Determination of dezocine and pethidine in human hair by UPLC-MS/MS / 中国药科大学学报

@#A rapid analytical method for the determination of dezocine and pethidine in hair samples using ultra performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) was established.After cleaned hair was extracted by grinding with methanol and ultrasonic, the final solution was analyzed by UPLC-MS/MS.The targets were gradient eluted on a Waters Acquity BEH C18 (2.1 mm × 100 mm, 1.7 μm) column with 0.1% formic acid-water and methanol as mobile phase at a flow rate of 0.4 mL/min.The ESI+ ion source and multiple reaction monitoring (MRM) were used to select the qualitative and quantitative ion pairs of dezocine and pethidine.Dezocine and pethidine showed good linearity in the range of 0.01-8 ng/mg, with the limit of detection of 0.005 ng/mg and the LOQs of 0.01 ng/mg.The accuracy, precision, matrix effect, extraction recovery, and stability all met the requirements.The established method is simple, rapid, and accurate for the qualitative and quantitative determination of dezocine and pethidine in hair, which can be applied in the case analysis of dezocine and/or pethidine abuse.

Comparison of analgesic efficacy of intramuscular tramadol and pethidine in labour

Background: Labour pain is among the most severe pain experienced by women. It is unpleasant and distressing to the parturient. The objective of the study was to evaluate and compare the analgesic efficacy and adverse effects of intramuscular tramadol and pethidine in labour. Methods: The prospective study conducted in SDM College of Medical Sciences and Hospital, Department of OBG, from December 2013 to November 2014. The study was a study of the parturients admitted in the labour theatre. Written and informed consent was taken from all the patients enrolled in the study. One hundred parturient at term in active labour were randomly assigned to one of the two groups to receive intramuscularly either tramadol 100 mg or pethidine 75 mg. Results: Results were comparable in terms of maternal age, maternal weight and neonatal weight. Proportion of cases with satisfactory to good pain relief was 74% in the tramadol group and 78% in the pethidine group. Nausea and/or vomiting (12% versus 8%), fatigue (6% versus 4%) and drowsiness (8% versus 4%) were significantly high in the pethidine group than the tramadol group(p<0.05). The drugs used did not appear to influence the mode of delivery. Proportion of cases with non-reassuring foetal heart rate was high in the pethidine group. Meconium stained liquor was equally seen in both the groups and there were no incidence of neonatal respiratory depression in any of the groups.Conclusion: Tramadol is an equally effective labour analgesic as pethidine with less maternal and perinatal side effects.

Analysis on the use of narcotic drugs for inpatients / 药学实践杂志

Objective To investigate and analyze the inpatient use of narcotic drugs, provide reference for clinical norms and rational use of narcotic drugs. Methods The narcotic prescription number, usage and cost were analyzed statistically. The inpatient narcotic use was analyzed by screening the dose form, indication, and dosage. Results The injections topped the list of narcotic prescriptions from year 2016 to 2019 with 15 820 (61.4%), 15 813 (61.5%), 16 682 (64.7%) and 17 293 (71.5%) prescriptions respectively. The oral and topical narcotic drugs were less prescribed. Although pethidine hydrochloride injection prescriptions decreased year by year, it still topped in the narcotic use with 8 009 (31.1%), 7 707 (30.0%), 7 151 (27.7%) and 6 844 (28.3%) prescriptions each year. Pethidine hydrochloride injection was mostly used for patients with cancer and chronic pancreatitis. Conclusion Doctors preferred to use injectable narcotics for patients with moderate to severe pain. Improper use of narcotic drugs was noticed, such as unsuitable choice of dose form, inappropriate use of pethidine hydrochloride injection, etc. Pharmacists should keep vigilant in prescription review and medication intervention for narcotic drugs to improve the standardization and rational use of narcotics.

Study to Determine the Definite Percentage of the Different Analgesic Drugs and Analgesic Techniques Used At the Postoperative Ward for Pain Management in Sir Salimullah Medical College Hospital, Mitford, Dhaka

Background: The rationale of determining the percentage ofanalgesics used in postoperative period is to determine the realutilization of opioid sparing effect of nonsteroidal antiinflammatory drugs and the concept of multimodal analgesia.Objectives: To determine the cost of opioids consumptionbecause the opioids are expensive.Methods: Total 541 patients were selected to find out thetypes of analgesics are being used in the postoperative eperiod irrespective of the types of operation and anaesthesia,premedication by analgesics and intraoperative analgesicsused or not. Patients were divided into several age groups.Results: In the existing prospective cross sectional study it isviewed that combination of intramuscular injection of pethidineand nonsteroidal anti-inflammatory drugs (either in suppositoryform or intravenous or intramuscular route) have the highestpercentage in postoperative pain relief.

