A Prospective Double-Blind Comparative Clinical Study Between Caudal Levobupivacaine (0.125%) with Clonidine and Ropivacaine (0.125%) with Clonidine on Post-Operative Analgesia in Paediatric Patients Undergoing Infra-Umbilical Surgery.

INTRODUCTION: Caudal epidural block is a reliable technique in paediatric patients but associated with various complications especially with higher concentration of drugs. We proposed a comparative study between levobupivacaine and ropivacaine at low concentration (0.125%) with clonidine at low dose (1 mcg/kg) taken as adjuvant. We aimed to see duration of post-operative analgesia, degree of motor blockade and other associated complications. MATERIALS AND METHODS: Eighty paediatric patients (1-6 years), American society of anaesthesiologists grade I and II, undergoing infra-umbilical surgery under general anaesthesia were randomly allocated into two groups of 40 each. Group A patients were given caudal levobupivacaine (0.125%) and Group B patients were given caudal ropivacaine (0.125%). Clonidine (1 mcg/kg) was taken as adjuvant in both the groups. Post-operative pain, sedation and motor blockade were assessed at 30 minutes, 1 hour, 2 hours, 4 hours, 6 hours, 12 hours, 18 hours and 24 hours using Observational Pain Scale, modified Bromage Scale and four-point sedation score, respectively. Any other complications were also noted. RESULTS: Motor blockade was not associated with any of the patients. Duration of post-operative sedation was similar in both the groups. Duration of post-operative analgesia was significantly higher in Group A (p < 0.0001). Adverse effects and complications were negligible in both the groups. CONCLUSION: Both levobupivacaine and ropivacaine can be used safely at low concentration (0.125%) taking clonidine at low dose (1 mcg/kg) as adjuvant in paediatric caudal epidural block without significant motor blockade and other complications, duration of post-operative analgesia being significantly higher in the levobupivacaine group.

Role of semi-purified andrographolide from Andrographis paniculata extract as nano-phytovesicular carrier for enhancing oral absorption and hypoglycemic activity / 中草药·英文版

Objective: Andrographis paniculata is a well-known medicinal plant in Southeast Asia, India and China. The plant contains andrographolide (AN), a very important phytochemical used in various health problems. However, AN is low in oral absorption bioavailability of AN due to the rapid clearance and high protein binding capacity. Methods: The present study was aimed to develop a nano-phytovesicular formulation of semi-purified AN extracts from a naturally occurring phospholipid (soya phosphatidylcholine) in order to increase the oral absorption and antihyperglycemic activity in rats. Results: The nano-phyto vesicle of semi-purified AN extracts equivalent to 25 mg /kg AN significantly protected the hyperglycemic condition of rats. The in vitro and in vivo experiments results proved that the nano- phytovesicular system of plant extracts containing AN produced better oral absorption, bioavailability and improved antihyperglycemic activity compared with that of free AN at dose of 50 mg/kg. Conclusion: Hence, the prepared semi-purified extract nano-phytovesicular system is helpful in solving the problem of rapid clearance of AN.