Cardiovascular effects of hyoscine butylbromide in patients under general anaesthesia.

BACKGROUND: Cardiovascular effects for drugs such as hyoscine butylbromide are poorly documented in the literature, unlike atropine, which is considered the antimuscarinic of choice in the presence of intraoperative bradycardia. AIM: The aim of the study was to describe the dose-related cardiovascular effect of hyoscine butylbromide in patients between 18 and 65 years of age, with low perioperative risk undergoing elective surgery under general anaesthesia on an outpatient basis or hospitalised at our institution between 1 January and 31 May 2019. METHODS: Descriptive, cross-sectional, retrospective study; 28 patients with low perioperative risk who underwent general anaesthesia were selected. Changes in heart rate and blood pressure were analysed during the first 6 minutes after the administration of hyoscine butylbromide. The data obtained was recorded in a Microsoft Excel database and analysed using the Excel analysis tool and IBM SPSS. RESULTS: The average dose of 0.15mg/kg of hyoscine butylbromide achieved an increase in heart rate and mean arterial pressure in 96% and 92.8%, respectively, in the first 6 minutes after the administration. Significant changes in heart rate and blood pressure were obtained during the first 6 minutes at doses between 0.05mg/kg and 0.15mg/kg. CONCLUSION: Hyoscine butylbromide generates positive effects on the heart rate and blood pressure of patients under general anaesthesia, representing a possible alternative in the management of intraoperative bradycardia.

Butil bromuro de hioscina: ¿Una opción para el manejo de bradicardia intraoperatoria? / Hyoscine butyl bromide useful in the management of perioperative bradycardia?

INTRODUCTION: Hyoscine butyl bromide, better known as buscapine, widely used in medicine, is a muscarinic antagonist that shares properties with atropine. OBJECTIVE: To review the pharmacology, mechanism of action, systemic effects, interactions, toxicity, and side effects of hyoscine butyl bromide to understand why it may be useful in the management of perioperative bradycardia. MATERIALS AND METHODS: A bibliographic review was carried out in the main databases with the search of the scientific literature according to the key words defined. CONCLUSIONS: Butyl bromide hyoscine may be an option in the management of intraoperative bradyarrhythmias with a rapid onset of action, more controlled increased heart rate and low penetration to the central nervous system.

INTRODUCCIÓN: El butilbromuro de hioscina más conocido como buscapina, ampliamente utilizado en medicina, es un antagonista muscarínico que comparte propiedades con la atropina. OBJETIVO: Realizar una revisión de la farmacología, mecanismo de acción, efectos sistémicos, interacciones, toxicidad y efectos secundarios del butil bromuro de hioscina para poder entender por qué puede ser útil en el manejo de bradicardia perioperatoria. MATERIALES Y MÉTODOS: Se realizó una revisión bibliográfica en las principales bases de datos como PubMed, con la búsqueda de la literatura científica de acuerdo a las palabras claves definidas. CONCLUSIONES: El butil bromuro de hioscina puede ser una opción en el manejo de bradiarritmias intraoperatorias con un rápido inicio de acción, aumento de la frecuencia cardíaca más controlado y baja penetración al sistema nervioso central.

Effect of Synadenium grantii and its isolated compound on dysmenorrhea behavior model in mice.

OBJECTIVE: This study aimed to evaluate the effects of the methanol extract of Synadenium grantii Hook f. stems and its main isolated compound Query3,4,12,13-tetraacetylforbol-20-phenylacetate (1) on experimental dysmenorrhea in mice. METHODS: Female Swiss mice (n = 6-15) of 6-8 weeks old were used, selected according to the period of the estrous cycle. Animals in proestrus were treated intraperitoneally (i.p.) for 3 days with estradiol. They orally received, on the 4th day, S. grantii extract, the compound 1, ibuprofen or hyoscine butylbromide (Buscopan compound®). Then they were injected (i.p.) with oxytocin 1 h later and individually observed regarding the abdominal writhing for 45 min. The uterus was weighed, photographed and fixed in paraffin for histological analysis. KEY FINDINGS: The extract inhibited the abdominal writhing and similar results were obtained with compound 1 and the positive control drugs Ibuprofen and hyoscine butylbromide. Reduction of uterus volume and histological inflammatory parameters, such as oedema and leukocyte infiltrate, were observed in animals treated with the extract and compound 1. CONCLUSIONS: Our data show promising activity of the extract against dysmenorrhea, indicating important anti-inflammatory activity. Compound 1 appears to be, at least in part, the main responsible for this promising biological effect.