A Prospective And Randomized Double Blind Study To Compare The Effectiveness Of Prophylactic Granisetron Versus Pethidine For The Prevention Of Postoperative Shivering In Patients Undergoing Elective Thyroid Surgeries

MATERIALS AND METHODS 90 Patients randomly allocated into three groups- qroup P, qroup G, qroup S in each group 30patientswere Selected Group P Patients were given Inj Pethidine 25 mg intravenously 5 minutes before induction of general anaesthesia. Group G Patients were given Inj Granisetron 40 microgram /Kgintravenously 5 minutes before induction of general anaesthesia. Group S Patients were given Saline intravenously 5 minutes before induction of general anaesthesia. RESULTS Postoperative shivering graded after extubation at 15 and 30 minutes interval no shivering in Pethidine group 83.3% {n= 25} Granisetron, qroup 73% {n=22} Placebo qroup 27% {n=8} P value not significant between P & G group but significant in Placebo qroup {P <0.05}. shivering occurs at grade 3in pethidine group 7% [n=2] Granisetron group 10%[n=3], Placebo group 60%[n=18] P value statistically not significant between P & G groups but significant in Placebo qroup {P <0.05}. CONCLUSION From this study prophylactic use of both Pethidine and Granisetron were equally effective for the prevention of postoperative shivering

Pethidine in low doses versus dipyrone for pain relief in labor: a randomized controlled trial / Petidina em doses baixas versus dipirona para alívio da dor no trabalho de parto: um ensaio clínico randomizado

Abstract Objective To compare low doses of pethidine with dipyrone in labor analgesia. Methods In a randomized prospective study conducted by Universidade de Fortaleza, in the state of Ceará, Brazil, between May and December 2016, 200 full-term parturients, with very painful uterine contractions and exhibiting uterine cervix dilatation ≥ 5 cm, were selected to receive a single intravenous dose of either 0.25 mg/kg of pethidine (n = 100) or of 25 mg/kg of dipyrone (n = 100). Pain was assessed using the visual analogue scale. The data were analyzed using the Student t-test, the chi-square test and the likelihood ratio. Results There was a significant improvement in pain in 35% of the parturients. Both drugs presented a similar analgesic effect 1 hour after the intervention (p = 0.692). There was no analgesic effect during the evaluation of the second hour after the intervention with pethidine or dipyrone. There were no adverse effects, such as maternal drowsiness, nausea or vomiting, related to the drugs used. Conclusion Pethidine in low doses and dipyrone presented equivalent analgesia during labor. Public Registry of Clinical TrialsRBR-4hsyy4.

Resumo Objetivo Comparar doses baixas de petidina com dipirona na analgesia de parto. Métodos Em um estudo prospectivo randomizado realizado pela Universidade de Fortaleza, Ceará, Brasil, entre maio e dezembro de 2016, 200 parturientes a termo, com contrações uterinas muito dolorosas e apresentando dilatação do colo uterino ≥ 5 cm, foram selecionadas para receber dose única intravenosa de 0,25 mg/kg de petidina (n = 100) ou 25 mg/kg de dipirona (n = 100). A dor foi avaliada pela escala visual analógica. Os dados foram analisados por meio dos testes t de Student, qui-quadrado e razão de verossimilhança. Resultados Houve melhora significativa da dor em 35% das parturientes. Ambas as drogas apresentaram efeito analgésico semelhante 1 hora após a intervenção (p = 0.692). Inexistiu efeito analgésico durante a avaliação da segunda hora após a intervenção com a petidina ou com a dipirona. Não houve efeitos adversos, como sonolência, náuseas ou vômitos maternos, relacionados aos medicamentos utilizados. Conclusão A petidina em doses baixas e a dipirona apresentaram analgesia equivalente durante o trabalho de parto. Registro público de testes clínicosRBR-4hsyy4.

