ABSTRACT
Wound healing is characterized by a systemic and complex process of cellular and molecular activities. Dipotassium Glycyrrhizinate (DPG), a side product derived from glycyrrhizic acid, has several biological effects, such as being antiallergic, antioxidant, antibacterial, antiviral, gastroprotective, antitumoral, and anti-inflammatory. This study aimed to evaluate the anti-inflammatory effect of topical DPG on the healing of cutaneous wounds by secondary intention in an in vivo experimental model. Twenty-four male Wistar rats were used in the experiment, and were randomly divided into six groups of four. Circular excisions were performed and topically treated for 14 days after wound induction. Macroscopic and histopathological analyses were performed. Gene expression was evaluated by real-time qPCR. Our results showed that treatment with DPG caused a decrease in the inflammatory exudate as well as an absence of active hyperemia. Increases in granulation tissue, tissue reepithelization, and total collagen were also observed. Furthermore, DPG treatment reduced the expression of pro-inflammatory cytokines (Tnf-α, Cox-2, Il-8, Irak-2, Nf-kB, and Il-1) while increasing the expression of Il-10, demonstrating anti-inflammatory effects across all three treatment periods. Based on our results, we conclude that DPG attenuates the inflammatory process by promoting skin wound healing through the modulation of distinct mechanisms and signaling pathways, including anti-inflammatory ones. This involves modulation of the expression of pro- and anti-inflammatory cytokine expression; promotion of new granulation tissue; angiogenesis; and tissue re-epithelialization, all of which contribute to tissue remodeling.
Subject(s)
Anti-Inflammatory Agents , Glycyrrhizic Acid , Wound Healing , Animals , Male , Rats , Anti-Inflammatory Agents/pharmacology , Anti-Inflammatory Agents/therapeutic use , Cytokines/metabolism , Glycyrrhizic Acid/pharmacology , Glycyrrhizic Acid/therapeutic use , Granulation Tissue/metabolism , Rats, Wistar , Skin/metabolism , Wound Healing/drug effectsABSTRACT
PURPOSE: Dipotassium glycyrrhizinate (DPG) has anti-inflammatory properties, besides promoting the regeneration of skeletal muscle. However, it has not been reported on skin wound healing/regeneration. This research aimed to characterize the effects of DPG in the treatment of excisional wounds by second intention. METHODS: Male adults (n=10) and elderly (n=10) Wistar rats were used. Two circular wounds were excised on the dorsal skin. The excised normal skins were considered adult (GAN) and elderly (GIN) naïve. For seven days, 2% DPG was applied on the proximal excision: treated adult (GADPG) and elderly (GIDPG), whereas distal excisions were untreated adult (GANT) and elderly (GINT). Wound healing areas were daily measured and removed for morphological analyses after the 14th and the 21st postoperative day. Slides were stained with hematoxylin-eosin, Masson's trichrome, and picrosirius red. RESULTS: Histological analysis revealed intact (GAN/GIN) and regenerated(GANT/GINT/GADPG/GIDPG) skins. No differences of wounds' size were found among treated groups. Epidermis was thicker after 14 days and thinner after 21 days of DPG administration. Higher collagen I density was found in GIDPG (14th day) and GADPG (21st day). CONCLUSIONS: DPG induced woundhealing/skin regeneration, with collagen I, being more effective in the first 14 days after injury.
Subject(s)
Glycyrrhizic Acid , Wound Healing , Animals , Anti-Inflammatory Agents , Glycyrrhizic Acid/pharmacology , Male , Rats , Rats, Wistar , SkinABSTRACT
ABSTRACT Purpose: Dipotassium glycyrrhizinate (DPG) has anti-inflammatory properties, besides promoting the regeneration of skeletal muscle. However, it has not been reported on skin wound healing/regeneration. This research aimed to characterize the effects of DPG in the treatment of excisional wounds by second intention. Methods: Male adults (n=10) and elderly (n=10) Wistar rats were used. Two circular wounds were excised on the dorsal skin. The excised normal skins were considered adult (GAN) and elderly (GIN) naïve. For seven days, 2% DPG was applied on the proximal excision: treated adult (GADPG) and elderly (GIDPG), whereas distal excisions were untreated adult (GANT) and elderly (GINT). Wound healing areas were daily measured and removed for morphological analyses after the 14th and the 21st postoperative day. Slides were stained with hematoxylin-eosin, Masson's trichrome, and picrosirius red. Results: Histological analysis revealed intact (GAN/GIN) and regenerated(GANT/GINT/GADPG/GIDPG) skins. No differences of wounds' size were found among treated groups. Epidermis was thicker after 14 days and thinner after 21 days of DPG administration. Higher collagen I density was found in GIDPG (14th day) and GADPG (21st day). Conclusions: DPG induced woundhealing/skin regeneration, with collagen I, being more effective in the first 14 days after injury.
Subject(s)
Animals , Male , Rats , Wound Healing , Glycyrrhizic Acid/pharmacology , Skin , Rats, Wistar , Anti-Inflammatory AgentsABSTRACT
ABSTRACT BACKGROUND AND OBJECTIVES: Opioids are drugs used to relieve pain, but may cause increased pain sensitivity, known as opioid-induced hyperalgesia, which adversely affects pain management. This study aimed to check if fentanyl, an opioid widely used in the clinical practice, produces hyperalgesia that can be attenuated by duloxetine, fluoxetine and pregabalin. METHODS: Thirty male Wistar rats were divided into six groups. The animals in group 1 received 1mL of 0.9% saline solution intraperitoneally (IP) and gavage; group 2 received fentanyl at a dose of 100µg.kg-1 IP and 0.9% saline solution per gavage; groups 3, 4 and 5 received fentanyl at the dose of 100µg.kg-1 IP, and gavage with duloxetine, 40mg.kg-1, fluoxetine, 40mg.kg-1 and pregabalin, 40mg.kg-1, respectively. Under general anesthesia with isoflurane, all animals were submitted to plantar surgical incision. The application of Von Frey filaments assessed hyperalgesia at the second hour, one, three, five and seven days after treatment. RESULTS: Two hours after the procedure, no differences were observed between G1 and G2, although G3, G4, and G5 showed less hyperalgesia. On day one and day three, a greater hyperalgesic effect was observed in G2 when compared to G1, G3, G4 and G5. On day five, there was a hyperalgesic effect on G2, and on day seven, there were no differences among the groups. CONCLUSION: The results suggest that fentanyl induces hyperalgesia and the efficacy of duloxetine, fluoxetine, and pregabalin in reducing it.
