Effects of repeated exposure to different concentrations of sevoflurane on the neonatal mouse hippocampus / Efeitos da exposição repetida a diferentes concentrações de sevoflurano sobre o hipocampo de ratos neonatos

Abstract Background and objectives: Developing brain is more vulnerable to environmental risk than is the developed brain. We evaluated the effects of repeated exposure to different concentrations of sevoflurane on the neonatal mouse hippocampus using stereological methods. Methods: Eighteen neonatal male mice were randomly divided into three groups. Group A, inhaled sevoflurane at a concentration of 1.5%; Group B, inhaled sevoflurane at a concentration of 3%; and Group C (control group), inhaled only 100% oxygen. Treatments were applied for 30 min a day for 7 consecutive days. The hippocampal volume, dendrite length, number of neurons, and number of glial cells were evaluated in each group using stereological estimations. Results: We identified a ∼2% reduction in the volume of the hippocampus in Group A compared to Group C. Mean hippocampal volume was ∼11% smaller in Group B than it was in Group C. However, these differences in hippocampal volume between the groups were not statistically significant (p > 0.05 for all). As for the number of neurons, we found significantly fewer neurons in Group A (∼29% less) and Group B (∼43% less) than we did in Group C (p < 0.05 for both). The dendrite length was ∼8% shorter in Group A and ∼11% shorter in Group B than it was in Group C. Conclusions: Repeated exposure to sevoflurane, regardless of the concentration, reduced the volume of the neonatal mouse hippocampus, as well as the number of neurons and dendrite length.

Resumo Justificativa e objetivos: O cérebro em desenvolvimento é mais vulnerável ao risco ambiental do que o cérebro já desenvolvido. Avaliamos os efeitos da exposição repetida a diferentes concentrações de sevoflurano sobre o hipocampo de ratos neonatos com o uso de métodos estereológicos. Métodos: Dezoito ratos neonatos foram divididos aleatoriamente em três grupos. O Grupo A foi submetido à inalação de sevoflurano a uma concentração de 1,5%; o Grupo B foi submetido à inalação de sevoflurano a uma concentração de 3%; o Grupo C (controle) foi submetido à inalação de apenas oxigênio a 100%. Os tratamentos foram aplicados durante 30 minutos por dia, durante sete dias consecutivos. Volume do hipocampo, comprimento do dendrito, número de neurônios e número de células gliais foram avaliados em cada grupo com o uso de estimativas estereológicas. Resultados: Identificamos uma redução de ∼2% no volume do hipocampo no Grupo A em comparação com o Grupo C. O volume médio do hipocampo foi ∼11% menor no Grupo B do que no Grupo C. Entretanto, essas diferenças no volume do hipocampo entre os grupos não foram estatisticamente significativas (p > 0,05 para todos). Quanto ao número de neurônios, encontramos um número significativamente menor de neurônios no Grupo A (∼29% menos) e no Grupo B (∼43% menos) do que no Grupo C (p < 0,05 para ambos). O comprimento do dendrito foi ∼8% menor no Grupo A e ∼1% menor no Grupo B que no Grupo C. Conclusões: A exposição repetida ao sevoflurano, independentemente da concentração, reduziu o volume do hipocampo neonatal de camundongos, bem como o número de neurônios e o comprimento dos dendritos.

[Effects of repeated exposure to different concentrations of sevoflurane on the neonatal mouse hippocampus]. / Efeitos da exposição repetida a diferentes concentrações de sevoflurano sobre o hipocampo de ratos neonatos.

