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Sample records for local anesthetic action

  1. Enhanced local anesthetic action of mepivacaine from the bioadhesive gels.

    Science.gov (United States)

    Cho, Cheong-Weon; Choi, Jun-Shik; Shin, Sang-Chul

    2011-01-01

    Mepivacaine, an amide-type local anesthetic, has been used to relieve local pain. Among the many drug delivery systems, transdermal drug delivery has some advantages, as it provides controlled drug delivery for an extended period of time. To develop new gel formulations that have suitable bioadhesion, the bioadhesive force of hydroxypropyl methylcellulose (HPMC) was assessed using an auto-peeling tester. The effect of drug concentration on drug release from 2% HPMC gel was studied using synthetic cellulose membrane at 37±0.5°C. The drug concentrations tested were 0.5, 1, 1.5, 2, and 2.5%. The effect of temperature on drug release from the 2% drug gel was evaluated at 27, 32, 37 and 42°C. To increase the skin permeation of mepivacaine from HPMC gel, enhancers such as saturated and unsaturated fatty acids, pyrrolidones, propylene glycol derivatives, glycerides, and non-ionic surfactants were incorporated into the mepivacaine-HPMC gels. The enhancing effect of the enhancer on drug permeation was then examined in the modified Keshary-Chien cell. For the efficacy study, the anesthetic action of the formulated mepivacaine gel containing enhancer and vasoconstrictor was evaluated with the tail-flick analgesimeter. Among the various kinds of HPMC, HPMC-K100M gel showed the highest viscosity and bioadhesive force. As the viscosity of the HPMC gels increased, the bioadhesive forces increased. Increasing the drug concentration or temperature increased the drug release rate. Among the enhancers used, polyoxyethylene 2-oleyl ether showed the greatest enhancement of permeation. Based on the area under the efficacy curve of the rat tail flick test curve, mepivacaine gel containing polyoxyethylene 2-oleyl ether and tetrahydrozoline showed prolonged and increased local anesthetic action compared to the control. For bioadhesive mepivacaine gels with enhanced local anesthetic action, mepivacaine gels containing penetration enhancer and vasoconstrictor could be developed with the

  2. Improvement of Lidocaine Local Anesthetic Action Using Lallemantia royleana Seed Mucilage as an Excipient.

    Science.gov (United States)

    Atabaki, Rabi; Hassanpour-Ezatti, Majid

    2014-01-01

    Lallemantia royleana (Balangu) is a well known Iranian medicinal plant that its seed mucilage has many applications in modern pharmacology. Plant mucilage traditionally was used as a gel supplement, and natural matrix for sustained release of drugs. But it seems that these compounds are not a simple additive and also have many undiscovered pharmacological properties. In this research, the anesthetic action of gel prepared from Balangu mucilage alone and its mixture with lidocaine hydrochloride are compared with the effect of commercial 2% lidocaine gel by rat tail flick test. Mucilage of Balangu seed alone showed analgesic effect. Duration and potency of anesthesia induced by gel containing mucilage alone (0.01 g/mL) were identical to commercial 2% lidocaine gel. But, local anesthetic potency and duration of gel made from 2% lidocaine-mucilage gel mixture was significantly higher than commercial 2% lidocaine gel. The gel prepared from mucilage causes a good analgesia with unknown mechanism. Besides, mixture of Balangu mucilage prepared gel with lidocaine improves lidocaine anesthesia. The increase in potency of lidocaine action results from mucilage dermal penetration enhancing effects; and longer anesthetic duration of this mixture are related to the capability of mucilage based gel for sustained drug release.

  3. Synthesis and antispasmodic activity of lidocaine derivatives endowed with reduced local anesthetic action.

    Science.gov (United States)

    Costa, Jorge C S; Neves, Josiane S; de Souza, Marcus V N; Siqueira, Rodrigo A; Romeiro, Nelilma C; Boechat, Nubia; e Silva, Patrícia M R; Martins, Marco A

    2008-02-01

    The present structure-activity relationship (SAR) study focused on chemical modifications of the structure of the local anesthetic lidocaine, and indicated analogues having reduced anesthetic potency, but with superior potency relative to the prototype in preventing anaphylactic or histamine-evoked ileum contraction. From the SAR analysis, 2-(diethylamino)-N-(trifluoromethyl-phenyl) and 2-(diethylamino)-N-(dimethyl-phenyl) acetamides were selected as the most promising compounds. New insights into the applicability of non-anesthetic lidocaine derivatives as templates in drug discovery for allergic syndromes are provided.

  4. Improvement of Lidocaine Local Anesthetic Action Using Lallemantia royleana Seed Mucilage as an Excipient

    OpenAIRE

    Atabaki, Rabi; Hassanpour-Ezatti, Majid

    2014-01-01

    Lallemantia royleana (Balangu) is a well known Iranian medicinal plant that its seed mucilage has many applications in modern pharmacology. Plant mucilage traditionally was used as a gel supplement, and natural matrix for sustained release of drugs. But it seems that these compounds are not a simple additive and also have many undiscovered pharmacological properties. In this research, the anesthetic action of gel prepared from Balangu mucilage alone and its mixture with lidocaine hydrochlorid...

  5. Effects of Various Antiepileptics Used to Alleviate Neuropathic Pain on Compound Action Potential in Frog Sciatic Nerves: Comparison with Those of Local Anesthetics

    Directory of Open Access Journals (Sweden)

    Yuhei Uemura

    2014-01-01

    Full Text Available Antiepileptics used for treating neuropathic pain have various actions including voltage-gated Na+ and Ca2+ channels, glutamate-receptor inhibition, and GABAA-receptor activation, while local anesthetics are also used to alleviate the pain. It has not been fully examined yet how nerve conduction inhibitions by local anesthetics differ in extent from those by antiepileptics. Fast-conducting compound action potentials (CAPs were recorded from frog sciatic nerve fibers by using the air-gap method. Antiepileptics (lamotrigine and carbamazepine concentration dependently reduced the peak amplitude of the CAP (IC50=0.44 and 0.50 mM, resp.. Carbamazepine analog oxcarbazepine exhibited an inhibition smaller than that of carbamazepine. Antiepileptic phenytoin (0.1 mM reduced CAP amplitude by 15%. On the other hand, other antiepileptics (gabapentin, sodium valproate, and topiramate at 10 mM had no effect on CAPs. The CAPs were inhibited by local anesthetic levobupivacaine (IC50=0.23 mM. These results indicate that there is a difference in the extent of nerve conduction inhibition among antiepileptics and that some antiepileptics inhibit nerve conduction with an efficacy similar to that of levobupivacaine or to those of other local anesthetics (lidocaine, ropivacaine, and cocaine as reported previously. This may serve to know a contribution of nerve conduction inhibition in the antinociception by antiepileptics.

  6. Strabismus complications from local anesthetics.

    Science.gov (United States)

    Guyton, David L

    2008-01-01

    Strabismus developing after retrobulbar or peribulbar anesthesia for both anterior and posterior segment eye surgery may be due to myotoxicity to an extraocular muscle from the local anesthetic agent. Initial paresis often causes diplopia immediately after surgery, but later progressive segmental fibrosis occurs, and/or hypertrophy of the muscle, producing diplopia in the opposite direction from the direction of the initial diplopia. The inferior rectus muscle is most commonly affected. Usually a large recession on an adjustable suture of the involved muscle(s) yields good alignment. Using topical anesthesia or sub-Tenon's anesthesia can avoid this complication.

  7. Hypnotic Actions of Local Anesthetics in Mice%局部麻醉药对小鼠催眠作用的研究

    Institute of Scientific and Technical Information of China (English)

    阿里·塞德; 孟庆涛; 夏中元; 陈向东

    2012-01-01

    目的:研究局部麻醉药的全身麻醉作用及其基本机制.方法:C57BL/6小鼠通过尾静脉分别注射利多卡因、布比卡因和罗哌卡因,同时使用或不使用氯胺酮、钠通道阻滞剂TTX和NMDA受体阻滞剂MK-801.通过翻正反射的消失(LORR)来评估这些药物对小鼠的催眠作用.结果:局部麻醉药利多卡因(15 mg/kg),布比卡因(5mg/kg),罗哌卡因(5 mg/kg)的全身应用均可产生直接的催眠作用,并达到其半数有效浓度(EC50).利多卡因可以增强氯胺酮的催眠作用(达到EC50的氯胺酮+利多卡因),表明了利多卡因和氯胺酮的联合使用可以增强其对小鼠的催眠作用.而钠通道阻滞剂不能改变利多卡因的催眠作用.NMDA受体阻滞剂(11-15 mg/kg)可增强并达到EC50利多卡因的LORR.结论:局部麻醉药可以产生直接的催眠作用,全身麻醉药氯胺酮可增强其麻醉效应,而钠通道阻滞剂则不能,NMDA受体阻滞剂可增强利多卡因的催眠作用.%Objective:. To investigate the systemic action of local anesthetics and their underlying mechanisms. Methods: Lidocaine, bupivacaine, and ropivacaine respectively were injected into C57BL/ 6 mice through tail vein intravenously, and loss of righting reflex (LORR) was used to evaluate the hypnotic action of these drugs with or without ketamine, sodium channel blocker TTX and NMDA receptor blocker MK-801. Results: Systemic application of all three local anesthetics directly produced hypnotic action with half effective concentration (EC50) of 15 mg/kg for lidocaine and 5 mg/kg for bupivacaine and ropivacaine. Lidocaine also enhanced the hypnotic action of ketamine, yielding an EC50 fraction of ketamine plus lidocaine of 1. 09, which suggested that lidocaine and ketamine have additive hypnotic action in mice. Blocking of sodium channel by TTX failed to alter hypnotic action of lidocaine. Blocking of NMDA receptor enhanced the LORR of lidocaine with EC50 from 11 mg/kg to 15 mg/kg. Conclusion

  8. Local anesthetics: dentistry's most important drugs.

    Science.gov (United States)

    Malamed, S F

    1994-12-01

    One hundred and fifty years ago, Horace Wells opened the door to local anesthetics. Since then, many advances have been made in pain control. The development of dentistry's most important drugs is highlighted here.

  9. Effect of local anesthetics on serotonin1A receptor function.

    Science.gov (United States)

    Rao, Bhagyashree D; Shrivastava, Sandeep; Chattopadhyay, Amitabha

    2016-12-01

    The fundamental mechanism behind the action of local anesthetics is still not clearly understood. Phenylethanol (PEtOH) is a constituent of essential oils with a pleasant odor and can act as a local anesthetic. In this work, we have explored the effect of PEtOH on the function of the hippocampal serotonin1A receptor, a representative neurotransmitter receptor belonging to the G protein-coupled receptor (GPCR) family. Our results show that PEtOH induces reduction in ligand binding to the serotonin1A receptor due to lowering of binding affinity, along with a concomitant decrease in the degree of G-protein coupling. Analysis of membrane order using the environment-sensitive fluorescent probe DPH revealed decrease in membrane order with increasing PEtOH concentration, as evident from reduction in rotational correlation time of the probe. Analysis of results obtained shows that the action of local anesthetics could be attributed to the combined effects of specific interaction of the receptor with anesthetics and alteration of membrane properties (such as membrane order). These results assume relevance in the perspective of anesthetic action and could be helpful to achieve a better understanding of the possible role of anesthetics in the function of membrane receptors.

  10. LOCAL ANESTHETICS IN PATIENTS WITH CARDIOVASCULAR DISEASES.

    Directory of Open Access Journals (Sweden)

    risto Daskalov

    2015-03-01

    Full Text Available A significant problem in the dental medicine is pain alleviation. Many studies in the dental anesthesiology result in the production of new agents for locoregional anesthesia. Objective: This article aim to present the results of the last studies on the effect of the local anesthetics used in the oral surgery on patients with cardiovascular diseases. Material: A general review of the existing literature on the effect of the adrenaline, included as vasoconstrictor in the local anesthetics, used in patients with cardiovascular diseases is made. The benefits of vasoconstrictors for the quality of the anesthetic effect are proven. Conclusion: A small amount of adrenaline in the anesthetic solution does not result in complications development in patients with controlled cardiovascular diseases. Articaine is recommended agent of first choice for local anesthesia in the oral surgery.

  11. SYSTEMIC TOXIC REACTIONS TO LOCAL ANESTHETICS

    Science.gov (United States)

    Moore, Daniel C.; Green, John

    1956-01-01

    The topical use of anesthetic agents involves an element of risk. Systemic toxic reactions are rare, but they do occur and may result in death. When a reaction occurs from a topical application, it usually progresses rapidly to respiratory and cardiovascular collapse, and thus therapy must be instituted with more haste to avoid deaths. Fatal systemic toxic reactions from topically administered anesthetic drugs are, in effect, usually not due to well informed use of the drug but to misuse owing to less than complete understanding of absorption. Emphasis is placed on the causes, prophylaxis and treatment of severe systemic toxic reactions which follow the topical application of local anesthetic drugs. If systemic toxic reactions resulting from a safe dose of a local anesthetic agent are correctly treated, there will usually follow an uneventful recovery rather than a catastrophe. PMID:13343009

  12. Water solvent and local anesthetics: A computational study

    Science.gov (United States)

    Bernardi, R. C.; Gomes, D. E. B.; Pascutti, P. G.; Ito, A. S.; Taft, C. A.; Ota, A. T.

    There are various experimental studies regarding the toxicity and the time of action of local anesthetics, which contain general insights about their pharmacological and physicochemical properties. Although a detailed microscopic analysis of the local anesthetics would contribute to understanding these properties, there are relatively few theoretical studies about these molecules. In this article, we present the results from calculations performed for three local anesthetics: tetracaine, procaine, and lidocaine, both in their charged and uncharged forms, in aqueous environment. We have used the density functional theory and molecular dynamics simulations to study the structural characteristics of these compounds. The radial distribution function g(r) was used to examine the structure of water molecules surrounding different regions of the local anesthetics. We demonstrated the nonhomogeneous character of the anesthetics with respect to their affinity to water solvent molecules as well as the modifications in their affinity to water caused by changes in their charge state. We also observed that the biological potency of the anesthetics is more related to the behavior of specific groups within the molecule, which are responsible for the interaction with the lipid phase of membranes, rather than the general properties of the molecule as a whole.

  13. Knowledge about local anesthetics in odontology students.

    Science.gov (United States)

    Guzmán Alvarez, Rodrigo; Campos Sepúlveda, Alfonso Efraín; Martínez González, Adrian Alejandro

    2009-01-01

    The purpose of the study was to identify the level of knowledge of local anesthetics frequently used in the surgical clinic by third and fourth year dental students in daily practice. The importance of pharmacology in dental practice in underscored by potential drug toxicity. The study was performed with 244 third and fourth grade career dental students (CDS). Eleven items regarding the knowledge over local anesthetics at the clinic; i.e., the appropriate doses, possible toxic effects and side effects were examined. The reference questionnaire which is in a validation process, is a way to evaluate student knowledge about most drugs used in odontology practice such as: NSAIDs, antibiotics and local anesthetics. The results were found to be unsatisfactory with a high percentage of students failing (less than six of eleven items correct). We conclude that determination of practice knowledge is an essential step in informing the institution about cognitive deficiencies identified in order to plan learning solutions.

  14. Adjuvants to local anesthetics: Current understanding and future trends

    Science.gov (United States)

    Swain, Amlan; Nag, Deb Sanjay; Sahu, Seelora; Samaddar, Devi Prasad

    2017-01-01

    Although beneficial in acute and chronic pain management, the use of local anaesthetics is limited by its duration of action and the dose dependent adverse effects on the cardiac and central nervous system. Adjuvants or additives are often used with local anaesthetics for its synergistic effect by prolonging the duration of sensory-motor block and limiting the cumulative dose requirement of local anaesthetics. The armamentarium of local anesthetic adjuvants have evolved over time from classical opioids to a wide array of drugs spanning several groups and varying mechanisms of action. A large array of opioids ranging from morphine, fentanyl and sufentanyl to hydromorphone, buprenorphine and tramadol has been used with varying success. However, their use has been limited by their adverse effect like respiratory depression, nausea, vomiting and pruritus, especially with its neuraxial use. Epinephrine potentiates the local anesthetics by its antinociceptive properties mediated by alpha-2 adrenoreceptor activation along with its vasoconstrictive properties limiting the systemic absorption of local anesthetics. Alpha 2 adrenoreceptor antagonists like clonidine and dexmedetomidine are one of the most widely used class of local anesthetic adjuvants. Other drugs like steroids (dexamethasone), anti-inflammatory agents (parecoxib and lornoxicam), midazolam, ketamine, magnesium sulfate and neostigmine have also been used with mixed success. The concern regarding the safety profile of these adjuvants is due to its potential neurotoxicity and neurological complications which necessitate further research in this direction. Current research is directed towards a search for agents and techniques which would prolong local anaesthetic action without its deleterious effects. This includes novel approaches like use of charged molecules to produce local anaesthetic action (tonicaine and n butyl tetracaine), new age delivery mechanisms for prolonged bioavailability (liposomal

  15. Local anesthetics as pain therapy in horses.

    Science.gov (United States)

    Doherty, Thomas J; Seddighi, M Reza

    2010-12-01

    This article describes the rationale behind the use of systemically administered lidocaine as an analgesic. The analgesic efficacy of intravenously administered lidocaine is well documented by studies in human patients and laboratory animals. The mechanism by which systemically administered lidocaine produces analgesia is uncertain but is thought to include action at sodium, calcium, and potassium channels and the N-methyl-D-aspartate acid receptor. In addition, the anti-inflammatory actions of lidocaine are important in producing analgesia because inflammatory mediators augment neuronal excitability. The available studies of systemically administered lidocaine in horses provide evidence for the analgesic and anesthetic effects of intravenous lidocaine in this species.

  16. Trigeminal nerve injury associated with injection of local anesthetics

    DEFF Research Database (Denmark)

    Hillerup, Søren; Jensen, Rigmor H.; Ersbøll, Bjarne Kjær

    2011-01-01

    anesthetics (from 1995 through 2007), 292 reports to the Danish Medicines Agency, Copenhagen, Denmark, of adverse reactions to local anesthetic drugs, and a clinical sample of 115 patients with NSD associated with local anesthetics. The authors assessed lidocaine 2 percent, mepivacaine 2 percent and 3 percent...

  17. Antidepressants and local anesthetics: drug interactions of interest to dentistry

    Directory of Open Access Journals (Sweden)

    Lea Rosa Chioca

    2010-10-01

    Full Text Available Introduction: Since there is a vast variety of pharmacological treatments for mental conditions, it has been increasingly more common that patients seeking dentistry treatment are continually using psychoactive drugs as antidepressants. The number of people taking antidepressants is increasing; consequently, dentists should update their knowledge on the interaction between this drug class and those used in dental daily practice, such as local anesthetics and vasoconstrictors. Objective: To conduct a literature review on this subject. Literature review and conclusion: Literature data suggest that sympathomimetic vasoconstrictors (epinephrine, norepinephrine, and phenylephrine associated with local anesthetics may potentiate the side effects of antidepressants, particularly tricyclics and MAO inhibitors, on the cardiovascular system. There are few clinical trials and preclinical studies on this subject, and most of them were carried out between the 60s and 80s. Current studies are needed, since many new antidepressant drugs with different mechanisms of action are currently marketed and being used.

  18. Interactions of some local anesthetics and alcohols with membranes.

    Science.gov (United States)

    Frangopol, P T.; Mihăilescu, D

    2001-09-01

    A review of the results obtained by our group in the last decade regarding the interactions of procaine, lidocaine, dibucaine and tetracaine with membranes is presented in the context of the literature data. The action upon membranes, in first approximation monomolecular film of stearic acid spread at the air/water interface used as a membrane model, the modification of biomembrane structure and function using diffraction methods, lipid phase transition, fluidity of lipids and proteins, membrane expansion and platelet aggregation were studied. The thermodynamic knowledge of membrane-alcohol interactions improved by using highly sensitive calorimetric techniques are briefly reported. One of the main conclusions is that the physical state of a monolayer model membrane was the result of competitive interactions between film-film and film-substrate interactions. It was taken into account that local anesthetics, such as lidocaine, carbisocaine, mesocaine, showed changes in the bilayer structure, reflected in macroscopic mechanical properties. This restructuring of the lipid bilayer has a significant influence on the operation of functional subunits, e.g. ionic channels formed by gramicidin. The results support the concept of non-specific interactions of local anesthetics with lipid bilayers. The theoretical modeling of the interactions of local anesthetics is closely compared with experimental data. Our new theory of relaxation for these interactions is using a non-archimedean formalism based on a process resulting from superpositions of different component processes which take place at different scales of time.

  19. Identifying and Managing Local Anesthetic Allergy in Dermatologic Surgery.

    Science.gov (United States)

    Fathi, Ramin; Serota, Marc; Brown, Mariah

    2016-02-01

    Local anesthetic (LA) allergy is a concern for dermatologic surgeons given the large number of procedures performed yearly with LAs. Many patients also have anxiety about past or potential anesthesia allergy. This article will review the symptoms of IgE-mediated allergic reactions, the prevalence of IgE-mediated LA allergy, discuss common mimics of LA, and propose a practical approach for diagnostic and therapeutic options for LA allergy for the dermatologic surgeon in practice. A literature search of Pubmed using keywords "lidocaine," "local anesthetic," "hypersensitivity," and "allergy" was performed. Amide anesthetics result in the most reports of true local anesthetic immediate hypersensitivity. True IgE-mediated anaphylaxis to local anesthesia is very rare. Dermatologic surgeons should be aware of the symptoms of anesthetic allergy and its mimickers, as well as how to manage allergic reactions in their clinical practice.

  20. Local anesthetics: dentistry's most important drugs, clinical update 2006.

    Science.gov (United States)

    Malamed, Stanley F

    2006-12-01

    Local anesthetics are the safest most effective drugs in medicine for the control and management of pain. They also represent the most important drugs in dentistry. Today, dentistry has a spectrum of local anesthetics that permit pain control to be tailored to the specific needs of the patient: short-, intermediate-, and long-acting drugs. Bupivacaine has become a standard part of the armamentarium for postsurgical pain control while articaine has become the second-most used local anesthetic in the United States since its introduction in 2000. Despite an increase in anecdotal reports of paresthesia since articaine's introduction there is yet, no supporting scientific evidence.

  1. Trigeminal nerve injury associated with injection of local anesthetics

    DEFF Research Database (Denmark)

    Hillerup, Søren; Jensen, Rigmor H.; Ersbøll, Bjarne Kjær

    2011-01-01

    , prilocaine 3 percent, and articaine 4 percent sold in cartridges. Results. The study results showed a highly significant overrepresentation of NSDs associated with articaine 4 percent, in particular with mandibular blocks. Conclusions. The distribution of NSDs was disproportionate to the market share......Background. The authors used comprehensive national registry and clinical data to conduct a study of adverse drug reactions (ADRs), in particular neurosensory disturbance (NSD), associated with local anesthetics used in dentistry. Methods. The study included data sets of annual sales of local...... anesthetics (from 1995 through 2007), 292 reports to the Danish Medicines Agency, Copenhagen, Denmark, of adverse reactions to local anesthetic drugs, and a clinical sample of 115 patients with NSD associated with local anesthetics. The authors assessed lidocaine 2 percent, mepivacaine 2 percent and 3 percent...

  2. Recognition of local anesthetics by alphabeta+ T cells.

    Science.gov (United States)

    Zanni, M P; von Greyerz, S; Hari, Y; Schnyder, B; Pichler, W J

    1999-02-01

    Patients with drug allergy show a specific immune response to drugs. Chemically nonreactive drugs like, for example, local anesthetics are directly recognized by alphabeta+ T cells in an HLA-DR restricted way, as neither drug metabolism nor protein processing is required for T cell stimulation. In this study we identified some of the structural requirements that determine cross-reactivity of T cells to local anesthetics, with the aim to improve the molecular basis for the selection of alternatives in individuals sensitized to a certain local anesthetic and to better understand presentation and T cell recognition of these drugs. Fifty-five clones (52 lidocaine specific, three mepivacaine specific from two allergic donors) were analyzed. Stimulatory compounds induced a down-regulation of the T cell receptor, demonstrating that these non-peptide antigens are recognized by the T cell receptor itself. A consistent cross-reactivity between lidocaine and mepivacaine was found, as all except one lidocaine specific clone proliferated to both drugs tested. Sixteen chemically related local anesthetics (including ester local anesthetics, OH- and desalkylated metabolites) were used to identify structural requirements for T cell recognition. Each of the four clones examined in detail was uniquely sensitive to changes in the structures of the local anesthetic: clone SFT24, i.e., did not recognize any of the tested OH- or desalkylated metabolites, while the clone OFB2 proliferated to all OH-metabolites and other differently modified molecules. The broadly reactive clone OFB2 allowed us to propose a model, suggesting that the structure of the amine side chain of local anesthetics is essential for recognition by the T cell receptor.

  3. Local anesthetics: New insights into risks and benefits

    NARCIS (Netherlands)

    Lirk, P.

    2014-01-01

    Conventional local anesthetics in contemporary use block the voltage-gated sodium channel by binding to a specific site on the inner facet of the channel pore. Only little fractions of local anaesthetic are thought to participate in nerve blockade, the rest is absorbed into surrounding tissues or th

  4. [Action of a dental anesthetic on cell respiration].

    Science.gov (United States)

    di Jeso, F; Truscello, A; Martinotti, G; Colli, S

    1987-01-01

    It is often required to employ local anesthetics in practising dentistry, particularly when children have to be treated. Our researches on neurotropic drugs in the last years follow our hypothesis that the strong effects on nervous system have always hidden more widespread effects on all tissues and cells. In vitro essays carried out on rat liver mitochondria show that a dental anesthetic, lidocaine, depress respiration coupled to phosphorylation in mitochondria having a good respiratory control; so respiratory control too is depressed, but P/O ratio is unaffected; also respiration uncoupled by 2,4-dinitrophenol is depressed. Depressing respiration cooperates with anesthesia; unchanging P/O is good for the health of the cells and tissues treated by the lidocaine.

  5. Electronic dental anesthesia in a patient with suspected allergy to local anesthetics: report of case.

    Science.gov (United States)

    Malamed, S F; Quinn, C L

    1988-01-01

    A 56-year-old patient with alleged allergy to local anesthetics required restorative dental treatment. Electronic dental anesthesia was used successfully, in lieu of injectable local anesthetics, to manage intraoperative pain associated with the restoration of vital mandibular teeth.

  6. Fentanyl, dexmedetomidine, dexamethasone as adjuvant to local anesthetics in caudal analgesia in pediatrics: A comparative study

    Directory of Open Access Journals (Sweden)

    Elham M. El-Feky

    2015-04-01

    Conclusion: Both caudal dexmedetomidine and caudal dexamethasone added to local anesthetics are good alternatives in prolongation of postoperative analgesia compared to caudal local anesthetic alone or added to caudal fentanyl. Also they showed less side effects compared to caudal fentanyl.

  7. Infrared image monitoring of local anesthetic poisoning in rats

    OpenAIRE

    Carstens, Angelo Manoel G.; Tambara,Elizabeth Milla; Colman,Daniel; Márcio G. Carstens; Matias, Jorge Eduardo Fouto

    2016-01-01

    Abstract Background and objectives: To evaluate the thermographic predictive value of local anesthetic poisoning in rats that indicates the early recognition of thermal signs of intoxication and enable the immediate start of advanced life support. Methods: Wistar rats underwent intraperitoneal injection of saline and ropivacaine; they were allocated into pairs, and experiments performed at baseline and experimental times. For thermography, central and peripheral compartment were analyzed, c...

  8. Intraperitoneal Local Anesthetic in Pediatric Surgery: A Systematic Review.

    Science.gov (United States)

    Hamill, James K; Rahiri, Jamie-Lee; Liley, Andrew; Hill, Andrew G

    2016-12-01

    Introduction Systematic reviews report intraperitoneal local anesthetic (IPLA) effective in adults but until now no review has addressed IPLA in children. The objective of this review was to answer the question, does IPLA compared with control reduce pain after pediatric abdominal surgery. Materials and Methods Data sources: MEDLINE, EMBASE, Cochrane databases, trials registries, ProQuest, Web of Science, Google Scholar, and Open Gray.

  9. Conformation and kinetic characteristics of interactions between local anesthetics and aqueous solutions of hydroxypropylmethylcellulose.

    Science.gov (United States)

    Galenko-Yaroshevskii, A P; Varlashkina, I A; Takhchidi, Kh P; Malyugin, B E; Dukhanin, A S

    2007-05-01

    Conformation and kinetic characteristics of the interactions of local anesthetics lidocaine (xycaine), tetracaine (dicaine), bupivacaine, and new RU-1117 compound with proven anesthetic activity with Visiton (1% hydroxypropylmethylcellulose in phosphate buffer) were studied. It was found that complex formation between the local anesthetics and hydroxypropylmethylcellulose is a time-dependent reversible process. The equilibrium is attained within 2.5-8.0 h and depends on the chemical nature of local anesthetic.

  10. Methylparaben concentration in commercial Brazilian local anesthetics solutions

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    Gustavo Henrique Rodriguez da Silva

    2012-08-01

    Full Text Available OBJECTIVE: To detect the presence and concentration of methylparaben in cartridges of commercial Brazilian local anesthetics. MATERIAL AND METHODS: Twelve commercial brands (4 in glass and 8 in plastic cartridges of local anesthetic solutions for use in dentistry were purchased from the Brazilian market and analyzed. Different lots of the commercial brands were obtained in different Brazilian cities (Piracicaba, Campinas and São Paulo. Separation was performed using high performance liquid chromatography (HPLC with UV-Vis detector. The mobile phase used was acetonitrile:water (75:25 - v/v, pH 4.5, adjusted with acetic acid at a flow rate of 1.0 ml.min-1. RESULTS: When detected in the solutions, the methylparaben concentration ranged from 0.01% (m/v to 0.16% (m/v. One glass and all plastic cartridges presented methylparaben. CONCLUSION: 1. Methylparaben concentration varied among solutions from different manufacturers, and it was not indicated in the drug package inserts; 2. Since the presence of methylparaben in dental anesthetics is not regulated by the Brazilian National Health Surveillance Agency (ANVISA and this substance could cause allergic reactions, it is important to alert dentists about its possible presence.

  11. Methylparaben concentration in commercial Brazilian local anesthetics solutions

    Science.gov (United States)

    da SILVA, Gustavo Henrique Rodriguez; BOTTOLI, Carla Beatriz Grespan; GROPPO, Francisco Carlos; VOLPATO, Maria Cristina; RANALI, José; RAMACCIATO, Juliana Cama; MOTTA, Rogério Heládio Lopes

    2012-01-01

    Objective To detect the presence and concentration of methylparaben in cartridges of commercial Brazilian local anesthetics. Material and methods Twelve commercial brands (4 in glass and 8 in plastic cartridges) of local anesthetic solutions for use in dentistry were purchased from the Brazilian market and analyzed. Different lots of the commercial brands were obtained in different Brazilian cities (Piracicaba, Campinas and São Paulo). Separation was performed using high performance liquid chromatography (HPLC) with UV-Vis detector. The mobile phase used was acetonitrile:water (75:25 - v/v), pH 4.5, adjusted with acetic acid at a flow rate of 1.0 ml.min-1. Results When detected in the solutions, the methylparaben concentration ranged from 0.01% (m/v) to 0.16% (m/v). One glass and all plastic cartridges presented methylparaben. Conclusion 1. Methylparaben concentration varied among solutions from different manufacturers, and it was not indicated in the drug package inserts; 2. Since the presence of methylparaben in dental anesthetics is not regulated by the Brazilian National Health Surveillance Agency (ANVISA) and this substance could cause allergic reactions, it is important to alert dentists about its possible presence. PMID:23032206

  12. Memory-impairing effects of local anesthetics in an elevated plus-maze test in mice

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    S.L. Blatt

    1998-04-01

    Full Text Available Post-training intracerebroventricular administration of procaine (20 µg/µl and dimethocaine (10 or 20 µg/µl, local anesthetics of the ester class, prolonged the latency (s in the retention test of male and female 3-month-old Swiss albino mice (25-35 g body weight; N = 140 in the elevated plus-maze (mean ± SEM for 10 male mice: control = 41.2 ± 8.1; procaine = 78.5 ± 10.3; 10 µg/µl dimethocaine = 58.7 ± 12.3; 20 µg/µl dimethocaine = 109.6 ± 5.73; for 10 female mice: control = 34.8 ± 5.8; procaine = 55.3 ± 13.4; 10 µg/µl dimethocaine = 59.9 ± 12.3 and 20 µg/µl dimethocaine = 61.3 ± 11.1. However, lidocaine (10 or 20 µg/µl, an amide class type of local anesthetic, failed to influence this parameter. Local anesthetics at the dose range used did not affect the motor coordination of mice exposed to the rota-rod test. These results suggest that procaine and dimethocaine impair some memory process(es in the plus-maze test. These findings are interpreted in terms of non-anesthetic mechanisms of action of these drugs on memory impairment and also confirm the validity of the elevated plus-maze for the evaluation of drugs affecting learning and memory in mice

  13. In Vivo Quantitation of Local Anesthetic Suppression of Leukocyte Adherence

    Science.gov (United States)

    Giddon, D. B.; Lindhe, J.

    1972-01-01

    Using intravital microscopy, topically applied amide-type local anesthetics suppressed the adherence of leukocytes to the venular endothelium within surgical defects in the hamster cheek pouch. The response was reversible with physiologic saline and was localized to venules within the defect. Quantitation in terms of the percent of initially adhering leukocytes remaining in place on the venule wall at each minute following application of lidocaine and physiologic saline, respectively, revealed the suppression to be reliably related to the concentration, viz: 20.0 >10.0 >5.0 >0.0 mg ml of commercially available Xylocaine® (lidocaine) HCl. ImagesFig 1Fig 1 PMID:5049429

  14. Trigeminal nerve injury associated with injection of local anesthetics: needle lesion or neurotoxicity?

    DEFF Research Database (Denmark)

    Hillerup, Søren; Jensen, Rigmor H; Ersbøll, Bjarne Kjær

    2011-01-01

    anesthetics (from 1995 through 2007), 292 reports to the Danish Medicines Agency, Copenhagen, Denmark, of adverse reactions to local anesthetic drugs, and a clinical sample of 115 patients with NSD associated with local anesthetics. The authors assessed lidocaine 2 percent, mepivacaine 2 percent and 3 percent...

