Effect of magnesium sulfate on morphine activity retention to control pain after herniorrhaphy

Comparison of adjuvant therapy with midazolam, paracetamol, tramadol, or magnesium sulfate during intravenous regional anesthesia with ropivacaine: A randomized clinical trial

Background

Intravenous (IV) regional anesthesia is an easy, safe, reliable, and efficient option for inducing anesthesia during surgeries but with tourniquet-related pain. This study aimed to evaluate midazolam, paracetamol, tramadol, and magnesium sulfate administration as adjuvants with ropivacaine on pain relief and hemodynamic changes in IV regional anesthesia.

Methods

A randomized, double-blind, placebo-controlled trial was conducted in subjects undergoing forearm surgery with IV regional anesthesia. The block randomization method was used to assign eligible participants to each of five study groups. Hemodynamic parameters were assessed before applying the tourniquet, at prespecified time points (5, 10, 15, and 20 min), then and every subsequent 10 min until surgery completion. A Visual Analog Scale was used to assess pain severity at baseline followed by every 15 min until completion of the surgery, and after tourniquet deflation every 30 min to 2 h, and at 6, 12, and 24 h postoperative. Data were analyzed using Chi-square and analysis of variance with repeated data testing.

Results

The shortest onset and the longest duration of sensory block were observed in the tramadol group and the shortest onset of motor block in the midazolam group (P < 0.001). Pain score was estimated to be significantly lower in the tramadol group at the time of tourniquet application and release, and 15 min to 12 h after tourniquet release (P < 0.05). In addition, the lowest dose of pethidine consumption was observed in the tramadol group (P < 0.001).

Conclusion

Tramadol appeared to be able to effectively relieve pain, shorten the onset of sensory block, prolong the duration of sensory block, and achieve the lowest consumption of pethidine.

Measuring serum sodium levels using blood gas analyzer and auto analyzer in heart and lung disease patients: A cross-sectional study

Objective

Methods

Results

Conclusion

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Emergency services require precise and rapid measurement of electrolytes to initiate treatment.

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Blood gas analyzers analyzes blood samples in seconds however, its accuracy is still debatable.

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Blood gas analyzer method has a high correlation with laboratory analyzer.

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In cases of hypernatremia, the blood gas analyzer method decreases and especially in acidosis.

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In patients with pulmonary problems, the difference with laboratory method increases.

Contralateral medial pectoral nerve transfer with free gracilis muscle transfer in old brachial plexus palsy

BACKGROUND

There is a very small chance of success for nerve reconstruction in patients with old total brachial plexus palsy who visit after 2 y or suffer from flail upper extremity after the failure of previous operations.

MATERIALS AND METHODS

For these individuals, the surgeon has to find a recipient motor nerve to perform free gracilis muscle transplantation. In this study, contralateral medial pectoral nerve from the intact side was transferred to the damaged side as a recipient nerve. Then, in the second operation, approximately 15 mo later, the free gracilis muscle transfer was performed. The gracilis muscle was removed and transferred to provide elbow and finger flexion.

RESULTS

In a retrospective study (over 10 y), we reviewed 68 patients for whom this method had been performed. After 1 y, the results were investigated using the Medical Research Council grading system. Five patients did not participate in the study, and the muscle underwent necrosis in two patients. M3 and M4 muscle power was regained in 26 (42.6%) and 21 (34.4%) patients, respectively.

CONCLUSIONS

Contralateral pectoral nerve transfer followed by free muscle transplantation can be a good option for patients with old total brachial plexus palsy.

Core-shell fibrous scaffold as a vehicle for sustained release of retinal pigmented epithelium-derived factor (PEDF) for photoreceptor differentiation of conjunctiva mesenchymal stem cells

Coaxial electrospinning technique was introduced as a flexible and promising technique for the fabrication of core-shell fibrous scaffold from poly ethylene glycol/poly caprolactone (PEG/PCL), where retinal pigmented epithelium-derived factor (PEDF) was encapsulated in the core, for photoreceptor differentiation of conjunctiva mesenchymal stem cells (CJMSCs) seed on scaffolds. The morphology and structure of fibers were characterized using SEM and TEM and photoreceptor differentiation was examined by quantitative real time PCR (qPCR). Release study showed that, a sustained release of PEDF from PEG/PCL scaffold was observed over 14 days. qPCR analysis demonstrated that rhodopsin (as a main photoreceptor gene) was significantly expressed in CJMSCs cultured on scaffold loaded with PEDF. According to the result, the core-shell scaffold loaded with PEDF (PEG + PEDF)/PCL) has superior control over factor release profile and has a potential for guiding photoreceptor differentiation of mesenchymal stem cells and promoting retinal regeneration. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 3514-3519, 2017.