Comparison of the anesthetic latency of articaine, lidocaine, levobupivacaine and ropivacaine, through Pulp Tester

INTRODUCTION : A thorough knowledge of dental anesthetics, like the lag time of the drug, can ensure the success of pain control during and after surgery.OBJECTIVE : Comparing the latency time of 4 anesthetics, in other words, the time between the deposition of the local anesthetic and when its effects become noticeable. However, this is not related with the successful pain control during and after surgery (depth of anesthesia).MATERIAL AND METHOD : We conducted a double-blind, crossover, randomized study with 30 volunteers underwent 04 procedures in one-week intervals from the posterior superior alveolar block. In the second molar being treated, the pulp tester was used at intervals of 02 minutes, considering the insensitivity of the pulp when there is no response after two consecutive tests of 80muV, peaking at 10 minutes thus determining the latency period of the anesthetic. The data were submitted to t-student test, Friedman test and Kruskal-Wallis test (p&lt;0.05).RESULT : There were no statistically significant differences (p=0.8327) between the anesthetics. In all cases the median was 2 minutes. Still, there were no significant differences between genders in relation to age (p=0.4545), as well as between the values when it attempted to observe the influence of gender in latency values (p=0.6754).CONCLUSION : Since the average lag time was identical, the choice of the drug will depend on the duration of the oral surgery and the necessity of postoperative analgesia.Um conhecimento profundo dos anestésicos odontológicos, como o tempo de latência da droga, pode assegurar o êxito do controle da dor no trans e no pós-operatório. Comparar a latência entre quatro soluções anestésicas, ou seja, o tempo entre o início da deposição do anestésico local e o momento em que seus efeitos tornam-se perceptíveis. Entretanto, isso não está relacionado com o êxito do controle da dor no trans e no pós-operatório (profundidade da anestesia). Foi realizado um estudo duplo cego, cruzado e randomizado, com 30 pacientes voluntários submetidos a quatro procedimentos em intervalos de uma semana, a partir de bloqueio do alveolar superior posterior. No segundo molar a ser tratado, foi utilizado o 'pulp tester' em intervalos de 2 minutos, considerando a insensibilidade da polpa quando da ausência de resposta após dois testes consecutivos de 80muV, chegando ao máximo de 10 minutos e determinando, assim, o período de latência do anestésico. Os dados foram submetidos aos testes T-student, de Friedman e de Kruskal-Wallis (p<0,05). Não houve diferenças estatisticamente significativas (p=0,8327) entre as soluções anestésicas. Para todas estas, a mediana foi 2 minutos. Não houve, ainda, diferenças significantes entre os gêneros em relação à idade (p=0,4545), bem como entre os valores, quando se tentou observar a influência do gênero nos valores de latência (p=0,6754). Sendo os tempos médios de latência idênticos, a escolha da droga dependerá da duração do procedimento cirúrgico-odontológico a se realizar, além da necessidade ou não de analgesia pós-operatória431814A thorough knowledge of dental anesthetics, like the lag time of the drug, can ensure the success of pain control during and after surgery. Comparing the latency time of 4 anesthetics, in other words, the time between the deposition of the local anesthetic and when its effects become noticeable. However, this is not related with the successful pain control during and after surgery (depth of anesthesia). We conducted a double-blind, crossover, randomized study with 30 volunteers underwent 04 procedures in one-week intervals from the posterior superior alveolar block. In the second molar being treated, the pulp tester was used at intervals of 02 minutes, considering the insensitivity of the pulp when there is no response after two consecutive tests of 80muV, peaking at 10 minutes thus determining the latency period of the anesthetic. The data were submitted to t-student test, Friedman test and Kruskal-Wallis test (p&lt;0.05). There were no statistically significant differences (p=0.8327) between the anesthetics. In all cases the median was 2 minutes. Still, there were no significant differences between genders in relation to age (p=0.4545), as well as between the values when it attempted to observe the influence of gender in latency values (p=0.6754). Since the average lag time was identical, the choice of the drug will depend on the duration of the oral surgery and the necessity of postoperative analgesi

