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1.
Rev Med Liege ; 75(1): 17-22, 2020 Jan.
Artigo em Francês | MEDLINE | ID: mdl-31920039

RESUMO

Inhalation of gastric content is a significant risk factor for perioperative complications. Preoperative fasting reduces this risk. The preanesthesia fasting time is variable and is subject to recommendations from different scientific societies. The clinician can identify some risk factors for inhalation during the preoperative anesthetic consultation. On the day of the procedure, the gastric ultrasound allows quantitative or semi-quantitative assessment of the gastric content. In that way, the anesthesiologist can adapt the anesthesia, in particular by using a so-called rapid sequence induction and esophageal compression.


Assuntos
Anestesia , Jejum , Cuidados Pré-Operatórios , Humanos , Encaminhamento e Consulta , Fatores de Risco , Ultrassonografia
2.
J Physiol Pharmacol ; 70(3)2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31539887

RESUMO

Prilocaine is widely used for spinal anesthesia. Its intermediate effect makes it a valuable choice for one-day surgery. The duration of the motor blockade (DMB) may have an impact on the length of stay. The goal of this study was to establish a correlation between the DMB and different parameters (hyperbaric prilocaine dose, puncture level, surgical position, age, patient weight, and patient height). We prospectively enrolled adult patients scheduled for ambulatory surgery (n = 384). Univariate and multivariate regressions (backward stepwise) were applied. A P value lower than 0.05 was considered significant. We performed first analyzes on the entire population. We achieved same on a subgroup only composed of patients who received 60 mg of hyperbaric prilocaine between L4 and L5 and staying on dorsal position during surgery. The univariate analyses of the entire population demonstrate a significant correlation between DMB and 1) the prilocaine dose (P < 0.001), and 2) the BMI (P = 0.011). On the same population, the multivariate analyses confirm these two independent parameters correlated to the DMB: the patient height (P = 0.03) and the hyperbaric prilocaine dose (P < 0.001). The second analyses performed on the subgroup (n = 65), demonstrate a wide variability in the DBM (mean ± SD): 90.12 ± 30.36 minutes. For this concern, univariate analyses illustrate that only the patient height was significantly correlated to the DMB (P = 0.005). The multivariate analyses confirm that patient height could be considered as an independent parameter of DBM (P = 0.005). Within our entire population, there exists a considerable variation in the duration of the motor block after a unique injection of hyperbaric prilocaine. The prilocaine dose and the patient height were the only independent factors of the extension of the DMB. However, this relation is extremely weak and only allows explaining the variability of the DMB in a minority of the patients. This unknown pharmacological property of hyperbaric prilocaine could restrict its use for day-care surgery.

3.
Rev Med Liege ; 74(5-6): 336-341, 2019 05.
Artigo em Francês | MEDLINE | ID: mdl-31206277

RESUMO

The anesthetic management of the patient with unhealthy alcohol use is challenging. Chronic alcohol intake results in numerous co-morbid diseases, physiologic changes and pharmacologic alterations leading to increased perioperative morbidity and mortality. Hence anesthesiologists should search for chronic and acute effects of alcohol abuse when managing such patients. Also, the anesthetic approach of these patients must be adapted to prevent perioperative complications, including withdrawal symptoms. Last, the preoperative period is on opportunity to initiate alcohol withdrawal, with patient's agreement and collaboration.


Assuntos
Alcoolismo , Anestesia Geral , Alcoolismo/complicações , Anestesistas , Humanos , Morbidade
4.
Obes Surg ; 27(3): 716-729, 2017 03.
Artigo em Inglês | MEDLINE | ID: mdl-27599985

