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1.
Spectrochim Acta A Mol Biomol Spectrosc ; 264: 120241, 2022 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-34364038

RESUMO

A new approach to determine the local anesthetic benoxinate spectrofluorimetrically was developed. It was found that benoxinate exhibits strong native fluorescence in ethanol at 371 nm after excitation at 297 nm. There was a linear response between the fluorescence intensity and the concentration of the studied drug over the range of 10.0-100.0 ng/ mL. The suggested spectrofluorimetric method was optimized and validated following the pharmacopoeial guidelines. The obtained results were fully discussed and statistically analyzed in relevance to a previous published spectroscopic method. The limit of quantification (LOQ) of the present method was 1.79 ng/mL. Inter-day and intra-day precision relative standard deviations were lower than 1.5%.Finally, the proposed methodology has been adopted for determination of benoxinate in aqueous humor with a mean percentage recovery 99.87 ± 1.66 as well as in the pharmaceutical eye drops with a mean percentage recovery 100.37 ± 1.32. The method is cost-effective and green as it depends in water and ethanol mainly.


Assuntos
Humor Aquoso , Procaína , Soluções Oftálmicas , Procaína/análogos & derivados , Espectrometria de Fluorescência
3.
Vet Anaesth Analg ; 48(6): 972-976, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34538596

RESUMO

OBJECTIVE: To compare the corneal anaesthetic effect of 0.5% bupivacaine, 2% lidocaine and 0.4% oxybuprocaine on normal equine eyes. STUDY DESIGN: Prospective, blinded crossover study. ANIMALS: A group of 10 clinically healthy horses. METHODS: Corneal sensitivity was determined in each eye by measuring corneal touch threshold (CTT). The study had three phases. Each subject was randomly given one of the three treatments followed by a 72 hour washout period. Every horse received all treatments. Baseline CTT was recorded prior to anaesthetic instillation (T0) then CTT was measured 5 and 10 minutes after (T1 and T2, respectively), then 20 to 90 minutes (T3 to T10) at 10 minute intervals. CTT data were compared among treatments at each time point using the Friedman test p < 0.05. RESULTS: Median (range) baseline CTT was 51.3 (25.0-60.0) mm for bupivacaine, 50.0 (40.0-55.0) mm for oxybuprocaine and 55.0 (30.0-60.0) mm for lidocaine. All treatments caused a significant decrease in CTT at T1. The lowest CTT was observed at T3 with bupivacaine and oxybuprocaine treatments. Median CTTs at this time point were 18.7 (5.0-25.0) mm and 28.7 (25.0-40.0) mm, respectively. The lowest CTT with lidocaine treatment was 28.7 (20.0-50.0) mm at T6 (50 minutes). At T3, CTT was significantly lower with the bupivacaine treatment compared with oxybuprocaine and lidocaine treatments (p < 0.0074). There was no significant difference in CTT values between T1 and T6 for bupivacaine, between T1 and T7 for lidocaine, and between T1 and T8 for oxybuprocaine. Duration of the maximum effect was 45 minutes for the bupivacaine, 55 minutes for the lidocaine and 65 minutes for the oxybuprocaine treatment. CONCLUSIONS AND CLINICAL RELEVANCE: Administration of a 0.5% injectable solution of bupivacaine or a 2% lidocaine had similar anaesthetic effect to the commonly used oxybuprocaine. Therefore, they might be used as alternatives for corneal anaesthesia.


Assuntos
Bupivacaína , Lidocaína , Anestesia Local/veterinária , Anestésicos Locais , Animais , Estudos Cross-Over , Cavalos , Procaína/análogos & derivados , Estudos Prospectivos
4.
Eur J Pharm Sci ; 166: 105966, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34389487