Is pethidine safe during labor? Systematic review / A petidina é segura durante o trabalho de parto? Revisão sistemática

Abstract Purpose To verify if pethidine is safe for the conceptus when used during labor. Methods Systematic review in the Capes Periodicals/PubMed and MEDLINE/Virtual Health Library (BVS, in the Portuguese acronym) databases. Results A total of 17 studies published from January 1st, 2000, to September 2nd, 2016, with a total of 1,688 participants involved were included in the present review. There was no record of conceptus vitality decrease associated with low doses of pethidine being administered to mothers during labor. Conclusions Intramuscular (IM) or intravenous (IV) pethidine at low doses, of up to 50 mg, is safe to administer during labor.

Resumo Objetivo Verificar se a petidina é segura para o concepto quando utilizada durante o trabalho de parto. Método Revisão sistemática nas bases de dados dos Periódicos Capes/PubMed e MEDLINE/Biblioteca Virtual em Saúde (BVS). Resultados Um total de 17 estudos, publicados de 1° de janeiro de 2000 a 2 de setembro de 2016, totalizando 1.688 participantes envolvidos, foram incluídos nesta revisão. Não houve registro de depressão na vitalidade dos conceptos comdoses baixas de petidina administradas às mães durante o trabalho de parto. Conclusão Petidina intramuscular (IM) ou intravenosa (IV) em baixas doses, de até 50 mg, é segura durante o trabalho de parto.

Study on Anesthesia Method Improvement for Branchofiberoscope / 中国药房

OBJECTIVE:To compare anesthesia effects of 3 anesthesia methods,to investigate anesthesia improvement method for bronch fiber oscope. METHODS:315 patients undergoing bronch fiber oscope were randomly divided into group A(106 cas-es),group B(104 cases)and group C(105 cases). Group A was treated with traditional bronch fiber oscope lidocaine atomization local anesthesia,group B was treated with modified bronch fiber oscope pethidine combined with lidocaine atomization local anes-thesia and group C was treated with three-limb tube connected with laryngeal mask and target-controlled propofol and remifentanil general anesthesia. SaO2,SBP,DBP,heart rate,breathing rate,excellent anesthesia rate,compliance rate,the rate of bodymove-ment and choking,pain recalling rate were compared among 3 groups before and during examination,and ADR was observed. RE-SULTS:Compared with before examination,SaO2 of group A was decreased significantly during examination,with statistical sig-nificance(P<0.05);that of group B and C had no obvious change before and during examination. Blood pressure,heart rate and breathing rate of 3 groups had no obvious change before and during examination. The excellent anesthesia rate and compliance rate of group A were significantly lower than those of group B and C,but the rate of bodymovement cough and pain recalling rate were significantly higher than group B and C,with statistical significantly(P<0.05). The excellent anesthesia rate and compliance rate of group B were significantly lower than those of group C,but the rate of bodymovement cough and pain recalling rate were signifi-cantly higher than group C,with statistical significance (P<0.05). No ADR was found in 3 groups. CONCLUSIONS:Modified bronchoscope atomization local anesthesia and modified painless bronchoscope are better than traditional bronch fiber oscope atomi-zation local anesthesia in anesthesia effect,safety,degree of comfort and acceptability. Modified bronchoscope atomization local an-esthesia was best but most expensive,so these methods can be chosen according to patient’s condition.

Effect of paracetamol, dexketoprofen trometamol, lidocaine spray, pethidine & diclofenac sodium application for pain relief during fractional curettage: A randomized controlled trial.

Background & objectives: Patients frequently experience pain of moderate to severe degree during gynaecologic procedures. This prospective, randomized, placebo-controlled trial was aimed to investigate the analgesic efficacy of preoperative oral dexketoprofen trometamol, intravenous paracetamol, lidocaine spray, pethidine and diclofenac sodium on fractional curettage procedure. Methods: A total of 144 mutiparous women were randomly allocated to one of the six groups. The first group (control group) consisted of 22 participants and they did not receive any treatment. The second group had 26 participants receiving oral 25 mg dexketoprofen trometamol. The 23 participants of the third group received two puff lidocaine sprays on cervical mucosa. The forth group consisted of 25 participants receiving 100 mg pethidine. In the fifth group, the 23 participants received 1000 mg intravenous paracetamol and the sixth group consisted of 25 participants receiving diclofenac sodium. Results: Pethidine was the best choice for reducing pain score during curettage procedure (t2:intra-operative). All analgesic procedures were significantly effective in reducing pain during postoperative period (t3). Significant pain reduction was achieved for both intra- and postoperative period by using analgesics. Interpretation & conclusions: The results of our study showed that lidocaine puffs provided the best pain relief than the other analgesics used. Therefore, lidocaine may be considered as the first choice analgesic in fractional curettage (NCT ID: 01993589).