RESUMO

BACKGROUND: Severe obstructive sleep apnea (OSA) is an independent risk factor for perioperative complications. Clinical scores such as Snoring, Tiredness, Observed apnea, high blood Pressure, Body Mass Index (BMI) higher than 35 kg m-2, Age older than 50 years, Neck circumference larger than 40 cm, and male gender (STOP-Bang), perioperative sleep apnea prediction (P-SAP), and OSA50 have been proposed for detecting OSA. We recently proposed a new score based on morphological metrics only, the DES-OSA score. This study compared the DES-OSA score to the three other ones with regard to their ability to detect OSA. Obese patients are particularly at risk of OSA. METHODS: Following informed consent and institutional review board (IRB) approval, 1584 consecutive adults were. Should the STOP-Bang be indicative of increased risk of severe OSA, the patient was referred to complementary polysomnography (PSG). Eventual already existing recent PSG data were also collected. The abilities of the four scores to predict OSA severity were compared using sensitivity, specificity, Cohen's kappa coefficient (CKC), and area under ROC curve (AUROC) analysis. RESULTS: PSG was performed in 150 patients. For detecting severe OSA, OSA50 had the highest sensitivity [value (95 % CI) 0.98 (0.90-1)]. STOP-Bang was significantly less sensitive than P-SAP and OSA50. In that respect, DES-OSA was significantly more specific than the three other ones [0.75 (0.65-0.83)]. The AUROC of DES-OSA was significantly the largest [0.9 (0.84-0.95)]. The highest CKC at detecting severe OSA was 0.62 (0.49-0.74) for DES-OSA. Similar results were obtained for moderate to severe OSA prediction. CONCLUSIONS: DES-OSA, which is the only exclusively morphological score available, appears to surpass the three other scores in their ability to predict moderate to severe and severe OSA, at least in our setting and in our screened population. CLINICAL TRIAL REGISTRATION: ClinicalTrial.gov NCT02051829.


Assuntos
Cuidados Pré-Operatórios/métodos , Apneia Obstrutiva do Sono/diagnóstico , Adolescente , Adulto , Idoso , Índice de Massa Corporal , Fadiga/etiologia , Feminino , Humanos , Hipertensão/etiologia , Masculino , Programas de Rastreamento/métodos , Pessoa de Meia-Idade , Obesidade/complicações , Obesidade Mórbida/complicações , Polissonografia/métodos , Valor Preditivo dos Testes , Fatores de Risco , Sensibilidade e Especificidade , Índice de Gravidade de Doença , Apneia Obstrutiva do Sono/complicações , Ronco/epidemiologia , Adulto Jovem
5.
J Physiol Pharmacol ; 67(4): 617-624, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27779482

RESUMO

Postoperative development or worsening of obstructive sleep apnea is a potential complication of anesthesia. The objective of this study was to study the effects of a premedication with alprazolam on the occurrence of apneas during the immediate postoperative period. Fifty ASA 1 - 2 patients undergoing a colonoscopy were recruited. Patients with a history of obstructive sleep apnea (OSA) were excluded. Recruited patients were randomly assigned to one of two groups: in Group A, they received 0.5 mg of alprazolam orally one hour before the procedure; and in Group C, they received placebo. Anesthesia technique was identical in both groups. Patients were monitored during the first two postoperative hours to establish their AHI (apnea hypopnea index, the number of apneas and hypopneas per hour). Nine patients were excluded (4 in group A and 5 in group C) due to technical problems or refusal. Interestingly, premedication by alprazolam did not change intra-operative propofol requirements. During the first two postoperative hours, the AHI was significantly higher in group A than in group C (Group A: 20.33 ± 10.97 h-1, C: 9.63 ± 4.67 h-1). These apneas did not induce significant arterial oxygen desaturation, or mandibular instability. Our study demonstrates that a premedication with 0.5 mg of alprazolam doesn't modify intra-operative anesthetic requirements during colonoscopy, but is associated with a higher rate of obstructive apneas during at least three and a half hours after ingestion. No severe side effects were observed in our non-obese population. Our results must be confirmed on a larger scale.


