of exudate volume and leukocyte immigration in rat pleurisy induced by carrageenan, and reduction of granuloma weights in the model of subcutaneous granulomas promoted by cotton pellets. In addition, the plant extract significantly inhibited the vascular permeability increase induced by intraperitoneal acetic acid. It also showed marked antinociceptive effect in acetic acid-induced writhing test and in the second phase of formalin test in mice. These findings evidence the anti-inflammatory potential of Bowdichia virgilioides bark and supports its traditional use in inflammatory conditions.

A casca do caule de Bowdichia virgilioides H.B.K (Fabaceae), conhecida localmente como sucupira-preta, é um remédio popular muito utilizado para tratar inflamações. Com o objetivo de validar sua crença popular, o extrato etanólico de B. virgilioides foi avaliado em vários modelos experimentais de inflamação e nocicepção. O extrato administrado, via oral, em doses de 100 a 1000 mg/kg de peso corporal produziu inibição significativa no edema de pata induzido por carragenina, no aumento na permeabilidade vascular induzido por acido acético, no volume de exudato e na migração leucocitária no teste de pleurisia induzida por carragenina, bem como no peso de granulomas induzidos por pelotas de algodão, em ratos. Em camundongos, o EE Bv reduziu o número de contorções abdominais induzidas por ácido acético e a lambedura da pata na segunda fase do teste da formalina. Esses resultados validam o potencial anti-inflamatório da casca de Bowdichia virgilioides e referendam seu uso tradicional em condições inflamatórias.