Comparison of epidural ropivacaine 0.2% and ropivacaine 0.2% in combination with sufentanil 0.75 microg mL-1 for postcaesarean analgesia.

PubMed: 19117154Analgesic techniques after c-section must be effective producing early mobilisation to enable mothers to care effort their babies. In this study, the comparison of ropivacaine 0.2% alone, with ropivacaine 0.2%+sufentanil 0.75 microg mL-1 for patient controlled epidural analgesia (PCEA) was aimed. Fifty women (ASA-I) were enrolled in the study. All patients had combined spinal-epidural anaesthesia. Infusion of analgesic solutions was started when sensory level decreased by two dermatome levels. The patients randomly assigned, into two groups (n=25). In Group-I, ropivacaine 0.2% and sufentanil 0.75 microg mL-1, in Group-II, ropivacaine 0.2% alone were applied (bolus 1.25 mL, lockout 30 min, with 2.5 mL h-1 background infusion). Pain (Visual Analog Scale), motor blockage (Bromage scale) and sedation (Four point scale) were evaluated during 24 hours after Caesarean, using the scales of visual analogue, bromage, and four-point, respectively. Haemodynamic and respiratory parameters, side effects, total drug consumption and additional analgesic need, were recorded. Statistical analysis included student-t, chi-square, and Mann Whitney U tests. There was no difference in demographic data, sedation scores, haemodynamic and respiratory parameters, between the groups. Motor block and pain scores were significantly higher in Group-II than in Group-I at 2 and 4. h. Total drug consumption was 65.24+/-4.20 mL for Group-I and 81.1+/-6.44 mL for Group-II, (P<0.05). Four patients in Group-I and 21 patients in Group-II received additional analgesic. Pruritus was observed more frequently in Group-I. The addition of sufentanil 0.75 microg mL-1 to ropivacaine 0.2% for PCEA after Caesarean led to more effective analgesia and less motor weakness when compared to ropivacaine 0.2% alone, especially during early postoperative period

Anormal uterin kanama ile başvuran ve endometriyal polip saptanan hastalarda uterin arter Doppler sonografi, salin hidrosonografi ve patoloji sonuçlarinin karşilaştirilmasi

Objective: The aim of this study was to compare uterine artery doppler sonography, saline infusion sonography and endometrial biopsy results in premenopausal patients with abnormal uterine bleeding. Material and Methods: This study was performed on 60 premenopausal patients who had abnormal uterine bleeding and whose endometrial thickness were ? 5 mm. Transvaginal ultrasonography, uterine artery Doppler sonography and saline hydrosonography were performed for each patient. Afterwards, endometrial biopsies were performed and sent to the pathology department. After the pathology results were delivered, 25 patients were included in the endometrial polyp group. Patients with abnormal uterine bleeding, who didn't have any intracavitary lesions were considered as the control group. The result for transvaginal ultrasonography, uterine artery doppler sonography and saline hydrosonography were compared with pathology results. Results: The mean uterine artery resistance index value in the endometrial polyp group was 0.63 ± 0.2 and in the control group it was 0.66 ± 0.17 (p= 0.48). The mean uterine artery pulsatility index in the endometrial polyp group was 1.75 ± 0.74 and in the control group it was 1.95 ± 0.63 (p= 0.31). The sensitivity, specificity, positive predictive value and negative predictive value of saline hydrosonography in directly visualizing endometrial polyps were 96%, 84.6%, 95.7% and 85.7%, respectively (p< 0.05). Conclusion: Uterine artery doppler sonography dose not have any additive value to conventional ultrasonography and salin hydrosonography, in differentiating endometrial polyps from patients with abnormal uterine bleeding who do not have any intracavitary lesions. Copyright © 2010 by Türkiye Klinikleri

Topical dimethyl sulfoxide inhibits corneal neovascularization and stimulates corneal repair in rabbits following acid burn

Neovascularization of the cornea is characterized by the growth of blood vessels caused by imbalances between angiogenic and anti-angiogenic factors. We investigated whether the expression of Vascular endothelial growth factor (VEGF), Vascular endothelial growth factor receptor (VEGF), Vascular endothelial growth inhibitor (VEGI) receptors, as well as topical drug treatments, participate in regulating corneal neovascularization after corneal damage and remodeling. We used 72 mature male New Zealand rabbits. Corneal burns were induced by hydrofluoric acid under general anesthesia. The rabbits then were treated with indomethacin or dimethyl sulfoxide (DMSO). The animals were euthanized on days 2, 7 and 14 after injury. Each cornea was fixed with 10% neutral formalin. On days 2, 7 and 14, VEGF, flk1/KDR and flt1/fms were strongly expressed in the epithelial, stromal and inflammatory cells, but not in the corneal endothelial cells. On day 7, newly formed blood vessels were observed growing toward the center of the cornea. In the control, indomethacin treated, DMSO-treated, and indomethacin + DMSO-treated animals, VEGI, VEGF, and the receptors, flk1/KDR, flt1/fms and flt4, were expressed at different densities in the neovascular regions. This was particularly evident in the indomethacin- and indomethacin + DMSO-treated groups on days 7 and 14, compared to day 2. Treatment with VEGF and DMSO stimulated repair of corneal damage. We suggest that VEGI in the endothelial cells of neovascularized cornea may act as a signaling protein that promotes balance between cell proliferation and apoptosis. Topical administration of DMSO inhibited corneal neovascularization more effectively than indomethacin