AVALIAÇÃO DA EFICÁIA DE MEDICAMENTO HOMEOPÁTICO COMO ANALGÉSICOS PREEMPTIVOS EM CASO DE DOR APÓS EXODONTIAS DE PRIMEIROS MOLARES INFERIORES

A dor é um fenômeno biológico essencial para a defesa e manutenção do equilíbrio homeostático

Digestible lysine levels for barrows with high genetic potencial from 95 to 125 kg

Avaliou-se o efeito de níveis de lisina digestível sobre o desempenho e a composição de carcaça de suínos machos castrados de alto potencial genético para deposição de carne. Foram utilizados 80 animais com peso inicial de 95,55 ± 1,04 distribuídos em delineamento experimental de blocos ao acaso, com cinco dietas (0,540; 0,642; 0,744; 0,846 e 0,948% de lisina digestível), oito repetições e dois animais por unidade experimental. As dietas experimentais e água foram fornecidas à vontade durante todo o período experimental. Os níveis de lisina digestível não influenciaram o consumo de ração diário e o peso de carcaça dos animais. O ganho de peso diário e a conversão alimentar melhoraram de forma quadrática até os níveis de lisina digestível estimados de 0,803 e 0,817%, respectivamente. Foi observado efeito linear crescente dos tratamentos sobre o consumo diário de lisina e sobre a quantidade de carne. Embora, a deposição diária de carne tenha aumentado de forma linear, o modelo LRP foi o que melhor se ajustou aos dados que permaneceram em um platô a partir do nível de lisina digestível de 0,803%. Os níveis de lisina digestível influenciaram a espessura de toucinho P2 dos animais que reduziu de forma linear. O nível de lisina digestível de 0,803%, que corresponde a consumo de 24,60 g/dia de lisina digestível, proporciona os melhores resultados de ganho de peso e deposição de carne, enquanto o nível de 0,817%, correspondente a consumo de 25,03 g/dia de lisina, proporciona melhor conversão alimentar e o de 0,948%, correspondente a consumo de 29,09 g/dia de lisina digestível, promove maior deposição de carne e espessura de toucinho em suínos machos castrados na fase dos 95 aos 125 kg.This work evaluated levels of digestible lysine on performance and carcass composition of barrows with high genetic potential for meat deposition. It was used 80 animals with initial body weight of 95.55 ± 1.04 kg, distributed in a completely randomized block design, with 5 diets (0.540; 0.642; 0.744; 0.846 and 0.948% of digestible lysine), eight replicates and two animals per experimental unit. The experimental diets and water were provided ad libitum throughout the experimental period. Digestible lysine levels did not change daily feed intake and carcass weight of the animals. Daily weight gain and feed conversion improved in a quadratic way up to the estimated levels of 0.803 and 0.871% of digestible lysine, respectively. It was observed an increasing linear effect of the treatments on daily lysine intake and amount of meat. Although daily meat deposition had increased in a linear way, the LRP was the model that best adjusted to the data which remained on a plateau from 0.803% of digestible lysine level. The levels of digestible lysine influenced the P2 backfat thickness of the animals which decreased in a linear way. The digestible lysine level of 0.803%, corresponding to an intake of 24.60 g/day of digestible lysine provides the best results of weight gain and meat deposition whereas the level of 0.817% corresponding to an intake of 25.30 g/day of lysine provides the best result of feed conversion, and the digestible lysine level of 0.948% corresponding to an intake of 29.09 g/day of digestible lysine provides the best results of meat deposition and backfat thickness of barrows from 95 to 125 kg

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure &lt;= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

Comparação da latência anestésica de Articaína, Lidocaína, Levobupivacaína e Ropivacaína através de 'Pulp Tester'

