Efficacy and safety of parecoxib versus ketorolac tromethamine for perioperative analgesia：a systematic review / 中国药房

OBJECTIVE To compare the efficacy and safety of parecoxib and ketorolac tromethamine for perioperative analgesia， and to provide evidence-based reference for clinical drug use. METHODS Retrieved from PubMed， Embase， the Cochrane Library， CNKI， VIP， Wanfang Data， Baidu and Google， randomized controlled trials （RCT） about parecoxib （trial group） versus ketorolac tromethamine （control group） for perioperative analgesia were collected from the inception to Jun. 17th， 2022. After screening the literature and extracting the data， the quality of the included literature was evaluated using the bias risk assessment tool recommended by Cochrane system evaluator manual 5.1.0. Meta-analysis， sensitivity analysis and publication bias analysis were performed with RevMan 5.4 software. RESULTS A total of 12 RCTs were included， with 1 118 patients. Meta- analysis results showed that at the time of administration before anesthesia induction， there was no statistically significant difference between the 2 groups in visual analogue scale （VAS） [MD＝－0.16， 95%CI （－0.41， 0.09）， P＝0.20]， numerical rating scale （NRS） [MD＝0.01， 95%CI （－0.36， 0.38）， P＝0.97]， postoperative bleeding [MD＝0.15， 95%CI （－0.63， 0.93）， P＝0.71]， and consumption of opioid analgesics [MD＝0.12， 95%CI （－0.77， 1.01）， P＝0.79]. At the time of postoperative administration， VAS and bleeding volume at 48 h after operation of trial group were significantly lower than control group （P＜0.05）. The results of subgroup analysis by different com assessment time points showed that the VAS of patients in trial group at 0 h after operation were significantly lower than control group at the time of administration before anesthesia induction； at the time of postoperative administration， VAS of patients in the trial group at 12 h and 48 h after operation were significantly lower than control group （P＜0.05）. There was no statistical significance in the incidence of ADR between 2 groups [RR＝0.93，95%CI （0.78，1.11），P＝0.43]. The results of subgroup analysis according to different types of adverse reactions showed that the incidence of nausea and vomiting of trial group was significantly lower than control group， and the incidence of other adverse reactions was significantly higher than control group （P＜0.05）. Results of sensitivity analysis showed that study results were stable and reliable. Results of publication bias analysis showed that there was great possibility of publication bias in this study. CONCLUSIONS The efficacy of parecoxib is equivalent to that of ketorolac tromethamine for perioperative analgesia before operation； at the time of administration after operation， parecoxib has better analgesic effect and less postoperative bleeding； the incidence of nausea and vomiting caused by parecoxib is lower at any time of administration.

Designing of promising Tromethamine-Diflunisal-Pyrrole combinations based on COX binding, drug-properties and safety-Supplementary Data

Gastric issues that accompany the use of NSAIDs (Non-steroid anti-inflammatory drugs) are always a serious global concern. The inhibition of the Cycloxygenase enzyme (COX) limits the prostaglandin synthesis and thereby facilitates the control of pains, inflammation etc. But this creates gastric issues due to the reduction of mucin formation in the stomach. The present work was performed to create a modification in the structure of NSAID drug Diflunisal, to reduce the gastric effect of acidic moiety in the structure and elevate the overall biological properties. The drug Tromethamine, a base used in acidosis treatment was substituted to reduce the acidic issues. The heterocyclic compound pyrrole was substituted to elevate the properties. Neutral, salt, amide and ester combinations of Tromethamine-Diflunisal were designed, optimized and docked to the crystal structures of COX-1 (PDB ID: 6Y3C) and COX-2 (PDB ID: 5IKR) enzymes, using PyRx software. The combinations with lower COX-1 and COX-2 binding energies relative to Diflunisal were noted. It was analysed if the combinations of Diflunisal, Tromethamine and pyrrole lowers drug-properties or induce toxicities. Pyrrole substitution at position R4 was not found favourable for COX binding. Among the favourable combinations, DF19 is the Diflunisal-Pyrrole-Tromethamine combination, equally favourable for binding to COX targets.