RESUMO JUSTIFICATIVA E OBJETIVOS: Opioides são fármacos utilizados para o alívio da dor, porém, podem causar aumento da sensibilidade dolorosa, denominada hiperalgesia induzida por opioides, que afeta negativamente o tratamento da dor. O objetivo deste estudo foi avaliar se o fentanil, opioide amplamente utilizado na prática clínica, produz hiperalgesia que pode ser atenuada pela duloxetina, fluoxetina e pregabalina. MÉTODOS: Trinta ratos Wistar machos, foram divididos em 6 grupos. No grupo 1, os animais receberam 1mL de solução fisiológica (SF) a 0,9% por via intraperitoneal (IP) e por gavagem; no grupo 2, fentanil na dose de 100µg.kg-1 IP e SF a 0,9% por gavagem; nos grupos 3, 4 e 5 os animais receberam fentanil na dose de 100µg.kg-1 IP e, por gavagem, receberam respectivamente duloxetina, 40mg.kg-1, fluoxetina, 40mg.kg-1 e pregabalina, 40mg.kg-1. A avaliação da hiperalgesia e sua atenuação foi feita pela aplicação de filamentos de Von Frey, na 2ª hora e nos dias 1, 3, 5 e 7, após o tratamento. RESULTADOS: Na 2ª hora pós-procedimento não foram observadas diferenças entre G1 e G2, entretanto, G3, G4 e G5 se mostraram com menor hiperalgesia. No 1º e 3º dias foi observado maior efeito hiperalgésico em G2 quando comparado com G1, G3, G4 e G5. No 5º dia foi observado efeito hiperalgésico no G2, e no 7º dia não houve diferenças entre os grupos. CONCLUSÃO: Os resultados sugerem que o fentanil induz hiperalgesia e eficácia da duloxetina, fluoxetina e pregabalina na sua redução.
ABSTRACT
Lesões endo-perio são lesões inflamatórias que acometem, em diversos graus, tanto os tecidos periodontais como a polpa dental. O objetivo deste artigo é mostrar, através de uma revisão da literatura, a importância da classificação das lesões endo-perio, assim como o diagnóstico dessas lesões. A partir dos trabalhos revisados, conclui-se que as lesões endo-perio apresentam uma etiologia variada, sendo de fundamental importância o conhecimento do profissional quanto às causas e seu correto diagnóstico. Assim, para o sucesso e a resolução das lesões endo-perio, uma avaliação clínica e radiográfica eficaz determinará a correta classificação e, consequentemente, a melhor forma de tratamento.
Endo-periodontal lesions are inflammatory conditions that affect the periodontal tissues and the dental pulp. The aim of this article is to show the importance of the classification and the diagnosis of the endo-perio lesions. From the studies reviewed, it is concluded that endo-perio lesions present a varied etiology, being of fundamental importance the knowledge of the professional as to its causative factors and its correct diagnosis. Thus, for the success and resolution of endo-perio lesions an effective clinical and radiographic evaluation will determine the correct classification and consequently the best form of treatment.
Subject(s)
Humans , Male , Female , Dental Pulp Cavity/diagnostic imaging , Dental Pulp Cavity/injuries , Dental Pulp Diseases/classification , Dental Pulp Diseases/diagnosis , Dental Pulp/injuries , Periodontal DiseasesABSTRACT
ABSTRACT BACKGROUND AND OBJECTIVES: Self-mutilation is a self-destruction behavior elicited by the desire of self-punishment which may be unconscious and has major impact on individuals' lives. This study aimed at identifying pain intensity which satisfies self-mutilation need the most, in addition to triggering and rewarding factors. METHODS: Cohort study, carried out by means of a questionnaire with participation of 20 patients aged above 18 years, treated in a Psychiatry ambulatory of a medium-sized city of Vale do Paraiba. RESULTS: Participants were aged between 16 and 60 years, being 85% females. Depression was the most prevalent disease and sadness was the triggering factor. With regard to feelings, 65% have answered being relieved and the period with large number of occurrences was at night. As to pain intensity according to pain numerical scale, 45% have reported no pain, 35% mild pain, 15% moderate and 5% severe pain. However, when considering pain interpreted outside the moment of crisis, 5% have reported no pain, 45% moderate pain and 50% severe pain. CONCLUSION: The prevalence of self-mutilation was higher among young females with some psychiatric disorder and the period with large number of occurrences was at night. Pain intensity was low to mild, especially as compared to patients' evaluation outside the moment of crisis.
RESUMO JUSTIFICATIVA E OBJETIVOS: A automutilação é um comportamento de autodestruição oriundo de um desejo de se punir que pode ser inconsciente e apresenta grande impacto na vida do indivíduo. O presente estudo teve como objetivo identificar a intensidade dolorosa que mais satisfaz a necessidade da automutilação, assim como os fatores desencadeantes e gratificantes. MÉTODOS: Estudo de coorte, realizado mediante resposta a um questionário com participação de 20 pacientes com idade superior a 18 anos; atendidos em ambulatório de Psiquiatria, de uma clínica de uma cidade de médio porte do Vale do Paraíba. RESULTADOS: Os participantes do estudo apresentavam idade entre 16 e 60 nos, sendo 85% do gênero feminino. A depressão foi a doença mais prevalente e o fator desencadeante foi a tristeza. Em relação ao sentimento alcançado, 65% responderam obter alívio e o período do dia de maior ocorrência foi o noturno. Quanto a intensidade dolorosa, segundo a escala numérica de dor, 45% relataram ausência de dor, 35% dor leve, 15% moderada e 5% intensa. Porém, ao se considerar a dor interpretada fora do momento da crise, 5% relatou ausência de dor, 45% dor moderada e 50% intensa. CONCLUSÃO: A prevalência da automutilação foi maior em mulheres, jovens, portadoras da algum transtorno psiquiátrico e o período do dia de maior ocorrência ocorreu a noite. Quanto a percepção dolorosa, foi de baixa a leve intensidade, principalmente se comparadas ao que o paciente avalia para o mesmo fenômeno fora das crises.