Hyoscine butylbromide for colorectal polyp detection: prospective, randomized, placebo-controlled trial.

OBJECTIVES:: The removal of pre-malignant colorectal lesions prevents cancer. Hyoscine has been proposed as a means of improving diagnosis by reducing colonic movements. The aim of this study was to analyze whether this anti-spasmodic enhances the detection of pre-malignant colorectal lesions. METHODS:: In a randomized, double-blinded fashion patients received hyoscine or a saline solution in all consecutive colonoscopies in which the cecum was reached. Lesions were analysed with respect to number, size, location, histology and capillary pattern. RESULTS:: A total of 440 colonoscopies were randomized. The overall polyp detection rate (PDR) and the adenoma detection rate (ADR) were 65.2% and 49.3%, respectively. In the hyoscine group, non-polypoid lesions were detected significantly more often (p=0.01). In the placebo group 281 lesions were diagnosed (202 adenomas) and in the hyoscine group 282 lesions were detected (189 adenomas) (p=0.23). The PDR and ADR were similar between the placebo and hyoscine groups (64% vs 66% and 50% vs 47%, respectively). No differences were observed between the two groups in the advanced-ADR or advanced neoplasia detection rate, as well the mean numbers of polyps, adenomas, advanced adenomas and advanced neoplasias detected per patient. The administration of hyoscine also did not improve the diagnostic accuracy of digital chromoendoscopy. The presence of adenomatous polyps in the right colon was detected significantly more frequently in the hyoscine group (OR 5.41 95% CI 2.7 - 11; p<0.01 vs OR 2.3 95% CI 1.1 - 4.6; p=0.02). CONCLUSION:: The use of hyoscine before beginning the withdrawal of the colonoscope does not seem to enhance the PDR and the ADR.

Hyoscine butylbromide for colorectal polyp detection: prospective, randomized, placebo-controlled trial

OBJECTIVES: The removal of pre-malignant colorectal lesions prevents cancer. Hyoscine has been proposed as a means of improving diagnosis by reducing colonic movements. The aim of this study was to analyze whether this anti-spasmodic enhances the detection of pre-malignant colorectal lesions. METHODS: In a randomized, double-blinded fashion patients received hyoscine or a saline solution in all consecutive colonoscopies in which the cecum was reached. Lesions were analysed with respect to number, size, location, histology and capillary pattern. RESULTS: A total of 440 colonoscopies were randomized. The overall polyp detection rate (PDR) and the adenoma detection rate (ADR) were 65.2% and 49.3%, respectively. In the hyoscine group, non-polypoid lesions were detected significantly more often (p=0.01). In the placebo group 281 lesions were diagnosed (202 adenomas) and in the hyoscine group 282 lesions were detected (189 adenomas) (p=0.23). The PDR and ADR were similar between the placebo and hyoscine groups (64% vs 66% and 50% vs 47%, respectively). No differences were observed between the two groups in the advanced-ADR or advanced neoplasia detection rate, as well the mean numbers of polyps, adenomas, advanced adenomas and advanced neoplasias detected per patient. The administration of hyoscine also did not improve the diagnostic accuracy of digital chromoendoscopy. The presence of adenomatous polyps in the right colon was detected significantly more frequently in the hyoscine group (OR 5.41 95% CI 2.7 - 11; p<0.01 vs OR 2.3 95% CI 1.1 - 4.6; p=0.02). CONCLUSION: The use of hyoscine before beginning the withdrawal of the colonoscope does not seem to enhance the PDR and the ADR.