Designing of promising Tromethamine-Diflunisal-Pyrrole combinations based on COX binding, drug-properties and safety-Supplementary Data

Gastric issues that accompany the use of NSAIDs (Non-steroid anti-inflammatory drugs) are always a serious global concern. The inhibition of the Cycloxygenase enzyme (COX) limits the prostaglandin synthesis and thereby facilitates the control of pains, inflammation etc. But this creates gastric issues due to the reduction of mucin formation in the stomach. The present work was performed to create a modification in the structure of NSAID drug Diflunisal, to reduce the gastric effect of acidic moiety in the structure and elevate the overall biological properties. The drug Tromethamine, a base used in acidosis treatment was substituted to reduce the acidic issues. The heterocyclic compound pyrrole was substituted to elevate the properties. Neutral, salt, amide and ester combinations of Tromethamine-Diflunisal were designed, optimized and docked to the crystal structures of COX-1 (PDB ID: 6Y3C) and COX-2 (PDB ID: 5IKR) enzymes, using PyRx software. The combinations with lower COX-1 and COX-2 binding energies relative to Diflunisal were noted. It was analysed if the combinations of Diflunisal, Tromethamine and pyrrole lowers drug-properties or induce toxicities. Pyrrole substitution at position R4 was not found favourable for COX binding. Among the favourable combinations, DF19 is the Diflunisal-Pyrrole-Tromethamine combination, equally favourable for binding to COX targets.

Designing of promising Tromethamine-Diflunisal-Pyrrole combinations based on COX binding, drug-properties and safety

Gastric issues that accompany the use of NSAIDs (Non-steroid anti-inflammatory drugs) are always a serious global concern. The inhibition of the Cycloxygenase enzyme (COX) limits the prostaglandin synthesis and thereby facilitates the control of pains, inflammation etc. But this creates gastric issues due to the reduction of mucin formation in the stomach. The present work was performed to create a modification in the structure of NSAID drug Diflunisal, to reduce the gastric effect of acidic moiety in the structure and elevate the overall biological properties. The drug Tromethamine, a base used in acidosis treatment was substituted to reduce the acidic issues. The heterocyclic compound pyrrole was substituted to elevate the properties. Neutral, salt, amide and ester combinations of Tromethamine-Diflunisal were designed, optimized and docked to the crystal structures of COX-1 (PDB ID: 6Y3C) and COX-2 (PDB ID: 5IKR) enzymes, using PyRx software. The combinations with lower COX-1 and COX-2 binding energies relative to Diflunisal were noted. It was analysed if the combinations of Diflunisal, Tromethamine and pyrrole lowers drug-properties or induce toxicities. Pyrrole substitution at position R4 was not found favourable for COX binding. Among the favourable combinations, DF19 is the Diflunisal-Pyrrole-Tromethamine combination, equally favourable for binding to COX targets.

Determination of tromethamine residues in human coagulation factor Ⅷ by high performance liquid chromatography method / 中国输血杂志

【Objective】 To develop and verify high performance liquid chromatography (HPLC) detection for tromethamine (Tris) residues in human coagulation factor Ⅷ. 【Methods】 Alanine was used as internal standard, and AQC for pre-column derivation. Inertsil® ODS-SP was adopted, and acetic acid-sodium acetate buffer and acetonitrile were used for gradient elution at the flow rate of 1 mL/min and column temperature of 37℃. The 25 μL sample was loaded and determined by UV-detector with detection wavelength at 248 nm. This method was then verified. 【Results】 Glycine, sodium citrate and calcium chloride showed no interference with the detection of tromethamine (Tris) residues. The recovery rate of spike samples was within 90.0%~100.8%. The RSD in repeatability test were 2.5%, 0.7% and 1.2%, respectively, and in intermediate precision test 0.8%. The tromethamine (Tris) at concentrates of (0.5~4.0)μg/mL showed good linear relationship to the peak area to internal standard, of which the regression equation was Y=0.012 9X-0.000 782, R=0.999 97.The quantitative detection limit was 0.04μg/mL. 【Conclusion】 The HPLC for determination of tromethamine (Tris) residues in human coagulation factor Ⅷ was successfully developed, which showed good linearity as well as high specificity, precision and accuracy.

Systematic Evaluation of the Preventive Effect of Dexmedetomidine on Adverse Drug Reactions Caused by Carboprost Tromethamine During Cesarean Section / 中国药房