ABSTRACT
INTRODUCTION: The purpose of this study was to evaluate the clinical relevance of high values of central venous-to-arterial carbon dioxide difference (PCO2 gap) in high-risk surgical patients admitted to a postoperative ICU. We hypothesized that PCO2 gap could serve as a useful tool to identify patients still requiring hemodynamic optimization at ICU admission. METHODS: One hundred and fifteen patients were included in this prospective single-center observational study during a 1-year period. High-risk surgical inclusion criteria were adapted from Schoemaker and colleagues. Demographic and biological data, PCO2 gap, central venous oxygen saturation, lactate level and postoperative complications were recorded for all patients at ICU admission, and 6 hours and 12 hours after admission. RESULTS: A total of 78 (68%) patients developed postoperative complications, of whom 54 (47%) developed organ failure. From admission to 12 hours after admission, there was a significant difference in mean PCO2 gap (8.7 ± 2.8 mmHg versus 5.1 ± 2.6 mmHg; P = 0.001) and median lactate values (1.54 (1.1-3.2) mmol/l versus 1.06 (0.8-1.8) mmol/l; P = 0.003) between patients who developed postoperative complications and those who did not. These differences were maximal at admission to the ICU. At ICU admission, the area under the receiver operating characteristic curve for occurrence of postoperative complications was 0.86 for the PCO2 gap compared to Sequential Organ Failure Assessment score (0.82), Simplified Acute Physiology Score II score (0.67), and lactate level (0.67). The threshold value for PCO2 gap was 5.8 mmHg. Multivariate analysis showed that only a high PCO2 gap and a high Sequential Organ Failure Assessment score were independently associated with the occurrence of postoperative complications. A high PCO2 gap (≥6 mmHg) was associated with more organ failure, an increase in duration of mechanical ventilation and length of hospital stay. CONCLUSION: A high PCO2 gap at admission in the postoperative ICU was significantly associated with increased postoperative complications in high-risk surgical patients. If the increase in PCO2 gap is secondary to tissue hypoperfusion then the PCO2 gap might be a useful tool complementary to central venous oxygen saturation as a therapeutic target.
Subject(s)
Blood Gas Analysis/methods , Carbon Dioxide/blood , Catheterization, Central Venous/methods , Postoperative Complications/blood , Postoperative Complications/diagnosis , Aged , Female , Humans , Male , Middle Aged , Postoperative Complications/etiology , Prognosis , Prospective Studies , Risk Factors , Thoracic Surgical Procedures/adverse effectsABSTRACT
BACKGROUND AND OBJECTIVES: Painful phenomenon is one of the most important and complex experiences. Phentolamine is a non-selective alpha-adrenergic antagonist. The objective of this study was to compare the effect of increasing doses of phentolamine into subarachnoid space in rats in the modulation of painful phenomenon. METHODS: 84 male Wistar rats were divided into formalin and plantar incision groups, subdivided into six subgroups (n = 7). Control group received only saline (10 µL); active subgroups received phentolamine 10 µmg (GF10), 20 mg (GF20), 30 mg (GF30), 40 mg (GF40), and 50 g (GF50). In formalin group, pain was induced by injection of 50 µL of 2% formalin in dorsal region of right posterior paw. In plantar incision group, pain was induced by plantar incision and evaluated using von Frey filaments. Induction and maintenance of anesthesia were performed with 3% halothane for catheter placement into subarachnoid space and plantar incision. Statistical analysis was performed using the JMP program from SAS with 5% significance level. RESULTS: Phentolamine at doses of 20 and 30 g increased the algesic response in the intermediate phase of the formalin test. In plantar incision test, it had hyperalgic effect on first, third, fifth, and seventh days at a dose of 10 g and on first, third, and fifth days at a dose of 20 g and on fifth day at a dose of 30 g. CONCLUSION: Subarachnoid administration of phentolamine showed hyperalgesic effect, possibly due to the involvement of different subclasses of alpha-adrenergic receptors in modulating pain pathways. .
JUSTIFICATIVA E OBJETIVOS: O fenômeno doloroso é uma das mais importantes e complexas experiências. A fentolamina é antagonista alfa-adrenérgico não seletivo. O objetivo foi comparar os efeitos de doses crescentes da fentolamina, por via subaracnóidea, em ratos na modulação do fenômeno doloroso. MÉTODO: Foram usados 84 ratos Wistar machos, divididos nos grupos formalina e incisão plantar, subdivididos em seis subgrupos (n = 7). No subgrupo controle (GC) apenas salina (10 µL), nos subgrupos ativos, 10 µg de fentolamina (GF10), 20 µg (GF20), 30 µg (GF30), 40 µg (GF40) e 50 µg (GF50). No grupo formalina, a dor foi induzida com injeção de 50 µL de formalina a 2%, na região dorsal da pata posterior direita. No grupo incisão plantar, a dor foi induzida por incisão plantar e avaliação pelos filamentos de Von Frey. Indução e manutenção anestésica com halotano a 3% para introdução de cateter no espaço subaracnóideo e feitura da incisão plantar. Análise estatística dos resultados pelo programa JMP do SAS com nível de significância 5%. RESULTADOS: A fentolamina nas doses de 20 e 30 µg produziu aumento da resposta álgica na fase intermediária do teste da formalina. No teste da incisão plantar, promoveu efeito hiperálgico no primeiro, terceiro, quinto e sétimo dias na dose de 10 µg, no primeiro, terceiro e quinto dias na dose de 20 µg e no quinto dia na dose de 30 µg. CONCLUSÃO: A fentolamina por via subaracnóidea promoveu efeito hiperálgico, possivelmente pela participação de diferentes subclasses de receptores alfa-adrenérgicos nas vias modulatórias da dor. .
JUSTIFICACIÓN Y OBJETIVOS: El fenómeno doloroso es una de las más importantes y complejas experiencias. La fentolamina es un antagonista alfaadrenérgico no selectivo. El objetivo fue comparar los efectos de dosis crecientes de fentolamina por vía subaracnoidea en la modulación del fenómeno doloroso en ratones. MÉTODO: Fueron usados 84 ratones Wistar machos, divididos en los grupos formalina e incisión plantar, subdivididos en 6 subgrupos (n = 7). En el subgrupo control (GC) solamente se administró solución salina (10 µL); en los subgrupos activos, 10 µg de fentolamina (GF10), 20 µg (GF20), 30 µg (GF30), 40 µg (GF40) y 50 µg (GF50). En el grupo formalina, el dolor fue inducido con una inyección de 50 µL de formalina al 2% en la región dorsal de la pata posterior derecha. En el grupo incisión plantar, el dolor se indujo por incisión plantar y evaluación por los filamentos de Von Frey. La inducción y el mantenimiento anestésico se llevó a cabo con halotano al 3% para la introducción de catéter en el espacio subaracnoideo y la realización de la incisión plantar. El análisis estadístico de los resultados se hizo mediante el programa JMP(r) del SAS con un nivel de significación del 5%. RESULTADOS: La fentolamina en las dosis de 20 y 30 µg produjo un aumento de la respuesta de dolor en la fase intermedia del test de la formalina. En el test de la incisión plantar, generó un efecto hiperalgésico en el primero, tercero, quinto y séptimo días con dosis de 10 µg; en el primero, tercero y quinto días con dosis de 20 µg; y en el quinto día con dosis de 30 µg. CONCLUSIÓN: La fentolamina por vía subaracnoidea generó un efecto hiperalgésico posiblemente por la participación de diferentes subclases de receptores alfaadrenérgicos en las vías moduladoras del dolor. .