A fast and sensitive UHPLC-MS/MS method for the determination of N-butylscopolamine in human plasma: application in a bioequivalence study.

We have developed and validated a fast and sensitive ultra high-performance liquid chromatography with positive ion electrospray ionization tandem mass spectrometry method for determining N-butylscopolamine levels in human plasma using propranolol as an internal standard. The acquisition was set up in the multiple reaction monitoring mode with the transitions m/z 360.3 → 138.0 for N-butylscopolamine and m/z 260.2 → 116.1 for IS. This method uses a liquid-liquid extraction process with dichloromethane. The analyte and IS were chromatographed on a C18 , 50 × 2.1 mm, 1.7 µm column through isocratic elution with acetonitrile-5 mm ammonium acetate (adjusted to pH 3.0 with formic acid). The method was linear in the 1-1000 pg/mL range for N-butylscopolamine and was selective, precise, accurate and robust. The validated method was successfully applied to perform a bioequivalence study of the reference (Buscopan® , from Boehringer Ingelheim) and the test sample coated-tablet formulations (from Foundation for Popular Remedy), both containing 10 mg of N-butylscopolamine bromide administered as a single dose. Using 58 healthy volunteers and accounting for the high intra-individual variability confirmed by statistical calculations (38%), the two formulations were considered bioequivalent because the rate and extent of absorption (within 80-125% interval), satisfying international requirements.

Neonatal treatment with scopolamine butylbromide prevents metabolic dysfunction in male rats.

We tested whether treatment with a cholinergic antagonist could reduce insulin levels in early postnatal life and attenuate metabolic dysfunctions induced by early overfeeding in adult male rats. Wistar rats raised in small litters (SLs, 3 pups/dam) and normal litters (NLs, 9 pups/dam) were used in models of early overfeeding and normal feeding, respectively. During the first 12 days of lactation, animals in the SL and NL groups received scopolamine butylbromide (B), while the controls received saline (S) injections. The drug treatment decreased insulin levels in pups from both groups, and as adults, these animals showed improvements in glucose tolerance, insulin sensitivity, vagus nerve activity, fat tissue accretion, insulinemia, leptinemia, body weight gain and food intake. Low glucose and cholinergic insulinotropic effects were observed in pancreatic islets from both groups. Low protein expression was observed for the muscarinic M3 acetylcholine receptor subtype (M3mAChR), although M2mAChR subtype expression was increased in SL-B islets. In addition, beta-cell density was reduced in drug-treated rats. These results indicate that early postnatal scopolamine butylbromide treatment inhibits early overfeeding-induced metabolic dysfunctions in adult rats, which might be caused by insulin decreases during lactation, associated with reduced parasympathetic activity and expression of M3mAChR in pancreatic islets.

Hyoscine-N-butylbromide premedication on cardiovascular variables of horses sedated with medetomidine.