OBJECTIVE：To evaluate the preventive effect of dexmedetomidine （DEX）on adverse drug reactions induced by carboprost tromethamine used in cesarean section ，and to provide evidence-based reference for rational drug use of cesarean section. METHODS：Retrieved from PubMed ，Cochrane library ，Embase，CNKI，CBM，Wanfang database and VIP during inception to June of 2019，randomized controlled trials about DEX （trial group ）versus normal saline （control group ）in the prevention of adverse drug reactions induced by carboprost tromethamine in cesarean section were collected. After data extraction of included literatures and quality evaluation with modified Jadad scale ，Meta-analysis was performed by using Rev Man 5.3 statistical software. RESULTS ：A total of 11 RCTs with 714 patients were included in this study. Results of Meta-analysis showed that the incidence of nausea [OR ＝0.09，95％CI（0.06，0.14），P＜0.000 01]，vomiting [OR ＝0.09，95％CI（0.05，0.15），P＜0.000 01]， facial flushing [OR ＝0.15，95％CI（0.10，0.22），P＜0.000 01]，chest distress [OR ＝0.12，95％CI（0.08，0.18），P＜0.000 01]， hypertension [OR ＝0.06，95％CI（0.04，0.11），P＜0.000 01] and tachycardia [OR ＝0.17，95％CI（0.12，0.25），P＜0.000 01] in trial group were significantly lower than control group ，with statistical significance. CONCLUSIONS ：DEX can reduce adverse drug reactions such as nausea and vomiting caused by carboprost tromethamine used in cesarean section.

Formulation and pharmacopoeial quality evaluation of ketorolac tromethamine IR tablet and comparison with marketed product

This study describes the formulation of immediate release Ketorolac tromethamine (KT) 10-mg tablet by directcompression method; evaluation of their compliance to various Pharmacopoeial quality parameters, i.e., weightvariation, friability, hardness, thickness, moisture content, disintegration, assay, and dissolution; and their comparisonwith marketed brands for determination of pharmaceutical equivalency. Five formulations of KT were prepared(coded as FKT1, FKT2, FKT3, FKT4, and FKT5) by direct compression method using different superdisintegrants.Micrometric properties of the mixtures of the drug and the excipients prepared for formulation were evaluated. Qualityevaluation of the five different formulations and randomly selected four different brands of KT 10-mg tablets purchasedfrom the local market (coded as LKT1, MKT2, MKT3, and SKT4) were performed according to Pharmacopoeia. Theresults were obtained by UV-Vis spectrophotometer and all the dissolution profiles were characterized by the zeroorder kinetics. All the brands of KT and developed formulations met the official specification except SKT4 whichshowed excessive moisture content of 7.18%. None of the tested brands of KT were found to be pharmaceuticallyequivalent, whereas two developed formulation were pharmaceutically equivalent with the in house benchmark(MKT2) from which their interchangeability can be suggested.

The application timing and curative effect of carprostol tromethamine in the treatment of postpartum hemorrhage due to uterine atony / 中国基层医药

Objective@#To explore the application timing of carprostol tromethamine in the treatment of postpartum hemorrhage due to uterine atony, and to observe the clinical efficacy.@*Methods@#From January 2016 to June 2018, 62 patients with uterine atony and postpartum hemorrhage admitted to the Second People′s Hospital of Lianyungang were selected as study objects, and they were randomly divided into two groups according to the digital table, with 31 cases in each group.In the control group, after the delivery of the fetus, 20U of oxytocin was intravenously injected.If there was active hemorrhage on the dissection surface of the placenta, 40U of oxytocin was continued.If there was still hemorrhage, the uterus was injected with 250μg of carprostol tromethamine.In the observation group, after the delivery of the fetus, 20U of oxytocin was intravenously injected.If there was active hemorrhage on the dissection surface of the placenta, 250μg of carprostol tromethamine was injected immediately.If the patients in the two groups still had active bleeding in the uterus after the above treatments, the uterine cavity was filled with gauze or uterine artery ligation was performed to stop bleeding.The blood loss during the operation, 2h and 24h after surgery were recorded and compared between the two groups.The 24h postpartum hemoglobin(Hb) decreased value, treatment efficacy and the incidence of adverse reactions were also recorded and compared between the two groups.@*Results@#The intraoperative blood loss was (1 066.1±71.3)mL in the observation group, which was significantly lower than that in the control group [(1 163.6±70.9)mL], the difference was statistically significant(t=5.393, P<0.001). There were no statistically significant differences in 2h and 24h postoperative blood loss between the two groups (all P>0.05). The decrease of Hb in the observation group at 24h after birth was (20.80±6.25)g/L, which was lower than that in the control group [(26.90±9.21)g/L], and the difference was statistically significant(t=3.033, P<0.01). The treatment effective rate of the observation group was 87%(27/31), which of the control group was 77%(24/31), there were no statistically significant differences between the two groups(P>0.05).@*Conclusion@#Postpartum hemorrhage caused by uterine atony can be treated by early use of carprostol tromethamine, which can effectively reduce postpartum bleeding and promote the rehabilitation of patients.The curative effect is better than oxytocin, and it is worthy of clinical application.

