Cortisol, progesterone, 17αOHprogesterone, and pregnenolone in foals born from mare's hormone-treated for experimentally induced ascending placentitis.

This study aimed to evaluate steroid hormones in foals born from mares treated for ascending placentitis with different combinations of trimethoprim-sulfamethoxazole (TMS), flunixin meglumine (FM), long-acting altrenogest (ALT) and estradiol cypionate (ECP) for ten consecutive days, starting two days after experimental induction of placentitis with Streptococcus zooepidemicus. Fourty-six pregnant mares and respective foals were assigned as healthy group (Control, n = 8) or treated groups as follows: TMS+FM (n = 8), TMS+FM+ALT (n = 8), TMS+FM+ALT+ECP (n = 6), TMS+FM+ECP (n = 6) and no treatment (NO TREAT n = 10). At delivery, foals were classified as high-risk or low-risk based on clinical and hematologic findings, and survival rates were recorded during the first week of life for comparisons across groups. Cortisol, progesterone, 17αOHprogesterone, and pregnenolone concentrations were determined via immunoassays in 31 of the 46 foals immediately after foaling (0 h), at 12, 24, 48 h, and seven days post-partum (168h). At birth, serum cortisol concentrations were higher in Control and TMS+FM+ECP foals than in remaining groups (p < 0.05). Foals in TMS+FM+ALT and TMS+FM groups had higher 17αOHprogesterone concentrations at 24 h and 48 h, respectively (p < 0.05). Pregnenolone concentrations were higher in TMS+FM than TMS+FM+ALT+ECP foals at 7 days (p < 0.05). High-risk and non-surviving foals had decreased concentrations of cortisol at parturition, but increased concentrations of progesterone from 0 h to 48 h. Pregnenolone and 17αOHprogesterone concentrations were increased and pregnenolone after 12 h in high-risk and non-surviving foals (p < 0.05). In conclusion, adding ECP to the treatment of experimentally-induced placentitis appears to improve foal viability and endocrine response. Cortisol and progestogen profiles were abnormal in high-risk and non-surviving foals, and those treated with ALT or TMS+FM only.

Efectividad de la profilaxis analgésica con clonixinato de lisina en exodoncias: ensayo clínico aleatorio / Effectiveness of preemptive lysine clonixinate in tooth extraction: a randomized controlled trial

Objetivo: Evaluar la efectividad de la profilaxis analgésica con dosis únicas de clonixinato de lisina (CL 125mg) en pacientes sometidos a extracciones dentales. Metodología: Ensayo clínico aleatorio, doble enmascaramiento placebo-controlado. Participaron pacientes ASA I y II con indicación de exodoncia dental de servicios públicos en la ciudad de Valdivia-Chile en el mes de octubre del 2012. Se asignó de manera aleatoria dos grupos: un grupo tratamiento quienes recibieron una dosis de 25mg de CL 15 minutos antes de la cirugía; y un grupo control quien recibió un placebo. A ambos grupos se indicó CL como analgésico de rescate. Mediante un cuestionario, los pacientes registraron el grado de dolor a través de una Escala Visual Análoga (EVA) durante primer día en las 7 primeras horas, después de 24 y a las 48 horas posterior a la cirugía. Además, se registró número de cápsulas de CL consumidos como rescate durante 3 días posteriores a la intervención. Se comparó el efecto analgésico observado (EVA) y el número de consumo de analgésicos adicionales entre ambos grupos mediante t-test (p<0,05). Resultados: Cincuenta y cuatro pacientes fueron intervenidos. No se encontró diferencia estadísticamente significativa entre las puntuaciones de dolor entre ambos grupos. Los pacientes con profilaxis de CL informaron similar consumo de números de cápsulas de rescate que el grupo control. Conclusión: La profilaxis analgésica con CL no demostró ser más efectiva en la reducción del dolor luego de extracciones dentales en comparación al uso de placebo y dosis postquirúrgicas.