The anesthesia effect in patients undergoing artificial abortion treated with droperidol and pethidine hydro-chloride in combination with paracervical block / 中国基层医药

Objective To analyze the anesthesia effect of droperidol and pethidine hydrochloride in combina-tion with paracervical block in artificial abortion.Methods 386 patients undergoing artificial abortion were admitted. They were randomly divided into the two groups.The study group(193 cases)was treated with droperidol and pethi-dine hydrochloride in combination with paracervical block,while the control group (193 cases)was treated with droperidol and pethidine hydrochloride only.The analgesic effect,hemodynamics,cervix relaxation and side effects between the two groups were compared.Results The analgesic effect of the study group was 9 1 .7%,which was much higher than 72.0% of the control group(χ2 =25.198,P<0.01),and there were significant differences between the two groups in hemodynamics(t=4.545,3.674,all P<0.01).The total cervix relaxation were 102 cases,and partly cervix relaxation were 69 cases in the study group,which were significantly higher than that of the control group (69 cases,60 cases,respectively;Z=4.643,P<0.01).There was no difference between side effects except for abor-tion syndrome(χ2 =7.580,P=0.006).Conclusion Droperidol and pethidine hydrochloride in combination with paracervical block have an excellent effect on artificial abortion.

A randomized, double blind comparison of pethidine and ketoprofen as adjuvants for lignocaine in intravenous regional anaesthesia / Estudo comparativo, randômico e duplo-cego de petidina e cetoprofeno como adjuvantes de lidocaína em anestesia regional intravenosa / Estudio comparativo, aleatorizado y doble ciego, de la petidina y del ketoprofeno como adyuvantes de la lidocaína en la anestesia regional intravenosa

BACKGROUND AND OBJECTIVES: A review of all the adjuncts for intravenous regional anaesthesia concluded that there is good evidence to recommend NonSteroidal Anti-Inflammatory agents and pethidine in the dose of 30 mg dose as adjuncts to intravenous regional anaesthesia. But there are no studies to compare pethidine of 30 mg dose to any of the NonSteroidal Anti-Inflammatory agents. METHODS: In a prospective, randomized, double blind study, 45 patients were given intravenous regional anaesthesia with either lignocaine alone or lignocaine with pethidine 30 mg or lignocaine with ketprofen 100 mg. Fentanyl was used as rescue analgesic during surgery. For the first 6 h of postoperative period analgesia was provided by fentanyl injection and between 6 and 24 h analgesia was provided by diclofenac tablets. Visual analogue scores for pain and consumption of fentanyl and diclofenac were compared. RESULTS: The block was inadequate for one case each in lignocaine group and pethidine group, so general anaesthesia was provided. Time for the first dose of fentanyl required for postoperative analgesia was significantly more in pethidine and ketoprofen groups compared to lignocaine group (156.7 ± 148.8 and 153.0 ± 106.0 vs. 52.1 ± 52.4 min respectively). Total fentanyl consumption in first 6 h of postoperative period was less in pethidine and ketoprofen groups compared to lignocaine group (37.5 ± 29.0 mcg, 38.3 ± 20.8 mcg vs. 64.2 ± 27.2 mcg respectively). Consumption of diclofenac tablets was 2.4 ± 0.7, 2.5 ± 0.5 and 2.0 ± 0.7 in the control, pethidine and ketoprofen group respectively, which was statistically not significant. Side effects were not significantly different between the groups. CONCLUSION: Both pethidine and ketoprofen are equally effective in providing postoperative analgesia up to 6 h, without significant difference in the side effects and none of the adjuncts provide significant ...

