Comparison of the pharmacological properties of 0.375% bupivacaine with epinephrine, 0.5% ropivacaine and a mixture of bupivacaine with epinephrine and lignocaine - a randomized prospective study.

One of the methods of anesthesia for orthopedic and plastic procedures for the upper limb is the brachial plexus block. The aim of the study was to compare the pharmacodynamic and pharmacokinetic properties of three commonly used local anesthetic solutions used for axillary brachial plexus blockade. Sixty patients scheduled for surgery of the upper limb were enrolled for the study. 3 different local anesthetic solutions: 0.375% bupivacaine with epinephrine (group B), 0.5% ropivacaine (group R) and a mixture of 0.5% bupivacaine with epinephrine and 2% lignocaine in a 1:1 ratio (group BL) were used to anesthesia. The study assessed the delay time of sensory and motor blockade and the duration of sensory and motor anesthesia of the operated limb. There were no significant differences in the onset of sensory block between the study groups. In the BL group, the onset of the motor block was significantly shorter than in group B and group R. The duration of the sensory and motor blockade was significantly longer in group B and group R than in the group BL. The solution of 0.375% bupivacaine with epinephrine and 0.5% ropivacaine used for axillary brachial plexus anesthesia provide the same level of the block. Addition of short acting local anesthetic - lignocaine to long acting bupivacaine decreases the time to onset of motor blockade, but also shortens the duration of the sensory and motor blockade in the post-operative period, compared to long acting local anesthetics of higher potency: bupivacaine with epinephrine or ropivacaine.

[Analysis of body composition with the use of bioimpedance in children with type 1 diabetes]. / Analiza skladu ciala z uzyciem metody bioimpedancji u dzieci z cukrzyca typu 1.

INTRODUCTION: Patients with diagnosed type 1 diabetes are a group particularly exposed to cardiovascular complications related to obesity. According to some previous data, one of the useful methods to analyze body composition may be a method of bioelectrical impedance. AIM OF THE STUDY: The aim of this research was to make an attempt of finding a correlation between anthropometric indicators and results of lipids profile and data obtained from bioelectrical impedance tests in children with diabetes. MATERIAL AND METHODS: The research sample comprised of 104 children with diabetes type 1 and 313 children without diabetes (a reference group). Anthropometric measurements were made in both groups. Furthermore data from lipids profile results was collected, as well as data from bioelectrical impedance analysis, such as: percentage and quantity (in kilograms) content of adipose tissue, fat-free body mass and total water content in the body. RESULTS: The tested and the reference groups were not different in respect of percentage content of adipose tissue, fat mass, fat-free body mass and total water content in the body. Substantially lower fat mass was noticed among children with overweight or obesity and diabetes than in the control children with overweight/obesity. In the whole sample a connection between percentage fat content and fat mass and standardized body mass index and waist circumference was noticed. The connection was stronger in the reference group, than among children with diabetes. Correlation between percentage content of adipose tissue with the fraction HLD-cholesterol and LDL-cholesterol and values of blood pressure were observed in the whole sample. CONCLUSIONS: The results of our research the confirm correlation between anthropometric parameters and the data collected from bioelectrical impedance. Those connections are, however, stronger in the group of children without diabetes than with diabetes, which questions the usefulness of this method in evaluation of adipose tissue among children treated with insulin.