Assuntos
Alprazolam/administração & dosagem , Hipnóticos e Sedativos/administração & dosagem , Apneia Obstrutiva do Sono/induzido quimicamente , Adulto , Idoso , Alprazolam/uso terapêutico , Analgésicos/uso terapêutico , Anestésicos Intravenosos/uso terapêutico , Colonoscopia , Método Duplo-Cego , Esquema de Medicação , Feminino , Humanos , Hipnóticos e Sedativos/uso terapêutico , Ketamina/uso terapêutico , Masculino , Pessoa de Meia-Idade , Propofol/uso terapêutico
7.
Minerva Anestesiol ; 81(9): 960-7, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25479468

RESUMO

BACKGROUND: Obstructive Sleep Apnea (OSA) increases the perioperative risk of complications. Chronic use of Continuous Positive Airway Pressure (CPAP) by patients decreases the importance of comorbidities caused by the OSA. However, many patients do not adhere to the treatment. Given the postoperative complications, it is important for the anesthesiologist to identify non-adherent patients. This prospective study was designed to identify factors that would predict patient adherence. METHODS: Ninety patients who were treated by CPAP for more than one year were recruited. Among them, and based on objective criteria such as length of use of CPAP during the night, 75 were considered as being adherent to CPAP, while the other 15 were not. Sixty-two potential causes of non-adherence were investigated (some have not been tested before), and further divided into five categories. Those categories included cultural, intellectual, or economic factors, OSA comorbidities, patient belief about health, ENT-related problems, and pathophysiological features estimating the degree of improvement afforded by CPAP introduction. RESULTS: Multivariate binary logistic regression analysis identified one criterion of non-adherence to treatment, namely the feeling of breathlessness, and three criteria of adherence, namely awareness of the risk of complications, awareness of treatment efficacy, and feeling of being less tired with CPAP therapy. CONCLUSIONS: These four new criteria should preoperatively be sought, in order to detect non-adherent patients more efficiently.


Assuntos
Pressão Positiva Contínua nas Vias Aéreas , Cooperação do Paciente/estatística & dados numéricos , Apneia Obstrutiva do Sono/terapia , Idoso , Anestesia , Pressão Positiva Contínua nas Vias Aéreas/efeitos adversos , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Período Perioperatório , Cuidados Pré-Operatórios , Estudos Prospectivos , Fatores Socioeconômicos
8.
Rev Med Liege ; 67(2): 69-74, 2012 Feb.
Artigo em Francês | MEDLINE | ID: mdl-22482235

RESUMO

Due to their action on the low-density lipoprotein-cholesterol (LDL-Cholesterol), statins efficiently take part in the treatment of coronary artery disease (CAD). Moreover, they exert various effects (called "pleiotropic") independently of their lipid lowering actions. All of these effects interact with inflammation, thrombosis and vasoconstriction during the perioperative period. However, statins may also increase the risk of rhabdomyolysis, a rare but potentially lethal complication. In this article, we will describe the advantages and disadvantages of statin therapy during the perioperative period. Although in the past, withdrawal of statins was recommended before anesthesia, there is now evidence that statins must be continued or even must be introduced before surgery. We will try to identify relevant situations were statins are still under-prescribed before surgery.


Assuntos
Anestesia/métodos , Inibidores de Hidroximetilglutaril-CoA Redutases/farmacologia , Cuidados Pré-Operatórios/métodos , LDL-Colesterol/efeitos dos fármacos , Doença da Artéria Coronariana/tratamento farmacológico , Interações de Medicamentos , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/administração & dosagem , Inibidores de Hidroximetilglutaril-CoA Redutases/efeitos adversos , Período Perioperatório , Rabdomiólise/induzido quimicamente
9.
Rev Med Liege ; 65(7-8): 442-7, 2010.
Artigo em Francês | MEDLINE | ID: mdl-20857701

RESUMO

Thirty percent of surgical patients undergoing routine surgery are smokers, and smoking is an additional risk for these patients. During the perioperative period, smokers are more prone than non smokers to present either systemic complications interesting the cardiovascular and pulmonary functions or specific complications related to the surgical procedure, such as infections, wound problems and delayed osteosynthesis. Therefore, coming-off from smoking addiction is an obvious prerequisite in these patients. Diagnosing smoking habit, evaluating its severity and its systemic repercussions on vital functions, as well as proposing an efficacious and appropriate help to smokers before surgery become one essential objective of pre-anesthetic assessment.


