A Single Preoperative Administration of Dexamethasone, Low-dose Pregabalin, or a Combination of the 2, in Spinal Surgery, Does Not Provide a Better Analgesia Than a Multimodal Analgesic Protocol Alone.

OBJECTIVES: A single perioperative dose of glucocorticoid or gabapentinoid, or a combination of the 2, may improve postoperative analgesia, but data are still insufficient to be conclusive. In this single-center, randomized, double-blind, and double-dummy trial, we aimed to test whether the analgesic effect of adding preoperative pregabalin, at a dose unlikely to induce side effects, to preoperative dexamethasone improves early mobilization after spinal surgery. MATERIALS AND METHODS: A total of 160 patients undergoing scheduled lumbar disk surgery (145 analyzed) comprised the study cohort. The patients received either 0.2 mg/kg intravenous dexamethasone before incision, or 150 mg oral pregabalin 1 hour before surgery, or a combination of the 2, or none of the above (control). Analgesia was supplemented by acetaminophen and ketoprofen, plus oxycodone ad libitum. The primary outcome was pain intensity during the first attempt to sit up, assessed the morning of the first postoperative day on an 11-point Numerical Rating Scale. Pain at rest and when standing up, opioid consumption, and tolerance were also assessed. RESULTS: None of the treatments tested differed from the control group in terms of efficacy or tolerance, even 6 months after surgery. The overall quality of analgesia was good, with only 10% and 30% of pain scores exceeding 3/10 for pain at rest and during movement, respectively. DISCUSSION: In this surgical model with the given anesthetic and analgesic environment, there was no advantage gained by adding low-dose pregabalin or dexamethasone. The multimodal analgesic protocol applied to all patients may have reduced the size of the effect.

Climate and atmosphere simulator for experiments on ecological systems in changing environments.

Grand challenges in global change research and environmental science raise the need for replicated experiments on ecosystems subjected to controlled changes in multiple environmental factors. We designed and developed the Ecolab as a variable climate and atmosphere simulator for multifactor experimentation on natural or artificial ecosystems. The Ecolab integrates atmosphere conditioning technology optimized for accuracy and reliability. The centerpiece is a highly contained, 13-m(3) chamber to host communities of aquatic and terrestrial species and control climate (temperature, humidity, rainfall, irradiance) and atmosphere conditions (O2 and CO2 concentrations). Temperature in the atmosphere and in the water or soil column can be controlled independently of each other. All climatic and atmospheric variables can be programmed to follow dynamical trajectories and simulate gradual as well as step changes. We demonstrate the Ecolab's capacity to simulate a broad range of atmospheric and climatic conditions, their diurnal and seasonal variations, and to support the growth of a model terrestrial plant in two contrasting climate scenarios. The adaptability of the Ecolab design makes it possible to study interactions between variable climate-atmosphere factors and biotic disturbances. Developed as an open-access, multichamber platform, this equipment is available to the international scientific community for exploring interactions and feedbacks between ecological and climate systems.

The respiratory metabolism of a lizard (Lacerta vivipara) in supercooled and frozen states.

We investigated the respiratory metabolism of the overwintering lizard Lacerta vivipara while in either supercooled or frozen states. With a variable pressure and volume microrespirometer and a chromatograph, we show that the oxygen consumption of the supercooled animals showed a nonlinear relationship with temperature and an aerobic metabolism demand between 0.5 and -1.5 degrees C. A significant increase in the respiratory quotient (RQ) values indicated an increasing contribution by the anaerobic pathways with decreasing temperature. In the frozen state, two phases are easily detectable and are probably linked to the ice formation within the body. During the first 5-6 h, the animals showed an oxygen consumption of 3.52 +/- 0.28 microl. g(-1). h(-1) and a RQ value of 0.52 +/- 0.09. In contrast, after ice equilibrium, oxygen consumption decreased sharply (0.55 +/- 0.09 microl. g(-1). h(-1)) and the RQ values increased (2.49 +/- 0.65). The present study confirms the fact that supercooled invertebrates and vertebrates respond differently to subzero temperatures, in terms of aerobic metabolism, and it shows that aerobic metabolism persists under freezing conditions.