Aim: To evaluate the effectiveness of prophylaxis with single-dose analgesic clonixinate lysine (CL 125 mg) in patients undergoing tooth extraction. Methods: A double-blind randomized placebo-controlled trial. Were included in the study patients ASA I and II with dental extraction indication in the city of Valdivia, Chile in October 2012. Were randomly assigned in two groups: the treatment group received a doses of 125mg of CL fifteen minutes before the surgery, and a control group who received placebo. Both groups used a CL as a rescue analgesic. Using a survey, patients reported the degree of pain via a visual analog scale (VAS) during the first day, at 24 and 48 hours after surgery. In addition, registered the number of CL capsules consumed as a ransom for 3 days after the surgery. We compared the analgesic effect observed in (VAS) and the number of additional analgesic consumption between the two groups using t-test (p <0,05). Results: Fifty-four patients were operated and there was no statistically significant difference between the pain scores between the two groups. Premedication patients reported the use of equal number of rescue capsules comparing with the control group. Conclusion: CL analgesic prophylaxis proved no more effective in reducing pain after tooth extraction when comparing to the use of placebo in a postoperative doses.

Bioequivalence of 250 mg lysine clonixinate tablets after a single oral dose in a healthy female Mexican population under fasting conditions.

OBJECTIVE: To evaluate the bioequivalence between two 250 mg-tablets of lysine clonixinate, Dorixina Forte (Siegfried Rhein, México) as reference product, and Prestodol (Farmaceúticos Rayere, S.A., México) as test formulation. METHODS: 26 healthy adult female Mexican volunteers received a single oral dose of 250-mg lysine clonixinate under fasting conditions. The drug was administered following a randomized, two-period, two-sequence, cross-over design. Twelve serial blood samples were collected up to 8 h after dosing, and clonixin (CLX) was measured by ultra-performance liquid chromatography (UPLC) coupled with tandem mass spectrometry. Decimal logarithm values of Cmax and area under the curve (AUC) were used to construct a classic confidence interval at 90% (90% CI). Bioequivalence was established if 90% CI of mean ratios (test/reference) fall within the 0.8-1.25 range. RESULTS: Volunteers formed a homogeneous population in terms of age (27.2 +/- 6.3 years), weight (55.9 +/- 6.5 kg), height (1.6 +/- 0.04 m), and body mass index (BMI) (22.91 +/- 2.03 kg/m(2)). Reference formulation exhibited the following pharmacokinetics: C(max) (32.39 +/- 8.32 microg/ml); t(max) (0.64 +/- 0.2 h); AUC0-8h (48.92 +/- 16.51 microg x h/ml); t1/2 (1.3 +/- 0.24 h); CLapp (5.64 +/- 1.99 l/h), and Vdapp (10.22 +/- 2.9 l). Concerning bioequivalence, 90% CI were: C(max) (82.32 - 98.79), AUC0-t (94.59-106.29), and AUC(0-inf) (94.61-106.42), with a statistical power of > 0.90 at every tested interval. CONCLUSIONS: This single-dose study found that both 250-mg immediate-release tablets of lysine clonixinate met the Mexican regulatory criteria for bioequivalence in these volunteers.

Hepatic effects of flunixin-meglumin in LPS-induced sepsis.

