Effect of continuous intra-incisional bupivacaine on postoperative pain in non-traumatic spinal fixation surgeries: a randomized controlled trial

Abstract Background Continuous injection of local anesthetics by using surgical wound catheters for postoperative pain relief has gained acceptance in recent years. However, whether this method can be alternatively used instead of systemic opioids in different surgical procedures has not yet been elucidated. Objectives The aim was to investigate the effect of continuous injection of bupivacaine through a catheter inside the surgical wound on reducing the postoperative pain of lumbar spine fusion surgeries. Methods In this clinical trial, 31 patients undergoing non-traumatic lumbar spine stabilization surgery were randomly assigned to receive (n = 15) or do not receive (n = 16) bupivacaine through a catheter inside the surgical wound, postoperatively. Pain intensity (NRS), dose of required morphine, and drug-related complications within 24 hours of intervention were assessed and compared by the Mann-Whitney and independent t-test. Results Mean pain intensity was significantly lower in the case group over the first postoperative hour in the recovery room (p < 0.001), which continued for the first 2 hours after entering the ward. The mean morphine intake was lower in the bupivacaine group during the first postoperative 24 hours (16 ± 0.88 vs. 7.33 ± 0.93 mg, p < 0.001). The two groups were not significantly different regarding drug-related complications. Conclusion Continuous intra-incisional infusion of bupivacaine helped better pain reduction during the early postoperative hours while sparing morphine consumption in the first postoperative day.

3-in-1 Block with Bupivacaine VS Bupivacaine Plus Dexamethasone in Acute Pain Control for Patients Undergoing Hip Nailing Surgery: A Double Blind Randomized Controlled Trial

Background: Femoral 3-in-1 block is one of the most effective methods in cases of hip nailing surgery because of its ease, low cost, and fewer complications. This study aims to evaluate the effect of adding dexamethasone to peripheral nerve block solution.Methods: Forty-four ASA (I,II & III) patients aged between 50-80 years, scheduled for elective hip-nailing surgery who met inclusion and exclusion criteria were enrolled in this double blind randomized controlled trial. Patients were allocated into two groups randomly; at the end of the surgery, femoral 3-in-1 nerve block was performed with 40 ml of bupivacaine 0.25% solution with or without 8 mg dexamethasone. Pain score was measured for 24 hours.Results: We found no significant difference in pain intensity scores until hour 0.5 and the scores were below 1. Thereafter, the VAS scores increased, yet it remained below 3 in the first 12 postoperative hours. Morphine was administered during hours 12-24 in both groups, when VAS scores reached to about 4. The total amount of morphine consumption was a little lower in the case group, although the difference was not statistically significant. Conclusion: Adding dexamethasone to bupivacaine 0.25% for 3-in-1 block has no more benefit than bupivacaine 0.25% alone for acute postoperative pain management after elective hip nailing surgery

A rare case of kinked reinforced endotracheal tube in an intensive care unit: a case report / Un caso infrecuente de acodamiento de un tubo endotraqueal reforzado en una unidad de cuidados intensivos: reporte de un caso

Abstract Reinforced endotracheal tubes (ETTs) are regularly applied in anesthetic practices to prevent compression or kinking. Although these tubes are designed to bend easily and prevent obstruction, they still carry a potential hazard of being obstructed following external forces. In this article, we reported an unusual case in which a reinforced ETT was collapsed due to the patient bite. The patient's bite force on the tube resulted in obstruction, hypoxia, and desaturation. To overcome this near-fatally condition, we removed the blocked reinforced ETT.

Resumen Los tubos endotraqueales reforzados (TET) se usan generalmente en la práctica anestésica para evitar la compresión o el acodamiento. Aun cuando dichos tubos están diseñados para flexionarse fácilmente y prevenir obstrucciones, de todos modos, existe la posibilidad de que se obstruyan, como consecuencia de fuerzas externas. En el presente trabajo reportamos un caso inusual en el cual se colapsó el TET a causa de la mordida del paciente. La fuerza de mordida sobre el tubo produjo obstrucción, hipoxia y desaturación. Con el fin de superar esta condición casi fatal, retiramos el TET reforzado bloqueado.