  15. Goalpha regulates volatile anesthetic action in Caenorhabditis elegans.

    Science.gov (United States)

    van Swinderen, B; Metz, L B; Shebester, L D; Mendel, J E; Sternberg, P W; Crowder, C M

    2001-06-01

    To identify genes controlling volatile anesthetic (VA) action, we have screened through existing Caenorhabditis elegans mutants and found that strains with a reduction in Go signaling are VA resistant. Loss-of-function mutants of the gene goa-1, which codes for the alpha-subunit of Go, have EC(50)s for the VA isoflurane of 1.7- to 2.4-fold that of wild type. Strains overexpressing egl-10, which codes for an RGS protein negatively regulating goa-1, are also isoflurane resistant. However, sensitivity to halothane, a structurally distinct VA, is differentially affected by Go pathway mutants. The RGS overexpressing strains, a goa-1 missense mutant found to carry a novel mutation near the GTP-binding domain, and eat-16(rf) mutants, which suppress goa-1(gf) mutations, are all halothane resistant; goa-1(null) mutants have wild-type sensitivities. Double mutant strains carrying mutations in both goa-1 and unc-64, which codes for a neuronal syntaxin previously found to regulate VA sensitivity, show that the syntaxin mutant phenotypes depend in part on goa-1 expression. Pharmacological assays using the cholinesterase inhibitor aldicarb suggest that VAs and GOA-1 similarly downregulate cholinergic neurotransmitter release in C. elegans. Thus, the mechanism of action of VAs in C. elegans is regulated by Goalpha, and presynaptic Goalpha-effectors are candidate VA molecular targets.

  16. Articaine - the best choice of local anesthetic in contemporary dentistry.

    Science.gov (United States)

    Nizharadze, N; Mamaladze, M; Chipashvili, N; Vadachkoria, D

    2011-01-01

    Local anesthesia forms the foundation of pain control techniques in clinical dentistry. Within the rich local anesthetic drugs available in dentistry for the prevention and management of pain 4% articaine solutions achieve highest level of anesthetic potency and lowest systemic toxicity in all clinical situations, prior to its superlative physicochemical characteristics and the pharmacological profile. These are - low lipid solubility, high plasma protein binding rate, fast metabolization, fast elimination half time; low blood level. Articaine inactivates in both ways: in the liver and the blood serum. It has good spreading through tissues. Thus, articaine seems to be the local anesthetic of first choice in tissues with suppurative inflammation, for adults, children (over 4), elderly, pregnant women, breastfeeding women, patients suffering from hepatic disorders and renal function impairment. In Articaine solutions (1: 200,000) epinephrine is in low concentration, thus in patients at high risk adverse responses are maximally decreased. In these patients articaine should be used with careful consideration of risk/benefit ratio. Articaine solutions must not be used in persons who are allergic or hypersensitive to sulphite, due to content of Sodium metabisulfite as vasoconstrictor's antioxidant in it. Incidence of serious adverse effects related to dental anesthesia with articaine is very low. Toxic reactions are usually due to an inadvertent intravascular injection or use of excessive dose. To avoid overdoses maximum recommendation dose (MRD) must not be exceeded and aspiration test always performed prior all LA injections. In these article we introduce new graphs providing a quick and effect way to determine maximum LA dose. If the overdose reactions develop, adherence to the basic step of emergency management with end to a successful outcome in virtually all cases.

  17. Under Utilization of Local Anesthetics in Infant Lumbar Punctures

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    Gorchynski, Julie

    2008-01-01

    Full Text Available Background: Lumbar Puncture (LP is an invasive procedure frequently used to diagnose meningitis among the pediatric population. Neonates and infants have not routinely received local anesthesia prior to LP. Study Objective: To determine whether emergency medicine physicians and pediatricians use local analgesics on neonates and infants prior to performing an LP and to identify which local anesthetics, if any, were used. Methods: Prospective, cohort study of all infants, six months of age or less, that received an LP in the emergency department (ED or inpatient pediatric units for suspected meningitis during a period of year at a university tertiary care hospital. Results: A total sample population of 111 infants that received an LP within the study period. A control population of 42 adults received an LP. Only 40.4% (45/111 of the infants received local analgesia prior to LP: either 1% lidocaine, EMLA or a combination of the two. Infants were less likely to receive lidocaine or EMLA prior to LP compared to adult subjects (OR= 0.27; 95% CI0.12 to 0.62. No neonates that were less than one month of age received local procedural anesthesia by emergency medicine or pediatric physicians. ED physicians’ use of local anesthesia prior to LP increased with increasing age of the infant. The pediatricians in this study used local anesthesia prior to LP when the infant was at least five months of age. Discussion: The data objectively support recent literature regarding the under use or lack of use of analgesia prior to LP among neonates and infants. Local anesthetics should be used routinely without exception prior to performing an LP in the pediatric population.

  18. Vasoconstriction Potency Induced by Aminoamide Local Anesthetics Correlates with Lipid Solubility

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    Hui-Jin Sung

    2012-01-01

    Full Text Available Aminoamide local anesthetics induce vasoconstriction in vivo and in vitro. The goals of this in vitro study were to investigate the potency of local anesthetic-induced vasoconstriction and to identify the physicochemical property (octanol/buffer partition coefficient, pKa, molecular weight, or potency of local anesthetics that determines their potency in inducing isolated rat aortic ring contraction. Cumulative concentration-response curves to local anesthetics (levobupivacaine, ropivacaine, lidocaine, and mepivacaine were obtained from isolated rat aorta. Regression analyses were performed to determine the relationship between the reported physicochemical properties of local anesthetics and the local anesthetic concentration that produced 50% (ED50 of the local anesthetic-induced maximum vasoconstriction. We determined the order of potency (ED50 of vasoconstriction among local anesthetics to be levobupivacaine > ropivacaine > lidocaine > mepivacaine. The relative importance of the independent variables that affect the vasoconstriction potency is octanol/buffer partition coefficient > potency > pKa > molecular weight. The ED50 in endothelium-denuded aorta negatively correlated with the octanol/buffer partition coefficient of local anesthetics (r2=0.9563; P<0.001. The potency of the vasoconstriction in the endothelium-denuded aorta induced by local anesthetics is determined primarily by lipid solubility and, in part, by other physicochemical properties including potency and pKa.

  19. Use of eutectic mixture of local anesthetics in children.

    Science.gov (United States)

    Dutta, S

    1999-01-01

    The Eutectic Mixture of Local Anesthetics (EMLA) is a topical application, which has proved to be a useful medication for providing pain relief among children. It is an emulsion containing a 1:1 mixture of lidocaine and prilocaine. The high concentration of the uncharged anesthetic base in the microdroplets of the emulsion ensure effective skin penetration. In the pediatric population EMLA has been shown to be efficacious when it is used prior to venipuncture, cannulation, lumbar puncture, laser treatment of port wine stains, curettage of molluscum contagiosum or vaccination. For several of these indications, the efficacy has been documented by double blind controlled trials, that have used objective and quasi-objective scales for assessing pain relief. The dose of EMLA is between 0.5 to 1 gram, and the cream should be applied half to one hour prior to the procedure. Local side effects are very mild, and the only systemic side effect of importance is the risk of methemoglobinemia in young infants. The literature has conflicting reports about the safety of EMLA in neonates.

  20. COMPARISON OF COMMON CLINICALLY USED LOCAL ANESTHETICS ON ANIMAL MODELS

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    Anthireddy Srinivas

    2012-08-01

    Full Text Available The animal models used in this study were Plexus anesthesia in frogs, Infiltration anesthesia in guinea pigs, Surface anesthesia in rabbits. The drugs were diluted with normal saline. Lignocaine2%: xylocaine hydrochloride injection IP, Bupivacaine 0.5%: Bupivacaine hydrochloride injections IP were prepared. Plexus anesthesia: Frog was pithed and spinal cord was destroyed up to the 3 vertebra. The abdominal pouch was filled with local anesthetic solution. Reflex activity was tested by immersing both feet of the frog every two minutes for not longer than 10 seconds into N/10 Hydrochloric acid. The time was noted. Surface anesthesia: Albino rabbits of either sex weighing 2.5 – 3.0kg ware selected. The conjunctival sac of one eye was held open, thus formed a pouch. 0.5ml of solution of the anesthetic was applied into the conjunctival sac for 30 sec. Infiltration anesthesia: Preparation of guinea pig: Guinea pigs (either sex weighing 250-300grams were used. Lignocaine produced rapid onset of plexus anesthesia in Frogs in comparison to the bupivacaine at concentration of 0.1% & 0.2% which is statistically significant. Bupivacaine is more potent than the lignocaine as a surface anesthetic agent in the Rabbit, where as lignocaine could produce surface anesthesia at concentration of 0.5% or 0.1% or both. Both bupivacaine and lignocaine produced infiltration anesthesia on intradermal injection in guinea pigs but the duration of infiltration anesthesia produced by bupivacaine is more prolonged which is statistically significant in comparison to the lignocaine at all the three concentrations tested i.e. 0.05%, 0.1% & 0.2%.

  1. Effects of local anesthetics and hemicholinium-3 on 45-Ca efflux in barnacle muscle fibers.

    Science.gov (United States)

    Chen, S S

    1975-04-01

    Benzocaine, which occurs in the uncharged form in the physiological range of pH, caused inhibition of 45-Ca efflux in branacle muscle fibers. By contrast, in the presence of a low external Ca-2+ concentration it produced stimulation of the efflux. Both the inhibitory and stimulatory actions of benzocaine appeared to be less potent than those of procaine. Hemicholinium-3 (HC-3), on the other hand, which exists only in the charged form, caused a large stimulation of the 45-Ca efflux following microinjection, and the potency of this action was found to be at least 10 times greater than that of procaine. External application of HC-3 produced inhibition occasionally. Effects of tetracaine were similar to those produced by procaine; however, its inhibitory action was greater in more alkaline solution, which is the opposite of that observed with procaine. Lidocaine produced a less consistent effect than procaine; the inhibitory action of the former was less potent but the stimulatory action of the two anesthetics were comparable, p-Aminobenzoic acid was without effect on 45-Ca efflux. These results indicate that both the charged and uncharged forms of local anesthetics are capable of causing stimulatory and inhibitory effects on 45-Ca efflux in barnacle muscle fibers, and that the inhibition produced is the result of action on the CA-Ca exchange system whereas the stimulation is the result of release of Ca from internal storage sites.

  2. From micro- to nanostructured implantable device for local anesthetic delivery.

    Science.gov (United States)

    Zorzetto, Laura; Brambilla, Paola; Marcello, Elena; Bloise, Nora; De Gregori, Manuela; Cobianchi, Lorenzo; Peloso, Andrea; Allegri, Massimo; Visai, Livia; Petrini, Paola

    2016-01-01

    Local anesthetics block the transmission of painful stimuli to the brain by acting on ion channels of nociceptor fibers, and find application in the management of acute and chronic pain. Despite the key role they play in modern medicine, their cardio and neurotoxicity (together with their short half-life) stress the need for developing implantable devices for tailored local drug release, with the aim of counterbalancing their side effects and prolonging their pharmacological activity. This review discusses the evolution of the physical forms of local anesthetic delivery systems during the past decades. Depending on the use of different biocompatible materials (degradable polyesters, thermosensitive hydrogels, and liposomes and hydrogels from natural polymers) and manufacturing processes, these systems can be classified as films or micro- or nanostructured devices. We analyze and summarize the production techniques according to this classification, focusing on their relative advantages and disadvantages. The most relevant trend reported in this work highlights the effort of moving from microstructured to nanostructured systems, with the aim of reaching a scale comparable to the biological environment. Improved intracellular penetration compared to microstructured systems, indeed, provides specific drug absorption into the targeted tissue and can lead to an enhancement of its bioavailability and retention time. Nanostructured systems are realized by the modification of existing manufacturing processes (interfacial deposition and nanoprecipitation for degradable polyester particles and high- or low-temperature homogenization for liposomes) or development of novel strategies (electrospun matrices and nanogels). The high surface-to-volume ratio that characterizes nanostructured devices often leads to a burst drug release. This drawback needs to be addressed to fully exploit the advantage of the interaction between the target tissues and the drug: possible strategies

  3. Efficacy of articaine: a new amide local anesthetic.

    Science.gov (United States)

    Malamed, S F; Gagnon, S; Leblanc, D

    2000-05-01

    The authors compared the safety and efficacy of 4 percent articaine with epinephrine 1:100,000 with 2 percent lidocaine with epinephrine 1:100,000. In three identical randomized, double-blind, multicenter trials, subjects 4 to 80 years of age received either 4 percent articaine with epinephrine 1:100,000 or 2 percent lidocaine with epinephrine 1:100,000 for simple or complex dental procedures. In each trial, the authors randomized the subjects in a 2:1 ratio to receive articaine or lidocaine. Efficacy was determined by both subject and investigator using a visual analog scale, or VAS. The authors used the Kruskal-Wallis test to analyze the data. A total of 882 subjects received articaine, and 443 received lidocaine. The authors found no statistical differences between the groups (P = .05). They also compared drug volumes for both articaine and lidocaine groups (2.5 milliliters +/- 0.07 standard error of mean, or SEM, vs. 2.6 mL +/- 0.09 SEM for simple procedures and 4.2 mL +/- 0.15 SEM vs. 4.5 mL +/- 0.21 SEM for complex procedures). The procedures' durations were comparable for both the articaine and lidocaine groups. The authors found no statistical difference between the two treatment groups (P = .05) with respect to subject or investigator pain ratings using the VAS; the mean pain scores determined by both patients and investigators for all groups tested were less than 1.0. The authors found that 4 percent articaine with epinephrine 1:100,000 was well-tolerated in 882 subjects. It also provided clinically effective pain relief during most dental procedures and had a time to onset and duration of anesthesia appropriate for clinical use and comparable to those observed for other commercially available local anesthetics. Pain control is a major component of patient comfort and safety. Local anesthetics form the backbone of pain control techniques in dentistry. Four percent articaine with epinephrine is an amide local anesthetic that will meet the clinical

  4. Loss of anatomical landmarks with eutectic mixture of local anesthetic cream for neonatal male circumcision.

    Science.gov (United States)

    Plank, Rebeca M; Kubiak, David W; Abdullahi, Rasak Bamidele; Ndubuka, Nnamdi; Nkgau, Maggie M; Dapaah-Siakwan, Fredrick; Powis, Kathleen M; Lockman, Shahin

    2013-02-01

    We report two cases of newborns who developed marked local edema after application of a eutectic mixture of local anesthetic (EMLA) topical anesthetic cream for neonatal male circumcision (NMC). Although local edema and erythema are known potential side effects of EMLA cream, a common anesthetic used for NMC, the loss of landmarks precluding safe NMC has not previously been reported, and is described here. Although we cannot recommend an alternate local anesthetic for neonates with this reaction to EMLA, based on a review of the published data we think that serious systemic adverse events related to EMLA are extremely rare.

  5. The sodium channel as a target for local anesthetic drugs

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    Harry A Fozzard

    2011-11-01

    Full Text Available Na channels are the source of excitatory currents for the nervous system and muscle. They are the target for a class of drugs called local anesthetics (LA, which have been used for local and regional anesthesia and for excitatory dysfunction problems such as epilepsy and cardiac arrhythmia. LA drugs are prototypes for new analgesic drugs. The LA drug binding site has been localized to the inner pore of the channel, where drugs interact mainly with a phenylalanine in domain IV S6. Drug affinity is both voltage- and use-dependent. Voltage-dependency is the result of changes in the conformation of the inner pore during channel activation and opening, allowing high energy interaction of drugs with the phenylalanine. LA drugs also reduce the gating current of Na channels, which represents the movement of charged residues in the voltage sensors. Specifically, drug binding to phenylalanine locks the domain III S4 in its outward (activated position, and slows recovery of the domain IV S4. Although strongly affecting gating, LA drugs almost certainly also block by steric occlusion of the pore. Molecular definition of the binding and blocking interactions may help in new drug development.

  6. Dual effect of local anesthetics on the function of excitable rod outer segment disk membrane

    Energy Technology Data Exchange (ETDEWEB)

    Mashimo, T.; Abe, K.; Yoshiya, I.

    1986-04-01

    The effects of local anesthetics and a divalent cation, Ca2+, on the function of rhodopsin were estimated from the measurements of light-induced proton uptake. The light-induced proton uptake by rhodopsin in the rod outer segment disk membrane was enhanced at lower pH (4) but depressed at higher pHs (6 to 8) by the tertiary amine local anesthetics lidocaine, bupivacaine, tetracaine, and dibucaine. The order of local anesthetic-induced depression of the proton uptake followed that of their clinical anesthetic potencies. The depression of the proton uptake versus the concentration of the uncharged form of local anesthetic nearly describes the same curve for small and large dose of added anesthetic. Furthermore, a neutral local anesthetic, benzocaine, depressed the proton uptake at all pHs between 4 and 7. These results indicate that the depression of the proton uptake is due to the effect of only the uncharged form. It is hypothesized that the uncharged form of local anesthetics interacts hydrophobically with the rhodopsin in the disk membrane. The dual effect of local anesthetics on the proton uptake, on the other hand, suggests that the activation of the function of rhodopsin may be caused by the charged form. There was no significant change in the light-induced proton uptake by rhodopsin when 1 mM of Ca2+ was introduced into the disk membrane at varying pHs in the absence or presence of local anesthetics. This fact indicates that Ca2+ ion does not influence the diprotonating process of metarhodopsin; neither does it interfere with the local anesthetic-induced changes in the rhodopsin molecule.

  7. Extended duration local anesthetic agent in a rat paw model.

    Science.gov (United States)

    Ickowicz, D E; Golovanevski, L; Domb, A J; Weiniger, C F

    2014-07-01

    Encapsulated local anesthetics extend postoperative analgesic effect following site-directed nerve injection; potentially reducing postoperative complications. Our study aim was to investigate efficacy of our improved extended duration formulation - 15% bupivacaine in poly(DL-lactic acid co castor oil) 3:7 synthesized by ring opening polymerization. In vitro, around 70% of bupivacaine was released from the p(DLLA-CO) 3:7 after 10 days. A single injection of the optimal formulation of 15% bupivacaine-polymer or plain (0.5%) bupivacaine (control), was injected via a 22G needle beside the sciatic nerve of Sprague-Dawley rats under anesthesia; followed (in some animals) by a 1cm longitudinal incision through the skin and fascia of the paw area. Behavioral tests for sensory and motor block assessment were done using Hargreave's hot plate score, von Frey filaments and rearing count. The 15% bupivacaine formulation significantly prolonged sensory block duration up to at least 48 h. Following surgery, motor block was observed for 48 h following administration of bupivacaine-polymer formulation and rearing was reduced (returning to baseline after 48 h). No significant differences in mechanical nociceptive response were observed. The optimized bupivacaine-polymer formulation prolonged duration of local anesthesia effect in our animal model up to at least 48 h.

  8. Preparation and characterization of poly(ε-caprolactone) nanospheres containing the local anesthetic lidocaine.

    Science.gov (United States)

    Ramos Campos, Estefânia Vangelie; Silva de Melo, Nathalie Ferreira; Guilherme, Viviane Aparecida; de Paula, Eneida; Rosa, André Henrique; de Araújo, Daniele Ribeiro; Fraceto, Leonardo Fernandes

    2013-01-01

    The objective of this work was to develop a modified release system for the local anesthetic lidocaine (LDC), using poly(ε-caprolactone) (PCL) nanospheres (NSs), to improve the pharmacological properties of the drug when administered by the infiltration route. In vitro experiments were used to characterize the system and investigate the release mechanism. The NSs presented a polydispersion index of 0.072, an average diameter of 449.6 nm, a zeta potential of -20.1 mV, and an association efficiency of 93.3%. The release profiles showed that the release of associated LDC was slower than that of the free drug. Atomic force microscopy analyses showed that the spherical structure of the particles was preserved as a function of time, as well as after the release experiments. Cytotoxicity and pharmacological tests confirmed that association with the NSs reduced the toxicity of LDC, and prolonged its anesthetic action. This new formulation could potentially be used in applications requiring gradual anesthetic release, especially dental procedures.

  9. Infrared image monitoring of local anesthetic poisoning in rats.

    Science.gov (United States)

    Carstens, Angelo Manoel G; Tambara, Elizabeth Milla; Colman, Daniel; Carstens, Márcio G; Matias, Jorge Eduardo Fouto

    To evaluate the thermographic predictive value of local anesthetic poisoning in rats that indicates the early recognition of thermal signs of intoxication and enable the immediate start of advanced life support. Wistar rats underwent intraperitoneal injection of saline and ropivacaine; they were allocated into pairs, and experiments performed at baseline and experimental times. For thermography, central and peripheral compartment were analyzed, checking the maximum and average differences of temperatures between groups. Thermographic and clinical observations were performed for each experiment, and the times in which the signs of intoxication occurred were recorded. In the thermal analysis, the thermograms corresponding to the times of interest were sought and relevant data sheets extracted for statistical analysis. Basal and experimental: the display of the thermal images at times was possible. It was possible to calculate the heat transfer rate in all cases. At baseline it was possible to see the physiology of microcirculation, characterized by thermal distribution in the craniocaudal direction. It was possible to visualize the pathophysiological changes or thermal dysautonomias caused by intoxication before clinical signs occur, characterized by areas of hyper-radiation, translating autonomic nervous system pathophysiological disorders. In animals poisoned by ropivacaine, there was no statistically significant difference in heat transfer rate at the experimental time. The maximum temperature, medium temperature, and heat transfer rate were different from the statistical point of view between groups at the experimental time, thus confirming the systemic thermographic predictive value. Copyright © 2016 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  10. Infrared image monitoring of local anesthetic poisoning in rats

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    Angelo Manoel G. Carstens

    Full Text Available Abstract Background and objectives: To evaluate the thermographic predictive value of local anesthetic poisoning in rats that indicates the early recognition of thermal signs of intoxication and enable the immediate start of advanced life support. Methods: Wistar rats underwent intraperitoneal injection of saline and ropivacaine; they were allocated into pairs, and experiments performed at baseline and experimental times. For thermography, central and peripheral compartment were analyzed, checking the maximum and average differences of temperatures between groups. Thermographic and clinical observations were performed for each experiment, and the times in which the signs of intoxication occurred were recorded. In the thermal analysis, the thermograms corresponding to the times of interest were sought and relevant data sheets extracted for statistical analysis. Results: Basal and experimental: the display of the thermal images at times was possible. It was possible to calculate the heat transfer rate in all cases. At baseline it was possible to see the physiology of microcirculation, characterized by thermal distribution in the craniocaudal direction. It was possible to visualize the pathophysiological changes or thermal dysautonomias caused by intoxication before clinical signs occur, characterized by areas of hyper-radiation, translating autonomic nervous system pathophysiological disorders. In animals poisoned by ropivacaine, there was no statistically significant difference in heat transfer rate at the experimental time. Conclusions: The maximum temperature, medium temperature, and heat transfer rate were different from the statistical point of view between groups at the experimental time, thus confirming the systemic thermographic predictive value.

  11. [Infrared image monitoring of local anesthetic poisoning in rats].

    Science.gov (United States)

    Carstens, Angelo Manoel G; Tambara, Elizabeth Milla; Colman, Daniel; Carstens, Márcio G; Matias, Jorge Eduardo Fouto

    To evaluate the thermographic predictive value of local anesthetic poisoning in rats that indicates the early recognition of thermal signs of intoxication and enable the immediate start of advanced life support. Wistar rats underwent intraperitoneal injection of saline and ropivacaine; they were allocated into pairs, and experiments performed at baseline and experimental times. For thermography, central and peripheral compartment were analyzed, checking the maximum and average differences of temperatures between groups. Thermographic and clinical observations were performed for each experiment, and the times in which the signs of intoxication occurred were recorded. In the thermal analysis, the thermograms corresponding to the times of interest were sought and relevant data sheets extracted for statistical analysis. Basal and experimental: the display of the thermal images at times was possible. It was possible to calculate the heat transfer rate in all cases. At baseline it was possible to see the physiology of microcirculation, characterized by thermal distribution in the craniocaudal direction. It was possible to visualize the pathophysiological changes or thermal dysautonomias caused by intoxication before clinical signs occur, characterized by areas of hyper-radiation, translating Autonomic Nervous System pathophysiological disorders. In animals poisoned by ropivacaine, there was no statistically significant difference in heat transfer rate at the experimental time. The maximum temperature, medium temperature, and heat transfer rate were different from the statistical point of view between groups at the experimental time, thus confirming the systemic thermographic predictive value. Copyright © 2016 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  12. Pain and efficacy of local anesthetics for central venous access

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    William C Culp Jr

    2008-11-01

    Full Text Available William C Culp Jr1, Mohammed Yousaf2, Benjamin Lowry1, Timothy C McCowan3, William C Culp21Division of Cardiothoracic Anesthesiology, Scott and White Hospital, The Texas A&M University College of Medicine, Temple, TX, USA; 2Division of Interventional Radiology, University of Arkansas for Medical Sciences, Little Rock, AR, USA; 3Department of Radiology, University of Mississippi Medical Center, Jackson, MS, USAPurpose: To compare pain during injection and efficacy of analgesia of local anesthetics during central venous line placement.Methods: Sixty-two patients were studied in a randomized, double-blinded prospective fashion. Patients received 1% lidocaine (L, buffered 1% lidocaine (LB, or 2% chloroprocaine (CP injected around the internal jugular vein for procedural analgesia for central venous access. Patients reported pain via a standard linear visual analog scale, with 0 representing no pain and 10 being the worst pain imaginable.Results: Overall patient perception of pain was better with CP and L than LB with mean scores of CP 2.4, L 2.6, LB 4.2. Pain with injection mean scores were CP 2.1, L 2.5, LB 3.2. Pain with catheter placement scores were CP 2.5, L 1.7, LB 3.4. Operator assessment of overall pain values were CP 1.9, L 2.2, LB 3.4. LB consistently scored the worst, though compared with CP, this only reached statistical significance in overall patient pain and pain at catheter insertion compared with L.Conclusion: Though chloroprocaine scored better than lidocaine in 3 of 4 parameters, this trend did not achieve statistical significance. Adding sodium bicarbonate to lidocaine isn’t justified in routine practice, nor is routine replacement of lidocaine with chloroprocaine.Keywords: local anesthesia, analgesia, central venous access, lidocaine, chloroprocaine

  13. From micro- to nanostructured implantable device for local anesthetic delivery

    Directory of Open Access Journals (Sweden)

    Zorzetto L

    2016-06-01

    Full Text Available Laura Zorzetto,1 Paola Brambilla,1 Elena Marcello,1 Nora Bloise,2 Manuela De Gregori,3 Lorenzo Cobianchi,4,5 Andrea Peloso,4,5 Massimo Allegri,6 Livia Visai,2,7 Paola Petrini1 1Department of Chemistry, Materials and Chemical Engineering ‘G. Natta’, Politecnico di Milano, Milan, 2Department of Molecular Medicine, Centre for Health Technologies (CHT, INSTM UdR of Pavia, University of Pavia, 3Pain Therapy Service, IRCCS Foundation Policlinico San Matteo Pavia, Pavia, 4General Surgery Department, IRCCS Foundation Policlinico San Matteo, Pavia, 5Departments of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, 6Department of Surgical Sciences, University of Parma, Parma, 7Department of Occupational Medicine, Toxicology and Environmental Risks, S. Maugeri Foundation, IRCCS, Lab of Nanotechnology, Pavia, Italy Abstract: Local anesthetics block the transmission of painful stimuli to the brain by acting on ion channels of nociceptor fibers, and find application in the management of acute and chronic pain. Despite the key role they play in modern medicine, their cardio and neurotoxicity (together with their short half-life stress the need for developing implantable devices for tailored local drug release, with the aim of counterbalancing their side effects and prolonging their pharmacological activity. This review discusses the evolution of the physical forms of local anesthetic delivery systems during the past decades. Depending on the use of different biocompatible materials (degradable polyesters, thermosensitive hydrogels, and liposomes and hydrogels from natural polymers and manufacturing processes, these systems can be classified as films or micro- or nanostructured devices. We analyze and summarize the production techniques according to this classification, focusing on their relative advantages and disadvantages. The most relevant trend reported in this work highlights the effort of moving from microstructured

  14. Activation of TRPA1 by membrane permeable local anesthetics

    Directory of Open Access Journals (Sweden)

    Kronewald Sergej

    2011-08-01

    Full Text Available Abstract Background Low concentrations of local anesthetics (LAs suppress cellular excitability by inhibiting voltage-gated Na+ channels. In contrast, LAs at high concentrations can be excitatory and neurotoxic. We recently demonstrated that LA-evoked activation of sensory neurons is mediated by the capsaicin receptor TRPV1, and, to a lesser extent by the irritant receptor TRPA1. LA-induced activation and sensitization of TRPV1 involves a domain that is similar, but not identical to the vanilloid-binding domain. Additionally, activation of TRPV1 by LAs involves PLC and PI(4,5P2-signalling. In the present study we aimed to characterize essential structural determinants for LA-evoked activation of TRPA1. Results Recombinant rodent and human TRPA1 were expressed in HEK293t cells and investigated by means of whole-cell patch clamp recordings. The LA lidocaine activates TRPA1 in a concentration-dependent manner. The membrane impermeable lidocaine-derivative QX-314 is inactive when applied extracellularly. Lidocaine-activated TRPA1-currents are blocked by the TRPA1-antagonist HC-030031. Lidocaine is also an inhibitor of TRPA1, an effect that is more obvious in rodent than in human TRPA1. This species-specific difference is linked to the pore region (transmembrane domain 5 and 6 as described for activation of TRPA1 by menthol. Unlike menthol-sensitivity however, lidocaine-sensitivity is not similarly determined by serine- and threonine-residues within TM5. Instead, intracellular cysteine residues known to be covalently bound by reactive TRPA1-agonists seem to mediate activation of TRPA1 by LAs. Conclusions The structural determinants involved in activation of TRPA1 by LAs are disparate from those involved in activation by menthol or those involved in activation of TRPV1 by LAs.

  15. Local anesthetic effects of cocaethylene and isopropylcocaine on rat peripheral nerves.

    Science.gov (United States)

    Tokuno, Hajime A; Bradberry, Charles W; Everill, Brian; Agulian, Samuel K; Wilkes, Steven; Baldwin, Ronald M; Tamagnan, Gilles D; Kocsis, Jeffery D

    2004-01-23

    Cocaethylene is a naturally occurring cocaine derivative that has been used as a tool in both clinical studies of cocaine reward and as a potential model compound for agonist substitution therapy in cocaine dependence. It is equipotent to cocaine at inhibiting dopamine uptake in-vitro and in-vivo. Because it has been reported that local anesthetic properties may influence the reinforcing effects of dopamine uptake inhibitors, we investigated the local anesthetic properties of cocaethylene as well as isopropylcocaine, another potential pharmacological tool in studies of cocaine reward and agonist substitution therapy. We compared the efficacy of nerve impulse blockade by lidocaine, cocaine, cocaethylene and isopropylcocaine using rat sciatic nerves and dorsal roots (DRs). Nerves were placed in a modified sucrose gap chamber and repetitively stimulated at high frequency. The amplitude of compound action potentials (CAPs) at the beginning and end of each stimulus train was measured before and after exposure to each compound. All compounds produced concentration-dependent and use-dependent decrements in CAP amplitude, but cocaethylene and isopropylcocaine at medium to high concentration (0.375-1.875 mM) showed a more prolonged block after washout relative to cocaine or lidocaine. Patch clamp studies on dorsal root ganglion (DRG) neurons indicated a use-dependent blockade of sodium channels. These studies provide a more complete understanding of the pharmaocology of potential agonist treatment candidates, and suggest a mechanism whereby cocaethylene produces a decreased euphoria in humans compared to cocaine.

  16. Trigeminal nerve injury associated with injection of local anesthetics: needle lesion or neurotoxicity?

    DEFF Research Database (Denmark)

    Hillerup, Søren; Jensen, Rigmor H; Ersbøll, Bjarne Kjær

    2011-01-01

    The authors used comprehensive national registry and clinical data to conduct a study of adverse drug reactions (ADRs), in particular neurosensory disturbance (NSD), associated with local anesthetics used in dentistry...

  17. Wound infiltration with local anesthetics for post-operative pain relief in lumbar spine surgery

    DEFF Research Database (Denmark)

    Kjærgaard, M; Møiniche, S; Olsen, K S

    2012-01-01

    In this systematic review, we evaluated double-blind, randomized and controlled trials on the effect of wound infiltration with local anesthetics compared with the effect of placebo on post-operative pain after lumbar spine surgery....

  18. Hypersensitive reactions to local dental anesthetics and patient information: critical review of a drug leaflet

    Directory of Open Access Journals (Sweden)

    Simonet D

    2011-09-01

    Full Text Available Daniel Simonet School of Business and Management, American University of Sharjah, Sharjah, United Arab Emirates Abstract: This paper discusses the case of a patient who experienced adverse reactions to a local anesthetic. It reviews symptoms of adverse reactions, possible causes, patient management, and alternative anesthesia modes. The second part of the paper discusses the product leaflet information and the associated legal issues. Keywords: hypersensitive reactions, local dental anesthetics, patient information

  19. Inhalational and local anesthetics reduce tactile and thermal responses in mimosa pudica.

    Science.gov (United States)

    Milne, A; Beamish, T

    1999-03-01

    In reaction to a variety of stimuli, the sensitive plant mimosa pudica closes its leaflets and drops its stems. The objective was to investigate the effects of anaesthetics on the reaction of mimosa pudica to a variety of stimuli. The ability of the plants leaflets to close (n=4, Q5min.) was tested after exposure to halothane 4% and 6L x min(-1) O2, or 6L x min(-1) O2. Lidocaine 2% or vehicle were administered through the roots, cut stems, or sprayed on the leaves (n=4). The test consisted of stimulating the leaves, by burning their tips (lidocaine experiments) or touching them with a metal rod (halothane); the closing of the leaflets, or the lack thereof was then observed. After 15 min exposure to halothane, the mimosas had slow and incomplete reactions to tactile stimulation. Following 20 min exposure, the plants had no visible reaction to touch, a stimulus which would normally cause the collapse of the entire leaf. After one minute, mimosa leaves sprayed with lidocaine had no reaction to a lit match being touched to the tips of the leaves, contrary to the control in which the leaves collapsed completely. After exposure to lidocaine 2% through the roots and cut stems, the mimosa's reactivity gradually decreased; after four hours the leaves were insensitive or had slow reaction to tactile stimuli. Inhalational and local anesthetics inhibited motor mechanisms of the mimosa plant. This may be a model to elucidate the mechanisms of action of anesthetics.