BACKGROUND AND OBJECTIVES: Developing brain is more vulnerable to environmental risk than is the developed brain. We evaluated the effects of repeated exposure to different concentrations of sevoflurane on the neonatal mouse hippocampus using stereological methods. METHODS: Eighteen neonatal male mice were randomly divided into three groups. Group A, inhaled sevoflurane at a concentration of 1.5%; Group B, inhaled sevoflurane at a concentration of 3%; and Group C (control group), inhaled only 100% oxygen. Treatments were applied for 30min a day for 7 consecutive days. The hippocampal volume, dendrite length, number of neurons, and number of glial cells were evaluated in each group using stereological estimations. RESULTS: We identified a ∼2% reduction in the volume of the hippocampus in Group A compared to Group C. Mean hippocampal volume was ∼11% smaller in Group B than it was in Group C. However, these differences in hippocampal volume between the groups were not statistically significant (p>0.05 for all). As for the number of neurons, we found significantly fewer neurons in Group A (∼29% less) and Group B (∼43% less) than we did in Group C (p<0.05 for both). The dendrite length was ∼8% shorter in Group A and ∼11% shorter in Group B than it was in Group C. CONCLUSIONS: Repeated exposure to sevoflurane, regardless of the concentration, reduced the volume of the neonatal mouse hippocampus, as well as the number of neurons and dendrite length.

Comparison of granisetron and lidocaine on reducing injection pain of etomidate: a controlled randomized study / Comparação de granisetrona e lidocaína na redução da dor causada pela injeção de etomidato: estudo randômico e controlado

Abstract Background and objectives Reducing pain on injection of anesthetic drugs is of importance to every anesthesiologist. In this study we pursued to define if pretreatment by granisetron reduces the pain on injection of etomidate similar to lidocaine. Methods Thirty patients aged between 18 and 50 years of American Society of Anesthesiologists physical status class I or II, whom were candidates for elective laparoscopic cholecystectomy surgery were enrolled in this study. Two 20 gauge cannulas were inserted into the veins on the dorsum of both hands and 100 mL of normal saline was administered during a 10 min period from each cannula. Using an elastic band as a tourniquet, venous drainage of both hands was occluded. 2 mL of granisetron was administered into one hand and 2 mL of lidocaine 2% at the same time into the other hand. One minute later the elastic band was opened and 2 mL of etomidate was administered to each hand with equal rates. The patients were asked to give a score from 0 to 10 (0 = no pain, 10 = severe pain) to each the pain sensed in each hand. Results Two patients were deeply sedated after injection of etomidate and unable to answer any questions. The mean numerical rating score for injection pain of intravenously administered etomidate after intravenous granisetron was 2.3 ± 1.7, which was lower when compared with pain sensed due to intravenously administered etomidate after administration of lidocaine 2% (4.6 ± 1.8), p < 0.05. Conclusion The result of this study demonstrated that, granisetron reduces pain on injection of etomidate more efficiently than lidocaine.

Resumo Justificativa e objetivos A redução da dor causada pela injeção de anestésicos é importante para todos os anestesiologistas. Neste estudo buscamos definir se o pré-tratamento com granisetrona reduz a dor causada pela injeção de etomidato de forma semelhante à lidocaína. Métodos Trinta pacientes entre 18 e 50 anos, estado físico ASA I ou II (de acordo com a classificação da Sociedade Americana de Anestesiologistas) e candidatos à colecistectomia laparoscópica eletiva foram incluídos neste estudo. Duas cânulas de calibre 20 foram inseridas nas veias do dorso de ambas as mãos e 100 mL de soro fisiológico foram administrados durante 10 minutos através de cada cânula. Com um torniquete elástico, a drenagem venosa de ambas as mãos foi ocluída. Granisetrona (2 mL) foi administrado em uma das mãos e lidocaína a 2% (2 mL) na outra mão ao mesmo tempo. Após um minuto, o torniquete foi afrouxado e 2 mL de etomidato foram administrados em velocidade igual a cada uma das mãos. Solicitamos dos pacientes uma classificação de 0 a 10 para a dor sentida em cada uma das mãos (0 = sem dor, 10 = dor intensa). Resultados Dois pacientes estavam profundamente sedados após a injeção de etomidato e, portanto, incapazes de responder a qualquer pergunta. O escore médio de classificação da dor à injeção de etomidato administrado por via endovenosa após granisetrona intravenoso foi de 2,3 ± 1,7, o que foi menor em comparação com a dor sentida à administração intravenosa de etomidato após a administração de lidocaína a 2% (4,6 ± 1,8), p < 0,05. Conclusão O resultado deste estudo demonstrou que granisetrona reduz a dor causada pela injeção de etomidato com mais eficácia do que lidocaína.