Effect of Tramadol Combined with Ketorolac Tromethamine in 30 Case of Patients of Patient-controlled Intravenous Analgesia after Gynecological Laparoscopic Surgery / 医药导报

Objective To observe the effect of combination use of tramadol and ketorolac tromethamine for patientcontrolled intravenous analgesia (PCIA) after gynecological laparoscopic surgery. Methods Ninety patients with American Society of Anesthesiologists (ASA) grade I or Ⅱ undergoing gynecological laparoscopic surgery under general anesthesia were randomly divided into three groups: group T (using tramadol for PCIA) , group TK (using tramadol and ketorolac tromethamine for PCIA) and group K (using ketorolac tromethamine for PCIA) . The visual analog scale (VAS) scores at rest and moving and Ramsay sedation scale(Ramsay) scores were recorded at 1 h (t1) ,4 h (t2) ,8 h (t3) , 12 h (t4) , 24 h (t5) , 36 h (t6) , 48 h (t7) after surgery.The total dosage of rescue analgesia drug and the times of needing rescue analgesia were recorded. Adverse reactions were also recorded. Results VAS scores at rest in t 1,t2,t3,t4,t5 and t6 after surgery were significantly lower in group T and group TK than in group K(P<0.05) . VAS scores at movement time was not significantly different. After surgery,incidence rate of nausea,vomiting,dizziness or sleepiness was significantly higher in group T than in group TK and group K(P<0.05) . The total dosage of rescue analgesia drug in group K was significantly higher than in group T and in group TK (P<0.05) . In 24 h after surgery,patients pressed the button of PCIA (2.89±0.597) times in group TK,(3.05±0.574) times in group T,(6.50±0.859) times in group K.Ramsay scores at each time points after surgery were significantly increased (P<0.05) . Total dosage amount of rescue drugs and number of patients using rescue drugs were significantly higher in group K than in group T and group TK (P< 0.05) . Conclusion Combination use of tramadol and ketorolac tromethamine for PCIA after gynecological laparoscopic surgery has better analgesia effect with reduced side effects.

The application timing and curative effect of carprostol tromethamine in the treatment of postpartum hemor-rhage due to uterine atony / 中国基层医药

Objective To explore the application timing of carprostol tromethamine in the treatment of postpartum hemorrhage due to uterine atony ,and to observe the clinical efficacy.Methods From January 2016 to June 2018,62 patients with uterine atony and postpartum hemorrhage admitted to the Second People 's Hospital of Lianyungang were selected as study objects ,and they were randomly divided into two groups according to the digital table,with 31 cases in each group.In the control group,after the delivery of the fetus ,20U of oxytocin was intrave-nously injected.If there was active hemorrhage on the dissection surface of the placenta ,40U of oxytocin was contin-ued.If there was still hemorrhage,the uterus was injected with 250μg of carprostol tromethamine.In the observation group,after the delivery of the fetus ,20U of oxytocin was intravenously injected.If there was active hemorrhage on the dissection surface of the placenta ,250μg of carprostol tromethamine was injected immediately.If the patients in the two groups still had active bleeding in the uterus after the above treatments ,the uterine cavity was filled with gauze or uterine artery ligation was performed to stop bleeding.The blood loss during the operation ,2h and 24h after surgery were recorded and compared between the two groups.The 24h postpartum hemoglobin (Hb) decreased value,treatment efficacy and the incidence of adverse reactions were also recorded and compared between the two groups . Results The intraoperative blood loss was (1 066.1 ±71.3) mL in the observation group,which was significantly lower than that in the control group [(1 163.6 ±70.9) mL],the difference was statistically significant ( t＝5.393, P＜0.001).There were no statistically significant differences in 2h and 24h postoperative blood loss between the two groups (all P＞0.05).The decrease of Hb in the observation group at 24h after birth was (20.80 ±6.25)g／L,which was lower than that in the control group [(26.90 ±9.21) g／L],and the difference was statistically significant ( t＝ 3.033,P＜0.01).The treatment effective rate of the observation group was 87%(27／31),which of the control group was 77%( 24／31 ), there were no statistically significant differences between the two groups ( P ＞0.05 ). Conclusion Postpartum hemorrhage caused by uterine atony can be treated by early use of carprostol tromethamine , which can effectively reduce postpartum bleeding and promote the rehabilitation of patients .The curative effect is better than oxytocin,and it is worthy of clinical application.