Assuntos
Complicações Pós-Operatórias/prevenção & controle , Período Pós-Operatório , Período Pré-Operatório , Abandono do Hábito de Fumar , Humanos , Cicatrização
10.
Rev Med Liege ; 65(5-6): 332-7, 2010.
Artigo em Francês | MEDLINE | ID: mdl-20684415

RESUMO

Smoking concerns 30% of the patients scheduled to anesthesia. Tobacco is one of the most important risk factors for postoperative complications. There are two classes of complications: those induced by the smoking habits on the cardiovascular and the respiratory systems, and those that predispose to other complications by direct interference with processes required for the success of surgery: healing and immune responses. The preoperative period represents a crucial period to overcome clinical inertia and profit of a better compliance. Some strategies applicable by the general practitioner and the anesthesiologist during the preoperative consultation to establish smoking cessation and help the patient to comply with are proposed.


Assuntos
Atitude do Pessoal de Saúde , Cooperação do Paciente , Abandono do Hábito de Fumar , Fidelidade a Diretrizes , Humanos , Cuidados Pré-Operatórios
11.
Br J Anaesth ; 105(2): 196-200, 2010 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-20581214

RESUMO

BACKGROUND: Thoracotomy results in severe postoperative pain potentially leading to chronic pain. We investigated the potential benefits of oral celecoxib on postoperative analgesia combined with thoracic epidural analgesia (TEA). METHODS: Forty patients undergoing thoracotomy were included in this prospective, randomized, double-blind, placebo-controlled study. General anaesthesia was standardized. Patient-controlled epidural analgesia (T4-T5) was used during 48 h after surgery (ropivacaine 2 mg ml(-1) with sufentanil 0.5 microg ml(-1)). Patients were allocated to receive oral celecoxib or placebo from the evening before surgery until 48 h after operation. Postoperative pain scores, respiratory function, and morbidity were compared between the two groups. RESULTS: Postoperative pain scores at rest (P=0.026) and during coughing (P=0.021) were lower and patient satisfaction was greater (P=0.0033) in the celecoxib group. Consumption of the local anaesthetic solution was comparable between groups. Postoperative restrictive pulmonary syndrome and morbidity were comparable between groups. CONCLUSIONS: Celecoxib improves postoperative analgesia provided by TEA after thoracotomy.


Assuntos
Analgesia Epidural/métodos , Inibidores de Ciclo-Oxigenase 2/administração & dosagem , Dor Pós-Operatória/prevenção & controle , Pirazóis/administração & dosagem , Sulfonamidas/administração & dosagem , Toracotomia/efeitos adversos , Administração Oral , Adulto , Idoso , Celecoxib , Método Duplo-Cego , Feminino , Volume Expiratório Forçado/efeitos dos fármacos , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor/métodos , Dor Pós-Operatória/etiologia , Satisfação do Paciente , Estudos Prospectivos , Capacidade Vital/efeitos dos fármacos , Adulto Jovem
12.
Br J Anaesth ; 100(2): 245-50, 2008 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-18083787

RESUMO

BACKGROUND: Delta pulse pressure (DPP) and delta down (DD) are indicators of volaemia. The threshold value of DPP for discriminating between responders and non-responders to fluid loading (FL) is 13%. This study aimed at comparing DD with DPP during intracranial surgery. METHODS: Twenty-six adult patients undergoing scheduled intracranial surgery under general anaesthesia were enrolled. DD and DPP were simultaneously measured every 10 min. A DPP>13% on two consecutive occasions prompted a 250 ml FL. Pairs of data were analysed using regression analysis, receiver operating characteristics (ROC) curve, and prediction probability (Pk). RESULTS: We found a significant correlation between DD and DPP (R2=0.5431, P<0.001). ROC curve analysis revealed an excellent accuracy of DD in predicting a DPP value higher or lower than 13% (area under the curve: 0.967, se: 0.013). The DD threshold associated with the best sensitivity (0.90) and specificity (0.99) was 5 mm Hg. The Pk of DD to predict a DPP value higher or lower than 13% was 0.97 (se: 0.01). A total of 41 FL performed in 19 patients resulted in a decrease of DD and DPP below 5 mm Hg and 13%, respectively, in all but one occasion. CONCLUSIONS: DD is as efficient as DPP to assess hypovolaemia and predict responsiveness to FL in patients undergoing intracranial surgery. A 5 mm Hg DD value can be considered as a valuable threshold for initiating FL. These results support its use during intracranial surgery.