  20. Evaluation of Surface anesthetic action of Aqueous Extract of Piper Betel leaf On Rabbit Cornea

    Directory of Open Access Journals (Sweden)

    Dr.T.Jayasree

    2014-07-01

    Full Text Available Aim: Piper betel Linn. (Piperaceae commonly known as betel leaf and the habit of betel chewing is widely prevalent in most parts of India. It is claimed to have aphrodisiac, laxative, antimicrobial, mucolytic, antiinflammatory and euphoric properties and proven antimutagenic and anti-carcinogenic effect. It is commonly observed that chewing of betel leaf produces numbness in the mouth, suggesting a possible local anesthetic effect. This observation prompted us to take this study . The aim of the study was to evaluate the local anesthetic activity of betel leaf extract after autoclaving the extract of betel leaf. Materials and methods: Extract of plain betel leaf, was tested for surface anesthetic activity using rabbits. Aqueous extraction of Piper betel leaf (AEPBL done by Soxhelts apparatus .Twenty male Rabbit’s were taken and divided in to four groups each group contain 5 animals, Group I - Standard (2% xylocaine, Group II - Test 0.3% (AEPBL, Group III - Test 0.6 % (AEPBL,Group IV - Test 12 % (AEPBL was instilled in conjunctival sac of right eyes. Standard protocol was followed to elicit light reflex, corneal reflex and to measure pupillary size after instilling the test drugs in the eye. There was dose dependent increase in onset and duration of local anesthetic activity with 6% and 12% doses of alcoholic extract of Piper betel leaf. Results: Betel leaf showed significant surface anesthetic activity comparable to that of Xylocaine. Conclusion: As a surface anesthetic, the onset was as quick as xylocaine and the duration was shorter than xylocaine

  1. History of T-cain: a local anesthetic developed and manufactured in Japan.

    Science.gov (United States)

    Tobe, Masaru; Saito, Shigeru

    2015-10-01

    In many anesthesia textbooks written in English, lidocaine, tetracaine, bupivacaine, ropivacaine, and chloroprocaine are listed as useful local anesthetics for spinal anesthesia. In contrast, T-cain is not included in these lists, even though it has been reported to be suitable for spinal anesthesia in Japan. T-cain was developed as a local anesthetic in the early 1940s by Teikoku Kagaku Sangyo Inc. in Itami, Japan, by replacing a methyl group on tetracaine (Pantocaine(®)) with an ethyl group. T-cain was clinically approved for topical use in Japan in November 1949, and a mixture of dibucaine and T-cain (Neo-Percamin S(®)) was approved for spinal use in May 1950. Simply because of a lack of foreign marketing strategy, T-cain has never attracted global attention as a local anesthetic. However, in Japan, T-cain has been used topically or intrathecally (as Neo-Percamin S(®)) for more than 60 years. Other than the side effects generally known for all local anesthetics, serious side effects have not been reported for T-cain. In fact, several articles have reported that T-cain decreases the neurotoxicity of dibucaine. In this historical review, the characteristics of T-cain and its rise to become a major spinal anesthetic in Japan are discussed.

  2. Local anesthetics after total knee arthroplasty: intraarticular or extraarticular administration? A randomized, double-blind, placebo-controlled study

    DEFF Research Database (Denmark)

    Andersen, L.O.; Kristensen, B.B.; Husted, H.;

    2008-01-01

    BACKGROUND: High-volume local infiltration analgesia with additional intraarticular and wound administration of local anesthetic has been shown to be effective after knee replacement, but the optimum site of administration of the local anesthetic (i.e. intraarticular or extraarticular) has not been...... or to receive 20 mL ropivacaine (0.2%) intraarticularly plus 30 mL ropivacaine (0.2%) in the extraarticular wound space 24 hours postoperatively. Pain intensity at rest and with mobilization was recorded for 4 hours after administration of additional local anesthetics. RESULTS: Intensity of pain at rest, during...... flexion, or straight leg lift was not statistically significantly different between the two groups, but there was a tendency of improved analgesia with administration of additional local anesthetic in the extraarticular wound space. INTERPRETATION: The optimal site of administration of local anesthetic...

  3. Difficult Airway Management Caused by Local Anesthetic Allergy During Emergent Cesarean Delivery: A Case Report.

    Science.gov (United States)

    Maxey-Jones, Courtney L; Palmerton, Alec; Farmer, Jocelyn R; Bateman, Brian T

    2017-08-01

    Difficult airway management in the gravid patient is a well-described phenomenon. We present a case of emergent cesarean delivery complicated by a "cannot intubate, cannot ventilate" scenario that was later determined to be secondary to an allergic, IgE-mediated reaction to epidurally administered local anesthetic.

  4. Dexmedetomidine as an adjuvant to local anesthetics in brachial plexus blocks

    Science.gov (United States)

    Ping, Yongmei; Ye, Qigang; Wang, Wenwei; Ye, Pingke; You, Zhibin

    2017-01-01

    Abstract Background: Brachial plexus block (BPB) for upper extremity surgery provides superior analgesia, but this advantage is limited by the pharmacological duration of local anesthetics. Dexmedetomidine (DEX) as a local anesthetics adjuvant for BPB has been utilized to prolong the duration of the nerve block in some randomized controlled trials (RCTs) but is far from unanimous in the efficacy and safety of the perineural route. Hence, an updated meta-analysis was conducted to assess the efficacy and safety of DEX as local anesthetic adjuvants on BPB. Methods: A search in electronic databases was conducted to collect the RCTs that investigated the impact of adding DEX to local anesthetics for BPB. Sensory block duration, motor block duration, onset time of sensory and motor block, time to first analgesic request, the common adverse effects were analyzed. Results: Eighteen trails (1014 patients) were included with 515 patients receiving perineural DEX. The addition of DEX prolonged the duration of sensory block (WMD 257 minutes, 95%CI 191.79–322.24, P administration of DEX. PMID:28121930

  5. [Pregnancy and lactation period: Which local anesthetics and analgesics?].

    Science.gov (United States)

    Fatori Popovic, Sandra; Lübbers, Heinz-Theo; von Mandach, Ursula

    2016-01-01

    The aim of this paper is to show relevant aspects of dental treatment in pregnancy. Common medication used in dental offices should be highlighted in special regard to the pregnant patient during dental treatment. The reader should gain more security in the election of the proper drugs for local anesthesia and oral analgesics. Local anaesthetics such as articain with adrenalin in a dilution of 1 : 200 000 can be used for dental treatment at any time. Paracetamol should be used as first line oral analgesic. Elective dental procedures should be postponed after delivery and after lactation period.

  6. [Pregnancy and lactation period: Which local anesthetics and analgesics].

    Science.gov (United States)

    Fatori Popovic, Sandra; Lübbers, Heinz-Theo; von Mandach, Ursula

    2016-01-01

    The aim of this paper is to show relevant aspects of dental treatment in pregnancy. Common medication used in dental offices should be highlighted in special regard to the pregnant patient during dental treatment. The reader should gain more security in the election of the proper drugs for local anesthesia and oral analgesics. Local anaesthetics such as articain with adrenalin in a dilution of 1 : 200 000 can be used for dental treatment at any time. Paracetamol should be used as first line oral analgesic. Elective dental procedures should be postponed after delivery and after lactation period.

  7. Transient peripheral facial nerve paralysis after local anesthetic procedure

    OpenAIRE

    A. Rosmaninho; Lobo, I.; Caetano, M.; Taipa, R; Magalhães, M.; Costa, V; Selores, M.

    2012-01-01

    Complications may arise after laser therapy of the face. The most common ones are bleeding and infections; facial nerve paresis or paralysis is rarely reported. We describe a case of a transient peripheral facial nerve paralysis after laser therapy of an epidermal verrucous nevus localized at the left preauricular area.

  8. Studies concerning the interaction between local anesthetics and lipid membrane by phosphorus-31, deuterium and proton NMR; Estudo da interacao entre anestesicos locais e membranas lipidicas por ressonancia magnetica de fosforo ({sup 31} P), deuterio ({sup 2} H) e proton ({sup 1} H)

    Energy Technology Data Exchange (ETDEWEB)

    Paula, Eneida de [Universidade Estadual de Campinas (UNICAMP), SP (Brazil). Dept. de Bioquimica; Jarrell, Harold C. [National Research Council of Canada, Ottawa, ON (Canada). Inst. for Biological Sciences; Schreier, Shirley [Sao Paulo Univ., SP (Brazil). Inst. de Quimica

    1993-12-31

    Local anesthetics block the conduction of nervous stimulus by impeding the entrance of sodium ion and the consequently depolarization of the nervous membrane. The action mechanism of local anesthetics, however, is not fully understood yet. In the present work the interaction between local anesthetics and membranes are studied by the perspective of lipid phase perturbation using NMR to elucidate the mechanism. Results are presented and discussed 5 refs., 1 fig., 1 tab.

  9. Evaluation and Management of Hypersensitivity to Local Anesthetics in Pediatric Dentistry

    OpenAIRE

    1987-01-01

    The clinical histories of four children with a history of adverse reactions to local anesthesia and who required dental treatment are reviewed retrospectively. The children described had been referred to the allergy unit for evaluation between 1984 and 1985 and are representative of the dilemma of cases of suspected hypersensitivity to local anesthetics. The first two cases had been previously treated without the use of regional anesthesia because of a family history of atopic reactions as we...

  10. Tumescent local anesthetic technique for inguinal hernia repairs

    OpenAIRE

    2014-01-01

    Purpose We evaluated the adequacy and feasibility of a tumescent solution containing lidocaine and bupivacaine for inguinal hernia repairs. Methods The medical records of 146 consecutive inguinal hernia patients with 157 hernia repairs using the tumescent local anesthesia technique performed by a single surgeon between September 2009 and December 2013 were retrospectively reviewed. Results The mean operation time (±standard deviation) and hospital stay were 64.5 ± 17.6 minutes and 2.7 ± 1.5 d...

  11. Onset and duration of anesthesia for local anesthetic combinations commonly used in forefoot surgery; surprise results with sequential blocks.

    Science.gov (United States)

    Blazer, Marie Mantini; Petrozzi, Rocco; Harris, Samantha Y; Greer, Hillary; Goldfarb, Jacqueline; Biernacki, Tomasz; Kawalec, Jill S

    2015-06-01

    Local anesthetic nerve blocks are frequently used for postoperative analgesia and to the best of our knowledge no studies have evaluated the effects of injecting bupivacaine into an area previously injected with lidocaine. Sensation was tested in three groups of subjects receiving local anesthetic digital blocks. Group A received bupivacaine 0.25% plain. Group B received a 1:1 mixture of lidocaine 1% plain and bupivacaine 0.25%. Group C received an initial block of lidocaine 1% plain sequentially followed by bupivacaine 0.25% 1h later. Bupivacaine exhibited a delayed onset and the longest duration when compared to the other two groups. The group receiving the 1:1 mixture showed a rapid onset that resembled that of lidocaine and a shortened duration that did not resemble bupivacaine. The group receiving the sequential injections showed that even after a 1h interval following the lidocaine infiltration, there was a deleterious effect on duration of action of the bupivacaine. Using bupivacaine as a post-surgical block in the presence of residual lidocaine from a preoperative block is not warranted as once again, the extended duration of bupivacaine is mitigated. Bupivacaine alone as an initial operative block affords clinically acceptable onset of anesthesia while also providing extended duration of action.

  12. Anesthetic effectiveness of the supplemental intraligamentary injection, administered with a computer-controlled local anesthetic delivery system, in patients with irreversible pulpitis.

    Science.gov (United States)

    Nusstein, John; Claffey, Elizabeth; Reader, Al; Beck, Mike; Weaver, Joel

    2005-05-01

    The purpose of this study was to determine the anesthetic effectiveness of the supplemental intraligamentary injection, administered with a computer-controlled local anesthetic delivery system, in mandibular posterior teeth diagnosed with irreversible pulpitis when the conventional inferior alveolar nerve block failed. Fifty-four emergency patients, diagnosed with irreversible pulpitis of a mandibular posterior tooth, received an inferior alveolar nerve block and had moderate to severe pain upon endodontic access. A computer-controlled local anesthetic delivery system was then used to administer intraligamentary injections of 1.4 ml of 2% lidocaine with 1:100,000 epinephrine. Success of the intraligamentary injection was defined as none or mild pain upon endodontic access or initial instrumentation. The results demonstrated that anesthetic success was obtained in 56% (30 of 54) of the patients. We concluded that when the inferior alveolar nerve block failed to provide profound pulpal anesthesia in mandibular posterior teeth of patients presenting with irreversible pulpitis, the intraligamentary injection administered with a computer-controlled local anesthetic delivery system was successful approximately 56% of the time.

  13. Local anesthesia for extracorporeal shock wave lithotripsy: a study comparing eutetic mixture of local anesthetics cream and lidocaine infiltration

    DEFF Research Database (Denmark)

    Honnens de Lichtenberg, M; Miskowiak, J; Mogensen, P

    1992-01-01

    A study of the anesthetic efficacy of a eutetic mixture of local anesthetics (EMLA cream) versus lidocaine infiltration in extracorporeal shock wave lithotripsy (ESWL) was done. A total of 46 patients had 30 gm. of EMLA cream applied to the skin over the kidney and 45 had subcutaneous infiltration...... analgesics were not significantly different between the 2 groups. There were no significant differences between the groups with regard to post-ESWL skin changes. Therefore, EMLA cream can be recommended for ESWL provided it is applied correctly....

  14. New procedure to synthesize silver nanoparticles and their interaction with local anesthetics

    Directory of Open Access Journals (Sweden)

    Mocanu A

    2013-10-01

    Full Text Available Aurora Mocanu,1 Roxana Diana Pasca,1 Gheorghe Tomoaia,2 Corina Garbo,1 Petre T Frangopol,1 Ossi Horovitz,1 Maria Tomoaia-Cotisel11Chemical Engineering Department, Babes-Bolyai University, 2Orthopedic Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, RomaniaAbstract: Silver nanoparticles (AgNPs were prepared in aqueous colloid dispersions by the reduction of Ag+ with glucose in alkaline medium. Tetraethyl orthosilicate and l-asparagine were added as stabilizers of NPs. The AgNPs were characterized, and their interaction with three local anesthetics (procaine, dibucaine, or tetracaine was investigated. Optical spectra show the characteristic absorption band of AgNPs, due to surface plasmon resonance. Modifications in the position and shape of this band reflect the self-assembly of metal NPs mediated by anesthetic molecules and the progress in time of the aggregation process. Zeta-potential measuring was applied in order to characterize the electrostatic stability of the NPs. The size and shape of the AgNPs, as well as the features of the assemblies formed by their association in the presence of anesthetics, were evidenced by transmission electron microscopy images. Atomic force microscopy images showed the characteristics of the films of AgNPs deposited on glass support. The effect of the anesthetics could be described in terms of electrostatic forces between the negatively charged AgNPs and the anesthetic molecules, existing also in their cationic form at the working pH. But also hydrophobic and hydrogen bonding interactions between the coated nanoparticles and anesthetics molecular species should be considered.Keywords: self-assembled nanostructures, UV-vis spectra, TEM, AFM, zeta potential

  15. Mechanisms of action of anesthetics for the modulation of perioperative thrombosis: evidence for immune mechanisms from basic and clinical studies.

    Science.gov (United States)

    Azma, Toshiharu; Tuluc, Florin; Ito, Taishin; Aoyama-Mani, Chikako; Kawahito, Shinji; Kinoshita, Hiroyuki

    2014-01-01

    Thrombotic events occurring in either arteries or veins are the primary causes of fatal perioperative cardiovascular events. Risk factors for deep vein thrombosis, several of which are evidently associated with specific surgical procedures, are quite different from those for arterial thrombosis (e.g., aging or atherosclerotic diseases). Thrombus formed in arteries consists mainly of platelets coated with fibrin (i.e., white thrombus), while venous thrombus formed at relatively lower shear stress consists of all blood components including erythrocytes as well as leukocytes infiltrated with fibrin (red thrombus). Clinical evidence indicates beneficial roles of neuraxial anesthesia/analgesia in the prevention of VTE for patients undergoing high risk surgical procedures. To date, mechanisms of action of drugs used for neuraxial anesthesia/analgesia to prevent venous thrombosis are uncertain. However, accumulation of clinical as well as experimental findings points to the involvement of immune cells (especially monocytes) in red thrombus generation and to the interaction of anesthetics with these cells. We also suggest that adhesion molecules associated with the formation of monocyte platelet aggregates as well as substance P: neurokinin-1 receptor (SP/NK1R) pathway that involves neurogenic inflammation are crucial. Local anesthetics and NK1R antagonists are candidate drugs that may possess the capability to prevent venous thrombotic disorders in perioperative settings.

  16. Do Local Anesthetics Containing Epinephrine Affect Blood Pressure in the Elderly?

    Directory of Open Access Journals (Sweden)

    Ayse Arpaci

    2014-11-01

    Full Text Available Aim: Dental procedures are often performed under local anesthesia. Vasoconstrictors added to local anesthetics might have unwanted effects in the elderly and in patients with comorbid diseases. The aim of this study was to evaluate the effects of local anesthetics containing epinephrine on blood pressure in elderly patients undergoing dental procedures. Material and Method: The study included 479 patients (age, 67.37±6.62 who underwent tooth extraction. Patient demographics, current health conditions, and blood pressure values were recorded before local anesthesia and at 5 minutes after anesthesia administration. Patients were divided into 4 groups: Group I (n=272 received 40 mg articaine/0.012 mg epinephrine (Ultracain® D-S Forte; Group II (n=196 received 40 mg articaine/0.01 mg epinephrine (Maxicaine FORT; Group III (n=6 received 40 mg articaine/0.006 mg epinephrine (Ultracain® D-S; and Group IV (n=5 received 40 mg articaine/0.005 mg epinephrine (Maxicaine. Statistical analyses were performed using SPSS version 20.0. Results: A total of 479 patients were included in the analysis. Hypertension and diabetes were the most frequently reported comorbidities among these patients. Blood pressure values after administration of anesthesia were higher than those recorded before the procedure in all groups. Discussion: Local anesthetics containing epinephrine are not associated with a significant increase in blood pressure in elderly patients undergoing dental procedures. Obtaining a detailed clinical history may reduce the risk of procedure-related morbidity.

  17. Triple rubber band ligation for hemorrhoids: prospective, randomized trial of use of local anesthetic injection.

    Science.gov (United States)

    Law, W L; Chu, K W

    1999-03-01

    Rubber band ligation is a common office procedure for hemorrhoids. Triple rubber band ligation in a single session has been shown to be a safe and economical way of treating hemorrhoids. However, postligation discomfort after triple rubber band ligation is not uncommon. The aim of this study was to evaluate the effectiveness of local anesthetic injection to the banded hemorrhoidal tissue in reducing postligation discomfort. Patients attending an outpatient clinic for symptomatic hemorrhoids suitable for triple rubber band ligation were randomly assigned to two groups. In the treatment group rubber band ligation was performed at three columns of hemorrhoids, and 1 to 2 ml of 2 percent lignocaine was injected into the banded hemorrhoidal tissue. In the control group triple rubber band ligation was performed in a similar manner, but local anesthetic was not given. Patients were followed up by telephone at the second week and in the clinic after six weeks. From April to August 1996, 101 patients entered the trial and were treated with triple rubber band ligation. Sixty-two patients were randomly assigned to the local anesthetic injection group and 39 to the control group. Overall good to excellent results occurred in 89 percent of patients, and there was no difference between the two groups. Postligation pain occurred in 26 and 20 percent of patients in the treatment and control groups, respectively (P > 0.05). Postligation tenesmus occurred in 32 and 41 percent of patients in the treatment and control groups, respectively (P > 0.05). No patients suffered from septic complications or bleeding that required transfusion. Triple rubber band ligation in a single session is a safe, economical, and effective way of treating symptomatic hemorrhoids. Postligation pain and tenesmus occurred in 24 and 37 percent, respectively. Discomfort was usually tolerable. Local anesthetic injection to the banded hemorrhoidal tissue did not help to reduce postligation discomfort.

  18. Tolerance of local anesthetic for transrectal ultrasound-guided prostate biopsy: our experience and a literature review

    Energy Technology Data Exchange (ETDEWEB)

    Buckley, M.R.E.; Bryant, N.J.; Brown, J.A.; Tiwari, P.; Cooperberg, P.L.; Wong, A.D. [St Paul' s Hospital, Ultrasound Dept., Vancouver, British Columbia (Canada)]. E-mail: twong@providcencehealth.bc.ca

    2006-06-15

    To determine whether local anesthetic injection or gel reduced pain during transrectal ultrasound-guided prostate biopsies and whether there was significant difference between quadrant and apex-only anesthesia. Between September 2001 and May 2002, 240 male patients with elevated prostate-specific antigen and (or) abnormal digital rectal examination were randomized into 1 of 4 groups: 1) transrectal lidocaine gel, 2) quadrant lidocaine injections, 3) apex-only lidocaine injections, or 4) no local anesthetic. Patients scored their pain on a numerical rating scale where 0 indicated no pain and 10 indicated worst pain. We analyzed mean and standard deviations of scores, using a 1-way analysis of variance (ANOVA) and post hoc multiple comparisons with Tukey's honestly significant difference (HSD) studentized range test to determine whether there were significant differences across the groups. There was no significant difference between local anesthetic gel (mean 3.1, SD 1.9) and no anesthetic (mean 3.5, SD 1.9) or between quadrant (mean 1.7, SD 1.7) and apex-only (mean 2.0, SD 1.8) local anesthetic injections. There was significant difference between quadrant injections (mean 1.7, SD 1.7) and no local anesthetic (mean 3.5, SD 1.9) and between apex-only injections (mean 2.0, SD 1.8) and no local anesthetic (mean 3.5, SD 1.9). There was significant pain reduction with local anesthetic injections but not with gel, and since there was no significant difference in efficacy between quadrant and apex-only injections, we recommend apex-only local anesthetic injections for transrectal ultrasound-guided prostate biopsies because it simplifies the injection procedure. (author)

  19. Lipid Emulsions Enhance the Norepinephrine-Mediated Reversal of Local Anesthetic-Induced Vasodilation at Toxic Doses

    Science.gov (United States)

    Lee, Soo Hee; Sung, Hui-Jin; Ok, Seong-Ho; Yu, Jongsun; Choi, Mun-Jeoung; Lim, Jin Soo

    2013-01-01

    Purpose Intravenous lipid emulsions have been used to treat the systemic toxicity of local anesthetics. The goal of this in vitro study was to examine the effects of lipid emulsions on the norepinephrine-mediated reversal of vasodilation induced by high doses of levobupivacaine, ropivacaine, and mepivacaine in isolated endothelium-denuded rat aorta, and to determine whether such effects are associated with the lipid solubility of local anesthetics. Materials and Methods The effects of lipid emulsions (0.30, 0.49, 1.40, and 2.61%) on norepinephrine concentration-responses in high-dose local anesthetic (6×10-4 M levobupivacaine, 2×10-3 M ropivacaine, and 7×10-3 M mepivacaine)-induced vasodilation of isolated aorta precontracted with 60 mM KCl were assessed. The effects of lipid emulsions on local anesthetic- and diltiazem-induced vasodilation in isolated aorta precontracted with phenylephrine were also assessed. Results Lipid emulsions (0.30%) enhanced norepinephrine-induced contraction in levobupivacaine-induced vasodilation, whereas 1.40 and 2.61% lipid emulsions enhanced norepinephrine-induced contraction in both ropivacaine- and mepivacaine-induced vasodilation, respectively. Lipid emulsions (0.20, 0.49 and 1.40%) inhibited vasodilation induced by levobupivacaine and ropivacaine, whereas 1.40 and 2.61% lipid emulsions slightly attenuated mepivacaine (3×10-3 M)-induced vasodilation. In addition, lipid emulsions attenuated diltiazem-induced vasodilation. Lipid emulsions enhanced norepinephrine-induced contraction in endothelium-denuded aorta without pretreatment with local anesthetics. Conclusion Taken together, these results suggest that lipid emulsions enhance the norepinephrine-mediated reversal of local anesthetic-induced vasodilation at toxic anesthetic doses and inhibit local anesthetic-induced vasodilation in a manner correlated with the lipid solubility of a particular local anesthetic. PMID:24142661

  20. [Intravenous regional anesthesia with long-acting local anesthetics. An update].

    Science.gov (United States)

    Atanassoff, P G; Lobato, A; Aguilar, J L

    2014-02-01

    Intravenous regional anesthesia is a widely used technique for brief surgical interventions, primarily on the upper limbs and less frequently, on the lower limbs. It began being used at the beginning of the 20th century, when Bier injected procaine as a local anesthetic. The technique to accomplish anesthesia has not changed much since then, although different drugs, particularly long-acting local anesthetics, such as ropivacaine and levobupivacaine in low concentrations, were introduced. Additionally, drugs like opioids, muscle relaxants, paracetamol, neostigmine, magnesium, ketamine, clonidine, and ketorolac, have all been investigated as adjuncts to intravenous regional anesthesia, and were found to be fairly useful in terms of an increased onset of operative anesthesia and longer lasting perioperative analgesia. The present article provides an overview of current knowledge with emphasis on long-acting local anesthetic drugs. Copyright © 2013 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Published by Elsevier España. All rights reserved.

  1. [Axillary local anesthetic spread after the thoracic interfacial ultrasound block - A cadaveric and radiological evaluation].

    Science.gov (United States)

    Torre, Patricia Alfaro de la; Jones, Jerry Wayne; Álvarez, Servando López; Garcia, Paula Diéguez; Miguel, Francisco Javier Garcia de; Rubio, Eva Maria Monzon; Boeris, Federico Carol; Sacramento, Monir Kabiri; Duany, Osmany; Pérez, Mario Fajardo; Gordon, Borja de la Quintana

    2017-09-01

    Oral opioid analgesics have been used for management of peri- and postoperative analgesia in patients undergoing axillary dissection. The axillary region is a difficult zone to block and does not have a specific regional anesthesia technique published that offers its adequate blockade. After institutional review board approval, anatomic and radiological studies were conducted to determine the deposition and spread of methylene blue and local anesthetic injected respectively into the axilla via the thoracic inter-fascial plane. Magnetic Resonance Imaging studies were then conducted in 15 of 34 patients scheduled for unilateral breast surgery that entailed any of the following: axillary clearance, sentinel node biopsy, axillary node biopsy, or supernumerary breasts, to ascertain the deposition and time course of spread of solution within the thoracic interfascial plane in vivo. Radiological and cadaveric studies showed that the injection of local anesthetic and methylene blue via the thoracic inter-fascial plane, using ultrasound guide technique, results in reliable deposition into the axilla. In patients, the injection of the local anesthetic produced a reliable axillary sensory block. This finding was supported by Magnetic Resonance Imaging studies that showed hyper-intense signals in the axillary region. These findings define the anatomic characteristics of the thoracic interfascial plane nerve block in the axillary region, and underline the clinical potential of this novel nerve block. Copyright © 2016 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  2. Volatile anesthetic action in a computational model of the thalamic reticular nucleus.

    Science.gov (United States)

    Gottschalk, Allan; Miotke, Sam A

    2009-05-01

    Although volatile anesthetics (VAs) modulate the activity of multiple ion channels, the process whereby one or more of these effects are integrated to produce components of the general anesthetic state remains enigmatic. Computer models offer the opportunity to examine systems level effects of VA action at one or more sites. Motivated by the role of the thalamus in consciousness and sensory processing, a computational model of the thalamic reticular nucleus was used to determine the collective impact on model behavior of VA action at multiple sites. A computational model of the thalamic reticular nucleus was modified to permit VA modulation of its ion channels. Isobolographic analysis was used to determine how multiple sites interact. VA modulation of either T-type Ca(2+) channels or gamma-aminobutyric acid type A receptors led to increased network synchrony. VA modulation of both further increased network synchronization. VA-induced decrements in Ca(2+) current permitted greater impact of inhibitory currents on membrane potential, but at higher VA concentrations the decrease in Ca(2+) current led to a decreased number of spikes in the burst generating the inhibitory signal. MAC-awake (the minimum alveolar concentration at which 50% of subjects will recover consciousness) concentrations of both isoflurane and halothane led to similar levels of network synchrony in the model. Relatively modest VA effects at both T-type Ca(2+) channels and gamma-aminobutyric acid type A receptors can substantially alter network behavior in a computational model of a thalamic nucleus. The similarity of network behavior at MAC-awake concentrations of different VAs is consistent with a contribution of the thalamus to VA-induced unconsciousness through action at these channels.

  3. Amide-type local anesthetics and human mesenchymal stem cells: clinical implications for stem cell therapy.

    Science.gov (United States)

    Dregalla, Ryan C; Lyons, Nicolette F; Reischling, Patrick D; Centeno, Christopher J

    2014-03-01

    In the realm of regenerative medicine, human mesenchymal stem cells (hMSCs) are gaining attention as a cell source for the repair and regeneration of tissues spanning an array of medical disciplines. In orthopedics, hMSCs are often delivered in a site-specific manner at the area of interest and may require the concurrent application of local anesthetics (LAs). To address the implications of using hMSCs in combination with anesthetics for intra-articular applications, we investigated the effect that clinically relevant doses of amide-type LAs have on the viability of bone marrow-derived hMSCs and began to characterize the mechanism of LA-induced hMSC death. In our study, culture-expanded hMSCs from three donors were exposed to the amide-type LAs ropivacaine, lidocaine, bupivacaine, and mepivacaine. To replicate the physiological dilution of LAs once injected into the synovial capsule, each anesthetic was reduced to 12.5%, 25%, and 50% of the stock solution and incubated with each hMSC line for 40 minutes, 120 minutes, 360 minutes, and 24 hours. At each time point, cell viability assays were performed. We found that extended treatment with LAs for 24 hours had a significant impact on both hMSC viability and adhesion. In addition, hMSC treatment with three of the four anesthetics resulted in cell death via apoptosis following brief exposures. Ultimately, we concluded that amide-type LAs induce hMSC apoptosis in a time- and dose-dependent manner that may threaten clinical outcomes, following a similar trend that has been established between these particular anesthetics and articular chondrocytes both in vitro and in vivo.

  4. Amide-Type Local Anesthetics and Human Mesenchymal Stem Cells: Clinical Implications for Stem Cell Therapy

    Science.gov (United States)

    Lyons, Nicolette F.; Reischling, Patrick D.; Centeno, Christopher J.

    2014-01-01

    In the realm of regenerative medicine, human mesenchymal stem cells (hMSCs) are gaining attention as a cell source for the repair and regeneration of tissues spanning an array of medical disciplines. In orthopedics, hMSCs are often delivered in a site-specific manner at the area of interest and may require the concurrent application of local anesthetics (LAs). To address the implications of using hMSCs in combination with anesthetics for intra-articular applications, we investigated the effect that clinically relevant doses of amide-type LAs have on the viability of bone marrow-derived hMSCs and began to characterize the mechanism of LA-induced hMSC death. In our study, culture-expanded hMSCs from three donors were exposed to the amide-type LAs ropivacaine, lidocaine, bupivacaine, and mepivacaine. To replicate the physiological dilution of LAs once injected into the synovial capsule, each anesthetic was reduced to 12.5%, 25%, and 50% of the stock solution and incubated with each hMSC line for 40 minutes, 120 minutes, 360 minutes, and 24 hours. At each time point, cell viability assays were performed. We found that extended treatment with LAs for 24 hours had a significant impact on both hMSC viability and adhesion. In addition, hMSC treatment with three of the four anesthetics resulted in cell death via apoptosis following brief exposures. Ultimately, we concluded that amide-type LAs induce hMSC apoptosis in a time- and dose-dependent manner that may threaten clinical outcomes, following a similar trend that has been established between these particular anesthetics and articular chondrocytes both in vitro and in vivo. PMID:24436443

  5. Behavioral response and pain perception to computer controlled local anesthetic delivery system and cartridge syringe.

    Science.gov (United States)

    Yogesh Kumar, T D; John, J Baby; Asokan, Sharath; Geetha Priya, P R; Punithavathy, R; Praburajan, V

    2015-01-01

    The present study evaluated and compared the pain perception, behavioral response, physiological parameters, and the role of topical anesthetic administration during local anesthetic administration with cartridge syringe and computer controlled local anesthetic delivery system (CCLAD). A randomized controlled crossover study was carried out with 120 children aged 7-11 years. They were randomly divided into Group A: Receiving injection with CCLAD during first visit; Group B: Receiving injection with cartridge syringe during first visit. They were further subdivided into three subgroups based on the topical application used: (a) 20% benzocaine; (b) pressure with cotton applicator; (c) no topical application. Pulse rate and blood pressure were recorded before and during injection procedure. Objective evaluation of disruptive behavior and subjective evaluation of pain were done using face legs activity cry consolability scale and modified facial image scale, respectively. The washout period between the two visits was 1-week. Injections with CCLAD produced significantly lesser pain response, disruptive behavior (P < 0.001), and pulse rate (P < 0.05) when compared to cartridge syringe injections. Application of benzocaine produced lesser pain response and disruptive behavior when compared to the other two subgroups, although the result was not significant. Usage of techniques which enhance behavioral response in children like injections with CCLAD can be considered as a possible step toward achieving a pain-free pediatric dental practice.