Clinical study of prophylactic propofol on the side effects of carboplatin and trometamol infusion at different plasma target concentrations in cesarean section / 中国基层医药

Objective To observe the effect of propofol infusion on the side effects of carboplatin and trometamol at different plasma target concentrations in cesarean section.Methods From January 2016 to October 2017,a total of 184 cases of cesarean section pregnant women in the People's Hospital of Quzhou were selected for prospective study.They were divided into A group ,B group,C group and control group (N group) according to random number table method,with 46 cases in each group.The A,B,C three groups were target -controlled infusion of propofol,the concentrations were 0.8μg/mL,1.2μg/mL,1.6μg/mL,respectively,while N group was infused 0.9%sodium chloride injection at the rate of 0.5mL· kg-1· h-1.The operative time,intraoperative blood loss,fluid replacement,elevated blood pressure,decreased blood pressure ,the incidence of tachycardia and adverse reactions were compared among the four groups.Results The operation time of the four groups were (46.65 ±5.32) min, (49.21 ±4.75)min,(48.74 ±4.28) min,(49.76 ±5.25) min,respectively,the differences were not statistically significant(F＝1.501,P ＞0.05).The volume of intraoperative blood loss in the four groups were (425.66 ± 39.54)mL,(428.71 ±41.03)mL,(427.96 ±41.55)mL,(431.56 ±42.35)mL,respectively,the differences were not statistically significant(F＝1.882,P＞0.05).The fluid replacement in the four groups were (884.59 ±51.22)mL, (879.20 ±47.63)mL,(883.59 ±50.14)mL,(896.33 ±50.23)mL,respectively,the differences were not statistically significant(F＝1.634,P＞0.05).The satisfaction rate of sedation in B group was 91.30%,which was significantly higher than 58.70%in A group and 30.43%in C group(Z＝91.428,P＜0.05).The incidence rates of cardiovascular events in B group and C group were significantly lower than those in A group (all P＜0.05),which in B group were lower than those in C group(all P＜0.05).There were no statistically significant differences in chest tightness ,head-ache,facial flushing incidence in the three groups (χ2＝3.450,4.816,5.396,all P＞0.05).The incidence rates of nausea and vomiting in B group were 8.70%and 4.35%,respectively.The incidence rates of nausea and vomiting in C group were 8.70%and 2.17%,respectively,which were significantly lower than those in A group (26.09% and 19.57%)(χ2＝7.485,10.405,all P＜0.05).Conclusion Targeted infusion of propofol at 1.2 μg/mL can effec-tively prevent the side effects of cesarean section carduvastatin trometamol with good sedative effect .

Ketorolac tromethamine combiend with sufentanil on median effective dose of analgesia after cesarean delivery / 中国基层医药

Objective@#To study the median effective dose of ketorolac tromethamine combined with different doses of sufentanil.@*Methods@#From February 2016 to June 2017, 60 cases of cesarean section were selected.According to the random number table method, they were divided into two groups, with 30 cases in each group.Group I was treated with sufentanil 0.75μg/kg+ dexmedetomidine 200μg, while sufentanil 1μg/kg+ dexmedetomidine 200μg was used in group II.The first two groups were added to pump 150 mg ketorolac tromethamine, gradually increased or decreased in accordance with 30mg effect according to satisfaction or dissatisfaction.The median effective dose of ketorolac tromethamine in the two groups was analyzed.@*Results@#After operation, the systolic blood pressure[(112.5±9.6)mmHg vs.(122.5±8.4)mmHg, (114.2±9.9)mmHg vs.(124.1±8.2)mmHg]and heart rate[(80.6±13.5)times/min vs.(90.5±16.5)times/min, (77.6±15.5)times/min vs.(88.2±18.8)times/min]in the two groups were significantly lower than those before operation (t=4.587, 5.248, 4.214, 3.983, all P<0.05). The VSA scores of the two groups decreased significantly[(6.8±2.4)points, (3.4±1.4)points, (2.1±0.9)points, (6.9±3.1)points, (3.5±1.7)points, (2.2±0.7)points], the difference was statistically significant at different time points (F=4.977, P<0.05). ED50 and 95% confidence interval of ketorolac tromethamine in the group I was 91.75mg, 78.69-106.98mg, which in the group II was 72.44mg, 60.40-86.90mg.@*Conclusion@#Ketorolac tromethamine combined with sufentanil has good analgesia effect, less adverse reaction.When sufentanil was given at 0.75 and 1μg/kg, the ED50 of ketorolac tromethamine were 91.75mg and 72.44mg.