Subject(s)
Animals , Rats , Phentolamine/pharmacology , Pain Measurement/methods , Sweating, GustatoryABSTRACT
BACKGROUND AND OBJECTIVES: Painful phenomenon is one of the most important and complex experiences. Phentolamine is a non-selective alpha-adrenergic antagonist. The objective of this study was to compare the effect of increasing doses of phentolamine into subarachnoid space in rats in the modulation of painful phenomenon. METHODS: 84 male Wistar rats were divided into formalin and plantar incision groups, subdivided into six subgroups (n=7). Control group (CG) received only saline (10µL); active subgroups received phentolamine 10µmg (GF10), 20mg (GF20), 30mg (GF30), 40mg (GF40), and 50g (GF50). In formalin group, pain was induced by injection of 50µL of 2% formalin in dorsal region of right posterior paw. In plantar incision group, pain was induced by plantar incision and evaluated using Von Frey filaments. Induction and maintenance of anesthesia were performed with 3% halothane for catheter placement into subarachnoid space and plantar incision. Statistical analysis was performed using the JMP program from SAS with 5% significance level. RESULTS: Phentolamine at doses of 20 and 30g increased the algesic response in the intermediate phase of the formalin test. In plantar incision test, it had hyperalgic effect on first, third, fifth, and seventh days at a dose of 10g and on first, third, and fifth days at a dose of 20g and on fifth day at a dose of 30g. CONCLUSION: Subarachnoid administration of phentolamine showed hyperalgesic effect, possibly due to the involvement of different subclasses of alpha-adrenergic receptors in modulating pain pathways.
ABSTRACT
BACKGROUND AND OBJECTIVE: to evaluate the clinical, hemodynamic, gas analysis and metabolic repercussions of high transient pressures of pneumoperitoneum for a short period of time to ensure greater security for introduction of the first trocar. METHODS: sixty-seven patients undergoing laparoscopic procedures were studied and randomly distributed in P12 group: n=30 (intraperitoneal pressure [IPP] 12mmHg) and P20 group: n=37 (IPP of 20mmHg). Mean arterial pressure (MAP) was evaluated by catheterization of the radial artery; and through gas analysis, pH, partial pressure of oxygen (PaO2), partial pressure of CO2 (PaCO2), bicarbonate (HCO3) and alkalinity (BE) were evaluated. These parameters were measured in both groups at time zero before pneumoperitoneum (TP0); at time 1 (TP1) when IPP reaches 12mmHg in both groups; at time 2 (TP2) after five min with IPP=12mmHg in P12 and after 5min with IPP=20mmHg at P20; and at time 3 (TP3) after 10min with IPP=12mmHg in P12 and with return of IPP from 20 to 12mmHg, starting 10min after TP1 in P20. Different values from those considered normal for all parameters assessed, or the appearance of atypical organic phenomena, were considered as clinical changes. RESULTS: there were statistically significant differences in P20 group in MAP, pH, HCO3 and BE, but within normal limits. No clinical and pathological changes were observed. CONCLUSIONS: high and transient intra-abdominal pressure causes changes in MAP, pH, HCO3 and BE, but without any clinical impact on the patient.
Subject(s)
Blood Pressure , Pneumoperitoneum, Artificial , Adult , Aged , Bicarbonates/blood , Female , Humans , Hydrogen-Ion Concentration , Male , Middle Aged , Oxygen/blood , Pressure , Prospective StudiesABSTRACT
BACKGROUND AND OBJECTIVES: Drug administration to children is a widely spread practice, however it may lead to several health problems, because in addition to medical guidance it requires attention of parents and caregivers. This study aimed at identifying the prevalence of drug administration in children by their tutors, before medical assistance. METHODS: This is a quantitative descriptive research involving adults who were escorting children, before medical assistance in a Children's First Aid Unit of a medium-sized city of the Vale do Paraíba Paulista in the months of June, July and August 2011, being data recorded by means of a specific form. RESULTS: Participated in the study 105 adults responsible for the children who reported that 71.42% of children were medicated before medical assistance and only 28.58% have not adopted such practice. Most frequent symptom was fever, present in 40% of participants, and drugs used were paracetamol and dipirone. CONCLUSION: Our results allow concluding that there has been a high rate of drug administration to children before medical assistance, with predominance of non-steroid anti-inflammatory drugs, which may be noxious to health. It is clear the need for the adoption of measures which favor the access to health services, in addition to the awareness about the risk of administering drugs without medical prescription. .
JUSTIFICATIVA E OBJETIVOS: A administração de fármacos na criança é uma prática amplamente difundida, porém pode levar a inúmeros prejuízos à saúde, pois além da orientação médica, exige atenção dos pais e cuidadores. O objetivo deste estudo foi identificar a prevalência da administração de fármacos na criança, por seus responsáveis, previamente ao atendimento médico. MÉTODOS: Trata-se de uma pesquisa quantitativa descritiva, envolvendo adultos que acompanhavam as crianças antes do atendimento médico em um Pronto Socorro Infantil de um município de médio porte do Vale do Paraíba Paulista, nos meses de junho, julho e agosto de 2011, sendo os dados registrados por meio de um formulário específico. RESULTADOS: Participaram do estudo 105 adultos responsáveis pelas crianças que relataram que 71,42% das crianças foram medicadas previamente ao atendimento médico e apenas 28,58% não adotaram essa prática. O principal sintoma citado foi febre, presente em 40% dos participantes, e os fármacos mais utilizados foram o paracetamol e a dipirona. CONCLUSÃO: Os resultados obtidos permitem concluir que houve um alto índice de administração de fármacos nas crianças previamente ao atendimento médico, com predomínio dos anti-inflamatórios não esteroides, fármacos esses que podem causar lesões à saúde. Evidencia-se a necessidade de adoção de medidas que favoreçam o acesso aos serviços de saúde, além da conscientização sobre os riscos da administração de fármacos sem a devida prescrição médica. .