RESUMO

The present work focuses on modifying a local anaesthetic drug procaine into an ionic liquid and evaluating the resulting thermal behaviour and structural changes. Counter ions, salicylate, ibuprofenate, and docusate, were chosen due to different hydrogen-bonding abilities, molecular size, charge distribution, and functional groups. After synthesis of procaine salicylate, procaine ibuprofenate, and procaine docusate, spectroscopic investigations were performed using infrared (IR) and nuclear magnetic resonance (NMR) spectroscopy to confirm proton transfer. Differential scanning calorimetry (DSC) and thermogravimetric (TG) analysis were used to determine the obtained ionic liquids' thermal behaviour. Experimental measurements of density, viscosity, and electrical conductivity were performed to get insight into the interactions occurring in the obtained ionic liquids. The viscosity and electrical conductivity data were analysed using the Vogel-Fulcher-Tammann (VFT) equation, while thermal expansion coefficients were calculated from measured density data. The obtained results found that the synthesised procaine salicylate and procaine docusate an ionic liquid's behaviours, including weak intermolecular forces, while procaine ibuprofenate showed more liquid co-crystal behaviour due to the absence of proton transfer for ibuprofen. In a theoretical phase of the investigation, the density functional theory (DFT) and molecular dynamics (MD) calculations were conducted. The obtained descriptors and radial distribution functions were used to analyse the interactions between ions of synthesised ionic liquids. In addition, solubility determination results proved that procaine transformation into procaine salicylate and procaine ibuprofenate ionic liquids enhanced its solubility in water, while procaine docusate reduces procaine solubility.


Assuntos
Líquidos Iônicos , Ânions , Ligação de Hidrogênio , Íons , Procaína
5.
Neuroscience ; 473: 13-28, 2021 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-34418519

RESUMO

The present study was undertaken to identify the noradrenergic receptors underlying the production of hippocampal formation (HPC) type 2 theta rhythm. The experiments were performed on urethanized rats wherein type 2 theta is the only rhythm present. In three independent stages of experiments, the effects of noradrenaline (NE) and selective noradrenergic α and ß agonists and antagonists were tested. We indicate that the selective activation of three HPC noradrenergic receptors, α1, α2 and ß1, induced a similar effect (i.e., inhibition) on type 2 theta rhythm. The remaining HPC ß2 and ß3 noradrenergic receptors do not seem to be directly involved in the pharmacological mechanism responsible for the suppression of theta rhythm in anaesthetized rats. Obtained results provide evidence for the suppressant effect of exogenous NE on HPC type 2 theta rhythm and show the crucial role of α1, α2 and ß1 noradrenergic receptors in the modulation of HPC mechanisms of oscillations and synchrony. This finding is in contrast to the effects of endogenous NE produced by electrical stimulation of the locus coeruleus (LC) and procaine injection into the LC (Broncel et al., 2020).


Assuntos
Hipocampo , Ritmo Teta , Animais , Locus Cerúleo , Norepinefrina , Procaína , Ratos
6.
Sci Rep ; 11(1): 10035, 2021 05 11.
Artigo em Inglês | MEDLINE | ID: mdl-33976374

RESUMO

Chloroprocaine is a short-acting local anaesthetic with a rapid onset of action and an anaesthesia duration up to 60 min. In this pivotal study success rates, onset and remission of motor and sensory block and safety of chloroprocaine 2% was compared to ropivacaine 0.75% for short-duration distal upper limb surgery with successful block rates as primary outcome. The study was designed as a prospective, randomised, multi-centre, active-controlled, double-blind, parallel-group, non-inferiority study, performed in 4 European hospitals with 211 patients scheduled for short duration distal upper limb surgery under axillary plexus block anaesthesia. Patients received either ultrasound guided axillary block with 20 ml chloroprocaine 2%, or with 20 ml ropivacaine 0.75%. Successful block was defined as block without any supplementation in the first 45 min calculated from the time of readiness for surgery. 90.8% patients achieved a successful block with chloroprocaine 2% and 92.9% patients with Ropivacaine 0.75%, thus non-inferiority was demonstrated (10% non inferiority margin; 95% CI - 0.097, 0.039; p = 0.02). Time to onset of block was not significantly different between the groups. Median time to motor and sensory block regression was significantly shorter as was time to home discharge (164 [155-170] min for chloroprocaine versus 380 [209-450] for the ropivacaine group, p < 0.001). For short-duration surgical procedures, the short-acting Chloroprocaine 2% may be used, with success rates non-inferior to ropivacaine and a favourable safety profile.Trial registration: The trial was registered at Clinicaltrials.gov with registration number NCT02385097 (March 11th, 2015) and European Clinical Trial Database with the EudraCT number 2014-002519-40 (July 7th, 2015, Austria-BASG).