Fosfomycin tromethamine inhibits the expressions of TNF-α, IL-8 and IL-6 in the prostate tissue of rats with chronic bacterial prostatitis / 中华男科学杂志

<p><b>Objective</b>To investigate the effects of fosfomycin tromethamine (FT) on the expressions of tumor necrosis factor-α (TNF-α), interleukin-8 (IL-8), and interleukin-6 (IL-6) in the prostate tissue of the rats with chronic bacterial prostatitis (CBP).</p><p><b>METHODS</b>We randomly divided 70 male SD rats into 7 groups of equal number: blank control, CBP model control, positive control, 14 d low-dose FT, 7 d low-dose FT, 14 d high-dose FT, and 7 d high-dose FT. The CBP model rats in the latter five groups were treated intragastrically with levofloxacin at 100 mg/kg/d for 30 days and FT at 200 mg/kg/d for 14 and 7 days and at 300 mg/kg/d for 14 and 7 days, respectively. Then we collected the prostate tissue from the animals for determination of the levels of TNF-α, IL-8 and IL-6 by ELISA.</p><p><b>RESULTS</b>Compared with the blank controls, the CBP model rats showed significantly increased levels of TNF-α (［19.83 ± 6.1］ vs ［32.93 ± 6.21］ ng/g prot, P <0.01), IL-8 (［8.26 ± 0.52］ vs ［16.2 ± 2.84］ ng/g prot, P <0.01) and IL-6 (［1.55 ± 0.11］ vs ［2.51 ± 1.06］ ng/g prot, P <0.05) in the prostate tissue. In comparison with the CBP model controls, the levels of TNF-α and IL-8 were remarkably decreased in the groups of positive control (［20.54 ± 5.78］ ng/g prot, P <0.01; ［12.43 ± 4.02］ ng/g prot, P <0.05), 14 d low-dose FT (［21.95 ± 6.48］ ng/g prot, P <0.01; ［11.11 ± 2.86］ ng/g prot, P <0.01), 7 d low-dose FT (［23.8 ± 6.93］ ng/g prot, P <0.05; ［12.43 ± 4.02］ ng/g prot, P <0.05), 14 d high-dose FT (［19.97 ± 2.58］ ng/g prot, P <0.01; ［8.83 ± 1.32］ ng/g prot, P <0.01), and 7 d high-dose FT (［21.97 ± 3.38］ ng/g prot, P <0.01; ［12.68±1.97］ ng/g prot, P <0.05). No statistically significant differences were observed between the positive control and FT groups in the contents of TNF-α, IL-8 or IL-6 (P >0.05). The expression of IL-6 was markedly reduced in the 14 d high-dose FT group as compared with the model controls (［1.76 ± 0.46］ vs ［2.51 ± 1.06］ ng/g prot, P<0.05) but exhibited no significant difference between the CBP model control and the other groups (P >0.05).</p><p><b>CONCLUSIONS</b>Fosfomycin tromethamine inhibits the expressions of TNF-α, IL-8 and IL-6 in the prostate tissue, suppresses its inflammatory reaction, promotes the repair of damaged prostatic structure, and thus contributes to the treatment of chronic bacterial prostatitis in rats.</p>

The effect of BIS-guided propofol TCI in preventing adverse effect of carboprost tromethamine in puerperants undergoing caesarean section: a prospective, randomized controlled trial / 实用医学杂志

Objective To investigate whether BIS-guided (target-controlled infusion) propofol TCI can effectively prevent adverse effects of carboprost tromethamine in patients undergoing caesarean section.Methods Three hundred and fifty-four puerperants underwent spinal-epidural anesthesia were randomized into 3 groups:after fetal childbirth,in the control group,normal saline was infused at a rate of 10 ml/h.BIS 85 group,propofol with the initial target plasma concentrations of 0.8 μg/ml by TCI,adjusted TCI concentration and maintained BIS 80-90.BIS 75 group,propofol with the initial target plasma concentrations of 1.2 μg/ml by TCI,adjusted TCI concentration and maintained BIS 70-80,both until the end of operation.tThe rate of nausea,vomiting,diarrhea,chest congestion and headache were compared among 3 groups.Results Compared with the control group,the incidence of chest congestion was significantly reduced in BIS 85 group (P =0.004).The incidence of nausea,vomiting and chest congestion were significantly reduced in BIS 75 group (P ＜ 0.001,respectively).The puerperants in 2 BIS groups had no complaints of headache.Conclusion BIS-guided propofol TCI and maintaining BIS 70-80 can effectively prevent adverse effect of carboprost tromethamine in puerperants undergoing spinal-epidural anesthesia in caesarean section.