ABSTRACT
Justificativa e objetivo: avaliar as repercussões clínicas, hemodinâmicas, gasométricas e metabólicas das altas pressões transitórias do pneumoperitônio por curto período de tempo que garantem maior segurança para a introdução do primeiro trocarte. Métodos: foram estudados 67 pacientes submetidos a procedimentos videolaparoscópicos e aleatoriamente distribuídos em grupo P12: n = 30 (pressão intraperitoneal [PIP] de 12 mmHg) e grupo P20: n = 37 (PIP de 20 mmHg). Foram avaliados a pressão arterial média (PAM), por cateterismo da artéria radial; e, mediante gasometria, o pH, a pressão parcial de oxigênio arterial (PaO2), a pressão parcial de CO2 arterial (PaCO2), o bicarbonato (HCO3) e a reserva alcalina (BE). Esses parâmetros foram avaliados em ambos os grupos no tempo zero, antes do pneumoperitônio (TP0); no tempo um (TP1), quando a PIP atinge 12 mmHg em ambos os grupos; no tempo dois (TP2), após cinco minutos com PIP de 12 mmHg em P12 e após cinco minutos com PIP de 20 mmHg em P20; e no tempo três (TP3), após 10 minutos com PIP de 12 mmHg em P12 e com PIP retornada de 20 mmHg para 12 mmHg, contados 10 minutos após TP1 em P20. Os valores diferentes dos considerados normais para os parâmetros aquilatados ou o surgimento de fenômenos orgânicos atípicos foram considerados alteracões clínicas. Resultados: ocorreram diferenças estatísticas significantes no grupo P20 na PAM, no pH, no HCO3 e na BE, mas dentro dos limites da normalidade. Não foram evidenciadas alterações clínicas e patológicas. Conclusões: pressão intra-abdominal alta e transitória causa alterações da PAM, do pH, do HCO3 e da BE sem que haja repercussão clínica no paciente. .
Background and objective: to evaluate the clinical, hemodynamic, gas analysis and metabolic repercussions of high transient pressures of pneumoperitoneum for a short period of time to ensure greater security for introduction of the first trocar. Methods: sixty-seven patients undergoing laparoscopic procedures were studied and randomly distributed in P12 group: n = 30 (intraperitoneal pressure [IPP] 12 mmHg) and P20 group: n = 37 (IPP of 20 mmHg). Mean arterial pressure (MAP) was evaluated by catheterization of the radial artery; and through gas analysis, pH, partial pressure of oxygen (PaO2), partial pressure of CO2 (PaCO2), bicarbonate (HCO3) and alkalinity (BE) were evaluated. These parameters were measured in both groups at time zero before pneumoperitoneum (TP0); at time 1 (TP1) when IPP reaches 12mmHg in both groups; at time 2 (TP2) after five min with IPP = 12mmHg in P12 and after 5 min with IPP = 20mmHg at P20; and at time 3 (TP3) after 10 min with IPP = 12mmHg in P12 and with return of IPP from 20 to 12mmHg, starting 10min after TP1 in P20. Different values from those considered normal for all parameters assessed, or the appearance of atypical organic phenomena, were considered as clinical changes. Results: there were statistically significant differences in P20 group in MAP, pH, HCO3 and BE, but within normal limits. No clinical and pathological changes were observed. Conclusions: high and transient intra-abdominal pressure causes changes in MAP, pH, HCO3 and BE, but without any clinical impact on the patient. .
Justificación y objetivo: evaluar las repercusiones clínicas, hemodinámicas, gasométricas y metabólicas de las altas presiones transitorias del neumoperitoneo durante un corto período de tiempo para garantizar una mayor seguridad en la introducción del primer trocar. Métodos: fueron estudiados 67 pacientes sometidos a procedimientos videolaparoscópicos y distribuidos aleatoriamente en grupo P12: n = 30 (presión intraperitoneal [PIP] de 12 mmHg), y grupo P20: n = 37 (PIP de 20 mmHg). Se evaluó la presión arterial media por cateterismo de la arteria radial; y mediante gasometría, el pH, la presión parcial de oxígeno arterial, la presión parcial de CO2 arterial, el bicarbonato y la reserva alcalina. Esos parámetros fueron evaluados en ambos grupos en el tiempo cero, antes del neumoperitoneo (TP0); en el tiempo uno (TP1), cuando la PIP alcanza 12 mmHg en ambos grupos; en el tiempo 2 (TP2), después de 5 min con PIP de 12 mmHg en P12 y después de 5 min con PIP de 20 mmHg en P20; y en el tiempo 3 (TP3), después de 10 min con PIP de 12 mmHg en P12 y con PIP de retorno desde 20 mmHg a 12 mmHg, contados 10 min después de TP1 en P20. Los valores diferentes de los considerados normales para los parámetros medidos o el surgimiento de fenómenos orgánicos atípicos fueron considerados alteraciones clínicas. Resultados: hubo diferencias estadísticas significativas en el grupo P20 en la presión arterial media, en el pH, en el bicarbonato y en la reserva alcalina, pero dentro de los límites de la normalidad. No se evidenciaron alteraciones clínicas ni patológicas. Conclusiones: la presión intraabdominal alta y transitoria causa alteraciones de la presión arterial media, del pH, del bicarbonato y de la reserva alcalina sin repercusiones clínicas para el paciente. .
