Can adding Ephedrine to Admixture of Propofol & Lidocaine Overcome Propofol Associated Hemodynamic Changes and Injection Pain?

Purpose: There are numerous studies researching ways to alleviate propofol injection pain. In this study, we evaluated and compared the use of propofol-lidocaine admixture vs propofol-lidocaine combined with ephedrine, on vascular pain and hemodynamic changes associated propofol. Methods: This double-blinded, prospective, randomised study was performed on 100 patients with ASA I-II who were divided into two group. The first received admixture consisting of 20 mg of lidocaine and propofol 1% 20 ml (Group L), and the other received admixture consisting of 20 mcg ephedrine, 20 mg lidocaine and propofol 1% 20 ml (Group LE). Baseline and after induction heart rate, mean arterial pressure and rate pressure product (RPP) were recorded per minute. Vascular pain were evaluated with verbal rating scale. Results: Data of 40 patients in group L and 39 patients in Group LE were evaluated in the study. The incidence of pain in group L was 90%, it was 38.4% for Group LE. Mild pain was observed significantly more in Group L when compared to Group LE (p<0.05). Average blood pressure and RPP immediately after induction and 1 min after intubation were significantly higher in group LE compared to group L (p<0.05). Heart rate was higher in Group LE immediately after induction and at initially 4 minutes after intubation. Conclusion: Our study has demonstrated significant decrease in rate of vascular pain and increased hemodynamic stability in patients receiving 20 mg ephedrine added to 20 ml % 1 propofol and 20 mg lidocaine admixture when compared to those who only received the lidocaine-propofol admixtur

Fourteen days of smoking cessation improves muscle fatigue resistance and reverses markers of systemic inflammation

Cigarette smoking has a negative effect on respiratory and skeletal muscle function and is a risk factor for various chronic diseases. To assess the effects of 14 days of smoking cessation on respiratory and skeletal muscle function, markers of inflammation and oxidative stress in humans. Spirometry, skeletal muscle function, circulating carboxyhaemoglobin levels, advanced glycation end products (AGEs), markers of oxidative stress and serum cytokines were measured in 38 non-smokers, and in 48 cigarette smokers at baseline and after 14 days of smoking cessation. Peak expiratory flow (p = 0.004) and forced expiratory volume in 1 s/forced vital capacity (p = 0.037) were lower in smokers compared to non-smokers but did not change significantly after smoking cessation. Smoking cessation increased skeletal muscle fatigue resistance (p < 0.001). Haemoglobin content, haematocrit, carboxyhaemoglobin, total AGEs, malondialdehyde, TNF-α, IL-2, IL-4, IL-6 and IL-10 (p < 0.05) levels were higher, and total antioxidant status (TAS), IL-12p70 and eosinophil numbers were lower (p < 0.05) in smokers. IL-4, IL-6, IL-10 and IL-12p70 had returned towards levels seen in non-smokers after 14 days smoking cessation (p < 0.05), and IL-2 and TNF-α showed a similar pattern but had not yet fully returned to levels seen in non-smokers. Haemoglobin, haematocrit, eosinophil count, AGEs, MDA and TAS did not significantly change with smoking cessation. Two weeks of smoking cessation was accompanied with an improved muscle fatigue resistance and a reduction in low-grade systemic inflammation in smokers

Effects of transcutaneous electrical nerve stimulation on motor and sensorial nerves for diabetic polyneuropathy patients by use of electromyography

About 20-30% of diabetic patients are affected by DP. Transcutaneous electrical nerve stimulation (TENS) and electrical has been proposed as physical therapies. This study was aimed to investigate the effects of high rate frequency modulation (HRFM) with TENS treatment on patients which have diabetic polyneuropathy (DP). Patients with type 2 diabetes and DP (n=14) both upper extremities were treated for 20 min daily for twenty consecutive days. The patients' values of glucose, amplitude and latency were measured by use of EMG at before TENS, after TENS and following term of TENS. Patients were similar in terms of baseline characteristics, such as age, duration of diabetes, neurological symptoms scores and neurological disability scores. Differences among glucose levels related to before TENS, after TENS and following term of TENS are found statistically significant (p>0.05). Differences for amplitude did not change statistically. Differences on latencies belong to motor and sensorial nerves were found statistically significant (p>0.05). In conclusion, result of the study indicated that TENS treatment has been positive effect on diabetic polyneuropathy