Comparison of the effect of dexmedetomidine combined with butorphanol to prevent the adverse effects of carboprost tromethamine druing cesarean delivery / 临床麻醉学杂志

Objective To compare the effect of dexmedetomidine combined with butorphanol to prevent the adverse effects of carboprost tromethamine druing cesarean delivery.Methods Ninety parturients with the risk factor of uterine atony,aged 24-40 years,weighting 55-85 kg,ASA physical status Ⅰ or Ⅱ,undergoing full term cesarean section,were randomly divided into dexmedetomidine combined with butorphanol group (group DB,n=30),butorphanol group (group B,n=30)and control group (group N,n=30).Three groups were intravenously injected corresponding drugs of carboprost tromethamine into uterus.Group DB was given intravenous injection dexmedetomidine 1 μg/kg combined with butorphanol 20 mg/kg.Group B was given butorphanol 20 mg/kg.Group N was given 0.9% sodium chloride solution.MAP,HR,and SpO2were recorded at different times,10 min after go into operation room (T0),10 min after carboprost tromethamine into uterus (T1),end of operation (T2).Ramsay sedation score was recorded at T1.The adverse effects of carboprost tromethamine were recorded.The initial time of lactation after operation was recorded.The initial time of lactation after operation,the height of uterine fundus at 1,3,5 d after operation,the oxyto-cin doses within 72 h after operation were recorded.Results Compared with group N,the MAP and HR of group DB and group B decreased obviously at T1(P<0.05),and group DB was lower than group B obviously at T1(P<0.05).Compared with group N,the scores of Ramsay in group DB and group B were significantly higher (P<0.05),group DB was higher than that of group B(P<0.05). Compared with group N,the incidence of nausea,vomiting,chest tightness,chest pain,hyperten-sion,tachycardia and chills in group B and group DB were significantly lower (P<0.05),and group DB was lower than that of group B (P<0.05).There were no significant differences of the initial time of lactation after operation,height of uterine fundus at 1,3,5 d after operation,the oxytoxin doses within 72 h after operation between the three groups.Conclusion Dexmedetomidine combined with butorphanol can effectively reduce the adverse effects of carboprost tromethamine druing cesarean delivery,the more stable hemodynamics and sedative effect,the effect is better than the sin-gle application of butorphanol,at the same time does not affect lactation,it is safe and effective for clinical use.

Effect of prostaglandin tromethamine injection combined with oxytocin on postpartum hemorrhage of scarred uterus in late pregnancy / 中国生化药物杂志

Objective To investigate the effect of carboprost tromethamine combined with oxytocin on postpartum hemorrhage of scarred uterus in late pregnancy, and to provide theoretical basis for the application of carboprost tromethamine combined with oxytocin. Methods From May 2015 to May 2017, 52 pregnant woman with postpartum hemorrhage with scarred uterus in late pregnancy in the sixth hospital in Beijing were divided into the control group and the observation group. The control group was treated with oxytocin, and the observed value was treated with progesterone tromethamine injection and oxytocin. Postpartum hemorrhage, the incidence of postpartum hemorrhage in the two groups were compared. Results The intraoperative blood loss, postoperative 2 h and postoperative 24 h bleeding in the observation group were significantly lower than those in the control group, the difference was statistically significant (P<0.05). The incidence of postpartum hemorrhage in the observation group was 3.85％, significantly lower than 11.54％ in the control group, the difference was statistically significant (P<0.05). Conclusion carboprost tromethamine combined with oxytocin in the treatment of postpartum hemorrhage in the pregnant woman with scarred uterus in late pregnancy is effective and can reduce the rate of postpartum hemorrhage and the amount of bleeding, so it is worthy of popularization and application.

Effect of choprodin tromethamine combined with psychological intervention on clinical prevention and treatment of postpartum hemorrhage / 中国生化药物杂志

Objective To analyze the effect of choprodin tromethamine combined with psychological intervention on clinical prevention and treatment of postpartum hemorrhage. Methods 116 pregnant women with high risk in the first people's hospital in Chun'an county were divided into the control group and the experimental group according to the therapeutic regimen. The control group were received routine treatment, at the basis of routine treatment, the experimental group were given choprodin tromethamine combined with psychological intervention. Postpartum hemorrhage and satisfaction in the two groups were compared and analyzed. Results The incidence of postpartum hemorrhage was 12.07％ in the experimental group, which was significantly lower than 27.58％ in the control group (P<0.05). The nursing satisfaction was 94.83％ in the experimental group, which was significantly higher than 81.03％ in the control group (P<0.05). Conclusion Choprodin tromethamine combined with psychological intervention on the treatment of lying-in woman with high risk of postpartum hemorrhage, can significantly reduce the incidence of postpartum hemorrhage, improve patient satisfaction, the effect is significant which can be applied.

