Preoperative use of pregabalin for acute pain in spine surgery: A meta-analysis of randomized controlled trials.

BACKGROUND: We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the efficacy and safety of pregabalin for pain management following spine surgery. METHODS: In September 2016, a systematic computer-based search was conducted in PubMed, EMBASE, Web of Science, and Cochrane Database of Systematic Reviews. RCTs of patients prepared for spine surgery that compared pregabalin with placebo were retrieved. The primary endpoint was the VAS score with rest or mobilization at 12 hours, 24 hours, and 48 hours and cumulative morphine consumption at 24 hours and 48 hours. The secondary outcomes were complications of nausea, sedation, dizziness, headache, and visual disturbances. After testing for publication bias and heterogeneity between studies, data were aggregated for random-effects models when necessary. RESULTS: Ten clinical studies with 535 patients (pregabalin group = 294, control group = 241) were included in the meta-analysis. Pregabalin was associated with reduced pain scores at 12 hours, 24 hours, and 48 hours, corresponding to a reduction of 1.91 points (95% CI, -4.07 to 0.24 point) at 12 hours, 2.66 points (95% CI, -4.51 to -0.81 point) at 24 hours, and 4.33 points (95% confidence interval, -6.38 to -2.99 point) at 48 hours on a 100-point numeric rating scale. There was no significant difference between VAS scores with mobilization at 12 hours, 24 hours, or 48 hours. Similarly, pregabalin was associated with a reduction in cumulative morphine consumption at 24 hours (-7.07, 95% CI -9.84, -4.30) and 48 hours (-6.52, 95% CI -7.78, -5.25, P = 0.000). Furthermore, pregabalin can reduce the occurrence of nausea (RR 0.57, 95% CI 0.41, 0.79, P = 0.001, number needed to treat = 8.4). There were no significant differences in the occurrence of sedation, dizziness, headache, or visual disturbances. CONCLUSIONS: Preoperative use of pregabalin was efficacious in reduction of postoperative pain, total morphine consumption, and the occurrence of nausea following spine surgery. Because the sample size and the number of included studies were limited, a multicenter RCT is needed to identify the effects and optimal dose of pregabalin for reducing acute pain after spine surgery.

Chromatographic determination of biogenic amines in wines after treatment with ionic liquids as novel media.

Room temperature ionic liquids (RTIL), 1-butyl-3-methylimidazolium hexafluorophosphate ([C(4) MIM][PF(6) ]), were used as the novel media for derivatization, extraction and preconcentration of biogenic amines (BAs) in wines. Six BAs, tryptamine (Try), phenylethylamine (Phe), putrescine (Put), cadaverine (Cad), tyramine (Tyr) and spermine (Spe) were selected as the model compounds and dansyl chloride (Dns-Cl) as the derivatizing reagent. The derivatizations of amines were conducted in water-IL two-phase system, in which the partition property of related substance in the IL was investigated and the mechanism (http://www.iciba.com/mechanism/) of derivation and extraction of amines was discussed. The influencing factors, including sample volume, derivatizing reagent concentration, pH value and ultrasound reaction time, were optimized. The Dns-amines were separated by high-performance liquid chromatography (HPLC), and detected with UVD at 254 nm. For each of the tested amines, a good linearity was obtained in the concentration range of 0.1-20 mg/L with the correlation coefficient (R) of 0.9814-0.9930. The limits of detection reached µg/L level and the relative standard deviations (RSD, n=3) were between 3.2 and 8.1%. Satisfactory recovery for each BA was obtained, ranging from 82.3 to 114.0%. The developed method was successfully applied to determine six BAs in red wines and Chinese yellow wine.

[Operative treatment of upper lumbar disc herniation with modified transforaminal lumbar interbody fusion].