Assuntos
Anestésicos Locais/administração & dosagem , Bloqueio Nervoso , Procaína/análogos & derivados , Ropivacaina/administração & dosagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Axila , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Procaína/administração & dosagem , Estudos Prospectivos , Ultrassonografia de Intervenção , Adulto Jovem
8.
J Cardiothorac Surg ; 16(1): 94, 2021 Apr 17.
Artigo em Inglês | MEDLINE | ID: mdl-33865409

RESUMO

BACKGROUND: Congenital heart disease is a leading cause of death in newborns and infants. The feasibility of fetal cardiac surgery is linked to extracorporeal circulation (ECC); therefore, cardioplegic solutions need to be effective and long-lasting. METHODS: Eighteen pregnant sheep were divided into an ECC-only group, St. Thomas' Hospital cardioplegic solution (STH1) group (STH group), and HTK preservation solution (Custodiol®) group (HTK group). Markers of myocardial injury including troponin I (cTnI), troponin T (cTnT) and creatine kinase myocardial band (CKMB) were measured at specific time points (T1: pre-ECC, T2: 30 min of ECC, T3: 60 min of ECC, T4: 60 min post-ECC, T5: 120 min post-ECC). Myocardial tissue was removed from the fetal sheep at T5, and apoptosis was detected by TUNEL staining. RESULTS: Changes in the serum cTnI, cTnT and CKMB concentrations were not significantly different among the three groups before and during the ECC(T1,T2,T3). At 60 min after ECC shutdown(T4), cTnI and cTnT concentrations were significantly higher in the STH group than before the start of ECC. The concentration of cTnI was higher in the STH group than in the HTK and ECC-only groups. The concentration of cTnT was higher in the STH group than in the ECC-only group. At 120 min after ECC shutdown(T5), cTnI and cTnT concentrations were significantly higher in the ECC and HTK groups than before the start of ECC, and CKMB concentration was significantly higher in STH and HTK groups. The concentrations of cTnT, cTnI and CKMB was higher in the STH group than in the HTK and ECC-only groups. The number of TUNEL-positive cells in the HTK and STH groups was higher than in the ECC-only group. The number of TUNEL-positive cells in the STH group was higher than in the HTK group. There was no statistically significant difference among the groups in the heart rate and mean arterial pressure after ECC. CONCLUSION: The HTK preservation solution was significantly better than STH1 in reducing the release of cardiomyocyte injury markers and the number of apoptotic cells in fetal sheep ECC. Fetal sheep receiving ECC-only had an advantage in all indicators, which suggests ECC-only fetal heart surgery is feasible.


Assuntos
Soluções Cardioplégicas/farmacologia , Cardiotônicos/farmacologia , Circulação Extracorpórea/efeitos adversos , Terapias Fetais/métodos , Traumatismos Cardíacos/prevenção & controle , Coração/efeitos dos fármacos , Animais , Apoptose/efeitos dos fármacos , Bicarbonatos/farmacologia , Bicarbonatos/uso terapêutico , Biomarcadores/metabolismo , Cloreto de Cálcio/farmacologia , Cloreto de Cálcio/uso terapêutico , Soluções Cardioplégicas/uso terapêutico , Cardiotônicos/uso terapêutico , Glucose/farmacologia , Glucose/uso terapêutico , Traumatismos Cardíacos/etiologia , Traumatismos Cardíacos/metabolismo , Traumatismos Cardíacos/patologia , Magnésio/farmacologia , Magnésio/uso terapêutico , Manitol/farmacologia , Manitol/uso terapêutico , Miocárdio/metabolismo , Miocárdio/patologia , Cloreto de Potássio/farmacologia , Cloreto de Potássio/uso terapêutico , Procaína/farmacologia , Procaína/uso terapêutico , Distribuição Aleatória , Ovinos , Cloreto de Sódio/farmacologia , Cloreto de Sódio/uso terapêutico , Resultado do Tratamento
10.
Asian Cardiovasc Thorac Ann ; 29(2): 77-83, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33530706