[Comparison of granisetron and lidocaine on reducing injection pain of etomidate: a controlled randomized study]. / Comparação de granisetrona e lidocaína na redução da dor causada pela injeção de etomidato: estudo randômico e controlado.

BACKGROUND AND OBJECTIVES: Reducing pain on injection of anesthetic drugs is of importance to every anesthesiologist. In this study we pursued to define if pretreatment by granisetron reduces the pain on injection of etomidate similar to lidocaine. METHODS: Thirty patients aged between 18 and 50 years of American Society of Anesthesiologists physical status class I or II, whom were candidates for elective laparoscopic cholecystectomy surgery were enrolled in this study. Two 20 gauge cannulas were inserted into the veins on the dorsum of both hands and 100mL of normal saline was administered during a 10min period from each cannula. Using an elastic band as a tourniquet, venous drainage of both hands was occluded. 2mL of granisetron was administered into one hand and 2mL of lidocaine 2% at the same time into the other hand. One minute later the elastic band was opened and 2mL of etomidate was administered to each hand with equal rates. The patients were asked to give a score from 0 to 10 (0=no pain, 10=severe pain) to each the pain sensed in each hand. RESULTS: Two patients were deeply sedated after injection of etomidate and unable to answer any questions. The mean numerical rating score for injection pain of intravenously administered etomidate after intravenous granisetron was 2.3±1.7, which was lower when compared with pain sensed due to intravenously administered etomidate after administration of lidocaine 2% (4.6±1.8), p<0.05. CONCLUSION: The result of this study demonstrated that, granisetron reduces pain on injection of etomidate more efficiently than lidocaine.

Evaluation of spinal anesthesia blockade time with 0. 5% hyperbaric bupivacaine, with or without sufentanil, in chronic opioid users: a randomized clinical trial / Avaliação do tempo de bloqueio da raquianestesia com bupivacaína a hiperbárica 0, 5%, com ou sem sufentanil, em usuários crônicos de opioides: um estudo clínico randômico

Abstract Objective: The primary outcome of this study was to evaluate the effect of adding sufentanil to hyperbaric bupivacaine on duration of sensory blockade of spinal anesthesia in chronic opioid users in comparison with non-addicts. Methods: Sixty patients scheduled for orthopedic surgery under spinal anesthesia were allocated into four groups: group 1 (no history of opium use who received intrathecal hyperbaric bupivacaine along with 1 mL saline as placebo); group 2 (no history of opium use who received intrathecal bupivacaine along with 1 mL sufentanil [5 µg]); group 3 (positive history of opium use who received intrathecal bupivacaine along with 1 mL saline as placebo) and group 4 (positive history of opium use who received intrathecal bupivacaine along with 1 mL sufentanil [5 µg]). The onset time and duration of sensory and motor blockade were measured. Results: The duration of sensory blockade in group 3 was 120 ± 23.1 min which was significantly less than other groups (G1 = 148 ± 28.7, G2 = 144 ± 26.4, G4 = 139 ± 24.7, p = 0.007). The duration of motor blockade in group 3 was 145 ± 30.0 min which was significantly less than other groups (G1 = 164 ± 36.0, G2 = 174 ± 26.8, G4 = 174 ± 24.9, p = 0.03). Conclusions: Addition of 5 µg intrathecal sufentanil to hyperbaric bupivacaine in chronic opioid users lengthened the sensory and motor duration of blockade to be equivalent to blockade measured in non-addicts.