Effect of intra-hippocampal injection of human recombinant growth hormone on synaptic plasticity in the nucleus basalis magnocellularis-lesioned aged rats / Efeito da injeção intrahipocampal de hormônio do crescimento humano recombinante sobre a plasticidade sináptica em ratos envelhecidos lesados do núcleo basalis magnocellularis

ABSTRACT In this study, we proposed that administration of hippocampal growth hormone in ageing animals with growth hormone deficiency can compensate long-term potentiation and synaptic plasticity in nucleus basalis magnocellularis (NBM)-lesioned rats. Aged male Wistar rats were randomly divided into six groups (seven in each) of sham-operated healthy rats (Cont); NBM-lesioned rats (L); NBM-lesioned rats and intrahippocampal injection of growth hormone vehicle (L + Veh); NBM-lesioned and intrahippocampal injection of growth hormone (10, 20 and 40 µg.2 µl-1) (L + GH). In vivo electrophysiological recording techniques were used to characterize maintenance of long-term potentiation at distinct times (1, 2, 3, 24 and 48 hours) after high-frequency stimulation. The population spike was enhanced significantly for about 48 hours following tetanic stimulation in rats treated with a dose-dependent growth hormone compared to the vehicle group (p < 0.05), possibly through neuronal plasticity and neurogenesis in affected areas.

RESUMO Neste estudo, propusemos que a administração de hormônio hipocampal do crescimento em animais envelhecidos com deficiência de hormônio do crescimento pode compensar a potencialização em longo prazo e a plasticidade sináptica em ratos lesados do núcleo basalis magnocellularis (NBM). Ratos machos Wistar foram divididos aleatoriamente em seis grupos (sete ratos em cada grupo) de ratos falso-operados saudáveis (Cont); ratos lesados do NBM (L); ratos lesados do NBM e injeção intrahipocampal de veículo de hormônio do crescimento (L + Veh); ratos lesados do NBM e injeção de hormônio do crescimento (10, 20 e 40 μg.2 μl-1) (L + GH). Técnicas de registro eletrofisiológico in vivo foram utilizadas para caracterizar a manutenção da potencialização em longo prazo em momentos distintos (1, 2, 3, 24 e 48 horas) após estimulação de alta frequência. O pico populacional aumentou significativamente cerca de 48 horas após a estimulação tetânica em ratos tratados com um hormônio do crescimento dose-dependente, em comparação com o grupo veículo (p <0,05), possivelmente através da plasticidade neuronal e da neogênese nas áreas afetadas.

Preventive Effects of Ellagic Acid on Nucleus Tractus Solitarius Electrical Activity and Oxidative Stress Altered by Cerebral Global Ischemia/Reperfusion in Rat

ABSTRACT Cerebral ischemia commonly occurs when the blood flow to the entire brain or some part of the brain is disrupted. Global cerebral ischemia attenuates the nucleus tractus solitaries (NTS) EEG rhythm, increases the free radicals production and brain inflammation. Ellagic acid (EA) has antioxidative and anti-inflammatory effects against neural damages. The aim of this study was to evaluate the role of ellagic acid on EEG power in the global cerebral ischemia.Rats were divided into four groups: SO (sham) received normal saline, EA+SO, I/R (normal saline + ischemia/reperfusion), and EA + I/R. EA (100 mg/kg, dissolved in normal saline) or normal saline was administered orally (gavage) for 10 days. Animal underwent to 20 minutes of ischemia followed by 30 minutes of reperfusion in I/R and I/R+EA groups. EEG was recorded from NTS and serum antioxidant enzyme activity was measured.Data showed that ellagic acid improved electrical power of NTS. Theta and delta bands frequencies in the ischemic animals were decreased in I/R group with compared to SO group significantly (P<0.001). Ellagic acid has beneficial effect on superoxide dismutase activity in the ischemic animals with compared to I/R group (P<0.01). In contrast, ellagic acid has no significant role on glutathione peroxidase activity in the pretreated ischemic rats in comparison with I/R group.These findings suggest that ellagic acid increased antioxidant enzymes activity that scavenge the ROS due to ischemia so that it may have neuroprotective effect on NTS neurons and consequently reverse its electrophysiology pattern.