Effect of ketorolac tromethamine preemptive analgesia on inflammatory factors and stress status in patients with knee osteoarthritis / 中国生化药物杂志

Objective To study the ketone luo acid tromethamine analgesia in patients with knee osteoarthritis joint replacement in advance of inflammatory factor and the influence of stress state. Methods Choice for knee osteoarthritis knee joint replacement patients 61 cases, were randomly divided into control group (30 caese) and the observation group (31caese), the control group only received intravenous anesthesia compound epidural block, on the basis of the observation group receied ketone luo acid tromethamine analgesia in advance, the contrast analysis of two groups of patients with preoperative and postoperative VAS score, cytokines and cortisol levels. Results The observation group of patients with postoperative pain VAS score (24 h, 48 h, 72 h) were significantly lower than control group (P<0.05);Observation group with 24h after IL - 8, TNF alpha level significantly lower than the control group (P<0.05), the observation group after 48h of IL-6, IL-8, TNF-a levels were significantly lower than control group (P<0.05).0bservation group 24h after surgery in patients with Cor significantly lower than the control level (P<0.05), after 48 h Cor and ACTH level observation group were significantly lower than the control group (P<0.05).Conclusion Ketone luo acid tromethamine analgesia in advance can obviously relieve knee osteoarthritis pain after joint replacement, and can significantly reduce inflammatory factor levels, reduce the postoperative patients with stress state.

Observation on the curative effect of carboprost tromethamine combined with mifepristone on the treatment of the patients with risky placenta previa / 中国生化药物杂志

Objective Onto observe the curative effect of carboprost tromethamine injection combined with mifepristone on the treatment of the patients with risky placenta previa. Methods 66 cases with placenta previa during mid pregnancy from January 2016 to December 2016 in Dingbian county people's hospital were randomly divided into two groups, 33 cases in the control group and 33 cases in the observation group. All patients were received cesarean section and traditional treatments such as oxytocin and gauze filling. Hemostatic effect, prognosis and incidence of adverse reactions in the two groups were compared. Results The intraoperative bleeding volume, the amount of vaginal bleeding 2 hours after operation and the amount of vaginal bleeding 2 to 24 hours after operation in the observation group were less than those in the control group (P<0.05). The rate of postpartum hemorrhage, the rate of disseminated intravascular coagulation and the incidence of puerperal disease in the observation group were significantly less than those in the control group (P<0.05). The sanguinous lochia time and menstrual recovery time in the observation group were better than those in the control group (P<0.05). There was no significant difference in the rate of hysterectomy and adverse reactions between the two groups. Conclusion Carboprost Tromethamine Injection combined with mifepristone in the treatment of pernicious placenta previa can effectively reduce the bleeding rate and promote the rehabilitation of pregnant women. It is safe and has no obvious adverse reactions. It is worthy of clinical application.

Study on the clinical effect and the influence to coagulation factor of carboprost tromethamine on the treatment of the patients with postpartum hemorrhage / 中国生化药物杂志

Objective To investigate the clinical effect and the influence to coagulation factor of carboprost tromethamine on the treatment of the patients with postpartum hemorrhage. Methods 60 pregnant women with placenta previa complicated with postpartum hemorrhage from May 2016 to March 2017 were randomly divided into the control group (n=30) and the observation group (n=30). The control group were given oxytocin, the observation group were received carboprost tromethamine. Fibrinogen (FIB), prothrombin time (APTT), prothrombin time (PT) and platelet count before and after surgery in the two groups were analyzed by CA7000 automatic blood analyzer. The effect and coagulation indexes in the two groups were compared. Results The clinical curative rate in the observation group was 96.67% and 93.33% in the control group, the differences had no statistically significant. The amount of hemorrhage in postpartum 2h and 24h and the hemoglobin in postpartum 24h in the observation group were less than those in the control group (P<0.05); There was no significant difference about coagulation indexes between the 2 groups before treatment;The platelet count, PT and APTT levels in the observation group were lower than those in the control group, and the level of FIB was higher than that in the control group (P<0.05); The incidence of adverse reaction was 6.67% in the observation group and 10% in the control group, the difference was not statistically significant. Conclusion Choosing carboprost tromethamine to treat placenta prevail complicated with postpartum hemorrhage has a good curative effect, which is helpful to reduce the amount of postpartum hemorrhage and improve the coagulation indexes, so it is worth popularizing