JUSTIFICATIVA E OBJETIVOS: uma revisão de todos os adjuvantes para anestesia regional intravenosa concluiu que há boas evidências para recomendar os agentes anti-inflamatórios não esteroides e petidina em dose de 30 mg como adjuvantes para anestesia regional intravenosa. Porém, não há estudos que comparem petidina (30 mg) com quaisquer dos agentes anti-inflamatórios não esteroides. MÉTODOS: em um estudo prospectivo, randômico e duplo-cego, 45 pacientes receberam anestesia regional intravenosa com apenas lidocaína ou lidocaína com petidina (30 mg) ou lidocaína com cetoprofeno (100 mg). Fentanil foi usado como analgésico de resgate durante a cirurgia. Durante as seis primeiras horas de pós-operatório, analgesia foi fornecida via injeção de fentanil e, entre seis e 24 horas, analgesia foi fornecida via comprimidos de diclofenaco. Os escores visuais analógicos para dor e do consumo de fentanil e diclofenaco foram comparados. RESULTADOS: o bloqueio foi inadequado para um caso tanto do grupo lidocaína quanto do grupo petidina; portanto, anestesia geral foi administrada. O tempo para a primeira dose necessária de fentanil para analgesia pós-operatória foi significativamente maior nos grupos petidina e cetoprofeno em comparação com o grupo lidocaína (156,7 ± 148,8 e 153,0 ± 106,0 vs. 52,1 ± 52,4 minutos, respectivamente). O consumo total de fentanil nas primeiras seis horas de pós-operatório foi menor nos grupos petidina e cetoprofeno em comparação com o grupo lidocaína (37,5 ± 29,0 mcg, 38,3 ± 20,8 mcg vs. 64,2 ± 27,2 mcg, respectivamente). O consumo de comprimidos de diclofenaco foi de 2,4 ± 0,7, 2,5 ± 0,5 e 2,0 ± 0,7 no grupo controle, petidina e cetoprofeno, respectivamente, o que não foi estatisticamente significante. ...

JUSTIFICACIÓN Y OBJETIVOS: una revisión sobre todos los adyuvantes para la anestesia regional intravenosa concluyó que hay buenas evidencias para recomendar los agentes antiinflamatorios no esteroideos y la petidina en dosis de 30 mg como adyuvantes para la anestesia regional intravenosa. Sin embargo, no hay estudios comparando la petidina (30 mg) con cualesquiera de los agentes antiinflamatorios no-esteroideos. MÉTODOS: en un estudio prospectivo, aleatorizado y doble ciego, 45 pacientes recibieron anestesia regional intravenosa con solamente lidocaína o lidocaína con petidina (30 mg) o lidocaína con ketoprofeno (100 mg). El fentanilo fue usado como analgésico de rescate durante la cirugía. Durante las 6 primeras horas del postoperatorio, la analgesia fue suministrada vía inyección de fentanilo y entre 6 y 24 h, la analgesia fue suministrada vía comprimidos de diclofenaco. Se compararon las puntuaciones visuales analógicas para el dolor y el consumo de fentanilo y diclofenaco. RESULTADOS: el bloqueo fue inadecuado para un caso tanto del grupo lidocaína como del grupo petidina; por tanto, se administró anestesia general. El tiempo para la primera dosis necesaria de fentanilo para analgesia postoperatoria fue significativamente mayor en los grupos petidina y ketoprofeno en comparación con el grupo lidocaína (156,7 ± 148,8 y 153,0 ± 106,0 vs. 52,1 ± 52,4 min, respectivamente). El consumo total de fentanilo en las primeras 6 h del postoperatorio fue menor en los grupos petidina y ketoprofeno en comparación con el grupo lidocaína (37,5 ± 29,0 mcg; 38,3 ± 20,8 mcg vs. 64,2 ± 27,2 mcg, respectivamente). El consumo de comprimidos de diclofenaco fue de 2,4 ± 0,7; 2,5 ± 0,5; y 2 ± 0,7 en el grupo control, petidina y ketoprofeno, respectivamente, lo que no fue estadísticamente significativo. Los ...