Assuntos
Craniotomia , Hidratação/métodos , Hipovolemia/diagnóstico , Complicações Intraoperatórias/diagnóstico , Monitorização Intraoperatória/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Anestesia Geral/métodos , Pressão Sanguínea , Determinação da Pressão Arterial/métodos , Métodos Epidemiológicos , Feminino , Humanos , Hipovolemia/terapia , Cuidados Intraoperatórios/métodos , Complicações Intraoperatórias/terapia , Masculino , Pessoa de Meia-Idade , Fluxo Pulsátil , Respiração Artificial
13.
Br J Anaesth ; 97(3): 340-6, 2006 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-16829672

RESUMO

BACKGROUND: Bispectral index (BIS) and state entropy (SE) monitor hypnosis. We evaluated the correlation and the agreement between those parameters during propofol anaesthesia and laryngoscopy with and without muscle relaxation. METHODS: A total of 25 patients were anaesthetized with propofol. At steady state (SS: BIS 40-50), they randomly received rocuronium (R) or saline (S); 3 min thereafter, a 20 s laryngoscopy was performed. Correlation (regression analysis) and agreement (Bland-Altman analysis) were evaluated before induction (baseline), at loss of eyelash reflex (LER), at SS and during the first 3 min after laryngoscopy (L). RESULTS: The correlation coefficient r (95% CI), the mean difference (MD) (95% CI), and the limits of agreement [lower-upper limits of 95% CI of MD (sd 1.96)] between BIS and SE were as follows. Overall recordings: 0.87 (0.83 to 0.90), 2.5 (1.2 to 3.0), and [-19.5 to 24.6]; Baseline: 0.45 (0.06 to 0.72), 7.6 (6.0 to 9.2), and [-2.7 to 17.9]; LER: 0.74 (0.47 to 0.88), 8.3 (3.5 to 13.2), and [-22.6 to 39.3]; SS, all patients: 0.41 (0.14 to 0.63), 2.0 (-0.5 to 4.6), and [-19.0 to 23.3]; SS, Group S: 0.36 (-0.07 to 0.68), 1.9 (-2.5 to 6.3), and [-25.0 to 28.8]; SS, Group R: 0.63 (0.32 to 0.82), 0.2 (-2.0 to 2.3), and [-14.0 to 14.4]; L, all patients: 0.49 (0.32 to 0.63), 0.7 (-1.6 to 3.0), and [-25.6 to 27.1]; L, Group S: 0.41 (0.13 to 0.63), 2.3 (-2.4 to 7.1), and [-36.7 to 41.3]; L, Group R: 0.72 (0.56 to 0.83), -0.6 (-2.2 to 1.0), and [-14.3 to 13.1]. The correlation was good except for SS in Group S. The MD was significantly different from 0 for overall recordings, during baseline and LER, but not for the other conditions. The agreement was poor except for baseline, and SS and L in Group R. CONCLUSIONS: BIS and SE are globally well correlated. In contrast, agreement is poor as differences of more than 20 units are frequently observed, except for awake and paralysed patients.


Assuntos
Anestésicos Intravenosos/farmacologia , Eletroencefalografia/efeitos dos fármacos , Monitorização Intraoperatória/métodos , Propofol/farmacologia , Processamento de Sinais Assistido por Computador , Adulto , Idoso , Idoso de 80 Anos ou mais , Androstanóis/farmacologia , Método Duplo-Cego , Eletromiografia/efeitos dos fármacos , Entropia , Feminino , Humanos , Laringoscopia , Masculino , Pessoa de Meia-Idade , Fármacos Neuromusculares não Despolarizantes/farmacologia , Estudos Prospectivos , Reprodutibilidade dos Testes , Rocurônio
14.
Rev Med Liege ; 59(1): 19-28, 2004 Jan.
Artigo em Francês | MEDLINE | ID: mdl-15035539

RESUMO

Since two decades, sleep breathing disorders are more wisely recognized by the Belgian medical community. Among these, the Obstructive Sleep Apnea Syndrome (OSA) is the best known but its frontiers with others syndromes such as the Upper Airway Resistance Syndrome (UARS), the Central Sleep Apnea Syndrome (CSAS) or the Overlap Syndrome are still matter of discussion. Its causes are plurifactorial, and many recent publications draw the attention to its long term effects in the cardiovascular and neuropsychiatric fields. This article summarizes the present definitions and features associated with OSA, from clinical and neurophysiological perspectives, and the different consequences to which untreated or underdiagnosed patients are exposed.


