RESUMO
To compare the quality of sedation using propofol (n = 8) vs midazolam (n = 7) we evaluated their effectiveness, safety, and recovery time after their continuous infusion in patients who required mechanical ventilation after cervical spine surgery. We also calculated the cost of drugs used during the mechanical ventilation. In addition, processed electroencephalogram (pEEG) was monitored employing spectral edge frequency 90 (SEF 90) as an indicator of sedation. Both drugs produced good sedation without any complication. The patients who had received propofol were extubated significantly earlier than those who had received midazolam (P; 35 +/- 18 mins, M; 97 +/- 55 mins). However, the mean drug cost in the propofol group was five times higher than that in the midazolam group (P; yen 15,881 +/- 7,788, M; yen 3,355 +/- 1,187). There was no correlation between the value of SEF 90 and the depth of sedation during mechanical ventilation. In conclusion, propofol exhibited the shorter recovery time after cessation of the continuous infusion than midazolam, but it costed five times compared with midazolam. SEF 90 failed to indicate the depth of sedation during mechanical ventilation.
Assuntos
Sedação Consciente , Hipnóticos e Sedativos , Midazolam , Cuidados Pós-Operatórios , Propofol , Respiração Artificial , Adulto , Idoso , Vértebras Cervicais/cirurgia , Custos de Medicamentos , Eletroencefalografia , Feminino , Humanos , Masculino , Midazolam/economia , Pessoa de Meia-Idade , Monitorização Fisiológica , Propofol/economiaRESUMO
Nerve regeneration across peripheral nerve allografts and control autografts in primates immunosuppressed with Cyclosporin A was quantitatively evaluated by electrophysiologic and histologic methods. Twelve cynomolgus monkeys received 3-cm autografts and allografts in contralateral ulnar nerves. They were immunosuppressed with Cyclosporin A at 25 mg/kg per day or placebo vehicle. Morphometric analysis of nerve graft and distal nerve segments was assessed at 1 year after engraftment. Quantitative electrophysiologic studies were performed percutaneously at 6 and 12 months, and compound action potentials were measured directly across the nerve grafts at 1 year. Excellent regeneration was seen across autografts and allografts in Cyclosporin A-treated and placebo-treated recipients.