Effects of different drugs on patients undergoing endoscopic variceal ligation / 中华消化内镜杂志

Objective To study the sedative and analgesic effects of different drugs on patients under-going endoscopic variceal ligation( EVL). Methods Sixty patients undergoing selective EVL were randomly assigned to three groups:pethidine group( A),propofol-fentanyl group( B)and dexmedetomidine-fentanyl group(C). Data concerning blood pressure,heart rate,peripheral oxygen saturation,Ramsay score,endo-scopic operation and anesthesia time,surgeons' satisfaction and adverse reactions were recorded. Follow-up was done 24 hours later to confirm the patients' satisfaction and incidence of intraoperative awareness. Results The Ramsay scores of group B(5. 2 ± 0. 3)and C(3. 5 ± 0. 4)were significantly higher than group A (1. 6 ± 0. 4)(P<0. 05). There was no cough,body movement and high blood pressure during the EVL in group B or C,while the incidences of these symptoms in group A(40%,40% and 30%)were obviously higher (P<0. 05). The surgeons'satisfaction of group B(9. 2 ± 0. 3)and C(9. 6 ± 0. 4)were significantly higher than that of group A(5. 0 ± 0. 4)(P<0. 05). The patients' satisfaction scores of group B(9. 6 ± 0. 3)and C (9. 6 ± 0. 4)were also markedly higher than that of group A(5. 4 ± 0. 3)(P<0. 05). There was no difference of operation time among the three groups. The anesthesia time of group A(44 ± 6)was obviously longer than those of group B(35 ± 4)and C(36 ± 5)(P<0. 05). There was no difference in patients'or surgeons'satis-faction,or anesthesia time between group B and C. But the incidences of bradycardia( 40%),hypotension(30%)and hyoxemia(30%)in group B were obviously higher than those of group C(5%,0,0)(P<0. 05). There was no intraoperative awareness in group B or C. Conclusion Both dexmedetomidine and propofol com-bined with fentanyl are superior to pethidine for patients undergoing EVL,while dexmedetomidine provides bet-ter hemodynamics and respiratory conditions compared with propofol.

Trends and characteristics of pethidine use in Taiwan: a six-year-long survey

OBJECTIVES: To investigate the trends and characteristics of pethidine prescriptions and users in Taiwan from 2002 to 2007. METHOD: All pethidine users (n = 3,301,136) in Taiwan from 2002 to 2007 were linked to National Health Insurance claims to identify pethidine prescriptions. We examined the trends in pethidine user prevalence and the proportion of pethidine prescriptions according to health care characteristics. A logistic regression model was used to compare patient demographics and health care characteristics associated with pethidine prescriptions between 2002 and 2007. RESULTS: Despite the decline in the number of pethidine users and prescriptions over the six-year period, more than half a million people were prescribed pethidine annually. In fact, an increasing proportion of pethidine prescriptions were observed in clinics, outpatient settings, and patients who had both operations and cancer diagnoses. Pethidine prescriptions were mostly associated with a non-operation status without a cancer diagnosis (>60%). However, approximately 10% of the total pethidine prescriptions were found in patients with a cancer diagnosis but no operation. Compared to those in 2002, pethidine prescriptions in 2007 were more likely to be found in people 80 years or older, rural residents, patients from clinics, outpatient settings and operation patients with cancer diagnoses. CONCLUSIONS: A population-based survey in Taiwan demonstrated decreasing consumption of pethidine from 2002 to 2007; however, an increased proportion of prescriptions in certain health care settings was observed. In addition, 10% of the pethidine prescriptions were for cancer patients without operations. These cases need further evaluation for the determination of appropriate pethidine use.

Emergency Department-Based Treatment of Acute Ureteral Colic with Hydromorphone and Pethidine: Prospective, Randomized Control Trial

PURPOSE: To compare the efficacies and side effects of intravenous hydromorphone and pethidine in the emergency department (ED) treatment of ureteral colic. METHODS: A prospective, controlled, randomized clinical trial was conducted in a university-affiliated tertiary referral center. All adult patients who presented to the ED with severe ureteral colic were included. The patients received either 1 mg of hydromorphone (n=26) or 50 mg of pethidine (n=26) intravenously. Pain intensity was determined using a 10 cm visual analogue scale 0, 15, 30, and 120 minutes after injection. RESULTS: Dermographic characteristics and baseline pain scores of both groups were comparable (p>0.05). The pain intensity level for the hydromorphone group was lower than for the pethidine group at 15, 30, and 120 minutes. Pain relief was better with hydromorphone at 15 minutes (p<0.05). Side effects of the two groups were not statistically significant. CONCLUSION: The ureteral colic patients receiving hydromorphone achieved more pain relief. The side effects were similar for either treatment. Hydromorphone should be the preferred agent in suspected ureteral colic, when an opioid analgesic is to be used.

