Hemodynamic and renal involvement of B1 and B2 kinin receptors during the acute phase of endotoxin shock in mice.

B1 kinin receptor (B1R) is up-regulated by endotoxins and thus may represent a therapeutic target in sepsis. We investigated the expression and role of B1R and B2R in the acute phase of lipopolysaccharide (LPS)-induced endotoxin shock in C57BL/6 mice (WT) and B1R and B2R knock out mice (B1KO, B2KO). B1R mRNA was enhanced from 6 to 48 h after LPS while B2R mRNA was further increased in B1KO. Maximal hypotension was found 24 h after LPS, and was more pronounced in B1KO, but was reduced in B2KO. Glomerular filtration rate was more reduced by LPS in B1KO than in WT and B2KO. Glycemia was reduced by LPS and particularly in B1KO and B2KO mice. Mortality was increased by LPS in B1KO. These data suggest that the up-regulated B1R plays, at least transiently, a significant beneficial role in acute LPS-induced hypotension. Conversely, supra activation of B2R could be also involved in the increased mortality observed in B1KO mice.

[Psoas compartment block with general anaesthesia: descriptive study of 93 cases]. / Bloc du plexus lombaire par voie postérieure réalisé sous anesthésie générale: étude descriptive de 93 cas.

OBJECTIVES: During many years the approach to the lumbar plexus has been the anterior paravascular technique described as a "3-1" block by Winnie. The posterior approach results in a complete block of the principal nerves of the lumbar plexus. The goal of the study was to evaluate the performance of the psoas compartment block with general anaesthesia. STUDY DESIGN: Prospective, descriptive, non randomized study. PATIENTS AND METHODS: Ninety-three patients scheduled for hip surgery were studied after informed consent. Demographic data, technical aspects of the puncture, complications, and intra- and postoperative analgesics were recorded. RESULTS: The block was performed by resident alone, senior alone, both in respectively 44%, 45, and 11% of cases. The mean duration of the procedure was 6+/-3 min for the residents, 5+/-2 min for the seniors, and 9+/-4 min for both. The transverse process was reach in 72% of cases during the first approach, after reorientation of the needle in the others cases, except 3 failures of attempt. The lumbar plexus was assessed within 60-90 mm of depth, with a median of 75 mm. The motor response was mainly a femoral response; the minimal intensity of stimulation was ranged between 0.3 and 1 mA, with a median of 0.6 mA. The duration of analgesic block was 16.5+/-4.5 hours, with a median of 18 hours. The morphine use during the first postoperative 24 hours was 8+/-8 mg, with a median of 5.6 mg. No neurologic complication was recorded at discharge from the hospital. CONCLUSION: The psoas compartment block with general anaesthesia have shown it feasibility and efficiency on intra- and postoperative analgesia during hip surgery.