The comparison of the effects of different doses of levobupivacaine infiltration on wound healing.

UNLABELLED: INTRODUCTION-AIM: The easiest method in postoperative analgesia is the infiltration of the wound with local anesthetic drugs. Although many local anesthetic drugs have been used for this type of infiltration, studies on levobupivacaine are rare. The aim of this study was to investigate the effects of different concentrations of levobupivacaine infiltration on wound healing. METHOD: Forty female Wistar-Albino rats (280-300 g) were included in the study, which were randomly separated into four groups. Rats were infiltrated with 1.25 mg/mL levobupivacaine in group L(1.25) (n = 10), with 2.50 mg/mL levobupivacaine in group L(2.5) (n = 10), with 3.75 mg/mL levobupivacaine in group L(3.75) (n = 10), and with normal saline in control group (n = 10). Breaking-strength measurements, levels of hydroxyproline, and fibrotic index were evaluated in the tissue samples taken from the rats. RESULTS: When the breaking-strength measurements were evaluated, we have found a significant difference between the control and the study groups (p < 0.05). In the intergroup comparison the difference between groups L(1.25) and L(3.75) was statistically significant (p < 0.05). In all of the levobupivacaine groups the levels of hydroxyproline were higher compared to the control group. Also significant differences were observed between groups L(1.25) and L(2.5) and groups L(1.25) and L(3.75) (p < 0.05). The levels of tissue fibrotic index were higher in all of the levobupivacaine groups compared to the control group (p < 0.05) and also a difference was observed between groups L(1.25) and L(3.75) in terms of tissue fibrotic index (p < 0.05). CONCLUSION: We have concluded that levobupivacaine used in clinical doses have a significant effect on the fastening of wound healing and this effect increases with an increase in the concentration of the levobupivacaine. We believe that levobupivacaine will be more widely preferred in the near future in the postoperative analgesia.

Oronasopharyngeal suction versus no suction in normal and term infants delivered by elective cesarean section: a prospective randomized controlled trial.

BACKGROUND/AIM: There are controversies about the routine use of oronasopharyngeal suction (ONPS) in healthy infants. This study aimed to compare the effects of oronasopharyngeal suction with those of no suction in normal, term infants delivered by cesarean section. METHODS: 140 term, healthy newborns of uncomplicated pregnancies were prospectively randomized to one of two groups according to the use of ONPS procedure. Differences in oxygen saturation levels, heart rates, and Apgar scores were determined. RESULTS: The mean SaO(2) values through the 2nd and 6th min of life were significantly higher in the no suction group (p < 0.001). The maximum time to reach SaO(2) of > or =92% (6 vs. 11 min) and > or =86% (5 vs. 8 min) saturation were shorter in the no suction group than in the ONPS group. The mean heart rates were consistently and significantly lower in the no suction group during the first 6 min except the second one. All neonates without suction had an Apgar score of 10 at the 5th min, while the mean +/- SD for ONPS group was 9.34 +/- 0.48 (p < 0.001). CONCLUSION: Although findings remained on statistical level and did not lead to clinically adverse outcomes, there is no statistical or physiological basis for oronasopharyngeal suction as a systematic procedure in healthy, term infants delivered by cesarean section.

Oronasopharyngeal suction versus no suction in normal, term and vaginally born infants: a prospective randomised controlled trial.

This prospective randomised controlled trial aimed to compare the effects of oronasopharyngeal suction with those of no suction in normal, term and vaginally born infants and was performed at a Turkish tertiary hospital from June 2003 to January 2004. A total of 140 newborns were enrolled in the trial (n = 70 per group). The no suction group showed lower mean heart rates through the 3rd and 6th minutes and higher SaO(2) values through the first 6 mins of life (P < 0.001). The maximum time to reach SaO2 of >or= 92% (6 vs. 11 min) and >or= 86% (5 vs. 8 min) were shorter in the no suction group (P < 0.001).

Effect of bupivacaine after operative laparoscopic gynecologic procedures.

STUDY OBJECTIVE: To evaluate the effect of intraperitoneal installation and periportal infiltration of bupivacaine on postoperative pain and return of bowel function. DESIGN: A prospective, double-blind, randomized trial (Canadian Task Force classification I). SETTING: GATA School of Medicine, Department of Obstetrics and Gynecology, Reproductive Endocrinology Unit. PATIENTS: Eighty patients undergoing operative gynecologic laparoscopy. INTERVENTION: Periportal infiltration of local anesthesia with 10 mL 0.5% bupivacaine before incision and another 20 mL 0.5% bupivacaine diluted with 20 mL of saline or equal amount of physiologic saline injected into the peritoneal cavity at the end of the procedure. MEASUREMENTS AND MAIN RESULTS: Each patient recorded the severity of her pain on a visual analog scale (VAS) at 1, 6, 18, and 24 hours and the time of first bowel movement and first flatus after surgery. Seventy-seven patients completed the study (38 in the bupivacaine group; 39 in the control group). The severity of postoperative pain, as recorded on the VAS, was significantly less at 1, 6, 18, and 24 hours after surgery in the group receiving bupivacaine compared with those in the control group. The first bowel movement in the bupivacaine group occurred earlier than in the control group (284.80 +/- 31.62 min vs 453.23 +/- 33.08 min, p <.001); similarly, the first flatus occurred earlier in the bupivacaine group than in the control group (466.2 +/- 29.59 min vs 658.80 +/- 40.92 min p <.001). CONCLUSION: Intraperitoneal installation and periportal infiltration of bupivacaine decrease postoperative pain and hasten the return of bowel function. Both decreased postoperative pain and shortened duration for the return of bowel function are crucial for comfort and discharge of the patient.