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Blood Pressure , Pneumoperitoneum, Artificial , Bicarbonates/blood , Hydrogen-Ion Concentration , Oxygen/blood , Pressure , Prospective StudiesABSTRACT
JUSTIFICATIVA E OBJETIVOS: O planejamento da analgesia no tratamento da dor aguda pós-operatória é fundamental para o seu controle efetivo, pois quando não tratada acarreta alterações nocivas ao organismo. Este estudo teve como objetivo analisar a mudança na prescrição de analgésicos no período pós-operatório de cirurgias gerais antes e após a apresentação de simpósio e o fornecimento de manual sobre tratamento da dor. MÉTODO: Estudo prospectivo com 45 pacientes, com idade entre 18 e 70 anos, submetidos a cirurgias gerais, avaliando a efetividade da analgesia pós-operatória pela aplicação da escala numérica da dor e análise da prescrição dos analgésicos, antes e após a apresentação de palestra e o fornecimento de manual sobre tratamento da dor pós-operatória, para os médicos assistentes, residentes e internos da Clinica Cirúrgica de um hospital escola de médio porte. RESULTADOS: No grupo controle, a intensidade da dor foi 3,64 ± 3,2 na 1ª hora, 4,24 ± 2,9 em 12 horas, 4,84 ± 2,2 em 24 horas e 4,08 ± 2,3 em 48 horas. No grupo pós-estudo, a intensidade da dor foi 2,85 ± 2,8 em 1 hora, 2,90 ± 2,7 em 12 horas 2,25 ± 2,6 em 24 horas e 1,95 ± 2,4 em 48 horas. Não houve diferença estatística significativa entre as diferentes horas do mesmo grupo, mas existiu uma diferença entre a 24ª hora do grupo controle em relação ao grupo estudo (p < 0,001), e entre a 48ª hora de grupo controle em relação ao grupo estudo (p < 0,005). CONCLUSÃO: A intervenção proposta gerou mudanças discretas nas prescrições analgésicas pós-operatórias, porém suficientes para proporcionar diminuição na intensidade da dor em alguns momentos do estudo.
BACKGROUND AND OBJECTIVES: Analgesic planning to manage acute postoperative pain is critical for its effective control, because if untreated it brings noxious changes to the body. This study aimed at analyzing the change in analgesics prescription in the postoperative period of general surgeries before and after the presentation of a symposium and the distribution of a pain management manual. METHOD: This was a prospective study with 45 patients aged between 18 and 70 years, submitted to general surgeries, to evaluate the effectiveness of postoperative analgesia via the pain numerical scale, and to analyze analgesics prescription before and after a presentation and the distribution of a postoperative pain management manual for assistant, resident and internship physicians of the Surgical Clinic of a medium-sized teaching hospital. RESULTS: Pain intensity in the control group was 3.64 ± 3.2 in the 1st hour, 4.24 ± 2.9 within 12 hours, 4.84 ± 2.2 within 24 hours and 4.08 ± 2.3 within 48 hours. Pain intensity in the post-study group was 2.85 ± 2.8 in 1 hour, 2.90 ± 2.7 within 12 hours, 2.25 ± 2.6 within 24 hours and 1.95 ± 2.4 within 48 hours. There has been no statistically significant difference among different hours for the same group, however there has been a difference between the 24th hour of the control group as compared to the study group (p < 0.001) and between the 48th hour of the control group as compared to the study group (p < 0.005). CONCLUSION: The proposed intervention has generated mild changes in postoperative analgesics prescription, however enough to provide pain intensity decrease in some studied moments.
Subject(s)
Analgesia , General Surgery , Pain MeasurementABSTRACT
JUSTIFICATIVA E OBJETIVOS: O planejamento da analgesia no tratamento da dor aguda pós-operatória é fundamental para o seu controle efetivo, pois quando não tratada acarreta alterações nocivas ao organismo. Este estudo teve como objetivo analisar a mudança na prescrição de analgésicos no período pós-operatório de cirurgias ginecológicas antes e após a apresentação de simpósio e o fornecimento de manual sobre tratamento da dor. MÉTODO: Estudo prospectivo com 72 pacientes, com idade entre 18 e 80 anos, submetidas à cirurgias ginecológicas, avaliando a efetividade da analgesia pós-operatória pela aplicação da escala numérica da dor e análise da prescrição dos analgésicos, antes e após a apresentação de palestra e o fornecimento de manual sobre tratamento da dor pós-operatória, para os médicos assistentes, residentes e internos da Clínica de Ginecologia de um hospital escola de médio porte. RESULTADOS: A intensidade da dor na 1ªh de pós-operatório foi de 3,62 ± 2,48 no grupo 1; 3,62 ± 3,65 no grupo 2; 2,58 ± 1,93 no grupo 3 (p = 0,33). Na 12ªh, a intensidade da dor foi de 3,62 ± 2,28, no grupo 1; 3,91 ± 3,26, no grupo 2; 3,50 ± 2,14, no grupo 3 (p = 0,85). Na 24ªh, a média da intensidade da dor foi de 2,35 ± 1,98, no grupo 1; 3,70 ± 2,75, no grupo 2; 2,95 ± 1,65, no grupo 3 (p = 0,12). Na 48ªh, a média da intensidade variou de 3,00 ± 1,82, no grupo 1; 3,44 ± 1,81, no grupo 2; 3, 33 ± 1,36, no grupo 3 (p = 0,90). Conforme observado, não houve diferenças estatisticamente significantes entre as etapas na 1ª, 12ª, 24ª e 48ªh pós-operatória. CONCLUSÃO: A intervenção proposta não gerou alterações estatisticamente significantes, porém a combinação analgésica multimodal utilizada proporcionou analgesia adequada.
BACKGROUND AND OBJECTIVES: The planning of analgesia to treat acute postoperative pain is critical for its effective control, because if untreated it brings noxious changes for the body. This study aimed at analyzing the change in analgesics prescription in the postoperative period of gynecological surgeries before and after a symposium and the distribution of a pain treatment manual. METHOD: This is a prospective study with 72 patients aged between 18 and 80 years, submitted to gynecological surgeries, to evaluate the effectiveness of postoperative analgesia by the pain numerical scale and analgesics prescription before and after a presentation and the distribution of a postoperative pain treatment manual to assistant physicians, residents and intern physicians of the Gynecology Clinic of a medium-sized teaching hospital. RESULTS: Pain intensity in the first postoperative hour was 3.62 ± 2.48 for group 1; 3.62 ± 3.65 for group 2; 2.58 ± 1.93 for group 3 (p = 0.33). In the 12th hour, pain intensity was 3.62 ± 2.28, for group 1; 3.91 ± 3.26, for group 2; 3.50 ± 2.14, for group 3 (p = 0.85). In the 24th hour, mean pain intensity was 2.35 ± 1.98, for group 1; 3.70 ± 2.75, for group 2; 2.95 ± 1.65, for group 3 (p = 0.12). In the 48th hour, mean intensity has varied from 3.00 ± 1.82, for group 1; 3.44 ± 1.81, for group 2; 3.33 ± 1.36, for group 3 (p = 0.90). As observed, there have been no statistically significant differences between stages in the 1st, 12th, 24th e 48th postoperative hour. CONCLUSION: Proposed intervention has not brought statistically significant changes, however the multimodal analgesic combination used has provided adequate analgesia.