Resumo Objetivo: Avaliar o efeito da adição de sufentanil à bupivacaína hiperbárica na duração do bloqueio sensorial da raquianestesia em usuários crônicos de opioides em comparação com não adictos. Métodos: Foram distribuídos em quatro grupos 60 pacientes agendados para cirurgia ortopédica sob raquianestesia: Grupo 1 (sem história de uso de ópio, recebeu bupivacaína hiperbárica intratecal juntamente com 1 mL de solução salina como placebo); Grupo 2 (sem história de uso de ópio, recebeu bupivacaína intratecal juntamente com 1 mL de sufentanil [5 µg]); Grupo 3 (com história de uso de ópio, recebeu bupivacaína intratecal juntamente com 1 mL de solução salina como placebo) e Grupo 4 (com história de uso de ópio, recebeu bupivacaína intratecal juntamente com 1 mL de sufentanil [5 µg]). O tempo de início e a duração dos bloqueios sensitivo e motor foram registrados. Resultados: A duração do bloqueio sensorial no Grupo 3 foi de 120 ± 23,1 min, um tempo significativamente menor do que nos outros grupos (G1 = 148 ± 28,7, G2 = 144 ± 26,4, G4 = 139 ± 24,7, p = 0,007). A duração do bloqueio motor no Grupo 3 foi de 145 ± 30,0 min, um tempo significativamente menor do que nos outros grupos (G1 = 164 ± 36.0, G2 = 174 ± 26.8, G4 = 174 ± 24,9; p = 0,03). Conclusões: A adição de 5 µg de sufentanil intratecal à bupivacaína hiperbárica em usuários crônicos de opioides aumenta a duração dos bloqueios sensorial e motor de forma equivalente ao bloqueio avaliado em não adictos.

Evaluation of spinal anesthesia blockade time with 0.5% hyperbaric bupivacaine, with or without sufentanil, in chronic opioid users: a randomized clinical trial.

OBJECTIVE: The primary outcome of this study was to evaluate the effect of adding sufentanil to hyperbaric bupivacaine on duration of sensory blockade of spinal anesthesia in chronic opioid users in comparison with non-addicts. METHODS: Sixty patients scheduled for orthopedic surgery under spinal anesthesia were allocated into four groups: group 1 (no history of opium use who received intrathecal hyperbaric bupivacaine along with 1mL saline as placebo); group 2 (no history of opium use who received intrathecal bupivacaine along with 1mL sufentanil [5µg]); group 3 (positive history of opium use who received intrathecal bupivacaine along with 1mL saline as placebo) and group 4 (positive history of opium use who received intrathecal bupivacaine along with 1mL sufentanil [5µg]). The onset time and duration of sensory and motor blockade were measured. RESULTS: The duration of sensory blockade in group 3 was 120±23.1min which was significantly less than other groups (G1=148±28.7, G2=144±26.4, G4=139±24.7, p=0.007). The duration of motor blockade in group 3 was 145±30.0min which was significantly less than other groups (G1=164±36.0, G2=174±26.8, G4=174±24.9, p=0.03). CONCLUSIONS: Addition of 5µg intrathecal sufentanil to hyperbaric bupivacaine in chronic opioid users lengthened the sensory and motor duration of blockade to be equivalent to blockade measured in non-addicts.

[Evaluation of spinal anesthesia blockade time with 0.5% hyperbaric bupivacaine, with or without sufentanil, in chronic opioid users: a randomized clinical trial]. / Avaliação do tempo de bloqueio da raquianestesia com bupivacaína a hiperbárica 0,5%, com ou sem sufentanil, em usuários crônicos de opioides: um estudo clínico randômico.

