The effect of additional propofol on intubation conditions.

STUDY OBJECTIVE: To evaluate whether an additional dose of propofol prior to intubation improves intubation conditions. DESIGN: Prospective, randomized, double-blinded clinical study. SETTING: Operating room in university hospital. PATIENTS: 102 ASA physical status I and II patients undergoing elective surgery with general anesthesia. INTERVENTIONS: Patients received different doses of propofol (Groups A and B, 1.5 mg/kg; Group C, 2 mg/kg) preceded by fentanyl (1.5 µg/kg). In Group B, additional propofol (0.5 mg/kg) was administered 45 seconds after rocuronium. Intubation was performed 90 seconds after administration of rocuronium 0.6 mg/kg. Intubation conditions and hemodynamic variables were compared among the three groups. MEASUREMENTS AND MAIN RESULTS: Intubation conditions were acceptable in 61.8% of Group A patients, 58.8% of Group C patients, and 91.1% of Group B patients (P = 0.005). Mean arterial pressure (MAP) three minutes after intubation was significantly lower in Group C (P = 0.006 vs. Groups A and B), while MAP did not differ between Group A and Group B. CONCLUSIONS: Administration of an additional dose of propofol (0.5 mg/kg) prior to intubation may significantly improve intubation conditions without increasing the frequency of hypotension.

Effect of topical fluoroquinolones on the expression of matrix metalloproteinases in the cornea.

BACKGROUND: Matrix metalloproteinases play an important role in extracellular matrix deposition and degradation. Based on previous clinical observations of corneal perforations during topical fluoroquinolone treatment, we decided to evaluate the comparative effects of various fluoroquinolone eye drops on the expression of matrix metalloproteinases (MMPs) in cornea. METHODS: Eighty female Lewis rats were divided into two experimental groups: intact and wounded corneal epithelium. Uniform corneal epithelial defects were created in the right eye with application of 75% alcohol in the center of the tissue for 6 seconds. The treatment groups were tested as follows: 1) Tear drops: carboxymethylcellulose sodium 0.5 % (Refresh, Allergan); 2) Ciprofloxacin 0.3% (Ciloxan, Alcon); 3) Ofloxacin 0.3%(Ocuflox, Allergan); 4) Levofloxacin 0.5%(Quixin, Santen). Eye drops were administered 6 times a day for 48 hours. Rats were sacrificed at 48 hours. Immunohistochemical analysis and zymography were conducted using antibodies specific to MMPs-1, 2, 8 and 9. RESULTS: MMP-1, MMP-2, MMP-8 and MMP-9 expression were detected at 48 hrs in undebrided corneal epithelium groups treated with the topical fluoroquinolones. No statistical difference was observed in quantitative expression of MMPs among ciprofloxacin 0.3%, ofloxacin 0.3%, levofloxacin 0.5%. When the artificial tear group and the fluoroquinolone groups with corneal epithelial defect were compared, increased expression of MMPs was observed as a result of the wound healing process. However, the fluoroquinolone treated group exhibited high statistically significantly levels of MMPs expression. CONCLUSIONS: Our study provides preliminary evidence that topical application of fluoroquinolone drugs can induce the expression of MMP-1, MMP-2, MMP-8 and MMP-9 in the undebrided corneal epithelium compared to artificial tear eye drops.