ABSTRACT
The effect of a locally infiltrated solution of bupivacaine was studied in 30 patients undergoing haemorrhoidectomy. A standard Milligan-Morgan haemorrhoidectomy, with preoperative infiltration of adrenaline solution (1:200,000), was performed. The patients were randomized to receive local four quadrant perianal infiltration of 20 ml of 0.5% bupivacaine or normal saline. Analgesia was available on demand postoperatively. There was no significant difference between the groups with respect to visual analogue pain scores, analgesic requirement, time to first bowel action or duration of hospital stay. Bupivacaine as a local infiltration in this situation does not confer analgesic effect into the postoperative period.
Subject(s)
Bupivacaine/administration & dosage , Hemorrhoids/surgery , Pain, Postoperative/drug therapy , Adult , Aged , Double-Blind Method , Female , Humans , Male , Middle Aged , Pain Measurement , Treatment OutcomeABSTRACT
The mechanism of weight loss after small intestinal bypass was studied in Wistar rats. Weight loss after 90 per cent bypass was twice that after equivalent small-bowel resection. This was not due to differences in absorption, as faecal fat and energy excretion were equally increased after both procedures. However, when resected rats were pair fed with bypassed animals, their weight curves were identical, suggesting that diminished food intake was responsible for the increased weight loss after bypass. Anaerobic organisms were rarely found in normal small bowel but were present in high concentrations in the bypassed segment. Metronidazole administration significantly reduced weight loss after bypass, but not after resection. Cephalexin had no effect. These results suggest that approximately half the weight loss occurring after bypass is due to shortening of small bowel. The remainder can be accounted for by reduced food intake as a result of anaerobic overgrowth of the long excluded segment of bowel.
Subject(s)
Body Weight , Ileum/surgery , Intestine, Small/microbiology , Jejunum/surgery , Anaerobiosis , Animals , Energy Metabolism , Feces/analysis , Lipids/analysis , Male , Rats , Rats, Inbred StrainsABSTRACT
A controlled trial of intraperitoneal noxytiolin (Noxiflex) solution in patients with peritonitis due to perforated appendicitis is reported. No significant difference was found in the incidence of complications between the treated and a control group, raising doubts as to whether this substance is of value when used intraperitoneally in peritonitis.