The aim of this study was to evaluate the actions of the non-steroidal anti-inflammatory drug flunixin-meglumin (FM) on the changes caused by lipopolysaccharide (LPS)-induced sepsis in the rat liver. Eight groups of five adult male Wistar rats were analysed: (1) saline injected (controls), (2) FM treated with 1.1 mg/kg, (3) FM treated with 2.2 mg/kg, (4) LPS-injected (10 mg/kg), (5) LPS-injected with 1.1 mg/kg FM pretreatment, (6) LPS-injected with 2.2 mg/kg FM pretreatment, (7) LPS-injected with 1.1 mg/kg FM post-treatment and (8) LPS-injected with 2.2 mg/kg FM post-treatment. All drugs were intraperitoneally injected. The following parameters were evaluated: plasma levels of hepatic enzymes and urea, hepatic histological characteristics, antioxidant enzymes and several metabolic fluxes. The latter comprised gluconeogenesis, ureagenesis and oxygen consumption. Liver damage in LPS-induced sepsis was characterized by histological changes, increased plasma levels of alanine aminotransferase and aspartate aminotransferase (P < 0.001) and diminished gluconeogenesis (P < 0.001) and ureagenesis (P < 0.01). LPS also induced oxidative stress as evidenced by increased catalase (P < 0.05) and superoxide dismutase activities and enhanced lipid peroxidation (P < 0.001). Pretreatment of the animals with FM minimized the histological changes and normalized, in part, all enzymatic activities. Pretreatment of the animals with FM also normalized gluconeogenesis and partly restored ureagenesis (P < 0.05). These and other results show that LPS-induced sepsis may lead to severe liver damage, affecting both structure and function. Treatment with FM can be used to avoid this damage. The antioxidant properties of FM can be, partly at least, responsible for this protective action.

Evaluation of adverse effects of long-term oral administration of carprofen, etodolac, flunixin meglumine, ketoprofen, and meloxicam in dogs.

OBJECTIVE: To evaluate adverse effects of long-term oral administration of carprofen, etodolac, flunixin meglumine, ketoprofen, and meloxicam in dogs. ANIMALS: 36 adult dogs. PROCEDURES: Values for CBC, urinalysis, serum biochemical urinalyses, and occult blood in feces were investigated before and 7, 30, 60, and 90 days after daily oral administration (n = 6 dogs/group) of lactose (1 mg/kg, control treatment), etodolac (15 mg/kg), meloxicam (0.1 mg/kg), carprofen (4 mg/kg), and ketoprofen (2 mg/kg for 4 days, followed by 1 mg/kg daily thereafter) or flunixin (1 mg/kg for 3 days, with 4-day intervals). Gastroscopy was performed before and after the end of treatment. RESULTS: For serum gamma-glutamyltransferase activity, values were significantly increased at day 30 in dogs treated with lactose, etodolac, and meloxicam within groups. Bleeding time was significantly increased in dogs treated with carprofen at 30 and 90 days, compared with baseline. At 7 days, bleeding time was significantly longer in dogs treated with meloxicam, ketoprofen, and flunixin, compared with control dogs. Clotting time increased significantly in all groups except those treated with etodolac. At day 90, clotting time was significantly shorter in flunixin-treated dogs, compared with lactose-treated dogs. Gastric lesions were detected in all dogs treated with etodolac, ketoprofen, and flunixin, and 1 of 6 treated with carprofen. CONCLUSIONS AND CLINICAL RELEVANCE: Carprofen induced the lowest frequency of gastrointestinal adverse effects, followed by meloxicam. Monitoring for adverse effects should be considered when nonsteroidal anti-inflammatory drugs are used to treat dogs with chronic pain.

Efecto analgésico comparativo del clonixinato de lisina y paracetamol en intervenciones odontológicas menores / Clonixinato comparative analgesic effect of lysine and acetaminophen in dental procedures under

Alvarez Falconi P. P. Novoa Lias E. Eecto analgésico comporativo del Clonixinato de lisina y paracetamol en intervenciones odontológicas menores. Rev Farmacol Terap (Lima) 5(1-2): 84-86, 199, en un ensayo clínico doble ciego, en 18 pacientes entre 22 a 60 años, divididos en 2 grupos de 9, se comparó la eficacia analgésica y tolerancia de 125 mg. de Clonixinato de lisina versus 500mg. de paracetamol, administrados por vía oral 3 veces al día por tres días, en el tratamiento del dolor subsecuente a intervenciones odontologías menores. La medición del dolor espontáneo se determinó en una escala de 0 a 10. Clonixinato de Lysina mostró mayor eficacia analgésica que Paracetamol alcanzando un valor comporativo porcentual significativo, p<0.01. No se notificaron reacciones adversas. La disminución más rápida y efectiva de las molestias dolorosas en los pacientes de Clonixinato de lisina mejoró su relación humana, la reiniciación de sus comunicaciones verbales, la ingesta de alimentos y la reincorporación a sus actividades laborales.