OBJECTIVE: The primary outcome of this study was to evaluate the effect of adding sufentanil to hyperbaric bupivacaine on duration of sensory blockade of spinal anesthesia in chronic opioid users in comparison with non-addicts. METHODS: Sixty patients scheduled for orthopedic surgery under spinal anesthesia were allocated into four groups: group 1 (no history of opium use who received intrathecal hyperbaric bupivacaine along with 1mL saline as placebo); group 2 (no history of opium use who received intrathecal bupivacaine along with 1mL sufentanil [5µg]); group 3 (positive history of opium use who received intrathecal bupivacaine along with 1mL saline as placebo) and group 4 (positive history of opium use who received intrathecal bupivacaine along with 1mL sufentanil [5µg]). The onset time and duration of sensory and motor blockade were measured. RESULTS: The duration of sensory blockade in group 3 was 120±23.1min which was significantly less than other groups (G1=148±28.7, G2=144±26.4, G4=139±24.7, p=0.007). The duration of motor blockade in group 3 was 145±30.0min which was significantly less than other groups (G1=164±36.0, G2=174±26.8, G4=174±24.9, p=0.03). CONCLUSIONS: Addition of 5µg intrathecal sufentanil to hyperbaric bupivacaine in chronic opioid users lengthened the sensory and motor duration of blockade to be equivalent to blockade measured in non-addicts.

[A randomized, double blind trial of prophylactic fibrinogen to reduce bleeding in cardiac surgery]. / Estudo randômico e duplo-cego de profilaxia com fibrinogênio para reduzir o sangramento em cirurgia cardíaca.

BACKGROUND AND OBJECTIVES: Postoperative bleeding has a great clinical importance and can contribute to increased mortality and morbidity in patients undergoing coronary artery bypass graft surgery. In this prospective, randomized, double-blind study, we evaluated the effect of prophylactic administration of fibrinogen concentrate on post-coronary artery bypass graft surgery bleeding. METHODS: A total of 60 patients undergoing coronary artery bypass surgery were randomly divided into two groups. Patients in the fibrinogen group received 1g of fibrinogen concentrate 30min prior to the operation, while patients in the control group received placebo. Post-operative bleeding volumes, prothrombin time, partial thromboplastin time, INR, hemoglobin and transfused blood products in both groups were recorded. A strict red blood cell transfusion protocol was used in all patients. RESULTS: There were no significant differences between intra-operative packed red blood cells infusion in the studied groups (1.0±1.4 in fibrinogen group, and 1.3±1.1 in control group). Less postoperative bleeding was observed in the fibrinogen group (477±143 versus 703±179, p=0.0001). Fifteen patients in the fibrinogen group and 21 in the control group required post-op packed red blood cells infusion (p=0.094). No thrombotic event was observed through 72h after surgery. CONCLUSION: Prophylactic fibrinogen reduces post-operative bleeding in patients undergoing coronary artery bypass graft.

A randomized, double blind trial of prophylactic fibrinogen to reduce bleeding in cardiac surgery.

BACKGROUND AND OBJECTIVES: Postoperative bleeding has a great clinical importance and can contribute to increased mortality and morbidity in patients undergoing coronary artery bypass graft surgery. In this prospective, randomized, double-blind study, we evaluated the effect of prophylactic administration of fibrinogen concentrate on post-coronary artery bypass graft surgery bleeding. METHODS: A total of 60 patients undergoing coronary artery bypass surgery were randomly divided into two groups. Patients in the fibrinogen group received 1g of fibrinogen concentrate 30 min prior to the operation, while patients in the control group received placebo. Post-operative bleeding volumes, prothrombin time, partial thromboplastin time, INR, hemoglobin and transfused blood products in both groups were recorded. A strict red blood cell transfusion protocol was used in all patients. RESULTS: There were no significant differences between intra-operative packed red blood cells infusion in the studied groups (1.0±1.4 in fibrinogen group, and 1.3±1.1 in control group). Less postoperative bleeding was observed in the fibrinogen group (477±143 versus 703±179, p=0.0001). Fifteen patients in the fibrinogen group and 21 in the control group required post-op packed red blood cells infusion (p=0.094). No thrombotic event was observed through 72 h after surgery. CONCLUSION: Prophylactic fibrinogen reduces post-operative bleeding in patients undergoing coronary artery bypass graft.