  6. Behavioral response and pain perception to computer controlled local anesthetic delivery system and cartridge syringe

    Directory of Open Access Journals (Sweden)

    T D Yogesh Kumar

    2015-01-01

    Full Text Available Aim: The present study evaluated and compared the pain perception, behavioral response, physiological parameters, and the role of topical anesthetic administration during local anesthetic administration with cartridge syringe and computer controlled local anesthetic delivery system (CCLAD. Design: A randomized controlled crossover study was carried out with 120 children aged 7-11 years. They were randomly divided into Group A: Receiving injection with CCLAD during first visit; Group B: Receiving injection with cartridge syringe during first visit. They were further subdivided into three subgroups based on the topical application used: (a 20% benzocaine; (b pressure with cotton applicator; (c no topical application. Pulse rate and blood pressure were recorded before and during injection procedure. Objective evaluation of disruptive behavior and subjective evaluation of pain were done using face legs activity cry consolability scale and modified facial image scale, respectively. The washout period between the two visits was 1-week. Results: Injections with CCLAD produced significantly lesser pain response, disruptive behavior (P < 0.001, and pulse rate (P < 0.05 when compared to cartridge syringe injections. Application of benzocaine produced lesser pain response and disruptive behavior when compared to the other two subgroups, although the result was not significant. Conclusion: Usage of techniques which enhance behavioral response in children like injections with CCLAD can be considered as a possible step toward achieving a pain-free pediatric dental practice.

  7. Topical anesthesia with eutetic mixture of local anesthetics cream in vasectomy: 2 randomized trials

    DEFF Research Database (Denmark)

    Honnens de Lichtenberg, M; Krogh, J; Rye, B

    1992-01-01

    Two paired randomized trials testing topical anesthesia with a eutetic mixture of local anesthetics (EMLA cream*) in vasectomy were performed. In 1 trial EMLA cream was applied on 1 side of the scrotum, while infiltration anesthesia into the skin and subcutaneous tissue with mepivacaine was used...... on the contralateral side. All but 1 of the 13 patients (p less than 0.05) preferred infiltration anesthesia because of pain as the incision reached the subcutaneous tissue. In the other trial 29 patients received EMLA cream on 1 side of the scrotum before bilateral mepivacaine infiltration. There was significantly...... less pain on the sides with the anesthetic cream (p less than 0.001). Many patients would pay the price of the cream. In conclusion, EMLA cream cannot replace but it can supplement infiltration anesthesia during vasectomy....

  8. Local anesthesia for extracorporeal shock wave lithotripsy: a study comparing eutetic mixture of local anesthetics cream and lidocaine infiltration

    DEFF Research Database (Denmark)

    Honnens de Lichtenberg, M; Miskowiak, J; Mogensen, P

    1992-01-01

    A study of the anesthetic efficacy of a eutetic mixture of local anesthetics (EMLA cream) versus lidocaine infiltration in extracorporeal shock wave lithotripsy (ESWL) was done. A total of 46 patients had 30 gm. of EMLA cream applied to the skin over the kidney and 45 had subcutaneous infiltration...... anesthesia with 20 ml. 1% lidocaine with epinephrine. All patients received an intravenous dose of morphine just before ESWL. The patients were comparable with regard to age, sex, weight, morphine dosage, number of shock waves given and duration of treatment. Median pain score and the amount of supplementary...... analgesics were not significantly different between the 2 groups. There were no significant differences between the groups with regard to post-ESWL skin changes. Therefore, EMLA cream can be recommended for ESWL provided it is applied correctly....

  9. New Updates Pertaining to Drug Delivery of Local Anesthetics in Particular Bupivacaine Using Lipid Nanoparticles

    Science.gov (United States)

    Beiranvand, Siavash; Eatemadi, Ali; Karimi, Arash

    2016-06-01

    Lipid nanoparticles (liposomes) were first described in 1965, and several work have led to development of important technical advances like triggered release liposomes and drug-loaded liposomes. These advances have led to numerous clinical trials in such diverse areas such as the delivery of anti-cancer, antifungal, and antibiotic drugs; the delivery of gene medicines; and most importantly the delivery of anesthesia drugs. Quite a number of liposomes are on the market, and many more are still in developmental stage. Lipid nanoparticles are the first nano-medicine delivery system to be advanced from laboratory concept to clinical application with high considerable clinical acceptance. Drug delivery systems for local anesthetics (LAs) have caught the interest of many researchers because there are many biomedical advantages connected to their application. There have been several formulation techniques to systemically deliver LA that include encapsulation in liposomes and complexation in cyclodextrins, nanoparticles, and to a little extent gold nanoparticles. The proposed formulations help to decrease the LA concentration utilized, increase its permeability, and most importantly increase the localization of the LA for a long period of time thereby leading to increase in the duration of the LA effect and finally to reduce any local and systemic toxicity. In this review, we will highlight on new updates pertaining to drug delivery of local anesthetics in particular bupivacaine using lipid nanoparticles.

  10. New Updates Pertaining to Drug Delivery of Local Anesthetics in Particular Bupivacaine Using Lipid Nanoparticles.

    Science.gov (United States)

    Beiranvand, Siavash; Eatemadi, Ali; Karimi, Arash

    2016-12-01

    Lipid nanoparticles (liposomes) were first described in 1965, and several work have led to development of important technical advances like triggered release liposomes and drug-loaded liposomes. These advances have led to numerous clinical trials in such diverse areas such as the delivery of anti-cancer, antifungal, and antibiotic drugs; the delivery of gene medicines; and most importantly the delivery of anesthesia drugs. Quite a number of liposomes are on the market, and many more are still in developmental stage. Lipid nanoparticles are the first nano-medicine delivery system to be advanced from laboratory concept to clinical application with high considerable clinical acceptance. Drug delivery systems for local anesthetics (LAs) have caught the interest of many researchers because there are many biomedical advantages connected to their application. There have been several formulation techniques to systemically deliver LA that include encapsulation in liposomes and complexation in cyclodextrins, nanoparticles, and to a little extent gold nanoparticles. The proposed formulations help to decrease the LA concentration utilized, increase its permeability, and most importantly increase the localization of the LA for a long period of time thereby leading to increase in the duration of the LA effect and finally to reduce any local and systemic toxicity. In this review, we will highlight on new updates pertaining to drug delivery of local anesthetics in particular bupivacaine using lipid nanoparticles.

  11. Systematic review of the effect of intravenous lipid emulsion therapy for local anesthetic toxicity

    DEFF Research Database (Denmark)

    Høgberg, Lotte Christine Groth; Bania, Theodore C; Lavergne, Valéry

    2016-01-01

    BACKGROUND: Following national and regional recommendations, intravenous lipid emulsion (ILE) has become established in clinical practice as a treatment for acute local anesthetic (LA) toxicity, although evidence of efficacy is limited to animal studies and human case reports. A collaborative lipid...... emulsion workgroup was therefore established by the American Academy of Clinical Toxicology to review the evidence on the effect of ILE for LA toxicity. METHODS: We performed a systematic review of the literature published through 15 December 2014. Relevant articles were determined based on pre...

  12. Topical anesthesia with eutetic mixture of local anesthetics cream in vasectomy: 2 randomized trials

    DEFF Research Database (Denmark)

    Honnens de Lichtenberg, M; Krogh, J; Rye, B

    1992-01-01

    Two paired randomized trials testing topical anesthesia with a eutetic mixture of local anesthetics (EMLA cream*) in vasectomy were performed. In 1 trial EMLA cream was applied on 1 side of the scrotum, while infiltration anesthesia into the skin and subcutaneous tissue with mepivacaine was used...... on the contralateral side. All but 1 of the 13 patients (p less than 0.05) preferred infiltration anesthesia because of pain as the incision reached the subcutaneous tissue. In the other trial 29 patients received EMLA cream on 1 side of the scrotum before bilateral mepivacaine infiltration. There was significantly...

  13. Local anesthetic interaction with human ether-a-go-go-related gene (HERG) channels: role of aromatic amino acids Y652 and F656

    DEFF Research Database (Denmark)

    Siebrands, Cornelia C; Schmitt, Nicole; Friederich, Patrick

    2005-01-01

    was to determine the effect of the mutations Y652A and F656A in the putative drug binding region of HERG on the inhibition by bupivacaine, ropivacaine, and mepivacaine. METHODS: The authors examined the inhibition of wild-type and mutant HERG channels, transiently expressed in Chinese hamster ovary cells...... by bupivacaine, ropivacaine, and mepivacaine. Whole cell patch clamp recordings were performed at room temperature. RESULTS: Inhibition of HERG wild-type and mutant channels by the different local anesthetics was concentration dependent, stereoselective, and reversible. The sensitivity decreased in the order...... bupivacaine > ropivacaine > mepivacaine for wild-type and mutant channels. The mutant channels were approximately 4-30 times less sensitive to the inhibitory action of the different local anesthetics than the wild-type channel. The concentration-response data were described by Hill functions (bupivacaine...

  14. Frequency of retromolar foramen and local anesthetic relevance. A literature review.

    Directory of Open Access Journals (Sweden)

    Maysa Brandt

    2012-07-01

    Full Text Available The retromolar foramen is a hole accessory jaw in the retromolar trigone zone. The knowledge of this variation is important for the presence of anatomical structures that enter via the foramen and can serve as via local anesthetic or be affected during surgical procedures. Objective: To determine the frequency of the retromolar foramen in dried humans mandibles and its association with local anesthesia reviewed in scientific literature. Methods: A descriptive study by systematic literature review. We analyzed articles related to the location of retromolar foramina in the MEDLINE and SciELO databases. Author name, sample number, gender, frequency and source side foramina were registred. We analyzed the clinic relevance about to presence of the retromolar foramen. Results: 55 articles, of which only 5(9% were selected. Between 40 to 475 mandibles humans was analized which the presence of the retromolar foramen ranged between 7.8% and 25%. The authors define the use of the foramen for the application of anesthetic techniques and ancillary care in third molar surgery. Conclusion: Accessory foramina occurs in a low percentage. However, it could be an important element for local anesthesia or surgical treatment of the area.

  15. Evaluating complications during intraoral administration of local anesthetics in a rural, portable special needs dental clinic.

    Science.gov (United States)

    Boynes, Sean; Riley, Amah; Milbee, Sarah

    2014-01-01

    The aim of this study was to identify and quantify complications with local anesthetic administration on consecutive patients seen for dental care in a portable dental clinic providing care to patients with special needs. This prospective study includes data on the patients seen by the portable dental team. A standardized form is used to determine complications and associated information for 172 dental visits in which local anesthetic is administered. After statistical analysis of 172 consecutive cases, the overall complication rate is 8.1%. All of the complications are considered to be mild or moderate; there are no reports of severe events. The complications encountered most frequently are associated with self-inflicted soft tissue injury or inadequate anesthesia. Comprehensive care with local anesthesia delivered by a portable dental clinic has a low risk of complication. The administration of an inferior alveolar nerve block or body-mass status appears to affect the incidence of complications. © 2013 Special Care Dentistry Association and Wiley Periodicals, Inc.

  16. Local anesthetic failure associated with inflammation: verification of the acidosis mechanism and the hypothetic participation of inflammatory peroxynitrite

    Directory of Open Access Journals (Sweden)

    Takahiro Ueno

    2008-11-01

    Full Text Available Takahiro Ueno1, Hironori Tsuchiya2, Maki Mizogami1, Ko Takakura11Department of Anesthesiology, Asahi University School of Dentistry, Mizuho, Gifu, Japan; 2Department of Dental Basic Education, Asahi University School of Dentistry, Mizuho, Gifu, JapanAbstract: The presence of inflammation decreases local anesthetic efficacy, especially in dental anesthesia. Although inflammatory acidosis is most frequently cited as the cause of such clinical phenomena, this has not been experimentally proved. We verified the acidosis mechanism by studying the drug and membrane lipid interaction under acidic conditions together with proposing an alternative hypothesis. Liposomes and nerve cell model membranes consisting of phospholipids and cholesterol were treated at different pH with lidocaine, prilocaine and bupivacaine (0.05%–0.2%, w/v. Their membrane-interactive potencies were compared by the induced-changes in membrane fluidity. Local anesthetics fluidized phosphatidylcholine membranes with the potency being significantly lower at pH 6.4 than at pH 7.4 (p < 0.01, supporting the acidosis theory. However, they greatly fluidized nerve cell model membranes even at pH 6.4 corresponding to inflamed tissues, challenging the conventional mechanism. Local anesthetics acted on phosphatidylserine liposomes, as well as nerve cell model membranes, at pH 6.4 with almost the same potency as that at pH 7.4, but not on phosphatidylcholine, phosphatidylethanolamine and sphingomyelin liposomes. Since the positively charged anesthetic molecules are able to interact with nerve cell membranes by ion-paring with anionic components like phosphatidylserine, tissue acidosis is not essentially responsible for the local anesthetic failure associated with inflammation. The effects of local anesthetics on nerve cell model membranes were inhibited by treating with peroxynitrite (50 μM, suggesting that inflammatory cells producing peroxynitrite may affect local anesthesia

  17. Articaine hydrochloride: a study of the safety of a new amide local anesthetic.

    Science.gov (United States)

    Malamed, S F; Gagnon, S; Leblanc, D

    2001-02-01

    Articaine is an amide local anesthetic introduced clinically in Germany in 1976 and subsequently throughout Europe, Canada and, in 2000, the United States. The authors report on three identical single-dose, randomized, double-blind, parallel-group, active-controlled multicenter studies that were conducted to compare the safety and efficacy of articaine (4 percent with epinephrine 1:100,000) with that of lidocaine (2 percent with epinephrine 1:100,000). A total of 1,325 subjects participated in these studies, 882 of whom received articaine 4 percent with epinephrine 1:100,000 and 443 of whom received lidocaine 2 percent with epinephrine 1:100,000. The overall incidence of adverse events in the combined studies was 22 percent for the articaine group and 20 percent for the lidocaine group. The most frequently reported adverse events in the articaine group, excluding postprocedural dental pain, were headache (4 percent), facial edema, infection, gingivitis and paresthesia (1 percent each). The incidence of these events was similar to that reported for subjects who received lidocaine. The adverse events most frequently reported as related to articaine use were paresthesia (0.9 percent), hypesthesia (0.7 percent), headache (0.55 percent), infection (0.45 percent), and rash and pain (0.3 percent each). Articaine is a well-tolerated, safe and effective local anesthetic for use in clinical dentistry.

  18. The efficacy of local anesthetics in reducing post operative pain after appendectomy

    Directory of Open Access Journals (Sweden)

    Masood Baghaee vaji

    2004-09-01

    Full Text Available Reducing post operative pain is a common issue in surgeries. This study was to evaluate the efficacy of wound infiltration with local anesthetics in reducing postoperative pain after appendectomy. This is a double-blind, placebo-controlled, randomized clinical trial on 40 patients with non-complicated acute appendicitis. Cases received a combination of lidocaine hydrochloride and bupivacaine hydrochloride after appendectomy and before closing the wound. Controls received the same volume of saline solution. Injections were done both under the fascia of external oblique muscle and intradermal. Pain assessment was done by two pain measuring scales, VAS and NRS, in 4, 8, 12 and 24 hours after the operation. Cases and controls were the same in age, sex, and history of opium addiction. Pain peaked in the 8th hour after operation in both groups and reduced afterwards. Pain assessments showed the same pattern using the NRS and VAS measuring scales. T-test showed the pain to be significantly less in cases comparing with the controls in all time points. No significant difference was seen in the time of receiving the first analgesic after the operation but the frequency of analgesic consumption was significantly lower in controls. This study showed local anesthetic infiltration to be effective in reducing the postoperative pain in patients undergoing appendectomy which is in contrast with the previous studies. This may be due to a different infiltration technique or pain assessment in the first 24 hours after the operation.

  19. Inhibition of brain cell excitability by lidocaine, QX314, and tetrodotoxin: a mechanism for analgesia from infused local anesthetics?

    Science.gov (United States)

    Butterworth, J; Cole, L; Marlow, G

    1993-07-01

    Local anesthetic infusions have been used to provide analgesia in a variety of painful conditions. The mechanism for this drug effect remains unknown. To better define the electrical effects of lidocaine concentrations comparable to those obtained during analgesic infusions, lidocaine (0.05-3 mmol.l-1), QX314 (an obligatorily charged, quaternary lidocaine derivative applied within the cells), and tetrodotoxin (10 mmol.l-1) were applied to rat hippocampal pyramidal cells. The three drugs, which inhibit Na+ currents by varying mechanisms, produced tonic increases in (firing) current threshold, and decreases in the amplitude of action potentials measured using an intracellular microelectrode technique. Lidocaine inhibited action potential spikes and increased current threshold in a concentration-dependent fashion. Lidocaine 50 and 100 mumol.l-1 did not inhibit action potentials, but increased firing threshold by nearly 100%. Lidocaine 1-3 mmol.l-1 significantly inhibited action potential amplitude and increased threshold by as much as 800%. Similarly, QX314 and tetrodotoxin produced greater increases in current threshold than in action potential amplitude. QX314 produced phasic (or frequency-dependent) block during trains of stimuli at 1 Hz, even when almost no tonic block was present. Lidocaine produced less phasic block than QX314, and required both greater tonic block and more frequent stimulation to produce the phenomenon. Tetrodotoxin demonstrated no phasic block. Increases in current threshold occurred in lidocaine concentrations associated with analgesia and toxicity; inhibition of action potentials occurred scarcely at all at these concentrations. Thus, tonic increases in current threshold may underlie analgesia and supplementation of general anesthesia by intravenous lidocaine.

  20. Local anesthetic effects of cocaine and several extracts of the coca leaf (E. coca).

    Science.gov (United States)

    Bedford, J A; Turner, C E; Elsohly, H N

    1984-05-01

    Cocaine and a number of different fractions of a crude ethanol extract of the coca leaf (E. coca) were subjected to a local anesthetic screen using rat tail withdrawal from electric shock. Following an intradermal injection of 0.1 ml of a 2.0% (w.v) solution of cocaine HCl, an immediate response was observed. Two of the coca fractions also produced some local anesthesia. An alkaloidal fraction, containing an equivalent amount of cocaine, produced a maximum effect that was approximately 20% less than that observed with cocaine. The only other fraction producing any effect, a water soluble cocaine-free fraction, showed a maximum response that was approximately 30% of that observed with cocaine.

  1. Hyperalgesia by low doses of the local anesthetic lidocaine involves cannabinoid signaling: an fMRI study in mice.

    Science.gov (United States)

    Bosshard, Simone C; Grandjean, Joanes; Schroeter, Aileen; Baltes, Christof; Zeilhofer, Hanns U; Rudin, Markus

    2012-07-01

    Lidocaine is clinically widely used as a local anesthetic inhibiting propagation of action potentials in peripheral nerve fibers. Correspondingly, the functional magnetic resonance imaging (fMRI) response in mouse brain to peripheral noxious input is largely suppressed by local lidocaine administered at doses used in a clinical setting. We observed, however, that local administration of lidocaine at doses 100 × lower than that used clinically led to a significantly increased sensitivity of mice to noxious forepaw stimulation as revealed by fMRI. This hyperalgesic response could be confirmed by behavioral readouts using the von Frey filament test. The increased sensitivity was found to involve a type 1 cannabinoid (CB(1)) receptor-dependent pathway as global CB(1) knockout mice, as well as wild-type mice pretreated systemically with the CB(1) receptor blocker rimonabant, did not display any hyperalgesic effects after low-dose lidocaine. Additional experiments with nociceptor-specific CB(1) receptor knockout mice indicated an involvement of the CB(1) receptors located on the nociceptors. We conclude that low concentrations of lidocaine leads to a sensitization of the nociceptors through a CB(1) receptor-dependent process. This lidocaine-induced sensitization might contribute to postoperative hyperalgesia.

  2. Topical amethocaine (Ametop) is superior to EMLA for intravenous cannulation. Eutectic mixture of local anesthetics.

    LENUS (Irish Health Repository)

    Browne, J

    2012-02-03

    PURPOSE: A eutectic mixture of local anesthetics (EMLA) is commonly used to provide topical anesthesia for intravenous (i.v.) cannulation. One of its side effects is vasoconstriction, which may render cannulation more difficult. A gel formulation of amethocaine (Ametop) is now commercially available. The aim of this study was to compare EMLA and Ametop with regard to the degree of topical anesthesia afforded, the incidence of vasoconstriction and the ease of i.v. cannulation. METHODS: Thirty two ASA I adult volunteers had a #16 gauge i.v. cannula inserted on two separate occasions using EMLA and Ametop applied in a double blind fashion for topical anesthesia. Parameters that were recorded after each cannulation included visual analogue pain scores (VAPS), the presence of vasoconstriction and the ease of cannulation, graded as: 1 = easy, 2 = moderately difficult, 3 = difficult and 4 = failed. RESULTS: The mean VAPS +\\/- SD after cannulation with Ametop M was 12+\\/-9.9 and with EMLA was 25.3+\\/-16.6 (P = 0.002). Vasoconstriction occurred after EMLA application on 17 occasions and twice after Ametop (P = 0.001). The grade of difficulty of cannulation was 1.44+\\/-0.88 following EMLA and 1.06+\\/-0.25 with Ametop (P = 0.023). CONCLUSIONS: Intravenous cannulation was less painful following application of Ametop than EMLA. In addition, Ametop caused less vasoconstriction and facilitated easier cannulation. Its use as a topical anesthetic agent is recommended, especially when i.v. access may be problematic.

  3. Application of a three-microneedle device for the delivery of local anesthetics

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    Ishikawa K

    2015-04-01

    Full Text Available Kayoko Ishikawa,1 Hidekazu Fukamizu,1 Tetsuya Takiguchi,1 Yusuke Ohta,1 Yoshiki Tokura2 1Department of Plastic and Reconstructive Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan; 2Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan Purpose: We investigated the effectiveness of a newly developed device for the delivery of local anesthetics in the treatment of axillary osmidrosis and hyperhidrosis. We developed a device with three fine, stainless steel needles fabricated with a bevel angle facing outside (“three-microneedle device” [TMD] to release a drug broadly and homogeneously into tissue in the horizontal plane. Use of this device could reduce the risk of complications when transcutaneous injections are undertaken.Patients and methods: Sixteen Japanese patients were enrolled. The mean volume of lidocaine hydrochloride per unit area needed to elicit anesthesia when using a TMD was compared with that the volume required when using a conventional 27-gauge needle. The visual analog scale (VAS score of needlestick pain and injection-associated pain was also compared.Results: The mean volume of lidocaine hydrochloride per unit area to elicit anesthesia using the TMD was significantly lower than that the volume required when using the conventional 27-gauge needle. The VAS score of needlestick pain for the TMD was significantly lower than that the VAS score for the 27-gauge needle.Conclusion: These data suggest that the TMD could be useful for the delivery of local anesthetics in terms of clinical efficacy and avoidance of adverse effects. Keywords: three-microneedle device, transcutaneous drug delivery, local anesthesia, lidocaine, pain

  4. [New anesthetics].

    Science.gov (United States)

    Malamed, S F

    2000-01-01

    Since the introduction of cocaine local analgesia in 1886, and the subsequent development of procaine (1904) and other closely related ester-type compounds, dentistry has prided itself on being as close to 'painless' as possible. In the late 1940s the newest group of the local anesthetic compounds, the amides, was introduced. The initial amide local analgesic, lignocaine (Xylocaine), revolutionised pain control in dentistry worldwide. In succeeding years other amide-type local anesthetics, mepivacaine, prilocaine, bupivacaine and etidocaine, were introduced. They gave the dental practitioner a local anesthetic armamentarium which provided pulpal analgesia for periods of from 20 minutes (mepivacaine) to as long as three hours (bupivacaine and etidocaine with adrenaline). In addition these popular drugs proved to be more rapid-acting than the older ester-type drug and, at least from the perspective of allergenicity, more safe. In 1976, in Germany, the newest amide local analgesic, carticaine HCl was introduced into dentistry. Articaine (the generic name was changed) possesses properties similar to lignocaine but has additional properties which made the drug quite attractive to the general dental practitioner. In 1986 articaine was introduced in North America (Canada) where it has become the most used local anesthetic, supplanting lignocaine. Articaine has been approved for use in the United Kingdom. In this introductory discussion we review the development of articaine and discuss its place in the dental local analgesic armamentarium.

  5. Local anesthetic failure associated with inflammation: verification of the acidosis mechanism and the hypothetic participation of inflammatory peroxynitrite.

    Science.gov (United States)

    Ueno, Takahiro; Tsuchiya, Hironori; Mizogami, Maki; Takakura, Ko

    2008-01-01

    The presence of inflammation decreases local anesthetic efficacy, especially in dental anesthesia. Although inflammatory acidosis is most frequently cited as the cause of such clinical phenomena, this has not been experimentally proved. We verified the acidosis mechanism by studying the drug and membrane lipid interaction under acidic conditions together with proposing an alternative hypothesis. Liposomes and nerve cell model membranes consisting of phospholipids and cholesterol were treated at different pH with lidocaine, prilocaine and bupivacaine (0.05%-0.2%, w/v). Their membrane-interactive potencies were compared by the induced-changes in membrane fluidity. Local anesthetics fluidized phosphatidylcholine membranes with the potency being significantly lower at pH 6.4 than at pH 7.4 (p acidosis theory. However, they greatly fluidized nerve cell model membranes even at pH 6.4 corresponding to inflamed tissues, challenging the conventional mechanism. Local anesthetics acted on phosphatidylserine liposomes, as well as nerve cell model membranes, at pH 6.4 with almost the same potency as that at pH 7.4, but not on phosphatidylcholine, phosphatidylethanolamine and sphingomyelin liposomes. Since the positively charged anesthetic molecules are able to interact with nerve cell membranes by ion-paring with anionic components like phosphatidylserine, tissue acidosis is not essentially responsible for the local anesthetic failure associated with inflammation. The effects of local anesthetics on nerve cell model membranes were inhibited by treating with peroxynitrite (50 μM), suggesting that inflammatory cells producing peroxynitrite may affect local anesthesia.

  6. A survey to access knowledge and practice among dentists regarding local anesthetic dosage in three cities of Uttarakhand

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    Laxman Singh Kaira

    2014-01-01

    Full Text Available Objective: Local anesthetics are the most commonly used drugs in routine dentistry. Although they are considered effective and safe in controlling pain during dental procedures, complications related to their use appear inevitable. Many dentists use these drugs routinely but are unaware of the dose calculations required and the maximum safe and effective dose of the drug. Materials and Methods: This study was aimed to determine the knowledge that general dental practitioners and dental specialists, in three different cities in India, have regarding dose calculations and the maximum-dose required of the most commonly used local anesthetics. A one page survey questionnaire was used in this study and data were analyzed using standard SPSS statistical program version 11, software (SPSS Inc. Chicago, Illinois, USA. Results: The respondents comprised 71.4% general dental practitioners and 28.5% dental specialists, with ages ranging from 26 to 50 years; Nearly 75% of the total respondent was males and 25% females. Nearly 69% of the respondents were unaware of the maximum recommended dose for use on adult, healthy patients and 81% were still confused about the maximum numbers of syringes containing 2% lignocaine with adrenaline that can be given to a patient. A total of 49% of general dental practitioners and specialists do not perform aspiration when injecting local anesthetics, whereas only 38% performed the aspiration in inferior nerve block technique, while only 12% performed aspiration in all types of injection techniques. A high percentage of the dentists (84% who responded are unaware of how to calculate the local anesthetic dose and 31% of them encountered complications during, or after, local anesthetic administration. Conclusion: General practitioners and dental specialists appear to have an inadequate knowledge about local anesthetics maximum-dose and dose calculations; further educational courses are recommended to update them regarding such

  7. Lipid emulsion-mediated reversal of toxic-dose aminoamide local anesthetic-induced vasodilation in isolated rat aorta

    OpenAIRE

    Ok, Seong-Ho; Han, Jeong Yeol; Lee, Soo Hee; Shin, Il-Woo; Lee, Heon Keun; Chung, Young-Kyun; Choi, Mun-Jeoung; Sohn, Ju-Tae

    2013-01-01

    Background Intravenous lipid emulsion has been used to treat systemic toxicity of local anesthetics. The goals of this in vitro study were to determine the ability of two lipid emulsions (Intralipid® and Lipofundin® MCT/LCT) to reverse toxic dose local anesthetic-induced vasodilation in isolated rat aortas. Methods Isolated endothelium-denuded aortas were suspended for isometric tension recording. Vasodilation was induced by bupivacaine (3 × 10-4 M), ropivacaine (10-3 M), lidocaine (3 × 10-3 ...

  8. Effects of the local anesthetic benzocaine on the human erythrocyte membrane and molecular models.

    Science.gov (United States)

    Suwalsky, Mario; Schneider, Carlos; Villena, Fernando; Norris, Beryl; Cárdenas, Hernán; Cuevas, Francisco; Sotomayor, Carlos P

    2004-04-01

    The interaction of the local anesthetic benzocaine with the human erythrocyte membrane and molecular models is described. The latter consisted of isolated unsealed human erythrocyte membranes (IUM), large unilamellar vesicles (LUV) of dimyristoylphospatidylcholine (DMPC), and phospholipid multilayers of DMPC and dimyristoylphospatidyletanolamine (DMPE), representatives of phospholipid classes located in the outer and inner monolayers of the human erythrocyte membrane, respectively. Optical and scanning electron microscopy of human erythrocytes revealed that benzocaine induced the formation of echinocytes. Experiments performed on IUM and DMPC LUV by fluorescence spectroscopy showed that benzocaine interacted with the phospholipid bilayer polar groups and hydrophobic acyl chains. X-ray diffraction analysis of DMPC confirmed these results and showed that benzocaine had no effects on DMPE. The effect on sodium transport was also studied using the isolated toad skin. Electrophysiological measurements indicated a significant decrease in the potential difference (PD) and in the short-circuit current (Isc) after the application of benzocaine, reflecting inhibition of active ion transport.

  9. Atomic determinants of state-dependent block of sodium channels by charged local anesthetics and benzocaine.

    Science.gov (United States)

    Tikhonov, Denis B; Bruhova, Iva; Zhorov, Boris S

    2006-11-13

    Molecular modeling predicts that a local anesthetic (LA) lidocaine binds to the resting and open Na(v)1.5 in different modes, interacting with LA-sensing residues known from experiments. Besides the major pathway via the open activation gate, LAs can reach the inner pore via a "sidewalk" between D3S6, D4S6, and D3P. The ammonium group of a cationic LA binds in the focus of the pore-helices macrodipoles, which also stabilize a Na(+) ion chelated by two benzocaine molecules. The LA's cationic group and a Na(+) ion in the selectivity filter repel each other suggesting that the Na(+) depletion upon slow inactivation would stabilize a LA, while a LA would stabilize slow-inactivated states.

  10. Bisphenol A binds to the local anesthetic receptor site to block the human cardiac sodium channel.

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    Andrias O O'Reilly

    Full Text Available Bisphenol A (BPA has attracted considerable public attention as it leaches from plastic used in food containers, is detectable in human fluids and recent epidemiologic studies link BPA exposure with diseases including cardiovascular disorders. As heart-toxicity may derive from modified cardiac electrophysiology, we investigated the interaction between BPA and hNav1.5, the predominant voltage-gated sodium channel subtype expressed in the human heart. Electrophysiology studies of heterologously-expressed hNav1.5 determined that BPA blocks the channel with a K(d of 25.4±1.3 µM. By comparing the effects of BPA and the local anesthetic mexiletine on wild type hNav1.5 and the F1760A mutant, we demonstrate that both compounds share an overlapping binding site. With a key binding determinant thus identified, an homology model of hNav1.5 was generated based on the recently-reported crystal structure of the bacterial voltage-gated sodium channel NavAb. Docking predictions position both ligands in a cavity delimited by F1760 and contiguous with the DIII-IV pore fenestration. Steered molecular dynamics simulations used to assess routes of ligand ingress indicate that the DIII-IV pore fenestration is a viable access pathway. Therefore BPA block of the human heart sodium channel involves the local anesthetic receptor and both BPA and mexiletine may enter the closed-state pore via membrane-located side fenestrations.

  11. Effects of local anesthetics on Na+ channels containing the equine hyperkalemic periodic paralysis mutation.

    Science.gov (United States)

    Sah, R L; Tsushima, R G; Backx, P H

    1998-08-01

    We examined the ability of local anesthetics to correct altered inactivation properties of rat skeletal muscle Na+ channels containing the equine hyperkalemic periodic paralysis (eqHPP) mutation when expressed in Xenopus oocytes. Increased time constants of current decay in eqHPP channels compared with wild-type channels were restored by 1 mM benzocaine but were not altered by lidocaine or mexiletine. Inactivation curves, which were determined by measuring the dependence of the relative peak current amplitude after depolarization to -10 mV on conditioning prepulse voltages, could be shifted in eqHPP channels back toward that observed for wild-type (WT) channels using selected concentrations of benzocaine, lidocaine, and mexiletine. Recovery from inactivation at -80 mV (50-ms conditioning pulse) in eqHPP channels followed a monoexponential time course and was markedly accelerated compared with wild-type channels (tauWT = 10.8 +/- 0.9 ms; taueqHPP = 2.9 +/- 0.4 ms). Benzocaine slowed the time course of recovery (taueqHPP,ben = 9.6 +/- 0.4 ms at 1 mM) in a concentration-dependent manner. In contrast, the recovery from inactivation with lidocaine and mexiletine had a fast component (taufast,lid = 3.2 +/- 0.2 ms; taufast,mex = 3.1 +/- 0.2 ms), which was identical to the recovery in eqHPP channels without drug, and a slow component (tauslow,lid = 1,688 +/- 180 ms; tauslow,mex = 2,323 +/- 328 ms). The time constant of the slow component of the recovery from inactivation was independent of the drug concentration, whereas the fraction of current recovering slowly depended on drug concentrations and conditioning pulse durations. Our results show that local anesthetics are generally incapable of fully restoring normal WT behavior in inactivation-deficient eqHPP channels.