RESUMO

BACKGROUND: Despite the increasing popularity of single-dose cardioplegia techniques in coronary artery bypass grafting, the time window for successful reperfusion remains unclear. This study aimed to compare different cardioplegic techniques based on early and 30-day clinical outcomes via thorough monitoring. METHODS: This prospective cohort study included high-risk patients undergoing coronary artery bypass grafting and receiving 3 different types of cardioplegia between January 2017 and June 2019. Group 1 (n = 101) had a single dose of del Nido cardioplegia, group 2 (n = 92) had a single dose of histidine-tryptophane-ketoglutarate, and group 3 (n = 119) had cold blood cardioplegia. Patients were examined perioperatively by memory loop recording and auto-triggered memory loop recording for 30 days, with documentation of predefined events. RESULTS: Interleukin-6 and cardiac troponin levels in group 1 were significantly higher than those in groups 2 and 3. The incidence of predefined events as markers of inadequate myocardial protection was significantly higher group 1, with more frequent atrial fibrillation attacks and more hospital readmissions. The readmission rate was 17.6% in group 1, 9% in group 2, and 8% in group 3. CONCLUSIONS: Our data demonstrate the long-term efficacy of cardioplegic techniques, which may become more crucial in high-risk patients who genuinely have a chance to benefit from adjunct myocardial protection. Patients given del Nido cardioplegia had a significantly more prominent inflammatory response and higher troponin levels after cardiopulmonary bypass. This group had issues in the longer term with significantly more cardiac events and a higher rehospitalization rate.


Assuntos
Temperatura Baixa , Ponte de Artéria Coronária , Doença da Artéria Coronariana/cirurgia , Eletrólitos/uso terapêutico , Parada Cardíaca Induzida , Lidocaína/uso terapêutico , Sulfato de Magnésio/uso terapêutico , Manitol/uso terapêutico , Cloreto de Potássio/uso terapêutico , Bicarbonato de Sódio/uso terapêutico , Soluções/uso terapêutico , Idoso , Biomarcadores/sangue , Temperatura Baixa/efeitos adversos , Ponte de Artéria Coronária/efeitos adversos , Eletrólitos/efeitos adversos , Feminino , Glucose/efeitos adversos , Glucose/uso terapêutico , Parada Cardíaca Induzida/efeitos adversos , Humanos , Interleucina-6/sangue , Lidocaína/efeitos adversos , Sulfato de Magnésio/efeitos adversos , Masculino , Manitol/efeitos adversos , Pessoa de Meia-Idade , Readmissão do Paciente , Complicações Pós-Operatórias/sangue , Complicações Pós-Operatórias/terapia , Cloreto de Potássio/efeitos adversos , Procaína/efeitos adversos , Procaína/uso terapêutico , Estudos Prospectivos , Medição de Risco , Fatores de Risco , Bicarbonato de Sódio/efeitos adversos , Soluções/efeitos adversos , Fatores de Tempo , Resultado do Tratamento , Troponina/sangue
12.
Heart Surg Forum ; 24(1): E170-E176, 2021 02 17.
Artigo em Inglês | MEDLINE | ID: mdl-33635238