A randomized, double blind trial of prophylactic fibrinogen to reduce bleeding in cardiac surgery / Estudo randômico e duplo-cego de profilaxia com fibrinogênio para reduzir o sangramento em cirurgia cardíaca / Estudio aleatorizado y doble ciego de profilaxis con fibrinógeno para reducir el sangrado en cirugía cardíaca

BACKGROUND AND OBJECTIVES: Postoperative bleeding has a great clinical importance and can contribute to increased mortality and morbidity in patients undergoing coronary artery bypass graft surgery. In this prospective, randomized, double-blind study, we evaluated the effect of prophylactic administration of fibrinogen concentrate on post-coronary artery bypass graft surgery bleeding. METHODS: A total of 60 patients undergoing coronary artery bypass surgery were randomly divided into two groups. Patients in the fibrinogen group received 1 g of fibrinogen concentrate 30 min prior to the operation, while patients in the control group received placebo. Post-operative bleeding volumes, prothrombin time, partial thromboplastin time, INR, hemoglobin and transfused blood products in both groups were recorded. A strict red blood cell transfusion protocol was used in all patients. RESULTS: There were no significant differences between intra-operative packed red blood cells infusion in the studied groups (1.0 ± 1.4 in fibrinogen group, and 1.3 ± 1.1 in control group). Less postoperative bleeding was observed in the fibrinogen group (477 ± 143 versus 703 ± 179, p = 0.0001). Fifteen patients in the fibrinogen group and 21 in the control group required post-op packed red blood cells infusion (p = 0.094). No thrombotic event was observed through 72 h after surgery. CONCLUSION: Prophylactic fibrinogen reduces post-operative bleeding in patients undergoing coronary artery bypass graft. .

JUSTIFICATIVA E OBJETIVO: a hemorragia no período pós-operatório é de grande importância clínica e pode contribuir para o aumento da morbidade e mortalidade em pacientes submetidos à cirurgia de revascularização coronária. Nesse estudo prospectivo, randômico e duplo-cego, avaliamos o efeito da administração profilática de concentrado de fibrinogênio sobre o sangramento após cirurgia de revascularização coronária. MÉTODOS: no total, 60 pacientes submetidos à cirurgia de revascularização coronária foram randomicamente divididos em dois grupos. Os pacientes do grupo fibrinogênio receberam 1 g de concentrado de fibrinogênio 30 minutos antes da operação, enquanto os doentes do grupo controle receberam placebo. Os volumes de sangramento no pós-operatório, tempo de protrombina, tempo de tromboplastina parcial, INR, hemoglobina e hemoderivados transfundidos em ambos os grupos foram registrados. Um protocolo de conduta rigoroso para transfusão de hemácias foi usado em todos os pacientes. RESULTADOS: não houve diferenças significantes entre as infusões de concentrados de hemácias nos grupos estudados (1,0 ± 1,4 no grupo fibrinogênio e 1,3 ± 1,1 no grupo controle). O grupo fibrinogênio apresentou menos sangramento no pós-operatório (477 ± 143 versus 703 ± 179, p = 0,0001). Quinze pacientes do grupo fibrinogênio e 21 do grupo controle precisaram de infusão de concentrado de hemácias no pós-operatório (p = 0,094). Evento trombótico não foi observado durante 72 h após a cirurgia. CONCLUSÃO: profilaxia com fibrinogênio reduz o sangramento no período pós-operatório de pacientes submetidos à revascularização coronária. .