  12. Evaluation of the effect of locally administered amitriptyline gel as adjunct to local anesthetics in irreversible pulpitis pain

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    Moghadamnia A

    2009-01-01

    Full Text Available Background: Amitriptyline is one of the most common tricyclic antidepressants, which binds to pain sensory nerve fibers close to the sodium channel; hence, it could interact to some degree with receptors of local anesthetics. This study was designed to assess the additional analgesic effects of 2% Amitriptyline local gel administration in irreversible pulpitis pain of the molars. Materials and Methods: This study was a randomized, double-blind clinical trial that was performed on 56 consented adult patients who did not receive enough analgesia after a lidocaine nerve block for their tooth pulpitis pain. Patients were treated with 0.2 ml of either 2% amitriptyline or placebo, which was directly injected into their mandibular molar pulp chamber after they had received two routine lidocaine injections. Patients were asked to score their pain as a mark on a 10-cm Visual Analogue Scale (VAS at different timepoints: 0 (just before gel administration, 1, 3, 5, 7, and 9 minutes after the treatments. Results: There was a 92.5% decrease in VAS scores of patients 9 minutes after amitriptyline administration compared to Time 0, while in the placebo group this difference was only 13.5%. Further, in the amitriptyline group, the VAS score at all timepoints was statistically different from Time 0 ( P < 0.01. The overall pain reduction and its trend was significantly higher in the amitriptyline group compared with the placebo group ( P < 0.001. Conclusion: Inter-pulp space administration of amitriptyline 2% gel for completing analgesia in irreversible pulpitis pain could be effective and useful as a conjunctive therapy to injections of local anesthetics.

  13. Action Localization by Tubelets from Motion

    NARCIS (Netherlands)

    Jain, M.; van Gemert, J.; Jégou, H.; Bouthemy, P.; Snoek, C.G.M.

    2014-01-01

    This paper considers the problem of action localization, where the objective is to determine when and where certain actions appear. We introduce a sampling strategy to produce 2D+t sequences of bounding boxes, called tubelets. Compared to state-of-the-art alternatives, this drastically reduces the n

  14. [Application of computer-controlled local anesthetic delivery system in children].

    Science.gov (United States)

    Zhao, Xin; Liu, Hongling; Qin, Man

    2011-08-01

    To compare the reaction of children receiving computer-controlled local anesthetic delivery system (CCLADS) and a conventional syringe, and evaluate the efficacy of anesthesia and the reaction after treatment. 30 children aged 4 to 9 years old, whose bilateral primary molars in the same jaw present similar lesions with similar treatment were included in the study. These bilateral primary molars were treated under local anesthesia in 2 separate visits with random use of either the CCLADS or conventional syringe. For the first visit, the first group received CCLADS anesthesia, in which buccal infiltration anesthesia was performed for maxillary primary molars, and periodontal ligament anesthesia was performed for mandibular primary molars. The second group received conventional anesthesia, in which buccal infiltration anesthesia was performed for both maxillary and mandibular primary molars. For the second visit, two groups used alternative anesthestic method. Pain behavior was observed and scored by modified-children's hospital of eastern ontario pain scale (MCHEOPS). Pain perception was rated using facial image scale (FIS). The MCHEOPS and FIS scores in 1 min injection of children with CCLADS were lower than children with conventional syringe (P0.05). In local anesthesia, CCLADS can reduce the injection pain caused by conventional syringe to a certain extent.

  15. Adductor Canal Block With 10 mL Versus 30 mL Local Anesthetics and Quadriceps Strength

    DEFF Research Database (Denmark)

    Jæger, Pia; Koscielniak-Nielsen, Zbigniew J; Hilsted, Karen Lisa;

    2015-01-01

    BACKGROUND AND OBJECTIVES: Adductor canal block (ACB) is predominantly a sensory nerve block, but excess volume may spread to the femoral triangle and reduce quadriceps strength. We hypothesized that reducing the local anesthetic volume from 30 to 10 mL may lead to fewer subjects with quadriceps...

  16. Synthesis of Two Local Anesthetics from Toluene: An Organic Multistep Synthesis in a Project-Oriented Laboratory Course

    Science.gov (United States)

    Demare, Patricia; Regla, Ignacio

    2012-01-01

    This article describes one of the projects in the advanced undergraduate organic chemistry laboratory course concerning the synthesis of two local anesthetic drugs, prilocaine and benzocaine, with a common three-step sequence starting from toluene. Students undertake, in a several-week independent project, the multistep synthesis of a…

  17. Synthesis of Two Local Anesthetics from Toluene: An Organic Multistep Synthesis in a Project-Oriented Laboratory Course

    Science.gov (United States)

    Demare, Patricia; Regla, Ignacio

    2012-01-01

    This article describes one of the projects in the advanced undergraduate organic chemistry laboratory course concerning the synthesis of two local anesthetic drugs, prilocaine and benzocaine, with a common three-step sequence starting from toluene. Students undertake, in a several-week independent project, the multistep synthesis of a…

  18. [Cervical epidural anesthesia for upper extremity surgery using three different formulations of local anesthetics].

    Science.gov (United States)

    Guevara-López, Uriah; Bárcenas-Olivares, Juan; Gutiérrez-Sougarret, Bernardo; Aldrete, J Antonio; Olascoaga-Ortega, Gabriela

    2005-01-01

    To evaluate the efficiency and safety of the cervical epidural blockade (CEB) in upper extremity surgery, using lidocaine 2%, bupivacaine 5% and a mixture of both local analgesics. Eighty five patients were submitted to upper limb surgery under CEB. They were assigned into one of three groups: group I received 100 mg of 2% lidocaine; group II received 30 mg of 0.5% bupivacaine, and group III received a mixture of 60 mg of 2% lidocaine and 15 mg of 0.5% bupivacaine. We evaluated their effects on vital signs, blockade quality, adverse effects, and patient comfort. Anesthesiologist and surgeon evaluated the technique as "good" in 80% of the patients. Significant differences were found for motor blockade. Group II developed complete motor block (100%). Observed adverse effects were vomiting in groups II and III and dural puncture was present in 6.7% of the cases in group II. This study confirms the safety of cervical epidural anesthesia for upper limb surgery using three different formulations of local anesthetics.

  19. Addition of local anesthetics to contrast media. Pt. 1. Effects on patient discomfort and hemodynamics in aortofemoral angiography

    Energy Technology Data Exchange (ETDEWEB)

    Nilsson, P.; Almen, T.; Golman, K.; Jonsson, K.; Nyman, U.

    Effects of equiosmolar solutions (osmolality 1.35 mol/kg) of the ratio 1.5 contrast medium metrizoate (250 mg I/ml) containing either the local anesthetic mepivacaine or saline were evaluated on subjective discomfort, aortic blood pressure and heart rate in 17 patients referred for aortofemoral angiography due to intermittent claudication. Each patient was injected with 30 ml (15 ml/s) of each solution in random double-blind order. Each patient was then injected with 45 ml (12 ml/s) of the raio 3 medium ioxaglate (320 mg I/ml, osmolality 0.58 ml/kg). Ioxaglate caused significantly less total discomfort, pain, heat, vocal reaction, involuntary movements and hemodynamic effects than mitrizoate-mepivacaine and metrizoate-saline. The effects of the two metrizoate solutions did not differ significantly. Previous contradictory reports on the effects of anesthetics in contrast media were reviewed with regard to experimental design, different osmolality of the test and control solutions, premedication, and pH dependence of local anesthetics. Ratio 3 media are recommended because they produce a more reliable relief of patient discomfort and fewer hemodynamic changes than the addition of local anesthetics to ratio 1.5 media.

  20. Comparison of Local Anesthetic Effect of Bupivacaine versus Bupivacaine plus Dexamethasone in Nasal Surgery

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    Abdolhosein Ma’somi

    2012-12-01

    Full Text Available   Introduction: Adequate pain control is an important consideration in the post-surgical management of patients. Local nerve blockade added to general anesthesia can provide excellent pain control during and after most nasal surgical procedures. The aim of this study was to determine the combined effect of local anesthetic drugs with corticosteroids in nasal surgery. Materials and Methods: In this double-blind clinical study, 60 patients who underwent different nasal surgical procedures were matched and divided into two equal groups. Bilateral local nerve blockade was used in both groups. Bupivacaine or bupivacaine plus dexamethasone was administered by injection (groups B and B+D, respectively. Postoperative visual analog scale (VAS pain values and the need for oral/intramuscular analgesic treatment in the first 24 h were recorded in all patients. Results: Thirty-eight male (63.3% and 22 female (36.7% patients were included in this study, with a mean age of 28.3 ± 8.2 years. At 1, 2, 4, 6, and 12 h post surgery, VAS pain values were significantly lower in the B+D group than in the B group. The analgesic requirement was significantly lower in the B+D group compared with the B group. No relevant complications were seen during surgery or postoperative hospitalization. Conclusion: This study demonstrates the positive effect of a combination of a dexamethasone with a bupivacaine in reducing pain and the need for analgesic drugs after different nasal surgeries. No acute or short-term post-surgical complications were observed in this study.   

  1. Faster onset time of supraclavicular brachial plexus block using local anesthetic diluted with dextrose

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    Hong Jin Lim

    Full Text Available Abstract Background and objectives: A high sodium concentration is known to antagonize local anesthetics when infiltrated around neural tissue. Thus, we hypothesized that the onset time for sensory and motor blockade, in supraclavicular brachial plexus block using ropivacaine diluted with dextrose would be shorter than with saline. Methods: Patients scheduled for upper limb surgery were randomized to receive ultrasound guided supraclavicular brachial plexus block with 0.5% ropivacaine. Evaluation of sensory and motor blockade was performed every 5 min for 60 min. Patients were followed-up on postoperative day 1, and between days 7 and 10 for the presence of any complications. Twenty-five patients in each group were analyzed. Results: Mean time for onset of analgesia for the dextrose group was 37.6 ± 12.9 min while the mean time for the saline group was 45.2 ± 13.9 min with a p-value of 0.05. The effect size was 0.567, which was moderate to large. No major complications were observed. Conclusion: We conclude that there was a decrease in onset time of analgesia when dextrose was used as a diluent instead of saline for ultrasound guided supraclavicular block.

  2. Molecular determinants of prokaryotic voltage-gated sodium channels for recognition of local anesthetics.

    Science.gov (United States)

    Shimomura, Takushi; Irie, Katsumasa; Fujiyoshi, Yoshinori

    2016-08-01

    Local anesthetics (LAs) inhibit mammalian voltage-gated Na(+) channels (Navs) and are thus clinically important. LAs also inhibit prokaryotic Navs (BacNavs), which have a simpler structure than mammalian Navs. To elucidate the detailed mechanisms of LA inhibition to BacNavs, we used NavBh, a BacNav from Bacillus halodurans, to analyze the interactions of several LAs and quaternary ammoniums (QAs). Based on the chemical similarity of QA with the tertiary-alkylamine (TAA) group of LAs, QAs were used to determine the residues required for the recognition of TAA by NavBh. We confirmed that two residues, Thr220 and Phe227, are important for LA binding; a methyl group of Thr220 is important for recognizing both QAs and LAs, whereas Phe227 is involved in holding blockers at the binding site. In addition, we found that NavBh holds blockers in a closed state, consistent with the large inner cavity observed in the crystal structures of BacNavs. These findings reveal the inhibition mechanism of LAs in NavBh, where the methyl group of Thr220 provides the main receptor site for the TAA group and the bulky phenyl group of Phe227 holds the blockers inside the large inner cavity. These two residues correspond to the two LA recognition residues in mammalian Navs, which suggests the relevance of the LA recognition between BacNavs and mammalian Navs. © 2016 Federation of European Biochemical Societies.

  3. The challenge of evaluating pain and a pre-incisional local anesthetic block

    Directory of Open Access Journals (Sweden)

    Carolyn M. McKune

    2014-04-01

    Full Text Available Background. Our objective was to test the effectiveness of a local anesthetic line block administered before surgery in reducing postoperative pain scores in dogs undergoing ovariohysterectomy (OVHX.Methods. This study is a prospective, randomized, blinded, clinical trial involving 59 healthy female dogs. An algometric pressure-measuring device was used to determine nociceptive threshold, and compared to three subjective pain scales. Group L/B received a line block of lidocaine (4 mg/kg and bupivacaine (1 mg/kg subcutaneously in the area of the incision site and saline subcutaneously as premedication; group L/BM (positive control received a similar block and morphine (0.5 mg/kg subcutaneously for premedication; and group SS (negative control received a saline line block and saline premedication. Criteria for rescue analgesia were defined before the study. Dogs were assessed prior to surgery, at extubation (time 0 and at 2, 4, 6, 8 and 24 h post-recovery. The data were analyzed with one-way ANOVA, and a Split Plot Repeated Measures ANOVA with one grouping factor and one repeat factor (time. P < 0.05 was considered statistically significant.Results. Approximately 33% of dogs required rescue analgesia at some point during the study, with no significant difference between groups. There was no significant difference between treatment groups with any assessment method.Conclusions. As there were no statistically significant differences between positive and negative controls, the outcome of this technique cannot be proven.

  4. Intraarticilar and periarticular injections of triamcinolone acetonide and a local anesthetic in knee osteoarthritis (controlled study

    Directory of Open Access Journals (Sweden)

    A V Glazunov

    2009-01-01

    Full Text Available Efficacy of intraarticular glucocorticoid injections in knee osteoarthritis (OA is considered to be proved. But authors do not know randomized studies comparing efficacy of intraarticular and periarticular injections of triamcinolone acetonide.Objective. To assess efficacy of intraarticular and periarticular injections of mixture of triamcinolone acetonide (TA and a local anesthetic (LA solution in comparison with injections of LA only in pts with knee OA. Material and methods. 86 pts participating in a two-center randomized double blind study ELITA (Efficacy of Local Injection Therapy of osteoArthritis were included. Each knee joint with pain value higher then 40 mm (on VAS was randomized for either intraarticular or periarticular injections of novocaine 0,5% 10 ml or its mixture with TA 20 mg. Periarticular injections were performed in regions of ligaments, muscles or tendons insertions. “Pain”, “Activity” and “Functional status” WOMAC scales were assessed at baseline, in 4, 8, and12 weeks after treatment. Results. LA injections were performed in 21 pts (group 1 – control. TA and LA mixture was injected in both knee joints of 8 pts (group 4. Periarticular injections of TA and LA mixture were performed bilaterally in 5 pts (group 6. Group 4 pts had significantly better effect than group 1 pts after 4 (“Pain” and “Functional status” scales and 8 weeks (“Functional status” scale. Group 6 pts had better results than group 1 pts after 4 (all scales, 8 (“Pain” and “Activity” scales and 12 weeks (“Activity” scale. In group 6 pts treatment was more effective than in group 4 pts after 4 (all scales, 8 and 12 weeks (“Activity” scale. Conclusion. Efficacy of TA and LA mixture intraarticular and periarticular injections in comparison with isolated LA injections was demonstrated. Effect persisted for at least 8 weeks. Periarticular injections were more effective than intraarticular.

  5. Local Scour Around Piles Under Wave Action

    Institute of Scientific and Technical Information of China (English)

    陈国平; 左其华; 黄海龙

    2004-01-01

    The model tests are performed with regular waves, and the effect of wave height, wave period, water depth, scdiment size and pile diameter is evaluated. The shape and size of local scour around piles are studied. There are three typical scour patterns due to wave action. It is found that a relationship exists between the erosion depth and the wave number. An empirical formula of the maximum local scour is thus derived.

  6. APT: Action localization Proposals from dense Trajectories

    NARCIS (Netherlands)

    van Gemert, J.C.; Jain, M.; Gati, E.; Snoek, C.G.M.; Xie, X.; Jones, M.W.; Tam, G.K.L.

    2015-01-01

    This paper is on action localization in video with the aid of spatio-temporal proposals. To alleviate the computational expensive video segmentation step of existing proposals, we propose bypassing the segmentations completely by generating proposals directly from the dense trajectories used to repr

  7. The Effect of Local Anesthetic Volume Within the Adductor Canal on Quadriceps Femoris Function Evaluated by Electromyography

    DEFF Research Database (Denmark)

    Grevstad, Ulrik; Jæger, Pia; Sørensen, Johan Kløvgaard;

    2016-01-01

    BACKGROUND: Single-injection adductor canal block (ACB) provides analgesia after knee surgery. Which nerves that are blocked by an ACB and what influence-if any-local anesthetic volume has on the effects remain undetermined. We hypothesized that effects on the nerve to the vastus medialis muscle...... (which besides being a motor nerve innervates portions of the knee) are volume-dependent. METHODS: In this assessor- and subject-blinded randomized trial, 20 volunteers were included. On 3 separate days, subjects received an ACB with different volumes (10, 20, and 30 mL) of lidocaine 1%. In addition......L was used (P = 0.0001). No statistically significant differences were found between volume and effect on the vastus lateralis (P = 0.81) or in muscle strength (P = 0.15). CONCLUSIONS: For ACB, there is a positive correlation between local anesthetic volume and effect on the vastus medialis muscle. Despite...

  8. Local anesthetic failure associated with inflammation: verification of the acidosis mechanism and the hypothetic participation of inflammatory peroxynitrite

    OpenAIRE

    Tsuchiya, Hironori

    2008-01-01

    Takahiro Ueno1, Hironori Tsuchiya2, Maki Mizogami1, Ko Takakura11Department of Anesthesiology, Asahi University School of Dentistry, Mizuho, Gifu, Japan; 2Department of Dental Basic Education, Asahi University School of Dentistry, Mizuho, Gifu, JapanAbstract: The presence of inflammation decreases local anesthetic efficacy, especially in dental anesthesia. Although inflammatory acidosis is most frequently cited as the cause of such clinical phenomena, this has not been experimentally proved. ...

  9. Hemodynamic response after injection of local anesthetics with or without adrenaline in adult Nigerian subjects undergoing simple tooth extraction

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    Olutayo James

    2015-01-01

    Full Text Available Objective: This study was conducted to determine the changes in the blood pressure (BP and the pulse rate (PR of normotensive patients having dental extraction under the administration of 2% lignocaine local anesthetic with or without adrenaline. Materials and Methods: This prospective study was carried out on 325 consecutive normotensive patients who presented at the exodontia clinic of the Lagos University Teaching Hospital (LUTH, Lagos, Yoruba State, Nigeria from December 2004 to August 2005 for simple tooth extraction. The patients were randomly allocated into two groups according to the type of anesthetic solution employed. Group A had tooth extraction done under the administration of 2% lignocaine with adrenaline (1:80,000 while group B had tooth extraction done under the administration of 2% lignocaine local anesthetic without vasoconstrictor (plain lignocaine. Each patient had single tooth extracted. The following parameters were monitored in each of the surgical interventions: systolic blood pressure (SBP, diastolic blood pressure (DBP, and PR. Measurements were taken in the waiting room before surgery, during the surgery after local anesthesia, during tooth extraction, and 15 min after tooth extraction. Results: The sample consisted of 176 females and 149 males. Age range of the patients was 18-89 years with the mean age of 35.08 ± 15.60 years. The hemodynamic responses to lignocaine with adrenaline (1:80,000 and plain lignocaine essentially follow the same pattern in the study. There was no statistically significant difference between the measured parameters in the two groups after the administration of local anesthetics. Conclusion: This study, therefore, shows that there was no difference in the hemodynamic changes observed with the use of lignocaine with adrenaline or plain lignocaine during a simple tooth extraction in healthy adults.

  10. A Novel Technique for Split-Thickness Skin Donor Site Pain Control: Subcutaneous Catheters for Continuous Local Anesthetic Infusion

    Science.gov (United States)

    2012-01-01

    has been described after laparotomy, tho- racotomy, inguinal hernia repair, and rib fractures.2–4 We describe our experience at the U.S. Army Insti... complications (one catheter insertion site infection and one early catheter discontinuation due to poor skin fixation). This report is limited by its...Sanchez B, Waxman K, Tatevossian R, Gamberdella M, Read B. Local anesthetic infusion pumps improve postoperative pain after inguinal hernia repair: a

  11. Analgesic Effect of Botulinum Toxin A in Myofascial Pain Syndrome Patients Previously Treated with Local Infiltration of Anesthetic and Steroids.

    Science.gov (United States)

    Cartagena-Sevilla, Joaquín; García-Fernández, María R; Vicente-Villena, Juan P

    2016-12-01

    The purpose of this study was to evaluate the analgesic effect of botulinum toxin A (BoNTA) injections in patients with myofascial pain syndrome (MPS) who were previously treated with the local infiltration of anesthetic and steroids (LIAS). The study included a retrospective phase and a longitudinal open-label prospective phase, which were conducted on consecutive patients with MPS previously treated with the local infiltration of anesthetic (levobupivacaíne 0.25%) and steroids (triamcinolone 40 mg). Eligible patients were treated with a single intramuscular injection of BoNTA (Botox; Allergan, Inc., Irvine, CA). The treatment efficacy was determined according to the degree of pain relief obtained. Eighty-two patients met the inclusion/exclusion criteria and were included in the study. Successful results were obtained for 32 (39.0%) and 30 (36.6%) patients, during treatment with BoNTA and LIAS, respectively. The mean (standard deviation) length of the analgesic effect was significantly longer with BoNTA (29.6 [SD = 17.7] weeks) than with LIAS (8.5 [SD = 6.4] weeks), P <.0001. As regards the side effects, 19 (23.2%) patients reported transient soreness at the injection site for 2 to 3 days with BoNTA. The MPS patients previously treated with a local infiltration of anesthetic and steroids who then received a single injection of BoNTA experienced significantly reduced pain for a relatively long time.

  12. Prevalence of hypersensitivity to dental local anesthetic drugs in patients referred to Tehran Allergy clinic (2005-2007

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    Akhlaghi F.

    2009-03-01

    Full Text Available "nBackground and Aim: According to controversies in the prevalence of hypersensitivity to dental local anesthetic drugs and patients who claim hypersensitivity to these drugs, the aim of this study was to determine the prevalence of hypersensitivity to dental amide local anesthetic drugs in patients referred to Tehran Allergy Clinic in 2005-2007. "nMaterials and Methods: In this Study (Review of existing data, records of 130 patients who were referred to "Tehran allergy Clinic" (2005-2007 were studied. "nResults: The average age of patients was 29.5±18.8 years. 34% of cases showed positive skin reactions to at least one of the tested Lidocain concentrations and 10% of cases showed positive skin reactions to at least one of the tested Prilocain concentrations. There was a statistically significant difference in hypersensitivity to Lidocain 0.01 and 0.001 (p=0.017 and also between Lidocain 0.001 and 0.0001 (p<0.01. There was no statistically significant difference between other tested drug concentrations (p>0.05. "nConclusion: Many patients with history of hypersensitivity, show positive reaction to local dental anesthetic drugs. Prilocain hypersensitivity reactions are less than Lidocain. So application of Prilocain accompanies with less risk but its application should not be considered completely safe.

  13. Anti-metastatic Potential of Amide-linked Local Anesthetics: Inhibition of Lung Adenocarcinoma Cell Migration and Inflammatory Src Signaling Independent of Sodium Channel Blockade

    Science.gov (United States)

    Piegeler, Tobias; Votta-Velis, E. Gina; Liu, Guoquan; Place, Aaron T.; Schwartz, David E.; Beck-Schimmer, Beatrice; Minshall, Richard D.; Borgeat, Alain

    2012-01-01

    Background Retrospective analysis of patients undergoing cancer surgery suggests the use of regional anesthesia may reduce cancer recurrence and improve survival. Amide-linked local anesthetics have anti-inflammatory properties, although the mechanism of action in this regard is unclear. As inflammatory processes involving Src tyrosine protein kinase and intercellular adhesion molecule-1 are important in tumor growth and metastasis, we hypothesized that amide-linked local anesthetics may inhibit inflammatory Src-signaling involved in migration of adenocarcinoma cells. Methods NCI-H838 lung cancer cells were incubated with Tumor Necrosis Factor-α in absence/presence of ropivacaine, lidocaine, or chloroprocaine (1nM-100μM). Cell migration and total cell lysate Src-activation and Intercellular Adhesion Molecule-1 phosphorylation were assessed. The role of voltage-gated sodium-channels in the mechanism of local anesthetic effects was also evaluated. Results Ropivacaine treatment (100μM) of H838 cells for 20 minutes decreased basal Src activity by 62% (p=0.003), and both ropivacaine and lidocaine co-administered with Tumor Necrosis Factor-α statistically significantly decreased Src-activation and Intercellular Adhesion Molecule-1 phosphorylation, whereas chloroprocaine had no such effect. Migration of these cells at 4 hours was inhibited by 26% (p=0.005) in presence of 1μM ropivacaine and 21% by 1μM lidocaine (p=0.004). These effects of ropivacaine and lidocaine were independent of voltage-gated sodium-channel inhibition. Conclusions This study indicates that amide-, but not ester-linked local anesthetics may provide beneficial anti-metastatic effects. The observed inhibition of NCI-H838 cell migration by lidocaine and ropivacaine was associated with the inhibition of Tumor Necrosis Factor-α-induced Src-activation and Intercellular Adhesion Molecule-1 phosphorylation, providing the first evidence of a molecular mechanism which appears to be independent of their

  14. PAIN REDUCING IN ICTERIC NEEWBORNS WHILE VENIPUNCTURING: COMPARISON OF LOCAL ANESTHETIC CREAM WITH ORALLY GLUCOSE

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    M. Noori Shadkam M.H. Lotfi

    2008-04-01

    Full Text Available A number of studies has shown that orally administered sweet-tasting solutions reduce signs of pain during painful procedures. The local anesthetic cream EMLA has recently been shown to be safe for use in neonates. The present study aimed to compare the pain-reducing effect of EMLA cream with that of orally administered glucose during venipuncturing in newborns in Yazd city. A randomized, controlled, double-blind Clinical trial was done on the 220 newborns undergoing venipuncture for clinical purposes. One hundred- six of the newborns received EMLA on the skin and orally administered placebo (sterile water and 114 received orally glucose 30% and placebo (Vit A+D on the skin. Symptoms associated with pain while venipuncturing measured by Neonatal/ Infant pain scale (NIPS and crying time were compared between two groups. There were no differences in background variables between the 2 groups. The results showed that the NIPS scores were significantly lower in the glucose group (Median: 2 compared with the EMLA group (Median: 3 (P=.000. The duration of crying in the first 2 minutes was significantly lower in the glucose group (Median: 2sec than in EMLA group (Median: 9sec (P<.01. 12.3% and 29.2% of neonates in glucose and EMLA groups had NIPS above 3 respectively where the observed difference was found to be statistically significant (P<.05. Our study showed that compared with EMLA cream, orally administration glucose can be more effective, tolerable and convenient in reducing of pain resulting from venipuncturing in neonatal period.

  15. Survey of responsible handling of local anesthetic in Indian dental operatory

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    Thavarajah Rooban

    2013-01-01

    Full Text Available Background: Dental operatory requires handling of numerous toxic fluids such as denture acrylic monomer, alcohol and formalin for effective oral care delivery. The efficacy and responsible handling of such fluids has not been analyzed among Indian dentists and this study aims to address this lacunae. Materials and Methods: Closed ended questionnaire was distributed through email to Indian dentists in July 2012. After inclusion/exclusion criteria, 1484 practitioners constituted the study group with a response rate of 52%. Statistics: SPSS ® Version 17.0 (SPSS-IBM Inc., IL, USA was used to carry out statistical analysis. Descriptive statistics were presented. Chi square test was used to identify the association between the parameters; P ≤ 0.05 was considered as statistically significant. Results: Males (80.8%, undergraduates (78%, exclusive practitioners (81.2%, urban practitioners (68.5% were the predominant respondents. Predominant of the respondents (97% used local anesthetic (LA from bottles. Eight percent have encountered instances of injecting formalin instead of LA in their settings. Safe disposal rules and regulations ( P ≤ 0.05, opinion on injecting the other fluids instead of LA as a severe negligent act ( P ≤ 0.05 were statistically significant between age groups. Educational status did not appear to influence the outcome. Only a third of the respondents were aware of the rules and regulations for safe disposal of empty LA bottles while 49.1% were not aware of them and willing to learn. Discussion: The lacunae in responsible handling of toxic fluids need to be addressed to prevent inadvertent and negligence suits against dentists, highlighting the need through continuing dental education programmes.

  16. Local Anesthetics in the Gas-Phase the Rotational Spectrum of Butamben and Isobutamben

    Science.gov (United States)

    Vallejo-López, Montserrat; Ecija, Patricia; Caminati, Walther; Grabow, Jens-Uwe; Lesarri, Alberto; Cocinero, Emilio J.

    2016-06-01

    Benzocaine (BZ), butamben (BTN) and isobutamben (BTI) are local anesthetics characterized by a hydrophilic head and a lipophilic aliphatic tail linked by an aminobenzoate group. Previous rotational work on BZ (H2N-C6H4-COO-Et) showed that its ethyl aliphatic tail may adopt either in-plane (trans) or out of plane (gauche) conformations, with a low interconversion barrier below 50 cm-1. Here we extend the rotational study to BTN and BTI, isolated in a supersonic jet expansion and vaporized either by heating or UV ps-laser ablation methods. Both molecules share a 14 heavy-atoms skeleton, differing in their butyl (-(CH2)3-CH3) or isobutyl (-CH2-CH(CH3)2) four-carbon tail. We detected a single conformer for BTN and two conformers for BTI. The two molecules do not adopt an all-trans carbon skeleton. Conversely, the β-ethyl carbon in BTN is gauche. For BTI the β-carbon may be either trans or gauche. The microwave spectrum covered the cm- (BTN, BTI, 6-18 GHz) and mm-wave (BTW, 50-75 GHz) frequency ranges.In all the cases, rotational and centrifugal distortion constants as well as the diagonal elements of the 14N nuclear quadrupole coupling tensor were accurate determined and compared to the theoretical results (ab initio and DFT). No transitions belonging to configurations predicted as higher minima of the PES were found, pointing out that conformational interconversions may take place in the jet. A. Lesarri, S. T. Shipman, G. G. Brown, L. Alvarez-Valtierra, R. D. Suenram, B. H. Pate, Int. Symp. Mol. Spectrosc., 2008, Comm. RH07. E. Aguado, A. Longarte, E. Alejandro, J. A. Fernández, F. Castaño, J. Phys. Chem. A, 2006, 110, 6010.

  17. Transdermal diclofenac patch vs eutectic mixture of local anesthetics for venous cannulation pain.

    Science.gov (United States)

    Agarwal, Anil; Gautam, Sujeet; Gupta, Devendra; Singh, Uttam

    2007-03-01

    To compare the efficacy and side effects of transdermal diclofenac patch with eutectic mixture of local anesthetic (EMLA) cream in attenuating venous cannulation pain. Adult ASA I or II patients undergoing elective surgery were randomly divided into three groups of 150 each. Group 1 (Control) patients received a placebo patch; Group 2 (EMLA) patients received EMLA cream; Group 3 (Diclofenac) patients received a transdermal diclofenac patch. The patches were applied at the proposed venous cannulation site 60 min prior to cannulation and pain resulting from an 18G cannula was assessed on an ten-point visual analogue scale (VAS). The cannulation site was observed for blanching, erythema, induration and edema for up to 24 hr. The incidence of venous cannulation pain was 100% in the control group, as compared to 37% and 48% of patients who experienced pain in the EMLA (P = 0.001) and diclofenac (P = 0.001) groups, respectively. The severity of venous cannulation pain [median (VAS) with interquartile ranges] was also higher in the control group: 6 (3) as compared to VAS sores of 0 (1) and 0 (2) in the EMLA (P = 0.001) and diclofenac (P = 0.001) groups. Blanching occurred with greater frequency in the EMLA group compared with the diclofenac (P = 0.001 at six hours) and placebo groups (P = 0.001 at six hours). Erythema, induration and edema were reduced in the diclofenac group compared with the EMLA (P = 0.001 for all comparisons) and placebo groups (P = 0.04 for edema at six hours and P = 0.001 for other comparisons). Transdermal diclofenac patch and EMLA are equally effective in reducing venous cannulation pain, but signs of erythema, induration and edema are less frequently observed with the transdermal diclofenac patch.

  18. Minimum effective local anesthetic dose of intrathecal hyperbaric ropivacaine and bupivacaine for cesarean section

    Institute of Scientific and Technical Information of China (English)

    GENG Zhi-yu; WANG Dong-xin; WU Xin-min

    2011-01-01

    Background Intrathecal anesthesia is commonly used for cesarean section. Bupivacaine and ropivacaine have all been used as intrathecal drugs. The minimum effective local anesthetic dose (MLAD) of intrathecal ropivacaine for nonobstetric patients has been reported. However, few data are available on the MLAD of hyperbaric ropivacine for obstetric patients and the relative potency to bupivacaine has not been fully determined. In this study, we sought to determine the MLAD of intrathecal ropivacaine and bupivacaine for elective cesarean section and to define their relative potency ratio.Methods We enrolled forty parturients undergoing elective cesarean section under combined spinal-epidural anesthesia and randomized them to one of two groups to receive intrathecal 0.5% hyperbaric ropivacaine or bupivacaine.The initial dose was 10 mg, and was increased in increments of 1 mg, using the technique of up-down sequential allocation. Efficacy was accepted if adequate sensory dermatomal anesthesia to pin prick to T7 or higher was attained within 20 minutes after intrathecal injection, and required no supplementary epidural injection for procedure until at least 50 minutes after the intrathecal injection.Results The intrathecal MLAD was 9.45 mg (95%confidence interval (CI), 8.45-10.56 mg) for ropivacaine and 7.53 mg (95%CI, 7.00-8.10 mg) for bupivacaine. The relative potency ratio was 0.80 (95% Cl, 0.74-0.85) for ropivacaine/bupivacaine when given intrathecally in cesarean section.Conclusion Ropivacaine is 20% less potent than bupivacaine during intrathecal anesthesia for cesarean delivery.

  19. Reduction of Environmental Temperature Mitigates Local Anesthetic Cytotoxicity in Bovine Articular Chondrocytes

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    Tarik Onur, Alexis Dang

    2014-09-01

    Full Text Available The purpose of this study was to assess whether reducing environmental temperature will lead to increased chondrocyte viability following injury from a single-dose of local anesthetic treatment. Bovine articular chondrocytes from weight bearing portions of femoral condyles were harvested and cultured. 96-well plates were seeded with 15,000 chondrocytes per well. Chondrocytes were treated with one of the following conditions: ITS Media, 1x PBS, 2% lidocaine, 0.5% bupivacaine, or 0.5% ropivacaine. Each plate was then incubated at 37°C, 23°C, or 4°C for one hour and then returned to media at 37°C. Chondrocyte viability was assessed 24 hours after treatment. Chondrocyte viability is presented as a ratio of the fluorescence of the treatment group over the average of the media group at that temperature (ratio ± SEM. At 37°C, lidocaine (0.35 ± 0.04 and bupivacaine (0.30 ± 0.05 treated chondrocytes show low cell viability when compared to the media (1.00 ± 0.03 control group (p < 0.001. Lidocaine treated chondrocytes were significantly more viable at 23°C (0.84 ± 0.08 and 4°C (0.86±0.085 than at 37°C (p < 0.001. Bupivacaine treated chondrocytes were significantly more viable at 4°C (0.660 ± 0.073 than at 37°C or 23°C (0.330 ± 0.069 (p < 0.001 and p = 0.002 respectively. Reducing the temperature from 37°C to 23°C during treatment with lidocaine increases chondrocyte viability following injury. Chondrocytes treated with bupivacaine can be rescued by reducing the temperature to 4°C.