Assuntos
Apneia Obstrutiva do Sono/complicações , Apneia Obstrutiva do Sono/diagnóstico , Doenças Cardiovasculares/etiologia , Cefalometria , Pressão Positiva Contínua nas Vias Aéreas , Fadiga/etiologia , Humanos , Programas de Rastreamento , Anamnese , Obesidade/complicações , Exame Físico , Polissonografia , Prevalência , Testes de Função Respiratória , Fatores de Risco , Índice de Gravidade de Doença , Apneia Obstrutiva do Sono/classificação , Apneia Obstrutiva do Sono/epidemiologia , Apneia Obstrutiva do Sono/terapia , Inquéritos e Questionários
15.
Rev Med Liege ; 57(8): 519-27, 2002 Aug.
Artigo em Francês | MEDLINE | ID: mdl-12405025

RESUMO

The diagnosis of narcolepsy-cataplexy is based on three axes: 1) the medical history is strongly suggestive when diurnal sleep attacks (narcolepsy) and drop attacks (cataplexy) are reported or observed; 2) the polysomnography is mandatory and shows nocturnal and diurnal (multiple sleep latency test) REM sleep onsets; 3) HLA typing, practically helps to exclude the diagnosis when HLA DR15-DQB1*0602 is not present. New pathogenetic hypotheses have been proposed, mostly based the absence of hypocretin in narcoleptic cerebrospinal fluid. This neurotransmitter was previously known exclusively by its involvement in alimentary behaviours. The new therapies remain symptomatic, but they are powerful to prevent somnolence, daytime sleepiness, cataplexy and insomnia associated with this syndrome.


Assuntos
Peptídeos e Proteínas de Sinalização Intracelular , Narcolepsia/diagnóstico , Narcolepsia/terapia , Proteínas de Transporte/líquido cefalorraquidiano , Progressão da Doença , Antígenos HLA-DQ/análise , Cadeias beta de HLA-DQ , Antígenos HLA-DR/análise , Subtipos Sorológicos de HLA-DR , Teste de Histocompatibilidade , Humanos , Anamnese , Narcolepsia/epidemiologia , Narcolepsia/etiologia , Neuropeptídeos/líquido cefalorraquidiano , Neuropeptídeos/deficiência , Orexinas , Polissonografia , Prevalência , Fases do Sono
16.
Rev Med Liege ; 57(2): 85-90, 2002 Feb.
Artigo em Francês | MEDLINE | ID: mdl-11942183

RESUMO

Two cases of acute internal carotid dissection are presented. Typical symptoms, pathogeny and imaging features are reviewed. Magnetic Resonance is actually the best technique for the diagnosis of internal carotid artery dissection, which should be searched in young patients presenting neurologic and cervico-facial symptoms.


Assuntos
Dissecação da Artéria Carótida Interna/diagnóstico , Fatores Etários , Dissecação da Artéria Carótida Interna/patologia , Diagnóstico Diferencial , Feminino , Síndrome de Horner/diagnóstico , Síndrome de Horner/patologia , Humanos , Angiografia por Ressonância Magnética , Pessoa de Meia-Idade
18.
Pathol Biol (Paris) ; 35(9): 1253-62, 1987 Nov.
Artigo em Francês | MEDLINE | ID: mdl-3320903

RESUMO

This review was focused on counter irritation by turpentine in the rat. The involvement of sympathetic system, adrenal steroids, beta-endorphin, axon reflexes, haptoglobin, alpha-2-macroglobulin, complement activation, prostaglandin synthesis, kinin formation and leukocyte accumulation was considered as possible explanation of the anti-inflammatory effect of counter irritation by turpentine. The main mechanism consists of the reduction of leucocyte accumulation.