Alvarez Falconi P. P. Novoa Lias E. comportive analgesic effect of lisien Cloxinate and Paracetamol in minor dental intervention. Rev Farmacol Terap (Lima) 5 (1-2): 84-86, 199, in a double blinded clinical study of 18 patients among 22 to 60 years of age, divided in 2 groups of 9 each, It was administered 125 mg. of lysine Clonixinato versus Paracetamol 500mg. , by oral route 3 times daily for three days for each group, for pain due to minor dental interventions. Pain was evaluated for scale from 0 to 10. Lysine Clonixinate showed better analgesic activation than paracetamol reaching a comparative per cent value, p <0.01. No adverse reactions were informed. Patients that received lysine Cloxinate had more rapid human verbal relationships and improve feeding and promt this labor activities.

[Effects of lysine clonixinate on platelet function. Comparison with other non-steroidal anti-inflammatory agents]. / Acción del clonixinato de lisina sobre la función plaquetaria. Comparación con otras drogas antiinflamatorias no esteroideas.

One of the mechanisms of action of non steroid antiinflammatory drugs (NSAIDs) consists of inhibition of prostaglandin synthesis. This explains many of the pharmacological effects and adverse events observed in medical practice. Administration of NSAIDs to patients with hemostatic disorders or perioperative conditions entails the risk of bleeding due to inhibition of platelet function. This study deals with platelet changes induced by lysine clonixinate vs diclofenac, ibuprofen and aspirin in classical tests such as platelet count, platelet factor 3 (PF3) activity and platelet aggregation with various inductors and more recent procedures such as P-selectin measurement by flow cytometry. Unlike control drugs, lysine clonixinate did not induce changes in platelet count or function when administered to healthy volunteers at the commonly used therapeutic doses.

Oral lysine clonixinate in the acute treatment of migraine: a double-blind placebo-controlled study.

Several oral nonsteroidal anti-inflammatory drugs (NSAIDs) are effective to treat migraine attacks. Lysine clonixinate (LC) is a NSAID derived from nicotinic acid that has proven to be effective in various pain syndromes such as renal colic and muscular pain. The aim of this double-blind, placebo-controlled study was to evaluate the efficacy of oral LC compared to placebo in the acute treatment of migraine. Sixty four patients with the diagnosis of migraine, according to the IHS criteria, were studied prospectively. Patients received LC or placebo once the headache reached moderate or severe intensity for 6 consecutive attacks. With regard to the moderate attacks, LC was superior than placebo after 1, 2 and 4 hours. The consumption of other rescue medications after 4 hours was significantly higher in the placebo group. With regard to the severe attacks, there was no difference between the active drug group and the placebo group concerning headache intensity and consumption of other rescue medications. We conclude that the NSAID lysine clonixinate is effective in treating moderately severe migraine attacks. It is not superior than placebo in treating severe migraine attacks.

Accion del Clonoxinato de lisina sobre la funcion plaquetaria comparacion con otras drogas antiinflamatorias no esteroideas / Effects of lysine clonixinate on platelet function. Comparison with other non-steroidal anti-inflammatory agents