Administration of venlafaxine after chronic methadone detoxification blocks post-depression relapse in rats

ABSTRACT Relapse is highly prevalent after detoxification and depression. Due to the advantages of venlafaxine compared with other antidepressants, it is expected that venlafaxine administration may reduce relapse after detoxification and depression. This study aimed to evaluate the effects of venlafaxine on depression-induced relapse to morphine dependence after methadone detoxification. Eighty Sprague-Dawley rats were habituated and conditioned with morphine (10 mg/kg, S.C., for 4 days). After that, primary forced swimming and conditioned place preference (CPP) were tested. They were followed by methadone (70 mg/kg/day, P.O., for 7 days) administration, extinguishing, forced swimming stress (FSS) and administration of venlafaxine (80 mg/kg/day, I.P., for 7 days). Finally same tests were performed. Administration of venlafaxine resulted in a decrement in final preference scores associated with a prime morphine injection (PMI) compared to the primary scores in methadone treated (MTD+) animals. In a swimming test, venlafaxine increased the amount of final floating and decreased final activity scores compared with the primary scores after administration of methadone. Venlafaxine reduced locomotor activity in MTD+ animals in the final test with PMI. There was a positive correlation between the final activity and preference scores after PMI. In conclusion, venlafaxine improved anxiety and depression-induced relapse on methadone detoxified rats.

Emerging Roles of microRNAs in Ischemic Stroke: As Possible Therapeutic Agents / 대한뇌졸중학회지

Stroke is one of the leading causes of death and physical disability worldwide. The consequences of stroke injuries are profound and persistent, causing in considerable burden to both the individual patient and society. Current treatments for ischemic stroke injuries have proved inadequate, partly owing to an incomplete understanding of the cellular and molecular changes that occur following ischemic stroke. MicroRNAs (miRNA) are endogenously expressed RNA molecules that function to inhibit mRNA translation and have key roles in the pathophysiological processes contributing to ischemic stroke injuries. Potential therapeutic areas to compensate these pathogenic processes include promoting angiogenesis, neurogenesis and neuroprotection. Several miRNAs, and their target genes, are recognized to be involved in these recoveries and repair mechanisms. The capacity of miRNAs to simultaneously regulate several target genes underlies their unique importance in ischemic stroke therapeutics. In this Review, we focus on the role of miRNAs as potential diagnostic and prognostic biomarkers, as well as promising therapeutic agents in cerebral ischemic stroke.

Effect of Gallic acid on dementia type of Alzheimer disease in rats: electrophysiological and histological studies

Introduction: To study the effect of gallic acid [GA] on hippocampal long-term potentiation [LTP] and histological changes in animal model of Alzheimer disease [AD] induced by beta-amyloid [Abeta]

Methods: Sixty-four adult male Wistar rats [300 +/- 20 g] were divided into 8 groups: 1] Control [Cont]; 2] AD; 3] Sham; 4-7] AD+GA [50, 100, and 200 mg/kg for 10 days, orally] or vehicle, 8] Cont+GA100, Abeta [1microg/microL in each site] was infused into hippocampus bilaterally. Changes of amplitude and slope of LTP induced in hippocampal dentate gyrus [DG] were evaluated by high frequency stimulation [HFS] of perforant path [PP]

Results: Data showed that LTP amplitude and area under curve significantly impaired in AD rats [P<0.001], while significantly improved in AD rats treated with GA [P<0.05, P<0.01]

Conclusion: Current findings suggest that GA reduces neural damage and brain amyloid neuropathology and improves cognitive function via free radicals scavenging and inhibiting oligomerization of Abeta but with no effect on healthy rats

Effect of grape seed extract on improving memory and learning impairment induced by streptozotocin in male rat

Background and Objective: Alzheimer's disease is an age-related disease that is characterized by dementia and loss of neurons in the brain. It has been shown that brain oxidative stress plays an important role in aging and neurodegenerative disorders. This study was done to evaluate the effect of grape seed extract [GSE] on memory impairment induced by intracerebroventricular [ICV] injection of streptozotocin [STZ] in animal model of Alzheimer's disease