OBJECTIVE: To evaluate the effects of intravenous (IV) or intramuscular (IM) hyoscine premedication on physiologic variables following IV administration of medetomidine in horses. STUDY DESIGN: Randomized, crossover experimental study. ANIMALS: Eight healthy crossbred horses weighing 330 ± 39 kg and aged 7 ± 4 years. METHODS: Baseline measurements of heart rate (HR), cardiac index (CI), respiratory rate, systemic vascular resistance (SVR), percentage of patients with second degree atrioventricular (2(o) AV) block, mean arterial pressure (MAP), pH, and arterial partial pressures of carbon dioxide (PaCO2 ) and oxygen (PaO2 ) were obtained 5 minutes before administration of IV hyoscine (0.14 mg kg(-1) ; group HIV), IM hyoscine (0.3 mg kg(-1) ; group HIM), or an equal volume of physiologic saline IV (group C). Five minutes later, medetomidine (7.5 µg kg(-1) ) was administered IV and measurements were recorded at various time points for 130 minutes. RESULTS: Medetomidine induced bradycardia, 2(o) AV blocks and increased SVR immediately after administration, without significant changes in CI or MAP in C. Hyoscine administration induced tachycardia and hypertension, and decreased the percentage of 2(o) AV blocks induced by medetomidine. Peak HR and MAP were higher in HIV than HIM at 88 ± 18 beats minute(-1) and 241 ± 37 mmHg versus 65 ± 16 beats minute(-1) and 192 ± 38 mmHg, respectively. CI was increased significantly in HIV (p ≤ 0.05). Respiratory rate decreased significantly in all groups during the recording period. pH, PaCO2 and PaO2 were not significantly changed by administration of medetomidine with or without hyoscine. CONCLUSION AND CLINICAL RELEVANCE: Hyoscine administered IV or IM before medetomidine in horses resulted in tachycardia and hypertension under the conditions of this study. The significance of these changes, and responses to other dose rates, requires further investigation.

Development and validation of a UPLC-ESI-MS/MS method for the determination of N-butylscopolamine in human plasma: application to a bioequivalence study.

A sensitive and fast ultra performance liquid chromatography-electrospray ionization-tandem mass spectrometry (UPLC-ESI-MS/MS) method for measurements of N-butylscopolamine in plasma was developed and validated. A single protein precipitation was proposed for the clean up of the plasma and N-methylhomatropine was added as internal standard (IS). The analyses were carried out using a C(18) column and mobile phase of acetonitrile: 5 mM ammonium acetate + 0.1% formic acid (90:10, v/v). The triple quadrupole mass spectrometer equipped with an electrospray source in positive mode, was set up in selective reaction monitoring, to detect precursor → product ion 360.0 → 194.0 m/z and 290.3 → 138.0 m/z transitions, for N-butylscopolamine and IS, respectively. The method was linear in 0.03 (lower limit of quantitation; LLOQ) - 10.00 ng/ml range for N-butylscopolamine. Satisfactory selectivity, linearity, precision, accuracy, and robustness were obtained for the UPLC-ESI-MS/MS method. The proposed method was successfully applied to a pharmacokinetic study of healthy human volunteers; the results showed that the two scopolamine butylbromide formulations tested are not bioequivalent in rate and extent of absorption.

Efficacy of three different alpha 1-adrenergic blockers and hyoscine N-butylbromide for distal ureteral stones.

PURPOSE: To evaluate hyoscine N-butyl bromide (HBB) and three different alpha-1 blockers in the treatment of distal ureteral stones. MATERIALS AND METHODS: A total of 140 patients with stones located in the distal tract of the ureter with stone diameters of 5 to 10mm were enrolled in the present study and were randomized into 4 equal groups. Group 1 received HBB, Group 2 received alfuzosin, Group 3 received doxazosin and Group 4 received terazosin. The subjects were prescribed diclofenac injection (75 mg) intramuscularly on demand for pain relief and were followed-up after two weeks with x-rays of the kidneys, ureters, bladder and urinary ultrasonography every week. The number of pain episodes, analgesic dosage and the number of days of spontaneous passage of the calculi through the ureter were also recorded. RESULTS: The average stone size for groups 1, 2, 3 and 4 was comparable (6.13, 5.83, 5.59 and 5.48 mm respectively). Stone expulsion was observed in 11%, 52.9%, 62%, and 46% in groups 1, 2, 3 and 4 respectively. The average time to expulsion was 10.55 ± 6.21 days in group 1, 7.38 ± 5.55 days in group 2, 7.85 ± 5.11 days in group 3 and 7.45 ± 5.32 days in group 4. Alpha blockers were found to be superior to HBB (p < 0.05). CONCLUSIONS: Medical treatment of distal ureteral calculi with alfuzosin, doxazosin and terazosin resulted in a significantly increased stone-expulsion rate and decreased expulsion time when compared with HBB. HBB seems to have a negative effect on stone-expulsion rate.