El grupo de los antiinflamatorios no esteroideos (AINEs) posee como uno de sus mecanismos de acción la inhibición de la síntesis de prostaglandinas. Este efecto explica muchas de las acciones farmacológicas y de los eventos adversos observados en el uso clínico. La administración de AINEs a pacientes con trastornos de la hemostasia o en estados perioperatorios incrementan el riesgo de hemorragias por inhibición de las funciones plaquetarias. En este trabajo se estudian las modificaciones plaquetarias inducidas por el clonixinato de lisina comparadas con las del diclofenac, ibuprofeno y aspirina, mediante pruebas clásicas (recuento de plaquetas, producción de factor 3 plaquetario, agregación con diversos inductores) y procedimientos más recientes (medición de P-selectina por citometría de flujo). El clonixinato de lisina no produjo modificaciones en el número ni en la función plaquetaria cuando fue administrado a voluntarios sanos en las dosis terapéuticas usuales, cosa que sí ocurrió con las drogas control. (Au)

Accion del Clonoxinato de lisina sobre la funcion plaquetaria comparacion con otras drogas antiinflamatorias no esteroideas / Effects of lysine clonixinate on platelet function. Comparison with other non-steroidal anti-inflammatory agents

El grupo de los antiinflamatorios no esteroideos (AINEs) posee como uno de sus mecanismos de acción la inhibición de la síntesis de prostaglandinas. Este efecto explica muchas de las acciones farmacológicas y de los eventos adversos observados en el uso clínico. La administración de AINEs a pacientes con trastornos de la hemostasia o en estados perioperatorios incrementan el riesgo de hemorragias por inhibición de las funciones plaquetarias. En este trabajo se estudian las modificaciones plaquetarias inducidas por el clonixinato de lisina comparadas con las del diclofenac, ibuprofeno y aspirina, mediante pruebas clásicas (recuento de plaquetas, producción de factor 3 plaquetario, agregación con diversos inductores) y procedimientos más recientes (medición de P-selectina por citometría de flujo). El clonixinato de lisina no produjo modificaciones en el número ni en la función plaquetaria cuando fue administrado a voluntarios sanos en las dosis terapéuticas usuales, cosa que sí ocurrió con las drogas control.

Analgesia en afecciones otorrinolaringológicas: clonixinato de lisina vs. ibuprofeno / Analgesia in otorhinolaryngolocial diseases: iysine clonixinate versus ibuprofen

Se estudiaron 80 pacientes portadores de afecciones dolorosas otorrinolaringológicas agudas.52 con diagnóstico faringoamigdalitis y 28 portadores de otitis media, mediante un ensayo clínico doble ciego, en grupos paralelos, con una dosis fija de clonizinato de lisina 125 mg o de ibuprofeno 400 mg cada 6 horas durante 2 días...En el mismo control ambos tratamientos redujeron significativamente en alrededor del 50 por ciento la intensidad del eritema y tumefacción local...Ambos tratamientos tuvieron muy buena tolerancia gastrointestinal y produjeron en forma similar una reducción significativa en la incidencia de cefaleas y náuseas que habitualmente acompañan a estas patologías

Clonixinato de lisina injetável intravenoso para o tratamento agudo das enxaquecas / Intravenous lysine clonixinate for the treatment of migraine: an open pilot study

Alguns antinflamatórios não esteroidais (AINE) orais são eficientes para o tratamento dos ataques de migrânea ou enxaqueca. A despeito de sua eficiência para o tratamento destas cefaléias e de outras dores, existem comercialmente poucos antinflamatórios não esteroidais disponíveis para administração parenteral. O clonixinato de lisina (CL) é um AINE derivado do ácido nicotínico que foi comprovadamente eficiente em vários tipos de síndrome álgicas como cólica renal, dor de compressão nervosa, dores musculares e odontalgias. O objetivo deste estudo foi avaliar a eficácia do CL intravenoso (IV) no tratamento de um episódio severo de migrância. Estudamos prospectivamente 19 pacientes, 17 mulheres e 2 homens, com idade de 18 a 57 anos e diagnóstico de migrânea de acordo com os critérios da Sociedade Internacional de Cefaléias (SIC). Os pacientes foram orientados a dirigirem-se à clínica no momento que a dor se iniciasse e, uma vez atingida a intensidade severa, foi iniciada a infusão venosa de CL e salina, em uma veia superficial do antebraço. Avaliadas após 30,60 e 90 minutos a intensidade da dor e a presença de efeitos colaterais, observamos que todos os 19 pacientes encontravam-se sem dor após 90 minutos. Alguns pacientes apresentaram efeitos adversos leves e não houve alterações significativas nos sinais vitais. Conluímos qe o AINE clonixinato de lisina (2-(3-cloro-otoluidino)piridino-3-carbolixato de lisina) IV, derivado do ácido nicotínico, com estrutura química semelhante à do ácido flufenâmico, foi eficiente em abolir um ataque de intensidade severa de migrânea em 90 minutos em 19 pacientes. Estudos controlados com metodologia duplo-cega e randomizada, assim como maior número de pacientes e ataques tratados, são necessários para confirmar estas observações iniciais.