JUSTIFICACIÓN Y OBJETIVOS: la hemorragia en el período postoperatorio es de gran importancia clínica y puede contribuir al aumento de la morbimortalidad en pacientes sometidos a cirugía de revascularización del miocardio. En este estudio prospectivo, aleatorizado y doble ciego, evaluamos el efecto de la administración profiláctica del concentrado de fibrinógeno sobre el sangrado después de la cirugía de revascularización del miocardio. MÉTODOS: en total, 60 pacientes sometidos a cirugía de revascularización del miocardio fueron aleatoriamente divididos en 2 grupos. Los pacientes del grupo fibrinógeno recibieron 1 g de concentrado de fibrinógeno 30 min antes de la operación, mientras que los del grupo control recibieron placebo. Los volúmenes de sangrado en el postoperatorio, tiempo de protrombina, tiempo de tromboplastina parcial, INR, hemoglobina y hemoderivados transfundidos en ambos grupos fueron registrados. En todo los pacientes se usó un protocolo de conducta riguroso para la transfusión de hematíes. RESULTADOS: no hubo diferencias significativas entre las infusiones de concentrados de hematíes en los grupos estudiados (1 ± 1,4 en el grupo fibrinógeno y 1,3 ± 1,1 en el grupo control). El grupo fibrinógeno presentó menos sangrado en el postoperatorio (477 ± 143 versus 703 ± 179, p = 0,0001). Quince pacientes del grupo fibrinógeno y 21 del grupo control necesitaron infusión de concentrado de hematíes en el postoperatorio (p = 0,094). Ningún evento trombótico fue observado durante 72 h después de la cirugía. CONCLUSIÓN: la profilaxis con fibrinógeno reduce el sangrado en el período postoperatorio de pacientes sometidos a revascularización del miocardio. .

Ondansetron reducing pain on injection of etomidate: a controlled randomized study.

INTRODUCTION: Etomidate causes pain when injected intravenously. In this study we sought to determine if pretreatment by ondansetron reduces the pain on injection of etomidate. METHODS: In this randomized, double blinded, placebo-controlled clinical trial, 20 patients of both sexes aged between 18 and 50 years of American Society of Anesthesiologists (ASA) physical status class I or II, whom were candidates for various elective surgical procedures and need more than one intravenous access were enrolled in the study. On arrival to the operating room two 22 gauge cannulas were inserted into veins on the dorsum of both hands. Following the infusion of 100mL normal saline into both intravenous lines, using an elastic band, venous drainage of hands was occluded at midarm. The patients were administered 8 mg (2 mL) of ondansetron into one hand and 2 mL of 0.9% saline into the other hand at the same time. The elastic band was removed after 1 min and 2mg (1 mL) of etomidate was administered at the same rate simultaneously into intravenous lines. The patients were asked to give a score of pain based on a verbal analog scale (VAS) to each hand. RESULTS: A total number of 20 patients were studied (male = 55%, female = 45%). The mean age of the participants was 37.5 ± 13.1 years old and the mean weight was 67.7 ± 7.3 kg. The mean VAS for injection pain of etomidate after pre-administration of intravenous ondansetron was 1.5 ± 1.2 which was lower compared to pre-administration of placebo (3.2 ± 2.8, p < 0.05). CONCLUSION: This study illustrates that pre-treatment with intravenous ondansetron significantly reduces the pain on injection of etomidate.

Ondansetron reducing pain on injection of etomidate: a controlled randomized study / Ondansetrona reduz a dor da injeção de etomidato: estudo randômico controlado / El ondansetrón reduce el dolor de la inyección de etomidato: estudio aleatorizado controlado

Introduction: Etomidate causes pain when injected intravenously. In this study we sought to determine if pretreatment by ondansetron reduces the pain on injection of etomidate. Methods: In this randomized, double blinded, placebo-controlled clinical trial, 20 patients of both sexes aged between 18 and 50 years of American Society of Anesthesiologists (ASA) physical status class I or II, whom were candidates for various elective surgical procedures and need more than one intravenous access were enrolled in the study. On arrival to the operating room two 22 gauge cannulas were inserted into veins on the dorsum of both hands. Following the infusion of 100 mL normal saline into both intravenous lines, using an elastic band, venous drainage of hands was occluded at midarm. The patients were administered 8 mg (2 mL) of ondansetron into one hand and 2 mL of 0.9% saline into the other hand at the same time. The elastic band was removed after 1 min and 2 mg (1 mL) of etomidate was administered at the same rate simultaneously into intravenous lines. The patients were asked to give a score of pain based on a verbal analog scale (VAS) to each hand. Results: A total number of 20 patients were studied (male = 55%, female = 45%). The mean age of the participants was 37.5 ± 13.1 years old and the mean weight was 67.7 ± 7.3 kg. The mean VAS for injection pain of etomidate after pre-administration of intravenous ondansetron was 1.5 ± 1.2 which was lower compared to pre-administration of placebo (3.2 ± 2.8, p < 0.05). Conclusion: This study illustrates that pre-treatment with intravenous ondansetron significantly reduces the pain on injection of etomidate. .

