RESUMEN
BACKGROUND: The aim of this study was to assess the efficacy of intraperitoneal different combinations for postoperative pain relief in patients undergoing laparoscopic unilateral ovarian cystectomy. METHODS: We conducted a double-blind randomized controlled trial that enrolled patients who were included to undergo laparoscopic unilateral ovarian cystectomy. Patients received one of the following combinations (30 patients each): group I: received bupivacaine plus magnesium sulfate, group II: received bupivacaine plus hydrocortisone, group III: received magnesium sulfate plus hydrocortisone, and group IV: received saline 0.9% only. The primary outcomes in the present study were the severity of postoperative abdominal and shoulder pain assessed by visual analog scale (VAS) every two hours till the end of the first day, and time for first postoperative analgesia requirement. RESULTS: Group I had statistically significant lower abdominal static and dynamic pain scores than the other groups till 18 hours postoperatively (P<0.001). In addition, group II had statistically significant lower abdominal static and dynamic pain scores than group III in the most of assessment points (P<0.05). The time for first required analgesics was significantly longer in group I (336.2±67.54 minutes) than other groups (P<0.001). The proportion of patients who required two or more doses of ketorolac was significantly lower in group I than other groups (P<0.001). The proportion of patients with nausea or vomiting was not significantly different across study's groups (P>0.05). CONCLUSIONS: Intraperitoneal bupivacaine-magnesium combination provides better analgesia and reduces postoperative morphine consumption than bupivacaine-hydrocortisone or magnesium-hydrocortisone combinations after laparoscopic ovarian cystectomy.
Asunto(s)
Anestésicos Locales/uso terapéutico , Antiinflamatorios/uso terapéutico , Bupivacaína/uso terapéutico , Hidrocortisona/uso terapéutico , Laparoscopía , Sulfato de Magnesio/uso terapéutico , Quistes Ováricos/cirugía , Dolor Postoperatorio/tratamiento farmacológico , Adolescente , Adulto , Anestésicos Locales/administración & dosificación , Antiinflamatorios/administración & dosificación , Bupivacaína/administración & dosificación , Método Doble Ciego , Femenino , Humanos , Hidrocortisona/administración & dosificación , Inyecciones Intraperitoneales , Ketorolaco/uso terapéutico , Sulfato de Magnesio/administración & dosificación , Persona de Mediana Edad , Dimensión del Dolor , Náusea y Vómito Posoperatorios/epidemiología , Resultado del Tratamiento , Adulto JovenRESUMEN
This study evaluated the association of NOS3 polymorphisms with hypertension risk and complications. eNOS (G894T) SNP was performed by RT-PCR on 70 hypertensive patients (25 were hypertensive, 25 were hypertensive with CAD, and 20 were diabetic with hypertension) and 30 age- and gender-matched individuals. Lipid and glucose profile were assessed by standard colorimetric assay. Our results revealed that combination of (GT + TT) genotype and T allele significantly increases the risk of hypertension (OR = 3.86 and 4.33), respectively. Subgroup analysis showed significant association between CAD with eNOS (G894T) mutant genotype (P = 0.002) and allele frequency (P < 0.001). Moreover, the mutant homozygous and heterozygous eNOS genotype together were significantly associated with higher TC, LDLc, (P < 0.001), and TG (P = 0.001). Thus, hypercholesterolemia (P < 0.001 and OR = 12.48) increases the risk of hypertension among T carrier. These results indicated that the T carriers significantly increase hypertension risk and complication (CAD), mainly with hypercholesterolemia and in elderly.