Efficacy and tolerance of lysine clonixinate versus paracetamol/codeine following inguinal hernioplasty.

In this study lysine clonixinate, a nonsteroidal antiinflammatory agent with selective inhibition of cyclooxygenase-2 and 5-lipooxygenase in in vitro and in vivo pharmacodynamic studies, was evaluated in a prospective, randomized, double-blind, double-dummy clinical study versus paracetamol/codeine, in 151 patients with pain following inguinal hernioplasty. Patients were treated with one 125 mg tablet of lysine clonixinate or paracetamol/codeine (500 mg + 30 mg) administered at fixed doses every 4 h during 2 days. Controls were carried out 1, 2 and 4 h after the first intake of day 1 and day 2. Each control included assessment of pain at rest, when coughing, sitting and upon moderate pressure. Both treatment groups (lysine clonixinate, 77 patients and paracetamol/codeine, 74 patients) were comparable in terms of demographic and baseline pain intensities. Spontaneous pain was reduced significantly in both treatment groups from the 1st-h control. The following values were recorded in the lysine clonixinate group during day 1: baseline: 6.86 +/- 1.24; 1st h: 4.49 +/- 1.77; 2nd h: 2.96 +/- 1.74; 4th h: 2.23 +/- 1.51. The following values for the same group during day 2 were: predose: 1.70 +/- 1.64; 1st h: 1.16 +/- 1.17; 2nd h: 0.78 +/- 1.06; 4th h: 0.63 +/- 1.05. The paracetamol/codeine group revealed the following values: day 1: baseline: 6.72 +/- 1.22; 1st h: 4.57 +/- 1.72; 2nd h: 2.97 +/- 1.68; 4th h: 2.47 +/- 1.68 and day 2: predose: 2.02 +/- 1.57; 1st h: 1.32 +/- 1.23; 2nd h: 0.82 +/- 0.99; 4th h: 0.66 +/- 0.89. Reduction of pain induced by coughing, sitting and pressure showed similar behavior patterns. No significant differences between both treatment groups were encountered in terms of analgesic efficacy. Incidence of adverse effects was significantly higher in the paracetamol/codeine group (X2: p < 0.05): 11 out of 74 patients; three patients had to discontinue treatment. In the lysine clonixinate group four out of 77 patients showed side effects but these did not require treatment discontinuation.

[Analgesic-antispasmodic effect and safety of lysine clonixinate and L-hyoscinbutylbromide in the treatment of dysmenorrhea]. / Efecto analgésico antiespasmódico y seguridad del clonixinato de lisina y bromuro de L-butilhioscina en el tratamiento oral de la dismenorrea.