Methods: In this experimental study, Eighty adult male Wistar rats were randomly allocated into control, sham, grape seed extract [100 mg/kg/bw, 30 days, orally] plus STZ and STZ plus grape seed extract. Animals memory were evaluated using Morris water maze, shuttle box and T maze tests

Results: Intracerebroventricular injection of STZ caused memory corruption in all tests. Administration of GSE before and after of administration of intracerebroventricular STZ in the Morris water maze test, significantly reduced latency to get to the hidden platform compared to Alzheimer's group [P<0.05]. The latency to enter the dark compartment in passive avoidance memory test significantly increased in compare to animal model of Alzheimer's disease [P<0.05]. The selection of the right arm of the T-maze test in animals that received grape seed extract before and after of STZ injection significantly increased compared to animal model of Alzheimer's disease [P<0.05]

Conclusion: Grape seed extract has important effect in prevention and improving memory impairment induced by intracerebventricular injection of STZ

A preliminary study of the anti-inflammatory and anti-apoptotic effects of crocin against gastric ischemia-reperfusion injury in rats

The aim of the present study was to investigate the protective effect of crocin on gastric mucosal lesions caused by ischemia-reperfusion (I/R) injury in rats. Thirty-two male rats were randomly divided into sham, I/R, I/R + crocin pretreatment and crocin alone groups. To induce I/R lesions, the celiac artery was clamped for 30 min, and the clamp was then removed to allow reperfusion for 3 h. Crocin-pretreated rats received crocin (15 mg/kg, i.p.) 30 min prior to the induction of I/R injury. Samples of gastric mucosa were collected to quantify the protein expression of caspase-3, an apoptotic factor, and inducible nitric oxide synthase (iNOS), a pro-inflammatory protein, by Western blot. Pretreatment with crocin decreased the total area of gastric lesions and decreased the protein expression levels of caspase-3 and iNOS induced by I/R injury. Our findings showed a protective effect of crocin in gastric mucosa against I/R injury. This effect of crocin was mainly mediated by reducing the protein expression of iNOS and caspase-3.

O objetivo do presente estudo foi investigar o efeito protetor da crocina em lesões da mucosa gástrica causadas por isquemia-reperfusão (I/R) em ratos. Trinta e dois ratos machos aleatoriamente divididos em grupos de ratos normais, operados como controle, I/R. I/R + pré-tratamento com crocina e crocina sozinha. Para induzir lesões I/R, a artéria celíaca foi grampeada durante 30 minutos e, em seguida, o grampo foi removido para permitir a reperfusão por 3 h. Ratos com pré-tratamento com crocina receberam crocina (15 mg/kg, ip) 30 minutos antes da indução do dano I/R. Amostras de mucosa gástrica foram coletadas para qiuantificar a expressão da proteína da caspase-3, o fator apoptótico, e óxido nítrico sintase induzível (iNOS), uma proteína anti-inflamatória, pela técnica de Western Blot. O pré-tratamento com crocina diminuiu a área total de lesões gástricas e a expressão de níveis de caspase-3 e iNOS induzidas pelo dano I/R. Nossos resultados mostraram o efeito protetor da crocina na mucosa gástrica contra o dano I/R. Este efeito foi mediado, principalmente, por diminuição da expressão das proteínas iNOS e caspase-3.

Motor disturbances and thalamic electrical power of frequency bands' improve by grape seed extract in animal model of Parkinson's disease

Previous studies showed that grape seed extract [GSE] is an excellent natural substance with potent antioxidant effect and free radical scavenger. This study aimed to evaluate the effect of GSE on motor dysfunctions and thalamic local Electroencephalography [EEG] frequency bands' powers in rats with Parkinson's disease [PD]. In this study 8 micro g 6-hydroxydopamine [6-OHDA] dissolved in 2 micro l normal saline containing 0.01% ascorbic acid was infused into right medial forebrain bundle [MFB] to make an animal model of PD. Rats with PD received four weeks GSE [100 mg/kg, p.o.] after apomorphine-induced rotation test. Spontaneous motor tests and also thalamic ventroanterior nucleus [AV] local EEG recording were done in freely moving rats in all groups. Chronic treatment of PD rats with GSE could influence potentially frequency bands' powers of thalamic VA and improve post-lesion motor dysfunctions significantly [p<0.05 and p<0.01, respectively]. Our findings suggest that GSE modulates the CNS function and has beneficial effects on the direct and indirect striato-thalamo-cortical pathways in PD. GSE acts as a new and potent natural free radical scavenger which removes oxidants produced by neurotoxin 6-OHDA in brain. Therefore, it reinforces electrical power of remained thalamic VA neurons and thereby improves post-lesion motor disorders