Subject(s)
Analgesia , General Surgery , Gynecology , Pain MeasurementABSTRACT
JUSTIFICATIVA E OBJETIVOS: Os inibidores seletivos da recaptação de serotonina como a fluoxetina, têm sido apontados como alternativa ao uso dos antidepressivos tricíclicos para o tratamento da dor crônica, pela menor incidência de efeitos colaterais. O objetivo deste estudo foi estudar o efeito da serotonina na modulação da dor aguda, pela administração de fluoxetina, por meio do teste da formalina, em ratos, anteriormente submetidos à constrição do nervo ciático. MÉTODO: Foram estudados 24 ratos Wistar, machos, com peso médio de 300 g, distribuídos em 5 grupos: 1. Controle sem tratamento; 2. Constrição do nervo ciático; 3. Constrição do nervo ciático tratados com 5 mg.kg-1.dia de fluoxetina, por via oral durante 15 dias; 4. Constrição do nervo ciático tratados com 5 mg.kg-1 de reserpina, por via oral a cada 72h e com 5 mg.kg-1.dia de fluoxetina por via oral, durante 15 dias; 5. Constrição do nervo ciático tratados com 5 mg.kg-1 de reserpina por via oral em intervalos de 72h, durante 15 dias. Todos os animais foram submetidos ao teste da formalina modificado após os tratamentos especificados. RESULTADOS: A resposta na fase I, na fase intermediária e na fase II do teste da formalina não foi alterada pela constrição do ciático. O tratamento com reserpina ou fluoxetina não interferiu com as fases I e intermediária do teste da formalina nos grupos submetidos à constrição do ciático. O número de elevações da pata na fase II do teste da formalina aumentou nos animais tratados com fluoxetina e diminuiu nos animais tratados com reserpina. Nos animais tratados com a associação reserpina e fluoxetina houve redução do número de elevações da pata em comparação com os animais tratados apenas com a fluoxetina. CONCLUSÃO: O tratamento com fluoxetina aumentou a sensação dolorosa após estímulo agudo em ratos submetidos à constrição do ciático, evidenciando ação algogênica do fármaco neste modelo experimental.
BACKGROUND AND OBJECTIVES: Selective serotonin reuptake inhibitors, such as fluoxetine, have been suggested as alternative to tricyclic antidepressants to treat chronic pain, due to the lower incidence of side effects. This study aimed at observing the effects of serotonin on acute pain modulation, by the administration of fluoxetine through the formalin test in rats previously submitted to sciatic nerve constriction. METHOD: We used 24 male Wistar rats, with mean weight of 300 g and distributed in 5 groups: 1. Control untreated; 2. Sciatic nerve constriction; 3. Sciatic nerve constriction and treated with 5 mg.kg-1.day oral fluoxetine for 15 days; 4. Sciatic nerve constriction treated with 5 mg.kg-1 oral reserpine every 72 hours and with 5 mg.kg-1.day oral fluoxetine for 15 days; 5. Sciatic nerve constriction treated with 5 mg.kg-1 oral reserpine every 72 hours for 15 days. All animals were submitted to modified formalin test after treatment. RESULTS: Response in the phase I, intermediate and phase II formalin test was not changed by sciatic nerve constriction. Treatment with reserpine or fluoxetine has not interfered with first and intermediate formalin test phases in the groups submitted to sciatic nerve constriction. The number of flinches in the second formalin test phase has increased in animals treated with fluoxetine and has decreased in animals treated with reserpine. There has been decrease in the number of flinches in animals treated with the association reserpina and fluoxetine as compared to animals treated with fluoxetine alone. CONCLUSION: Fluoxetine has increased painful sensation after acute stimulation in rats submitted to sciatic nerve constriction, showing the algogenic action of the drug in this experimental model.
Subject(s)
Animals , Rats , Fluoxetine , Pain , Pain Measurement , Reserpine , Sciatic NerveSubject(s)
Humans , Female , Pregnancy , Child , Adult , Anesthesiology/education , Airway Management/methods , Respiratory TherapyABSTRACT
JUSTIFICATIVA E OBJETIVOS: Diversos estudos têm demonstrado os efeitos benéficos dos ácidos graxos ômega-3 à saúde: no metabolismo lipídico, promovendo redução nos níveis plasmáticos dos triacilgliceróis, aumento de HDL colesterol e, ação anti-inflamatória ao reduzir a síntese de derivados do ácido araquidônico: prostaglandina E2 (PGE2), tromboxano A2 (TXA2), prostaciclina (PGI2) e leucotrieno B4. Portanto, há de se supor que a suplementação com ácidos graxos EPA e DHA(?-3), pode atenuar os efeitos do processo inflamatório a partir da diminuição da síntese dos eicosanoides, assim como a utilização indiscriminada dos anti-inflamatórios.O presente estudo teve como objetivo comparar o efeito analgésico e anti-inflamatório, entre a suplementação dietética com ácido graxo ômega-3 (?-3) e tenoxicam em ratos.MÉTODO: Participaram do estudo 18 ratos Wistar machos,pesando entre 220 e 300 g, distribuídos em três grupos (n = 6): Grupo controle (GC), Grupo tenoxicam (GT) e o Grupo ômega-3 (GO) para receberem respectivamente 0,2 mL de solução fisiológica, 1 mg.kg-1.dia-1 de tenoxicam e 200 mg.kg-1.dia-1 de ácido graxo ômega-3 diariamente, por gavagem. Após duas semanas de tratamento,foi realizado o teste da formalina e observação da resposta nociceptiva, já que à segunda fase do teste se atribui liberação de mediadores endógenos locais, que geram resposta inflamatória local, responsável pela sensibilização de aferentes primários e de neurônios medulares subsequente a ativação de nociceptores. A análise estatística dos resultados obtidos foi realizada utilizando o programa JMP do SAS, adotando o nível de significância de 5%.RESULTADOS: Os grupos tenoxicam e ômega-3 não apresentaram diferenças estatisticamente significantes quando comparados entre si nas fases do teste da formalina modificado. Não obstante, apresentaram menor resposta álgica, com significância estatística, na segunda fase do teste da formalina quando comparados com o GC.CONCLUSÃO: Os resultados demonstraram efeito anti-inflamatório comparável entre o emprego de tenoxicam e a suplementação dietética com ácido graxo ômega-3, sugerindo que o uso da suplementação dietética com ácido graxo ômega-3 poderá ser de grande valia,principalmente nos processos crônicos, onde o emprego de anti-inflamatórios não esteroides se relaciona a maior morbidade principalmente no sistema digestivo e renal.