The purpose of this longitudinal open but not comparative study was to confirm the safety and efficacy of Lysine clonixinate (125 mg) and hyoscinbutylbromide (10 mg) capsules, during a period of observation of there menstrual cycles on 30 women with uterine dysfunction due to primary or secondary dysmenorrhea. The time of evolution for primary dysmenorrhea was of 4.46 years, and for secondary was of 1.77 years. Some associated manifestations of dysmenorrhea were: nausea (92%), vomit (92%), general pain (82.1%), abdominal pain (85.7%) and headache (46.4%). Regarding to the menstrual pain intensity, at first was highly severe in 10.7% severe in 42.9%, and moderate in 46.4%. At the end of the study, only 1 of 28 patients showed menstrual pain of moderate intensity. Only three adverse effects of light intensity were found without needing treatment, related to the manifestations of gastralgia and sleepiness. The association of a spasmolytic analgesic (Lysine clonixinate and hyoscinbutylbromide bromide) on the treatment for primary or secondary dysmenorrhea, reduces and prevents the menstrual pain (colic) as well as the associated manifestations with few spasmolytic association is efficacy and safety.

Efecto analgésico antiespasmódico y seguridad del clonixinato de lisina y bromuro de L-Butilhioscina en el tratamiento oral de la dismenorrea / Antispasmodic-analgesic effect and safety of Lysene clonixinate and Butylhioscine broide for dysmenorrhea oral treatment

Fue realizado un estudio clínico longitudinal abierto, no comparativo, en 30 mujeres con diagnóstico de dismenorrea primaria o secundaria a dispositivo intrauterino. El objetivo del estudio fue evaluar la eficacia y seguridad del compuesto terapéutico, Clonixinato de lisina y Bromuro de butihioscina 125 y 10 mg respectivamente, en cápsulas, durante un periodo de observación de tres ciclos menstruales. El tiempo de evolución de la dismenorrea primaria fue de 4.46 años; para la secundaria fue de 1.77 años. A la dismenorrea le acompañaron síntomas asociados como: náusea 92 por ciento, vómito 92 por ciento, malestar general 82.1 por ciento, pesantez abdominales 85.7 por ciento y cefalea 46.4 por ciento. Respecto a la intensidad del dolor menstrual, al inicio fue muy severo en el 10.7 por ciento, severo en 42.9 por ciento y moderado 46.4 por ciento. Al final del estudio sólo una paciente de las 28, presentó dolor menstrual de intensidad moderada. Encontramos sólo tres menciones de efectos secundarios de intensidad leve y que no requirieron tratamiento; que correspondieron a dos menciones de gastralgía y una de somnolencia. La conclusión del estudio es que la asociación analgésica espasmolítica del Clonixinato de lisina y Bromuro de butilhioscina en el tratamiento de la dismenorrea primaria o secundaria, reduce y previene el dolor menstrual, así como las manifestaciones asociadas con pocos efectos secundarios. Esta asociación analgésica espasmolítica, es eficaz y segura

Lysine clonixinate vs. paracetamol / codeine in postepisiotomy pain

This study conducted to compare the analgesic action of Lysine Clonixinate (LC) vs Paracetamol/Codeine association (PC) in the treatment of postepisiotomy pain in primiparae women: 131 primiparous patients with moderate-to-severe postepisiotomy pain were enrolled in a double blind dummy design study and randomly allocated to either treatment with fixed doses of LC 125 mg or Paracetamol 500 mg+Codeine 30 mg 6 qh during 24 hours. Intensity of spontaneous pain and pain on walking was assessed according to a visual analog scale (VAS) and patientYs assessment before receiving treatment and after 1, 2, 6 and 24 hours. Intensity of spontaneous pain was reduced in 24 hours from 4.28+2.11 to 1.73+1.46 (P<0.0001) in the LC group and from 4.78+2.08 to 1.90+1.72 in the PC- treated group (p<0.0001); with no significant differences between treatments. 54 percent of the patients treated with LC and 55 percent of those receiving PC showed onset of analgesic action 30 minutes following dose administration. PatientYs final global assessment revealed that 95 percent of LC-treated patients and 96 percent of the PC group showed total or partial pain relief during the first treatment day. No sleep disturbances were seen during the night in 75 percent of patients. Only one patient reveiving LC showed nausea not requiring treatment discontinuation. It is concluded that both treatments are equally effective to relieve moderate-to-severe postepisiotomy pain. (AU)

