Epidural anesthesia with ropivacaine with or without clonidine and postoperative pain in hemorrhoidectomies

To determine the safety, pain intensity correlated with age and body mass index (BMI), epidural anesthesia with ropivacaine and clonidine in hemorrhoidectomy. METHODS: Eighty patients, both genders, 20-70 years old, ASA I or II, for hemorrhoidectomy were randomly divided into two groups: Control (n=38), epidural anesthesia with 14 mL of ropivacaine 0.75 % plus 0.0266 mL/kg of 0.9% saline solution; Experimental (n=42) epidural anesthesia with 14 mL of 0.75% ropivacaine plus 4.0 mcg/kg of clonidine. In preoperative and postoperative period were evaluated: systolic blood pressure (SBP), diastolic blood pressure (DBP ), heart rate (HR ), pulse oximetry (SpO2), electrocardiography (ECG), pain intensity (VAS ) in four, eight and, 12 hours and analgesic consumption. RESULTS: The VAS values differed between four, eight and 12 hours in the Experimental Group, where correlation of VAS 12h with age (p<0.05) occurred and not with BMI and more patients (p<0.05) did not receive analgesics. SBP, DBP, HR changed similarly in both groups at 15, 30 and 45 min. The ECG and SpO2 remained unchanged. CONCLUSIONS: Clonidine (4mcg/kg) in epidural anesthesia with ropivacaine 0.75% in hemorrhoidectomy showed safety and greater analgesia within four hours. The pain at 12 hours showed correlation with age and not with body mass index.(AU)

Does propofol and isoflurane protect the kidney against ischemia/reperfusion injury during transient hyperglycemia?

PURPOSE: To study the effect of isoflurane (Iso) or propofol (Prop) anesthesia on renal ischemia/reperfusion injury (IRI) during transient hyperglycemia. METHODS: Thirty six rats were randomly assigned into six groups of six animals each: PHS (Sham-Prop=1mg.kg-1.min-1 + Hyperglycemia=2.5g.kg-1 of glucose solution administered intraperitoneally); HIS (Sham-Iso + Hyperglycemia); PHI (Prop + Hyperglycemia + Ischemia); IHI (Iso + Hyperglycemia + Ischemia); PI (Prop + Ischemia), and II (Iso + Ischemia). After 30 minutes of anesthesia induction, right nephrectomy was performed (all animals) and the left renal artery was clamped during 25 minutes (ischemia). The animals were sacrificed after 24 hours and blood collection (to dose creatinine) and left kidney removal were performed for histological analysis, and flow cytometry (FCM): percentage of initial apoptosis (APTi) and viable cells (VC). RESULTS: Serum creatinine (mg/dL) was statistically different in groups PHI (3.60±0.40) and IHI (3.23±1.08), p<0.05. Histological analysis was statistically different in groups PHI (4.0[4.0;5.0]) and IHI (4.5[4.0;5.0]), p<0.05. APTi percentage was statistically different in groups PHI (73.2±7.1), and IHI (48.1±14). VC percentage was statistically different in groups PHI (25.8±6.9) and IHI (38.5±9.2), p<0.05. CONCLUSIONS: Propofol and isoflurane showed the same level of protection against ischemia/reperfusion injury in the normoglycemic groups. Transient hyperglycemia is associated with an increase in IRI.(AU)

A study of interleukin 6 IL-6 and tumor necrosis factor alpha TNF-α serum levels in rats subjected to fecal peritonitis and treated with intraperitoneal ropivacaine / Avaliação dos níveis séricos de interleucina 6 (IL-6) e fator de necrose tumoral TNF-α em ratos submetidos a peritonite fecal e tratado com ropivacaína intraperitoneal

PURPOSE: The objective of this study was to assess the cytokine serum levels of IL-6 and TNF-α in rats subjected to fecal peritonitis and treated with peritoneal lavage with 0.2% ropivacaine by peritoneal lavage. METHODS: We subjected 16 Wistar rats to laparotomy 6 hours after the induction of fecal peritonitis with autogenous stool and subsequently divided the rats randomly into 4 groups: I-control, no treatment; II- drying of the abdominal cavity; III- lavage of the abdominal cavity with 3 mL of 0.9% normal saline and drying; IV- lavage of the abdominal cavity with 3 mL of 0.2% ropivacaine and drying. Six hours following the laparotomy, the animals underwent cardiac puncture, and 1 mL of blood was collected for cytokine assessment before the animals were euthanized. RESULTS: The lavage with ropivacaine resulted in smaller TNF-α levels compared with those observed in the other treatment groups (p <0.05). Regarding IL-6, the ropivacaine group showed lower cytokine levels than those observed in groups I and II, but there was no significant difference (p> 0.05) between groups III and IV. CONCLUSION: Peritoneal lavage with 0.2% ropivacaine was shown to reduce plasma levels of IL-6 and TNF-α in the treatment of fecal peritonitis in rats.(AU)

OBJETIVO: O objetivo do presente estudo foi avaliar as dosagens séricas das citocinas Il-6 e TNF-α em ratos submetidos à peritonite fecal e tratados com lavagem peritoneal com ropivacaína a 0,2%. MÉTODOS: Utilizaram-se 16 ratos Wistar, submetidos à laparotomia 6 horas após a indução de peritonite fecal com fezes autógenas, distribuídos aleatoriamente em 4 grupos: I- Controle, nenhum tratamento; II- Enxugamento da cavidade abdominal; III- Lavagem da cavidade abdominal com 3 ml de solução salina 0,9% e enxugamento; IV- Lavagem da cavidade abdominal com 3 ml de ropivacaína a 0,2% e enxugamento. Seis horas após a laparotomia os animais foram submetidos à punção cardíaca com retirada de 1 mL de sangue para a dosagem das citocinas e, a seguir, eutanasiados. RESULTADOS: A lavagem com ropivacaína apresentou valores de TNF-α menores do que os observados com os outros tratamentos (p<0,05). Em relação aos valores da IL-6, o grupo da ropivacaína apresentou valores menores do que os observados com os grupos I e II, mas não houve diferença estatística (p>0,05) em relação ao grupo III. CONCLUSÃO: A lavagem peritoneal com ropivacaína a 0,2% no tratamento da peritonite fecal em ratos demonstrou reduzir os níveis plasmáticos de IL-6 e do TNF-α.(AU)