Comparison of local anesthetic effects of tramadol with prilocaine during circumcision procedure.

OBJECTIVES: To compare the local anesthetic effects of tramadol hydrochloride with prilocaine for circumcision procedure. METHODS: This study included 40 patients with American Surgical Association-I scores. Patients were randomly allocated to receive either 5% tramadol (2 mg/kg) plus adrenaline (0.0125/mL) (group 1, n = 20) or 2% prilocaine plus adrenaline (0.0125/mL) (group 2, n = 20). The degree of burning sensation and pain at the injection site were documented. Sensory block was assessed 1 minute after injection and the patients were asked to grade touch and pinprick sensation. Five minutes after drug administration, incision was performed and intensity of pain, felt by the patient was evaluated on a 4-point scale (0-3). Pain at the injection site and local skin reactions were also recorded. RESULTS: Mean ages were 9.7 and 10.3 years for groups 1 and 2, respectively. Mean duration of surgery was 19.6 minutes. In control visit, 2 of 20 (10%) in group 1 and 10 of 20 (50%) children in group 2 reported extra need for oral ibuprofen (P <.05). First analgesic medication time was 9.5 (+/- 2.1) hours in group 1 and 8.7 (+/- 3.1) hours in group 2 (P >.05). Total postoperative ibuprofen consumptions were 10 and 50 mg for groups 1 and 2, respectively (P <.05). CONCLUSIONS: A combination of tramadol 5% plus adrenaline can provide a safe and effective local anesthesia during circumcision procedure and postoperative period in children.

The effect of CAPE on lipid peroxidation and nitric oxide levels in the plasma of rats following thermal injury.

Both experimental and clinical studies have shown that oxygen-derived free radicals rise in the plasma after thermal injury and participate in the pathogenesis of tissue damage. Hence, various antioxidant molecules have been used in treatment of burn injury both experimentally and clinically. Caffeic acid phenethyl ester (CAPE), an active component of propolis from honeybee hives, is known to have potent antioxidant property. The purpose of the present study was to investigate the effects of CAPE on oxidative stress in plasma of burned rats. Experiment was designed in three groups of rats with 20% full-thickness burn: (a) sham burn (n = 7); (b) burn only (n = 22); (c) burn + treatment with CAPE (n = 22). Plasma levels of malondialdehyde (MDA), nitric oxide (NO) and the activities of xanthine oxidase (XO), and superoxide dismutase (SOD) were used as both bio-indicators of oxidant status and determinant of antioxidant effect of CAPE. They were assessed by biochemical methods at 1st, 3rd, 7th, and 14th post-burn days. In conclusion, CAPE was shown to possess antioxidant activity by saving SOD activity, preventing XO activity and decreasing the levels of MDA, and NO. Our study showed that CAPE may be beneficial in burn injury.

The value of scintimammography in reduction mammaplasties: a preliminary study.

Reduction mammaplasty results in architectural distortion, fat necrosis, and heavy scarring of the breast. In such conditions, mammography (MG) might not be reliable and an alternative unfailing imaging technique is demanded to prevent unnecessary apprehension and biopsy. With this study, the value of Tc-99m sestamibi (MIBI) scintimammography (SCM) as an adjunct test after reduction mammaplasty was explored. MIBI scintigraphy is not affected by scar tissue or breast density and is able to differentiate benign and malignant lesions. The study was conducted on 12 women undergoing a reduction mammaplasty operation (McKissock technique). The average age was 38 and the average weight of breast tissue removed from each breast was 320 g. All patients, except one who was 21 years old, underwent MG and SCM preoperatively, and these tests were repeated at the sixth postoperative month. Preoperative MG and SCM revealed no pathology except a finding in one patient consistent with fibroadenoma. Postoperatively, the most common findings in MG were parenchymal redistribution, elevation of the nipple, and retroareolar fibrotic bands. Calcifications and oil cysts were not seen. Other findings were areola and skin thickening. Interestingly, these findings were not evident on the SCM, in fact it was not possible to state whether or not the breast had been operated on. In conclusion, SCM may not be used as screening test, but it should be considered when the postoperative MG is not informative or is complicated by scaring. In this condition, SCM may be used as a complementary method to MG and may help to prevent unnecessary breast biopsies.