RESUMO

BACKGROUND: In cardiac surgery, myocardial protection is required during cross-clamping followed by reperfusion. The use of cardioplegic solutions helps preserve myocardial energy stores, hindering electrolyte disturbances and acidosis during periods of myocardial ischaemia. This study aimed to compare the efficacy and safety between the histidine-tryptophan-ketoglutarate (HTK) solution and blood cardioplegia in various cardiac surgeries. METHODS: Three-hundred-twenty patients aged 30-70 years old undergoing various cardiac surgeries were randomized into the HTK group and the blood cardioplegia group. The ventilation time, total bypass time, cross-clamp time, length of intensive care unit (ICU) or hospital stay, and postoperative complications were analyzed. RESULTS: The total bypass time and cross-clamp time were significantly shorter in the HTK group than in the blood cardioplegia group (P < 0.001). Segmental wall motion abnormalities (SWMA) at postoperative echocardiography were significantly higher in in the blood cardioplegia group (P = 0.008). The number of patients requiring DC Shock was significantly higher in the HTK group (P < 0.001). The number of patients requiring inotropic support was significantly higher in the blood cardioplegia group (P < 0.001). The length of ICU, hospital stay, and ventilation time were significantly longer in the blood cardioplegia group than in the HTK group (P = 0.004, P < 0.001, P < 0.001, respectively). The number of patients requiring prolonged ventilation was significantly higher in the blood cardioplegia group compared with the HTK group (P = 0.022). There was no significant difference between the study groups regarding electrocardiographic changes, 30-day mortality, and 30-day readmission. CONCLUSION: The use of HTK cardioplegia was associated with significantly shorter cross-clamp time, bypass time, duration of mechanical ventilation, length of ICU stay, and length of hospital stay. It is associated with less incidence of postoperative segmental wall abnormalities and less need for inotropic support than blood cardioplegia. Custodiol cardioplegia is a safe and feasible option that can be used as an effective substitute for blood cardioplegia to enhance myocardial protection.


Assuntos
Procedimentos Cirúrgicos Cardíacos/métodos , Doença da Artéria Coronariana/cirurgia , Parada Cardíaca Induzida/métodos , Complicações Pós-Operatórias/epidemiologia , Adulto , Idoso , Soluções Cardioplégicas , Egito/epidemiologia , Feminino , Glucose/farmacologia , Humanos , Incidência , Masculino , Manitol/farmacologia , Pessoa de Meia-Idade , Cloreto de Potássio/farmacologia , Procaína/farmacologia , Estudos Retrospectivos , Resultado do Tratamento
13.
Acta Vet Scand ; 63(1): 1, 2021 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-33407757

RESUMO

BACKGROUND: Since January 2019, surgical castration of male piglets must be performed using local anaesthesia, if farmers deliver pigs to the primary exporting slaughterhouses according to the "Danish quality scheme"; a voluntary initiative taken by the Danish pig industry. The approved procedure for local anaesthesia in Denmark is a three-step injection method with procaine. A comparison of lidocaine and procaine with the same concentration and injection methods of local anaesthetics has not previously been studied. The purpose of this study was to investigate the effect of two injection methods and two local anaesthetics on piglets' avoidance behaviour (vocalisation and resistance movements) as well as the time spent on the procedures. The study included 203 male piglets that were randomly assigned to one of five treatments: 1. CONTROL: Sham-handling without injection of local anaesthesia, 2. Pro3: Procaine injection using a three-step method, 3. Pro2: Procaine injection using a two-step method, 4. Lid3: Lidocaine injection using a three-step method, 5. Lid2: Lidocaine injection using a two-step method. During injection of local anaesthesia and castration, vocalisation was measured using a decibel meter and resistance movements were registrated by video recordings. RESULTS: During castration, piglets treated with local anaesthesia showed significantly reduced vocalisation and resistance movements and time spent on castration was also significantly reduced compared to the control group. During injection of the local anaesthesia, the piglets had significantly increased vocalisation and resistance movements compared to the control group. Piglets injected with lidocaine had a significantly reduced resistance movement score and a tendency to reduced vocalisation compared to piglets injected with procaine. No differences in avoidance behaviour were found between the injection methods. CONCLUSIONS: The use of local anaesthesia, irrespective of the method and local anaesthetic, was effective in reducing vocalisation and resistance movements during surgery as well as the time spent on castration.