  20. Paired assessment of volatile anesthetic concentrations with synaptic actions recorded in vitro.

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    Stuart J McDougall

    Full Text Available The volatile anesthetic isoflurane poses a number of experimental challenges in the laboratory. Due to its rapid evaporation, the open conditions of most in vitro electrophysiological recording systems make the determination of actual isoflurane concentrations a challenge. Since the absolute anesthetic concentration in solution is directly related to efficacy, concentration measurements are important to allow comparisons between laboratory and clinical studies. In this study we quantify the sources of isoflurane loss during experimentation and describe a method for the measurement of isoflurane concentrations using gas chromatography and mass spectrometry simultaneous to in vitro electrophysiological measurements. Serial samples of perfused bath solution allowed correlation of isoflurane concentrations with ongoing biological effects. Saturated physiological solutions contained 13.4 +/- 0.2 mM isoflurane and were diluted to desired "nominal" concentrations for experiments. The perfusion system established stable isoflurane concentrations within the bath by 2 minutes. However, bath isoflurane concentrations varied substantially and unpredictably between experiments. The magnitudes of such discrepancies in isoflurane concentrations spanned clinically important levels. Our studies suggest that, despite countermeasures, solution handling significantly impacted the isoflurane content in the tissue bath. The magnitude of these discrepancies appears to necessitate systematic direct measurement of bath isoflurane concentrations during most in vitro conditions.

  1. Lipídeos nas intoxicações por anestésicos locais Lipids in local anesthetic toxicity

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    Artur Udelsmann

    2012-09-01

    Full Text Available INTRODUÇÃO: Com o advento dos anestésicos locais de longa duração, a anestesia locorregional ganhou grande impulso sendo cada vez mais utilizada. Novas técnicas de bloqueios foram descritas e a técnica é frequentemente associada à anestesia geral com o objetivo de proporcionar analgesia pós-operatória. A contra-partida é a necessidade da utilização de grandes doses com risco de acidentes por injeção intravascular inadvertida; trata-se de complicação grave sem tratamento específico até há alguns anos. Em 1998 foi proposta a utilização de emulsões lipídicas em animais e a partir de 2006 vários trabalhos demonstraram o interesse dessas soluções nos casos de intoxicações por anestésicos locais com diminuição da morbi-mortalidade. O objetivo desta revisão foi fazer um levantamento da metodologia, revisando os mecanismos, interesses, limites e as condutas preconizadas atualmente. MÉTODO: Foram revistas algumas referências históricas sobre anestésicos locais, artigos publicados nos últimos 30 anos em revistas indexadas no Medline e em dois livros-texto. Foram selecionados os artigos que tratavam da intoxicação por anestésicos locais, da terapia com emulsões lipídicas, os de revisão sobre o assunto e as condutas adotadas em diversos serviços e países, sendo realizada uma síntese. CONCLUSÕES: A eficiência e interesse da terapia com emulsões lipídicas nas intoxicações por anestésicos locais não é mais a demonstrar; várias sociedades da especialidade já publicaram suas diretrizes e aconselham que se disponha desses produtos nos locais onde se pratica a anestesia locorregional.INTRODUCTION: With the advent of long-lasting local anesthetics, local and regional anesthesia gained considerable impetus and the use of these techniques has become increasingly widespread. New block techniques have been described and regional anesthesia is frequently associated with general anesthesia to provide

  2. Local Anesthetic Activity from Extracts, Fractions and Pure Compounds from the Roots of Ottonia anisum Spreng. (Piperaceae).

    Science.gov (United States)

    López, Kelvin S E; Marques, André M; Moreira, Davyson DE L; Velozo, Leosvaldo S; Sudo, Roberto T; Zapata-Sudo, Gisele; Guimarães, Elsie F; Kaplan, Maria Auxiliadora C

    2016-01-01

    Piperaceae species can be found worldwide in tropical and subtropical areas and many of them have been used for centuries in traditional folk medicine and in culinary. In Brazil, species of Piperaceae are commonly used in some communities as local anesthetic and analgesic. Countrified communities have known some species of the genus Ottonia as "anestesia" and it is a common habit of chewing leaves and roots of Ottonia species to relief toothache. The purpose of this study is to report our findings on new molecules entities obtained from the roots of Ottonia anisum Spreng, in which local anesthetic activity (sensory blockage) is demonstrated for the first time in vivo guinea pig model. Phytochemical investigation led to the isolation of three amides (pipercallosidine, piperine and valeramide) and in an enriched mixture of seven amides (valeramide, 4,5-dihydropiperlonguminine, N-isobutil-6-piperonil-2-hexenamide, piperovatine, dihydropipercallosidine, pipercallosidine and pipercallpsine). Our findings demonstrated the anesthetic potential for the methanolic extract from roots, its n-hexane partition and amides from O. anisum and it is in agreement with ethnobotanical survey.

  3. Local Anesthetic Activity from Extracts, Fractions and Pure Compounds from the Roots of Ottonia anisum Spreng. (Piperaceae

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    KELVIN S.E. LÓPEZ

    Full Text Available ABSTRACT Piperaceae species can be found worldwide in tropical and subtropical areas and many of them have been used for centuries in traditional folk medicine and in culinary. In Brazil, species of Piperaceae are commonly used in some communities as local anesthetic and analgesic. Countrified communities have known some species of the genus Ottonia as "anestesia" and it is a common habit of chewing leaves and roots of Ottonia species to relief toothache. The purpose of this study is to report our findings on new molecules entities obtained from the roots of Ottonia anisum Spreng, in which local anesthetic activity (sensory blockage is demonstrated for the first time in vivo guinea pig model. Phytochemical investigation led to the isolation of three amides (pipercallosidine, piperine and valeramide and in an enriched mixture of seven amides (valeramide, 4,5-dihydropiperlonguminine, N-isobutil-6-piperonil-2-hexenamide, piperovatine, dihydropipercallosidine, pipercallosidine and pipercallpsine. Our findings demonstrated the anesthetic potential for the methanolic extract from roots, its n-hexane partition and amides from O. anisum and it is in agreement with ethnobotanical survey.

  4. Cytotoxicity of solid lipid nanoparticles and nanostructured lipid carriers containing the local anesthetic dibucaine designed for topical application

    Science.gov (United States)

    Barbosa, R. M.; da Silva, C. M. G.; Bella, T. S.; de Araújo, D. R.; Marcato, P. D.; Durán, N.; de Paula, E.

    2013-04-01

    Dibucaine (DBC) is powerful long-lasting local anesthetic, but it is also considered fairly toxic to the CNS. Solid lipid nanoparticles (SLN) and nanostructured lipid carriers (NLC) have attracted attention as carriers for drug delivery. The aim of this study was to develop and to evaluate the cytotoxic activity of DBC-loaded SLN and NLC against 3T3 fibroblast and HaCat keratinocyte cells. The SLN and NLC had myristyl myristate and Liponate®GC as their lipid matrices, respectively, plus a surfactant. SLN and NLC were characterized in terms in their diameter, size distribution, surface charge and DBC encapsulation efficiency. The particle size of SLN and NLC were around 234.33 and 166.62 nm, respectively. The polydispersity index was kept below 0.2 for both nanomaterials. Negative surface charges were observed for both nanoparticles, which decreased in the presence of the anesthetic. Encapsulation efficiency reached 76% and 90%, respectively, in SLN and NLC. DBC alone was found to be toxic to 3T3 and HaCat cells in culture. However, NLC and SLN loaded DBC decreased its intrinsic cytotoxic effect against 3T3 and HaCat cells. In conclusion, encapsulation of DBC in SLN and NLC decreased the in vitro toxicity of the local anesthetic, indicating the potential of these nanocarriers for clinical applications.

  5. Effects of single injection of local anesthetic agents on intervertebral disc degeneration: ex vivo and long-term in vivo experimental study.

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    Koji Iwasaki

    Full Text Available Analgesic discography (discoblock can be used to diagnose or treat discogenic low back pain by injecting a small amount of local anesthetics. However, recent in vitro studies have revealed cytotoxic effects of local anesthetics on intervertebral disc (IVD cells. Here we aimed to investigate the deteriorative effects of lidocaine and bupivacaine on rabbit IVDs using an organotypic culture model and an in vivo long-term follow-up model.For the organotypic culture model, rabbit IVDs were harvested and cultured for 3 or 7 days after intradiscal injection of local anesthetics (1% lidocaine or 0.5% bupivacaine. Nucleus pulposus (NP cell death was measured using confocal microscopy. Histological and TUNEL assays were performed. For in vivo study, each local anesthetic was injected into rabbit lumbar IVDs under a fluoroscope. Six or 12 months after the injection, each IVD was prepared for magnetic resonance imaging (MRI and histological analysis.In the organotypic culture model, both anesthetic agents induced time-dependent NP cell death; when compared with injected saline solution, significant effects were detected within 7 days. Compared with the saline group, TUNEL-positive NP cells were significantly increased in the bupivacaine group. In the in vivo study, MRI analysis did not show any significant difference. Histological analysis revealed that IVD degeneration occurred to a significantly level in the saline- and local anesthetics-injected groups compared with the untreated control or puncture-only groups. However, there was no significant difference between the saline and anesthetic agents groups.In the in vivo model using healthy IVDs, there was no strong evidence to suggest that discoblock with local anesthetics has the potential of inducing IVD degeneration other than the initial mechanical damage of the pressurized injection. Further studies should be performed to investigate the deteriorative effects of the local injection of analgesic agents

  6. Clinical parameters of the local anesthetic effects of bupivacaine applied with and without a vasoconstrictor in oral implantology

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    Duka Miloš

    2007-01-01

    Full Text Available Background/Aim. Bupivacaine (Marcaine®, homologue of mepivacaine, chemically related to lidocaine, is used as a local anesthetic for local infiltration, peripheral nerve block, retrobulbar block, symphathetic block, and caudal and epidural anesthesia. The aim of this investigation was to determine and to compare clinical parameters of the local anesthetic effects of bupivacaine applied with and without a vasoconstrictor. Methods. This investigation included a total of 30 randomly selected patients, who ranged in age from 30−60 years, with partial or total anodontia in the molar region of the mandible. These patients with total or partial edentulous molar part of the mandible, scheduled for dental implantation placement, were asked to participate in the study. In the first phase of the investigation, the patients were subjected to local anesthesia with 3.5 cm3 of 0.5% bupivacaine with a vasoconstrictor (adrenalin, 1: 200 000 in the right side of the mandible. After administering local anesthesia, the placement of blade, cylindrical, transdental (B.C.T. implants was performed. In the second stage of the investigation, in 7−10 days period after the first oral surgery, the patients were subjected to local anesthesia with 3.5 cm3 of 0.5% bupivacaine, but without a vasoconstrictor, in the left side of the mandible. After administering local anesthesia, the placement of B.C.T. implants was performed. During the performance of both oral surgery procedures, the following clinical parameters of the local anesthetic effects were monitored: latent period, duration and the potency of anesthesia, and the evaluation of the postoperative pain level. Results. The latent period under local anesthesia with 3.5 cm3 of 0.5% bupivacaine and vasoconstrictor was statistically significantly shorter than without vasoconstrictor. The duration of local anesthesia was longer without vasoconstrictor. There was no difference in the potency of anesthesia with or without a

  7. Inhibition of cardiac Kv1.5 potassium current by the anesthetic midazolam: mode of action

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    Vonderlin N

    2014-11-01

    Full Text Available Nadine Vonderlin,1 Fathima Fischer,1 Edgar Zitron,1,2 Claudia Seyler,1 Daniel Scherer,1 Dierk Thomas,1,2 Hugo A Katus,1,2 Eberhard P Scholz1 1Department of Internal Medicine III, University Hospital Heidelberg, Heidelberg, Germany; 2German Centre for Cardiovascular Research (DZHK, Partner Site Heidelberg/Mannheim, Heidelberg, GermanyAbstract: Midazolam is a short-acting benzodiazepine that is widely used in anesthesia. Despite its widespread clinical use, detailed information about cardiac side effects of midazolam is largely lacking. Using the double-electrode voltage clamp technique, we studied pharmacological effects of midazolam on heterologously expressed Kv1.5 channels underlying atrial repolarizing current IKur. Midazolam dose-dependently inhibited Kv1.5 current, yielding an IC50 of 17 µM in an HEK cell line and an IC50 of 104 µM in Xenopus oocytes. We further showed that midazolam did not affect the half-maximal activation voltage of Kv1.5 channels. However, a small negative shift of the inactivation curve could be observed. Midazolam acted as a typical open-channel inhibitor with rapid onset of block and without frequency dependence of block. Taken together, midazolam is an open channel inhibitor of cardiac Kv1.5 channels. These data add to the current understanding of the pharmacological profile of midazolam.Keywords: anesthetics, potassium channels, pharmacology

  8. Inhibition of human two-pore domain K+ channel TREK1 by local anesthetic lidocaine: negative cooperativity and half-of-sites saturation kinetics.

    Science.gov (United States)

    Nayak, Tapan K; Harinath, S; Nama, S; Somasundaram, K; Sikdar, S K

    2009-10-01

    TWIK-related K+ channel TREK1, a background leak K+ channel, has been strongly implicated as the target of several general and local anesthetics. Here, using the whole-cell and single-channel patch-clamp technique, we investigated the effect of lidocaine, a local anesthetic, on the human (h)TREK1 channel heterologously expressed in human embryonic kidney 293 cells by an adenoviral-mediated expression system. Lidocaine, at clinical concentrations, produced reversible, concentration-dependent inhibition of hTREK1 current, with IC(50) value of 180 muM, by reducing the single-channel open probability and stabilizing the closed state. We have identified a strategically placed unique aromatic couplet (Tyr352 and Phe355) in the vicinity of the protein kinase A phosphorylation site, Ser348, in the C-terminal domain (CTD) of hTREK1, that is critical for the action of lidocaine. Furthermore, the phosphorylation state of Ser348 was found to have a regulatory role in lidocaine-mediated inhibition of hTREK1. It is interesting that we observed strong intersubunit negative cooperativity (Hill coefficient = 0.49) and half-of-sites saturation binding stoichiometry (half-reaction order) for the binding of lidocaine to hTREK1. Studies with the heterodimer of wild-type (wt)-hTREK1 and Delta119 C-terminal deletion mutant (hTREK1(wt)-Delta119) revealed that single CTD of hTREK1 was capable of mediating partial inhibition by lidocaine, but complete inhibition necessitates the cooperative interaction between both the CTDs upon binding of lidocaine. Based on our observations, we propose a model that explains the unique kinetics and provides a plausible paradigm for the inhibitory action of lidocaine on hTREK1.

  9. Cartridge syringe vs computer controlled local anesthetic delivery system: Pain related behaviour over two sequential visits - a randomized controlled trial.

    Science.gov (United States)

    Thoppe-Dhamodhara, Yogesh-Kumar; Asokan, Sharath; John, Baby-John; Pollachi-Ramakrishnan, GeethaPriya; Ramachandran, Punithavathy; Vilvanathan, Praburajan

    2015-10-01

    Local anesthetic injection is one of the most anxiety provoking procedure in dentistry. Knowledge about change in pain related behaviour during consecutive visits helps in and scheduling of treatment procedures and management of children in dental clinic. To compare the pain perception, behavioural response and the associated change in physiological parameters while receiving local anesthesia injection with cartridge syringe and computer controlled local anesthetic delivery system (CCLAD) over two consecutive visits. In this randomized controlled cross over trial, 120 children aged 7 - 11 years were randomly divided into group A: receiving injections with CCLAD during first visit; group B: receiving injections with cartridge syringe during first visit. The physiological parameters (heart rate and blood pressure) were recorded before and during injection procedure. Objective evaluation of disruptive behaviour and subjective evaluation of pain perceived were done using Face Legs Activity Cry Consolability (FLACC) scale and modified facial image scale (FIS) respectively. No statistical difference in pain response (p= 0.164) and disruptive behaviour (p = 0.120) between cartridge syringe and CCLAD injections were seen during the first visit although the latter showed lesser scores. However, during the second visit there were significant increase in pain response (p = 0.004) and disruptive behaviour (p = 0.006) in cartridge syringe group with an associated increase in heart rate. Injections with CCLAD produced lesser pain ratings and disruptive behaviour than cartridge syringe in children irrespective of order of visit. Behaviour, cartridge syringe, CCLAD, local anesthesia.

  10. Effect of local anesthetics on perioperative oxidative stress injury and nerve conduction function in diabetic or non-diabetic patients

    Institute of Scientific and Technical Information of China (English)

    Dong-Yang Zhu; Ping Li

    2016-01-01

    Objective:To study the effect of local anesthetics on perioperative oxidative stress injury and nerve conduction function in diabetic or non-diabetic patients.Methods:A total of 100 c diabetic patients and 100 non-diabetic patients who received selective surgery under intraspinal block anesthesia were selected as the research subjects, diabetic patients were selected as observation group, non-diabetic patients were selected as control group, serum and urine were collected respectively before and after operation, and reactive oxygen species (ROS), malondialdehyde (MDA), superoxide dismutase (SOD), 8-hydroxy-2 deoxyguanosine (8-OHdG) levels were determined; electromyography was carried out, and the motor nerve conduction velocity of median nerve and common peroneal nerve as well as sensory nerve conduction velocity of median nerve and superficial peroneal nerve were determined.Results:One day before operation and 1 day after operation, serum ROS and MDA levels and urine 8-OHdG levels of observation group were significantly higher than those of control group, and serum SOD levels were significantly lower than those of control group; ROS, MDA, SOD and 8-OHdG levels of observation group before and after operation changed more significantly than those of control group. 1 week after operation, MNCV of median nerve and common peroneal nerve as well as SNCV of median nerve and superficial peroneal nerve of observation group were significantly lower than those before operation, and MNCV of median nerve and common peroneal nerve as well as SNCV of median nerve and superficial peroneal nerve of control group were not significantly different from those before operation.Conclusions: Local anesthetics can cause peripheral nerve conduction function impairment in diabetic patients, and the possible molecular mechanism is that local anesthetics activate perioperative oxidative stress more significantly in diabetic patients than in non-diabetic patients.

  11. Efficacy of Benzocaine 20% Topical Anesthetic Compared to Placebo Prior to Administration of Local Anesthesia in the Oral Cavity: A Randomized Controlled Trial.

    Science.gov (United States)

    de Freiras, Guilherme Camponogara; Pozzobon, Roselaine Terezinha; Blaya, Diego Segatto; Moreira, Carlos Heitor

    2015-01-01

    The aim of the present study was to compare the effects of a topical anesthetic to a placebo on pain perception during administration of local anesthesia in 2 regions of the oral cavity. A split-mouth, double-blind, randomized clinical trial design was used. Thirty-eight subjects, ages 18-50 years, American Society of Anesthesiologists I and II, received 4 anesthetic injections each in regions corresponding to the posterior superior alveolar nerve (PSA) and greater palatine nerve (GPN), totaling 152 sites analyzed. The side of the mouth where the topical anesthetic (benzocaine 20%) or the placebo was to be applied was chosen by a flip of a coin. The needle used was 27G, and the anesthetic used for administration of local anesthesia was 2% lidocaine with 1:100,000 epinephrine. After receiving the administration of local anesthesia, each patient reported pain perception on a visual analog scale (VAS) of 100-mm length. The results showed that the topical anesthetic and the placebo had similar effects: there was no statistically significant VAS difference between the PSA and the GPN pain ratings. A higher value on the VAS for the anesthesia of the GPN, relative to the PSA, was observed for both groups. Regarding gender, male patients had higher values on the VAS compared with female patients, but these differences were not meaningful. The topical anesthetic and the placebo had similar effects on pain perception for injection of local anesthesia for the PSA and GPN.

  12. Approaches to local climate action in Colorado

    Science.gov (United States)

    Huang, Y. D.

    2011-12-01

    Though climate change is a global problem, the impacts are felt on the local scale; it follows that the solutions must come at the local level. Fortunately, many cities and municipalities are implementing climate mitigation (or climate action) policies and programs. However, they face many procedural and institutional barriers to their efforts, such of lack of expertise or data, limited human and financial resources, and lack of community engagement (Krause 2011). To address the first obstacle, thirteen in-depth case studies were done of successful model practices ("best practices") of climate action programs carried out by various cities, counties, and organizations in Colorado, and one outside Colorado, and developed into "how-to guides" for other municipalities to use. Research was conducted by reading documents (e.g. annual reports, community guides, city websites), email correspondence with program managers and city officials, and via phone interviews. The information gathered was then compiled into a series of reports containing a narrative description of the initiative; an overview of the plan elements (target audience and goals); implementation strategies and any indicators of success to date (e.g. GHG emissions reductions, cost savings); and the adoption or approval process, as well as community engagement efforts and marketing or messaging strategies. The types of programs covered were energy action plans, energy efficiency programs, renewable energy programs, and transportation and land use programs. Between the thirteen case studies, there was a range of approaches to implementing local climate action programs, examined along two dimensions: focus on climate change (whether it was direct/explicit or indirect/implicit) and extent of government authority. This benchmarking exercise affirmed the conventional wisdom propounded by Pitt (2010), that peer pressure (that is, the presence of neighboring jurisdictions with climate initiatives), the level of

  13. Local anesthetic wound infiltration for pain management after periacetabular osteotomy. A randomized, placebo-controlled, double-blind clinical trial with 53 patients

    DEFF Research Database (Denmark)

    Bech, Rune D; Ovesen, Ole; Lindholm, Peter;

    2014-01-01

    BACKGROUND AND PURPOSE: To our knowledge, there is no evidence to support the use of local infiltration analgesia (LIA) for postoperative pain relief after periacetabular osteotomy (PAO). We investigated the effect of wound infiltration with a long-acting local anesthetic (ropivacaine) for postop......BACKGROUND AND PURPOSE: To our knowledge, there is no evidence to support the use of local infiltration analgesia (LIA) for postoperative pain relief after periacetabular osteotomy (PAO). We investigated the effect of wound infiltration with a long-acting local anesthetic (ropivacaine...

  14. Effect of tramadol as an adjuvant to local anesthetics for brachial plexus block: A systematic review and meta-analysis.

    Science.gov (United States)

    Shin, Hye Won; Ju, Bum Jun; Jang, Yoo Kyung; You, Hae Seun; Kang, Hyun; Park, Ji Yong

    2017-01-01

    Tramadol, a 4-phenyl-piperidine analog of codeine, has a unique action in that it has a central opioidergic, noradrenergic, serotonergic analgesic, and peripheral local anesthetic (LA) effect. Many studies have reported contradictory findings regarding the peripheral analgesic effect of tramadol as an adjuvant to LA in brachial plexus block (BPB). This meta-analysis aimed to evaluate the effects of tramadol as an adjunct to LA in BPB during shoulder or upper extremity surgery. We searched the PubMed, EMBASE, Cochrane, KoreaMed databases, and Google Scholar for eligible randomized controlled trials (RCTs) that compared BPB with LA alone and BPB with LA and tramadol. Primary outcomes were the effects of tramadol as an adjuvant on duration of sensory block, motor block, and analgesia. Secondary outcomes were the effects of tramadol as an adjuvant on time to onset of sensory block and motor block and on adverse effects. We performed the meta-analysis using Review Manager 5.3 software. We identified 16 RCTs with 751 patients. BPB with tramadol prolonged the duration of sensory block (mean difference [MD], -61.5 min; 95% CI, -95.5 to -27.6; P = 0.0004), motor block (MD, -65.6 min; 95% CI, -101.5 to -29.7; P = 0.0003), and analgesia (MD, -125.5 min; 95% CI, -175.8 to -75.3; P tramadol. Tramadol also shortened the time to onset of sensory block (MD, 2.1 min; 95% CI, 1.1 to 3.1; P tramadol 100 mg (P tramadol 50 mg. The quality of evidence was high for duration of analgesia according to the GRADE system. Adverse effects were comparable between the studies. In upper extremity surgery performed under BPB, use of tramadol 100 mg as an adjuvant to LA appears to prolong the duration of sensory block, motor block, and analgesia, and shorten the time to onset of sensory and motor blocks without altering adverse effects.

  15. Efficacy of articaine and lidocaine in a primary intraligamentary injection administered with a computer-controlled local anesthetic delivery system.

    Science.gov (United States)

    Berlin, Jeffrey; Nusstein, John; Reader, Al; Beck, Mike; Weaver, Joel

    2005-03-01

    The purpose of this prospective, randomized, double-blind study was to compare the anesthetic efficacy of the intraligamentary injection of 4% articaine with 1:100,000 epinephrine and of 2% lidocaine with 1:100,000 epinephrine, administered with computer-controlled local anesthetic delivery system, in mandibular posterior teeth. Using a crossover design, intraligamentary injections of 1.4 mL of 4% articaine with 1:100,000 epinephrine and of 1.4 mL of 2% lidocaine with 1:100,000 epinephrine were randomly administered with a computer-controlled local anesthetic delivery system, in a double-blind manner on the mesial and distal aspects of a mandibular first molar, at 2 separate appointments to 51 subjects. A pulp tester was used to test for anesthesia, in 2-minute cycles for 60 minutes, of the mandibular first and second molars and second premolar. Anesthesia was considered successful when 2 consecutive 80 readings (highest output) were obtained within 20 minutes. Successful pulpal anesthesia was obtained 86% of the time for the first molar using the articaine solution and 74% of the time using the lidocaine solution. There were no significant differences (P > .05) between the articaine and lidocaine solutions. The mean onset times of pulpal anesthesia for the first molar were 1.3 minutes with articaine solution and 2.2 minutes with lidocaine solution. Duration of pulpal anesthesia for the first molar was 34 minutes for the articaine solution and 31 minutes for the lidocaine solution. The efficacy of 4% articaine with 1:100,000 epinephrine was similar to the efficacy of 2% lidocaine with 1:100,000 epinephrine for intraligamentary injections.

  16. Crystal structure of isoflurane bound to integrin LFA-1 supports a unified mechanism of volatile anesthetic action in the immune and central nervous systems

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Hongmin; Astrof, Nathan S.; Liu, Jin-Huan; Wang, Jia-huai; Shimaoka, Motomu; (Harvard-Med); (DFCI)

    2009-09-15

    Volatile anesthetics (VAs), such as isoflurane, induce a general anesthetic state by binding to specific targets (i.e., ion channels) in the central nervous system (CNS). Simultaneously, VAs modulate immune functions, possibly via direct interaction with alternative targets on leukocytes. One such target, the integrin lymphocyte function-associated antigen-1 (LFA-1), has been shown previously to be inhibited by isoflurane. A better understanding of the mechanism by which isoflurane alters protein function requires the detailed information about the drug-protein interaction at an atomic level. Here, we describe the crystal structure of the LFA-1 ligand-binding domain (I domain) in complex with isoflurane at 1.6 {angstrom}. We discovered that isoflurane binds to an allosteric cavity previously implicated as critical for the transition of LFA-1 from the low- to the high-affinity state. The isoflurane binding site in the I domain involves an array of amphiphilic interactions, thereby resembling a 'common anesthetic binding motif' previously predicted for authentic VA binding sites. These results suggest that the allosteric modulation of protein function by isoflurane, as demonstrated for the integrin LFA-1, might represent a unified mechanism shared by the interactions of volatile anesthetics with targets in the CNS. Crystal structure of isoflurane bound to integrin LFA-1 supports a unified mechanism of volatile anesthetic action in the immune and central nervous systems.

  17. Relief of Injection Pain During Delivery of Local Anesthesia by Computer-Controlled Anesthetic Delivery System for Periodontal Surgery: Randomized Clinical Controlled Trial.

    Science.gov (United States)

    Chang, Hyeyoon; Noh, Jiyoung; Lee, Jungwon; Kim, Sungtae; Koo, Ki-Tae; Kim, Tae-Il; Seol, Yang-Jo; Lee, Yong-Moo; Ku, Young; Rhyu, In-Chul

    2016-07-01

    Pain from local anesthetic injection makes patients anxious when visiting a dental clinic. This study aims to determine differences in pain according to types of local anesthetizing methods and to identify the possible contributing factors (e.g., dental anxiety, stress, and sex). Thirty-one patients who underwent open-flap debridement in maxillary premolar and molar areas during treatment for chronic periodontitis were evaluated for this study. A randomized, split-mouth, single-masked clinical trial was implemented. The dental anxiety scale (DAS) and perceived stress scale (PSS) were administered before surgery. Two lidocaine ampules for each patient were used for local infiltration anesthesia (supraperiosteal injection). Injection pain was measured immediately after local infiltration anesthesia using the visual analog pain scale (VAS) questionnaire. Results from the questionnaire were used to assess degree of pain patients feel when a conventional local anesthetic technique (CNV) is used compared with a computer-controlled anesthetic delivery system (CNR). DAS and PSS did not correlate to injection pain. VAS scores were lower for CNR than for CNV regardless of the order in which anesthetic procedures were applied. VAS score did not differ significantly with sex. Pearson coefficient for correlation between VAS scores for the two procedures was 0.80, also indicating a strong correlation. Within the limitations of the present study, relief from injection pain is observed using CNR.

  18. Image intensifier-guided injection of corticosteroid and local anesthetic agent for the treatment of recalcitrant plantar fasciitis.

    Science.gov (United States)

    Atkins, Kate L; Chin, Kuen Foo; Noorani, Ali M; Nairn, David S

    2010-08-01

    Plantar fasciitis is the most common cause of plantar heel pain. The condition is potentially self-limiting and can respond to conservative treatment, but patients may opt for surgery if the treatments fail. Surgical intervention is associated with potential complications. This study set out to explore the efficacy of the specific nonsurgical intervention offered to treatment-resistant cases in a local clinical setting. The technique involves image intensifier-guided injection of corticosteroid and local anesthetic agents under general anesthesia. Nineteen patients with recalcitrant plantar fasciitis of over 12 months' duration received injections. A simple follow-up questionnaire was given to patients after the procedure that focused on their subjective opinion of any change in their pain. They were also asked if the injection had solved their problems with heel pain. The improvements that the patients reported were found to be statistically significant (P = .012).

  19. 7 CFR 245.10 - Action by local educational agencies.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 4 2010-01-01 2010-01-01 false Action by local educational agencies. 245.10 Section... AND FREE MILK IN SCHOOLS § 245.10 Action by local educational agencies. (a) Each local educational... official or officials designated by the local educational agency to make eligibility determinations on...

  20. 局麻药骨骼肌毒性作用的研究与临床意义%The study and clinical significance of local anesthetic myotoxicity

    Institute of Scientific and Technical Information of China (English)

    马冬梅; 郑宏

    2009-01-01

    最新研究证实,局麻药(locae anesthetic,LA)可导致骨骼肌损伤,甚至引起肌肉坏死,临床上使用的LA均存在骨骼肌毒性,因此将其对骨骼肌的损害视为局麻药的潜在并发症,但在临床上相关病例却很少见.现将近来国外对LA骨骼肌毒性的研究进展综述如下.%A lot of studies revealed that the local anesthetic may cause the degeneration of striated muscle sarcoplasmic reticulum and myocyte edema, even necrosis. All clinically used local anesthetics are myotoxic, with a drug-specific and dose-dependent rate of myotoxicity. We have to see local anesthetic myotoxicity as a potential complication. The molecular mechanism of local anesthetic myotoxicity are still not completely revealed. This articale reviews the recent related myotoxicity studies as follows.

  1. Effects of tertiary amine local anesthetics on the assembly and disassembly of brain microtubules in vitro.

    Science.gov (United States)

    Genna, J M; Coffe, G; Pudles, J

    1980-09-01

    From kinetic and electron microscopy studies on the effects of procaine, tetracaine and dibucaine on the polymerization and depolymerization of the microtubules isolated from pig and rat brains the following results were obtained. 1. Procaine or tetracaine, at the concentration range of 0.5--20 mM and of 0.5--5 mM respectively, increases the rate of tubulin polymerization (24 degrees C or 37 degrees C) and of microtubule depolymerization (4 degrees C) as a linear function of the concentration of the anesthetics, while identical amounts of microtubules are formed. In the absence of microtubule-associated proteins the polymerization of tubulin is not induced by 10 mM procaine, furthermore, the critical concentration of microtubule proteins necessary for assembly into microtubules is not affected at this concentration level of the anesthetic. This suggests that procaine affects not the nucleation, but rather the elongation process. 2. Dibucaine, from 0.5 mM to 3 mM increases the lag time of the polymerization reaction, while from 0.5 mM to 2 mM it linearly decreases both tubulin polymerization (24 degrees C) and microtubule depolymerization (4 degrees C) rates. Dibucaine, up to mM concentration, does not affect the extent of tubulin polymerization; however, above this concentration it induces the formation of amorphous aggregates. 3. Procaine or tetracaine enhances the depolymerizing effect of calcium on microtubules. The half-maximal values for the depolymerizing effect of calcium were 0.96, 0.71 and 0.51 mM for the control, in the presence of 10 mM procaine and 5 mM tetracaine respectively.

  2. Screening of formulation variables for the preparation of poly(epsilon-caprolactone) nanocapsules containing the local anesthetic benzocaine.

    Science.gov (United States)

    Moraes, Carolina Morales; de Matos, Angélica Prado; Grillo, Renato; de Melo, Nathalie F S; de Paula, Eneida; Dias Filho, Newton Luiz; Rosa, André Henrique; Fraceto, Leonardo Fernandes

    2011-03-01

    In this work we describe the screening of four parameters in the preparation, by nanoprecipitation, of poly(epsilon-caprolactone) nanocapsules, used as a drug carrier system for the local anesthetic, benzocaine. A 2(4-1) factorial experimental design was used to study the influence of four different independent variables (polymer, oily phase, Span 60 and Tween 80) on nanocapsule characteristics (size, polydispersion index, zeta potential) and drug loading capability. Best results were obtained using an aqueous formulation comprising 100 mg of polymer, 200 mg of oily phase, 40 mg of Span 60 and 60 mg of Tween 80 in a final volume of 10 mL which produced a colloidal system with particle size of 188 nm, zeta potential -32 mV, polydispersion index 0.07, and benzocaine association efficiency > 87%. These findings open the way for future clinical studies using such formulations.