Justificativa e objetivo: etomidato causa dor quando administrado por via intravenosa. Neste estudo buscamos determinar se o pré-tratamento com ondansetrona reduz a dor causada pela injeção de etomidato. Métodos: neste estudo clínico randômico, duplo-cego e controlado por placebo, 20 pacientes de ambos os sexos, entre 18 e 50 anos, estado físico ASA I ou II, candidatos a procedimentos cirúrgicos eletivos que exigiam mais de um acesso intravenoso, foram incluídos. Ao darem entrada na sala de cirurgia, duas cânulas de calibre 22 foram inseridas nas veias do dorso de ambas as mãos. Após a infusão de 100 mL de solução salina normal em ambas as linhas de acesso intravenoso, a drenagem venosa das mãos foi ocluída até o meio do braço com o uso de um torniquete elástico. Os pacientes receberam 8 mg (2 mL) de ondansetrona em uma das mãos e 2 mL de solução salina a 0,9% na outra mão ao mesmo tempo. O torniquete foi removido após um minuto e 2 mg (1 mL) de etomidato foram administrados na mesma proporção simultaneamente nas linhas intravenosas. Pediu-se aos pacientes que dessem pontos à dor em cada mão, com base em uma escala verbal analógica (EVA). Resultados: avaliamos 20 pacientes (homens = 55%, mulheres = 45%). A média de idade e de peso foi de 37,5 ± 13,1 anos e 67,7 ±7,3 kg. A média do escore EVA para dor causada pela injeção de etomidato após a pré-administração de ondansetron IV foi de 1,5 ± 1,2, que foi menor em comparação com a pré-administração de placebo (3,2 ± 2,8, p < 0,05). Conclusão: este estudo mostra que o pré-tratamento com ondansetrona IV reduz significativamente a dor causada pela injeção de etomidato. .

Introducción: el etomidato causa dolor cuando es administrado por vía intravenosa. En este estudio buscamos determinar si el pretratamiento con ondansetrón reduce el dolor causado por la inyección de etomidato. Métodos: fueron incluidos en este estudio clínico aleatorizado, doble ciego y controlado por placebo, 20 pacientes de ambos sexos con edades entre 18 y 50 años, estado físico ASA I o II, candidatos a varios procedimientos quirúrgicos electivos, que exigían más de un acceso intravenoso. Al entrar en quirófano, se insertaron dos cánulas de calibre 22 en las venas del dorso de ambas manos. Después de la infusión de 100 mL de solución salina normal en ambas líneas de acceso intravenoso; usando un torniquete elástico, el drenaje venoso de las manos se cerró hasta la mitad del brazo. Los pacientes recibieron 8 mg (2 mL) de ondansetrón en una de las manos y 2 mL de solución salina al 0,9% en la otra mano al mismo tiempo. El torniquete fue retirado después de 1 min y 2 mg (1 mL) de etomidato se administró en la misma proporción simultáneamente en las líneas intravenosas. Se les solicitó a los pacientes que hiciesen una puntuación del dolor en cada mano, basándose en una escala verbal analógica (EVA). Resultados: evaluamos a un total de 20 pacientes (un 55% hombres y un 45% mujeres). La media de edad y del peso de los participantes fue de 37,5 ± 13,1 años y de 67,7 ±7,3/kg, respectivamente. El promedio de la puntuación EVA para el dolor causado por la inyección de etomidato después de la preadministración de ondansetrón iv fue de 1,5 ± 1,2, siendo menor en comparación con la preadministración de placebo (3,2 ± 2,8; p < 0,05). Conclusión: este estudio demuestra que el pretratamiento con ondansetrón iv reduce ...