Assuntos
Anestésicos Locais/administração & dosagem , Castração/veterinária , Lidocaína/administração & dosagem , Procaína/administração & dosagem , Animais , Animais Recém-Nascidos , Indústrias , Masculino , Carne , Medição da Dor/veterinária , Suínos , Resultado do Tratamento
14.
J Thorac Cardiovasc Surg ; 162(1): 228-237, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33036746

RESUMO

OBJECTIVE: Custodiol-HTK cardioplegia (Custodiol-HTK Koheler Chemie, GmbH, Bensheim, Germany) causes fluctuations in serum sodium levels, hyponatremia, and is associated with postoperative seizures. We investigated the influence of scavenging right atrial effluent during delivery on intraoperative serum sodium levels and postoperative seizure incidence in pediatric cardiac surgery patients. METHODS: A total of 204 patients younger than age 18 years undergoing congenital heart surgery between January 2016 and March 2018 were analyzed retrospectively. Serum sodium levels after administration of Custodiol-HTK cardioplegia were compared between the scavenge and nonscavenge groups and then in the propensity score-matched cohort (n = 96). Postoperative seizures were documented clinically and with electroencephalogram findings. Logistic regression models were used to identify the independent predictors of serum sodium level after aortic crossclamp. RESULTS: Of 204 patients, 156 (76.5%) were in the nonscavenge, and 48 (23.5%) in the scavenge groups. A serum sodium level <130 mEq/L after crossclamp and administration of Custodiol-HTK cardioplegia in the nonscavenge group were 70% versus 21% in the scavenge group (odds ratio, 8.8; 95% confidence interval, 4.1-18.3; P < .0001) in the entire cohort, and 77% versus 21% (odds ratio, 12.8; 95% confidence interval, 4.8-33.1; P < .0001) in the propensity score-matched cohort. Of 16 patients experiencing a postoperative seizure, 14 (87.5%) had a sodium level <130 mEq/L and 2 (12.5%) had a sodium level ≥130 mEq/L (odds ratio, 5.1; 95% confidence interval, 1.3-22.8; P = .021) after crossclamp. Postoperative seizures occurred in the nonscavenge group but not the scavenge group in the entire cohort (P = .02) and in the propensity score-matched patients (P = .041). Multivariable analysis of the entire cohort showed that scavenge intervention was an independent factor associated with significantly decreased risk of sodium level <130 mEq/L (odds ratio, 0.17; 95% confidence interval, 0.08-0.36; P = .000). CONCLUSIONS: Right atrial effluent scavenging was protective against fluctuations in serum sodium levels after crossclamp and Custodiol-HTK cardioplegia administration independently in both entire and matched cohort, and was also associated with decreased incidence of postoperative seizures.


Assuntos
Soluções Cardioplégicas/efeitos adversos , Parada Cardíaca Induzida , Hiponatremia , Convulsões , Soluções Cardioplégicas/uso terapêutico , Pré-Escolar , Glucose/efeitos adversos , Glucose/uso terapêutico , Parada Cardíaca Induzida/efeitos adversos , Parada Cardíaca Induzida/métodos , Humanos , Lactente , Manitol/efeitos adversos , Manitol/uso terapêutico , Complicações Pós-Operatórias , Cloreto de Potássio/efeitos adversos , Cloreto de Potássio/uso terapêutico , Procaína/efeitos adversos , Procaína/uso terapêutico , Estudos Retrospectivos , Sódio/sangue
15.
Transplant Proc ; 53(2): 661-664, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33139037

RESUMO

OBJECTIVE: This study aimed to evaluate how cold ischemia time (CIT) interferes with liver graft function in the first 7 days after surgery for Custodiol (HTK) preserved organs. METHODS: This retrospective observational study analyzed the medical records of 38 transplantation patients at Hospital Leforte Liberdade, São Paulo, in 2018. The study population was divided into 2 groups (group A, CIT < 8 hours; group B, CIT > 8 hours). Postoperative parameters-such as international normalized ratio, total bilirubin, aspartate aminotransferase/alanine aminotransferase, alkaline phosphatase, gamma glutamyl transferase (GGT), lactate dehydrogenase, lactate, creatinine, red blood cell transfusion, need for hemodialysis, use of vasoactive drugs, endotracheal intubation time, length of stay in the intensive care unit (ICU), and length of hospital stay-were compared. RESULTS: Group A (CIT < 8 hours) presented less need for red blood cell transfusions (odds ratio 0.29; confidence interval 0.06-0.98; P = .04), had a shorter hospital stay (P = .024), and had lower levels of total bilirubin (P = .05) and GGT (P = .05) in the first 7 postoperative days. The other variables showed no statistically significant difference. CONCLUSION: In livers preserved with Custodiol, CIT > 8 hours generated higher levels of total bilirubin and GGT in the postoperative period, in addition to higher hospital costs; greater need for red blood cell transfusions; and longer hospitalization, including longer stays in the ICU.