  3. Global and local aspects of spectral actions

    CERN Document Server

    Iochum, Bruno; Vassilevich, Dmitri

    2012-01-01

    The principal object in noncommutatve geometry is the spectral triple consisting of an algebra A, a Hilbert space H, and a Dirac operator D. Field theories are incorporated in this approach by the spectral action principle, that sets the field theory action to Tr f(D^2/\\Lambda^2), where f is a real function such that the trace exists, and \\Lambda is a cutoff scale. In the low-energy (weak-field) limit the spectral action reproduces reasonably well the known physics including the standard model. However, not much is known about the spectral action beyond the low-energy approximation. In this paper, after an extensive introduction to spectral triples and spectral actions, we study various expansions of the spectral actions (exemplified by the heat kernel). We derive the convergence criteria. For a commutative spectral triple, we compute the heat kernel on the torus up the second order in gauge connection and consider limiting cases.

  4. Acute physiological responses to castration-related pain in piglets: the effect of two local anesthetics with or without meloxicam.

    Science.gov (United States)

    Bonastre, C; Mitjana, O; Tejedor, M T; Calavia, M; Yuste, A G; Úbeda, J L; Falceto, M V

    2016-09-01

    Methods to reduce castration-related pain in piglets are still issues of concern and interest for authorities and producers. Our objectives were to estimate the effectiveness of two protocols of local anesthesia (lidocaine and the combination of lidocaine+bupivacaine) as well as the use of meloxicam as a postoperative analgesic in alleviating castration-related pain, measured by acute physiological responses. Eight groups (15 piglets/group) were included in the study: (1) castration without anesthesia or analgesia, without meloxicam (TRAD WITHOUT), (2) castration without anesthesia or analgesia, but with meloxicam (TRAD WITH), (3) handling without meloxicam (SHAM WITHOUT), (4) handling with meloxicam (SHAM WITH), (5) castration after local anesthesia with lidocaine but without meloxicam (LIDO WITHOUT), (6) castration after local anesthesia with lidocaine and meloxicam (LIDO WITH), (7) castration after local anesthesia with lidocaine+bupivacaine without meloxicam (LIDO+BUPI WITHOUT), (8) castration after local anesthesia with lidocaine+bupivacaine and meloxicam (LIDO+BUPI WITH). Acute physiological responses measured included skin surface temperature and serum glucose and cortisol concentrations. On days 4 and 11 post-castration BW was recorded and average daily gain was calculated over this period. Furthermore, piglet mortality was recorded over the 11-day post-castration period. Administration of local anesthetic or meloxicam did not prevent the decrease in skin surface temperature associated with castration. Lidocaine reduced the increase in glucose concentration associated with castration. For castrated pigs, the joint use of lidocaine and meloxicam caused a significant decrease in cortisol concentration; the combination of intratesticular lidocaine and bupivacaine did not seem to be more effective than lidocaine alone. No effect of treatments on mortality and growth were detected.

  5. Benzocaine loaded solid lipid nanoparticles: Formulation design, in vitro and in vivo evaluation of local anesthetic effect.

    Science.gov (United States)

    Basha, Mona; Abd El-Alim, Sameh Hosam; Kassem, Ahmed Alaa; El Awdan, Sally; Awad, Gamal

    2015-01-01

    The aim of the present work is the development and evaluation of solid lipid nanoparticles (SLNs) as carrier system for topical delivery of benzocaine (BZC) improving its local anesthesia aiming to produce a fast acting and long lasting topical formulation. BZC loaded SLNs were prepared using a full factorial design to study the influence of the type of polyoxyethylene sorbitan ester surfactants as well as their concentration as independent variables on the particle size, entrapment efficacy and zeta potential selected as dependent variables. Design of experiment (DOE) and the analysis of variance (ANOVA) were conducted to assess the optimization of the developed formulations. The results indicated that the fatty acid chain length of tested surfactants and their concentration had a significant effect on the studied responses. The optimized formulations were spherical in shape of mean particle diameters<350 nm with negatively charged surface <-20mV. Particles were characterized using differential scanning calorimetry and X-ray powder diffraction confirming the amorphous nature and the uniformity of drug inclusion in the lipid matrix. Optimized BZC-SLNs were incorporated into hydrogels characterized by a pseudoplastic non-Newtonian behavior. In vitro release study revealed an apparently biphasic release process with sustained release profile following Higuchi kinetics. BZC loaded SLNs hydrogels showed more potent anesthetic effect compared to BZC hydrogel evaluated using tail-flick analgesimeter, confirming significant improvement in both the intensity and duration of anesthetic effect. The above results proved that SLNs represent good candidates to encapsulate BZC improving its therapeutic efficacy for the topical treatment of pain.

  6. Novel serine-based gemini surfactants as chemical permeation enhancers of local anesthetics: A comprehensive study on structure-activity relationships, molecular dynamics and dermal delivery.

    Science.gov (United States)

    Teixeira, Raquel S; Cova, Tânia F G G; Silva, Sérgio M C; Oliveira, Rita; do Vale, M Luísa C; Marques, Eduardo F; Pais, Alberto A C C; Veiga, Francisco J B

    2015-06-01

    This work aims at studying the efficacy of a series of novel biocompatible, serine-based surfactants as chemical permeation enhancers for two different local anesthetics, tetracaine and ropivacaine, combining an experimental and computational approach. The surfactants consist of gemini molecules structurally related, but with variations in headgroup charge (nonionic vs. cationic) and in the hydrocarbon chain lengths (main and spacer chains). In vitro permeation and molecular dynamics studies combined with cytotoxicity profiles were performed to investigate the permeation of both drugs, probe skin integrity, and rationalize the interactions at molecular level. Results show that these enhancers do not have significant deleterious effects on the skin structure and do not cause relevant changes on cell viability. Permeation across the skin is clearly improved using some of the selected serine-based gemini surfactants, namely the cationic ones with long alkyl chains and shorter spacer. This is noteworthy in the case of ropivacaine hydrochloride, which is not easily administered through the stratum corneum. Molecular dynamics results provide a mechanistic view of the surfactant action on lipid membranes that essentially corroborate the experimental observations. Overall, this study suggests the viability of these serine-based surfactants as suitable and promising delivery agents in pharmaceutical formulations.

  7. COMPARISON OF GLYCEMIC EFFECT OF ADRENALIN CONTAINING LOCAL ANESTHETIC IN DIABETIC AND NON-DIABETIC PATIENTS UNDERGOING MINOR ORAL SURGICAL PROCEDURE

    Directory of Open Access Journals (Sweden)

    Pradeep

    2015-12-01

    Full Text Available AIM To compare the changes in blood glucose level associated with administration of adrenaline containing local anesthetic in diabetic and non-diabetic patients undergoing minor oral surgical procedures. METHODS AND MATERIAL The study included 150 well controlled diabetic patients and 150 non-diabetic healthy patients in age group of 40-60 years who underwent minor oral surgical procedures (trans alveolar extractions, alveoplasty and flap surgeries. Patients in both the group were administered 1.8ml of local anesthetic agent containing 1:100,000 adrenaline for inferior alveolar nerve block and 0.2 ml of anesthetic agent for long buccal nerve block. Blood glucose levels were assessed and compared during pre-operative and one hour post-operative period. STATISTICAL ANALYSIS The comparison of the random blood sugar levels preop and postop in both the groups were compared using paired t test and RBS levels between two groups were analysed using unpaired t test. P value less than 0.05 was considered statistically significant. RESULTS No statistically significant change in post-operative blood glucose level was noted between the diabetic and non-diabetic patients. CONCLUSION The study concluded that it is safe to administer local anesthetic containing 1:100,000 adrenaline in smaller volumes to well controlled diabetic patients.

  8. Introducing Action Learning in Local Government: A New Facilitator's Experience

    Science.gov (United States)

    Lowe, Kirsty

    2010-01-01

    This account of practice will explore how action learning has supported local authorities by providing an opportunity to share learning and experiences across organisational boundaries. It will look at the experiences of a new action learning facilitator working with local government scrutiny officers from different organisations.

  9. Local Agenda 21 - from global idea to local action

    DEFF Research Database (Denmark)

    Hoffmann, Birgitte

    1999-01-01

    The article give a status of the Danish works with Local Agenda 21 and discusses Local Agenda 21 as a planning tool. It describes the idea of Local Agenda 21 as a large meeting, which everybody attends. This picture is elaborated and discussed form different angles: the items on the agenda...

  10. Intravenous regional anesthesia: a review of common local anesthetic options and the use of opioids and muscle relaxants as adjuncts

    Directory of Open Access Journals (Sweden)

    Flamer D

    2011-11-01

    Full Text Available David Flamer, Philip WH PengDepartment of Anesthesia, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, CanadaPurpose: To provide a review of local anesthetic (LA agents and adjuncts, opioids and muscle relaxants, and their intraoperative effects and postoperative outcomes in intravenous regional anesthesia (IVRA.Source: A search for prospective, double-blind, randomized controlled trials evaluating LA agents, opioids and muscle relaxants as adjuvants for IVRA, was conducted (MEDLINE®, Embase. Intraoperative benefits (onset/recovery of sensory and motor block, intraoperative analgesia, tourniquet pain, postoperative benefits (pain score, analgesic consumption, time to first analgesia, and side effects were recorded. A conclusion for overall benefit was made based on statistical significance and clinical relevance.Findings: Thirty-one studies were evaluated, with data collected on 1523 subjects. LA agents evaluated were lidocaine, ropivacaine, and prilocaine. Adjuncts evaluated were opioids (morphine, fentanyl, meperidine, sufentanil, tramadol and muscle relaxants (pancuronium, atracurium, mivacurium, cisatacurium. There was good evidence that ropivacaine provided effective IVRA and improved postoperative analgesia. Lidocaine and prilocaine were effective LA agents, however they lacked postoperative benefits. Morphine, fentanyl, and meperidine as sole adjuncts did not demonstrate clinically significant benefits or result in an increased risk of side effects. Sufentanil data was limited, but appeared to provide faster onset of sensory block. Tramadol provided faster onset of sensory block and tourniquet tolerance, however postoperative benefits were not consistent and the risk of minor side effects increased. Muscle relaxants improved the quality of motor block, but at the expense of delayed motor recovery. The combination of fentanyl and muscle relaxants can achieve an equivalent quality of IVRA with 50

  11. Benzocaine-loaded polymeric nanocapsules: study of the anesthetic activities.

    Science.gov (United States)

    De Melo, Nathalie Ferreira Silva; De Araújo, Daniele Ribeiro; Grillo, Renato; Moraes, Carolina Morales; De Matos, Angélica Prado; de Paula, Eneida; Rosa, André Henrique; Fraceto, Leonardo Fernandes

    2012-03-01

    This paper describes a comparison of different polymeric nanocapsules (NCs) prepared with the polymers poly(D,L-lactide-co-glycolide), poly(L-lactide) (PLA), and poly(ε-caprolactone) and used as carrier systems for the local anesthetic (LA) benzocaine (BZC). The systems were characterized and their anesthetic activities investigated. The results showed particle size distributions with polydispersity indices below 0.135, average diameters up to 120 nm, zeta potentials up to -30 mV, and entrapment efficiencies around 70%. Formulations of BZC using the polymeric NCs presented slower release profiles, compared with that of free BZC. Slowest release (release constant, k = 0.0016 min(-1)) was obtained using the PLA NC system. Pharmacological evaluation showed that encapsulation of BZC in PLA NCs prolonged its anesthetic action. This new formulation could potentially be used in future applications involving the gradual release of local anesthetics (LAs).

  12. Imobilidade: uma ação essencial dos anestésicos inalatórios Inmovilidad: una acción esencial de los anestésicos inhalatorios Immobility: essential inhalational anesthetics action

    Directory of Open Access Journals (Sweden)

    Leonardo Teixeira Domingues Duarte

    2005-02-01

    -HT2A, y canales de sodio voltaje-dependientes. CONCLUSIONES: La inmovilidad producida por los anestésicos inhalatorios es mediada, principalmente, a través de una acción sobre la médula espinal. Ese efecto ocurre por la acción anestésica sobre la excitabilidad de las neuronas motoras espinales, pero también sobre neuronas e interneuronas nociceptivas del cuerno posterior de la médula. La acción sobre receptores específicos ejerce efecto sobre la transmisión sináptica de esas neuronas.BACKGROUND AND OBJECTIVES: Immobility is an essential component of general anesthesia and should be looked for and maintained throughout anesthesia. Anesthetic potency, called Minimum Alveolar Concentration (MAC, results from the inhibition of movement response to noxious stimulation. However, although spinal cord is recognized as the primary mediator of surgical immobility, cellular and subcelular mechanisms of action of inhaled anesthetics to produce immobility are not yet totally known. Considering major research advances on mechanisms of action of inhaled anesthetics and resulting wide variety of information, this review aimed at critically evaluating clinical and experimental studies performed to identify sites of action and mechanisms of inhaled anesthetics to promote immobility in response to noxious stimulations. CONTENTS: Complex mechanisms of action of inhaled anesthetics on central nervous system may be divided into three levels: macroscopic, microscopic, and molecular. Macroscopically, behavioral studies have shown spinal cord to be the primary anesthetic site of action to promote immobility in response to noxious stimulations. At cellular level, excitability of motor neurons, nociceptive neurons and synaptic transmission are involved in the anesthetic action. At molecular level, several receptors are affected by inhaled anesthetics, but only a few may directly mediate anesthetic action, among them: glycine, glutamate AMPA and 5-HT2A receptors, in addition to

  13. Local Flood Action Groups: Governance And Resilience

    NARCIS (Netherlands)

    Forrest, Steven; Trell, Elen-Maarja; Woltjer, Johan; Macoun, Milan; Maier, Karel

    2015-01-01

    A diverse range of citizen groups focusing on flood risk management have been identified in several European countries. The paper discusses the role of flood action (citizen) groups in the context of flood resilience and will do this by analysing the UK and its diverse range of flood groups. These c

  14. Dexmedetomidine (12.5 μg/mL) improves tissue distribution, anesthetic action, and hemodynamic effects of lidocaine after palatal infiltration in rats.

    Science.gov (United States)

    Akimoto, Takuma; Hashimoto, Shuichi; Sunada, Katsuhisa

    2016-09-01

    Dexmedetomidine hydrochloride (DEX) is a α2-adrenergic receptor agonist that causes vasoconstriction by acting on α2B-adrenergic receptors in peripheral blood vessels. The authors aimed to determine the influence of DEX on tissue distribution, anesthetic action, and hemodynamic effects of lidocaine in rats. The investigators injected indigo carmine-containing (14)C-labeled lidocaine hydrochloride (2 %) without and with 3.1, 12.5, or 50 μg/mL DEX or 10 μg/mL epinephrine into the right palatal mucosa mesial to the maxillary first molar of specific pathogen-free male Wistar rats. Autoradiography and liquid scintillation counting were performed to evaluate (14)C-labeled lidocaine concentrations in the palatal mucosa, maxillary bone, maxillary nerve, and peripheral blood. Somatosensory-evoked potentials were measured to analyze anesthetic action, and blood pressure and pulse rate were measured to compare hemodynamic effects. DEX extended the tissue distribution of lidocaine in a concentration-dependent manner. Lidocaine with 12.5 μg/mL DEX had similar blood peak arrival time and peak-to-peak amplitude as lidocaine with 10 μg/mL epinephrine, but it reduced pulse rate. The results of this study suggest that 12.5 μg/mL DEX improves tissue distribution, anesthetic action, and hemodynamic effects of lidocaine in rats. Therefore, 12.5 μg/mL DEX may be a suitable alternative to epinephrine in lidocaine formulations, especially for patients with ischemic heart disease and hypertension.

  15. Comparative evaluation of effectiveness of intra-pocket anesthetic gel and injected local anesthesia during scaling and root planing – A split-mouth clinical trial

    Directory of Open Access Journals (Sweden)

    Kalyan Chintala

    2017-01-01

    Full Text Available Background and Aim: Pain control is an important outcome measure for successful periodontal therapy. Injected local anesthesia has been used to secure anesthesia for scaling and root planing (SRP and continues to be the anesthetic of choice for pain control. Alternatively, intra-pocket anesthetic gel has been used as an anesthetic during SRP. Hence, this clinical trial was done to compare the effectiveness of intra-pocket anesthetic gel and injected local anesthesia during SRP and also to assess the influence of intra-pocket anesthetic gel on treatment outcomes in chronic periodontitis patients. Materials and Methods: Fifteen systemically healthy chronic periodontitis patients were recruited. The dental quadrants on right side received either intra-pocket 20% benzocaine gel (Gel group or infiltration/block by 2% lidocaine with 1:80,000 adrenaline (injection group. Quadrants on the left side received the alternative. Pain perception and patients preference for the type of anesthesia was recorded. Clinical parameters: plaque index, modified gingival index, modified sulcular bleeding index, probing pocket depth, and clinical attachment level were recorded at baseline and 1 month after treatment. Results: No difference was observed in visual analog scale (P > 0.05 and verbal rating scale (P > 0.05 pain perception between gel group and injection group. A slightly increased preference to gel as anesthesia (53% vs. 47% was observed. The treatment outcome after SRP did not show a significant difference between gel and injection group (P > 0.05. Conclusion: Intra-pocket administration of 20% benzocaine gel may be effective for pain control during SRP and may offer an alternative to conventional injection anesthesia.

  16. Local Agenda 21 - from global idea to local action

    DEFF Research Database (Denmark)

    Hoffmann, Birgitte

    1999-01-01

    A status of the work in Denmark with local Agenda 21 is given. Agenda 21 is described as a giant meeting where all the different actors is joining, all the citizens of the world is joining - whether the know it or not. From this picture different themes is discussed, e.g. the items on the agenda ...

  17. β–Cyclodextrin–Propyl Sulfonic Acid Catalysed One-Pot Synthesis of 1,2,4,5-Tetrasubstituted Imidazoles as Local Anesthetic Agents

    Directory of Open Access Journals (Sweden)

    Yan Ran

    2015-11-01

    Full Text Available Some functionalized 1,2,4,5-tetrasubstituted imidazole derivatives were synthesized using a one-pot, four component reaction involving 1,2-diketones, aryl aldehydes, ammonium acetate and substituted aromatic amines. The synthesis has been efficiently carried out in a solvent free medium using β-cyclodextrin-propyl sulfonic acid as a catalyst to afford the target compounds in excellent yields. The local anesthetic effect of these derivatives was assessed in comparison to lidocaine as a standard using a rabbit corneal and mouse tail anesthesia model. The three most potent promising compounds were subjected to a rat sciatic nerve block assay where they showed considerable local anesthetic activity, along with minimal toxicity. Among the tested analogues, 4-(1-benzyl-4,5-diphenyl-1H-imidazol-2-yl-N,N-dimethylaniline (5g was identified as most potent analogue with minimal toxicity. It was further characterized by a more favourable therapeutic index than the standard.

  18. Local climate action plans in climate change mitigation

    DEFF Research Database (Denmark)

    Damsø, Tue Noa Jacques; Kjær, Tyge; Christensen, Thomas Budde

    2016-01-01

    The article examines the climate action plans (CAPs) of local governments (LGs) in Denmark. Applying a quantitative content analysis approach, all available Danish LG action plans within the climate and energy field has been collected and coded, giving insight into the extent of LG CAPs. We assess...

  19. Application of carbon nanosorbent for PRiME pass-through cleanup of 10 selected local anesthetic drugs in human plasma samples.

    Science.gov (United States)

    Ma, Jian-Bo; Zhao, Li-Ming; Rui, Qiu-Hong; Liao, Yu-Feng; Chen, Yan-Min; Xu, Jin; Zhu, Yan; Zhao, Yong-Gang

    2017-04-01

    A novel PRiME (process, robustness, improvements, matrix effects, ease of use) pass-through cleanup procedure has been developed to improve the existing commercially available designs. Carbon nanosorbents, i.e., magnetic modified carboxyl-graphene (Mag-CG) and magnetic modified carboxyl-carbon nanotubes (Mag-CCNTs), have been synthesised and evaluated in PRiME pass-through cleanup procedure for human plasma prior to analysis of 10 selected local anesthetic drugs by liquid chromatography-tandem quadrupole mass spectrometry (LC-MS/MS). The matrix effect, an interesting phenomenon of ion suppression for local anesthetic drugs containing ester group and ion enhancement for other drugs containing acylamino group, has been minimized using carbon nanosorbents PRiME pass-through cleanup procedure. Under the optimal conditions, the obtained results show higher cleanup efficiency of the carbon nanosorbents with recoveries between 70.2% and 126%. Furthermore, the carbon nanosorbents are also evaluated for reuse up to 80-100 times. The limits of quantification (LOQs) for local anesthetic drugs are in the range of 0.024-0.15 μg/L. Validation results on linearity, specificity, accuracy, and precision, as well as the application to the analysis of lidocaine in five patients recruited from the lung cancer demonstrate the applicability to clinical studies.

  20. Ion-transfer voltammetry of local anesthetics at an organic solvent/water interface and pharmacological activity vs. ion partition coefficient relationship.

    Science.gov (United States)

    Kubota, Y; Katano, H; Senda, M

    2001-01-01

    The ion-transfer reaction of local anesthetics at an organic solvent/water interface has been studied using cyclic voltammetry (CV) with a stationary nitrobenzene (NB)/water (W) interface. Procaine and seven other local anesthetics gave reversible or quasi-reversible voltammograms at the NB/W interface in the pH range between 0.9 and 9.6. These drugs are present in aqueous solution in either neutral or ionic form, or both forms. The half-wave potential, as determined by the midpoint potential in CV, vs. pH curves, were determined and analyzed to determine the partition coefficients of both neutral and ionic forms of the drugs between NB and W. The partition coefficients of the ionic forms were derived from their formal potential of transfer at an NB/W interface. The dissociation constants of ionic forms of the drugs in NB were also deduced. A high correlation between the pharmacological activity and the partition coefficient of the ionic form of amide-linked local anesthetics has been shown.

  1. Molecular insights into the local anesthetic receptor within voltage-gated sodium channels using hydroxylated analogues of mexiletine

    Directory of Open Access Journals (Sweden)

    Jean-François eDesaphy

    2012-02-01

    Full Text Available We previously showed that the β-adrenoceptor modulators, clenbuterol and propranolol, directly blocked voltage-gated sodium channels, whereas salbutamol and nadolol did not (Desaphy et al., 2003, suggesting the presence of two hydroxyl groups on the aromatic moiety of the drugs as a molecular requisite for impeding sodium channel block. To verify such an hypothesis, we synthesized five new mexiletine analogues by adding one or two hydroxyl groups to the aryl moiety of the sodium channel blocker and tested these compounds on hNav1.4 channels expressed in HEK293 cells. Concentration-response relationships were constructed using an holding potential of -120 mV at 0.1 Hz (tonic block and 10 Hz (use-dependent block stimulation frequencies. The half-maximum inhibitory concentrations (IC50 were linearly correlated to drug lipophilicity: the less lipophilic the drug, minor was the block. The same compounds were also tested on F1586C and Y1593C hNav1.4 channel mutants, to gain further information on the molecular interactions of mexiletine with its receptor within the sodium channel pore. Alteration of tonic block suggests that the aryl moiety of mexiletine may interact either directly or indirectly with Phe1586 in the closed sodium channel to produce low-affinity binding block, and that this interaction depends on the electrostatic potential of the drug aromatic tail. Alteration of use-dependent block suggests that addition of hydroxyl groups to the aryl moiety may modify high-affinity binding of the drug ammine terminal to Phe1586 through cooperativity between the two pharmacophores, this effect being mainly related to drug lipophilicity. Mutation of Tyr1593 further impaired such cooperativity. In conclusion, these results confirm our former hypothesis showing that the presence of hydroxyl groups to the aryl moiety of mexiletine greatly reduced sodium channel block, and provide molecular insights into the intimate interaction of local anesthetics with

  2. Interaction of local anesthetics with a peptide encompassing the IV/S4-S5 linker of the Na+ channel.

    Science.gov (United States)

    Fraceto, Leonardo F; Oyama, Sérgio; Nakaie, Clóvis R; Spisni, Alberto; de Paula, Eneida; Pertinhez, Thelma A

    2006-08-20

    The peptide pIV/S4-S5 encompasses the cytoplasmic linker between helices S4-S5 in domain IV of the voltage-gated Na+ channel, residues 1644-1664. The interaction of two local anesthetics (LA), lidocaine and benzocaine, with pIV/S4-S5 has been studied by DOSY, heteronuclear NMR 1H-15N-HSQC spectroscopy and computational methods. DOSY indicates that benzocaine, a neutral ester, exhibits stronger interaction with pIV/S4-S5 than lidocaine, a charged amine-amide. Weighted average chemical shifts, Deltadelta(1H-15N), show that benzocaine affects residues L1653, M1655 and S1656 while lidocaine slightly perturbs residues I1646, L1649 and A1659, L1660, near the N- and C-terminus, respectively. Computational methods confirmed the stability of the benzocaine binding and the existence of two binding sites for lidocaine. Even considering that the approach of studying the peptide in the presence of a co-solvent (TFE/H2O, 30%/70% v/v) has an inherently limited implication, our data strongly support the existence of multiple LA binding sites in the IV/S4-S5 linker, as suggested in the literature. In addition, we consider that LA can bind to the S4-S5 linker with diverse binding modes and strength since this linker is part of the receptor for the "inactivation gate particle". Conditions for devising new functional studies, aiming to better understand Na+ channel functionality as well as the various facets of LA pharmacological activity are proposed in this work.

  3. Positive Allosteric Modulation of Kv Channels by Sevoflurane: Insights into the Structural Basis of Inhaled Anesthetic Action.

    Directory of Open Access Journals (Sweden)

    Qiansheng Liang

    Full Text Available Inhalational general anesthesia results from the poorly understood interactions of haloethers with multiple protein targets, which prominently includes ion channels in the nervous system. Previously, we reported that the commonly used inhaled anesthetic sevoflurane potentiates the activity of voltage-gated K+ (Kv channels, specifically, several mammalian Kv1 channels and the Drosophila K-Shaw2 channel. Also, previous work suggested that the S4-S5 linker of K-Shaw2 plays a role in the inhibition of this Kv channel by n-alcohols and inhaled anesthetics. Here, we hypothesized that the S4-S5 linker is also a determinant of the potentiation of Kv1.2 and K-Shaw2 by sevoflurane. Following functional expression of these Kv channels in Xenopus oocytes, we found that converse mutations in Kv1.2 (G329T and K-Shaw2 (T330G dramatically enhance and inhibit the potentiation of the corresponding conductances by sevoflurane, respectively. Additionally, Kv1.2-G329T impairs voltage-dependent gating, which suggests that Kv1.2 modulation by sevoflurane is tied to gating in a state-dependent manner. Toward creating a minimal Kv1.2 structural model displaying the putative sevoflurane binding sites, we also found that the positive modulations of Kv1.2 and Kv1.2-G329T by sevoflurane and other general anesthetics are T1-independent. In contrast, the positive sevoflurane modulation of K-Shaw2 is T1-dependent. In silico docking and molecular dynamics-based free-energy calculations suggest that sevoflurane occupies distinct sites near the S4-S5 linker, the pore domain and around the external selectivity filter. We conclude that the positive allosteric modulation of the Kv channels by sevoflurane involves separable processes and multiple sites within regions intimately involved in channel gating.

  4. Tetrodotoxin-sensitive α-subunits of voltage-gated sodium channels are relevant for inhibition of cardiac sodium currents by local anesthetics.

    Science.gov (United States)

    Stoetzer, C; Doll, T; Stueber, T; Herzog, C; Echtermeyer, F; Greulich, F; Rudat, C; Kispert, A; Wegner, F; Leffler, A

    2016-06-01

    The sodium channel α-subunit (Nav) Nav1.5 is regarded as the most prevalent cardiac sodium channel required for generation of action potentials in cardiomyocytes. Accordingly, Nav1.5 seems to be the main target molecule for local anesthetic (LA)-induced cardiotoxicity. However, recent reports demonstrated functional expression of several "neuronal" Nav's in cardiomyocytes being involved in cardiac contractility and rhythmogenesis. In this study, we examined the relevance of neuronal tetrodotoxin (TTX)-sensitive Nav's for inhibition of cardiac sodium channels by the cardiotoxic LAs ropivacaine and bupivacaine. Effects of LAs on recombinant Nav1.2, 1.3, 1.4, and 1.5 expressed in human embryonic kidney cell line 293 (HEK-293) cells, and on sodium currents in murine, cardiomyocytes were investigated by whole-cell patch clamp recordings. Expression analyses were performed by reverse transcription PCR (RT-PCR). Cultured cardiomyocytes from neonatal mice express messenger RNA (mRNA) for Nav1.2, 1.3, 1.5, 1.8, and 1.9 and generate TTX-sensitive sodium currents. Tonic and use-dependent block of sodium currents in cardiomyocytes by ropivacaine and bupivacaine were enhanced by 200 nM TTX. Inhibition of recombinant Nav1.5 channels was similar to that of TTX-resistant currents in cardiomyocytes but stronger as compared to inhibition of total sodium current in cardiomyocytes. Recombinant Nav1.2, 1.3, 1.4, and 1.5 channels displayed significant differences in regard to use-dependent block by ropivacaine. Finally, bupivacaine blocked sodium currents in cardiomyocytes as well as recombinant Nav1.5 currents significantly stronger in comparison to ropivacaine. Our data demonstrate for the first time that cardiac TTX-sensitive sodium channels are relevant for inhibition of cardiac sodium currents by LAs.

  5. Point mutations at the local anesthetic receptor site modulate the state-dependent block of rat Na v1.4 sodium channels by pyrazoline-type insecticides.

    Science.gov (United States)

    Silver, Kristopher S; Soderlund, David M

    2007-05-01

    Pyrazoline-type insecticides (PTIs) selectively block sodium channels at membrane potentials that promote slow sodium channel inactivation and are proposed to interact with a site that overlaps the local anesthetic (LA) receptor site. Mutagenesis studies identified two amino acid residues in the S6 segment of homology domain IV (Phe-1579 and Tyr-1586 in the rat Na(v)1.4 sodium channel) as principal elements of the LA receptor. To test the hypothesis that PTIs bind to the LA receptor, we constructed mutated Na(v)1.4/F1579A and Na(v)1.4/Y1586A cDNAs, expressed native and mutated channels in Xenopus oocytes, and examined the effects of these mutations on channel block by three PTIs (indoxacarb, its bioactivation product DCJW, and RH3421) by two-electrode voltage clamp. DCJW and RH3421 had no effect on Na(v)1.4 channels held at -120mV but caused a slowly developing block upon depolarization to -30mV. Estimated IC(50) values following 15min of exposure were 1 and 4muM for DCJW and RH3421, respectively. Indoxacarb failed to block Na(v)1.4 channels under all experimental conditions. Sensitivity to block by DCJW and RH3421 at -30mV was significantly reduced in Na(v)1.4/F1579A channels, a finding that is consistent with the impact of this mutation on drug binding. In contrast to its effect on drug binding, the Y1586A mutation increased the sensitivity of Na(v)1.4 channels held at -30mV to all three compounds, conferring modest sensitivity to indoxacarb and increasing sensitivity to DCJW and RH3421 by 58- and 16-fold, respectively. These results provide direct evidence for the action of PTIs at the LA receptor.

  6. Local Sustainability and Cooperation Actions in the Mediterranean Region

    Directory of Open Access Journals (Sweden)

    Tiberio Daddi

    2014-05-01

    Full Text Available The populations of the Middle East and Africa are increasing rapidly, contributing to rapid urban growth. This paper describes a two-year action research process involving diverse public, private, and community stakeholders. The actions aimed to develop and strengthen the capabilities of three Mediterranean cities (Marrakech, Morocco; Sin el Fil, Lebanon; and Bodrum, Turkey in managing and promoting local sustainable development. The needs and priorities of each Mediterranean partner were identified and pilot actions were elaborated to promote urban sustainability, the exploitation of local resources, and the enhancement of local tangible and intangible assets. The paper describes the outputs of pilot actions carried out in these cities, highlighting how these experiences contribute to the current debate on urban sustainability. Broad implications for policy and practice are discussed.

  7. 缝隙连接可能是吸入全麻药作用的分子靶位之一%Gap junctions may participate in the mechanism of action of inhalational anesthetics

    Institute of Scientific and Technical Information of China (English)

    陈章燕; 黎尚荣

    2013-01-01

    Background Inhalational anesthetics have been widely used in clinical anesthesia for a wide range of surgeries.But the mechanism of anesthetic actions is still not clear.Gap junctions (GJ) are important ways of information delivery among mediate cells in nervous system.Perhaps it is one of the molecular sites of inhalational anesthetic action.Objective The purpose of this article is to investigate whether GJ and GJ mediated intercellular communication may participate in the mechanism of action of inhalational anesthetics or not.Content The mechanism of action of inhalational anesthetics has been analyzed.Moreover,the structure,distribution and function of GJ and its relationship with inhalational anesthetics in the central nervous system were also described.Trend The research about GJ and the intercellular communication mediated by GJ is a new direction to explore the anesthetic mechanism.%背景 吸入麻醉药已在临床广泛应用,但其作用机理至今尚未明确.而缝隙连接(gap junctions,GJ)也是神经系统介导细胞间信息传递的重要方式,可能是吸入全麻药作用的分子靶位之一. 目的 分析推测GJ及其介导的细胞间传递是否参与吸入全麻药的麻醉作用. 内容 阐述吸入麻醉药的机制,GJ在中枢神经系统中的结构、分布、功能以及与吸入麻醉药作用的关系. 趋向 研究GJ及其介导的细胞间传递能为今后研究全麻药的作用机制提供新方向.

