ABSTRACT
BACKGROUND: One of the most common devastating problems that occur after urethroplasty is erection, which causes surgical complications (fistula, wound dehiscence, and surgical graft failure) and the need for repairing the complications. We attempted to compare the effect of continuous epidural infusion of dexmedetomidine and ropivacaine as a post-surgical erection prevention strategy. OBJECTIVES: In this study, we aimed to compare the effect of dexmedetomidine and ropivacaine epidural infusion on the incidence of erection after reconstructive urethral surgery. METHODS: An RCT was conducted on 45 patients who were scheduled for reconstructive urethral surgery. They were randomly divided into three groups: (1) control (n = 15), (2) epidural dexmedetomidine (n = 15), (3) and epidural ropivacaine (n = 15). The control group received oral medication after surgery according to the conventional method (cyproterone compound tablets 50 mg BD and diazepam tablets 2 mg TDS for a week) to prevent erection. The DEX group received dexmedetomidine as continuous epidural infusion, and the ROP group received ropivacaine in addition to the conventional method. The occurrence of erection during day and night was recorded separately until the seventh day after surgery. Due to the long-time interval between case selection, participants from different groups were not matched with each other. RESULTS: The incidence of erection in the dexmedetomidine group was lower than that in the ropivacaine group per person (0.87) and significantly lower than in the control group (2.8 per person). Also, there was significantly less erection in the ropivacaine group (1.2 per person) than in the control group. Our study showed that erection after surgery significantly decreased with the continuous epidural infusion of dexmedetomidine and ropivacaine. CONCLUSIONS: Dexmedetomidine seems to have a significant preventive effect on erection after reconstructive urethral surgery.
ABSTRACT
Propofol is a short-acting intravenous anesthetic that is commonly used for induction and maintenance of anesthesia. Subanesthetic low doses of propofol has also been used to treat intractable migraine attacks in emergency wards with dramatic results. However, there is little information on the long-term efficacy of this drug in migraine headaches. The aim of this nonrandomized prospective observational study was to assess the effect of propofol anesthesia on the pain severity and frequency of migraine attacks in a 6-month follow-up period after anesthesia in patients with migraine headaches. The study was conducted on 51 known cases of migraine ranging in age from 21 to 66 years. Before anesthesia, patients completed a questionnaire including their characteristics, pain intensity of the headache using a visual analog scale, and a number of headache repetitions per month. All patients received propofol as the main anesthetic agent. At the end of anesthesia, the total amount of propofol usage was recorded. Patients were then followed up by telephone in the first, third, and sixth months after anesthesia, and the severity and frequency of the headache were recorded. Pain intensity or pain frequency significantly improved in 22 patients (43.1%), remained unchanged in 24 (47%), and worsened in 5 cases (9.8%) 6 months after anesthesia compared to before the anesthesia. In conclusion, since about half of the patients had significant improvement in the headache, propofol anesthesia may be considered as an acceptable anesthetic method in patients with migraine.
ABSTRACT
INTRODUCTION: The present study was designed to clarify the effects of resveratrol (RSV) on social behavioral alterations and nociceptive reactivity in valproic acid (VPA)-induced autistic-like model in female and male rats. METHODS: Pregnant Wistar rats were randomly divided in five groups. Animals received saline, DMSO, VPA, RSV and RSV + VPA. VPA was administered (600 mg/kg, i. p.) on embryonic day 12.5 (E12.5) and pretreatment by resveratrol (3.6 mg/kg, s. c.) was applied on E6.5 until E18.5. All offspring were weaned on postnatal day 21 and the experiments were done in male and female rats on day 60. Social interaction, hot plate and tail flick tests were set out to assess social deficits and pain threshold, respectively. Sociability index (SI), Social novelty index (SNI) and latency time were calculated as the standard indices of social behaviors and pain threshold, respectively. RESULTS: The results indicated that systemic intraperitoneal administration of VPA (600 mg/kg) significantly decreased SI and SNI in social interaction test (SIT) especially in male rats, indicating the social impairments caused by VPA. RSV (3.6 mg/kg, s. c.) reversed VPA-induced social deficits in male rats, but not in female group. VPA administration resulted in significant increase in latency time in the hot plate and tail flick tests in male rats, whereas it had no such dramatic effect in females. RSV administration in combination with VPA had no significant effect on latency time compared to the valproic acid group in male rats. It is important to note that RSV by itself had no significant effect on SI, SNI and latency time in female and male rats. CONCLUSION: It can be concluded that valproic acid produces autistic-like behaviors and increases pain threshold in male rats which may be ameliorated at least in part by resveratrol administration. Further studies are needed to elucidate the molecular mechanisms involved in valproic acid and resveratrol-induced effects.
