The effect of palonosetron on rocuronium-induced withdrawal movement

AbstractBackgroundRocuronium causes pain and withdrawal movement during induction of anesthesia. In this study, palonosetron was investigated to have analgesic effect on the reduction of rocuronium-induced withdrawal movement.Methods120 patients were randomly assigned to one of three groups to receive either saline, lidocaine 20mg, or palonosetron 0.075mg with a tourniquet applied two minutes before thiopental sodium (5mg·kg−1) was given intravenously. After loss of consciousness, rocuronium (0.6mg·kg−1) was injected and the withdrawal movement was estimated by 4-point scale in a double-blind manner.ResultsThe overall incidence of rocuronium withdrawal movement was 50% with lidocaine (p=0.038), 38% with palonosetron (p=0.006) compared with 75% for saline. The incidence of no pain to mild pain was significantly lower in the lidocaine and palonosetron groups (85% and 92% respectively) than in the saline group (58%). However, there was no significant difference in withdrawal movement between the lidocaine and palonosetron groups. There was no severe movement with palonosetron.ConclusionPretreatment of palonosetron with venous occlusion may attenuate rocuronium-induced withdrawal movement as effective as the use of lidocaine. It suggested that peripheral action of palonosetron was effective to reduce rocuronium-induced withdrawal movement

Spinal Myoclonus Developed during Cervical Epidural Drug Infusion in Postherpetic Neuralgia Patient

Postherpetic neuralgia is the most frequent complication of herpes zoster. Treatment of this neuropathic pain syndrome is difficult and often disappointing. Although postherpetic neuralgia is generally a self-limited condition, it can last indefinitely. Continuous epidural blockade for patients with acute zoster can shorten the duration of treatment. However, continuous epidural block has some complications such as infection, dural puncture, and total spinal and nerve damages. We report a case of myoclonus during continuous epidural block with ropivacaine, morphine, and ketamine in an acute zoster patient

Synergetic Influence of Microcrystalline Quartz and Alkali Content in Aggregate on Deterioration of Concrete Railroad Ties Used for 15 Years in High-Speed Railways

This study investigated the deteriorations of precast prestressed concrete (PSC) ties that were used for 15 years in high-speed railways in Korea and its damaging mechanism. The collected PSC ties with longitudinal cracks on sides and map cracks on surfaces exhibited strength degradation. The deteriorations were likely related to alkali-silica reaction (ASR) and delayed ettringite formation (DEF) together, given that the presence of massive ettringite crystals and the decomposition of ASR gel were found from microstructural analyses. Although there were no typical reactive siliceous aggregates for ASR in this study, ASR cracks were generated in the PSC ties. This is because the aggregates in the PSC ties with cracks were potentially reactive, and its high alkali-silica reactivity was likely attributable to the presence of microcrystalline quartz, supplying reactive SiO2 to trigger ASR. Furthermore, the alkali content in aggregates was associated with the deterioration of the PSC ties. The alkali-bearing minerals in aggregates (i.e., alkali feldspars) likely supplied enough alkalis for ASR. Besides, micas in aggregates could promote ASR due to their porous structure, which helps easy water ingress

Use of Coal Bottom Ash and CaO-CaCl2-Activated GGBFS Binder in the Manufacturing of Artificial Fine Aggregates through Cold-Bonded Pelletization

This study investigated the use of coal bottom ash (bottom ash) and CaO-CaCl2-activated ground granulated blast furnace slag (GGBFS) binder in the manufacturing of artificial fine aggregates using cold-bonded pelletization. Mixture samples were prepared with varying added contents of bottom ash of varying added contents of bottom ash relative to the weight of the cementless binder (= GGBFS + quicklime (CaO) + calcium chloride (CaCl2)). In the system, the added bottom ash was not simply an inert filler but was dissolved at an early stage. As the ionic concentrations of Ca and Si increased due to dissolved bottom ash, calcium silicate hydrate (C-S-H) formed both earlier and at higher levels, which increased the strength of the earlier stages. However, the added bottom ash did not affect the total quantities of main reaction products, C-S-H and hydrocalumite, in later phases (e.g., 28 days), but simply accelerated the binder reaction until it had occurred for 14 days. After considering both the mechanical strength and the pelletizing formability of all the mixtures, the proportion with 40 relative weight of bottom ash was selected for the manufacturing of pilot samples of aggregates. The produced fine aggregates had a water absorption rate of 9.83% and demonstrated a much smaller amount of heavy metal leaching than the raw bottom ash

Administration of Vitamin C in a Patient with Herpes Zoster - A case report -

Herpes zoster as a result of reactivated varicella-zoster virus is characterized by vesicular eruptions on skin and painful neuralgia in the dermatome distribution. Pain during an acute phase of herpes zoster has been associated with a higher risk of developing postherpetic neuralgia. The current therapies for herpes zoster including analgesics and sympathetic nerve block as well as antiviral agents are important to alleviate pain and prevent postherpetic neuralgia. However, in some cases, the pain does not respond well to these treatments. We had a case in which a patient with herpes zoster did not respond to conventional therapy so we attempted to administer intravenous infusion of vitamin C which resulted in an immediate reduction in the pain

Cell based therapy for the management of chronic pain

The management of chronic pain, particularly neuropathic pain, still has significant unmet needs. In addition to inadequate symptomatic relief, there are concerns about adverse effects and addiction associated with treatments. The transplantation of cells that secrete neuroactive substances with analgesic properties into the central nervous system has only become of practical interest in more recent years, but provides a novel strategy to challenge current approaches in treating chronic pain. This review covers pre-clinical and clinical studies from both allogeneic and xenogeneic sources for management of chronic refractory pain

Myricetin improves endurance capacity and mitochondrial density by activating SIRT1 and PGC-1α

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