INTRODUÇÃO: Um conhecimento profundo dos anestésicos odontológicos, como o tempo de latência da droga, pode assegurar o êxito do controle da dor no trans e no pós-operatório. OBJETIVO: Comparar a latência entre quatro soluções anestésicas, ou seja, o tempo entre o início da deposição do anestésico local e o momento em que seus efeitos tornam-se perceptíveis. Entretanto, isso não está relacionado com o êxito do controle da dor no trans e no pós-operatório (profundidade da anestesia). MATERIAL E MÉTODO: Foi realizado um estudo duplo cego, cruzado e randomizado, com 30 pacientes voluntários submetidos a quatro procedimentos em intervalos de uma semana, a partir de bloqueio do alveolar superior posterior. No segundo molar a ser tratado, foi utilizado o 'pulp tester' em intervalos de 2 minutos, considerando a insensibilidade da polpa quando da ausência de resposta após dois testes consecutivos de 80muV, chegando ao máximo de 10 minutos e determinando, assim, o período de latência do anestésico. Os dados foram submetidos aos testes T-student, de Friedman e de Kruskal-Wallis (p<0,05). RESULTADO: Não houve diferenças estatisticamente significativas (p=0,8327) entre as soluções anestésicas. Para todas estas, a mediana foi 2 minutos. Não houve, ainda, diferenças significantes entre os gêneros em relação à idade (p=0,4545), bem como entre os valores, quando se tentou observar a influência do gênero nos valores de latência (p=0,6754). CONCLUSÃO: Sendo os tempos médios de latência idênticos, a escolha da droga dependerá da duração do procedimento cirúrgico-odontológico a se realizar, além da necessidade ou não de analgesia pós-operatória

Available phosphorus levels in diets for 30 to 60 kg female pigs selected for meat deposition by maintaining calcium and available phosphorus ratio

With the objective to evaluate levels of available phosphorus (aP) in diets for pigs selected for meat deposition by maintaining the calcium and available phosphorus ratio, it was used 50 commercial hybrid female pigs with initial weight of 30.32 ± 0.29 kg, distributed in a complete randomized experimental design, with five treatments, five replicates, and two animals per experimental unit. Treatments were composed of a corn-soybean meal basal diet and four diets obtained by supplementation of basal diet with dicalcium phosphate, resulting in diets with 0.144; 0.224; 0.304; 0.384 and 0.464% of aP. Calcium levels were adjusted by varying the quantities of limestone in the diets. There was no effect of aP on both daily feed intake and feed conversion. Levels of aP affected daily weight gain which increased quadratically up to the estimated level of 0.372%. There was no effect of aP on quantity of phosphorus in the bones. The quantity of calcium in the bones and percentage of ash in the bones were influenced in an increasing linear way by the aP in the rations. The best result of weight gain of swine females, from 30 to 60 kg, genetically selected for meat deposition, is provided by the level of available phosphorus of 0.372%, which corresponds to a relationship with calcium of 2.06:1 and to a daily intake of 8.20 g of available phosphorus

Digestible tryptophan levels in diets for pigs weighing 15 to 30 kg

In order to evaluate the effects of increasing dietary tryptophan levels on performance and carcass characteristics of growing pigs, a total of 60 crossbred castrated male pigs, with average initial and final body weights of 15.50 ± 1.15 and 30.60 ± 1.35 kg were used. Pigs were allotted in a completely randomized block design, with five dietary treatments (0.149, 0.158, 0.168, 0.177, and 0.187% digestible tryptophan, corresponding to digestible tryptophan:lysine relations of 16.0, 17.0, 18.0, 19.0, and 20.0%), six replicates, and two animals per experimental unit, which was represented by the pen. Experimental diets and water were supplied ad libitum throughout the experimental period. The average maximum and minimum temperatures inside the rooms were of 21.5 ± 1.12°C and 26.4 ± 1.91°C, respectively. There was no effect of digestible tryptophan on daily feed intake or protein deposition of pigs. Body weight gain increased quadratically with increasing digestible tryptophan in the diets up to 0.175% maximum response. Increasing digestible tryptophan in the diets linearly improved feed conversion of pigs. The greatest weight gain of 15 to 30 kg castrated male pigs is obtained at 0.175% digestible tryptophan, corresponding to a digestible tryptophan:lysine relation of 18.82% and an estimated daily intake of 2.32 grams of digestible tryptophan