Comparative study between atropine and hyoscine-N-butylbromide for reversal of detomidine induced bradycardia in horses.

REASONS FOR PERFORMING STUDY: Bradycardia may be implicated as a cause of cardiovascular instability during anaesthesia. HYPOTHESIS: Hyoscine would induce positive chronotropism of shorter duration than atropine, without adversely impairing intestinal motility in detomidine sedated horses. METHODS: Ten minutes after detomidine (0.02 mg/kg bwt, i.v.), physiological saline (control), atropine (0.02 mg/kg bwt) or hyoscine (0.2 mg/kg bwt) were randomly administered i.v. to 6 horses, allowing one week intervals between treatments. Investigators blinded to the treatments monitored cardiopulmonary data and intestinal auscultation for 90 min and 24 h after detomidine, respectively. Gastrointestinal transit was assessed for 96 h via chromium detection in dry faeces. RESULTS: Detomidine significantly decreased heart rate (HR) and cardiac index (CI) from baseline for 30 and 60 min, respectively (control). Mean ± s.d. HR increased significantly 5 min after atropine (79 ± 5 beats/min) and hyoscine (75 ± 8 beats/min). After this time, HR was significantly higher after atropine in comparison to other treatments, while hyoscine resulted in intermediate values (lower than atropine but higher than controls). Hyoscine and atropine resulted in significantly higher CI than controls for 5 and 20 min, respectively; but this effect coincided with significant hypertension (mean arterial pressures >180 mmHg). Auscultation scores decreased from baseline in all treatments. Time to return to auscultation scores ≥12 (medians) did not differ between hyoscine (4 h) and controls (4 h) but atropine resulted in significantly longer time (10 h). Atropine induced colic in one horse. Gastrointestinal transit times did not differ between treatments. CONCLUSION: Hyoscine is a shorter acting positive chronotropic agent than atropine, but does not potentiate the impairment in intestinal motility induced by detomidine. Because of severe hypertension, routine use of anticholinergics combined with detomidine is not recommended. POTENTIAL RELEVANCE: Hyoscine may represent an alternative to atropine for treating bradycardia.

Efficacy of three different alpha 1-adrenergic blockers and hyoscine N-butylbromide for distal ureteral stones

PURPOSE: To evaluate hyoscine N-butyl bromide (HBB) and three different alpha-1 blockers in the treatment of distal ureteral stones. MATERIALS AND METHODS: A total of 140 patients with stones located in the distal tract of the ureter with stone diameters of 5 to 10mm were enrolled in the present study and were randomized into 4 equal groups. Group 1 received HBB, Group 2 received alfuzosin, Group 3 received doxazosin and Group 4 received terazosin. The subjects were prescribed diclofenac injection (75 mg) intramuscularly on demand for pain relief and were followed-up after two weeks with x-rays of the kidneys, ureters, bladder and urinary ultrasonography every week. The number of pain episodes, analgesic dosage and the number of days of spontaneous passage of the calculi through the ureter were also recorded. RESULTS: The average stone size for groups 1, 2, 3 and 4 was comparable (6.13, 5.83, 5.59 and 5.48 mm respectively). Stone expulsion was observed in 11 percent, 52.9 percent, 62 percent, and 46 percent in groups 1, 2, 3 and 4 respectively. The average time to expulsion was 10.55 ± 6.21 days in group 1, 7.38 ± 5.55 days in group 2, 7.85 ± 5.11 days in group 3 and 7.45 ± 5.32 days in group 4. Alpha blockers were found to be superior to HBB (p < 0.05). CONCLUSIONS: Medical treatment of distal ureteral calculi with alfuzosin, doxazosin and terazosin resulted in a signi?cantly increased stone-expulsion rate and decreased expulsion time when compared with HBB. HBB seems to have a negative effect on stone-expulsion rate.