Assuntos
Isquemia Fria/métodos , Transplante de Fígado/métodos , Soluções para Preservação de Órgãos/farmacologia , Preservação de Órgãos/métodos , Feminino , Glucose/farmacologia , Humanos , Masculino , Manitol/farmacologia , Pessoa de Meia-Idade , Preservação de Órgãos/efeitos adversos , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Cloreto de Potássio/farmacologia , Procaína/farmacologia , Traumatismo por Reperfusão/etiologia , Estudos Retrospectivos
17.
Crit Rev Anal Chem ; 51(4): 339-352, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-32096424

RESUMO

Local anesthetics (LAs) are widely used in anesthesiology, ophthalmology, and otolaryngology as well as for treatment of chronic and oncological pain. However, anesthetics can cause adverse effects up to lethal ones. In this work, we cited reviews on chromatographic and spectroscopic methods of local anesthetics determination published earlier, and the main purpose was to review the possibilities and advantages of voltammetric methods used for the LAs determination. The electrochemical behavior, mechanism of LAs transformation on the various working electrodes and analytical parameters of voltammetric methods used for their determination were reviewed in the work. Vast majority of these methods were developed for the most widely used anesthetics in medicine like benzocaine, lidocaine and procaine. Special attention was paid to possible mechanisms of electrochemical oxidation and in some cases reduction of LAs or their derivatives. Voltammetry is used for the determination of LAs in pharmaceutical formulations and in biological fluids. The analytical characteristics in terms of sensitivity, selectivity, reproducibility also were discussed in the article.


Assuntos
Anestésicos Locais/análise , Benzocaína/análise , Lidocaína/análise , Procaína/análise , Composição de Medicamentos , Técnicas Eletroquímicas , Eletrodos , Polímeros de Fluorcarboneto/química , Hemoglobinas/química , Humanos , Limite de Detecção , Nanopartículas Metálicas/química , Polímeros Molecularmente Impressos/química , Nanotubos de Carbono/química , Oxirredução , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Propriedades de Superfície
19.
Anesth Analg ; 132(3): 666-675, 2021 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-32852294

RESUMO

BACKGROUND: For emergent intrapartum cesarean delivery (CD), the literature does not support the use of any particular local anesthetic solution to extend epidural analgesia to cesarean anesthesia. We hypothesized that 3% chloroprocaine (CP) would be noninferior to a mixture of 2% lidocaine, 150 µg of epinephrine, 2 mL of 8.4% bicarbonate, and 100 µg of fentanyl (LEBF) in terms of onset time to surgical anesthesia. METHODS: In this single-center randomized noninferiority trial, adult healthy women undergoing CD were randomly assigned to epidural anesthesia with either CP or LEBF. Sensory blockade (pinprick) to T10 was established before operating room (OR) entry for elective CD. On arrival to the OR, participants received the epidural study medications in a standardized manner to simulate the conversion of "epidural labor analgesia to surgical anesthesia." The primary outcome was the time to loss of touch sensation at the T7 level. A noninferiority margin was set at 3 minutes. The secondary outcome was the need for intraoperative analgesia supplementation. RESULTS: In total, 70 women were enrolled in the study. The mean onset time to achieve a bilateral sensory block to touch at the T7 dermatome level was 655 (standard deviation [SD] = 258) seconds for group CP and 558 (269) seconds for group LEBF, a difference in means of 97 seconds (90% confidence interval [CI], SD = -10.6 to 204; P = .10 for noninferiority). The upper limit of the 90% CI for the mean difference exceeded the prespecified 3-minute noninferiority margin. There was no meaningful difference in the requirement for intraoperative analgesia between the 2 groups. CONCLUSION: Both anesthetic solutions have a rapid onset of anesthesia when used to extend low-dose epidural sensory block to surgical anesthesia. Data from the current study provide insufficient evidence to confirm that CP is noninferior to LEBF for rapid epidural extension anesthesia for CD, and further research is required to determine noninferiority.