BACKGROUND AND OBJECTIVES: Several studies have shown the beneficial effects of Omega-3 fatty acids on health: on the lipid metabolism promoting plasma triglycerol levels decrease, increase in HDL cholesterol and anti-inflammatory action by decreasing arachidonic acid derivatives synthesis: prostaglandin E2(PGE3), tromboxane A2 (TXA2), prostacyclin (PGI2) and leukotriene B4. So, it is supposed that supplementation with EPA and DHA (?-3) fatty acids may attenuate inflammatory process effects by decreasing eiocosanoids synthesis as well as the indiscriminate use of anti-inflammatory drugs. This study aimed at comparing the analgesic / anti-inflammatory effect of dietary supplementation with omega-3 fatty acid (?-3) and tenoxicam in rats.METHOD: Participated in this study 18 male Wistar rats,weighing between 220 and 300 g, distributed in 3 groups(n = 6): Control group (CG), tenoxicam group (TG) and Omega group (OG), to receive, respectively 0.2 mL saline,1 mg.kg1.day-1 tenoxicam and 200 mg.kg-1.day-1 omega-3 fatty acid per day by gavage. Formalin test was performed after two weeks of treatment and nociceptive response was observed, since release of local endogenous mediators is attributed to the second phase, which generates local inflammatory response, responsible for the sensitization of primary afferents and of medullar neurons subsequent to the activation of nociceptors. Statistical analysis of results was performed with the SAS JMP program,adopting significance level of 5%.RESULTS: Tenoxicam and omega-3 groups were not statistically different when compared in the modified formalin test phase. However, they showed less painful response, with statistical significance, in the second formalin test phase as compared to CG.CONCLUSION: Results have shown comparable anti-inflammatory effect between tenoxicam and dietary supplementation with omega-3 fatty acid, suggesting that dietary supplementation with omega-3 fatty acid may be very useful, especially for chronic processes where the use of non-steroid anti-inflammatory drugs is associated to higher morbidity especially of the digestive and renal systems.
Subject(s)
Animals , Rats , Inflammation , Pain , RatsABSTRACT
JUSTIFICATIVA E OBJETIVOS: Diversos sistemas de receptores estão envolvidos na modulação central da dor: noradrenérgico, serotoninérgico e opioide, entre outros. O objetivo foi estudar os efeitos da amitriptilina sobre a modulação da dor em ratos, após ligadura do nervo ciático.MÉTODO: Foram estudados 24 ratos Wistar, machos,com peso médio de 300g, distribuídos em 5 grupos: (C) controle sem tratamento (n = 4), (LC) submetidos à ligadurado nervo ciático (n = 5), submetidos à ligadura do nervo ciático e tratados com: (A) amitriptilina (n = 5), (R) com reserpina (n = 5), (AR) com reserpina + amitriptilina.Todos os animais foram submetidos ao teste da formalina modificado.RESULTADOS: A ligadura do nervo ciático reduziu a resposta nociceptiva. O tratamento com reserpina não interferiu com a resposta álgica na fase 1 do teste da formalina. A amitriptilina restaurou a resposta álgica nafase 1 do teste da formalina, indicando potencialização da nocicepção periférica, e reduziu o número das elevações das patas durante a fase intermediária do teste daformalina, na ausência ou na presença de reserpina, indicando potencialização da resposta da via descendente inibitória da dor. A ligadura do ciático reduziu a respostana fase 2 do teste da formalina. A amitriptilina restauroua resposta anteriormente observada.CONCLUSÃO: O tratamento com amitriptilina e reserpina permite sugerir que no modelo de lesão neural periférica, a noradrenalina participa da transdução do sinal lesivo, na modulação da via descendente inibitória da dor e na nocicepção induzida pelo processo inflamatório. A participação dos outros mediadores da resposta inflamatória e da serotonina deve ser considerada.
BACKGROUND AND OBJECTIVES: Different receptor systems are involved with central pain modulation: noradrenergic, serotoninergic and opioid among others. This study aimed at evaluating amitriptyline effects on pain modulation in rats submitted to sciatic nerve ligation.METHOD: The sample was made up of 24 male Wistarr ats, mean weight of 300g, which were distributed in 5 groups: (C) control without treatment (n =4), (LC) submitted to sciatic nerve ligation (n = 5),submitted to sciatic nerve ligation and treated with:(A) amitriptyline (n = 5), (R) reserpine (n = 5), (AR) reserpine + amitriptyline. All animals were submittedto modified formalin test.RESULTS: Sciatic nerve ligation has decreased nociceptive response. Reserpine administration has not interfered with pain response in formalin test phase 1. Amitriptyline has restored pain response in formalin test phase 1, indicating peripheral nociception potentiation, and has decreased the number of flinches during the intermediate formalin test phase, in the absence or presence of reserpine, indicating potentiation of pain response inhibitory descending way. Sciatic nerve ligation has decreased response in formalin test phase 2. Amitriptyline has restored previously observed response.CONCLUSION: Treatment with amitriptyline and reserpine allows suggesting that in the peripheral neural injury model, norepinephrine participates in the injuring signal transduction, in the pain inhibitory descending way modulation and in the inflammation-induced nociception. The participation of other inflammatory response mediators and of serotonin should be considered.
ABSTRACT
BACKGROUND AND OBJECTIVES: There is evidence that the passage of nociceptive information through the posterior horn of the spinal cord (PHSC) on its way to rostral levels of the central nervous system undergoes profound excitatory and inhibitory influences. The objective of the present study was to compare the effects of the subarachnoid administration of methysergide, phentolamine, and phentolamine associated with methysergide on phases I, intermediate, and II of the modified formalin test in rats. METHODS: Twenty-eight male Wistar rats distributed randomly in four groups (n=7) to received subarachnoid saline solution (GC), phentolamine (GF), methysergide (GM), or phentolamine associated with methysergide (GFM). Pain was induced by the administration of formalin in the dorsal region of the right hind paw. The test was divided in three phases: phase I, intermediate, and phase II. Statistical analysis of the results was performed using the software SPSS (Statistical Package for Social Sciences), adopting a level of significance of 5%. RESULTS: In the intermediate phase the number of paw elevations was significantly higher in GF, GM, and GFM groups when compared to the GC group. CONCLUSIONS: The results suggest the existence of a noradrenergic and serotonergic effect in the inhibitory descending system of acute pain, with the possibility of using serotonergic and α1-adrenergic antagonists to control acute pain.