Buprenorfina sublingual versus meperidina intramuscular en el manejo del dolor postoperatorio en pacientes sometidas a cirugía ginecológica / Sublingual buprenorphine versus intramuscular meperidine in the post-operative pain management in patients submitted to ginecological surgery

La buprenorfina, de reciente introducción en nuestro medio, es un agonista parcial de los receptores opioides del subtipo µ con gran biodisponibilidad al ser administrada por vía sublingual (s.1) y larga duración de acción. El propósito del trabajo fue evaluar la calidad de la analgesia producida por la buprenorfina s.1 en el postoperatorio de pacientes sometidas a cirugía ginecológica, comparándola con un esquema de meperidina intramuscular (i.m.). Estudiamos en forma prospectiva, randomizada y doble ciego 27 pacientes (42 ñ 9 años), ASA i-II, sometidas a cirugía ginecológica electiva bajo anestesia general. Luego de la inducción anestésica, las pacientes fueron randomizadas en: grupo 1 (n= 12) que recibió meperidina 100 mg i.m. (intraoperatorio) y luego 50 mg i.m. c/6 horas por 48 horas; y, el grupo 2 (n= 15) que reciió buprenorfina 0,3 mg i.m. (intraoperatorio) y luego 0,2 mg s.1 c/6 horas por 48 horas en el posoperatorio. En caso de dolor se administró clonixino 100 mg i.v. a solicitud de la paciente. La evaluación posoperatoria duró 72 horas. Los pacientes que recibieron buprenorfina, tuvieron menos dolor durante todo el período en estudio que las pacientes del grupo meperidina, siendo esta diferencia significativa sólo a las 6 horas (p= 0,024). No hubo diferencias significativas en los requerimientos d clonixino, así como en el nivel de sedación, náuseas y vómitos, parámetros hemodinámicos y frecuencia respiratoria entre ambos grupos. Dos pacientes, una de cada grupo, presentaron depresión ventilaroria clínica (frecuencia respiratoria < 10 por minuto) sin problemas posteriores. Si bien beprenorfina s.1 como meperidina i.m. ofrecen un alivio adecuado del dolor después de cirugía ginecológica, la anagesia producida por la buprenorfina es superior con una incidencia similar de efectos adversos. La buprenorfina, por su facilidad de administración, se presenta como una buena alternativa para el manejo del dolor posoperatorio en cirugía de abdomen bajo

Infusión de morfina para el manejo del dolor postoperatorio en pacientes sometidos a cirugía abdominal alta / Morphine infusion for postoperative pain management in patients subjected to upper abdominal surgery

We compared the efficacy and side effects of postoperative continous infusions versus intermittent intravenous on-demand morphine, with or without the addition of clonixin. Eighty five helthy patients, aged 18 to 65 years, scheduled for elective cholecystectomy were prospectively randomized: group 1 (n=22) received morphine 2,5 mg iv on-demand; group 2 (n=22) received a clonixin 400 mg/day iv infusion; group 3 (n=19) a morphine 0,4 mg/kg/day iv infusion; and group 4 (n=22) received a clonixin 400 mg/day plus a morphine 0,4 mg/kg/day iv infusion. Groups 2, 3 and 4 also received, on-demand 2,5 mg iv bolus doses of morphine. A blind observer recorder analogue and descriptive pain scores, respiratory rates and side effects for 72 hours postoperatively. Groups with morphine infusions had less overall pain scores for the first day when compared with intermitent dosing (p<0.05); these groups also had less pain during the night (p=0.0016) and required less aditional morphine (p<0.0001). Side effects were similar and no cases of heavy sedation or respiratory depression were observed. We conclude that a morphine 0.4 mg/kg/day infusion is a safe and effective alternative to on demand dosing in helathy patients after elective cholecystectomy, achieving better analgesia without increasing side-effects. Clonixin 400 mg/day seems to add no significant benefits