The ACB technique: a biomagentic tool for monitoring gastrointestinal contraction directly from smooth muscle in dogs.

The aim of this paper was to verify whether AC biosusceptometry (ACB) is suitable for monitoring gastrointestinal (GI) contraction directly from smooth muscle in dogs, comparing with electrical recordings simultaneously. All experiments were performed in dogs with magnetic markers implanted under the serosa of the right colon and distal stomach, and their movements were recorded by ACB. Monopolar electrodes were implanted close to the magnetic markers and their electric potentials were recorded by electromyography (EMG). The effects of neostigmine, hyoscine butylbromide and meal on gastric and colonic parameters were studied. The ACB signal from the distal stomach was very similar to EMG; in the colonic recordings, however, within the same low-frequency band, ACB and EMG signals were characterized by simultaneity or a widely changeable frequency profile with time. ACB recordings were capable of demonstrating the changes in gastric and colonic motility determined by pharmacological interventions as well as by feeding. Our results reinforce the importance of evaluating the mechanical and electrical components of motility and show a temporal association between them. ACB and EMG are complementary for studying motility, with special emphasis on the colon. ACB offers an accurate method for monitoring in vivo GI motility.

Electrical and mechanical effects of hyoscine butylbromide on the human stomach: a non-invasive approach.

Due to the importance of motility in a number of gastrointestinal disorders, efforts have been made to evaluate both gastric motility counterparts: electrical activity and mechanical activity. The present work aimed to propose a new approach, associating AC biosusceptometry (ACB) and electrogastrography (EGG), to noninvasively monitoring mechanical and electrical gastric activity, respectively. Fourteen volunteers ingested a test meal and their gastric activity was evaluated by EGG and ACB at a baseline and after 20 mg of i.v. hyoscine butylbromide. ACB and EGG showed a similar signal pattern and high temporal correlation. Hyoscine butylbromide decreased the mechanical motility index (MI) by 50.9%, while for electrical MI the reduction was 36.5%. Delayed times to onset (mean+/-SD: 50+/-15 versus 40+/-20 s; P<0.01) and the inhibitory effect (16+/-4 versus 14+/-5 min; P<0.01) were calculated for ACB and EGG, respectively. ACB and EGG emerged due to their interesting nature, noninvasiveness and low cost to evaluate gastric motility. Our approach associating ACB and EGG allowed monitoring and quantification of the effects of an anticholinergic drug in gastric electrical activity and contractile activity in humans.

The effect of Buscopan on the development of the blow fly Chrysomya megacephala (F.) (Diptera: Calliphoridae).

This work investigated the effects of butylscopolamine bromide, a drug present in the pharmaceutical formulation Buscopan, on the development of Chrysomya megacephala, a blow fly species of considerable forensic and medical importance in Brazil. Larvae exposed to the drug showed a decreased rate of development, with higher drug concentrations further retarding the development. Besides, larvae reared on the presence of the drug showed smaller body weight and body length when compared with larvae reared on the absence of Buscopan. The drug also affected the mortality of the species.

Simultaneous determination of N-butylscopolamine and oxazepam in pharmaceutical formulations by first-order digital derivative spectrophotometry.

A simple method has been developed for the simultaneous determination of N-butylscopolamine bromide and oxazepam in pharmaceutical formulations using first-order digital derivative spectrophotometry. Acetonitrile was selected as the solvent in which both compounds showed well-defined bands. Both analytes showed good stability in this solvent when solutions of the analytes were exposed to light and temperatures between 20 degrees and 80 degrees C. The simultaneous determination of both drugs was performed by the zero-crossing method at 226.0 and 257.0 nm for N-butylscopolamine and oxazepam, respectively. The linear range of determination was found to be 2.5 x 10(-7) to 8.0 x 10(-5) mol/L for N-butylscopolamine and 7.1 x 10(-8) to 8.0 x 10(-5) mol/L for oxazepam. A very good level of repeatability (relative standard deviation) of 0.2% was observed for N-butylscopolamine and oxazepam. The ingredients commonly found in pharmaceutical formulations do not interfere. The proposed method was applied to the determination of these drugs in pharmaceutical formulations (capsules).