Effect of Anthum graveolens fruit extract on rat uterus contractions

Dill [Anethum graveolens] from Umbelliferae is used traditionally to treat convulsions and increasing milk production. Also, in Darab [Fars Province] and Yazd dill fruit is used traditionally to prevent abortion. Its antimicrobial, antihyperlipidaemic, anti-hypercholesteroaemic effects and reducing gastric acid secretion have been reported. The aim of the present study was to investigate the effects of dill fruit hydroalcoholic [DFHE] extract on virgin rat uterus contractions induced by KCI [60mM] and oxytocin [10 mU/ml]. Macerated method was used for extract preparation. Virgin Sprague Dawley female rats were pretreated with an injection of estradiol valerate [5mg/kg, s.c.] 24 hours prior to experiment. Rats were killed and uteri were dissected and mounted in an isolated organ bath containing De Jalon solutions [29°C] bubbled by oxygen. Contractile responses were recorded isometrically under 1g initial tension. The DFHE [0.5, 1, 2, 4 and 8 mg/ml] relaxed both KC1- and oxytocin-induced contractions dosedependently [p<0.0001]. However, the spasmolytic effect of extract on oxytocin-induced contractions was more potent. In Ca[2+] -free, rich K+ [120mM] De Jalon solution, cumulative adding of calcium [0.15, 0.3, 0.6, 1.2 and 2.4 mM], increased contractions dose dependently [p<0.0001]. DFHE [4 mg/ml] shifted this dose-response curve to the right [p<0.05]. In Ca[2+] free solution, oxytocin induced strong contractions if calcium [0.3 mM] was added to the bath. However, DFHE [8 mg/ml] reduced calcium-induced contraction [p<0.001]. The spasmolytic effect of DFHE was reversible. The spasmolytic effect of DFHE [4 mg/ml] was affected neither by propranolol [1micro M] nor by L-NAME [100 micro M]. These results suggest that the relaxatory effect of DFHE on KCI and oxytocin-induced uterus contractions is due, at least in part, to blockade voltage dependent calcium channels and partly by disturbing in releasing calcium from intracellular pool indirectly. In addition, the beta-adrenoceptors and NO are not involved in this inhibitory effect of DFHE. Our results may also support the traditionally usage of dill fruit for preventing abortion

Treatment of postoperative shivering with dexamethasone: a prospective randomized clinical trial

Postoperative shivering is an important and troublesome condition during recovery from general anesthesia. Corticosteroids have been recommended to facilitate recovery and diminish shivering after cardiac surgery. Previous studies recommended 0.6 mg/kg dexamethasone for reducing postoperative shivering in patients undergoing cardiac surgery. To test this assertion, we administered 0.15 mg/kg dexamethasone to patients undergoing routine surgeries, e.g., laparotomy, thoracotomy, and orthopedic, urologic and gynecological operations. A total of 200 patients undergoing elective operations were randomly selected and divided into two groups. To the first group 0.15 mg/kg dexamethasone and to the control group, a placebo was injected right after the induction of anesthesia and before making any skin incision. Patients did not have any coexisting diseases, e.g., diabetes, hypertension, ischemic heart disease, etc., nor were they on any specific medication. All patients received the same doses of diazepam, morphine, sodium thiopental, 50% O2, 50% N2O, and 0.5% halothane for the induction and maintenance of general anesthesia. Patients who had received dexamethasone had a significantly [p<0.001] lower incidence of postoperative shivering [12%] compared to the control group receiving placebo [31%]. Small doses of dexamethasone [0.15 mg/kg] could effectively decrease the incidence of postoperative shivering