Assuntos
Analgésicos Opioides/uso terapêutico , Anestesia Epidural , Anestesia Obstétrica , Anestésicos Locais/uso terapêutico , Cesárea , Epinefrina/uso terapêutico , Fentanila/uso terapêutico , Lidocaína/uso terapêutico , Procaína/análogos & derivados , Bicarbonato de Sódio/uso terapêutico , Adulto , Analgesia Epidural , Analgesia Obstétrica , Analgésicos Opioides/efeitos adversos , Anestesia Epidural/efeitos adversos , Anestesia Obstétrica/efeitos adversos , Anestésicos Locais/efeitos adversos , Arkansas , Cesárea/efeitos adversos , Procedimentos Cirúrgicos Eletivos , Epinefrina/efeitos adversos , Feminino , Fentanila/efeitos adversos , Humanos , Lidocaína/efeitos adversos , Gravidez , Procaína/efeitos adversos , Procaína/uso terapêutico , Limiar Sensorial/efeitos dos fármacos , Bicarbonato de Sódio/efeitos adversos , Fatores de Tempo , Tato/efeitos dos fármacos , Resultado do Tratamento , Adulto Jovem
20.
Medicine (Baltimore) ; 99(51): e23584, 2020 Dec 18.
Artigo em Inglês | MEDLINE | ID: mdl-33371088

RESUMO

ABSTRACT: To compare the difference between University of Wisconsin (UW) solution and histidine-tryptophan-ketoglutarate (HTK) solution in adult living donor liver transplantation (LDLT).This study included LDLT patients at the Liver Transplantation Center of West China Hospital of Sichuan University from November 2001 to June 2018. These patients were classified into 2 groups depending on the use of the different preservation solutions, and the confounding factors between the 2 groups were eliminated by propensity score matching. Finally, the incidence of complications; serum examination at postoperative days 1, 3, 5, 7, 14, 21, and 30; and the overall survival rate of the 2 groups were compared to observe whether there were any differences between the 2 preservation solutions.Of the 298 patients we screened, 170 were treated with UW solution and 128 with HTK solution. After propensity score matching, 106 pairs of patients were selected. In the comparison of the 2 groups, the length of intensive care unit stay in the UW group was significantly longer than that in the HTK group (P = .022), but there was no difference in the total length of hospital stay between the 2 groups (P = .277). No statistically significant difference was observed in the 2 groups in terms of the incidence of complications or postoperative examinations. However, the incidence of early allograft dysfunction in the HTK group was slightly lower than that in the UW group (HTK: UW = 14.1%: 20.7%), although the difference was not statistically significant. In terms of the overall survival rate, the 1, 3, and 5-year survival rates of the HTK group were 85.5%, 70.2%, and 65.1%, respectively, while the 1, 3, and 5-year survival rates of the UW group were 83.1%, 67.2%, and 59.8%, respectively, and there was no significant difference between the 2 groups.In conclusion, our study shows that UW solution and HTK solution are equivalent in perioperative safety, the recovery of transplanted liver function, the occurrence of postoperative complications and overall survival and can be safely and effectively applied in adult LDLT. If economic factors are taken into account, HTK can save costs to a certain extent.


Assuntos
Transplante de Fígado/métodos , Soluções para Preservação de Órgãos/uso terapêutico , Adenosina/uso terapêutico , Adulto , Alopurinol/uso terapêutico , China , Feminino , Glucose/uso terapêutico , Glutationa/uso terapêutico , Rejeição de Enxerto/epidemiologia , Humanos , Insulina/uso terapêutico , Tempo de Internação , Transplante de Fígado/mortalidade , Doadores Vivos , Masculino , Manitol/uso terapêutico , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Cloreto de Potássio/uso terapêutico , Procaína/uso terapêutico , Pontuação de Propensão , Rafinose/uso terapêutico , Análise de Sobrevida
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