Eficácia da N-butilescopolamina e dipirona sódica associadas ao cetoprofeno no alívio da dor pós-operatória de pacientes submetidas a duas técnicas diferentes de laqueadura por laparoscopia / Efficacy of N-butylscopolamine and sodium dipirone associated to ketoprofen for postoperative pain relief of patients submitted to two different laparoscopic sterilization techniques

JUSTIFICATIVA E OBJETIVOS: A laqueadura laparoscópica (LL) é um dos procedimentos mais dolorosos e a intensidade da dor varia com a técnica selecionada, sendo mais intensa com a técnica de oclusão das tubas uterinas com anel. As pacientes submetidas à LL referem dor em cólica no período PO e a N-butilescopolamina e a dipirona sódica, por suas propriedades anti-espasmódicas e analgésicas, associadas às propriedades antiinflamatórias do cetoprofeno, podem ser opção para profilaxia e tratamento de dor. O objetivo deste foi estudar a eficácia da N-butilescopolamina e da dipirona sódica associadas ao cetoprofeno, na prevenção de dor PO em pacientes submetidas à LL, com duas técnicas diferentes - diatermia e pinçamento com anel. MÉTODO: Participaram do estudo 50 pacientes, estado físico ASA I e II, com idade entre 23 e 47 anos. As pacientes foram distribuídas aleatoriamente em dois grupos: G1 - oclusão das tubas uterinas com anéis, G2 - oclusão das tubas uterinas com diatermia. Todas as pacientes receberam N-butilescopolamina (20 mg) e dipirona sódica (2500 mg) e cetoprofeno (100 mg), por via venosa, imediatamente antes da indução da anestesia. A dor foi avaliada pelo critério de escala numérica verbal, variando de 0 a 10, sendo 0 ausência de dor e 10 o máximo de dor, a cada 10 minutos na primeira hora, na sala de recuperação pós-anestésica (SRPA) e na 1ª, 2ª, 3ª e 4ª horas após a alta da SRPA. Dor com intensidade maior que 3 era tratada com tramadol (100 mg), por via venosa. A avaliação da dor foi realizada sem que se soubesse a que grupo pertencia a paciente. Para análise estatística, testes t de Student, Mann-Whitney e Friedman. RESULTADOS: Ambos os grupos foram idênticos com relação à idade, ao peso, à altura, à duração da cirurgia e anestesia. As pacientes do G1 apresentaram maior escore de dor que as do G2, em todos os momentos do estudo. Valores estatisticamente significativos: 80 por cento das pacientes de G1 e 16 por cento de G2 necessitaram de tramadol em algum momento do estudo. CONCLUSÕES: A N-butilescopolamina e a dipirona sódica associadas ao cetoprofeno mostraram ser alternativa de analgesia pós-operatória quando a laqueadura é realizada com a técnica de diatermia.

Valor terapêutico da associaçäo de espasmolítico com analgésico contendo brometo de N-butilescopolamina com dipirona / Therapeutic value of the combination between an spasmolithic with an analgesic: scopolamine-N-butyl bromide and dipirone

A grande mioria das combinaçöes de fármacos säo irracionais e perigosas. Por outro lado, existem algumas associaçöes medicamentosas que apresentam bases farmacológicas racionais ao lado de uma adequada relaçäo benefício/risco. A associaçäo entre o brometo de N-butilescopolamina com a dipirona é aprovada pelas autoridades sanitárias em vários países apresentando claras indicações terapêuticas, No Brasil particularmente, essa combinaçäo foi aprovada há mais de trinta anos, estando mesmo padronizada em muitos hospitais, principalmente na emergência. A classe médica considera essa combinaçäo fixa como uma associação analgésica de primeira escolha, prática, de baixo custo e muito eficaz