Assuntos
Inflamação/metabolismo , Cininas/metabolismo , Contagem de Leucócitos/efeitos dos fármacos , Prostaglandinas/biossíntese , Terebintina/farmacologia , Animais , Vasos Sanguíneos/efeitos dos fármacos , Proteínas do Sistema Complemento/metabolismo , Cobaias , Inflamação/patologia , Ratos
19.
J Pharmacol ; 17(2): 155-62, 1986.
Artigo em Francês | MEDLINE | ID: mdl-3091943

RESUMO

In normal rats, PGE1, arachidonic acid, indomethacin and diclofenac did not modify the leucocyte content of sponge exudates withdrawn 4 hours after implantation while arachidonic acid increased the level in PGE2 and indomethacin reduced it. The leucocyte content of sponges exudates withdrawn 18 hours after implantation was not modified by PGE1 and TXB2, but diminished by indomethacin and NDGA and increased by arachidonic acid. As the chemotactic effect of arachidonic acid was slightly reduced by indomethacin and abolished by NDGA, it could depend on the formation of lipoxygenase derivatives. In normal rats, the leucocyte content of sponge exudates withdrawn 18 hours after implantation was increased slightly by normal serum and largely by serum from turpentine-treated rats. The blood leucocyte content was not modified in turpentine-treated rats. However in these rats, the leucocyte content of sponge exudates was low comparatively to the leucocyte content in normal rats. This low level was not affected by indomethacin, arachidonic acid and normal serum. The leucocytes of turpentine-treated rats seem to be desensitizated towards chemotactic factors. Similar desensitization was observed in rats treated by iota carrageenan.


Assuntos
Exsudatos e Transudatos/citologia , Irritantes/farmacologia , Leucócitos/efeitos dos fármacos , Terebintina/farmacologia , Animais , Anti-Inflamatórios/farmacologia , Ácido Araquidônico , Ácidos Araquidônicos/metabolismo , Dinoprostona , Feminino , Contagem de Leucócitos/efeitos dos fármacos , Masculino , Prostaglandinas E/farmacologia , Ratos , Ratos Endogâmicos
20.
Naunyn Schmiedebergs Arch Pharmacol ; 332(2): 196-200, 1986 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-3517657

RESUMO

The influence of counter irritation by turpentine (0.2 ml) on zymosan- and carrageenan-oedemas was investigated in the rat. Zymosan-oedema was inhibited by mepyramine and methysergide and by leucopenia. It was not modified by captopril and developed normally in kininogendeficient Brown Norway rats. Leucocytes and mast cell amines but not kinins are thus involved in zymosan-oedema. The last phase of this reaction was inhibited by counter irritation alone, but the odema was largely depressed by counter irritation in rats pretreated with mepyramine and methysergide. Carrageenan-oedema was increased by kininase inhibitors and inhibited by leucopenia in normal rats. This inflammatory reaction had a small developement and was not increased by kininase inhibitors in kininogen-deficient BN rats. Leucocytes and kinins participate in the developement of this inflammatory reaction in normal rats while kinins are lacking in deficient rats. Counter irritation depressed carrageenan-oedema in deficient Brown Norway rats and suppressed the potentiating effect of kininase inhibitors in normal rats. Carrageenan oedema was nearly abolished in turpentine-treated leucopenic rats. These results suggest that the anti-inflammatory effect of counter irritation by turpentine could depend on a reduction of leucocyte accumulation into zymosan-oedema and on a reduction of both kinin formation and of leucocyte accumulation into carrageenan-oedema. The significance of T-kininogen as acute phase reactant is discussed.


Assuntos
Inflamação/induzido quimicamente , Terebintina/farmacologia , Animais , Sedimentação Sanguínea , Captopril/farmacologia , Carragenina , Edema/induzido quimicamente , Feminino , Cininogênios/metabolismo , Leucopenia , Masculino , Metotrexato/farmacologia , Metisergida/farmacologia , Pirilamina/farmacologia , Ratos , Ratos Endogâmicos , Zimosan
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