Effective analgesic dose of dexamethasone after painless abortion.

BACKGROUND AND PURPOSE: Dexamethasone is known to produce analgesic effects, but the optimal analgesic dosage of dexamethasone remains unclear, especially in patients without postoperative use of other analgesics. The purpose of this study was to explore the effective analgesic dose of dexamethasone in day surgery patients undergoing painless abortion. METHODS: 287 patients undergoing painless abortion were randomly assigned to one of four groups: control group receiving saline and dexamethasone groups receiving 0.1, 0.15, or 0.2 mg/kg dexamethasone. Drugs were intravenously injected 30 min before induction of anesthesia. All patients underwent the same anesthesia procedure using propofol and remifentan. The visual analogue scale (VAS) scores and occurrence of nausea, vomiting and drug-induced side effects were recorded at 1, 2 and 24 h after operation. RESULTS: There were no significant differences in patient's clinical characteristics, surgical features and frequency of occurrence of nausea and vomiting among the four groups (P > 0.05). The VAS scores at rest and during coughing at 2 h after operation (time of discharge from the hospital) were significantly lower in patients receiving 0.2 mg/kg dexamethasone compared with control patients (P < 0.05). CONCLUSION: Intravenous injection of 0.2 mg/kg dexamethasone before induction of anesthesia can significantly reduce the VAS scores at 2 h after painless abortion.

Influence of lateral decubitus positioning after combined use of hyperbaric and hypobaric ropivacaine on hemodynamic characteristics in spinal anesthesia for caesarean section.

PURPOSE: Positioning of the patient during and after surgery can have significant implications on recovery. Therefore, the purpose of the present study was to determine the influence of placing patients in a lateral decubitus position for 15 min after combined use of hyperbaric and hypobaric ropivacaine and assess hemodynamic characteristics during spinal anesthesia for caesarean section. METHODS: One hundred-forty patients undergoing elective cesarean delivery with combined use of hyperbaric and hypobaric ropivacaine were included in the present study. Patients meeting inclusion criteria (134) were randomly allocated into Group A: immediately turned to the supine position after induction of spinal anesthesia (n = 67) or Group B: maintained in a lateral decubitus position for 15 min before being turned to the supine position (n = 67). Primary endpoints of the study were to compare hemodynamic characteristics and sensory blockade levels in the two groups, while a secondary endpoint was to observe the incidence of complications. RESULTS: Both groups showed similar effects of the combined anesthetic treatment. Incidence of hypotension (43% vs 18%, P = 0.001), systolic AP < 90 mmHg (36% vs. 16%, P = 0.011), usage of ephedrine (43% vs. 18%, P = 0.001) and the total dose of ephedrine [0 (0-24) vs 0 (0-18), P = 0.001] were significantly higher in Group A compared to Group B. Group A had a higher incidence of nausea compared to Group B (25% vs 7%, P = 0.005). CONCLUSIONS: Combined use of hyperbaric and hypobaric ropivacaine had satisfactory anesthetic effects and a more stable hemodynamic characteristic than either drug used alone. Maintaining the patient in a lateral decubitus position for 15 min can significantly decrease the incidence of hypotension.

[Influence of transfection with human transforming growth factor-beta1 gene on the osteogenic potential of the cultured human gingival fibroblast].

OBJECTIVE: To study the influence of transfection with human transforming growth factor-beta1 (hTGF-beta1) gene on the osteogenic potential and differentiation of the cultured human gingival fibroblast (GF). METHODS: Enzyme kinetics method was used to measure the effects of the transfection on the alkaline phosphatase (ALP) activity. Immunohistochemistry stain and image analysis were applied to evaluate the alteration of the content of osteopontin (OPN), bone sialoprotein (BSP), osteonectin (ON), osteocalcin (OC) in the GF with transfection. Mineralization nodules formation in vitro was also used. RESULTS: The ALP activity of the GF after transfection was higher than the GF without transfection significantly (P<0.05), and was close to that of the PDLCs (P>0.05). The content of OC in GF was not improved after transfection, was similar with that of PDLCs (P>0.05). Under immunohistochemistry stain, the contents of OPN, ON, BSP expressed in GF with transfection were higher than those of GF without transfection (P<0.05), but similar to those of PDLCs (P>0.05). In the mineralized cultured medium, the nodules were observed in the GF with transfection and PDLCs after 21 days and 24 days alternatively. After von Kossa stain, purple mineralization nodules were observed. CONCLUSION: The GF transfected with pcDNA3-hTGF-beta1 could express some osteogenic characters, though these characters are restricted.

[Effects of gingival fibroblasts transfected with human transform growth factor-beta1 gene on improving the periodontal tissue regeneration].

OBJECTIVE: To evaluate the effects of gingival fibroblasts (GF) transfected with hTGF-beta1 gene on improving the periodontal tissue regeneration for the repair of degree II artificial furcation defects. METHODS: The gingival fibroblasts transfected with hTGF-beta1 gene was compounded to the cuttlebone-transformed nanometer hydroxyapatite (CBHA) material from the cuttlefish in vitro, the degree II furcation defects on the premolars of dogs were produced surgically, and the compound was to implanted into the defect (transfected group), and compared with the compound of periodontal ligament cells (PDLC) with nanometer HA material and the compound of untransfected GF with HA. The results were examined histologically 8 weeks after operation. RESULTS: In the transfected group and the positive control group, more new attachment was found compared with the negative control (P < 0.01), and the NC, NB and NC of the transfected group and the positive control group were: (2.97 +/- 0.50), (4.29 +/- 0.26) and (4.73 +/- 0.06) mm; (3.09 +/- 0.26), (4.46 +/- 0.25) and (4.69 +/- 0.10) mm, respectively. There was no significant difference between the two groups (P > 0.05). Although the alveolar bone regeneration was found in the untransfected group [NB = (3.46 +/- 0.32) mm], the root resorption was observed. The tracing experiment showed that the transfected GF were found in the new alveolar bone and the periodontal membrane. CONCLUSIONS: GF transfected with hTGF-beta1 gene can significantly improve the periodontal tissue regeneration in treatment of degree II furcation defects and is involved in the formation of the new alveolar bone and the new periodontal membrane.