Study on effects of Fentanyl transdermal patches and pethidine in postoperative analgesia of malignant tumor and nursing measures / 中国实用护理杂志

Objective To study and compare the effects of Fentanyl transdermal pain patches and Pethidine in postoperative analgesia of malignant tumor and its nursing methods.Methods 100 patients with malignant tumor in our hospital from January 2008 to November 2010 were selected as research object,all the patients were randomly divided into group A (Fentanyl transdermal pain patches group) and group B (Pethidine group)with 50 cases in each group,then the VAS score 2,4,8,24 and 48h after the surgery,incidence of adverse reactions,satisfaction rate and serum catecholamine,cortisol,blood glucose before and after the surgery were analyzed and compared,and all the patients were given corresponding nursing measures.Results The VAS score of group A at 2,4,8,24 and 48h after the surgery were all better than those of group B,incidence of adverse reactions was lower than that of group B,satisfaction rate was higher than that of group B,serum catecholamine,cortisol,blood glucose after the surgery were all lower than those of group B,there were significant differences.Conclusions The effects of Fentanyl transdermal pain patches in postoperative analgesia of malignant tumor is stable,and it gets good reputation from the patients,the effects is obvious combined with nursing.

Clinical observation of the treatment of chill by butorphanol after epidural anesthesia / 中国医师杂志

Objective To observe the clilnical effect of treatment of chill by butorphanol after epidural anesthesthia. Methods One hundred patients under going epidural anesthesia , divided into two groups randomly, 50 in butorphanol group(B)were injected intravenously through upper limbs with 0. 04% butorphanol (diluted with normal saline)20 μg/kg; 50 in pethidine group(P) were injected intravenously through upper limbs with 1% pethidine ( diluted with normal saline )0. 75 mg/kg. The speed of the two injection was30 ml/min, after five minutes the patients who were still chilling were injected with midazolam 0. 05 mg/kg. Observe the effect and complications after one minute, three minutes and five minutes. Results After one minute and five minutes the effect of treating chill was no statistically difference ( P ＞ 0. 05 ).However, after three minutes the effect of the butorphanol group was obviously superior to the pethidine group ( P ＜0. 05) ,And the complications of butorphanol group was also less than pethidine group ( P ＜0. 01) . Conclusion Butorphanol display good effect on treating the chill after epidural anesthesia.

Treatment of effects of mixtures of pethidine and haloperidol about treatment for Postoperative Delirium / 中国基层医药

Objective To explore the dose and effects of mixtures of pethidine and haloperidol for Postoperative Deliri-um. Methods Retrospective analysis was conducted on treatment dose and effects of 85 cases of patients with deliri-um during narcotic awake period or 1 day to 2 days after operation by mixtures (haloperidol with pethidine) from 2005 to 2006 in Affiliated Hospital of Hainan Medical College. Results 1/4 dose of mixture (pethidine 100 mg and haloperidol 5 mg) cured 9 patients, 1/2 dose of mixture cured 61 cases, we add 1/4 dose of mixture when 10 cases occurred delirium again ,5 cases added 1/2 dose of mixture again, all were cured. After administration ,aublood pres-sure declined all, but all were within normal range, the 17 cases's pulse oxygen saturation is less than 95%, Conclu-sion The mixture (haloperidol with pethidine) can be effective treatment for delirium during awake period of general anesthesia or after operation. However, application of low dose therapy from the beginning, and attention to its impact on respiration.

Intravenous Patient-controlled Analgesia for Postoperative Pain Management in Patients with Cerebral Palsy / 대한정형외과학회잡지

PURPOSE: The purpose of this study was to evaluate the safety and efficacy of intravenous patient-controlled analgesia (PCA) with fentanyl and ketorolac for postoperative pain management in patients with cerebral palsy. MATERIALS AND METHODS: Sixty patients were categorized based on operation complexity into either a minor operation group or a major operation group, and then subdivided based on the analgesic methods used, i.e., intravenous PCA with fentanyl and ketorolac or intravenous pethidine injection. Pain intensity was assessed using the Wong-Baker's faces pain scale. RESULTS: In the major operation group, patients that received PCA had significantly lower pain scores than those who received intravenous pethidine injection, while no significant differences in pain scores were observed in the minor operation group. Moreover, the side effects of these two analgesic methods did not differ significantly. CONCLUSION: Intravenous PCA with fentanyl and ketorolac is effective and safe for moderate to severe postoperative pain control in pediatric patients with cerebral palsy.