OBJECTIVE: To investigate the surgical methods and clinical results of modified transforaminal lumbar interbody fusion and internal fixation for the treatment of upper lumbar disc herniation. METHODS: Clinical data of 32 cases of upper lumbar disc herniation in our department from June 2005 to June 2009 were retrospectively analyzed. There were 21 males and 11 females, the age from 24 to 59 years with an average of 38.5 years. All the cases were treated by the use of nucleus pulposus removed, modified transforaminal lumbar interbody fusion (TLIF) and internal fixation with pedicle screw system. All patients were followed up with an average of 9 months (from 3 to 18 months), according to Japanese Orthopedic Association (JOA) scores and visual analogue scores (VAS) to evaluate clinical effects. RESULTS: All the cases were followed up from 3 to 18 months with an average of 9 months and the fusion rate was 100%. The JOA sores before and after operation were 10.5 +/- 2.1, 26.2 +/- 2.4 respectively, and the improvement rate was 84.9%. The VAS before and after operation was 7.2 +/- 1.3 and 1.4 +/- 1.1 respectively, and the rate of catabatic pain was 80.6%. Lumbar rigidity and unwell had 4 cases, obviously leg pain had 2 cases after operation, but the systems vanished gradually at 1-8 weeks after non-operative treatment. CONCLUSION: Modified transforaminal lumbar interbody fusion has the advantages of simple, safe operation and thoroughly decompression, and it is a therapeutic method for upper lumbar disc herniation.

[Clinical treatment of acute traumatic central cervical spinal cord syndrome without fracture and dislocation].

OBJECTIVE: To analyze clinical characteristics and therapeutic efficacy of acute traumatic central cervical spinal-cord syndrome without fracture and dislocation,and to investigate its treatment methods. METHODS: Clinical data of 47 cases with acute traumatic central cervical spinal-cord syndrome without fracture and dislocation were retrospectively analyzed. There were 3 female and 44 male,with a mean age of 56.2 years (ranging from 46 to 73 years). According to Frankel classification, 30 cases were grade B, 14 cases were grade C and 3 cases were grade D. Forty-two cases were treated without operation, and 5 cases which had significant compression factors or segmental instability were treated with surgical treatment. Among them, 3 cases were treated through anterior approach and 2 cases were treated through posterior approach. Causes of injuries, mechanisms of injuries,findings of imaging, functional impairment of nerve,methods of treatment,and therapeutic efficacy were analyzed. RESULTS: The average followed-up time was 12 months (ranging form 3 to 84 months), 2 cases of non-operation were dead and 6 were loss. Three months after treatment, some complications occurrenced on 7 patients of non-operation. The majority bequeathed different degree impairment of intrinsic muscles of hands. CONCLUSION: Reduction and fixation through the pedicle of fractured vertebra is an effective therapeutic options to treat the thoracolumbar burst fractures and desearved clinical study and expansion.

Simultaneous determination of seven phthalates and four parabens in cosmetic products using HPLC-DAD and GC-MS methods.

Studies on the determination of seven kinds of phthalates, i.e. diethyl phthalate, dipropyl phthalate, dibutyl phthalate, benzyl butyl phthalate, dicyclohexyl phthalate, di-(2-ethylhexyl) phthalate, and dioctyl phthalate, and four parabens, i.e. methylparaben, ethylparaben, propylparaben, and butylparaben, in 15 kinds of cosmetic products, including hair sprays, perfumes, deodorants, cream, lotion, etc., by HPLC with diode array detection and GC-MS in electron impact ionization mode with selected-ion monitoring have been carried out. Methods have been developed for both qualitative and quantitative detection of phthalates and parabens. Extraction, clean-up, and analysis procedures have been optimized. HPLC and GC-MS determinations were performed after sonication-assisted extraction with methanol and clean-up with C18 SPE. These techniques permit detection of phthalates at a level of 10.0-100.0 microg/kg and of parabens at a level of 20.0-200.0 microg/kg. Overall recoveries were 85-108% with RSD values of 4.2-8.8%. Only one of the 15 examined samples was free from phthalates and parabens. The remaining 14 samples were found to contain at least three or more of these phthalates and/or parabens. The predominant phthalates and parabens detected in the studied samples were methylparaben, propylparaben, diethyl phthalate, dibutyl phthalate, dicyclohexyl phthalate, and di-(2-ethylhexyl) phthalate. The residue level is at 1.22-5289 mg/kg.