RESUMEN
We hypothesised that relaxation of the serratus anterior muscle by long thoracic nerve (LTN) block could help pain relief after video-assisted thoracoscopic surgery. Patients undergoing thoracoscopic wedge resection for pneumothorax were randomly assigned to control or LTN block. LTN block was performed before induction of general anaesthesia. Pain was evaluated using a visual analogue scale before anaesthesia induction (T0), on arrival to the post-anaesthetic care unit (PACU) (T1), every ten minutes after arrival in the PACU for 30 minutes (T2, T3 and T4) and one hour and 24 hours after discharge from the PACU (T5 and T6). Visual analogue scale scores from T1 to T5 in the block group were lower than the control group (T1: 36±11 vs 48±14 [P=0001], T2: 36±11 vs 51±15 [P<0.001], T3: 35±vs 52±15 [P<0.001], T4: 30±7 vs 45±17 [P<0.001] and T5: 26±5 vs 32±5 [P<0.001]). Total intravenous patient-controlled analgesia bolus dose (alfentanil 75 µg/ml) during PACU stay (1.6±1.2 vs 3.9±2.0 ml, P<0.001) and one hour after discharge from the PACU (0.5±0.8 vs 1.7±1.2 ml, P<0.001) in the LTN group was significantly lower than the control group. Total intravenous patient-controlled analgesia bolus dose from 1-24 hours after discharge from the PACU was similar between groups (P=0197). These findings indicate that LTN block reduced pain after video-assisted thoracoscopic surgery from end-of-surgery to one hour after discharge from the PACU.
Asunto(s)
Bloqueo Nervioso/métodos , Neumotórax/cirugía , Cirugía Torácica Asistida por Video/métodos , Toracoscopía/métodos , Adolescente , Adulto , Femenino , Humanos , Masculino , Dimensión del DolorRESUMEN
This randomised controlled trial compared the effect of equipotent anaesthetic doses of sevoflurane (S group) versus propofol (P group), during remifentanil-based anaesthesia for off-pump coronary artery bypass surgery, on myocardial injury. Either sevoflurane or propofol was titrated to maintain bispectral index values between 40 and 50. In both groups, a targeted concentration of remifentanil 20 ng x ml(-1) was maintained during anaesthesia. The concentrations of creatine kinase MB and troponin I were measured before the start of surgery, on admission to the intensive care unit, and at 12 and 24 hours after intensive care unit admission. The postoperative values of creatine kinase MB (S group: 15.08 +/- 18.97, 20.78 +/- 20.92, 12.76 +/- 12.82 vs 2.09 +/- 1.54 ng x ml(-1); P group: 10.99 +/- 13.15 27.16 +/- 56.55 11.88 +/- 18.80 vs 1.84 +/- 1.67 ng x ml(-1)) and troponin I (S group: 3.56 +/- 5.19, 566 +/- 7.89, 3.35 +/- 4.55 vs 0.52 +/- 1.90 ng x ml(-1); P group: 2.42 +/- 3.33, 4.11 +/- 6.01, 3.04 +/- 5.31 vs 0.43 +/- 1.28 ng x ml(-1)) were significantly higher than preoperative values in both groups but there were no significant differences between the two groups. There were no significant differences in time to extubation (S group, 476 +/- 284 minutes; P group, 450 +/- 268 minutes) and intensive care unit length of stay (S group, 2775 +/- 1449 minutes; P group, 2797 +/- 1534 minutes) between the two groups. In conclusion, sevoflurane and propofol at equipotent doses guided by bispectral index with remifentanil 20 ng x ml(-1) had similar creatine kinase MB and troponin I values.
Asunto(s)
Anestésicos/farmacología , Puente de Arteria Coronaria Off-Pump/efectos adversos , Corazón/efectos de los fármacos , Éteres Metílicos/farmacología , Piperidinas/farmacología , Propofol/farmacología , Anciano , Forma MB de la Creatina-Quinasa/sangre , Electroencefalografía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Remifentanilo , Sevoflurano , Troponina I/sangreRESUMEN
Surface proteins of Trichomonas vaginalis (T. vaginalis) were analyzed to study the antigenic variation. The surface proteins of protozoa were labelled by N-hydroxysuccinimide-biotin (NHS-biotin), the NHS-biotin-labelled proteins were immunoprecipitated with rabbit antiserum to purify the antigenic fractions and analysed by SDS-PAGE plus electroblotting. The results obtained in this study were as follows; Biotinylated T. vaginalis-proteins obtained from intact cell and cells disrupted prior to labelling were detected by anti-biotin-peroxidase in Western blots. Labelled proteins were immunoprecipitated by T. vaginalis-immunized rabbit serum and the six bands with the molecular weights of 46, 60, 68, 90, 130 and 220 kDa were identified as having antigenicity. T. vaginalis HY-1, HY-15 and ATCC 50148 were immunoprecipitated by immune rabbit serum after biotinylation and there were no difference from antigenic bands among these strains by this technique. In conclusion with the results obtained in the present study, it was assumed that surface proteins of T. vaginalis were labelled by biotinylation and the six labelled bands at 46, 60, 68, 90, 130 and 220 kDa in their molecular weight were identified as having antigenicity by immunoprecipitation (IP) and this biotinylation-IP technique may be used for further study of surface antigen of T. vaginalis.