Analgetic effect of combined use of misoprostol and mixture of pethidine and droperidol during hysteroscopic operations / 中国微创外科杂志

Objective To investigate the value of combined use of misoprostol and intravenous mixture of pethidine and droperidol during operative hysteroscopy. Methods A total of 168 cases scheduled for hysteroscopy were divided into 4 groups: Group Ⅰ (42 cases) was transvaginally given 0.4 mg misoprostol as monotherapy; Group Ⅱ (41 cases) was given 0.4 mg transvaginal misoprostol in combination with intravenous mixture of 50 mg pethidine and 2.5 mg droperidol; Group Ⅲ (43 cases) was given 0.4 mg transvaginal misoprostol combined with intravenous mixture of 100 mg pethidine and 5 mg droperidol; and Group Ⅳ (42 cases), intravenous mixture of 100 mg pethidine and 5 mg droperidol. The heart rate, breath rate, blood pressure, oxygen saturation, cervical responses, VAS scores and complications were assessed respectively. Results There were statistically significant differences regarding the degree of cervical dilatation, the operation time, and the used volume of cavity-distention media between the Group Ⅳ and the Group Ⅰ, Group Ⅱ, and Group Ⅲ, respectively (P0.05). Significant differences were observed in the analgetic effect in the 4 groups (?~2=86.325,P=0.000), among which the Group Ⅱ and Group Ⅲ were superior to the other two. All patients in the 4 groups represented a stable respiratory process and blood circulation, with no significant differences in the rate of adverse effects (?~2=1.649, P=0.648). Conclusions Transvaginal application of misoprostol offers a convincing effect for cervical dilatation. Combined use of misoprostol and mixture of 50 mg pethidine and 2.5 mg droperidol gives a satisfactory analgetic effect during operative hysteroscopy.

Effect of Opioid Agonists , Diazepam and Ketamine on the Estrous and Pregnant Rat Uteri , in Vitro / 대한마취과학회지

Opiates have been used as analgesics in obstetrics since the Babylonian Sinee that time, a wide variety of opiates have been employed in an attempt to provide analgesia for childbirh. The effect of opioids on uterine contractility is of considerable interest. Morphine caused a concentration dependent decrease in the frequency of contraction of the estrous uterus, In contrast, both pethidine and pentazocine enhanced the contraction rate. The pregnant uterus showed little response to morphine, but exhibited an enhanced response to the stimulant activity of both pethidine and pentazocine.It has long been recognized that the tension development of uterine muscle is largely dependent on intracellular Ca2+ pools. Smooth muscle contraction is initiated by depolarization induced calcium entry into the myoplasm through voltage dependent calcium channels, The spontaneous or KC1-induced tension development in isolated uterine smooth musele is reduced by lowering the calium ion (Ca2+) concentration of the bathing medium. In our study, the effect of morphine, pethidine and pentazocine on estrous and pregnant uterine activity, and the effect of extracellular calcium on opiate induced uterine motility have been examined in rats in vitro The following results were obtained: 1) The frequency of contraction of the estrous and pregnant rat uteri in the control group decreased gradually with time. 2) Morphine caused a concentration- dependent decrease in the frequency of contraction of the estrous and pregnant rat uteri, but it was not significant 3) Pethidine and pentazocine caused a concentration dependent incrase in the frequency of contraction of the estrous and pregnant rat uteri.but it was not significant.4) Diazepam caused a concentration-dependent decrease in the frequency of contraction of the estrous and pregnant rat uteri. 5) Ketamine casued a concentration- dependent decrease in the frequency of contraction of the estrous and pregnant rat uteri, but it was not significant. 6) Addition of CaCI, to the Krebs Henseleit solution did not make any significant change in the result. 7) According to the condition of the estrous and pregnant rat uteri the change of contraction frequency was statistically significant in the control, morphine, pethidine and pentazocine groups.