  8. Anesthetic drug midazolam inhibits cardiac human ether-à-go-go-related gene channels: mode of action.

    Science.gov (United States)

    Vonderlin, Nadine; Fischer, Fathima; Zitron, Edgar; Seyler, Claudia; Scherer, Daniel; Thomas, Dierk; Katus, Hugo A; Scholz, Eberhard P

    2015-01-01

    Midazolam is a short-acting benzodiazepine that is in wide clinical use as an anxiolytic, sedative, hypnotic, and anticonvulsant. Midazolam has been shown to inhibit ion channels, including calcium and potassium channels. So far, the effects of midazolam on cardiac human ether-à-go-go-related gene (hERG) channels have not been analyzed. The inhibitory effects of midazolam on heterologously expressed hERG channels were analyzed in Xenopus oocytes using the double-electrode voltage clamp technique. We found that midazolam inhibits hERG channels in a concentration-dependent manner, yielding an IC50 of 170 μM in Xenopus oocytes. When analyzed in a HEK 293 cell line using the patch-clamp technique, the IC50 was 13.6 μM. Midazolam resulted in a small negative shift of the activation curve of hERG channels. However, steady-state inactivation was not significantly affected. We further show that inhibition is state-dependent, occurring within the open and inactivated but not in the closed state. There was no frequency dependence of block. Using the hERG pore mutants F656A and Y652A we provide evidence that midazolam uses a classical binding site within the channel pore. Analyzing the subacute effects of midazolam on hERG channel trafficking, we further found that midazolam does not affect channel surface expression. Taken together, we show that the anesthetic midazolam is a low-affinity inhibitor of cardiac hERG channels without additional effects on channel surface expression. These data add to the current understanding of the pharmacological profile of the anesthetic midazolam.

  9. Anesthetic strategy during endovascular therapy: General anesthesia or conscious sedation? (GOLIATH - General or Local Anesthesia in Intra Arterial Therapy) A single-center randomized trial.

    Science.gov (United States)

    Simonsen, Claus Z; Sørensen, Leif H; Juul, Niels; Johnsen, Søren P; Yoo, Albert J; Andersen, Grethe; Rasmussen, Mads

    2016-12-01

    Endovascular therapy after acute ischemic stroke due to large vessel occlusion is now standard of care. There is equipoise as to what kind of anesthesia patients should receive during the procedure. Observational studies suggest that general anesthesia is associated with worse outcomes compared to conscious sedation. However, the findings may have been biased. Randomized clinical trials are needed to determine whether the choice of anesthesia may influence outcome. The objective of GOLIATH (General or Local Anestesia in Intra Arterial Therapy) is to examine whether the choice of anesthetic regime during endovascular therapy for acute ischemic stroke influence patient outcome. Our hypothesis is that that conscious sedation is associated with less infarct growth and better functional outcome. GOLIATH is an investigator-initiated, single-center, randomized study. Patients with acute ischemic stroke, scheduled for endovascular therapy, are randomized to receive either general anesthesia or conscious sedation. The primary outcome measure is infarct growth after 48-72 h (determined by serial diffusion-weighted magnetic resonance imaging). Secondary outcomes include 90-day modified Rankin Scale score, time parameters, blood pressure variables, use of vasopressors, procedural and anesthetic complications, success of revascularization, radiation dose, and amount of contrast media. Choice of anesthesia may influence outcome in acute ischemic stroke patients undergoing endovascular therapy. The results from this study may guide future decisions regarding the optimal anesthetic regime for endovascular therapy. In addition, this study may provide preliminary data for a multicenter randomized trial. © 2016 World Stroke Organization.

  10. Anestésicos locais: interação com membranas biológicas e com o canal de sódio voltagem-dependente Local anesthetics: interaction with biological membranes and with the voltage-gated sodium channel

    Directory of Open Access Journals (Sweden)

    Daniele Ribeiro de Araujo

    2008-01-01

    Full Text Available Many theories about the mechanism of action of local anesthetics (LA are described in the literature. Two types of theories can be distinguished: those that focus on the direct effects of LA on their target protein in the axon membranes, i.e. the voltage-gated sodium channel and the ones that take into account the interaction of anesthetic molecules with the lipid membrane phase for the reversible nerve blockage. Since there is a direct correlation between LA hydrophobicity and potency, it is crucial to take this physico-chemical property into account to understand the mechanism of action of LA, be it on the sodium channel protein, lipid(s, or on the whole membrane phase.

  11. Multi-regional local anesthetic infiltration during laparoscopic cholecystectomy in patients receiving prophylactic multi-modal analgesia: a randomized, double-blinded, placebo-controlled study

    DEFF Research Database (Denmark)

    Bisgaard, T; Klarskov, B; Kristiansen, V B

    1999-01-01

    undergoing elective laparoscopic cholecystectomy. In addition, all patients received multi-modal prophylactic analgesic treatment. Fifty-eight patients were randomized to receive a total of 286 mg (66 mL) ropivacaine or 66 mL saline via periportal and intraperitoneal infiltration. During the first 3...... receiving prophylactic multi-modal analgesic treatment. IMPLICATIONS: A combination of incisional and intraabdominal local anesthetic treatment reduced incisional pain but had no effect on deep intraabdominal pain or shoulder pain in patients receiving multimodal prophylactic analgesia after laparoscopic...

  12. Epinephrine as adjuvant for propranolol produces a marked peripheral action in intensifying and prolonging analgesia in response to local dorsal cutaneous noxious pinprick in rats.

    Science.gov (United States)

    Tzeng, Jann-Inn; Pan, He-Jia; Liu, Kuo-Sheng; Chen, Yu-Wen; Chen, Yu-Chung; Wang, Jhi-Joung

    2014-10-05

    The aim of this study was to evaluate the effect of epinephrine as additive for propranolol as an infiltrative anesthetic. Using a rat model of cutaneous trunci muscle reflex (CTMR), we tested the effect of co-administration of epinephrine with propranolol on infiltrative cutaneous analgesia. Bupivacaine, a long-lasting local anesthetic, was used as control. Subcutaneous propranolol and bupivacaine elicited a dose-dependent local anesthetic effect on infiltrative cutaneous analgesia. On the 50% effective dose (ED50) basis, the relative potency was bupivacaine [2.05 (1.95-2.21) μmol/kg]>propranolol [9.21 (9.08-9.42) μmol/kg] (Ppropranolol or bupivacaine) at ED50 or ED95, respectively, intensified and prolonged drug action on infiltrative cutaneous analgesia. Intraperitoneal injection of combined drugs (propranolol or bupivacaine) at ED95 with epinephrine (0.012 μmol/kg) exhibited no cutaneous analgesia. We concluded that propranolol was less potent but produced a similar duration of action when compared to bupivacaine on infiltrative cutaneous analgesia. Epinephrine as adjuvant for propranolol or bupivacaine enhanced the potency and extended the duration of action on infiltrative cutaneous analgesia.

  13. Research on Local Scour at Bridge Pier under Tidal Action

    Directory of Open Access Journals (Sweden)

    Wang Jianping

    2015-01-01

    Full Text Available Through the local scour test at bridge pier under tidal action in a long time series, this paper observes the growing trend of the deepest point of local scour at bridge pier under tidal conditions with different characteristic parameters, analyzes the impact of repeat sediment erosion and deposition in the scouring pit caused by reversing current on the development process of the scouring pit, and clarifies the relation between the tide and local scouring depth at bridge pier under steady flow conditions, so as to provide a scientific basis for bridge design and safe operation of estuary and harbor areas.

  14. Anesthetics impact the resolution of inflammation.

    Directory of Open Access Journals (Sweden)

    Nan Chiang

    Full Text Available BACKGROUND: Local and volatile anesthetics are widely used for surgery. It is not known whether anesthetics impinge on the orchestrated events in spontaneous resolution of acute inflammation. Here we investigated whether a commonly used local anesthetic (lidocaine and a widely used inhaled anesthetic (isoflurane impact the active process of resolution of inflammation. METHODS AND FINDINGS: Using murine peritonitis induced by zymosan and a systems approach, we report that lidocaine delayed and blocked key events in resolution of inflammation. Lidocaine inhibited both PMN apoptosis and macrophage uptake of apoptotic PMN, events that contributed to impaired PMN removal from exudates and thereby delayed the onset of resolution of acute inflammation and return to homeostasis. Lidocaine did not alter the levels of specific lipid mediators, including pro-inflammatory leukotriene B(4, prostaglandin E(2 and anti-inflammatory lipoxin A(4, in the cell-free peritoneal lavages. Addition of a lipoxin A(4 stable analog, partially rescued lidocaine-delayed resolution of inflammation. To identify protein components underlying lidocaine's actions in resolution, systematic proteomics was carried out using nanospray-liquid chromatography-tandem mass spectrometry. Lidocaine selectively up-regulated pro-inflammatory proteins including S100A8/9 and CRAMP/LL-37, and down-regulated anti-inflammatory and some pro-resolution peptides and proteins including IL-4, IL-13, TGF-â and Galectin-1. In contrast, the volatile anesthetic isoflurane promoted resolution in this system, diminishing the amplitude of PMN infiltration and shortening the resolution interval (Ri approximately 50%. In addition, isoflurane down-regulated a panel of pro-inflammatory chemokines and cytokines, as well as proteins known to be active in cell migration and chemotaxis (i.e., CRAMP and cofilin-1. The distinct impact of lidocaine and isoflurane on selective molecules may underlie their opposite

  15. The use of dye surrogates to illustrate local anesthetic drug sequestration by lipid emulsion: a visual demonstration of the lipid sink effect.

    Science.gov (United States)

    Papadopoulou, Aikaterini; Willers, Johann W; Samuels, Theophilus L; Uncles, David R

    2012-01-01

    We hypothesized that by substituting a dye surrogate in place of local anesthetic, we could visually demonstrate dye sequestration by lipid emulsion that would be dependent on both dye lipophilicity and the amount of lipid emulsion used. We selected 2 lipophilic dyes, acid blue 25 and Victoria blue, with log P values comparable to lidocaine and bupivacaine, respectively. Each dye solution was mixed with combinations of lipid emulsion and water to emulate "lipid rescue" treatment at dye concentrations equivalent to fatal, cardiotoxic, and neurotoxic local anesthetic plasma concentrations. The lipid emulsion volumes added to each dye solution emulated equivalent intravenous doses of 100, 500, and 900 mL of 20% Intralipid in a 75-kg adult. After mixing, the samples were separated into a lipid-rich supernatant and a lipid-poor subnatant by heparin flocculation. The subnatants were isolated, and their colors compared against a graduated dye concentration scale. Lipid emulsion addition resulted in significant dye acquisition by the lipid compartment accompanied by a reduction in the color intensity of the aqueous phase that could be readily observed. The greatest amount of sequestration occurred with the dye possessing the higher log P value and the greatest amount of lipid emulsion. Our study provides a visual demonstration of the lipid sink effect. It supports the theory that lipid emulsion may reduce the amount of free drug present in plasma from concentrations associated with an invariably fatal outcome to those that are potentially survivable.

  16. Enhancement of the 1-Octanol/Water Partition Coefficient of the Anti-Inflammatory Indomethacin in the Presence of Lidocaine and Other Local Anesthetics.

    Science.gov (United States)

    Tateuchi, Ryo; Sagawa, Naoki; Shimada, Yohsuke; Goto, Satoru

    2015-07-30

    Side effects and excessive potentiation of drug efficacy caused by polypharmacy are becoming important social issues. The apparent partition coefficient of indomethacin (log P'IND) increases in the presence of lidocaine, and this is used as a physicochemical model for investigating polypharmacy. We examined the changes in log P'IND caused by clinically used local anesthetics-lidocaine, tetracaine, mepivacaine, bupivacaine, and dibucaine-and by structurally similar basic drugs-procainamide, imipramine, and diltiazem. The quantitative structure-activity relationship study of log P'IND showed that the partition coefficient values (log PLA) and the structural entropic terms (ΔSobs, log f) of the additives affect log P'IND. These results indicate that the local anesthetics and structurally similar drugs function as phase-transfer catalysts, increasing the membrane permeability of indomethacin via heterogeneous intermolecular association. Therefore, we expect that the potency of indomethacin, an acidic nonsteroidal anti-inflammatory drug, will be increased by concurrent administration of the other drugs.

  17. Lumbar segmental nerve blocks with local anesthetics, pain relief, and motor function: a prospective double-blind study between lidocaine and ropivacaine.

    Science.gov (United States)

    Wolff, André P; Wilder Smith, Oliver H G; Crul, Ben J P; van de Heijden, Marc P; Groen, Gerbrand J

    2004-08-01

    Selective segmental nerve blocks with local anesthetics are applied for diagnostic purposes in patients with chronic back pain to determine the segmental level of the pain. We performed this study to establish myotomal motor effects after L4 spinal nerve blocks by lidocaine and ropivacaine and to evaluate the relationship with pain. Therefore, 20 patients, of which 19 finished the complete protocol, with chronic lumbosacral radicular pain without neurological deficits underwent segmental nerve blocks at L4 with both lidocaine and ropivacaine. Pain intensity scores (verbal numeric rating scale; VNRS) and the maximum voluntary muscle force (MVMF; using a dynamometer expressed in newtons) of the tibialis anterior and quadriceps femoris muscles were measured on the painful side and on the control side. The median VNRS decrease was 4.0 (P control side (P = 0.016; Tukey test). Multiple regression revealed a significant negative correlation for change in VNRS score versus change in median MVMF (Spearman R = -0.48: P = 0.00001). This study demonstrates that in patients with unilateral chronic low back pain radiating to the leg, pain reduction induced by local anesthetic segmental nerve (L4) block is associated with increased quadriceps femoris and tibialis anterior MVMF, without differences for lidocaine and ropivacaine.

  18. Is local participation always optimal for sustainable action?

    DEFF Research Database (Denmark)

    Brandt, Urs Steiner; Svendsen, Gert Tinggaard

    2013-01-01

    . Why? Because as the number of participants grows, the more likely it is that the group will include individuals who have an extreme position and are unwilling to make compromises. Thus, the net gain of self-organization should be compared with those of its alternatives, for example voting, market......Is local participation always optimal for sustainable action? Here, Local Agenda 21 is a relevant case as it broadly calls for consensus-building among stakeholders. Consensus-building is, however, costly. We show that the costs of making local decisions are likely to rapidly exceed the benefits......-solutions, or not making any choices at all. Even though the informational value of meetings may be helpful to policy makers, the model shows that it also decreases as the number of participants increase. Overall, the result is a thought provoking scenario for Local Agenda 21 as it highlights the risk of less sustainable...

  19. Sustainability in China: Bridging Global Knowledge with Local Action

    Directory of Open Access Journals (Sweden)

    Bing Xue

    2015-03-01

    Full Text Available As the biggest emerging and developing country, and the second largest economy on the planet, China’s road to sustainability has attracted global attention; therefore, we need to have a deeper understanding to address this issue at very different levels. This editorial mainly reviews the contributions of the published papers in the Special Issue of “Sustainability in China: Bridging Global Knowledge with Local Action”, the main findings in this special edition suggest that the concept of sustainability is more comprehensive and complex, and the transformation process from scientific knowledge to local action still has a long way to go, not only in China, but also in many developing countries. More research on the fundamental and innovative processes of sustainable transformations should be conducted. China needs to make more efforts to strengthen its road to sustainability, by merging all relevant types of knowledge, both within and outside science, as well as locally and globally.As the biggest emerging and developing country, and the second largest economy on the planet, China's road to sustainability has attracted global attention; therefore, we need to have a deeper understanding to address this issue at very different levels. This editorial mainly reviews the contributions of the published papers in the Special Issue of "Sustainability in China: Bridging Global Knowledge with Local Action", the main findings in this special edition suggest that the concept of sustainability is more comprehensive and complex, and the transformation process from scientific knowledge to local action still has a long way to go, not only in China, but also in many developing countries. More research on the fundamental and innovative processes of sustainable transformations should be conducted. China needs to make more efforts to strengthen its road to sustainability, by merging all relevant types of knowledge, both within and outside science, as well as

  20. Position and locality constrained soft coding for human action recognition

    Science.gov (United States)

    Wang, Bin; Liu, Yu; Xiao, Wenhua; Xu, Wei; Zhang, Maojun

    2013-10-01

    Although the traditional bag-of-words model has shown promising results for human action recognition, in the feature coding phase, the ambiguous features from different body parts are still difficult to distinguish. Furthermore, it also suffers from serious representation error. We propose an innovative coding strategy called position and locality constrained soft coding (PLSC) to overcome these limitations. PLSC uses the feature position in a human oriented region of interest (ROI) to distinguish the ambiguous features. We first construct a subdictionary for each feature by selecting the bases from their spatial neighbor in human ROI. Then, a modified soft coding with locality constraint is adopted to alleviate the quantization error and preserve the manifold structure of features. This novel coding algorithm increases both the representation accuracy and discriminative power with low computational cost. The human action recognition experimental results on KTH, Weizmann, and UCF sports datasets show that PLSC can achieve a better performance than previous competing feature coding methods.

  1. Ultrasonography-guided bilateral rectus sheath block vs local anesthetic infiltration after pediatric umbilical hernia repair: a prospective randomized clinical trial.

    Science.gov (United States)

    Dingeman, R Scott; Barus, Lindsay M; Chung, Hyun Kee; Clendenin, David J; Lee, Christopher S; Tracy, Sarah; Johnson, Victor M; Dennett, Kate V; Zurakowski, David; Chen, Catherine

    2013-08-01

    Regional anesthetic techniques can be used to alleviate postoperative pain in children undergoing pediatric surgical procedures. Use of ultrasonographic guidance for bilateral rectus sheath block (BRSB) has been shown to improve immediate pain scores and reduce use of postoperative analgesia in the postanesthesia care unit (PACU). To compare efficacy of ultrasonography-guided BRSB and local anesthetic infiltration (LAI) in providing postoperative analgesia after pediatric umbilical hernia repair. Prospective, observer-blinded, randomized clinical trial. Tertiary-referral urban children's hospital. Eligible children 3 to 12 years of age undergoing elective umbilical hernia repair from November 16, 2009, through May 31, 2011. Ropivacaine hydrochloride administered at the conclusion of surgery as LAI by the surgeon (n = 25) or as ultrasonography-guided BRSB by the anesthesiologist (n = 27). Scores on the FACES Pain Rating Scale measured at 10-minute intervals and all use of analgesic medications in the PACU. Median FACES scores in the PACU were lower in the BRSB group compared with the LAI group at 10 minutes (0 vs 1; P = .04), 30 minutes (0 vs 1; P = .01), and 40 minutes or later (0 vs 1; P = .03). Fewer doses of opioid and nonopioid medications were given to the BRSB group compared with the LAI group (5 vs 11 doses for opioids; 5 vs 10 for nonopioids). In the PACU, ultrasonography-guided BRSB after umbilical hernia repair in children is associated with lower median FACES scores and decreased use of opioid and nonopioid medications compared with LAI. Future studies could examine the use of longer-acting anesthetic agents with ultrasonography-guided BRSB. clinicaltrials.gov Identifier: NCT01015053.

  2. Doxepin Has a Potent and Long-Acting Spinal Anesthetic Effect in Rats

    Directory of Open Access Journals (Sweden)

    Bor-Chin Cheng

    2006-02-01

    Full Text Available Doxepin, a tricyclic antidepressant, was recently found to be effective in the treatment of various acute and chronic painful conditions. However, the mechanism of its actions was not clear, especially when involving the spine. The aim of our study was to evaluate the spinal anesthetic effect of doxepin. Two commonly used traditional local anesthetics, bupivacaine and lidocaine, were used as controls. The potencies and durations of the drugs' action were evaluated in male Sprague-Dawley rats. We found that intrathecally administered doxepin, like bupivacaine and lidocaine, produced dose-related spinal anesthetic effects on motor activity, proprioception, and nociception. Among the three drugs, doxepin produced spinal anesthetic effects in rats more potent than that of lidocaine (p < 0.001, in each comparison and longer than that of bupivacaine and lidocaine (p < 0.001, in each comparison. The spinal activity of doxepin may provide some explanation of its clinical effect in pain management.

  3. Systemic toxisity of local anesthethics during regional anesthesia in orthopedics and traumatology

    Directory of Open Access Journals (Sweden)

    V. A. Koryachkin

    2015-01-01

    Full Text Available There are cases of accidental intravascular injection of local anesthetic when performing regional anesthesia. The frequency of this complication was 0.28 per 1,000. We describe the clinical manifestations and the basic principles of the treatment of local anesthetics systemic toxicity. Discussed in detail the mechanism of action of fat emulsion and the protocol of lipid resuscitation Accidental intravascular injection of local anesthetics. The mechanism of action of fat emulsion and the protocol of lipidrescue accidental intravascular injection of local anesthetics was discussed.

  4. Innovative parameters obtained for digital analysis of microscopic images to evaluate in vitro hemorheological action of anesthetics

    Science.gov (United States)

    Alet, Analía. I.; Basso, Sabrina; Delannoy, Marcela; Alet, Nicolás. A.; D'Arrigo, Mabel; Castellini, Horacio V.; Riquelme, Bibiana D.

    2015-06-01

    Drugs used during anesthesia could enhance microvascular flow disturbance, not only for their systemic cardiovascular actions but also by a direct effect on the microcirculation and in particular on hemorheology. This is particularly important in high-risk surgical patients such as those with vascular disease (diabetes, hypertension, etc.). Therefore, in this work we propose a set of innovative parameters obtained by digital analysis of microscopic images to study the in vitro hemorheological effect of propofol and vecuronium on red blood cell from type 2 diabetic patients compared to healthy donors. Obtained innovative parameters allow quantifying alterations in erythrocyte aggregation, which can increase the in vivo risk of microcapillary obstruction.

  5. Effectiveness of various formulations of local anesthetics and additives for topical anesthesia – a prospective, randomized, double-blind, placebo-controlled study

    Directory of Open Access Journals (Sweden)

    Weilbach C

    2017-05-01

    , the addition of trometamol (Tris/THAM accelerated the onset of the effect compared to the native formulation (at 0.4 and 0.8 N. In all of the adult subjects of this study, the minimum exposure time was 60 min for any of the tested topical anesthetic creams.Conclusion: The results of this study indicate that a cream containing 20% lidocaine, 38% trometamol and 10% propylene glycol may be used as an alternative to lidocaine/prilocaine with a comparable effect and without the need to extend exposure time. Keywords: local anesthetics, topical anesthesia, EMLA®, topical anesthetic cream, lidocaine, prilocaine 

  6. Scientometrics of anesthetic drugs and their techniques of administration, 1984–2013

    Directory of Open Access Journals (Sweden)

    Vlassakov KV

    2014-12-01

    Full Text Available Kamen V Vlassakov, Igor Kissin Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA Abstract: The aim of this study was to assess progress in the field of anesthetic drugs over the past 30 years using scientometric indices: popularity indices (general and specific, representing the proportion of articles on a drug relative to all articles in the field of anesthetics (general index or the subfield of a specific class of anesthetics (specific index; index of change, representing the degree of growth in publications on a topic from one period to the next; index of expectations, representing the ratio of the number of articles on a topic in the top 20 journals relative to the number of articles in all (>5,000 biomedical journals covered by PubMed; and index of ultimate success, representing a publication outcome when a new drug takes the place of a common drug previously used for the same purpose. Publications on 58 topics were assessed during six 5-year periods from 1984 to 2013. Our analysis showed that during 2009–2013, out of seven anesthetics with a high general popularity index (≥2.0, only two were introduced after 1980, ie, the inhaled anesthetic sevoflurane and the local anesthetic ropivacaine; however, only sevoflurane had a high index of expectations (12.1. Among anesthetic adjuncts, in 2009–2013, only one agent, sugammadex, had both an extremely high index of change (>100 and a high index of expectations (25.0, reflecting the novelty of its mechanism of action. The index of ultimate success was positive with three anesthetics, ie, lidocaine, isoflurane, and propofol, all of which were introduced much longer than 30 years ago. For the past 30 years, there were no new anesthetics that have produced changes in scientometric indices indicating real progress. Keywords: anesthetics, anesthetic adjuvants, mortality, safety margins, therapeutic indices

  7. General anesthetic action at an internal protein site involving the S4-S5 cytoplasmic loop of a neuronal K(+) channel.

    Science.gov (United States)

    Harris, T; Shahidullah, M; Ellingson, J S; Covarrubias, M

    2000-02-18

    The structural bases of general anesthetic action on a neuronal K(+) channel were investigated using the series of homologous 1-alkanols, electrophysiology, and mutational analysis. Domain swapping between dShaw2 (alkanol-sensitive) and hKv3.4 (alkanol-resistant) and site-directed mutagenesis demonstrated that a 13-amino acid cytoplasmic loop (S4-S5) determines the selective inhibition of native dShaw2 channels by 1-alkanols. The S4-S5 loop may contribute to a receptor for both 1-alkanols and the inactivation particle, because the enhanced 1-alkanol sensitivity of hKv3.4 channels hosting S4-S5 mutations correlates directly with disrupted channel inactivation. Evidence of a discrete protein site was also obtained from the analysis of the relationship between potency and alkyl chain length, which begins to level off after 1-hexanol. Rapid application to the cytoplasmic side of inside-out membrane patches shows that the interaction between dShaw2 channels and 1-alkanols equilibrates in 1000-fold slower when the drug is applied externally to outside-out membrane patches. The data strongly favor a mechanism of inhibition involving a discrete internal site for 1-alkanols in dShaw2 K(+) channels. A new working hypothesis proposes that 1-alkanols lock dShaw2 channels in their closed conformation by a direct interaction at a crevice formed by the S4-S5 loop.

  8. Avoiding coral reef functional collapse requires local and global action.

    Science.gov (United States)

    Kennedy, Emma V; Perry, Chris T; Halloran, Paul R; Iglesias-Prieto, Roberto; Schönberg, Christine H L; Wisshak, Max; Form, Armin U; Carricart-Ganivet, Juan P; Fine, Maoz; Eakin, C Mark; Mumby, Peter J

    2013-05-20

    Coral reefs face multiple anthropogenic threats, from pollution and overfishing to the dual effects of greenhouse gas emissions: rising sea temperature and ocean acidification. While the abundance of coral has declined in recent decades, the implications for humanity are difficult to quantify because they depend on ecosystem function rather than the corals themselves. Most reef functions and ecosystem services are founded on the ability of reefs to maintain their three-dimensional structure through net carbonate accumulation. Coral growth only constitutes part of a reef's carbonate budget; bioerosion processes are influential in determining the balance between net structural growth and disintegration. Here, we combine ecological models with carbonate budgets and drive the dynamics of Caribbean reefs with the latest generation of climate models. Budget reconstructions using documented ecological perturbations drive shallow (6-10 m) Caribbean forereefs toward an increasingly fragile carbonate balance. We then projected carbonate budgets toward 2080 and contrasted the benefits of local conservation and global action on climate change. Local management of fisheries (specifically, no-take marine reserves) and the watershed can delay reef loss by at least a decade under "business-as-usual" rises in greenhouse gas emissions. However, local action must be combined with a low-carbon economy to prevent degradation of reef structures and associated ecosystem services. Copyright © 2013 Elsevier Ltd. All rights reserved.

  9. Learning Human Actions by Combining Global Dynamics and Local Appearance.

    Science.gov (United States)

    Luo, Guan; Yang, Shuang; Tian, Guodong; Yuan, Chunfeng; Hu, Weiming; Maybank, Stephen J

    2014-12-01

    In this paper, we address the problem of human action recognition through combining global temporal dynamics and local visual spatio-temporal appearance features. For this purpose, in the global temporal dimension, we propose to model the motion dynamics with robust linear dynamical systems (LDSs) and use the model parameters as motion descriptors. Since LDSs live in a non-Euclidean space and the descriptors are in non-vector form, we propose a shift invariant subspace angles based distance to measure the similarity between LDSs. In the local visual dimension, we construct curved spatio-temporal cuboids along the trajectories of densely sampled feature points and describe them using histograms of oriented gradients (HOG). The distance between motion sequences is computed with the Chi-Squared histogram distance in the bag-of-words framework. Finally we perform classification using the maximum margin distance learning method by combining the global dynamic distances and the local visual distances. We evaluate our approach for action recognition on five short clips data sets, namely Weizmann, KTH, UCF sports, Hollywood2 and UCF50, as well as three long continuous data sets, namely VIRAT, ADL and CRIM13. We show competitive results as compared with current state-of-the-art methods.

  10. Inflationary magnetogenesis and non-local actions: The conformal anomaly

    CERN Document Server

    El-Menoufi, Basem Kamal

    2015-01-01

    We discuss the possibility of successful magnetogenesis during inflation by employing the one-loop effective action of massless QED. The action is strictly non-local and results from the long distance fluctuations of massless charged particles present at the inflationary scale. Most importantly, it encodes the conformal anomaly of QED which is crucial to avoid the vacuum preservation in classical electromagnetism. In particular, we find a blue spectrum for the magnetic field with spectral index $n_B \\simeq 2 - \\alpha_{\\text{e}}$ where $\\alpha_{\\text{e}}$ depends on both the number of e-folds during inflation as well as the coefficient of the one-loop beta function. In particular, the sign of the beta function has important bearing on the final result. A low reheating temperature is required for the present day magnetic field to be consistent with the lower bound inferred on the field in the intergalactic medium.

  11. Energy Survival: entertainment as a resource for local energy actions

    Energy Technology Data Exchange (ETDEWEB)

    Elburg, Henk van; Moosdijk, Catelijne van de [SenterNovem (Netherlands)

    2007-07-01

    In 2005, SenterNovem, the Dutch Broadcasting Corporation, a publishing company and a consortium of local authorities launched 'Energy Survival'; a renewing energy marketing strategy for children to create a demand for local energy actions. New elements are powerful branding and the use of cross media techniques through national TV, internet, local events and primary education. Through entertainment, Energy Survival influences children's attitude towards energy consumption and its convincing relation with the environment. It aims at qualifying children to become 'energy ambassadors' in their own local environment: family, school and neighbourhood. Energy Survival has become a well tested energy game-concept for children in whom public and private partners cooperate under one brand name and with a clear division of roles and interests. However, the backbone of the concept is the local approach: local actions in municipalities and in primary schools, supported by television and internet where children learn to deal with the upcoming energy challenges of the planet they will inherit. By providing an internet-based teaching method, especially primary schools will be an effective multiplier to reach children. Broadcasting the energy game on national TV on the one hand, and local events and preliminaries on the other hand, ensure opportunities for widespread 'duplication' of the concept, adapted to local policy priorities regarding sustainable energy because each municipality is permitted to choose its own themes. Despite the fact that the project is still young and that the partners consider it as a 'long term-investment', the first independent monitoring results indicate that Energy Survival so far is quite successful. Ratings of the first TV-series show a national market share of 20 % in the age group 6-12 years and significantly more interaction between children and their parents on energy related issues. The website

  12. Comparison of orbital muscle akinesia caused by rocuronium versus hyaluronidase mixed to the local anesthetic in single injection peribulbar block for cataract surgery

    Science.gov (United States)

    Messeha, Medhat M.; Elhesy, Abd-Elmonem

    2015-01-01

    Background: The aim of this study was to compare orbital muscle akinesia caused by rocuronium versus hyaluronidase when mixed with the local anesthetic in single-injection peribulbar anesthesia (PBA). Patients and Methods: Sixty patients were included in the study and subjected to cataract extraction using phacoemulsification technique with intraocular lens implantation. Group I received peribulbar block with 5 ml mixture of 30 IU/ml hyaluronidase and 2% lidocaine. Group II received peribulbar block with 5 ml mixture of rocuronium 5 mg and 2% lidocaine. The onset and duration of akinesia were assessed; the akinesia score at 2, 5, and 10 min was measured after injection. The need for supplementary injection was also recorded. Results and Conclusion: PBA using a mixture of rocuronium and lidocaine provides optimal globe akinesia and faster establishment of suitable conditions to start eye surgery and shortens the block onset time as compared with the addition of hyaluronidase to lidocaine. PMID:26712977

  13. DOES THE ADDITION OF DEXAMETHASON TO LOCAL ANESTHETIC PROLONG THE ANALGESIA OF INTERSCALEN PLEXUS BRACHIALIS BLOCK IN PATIENTS WITH SHOULDER SURGERY?

    Directory of Open Access Journals (Sweden)

    Nancheva Jasminka

    2016-07-01

    Full Text Available Abstract: Introduction: Peripherial nerve blocks is a suitable alternative to general anesthesia especially for one-day case surgery. Interscalene approach of plexus brachialis block as much as supraclavicular and infraclavicular provide reliable, safe, effective, low cost and most complete anesthesia with satisfactory postoperative analgesia for upper limb surgery. Postoperative analgesia of plexus brachialis blocks can be prolonged by using different drugs as adjuvants with local anesthetics. Dexamethasone has been shown to prolong the duration of postoperative analgesia when given as an adjunct for peripheral nerve blocks. The investigation was randomized, prospective, double blinded and controlled study. Objective: The study was designed to compare the effects of dexamethasone administered as an adjunct to bupivacaine in interscalene brachial plexus block on the onset, duration and postoperative analgesia in patients under the shoulder surgery. Methods: A prospective, double-blind study was undertaken in patients scheduled for shoulder surgeries under the interscalene brachial plexus block. We enrolled 60 patients, ASA I-II both sexes, aged 19-65 years, weighing 54-89 kg, divided to two groups G1 and G2. The brachial plexus block was performed by interscalene approach and mixture of 2% lidocaine (12ml and 0.5% bupivacaine (22 ml either alone or combined with dexamethasone (4 mg. The block was performed by using double technique neurostimulator/ultrasound technique. Results: In our investigation we found a significant increase in onset and duration of motor and sensory block in Group G2 (with dexamethasone as compared to Group G1 patients (p < 0.01. Conclusion: Addition of dexamethasone to local anesthetic drugs in interscalene plexus brachialis block, significantly prolongs the duration of analgesia and motor block in patients undergoing shoulder arthroscopy. Moreover, it is a remarkably safe and costeffective method of providing

  14. Mass deformed world-sheet action of semi local vortices

    Energy Technology Data Exchange (ETDEWEB)

    Jiang, Yunguo [School of Space Science and Physics, Shandong University at Weihai,264209 Weihai (China); Shandong Provincial Key Laboratory of Optical Astronomy and Solar-Terrestrial Environment,264209 Weihai (China)

    2014-02-10

    The mass deformed effective world-sheet theory of semi local vortices was constructed via the field theoretical method. By Euler-Lagrangian equations, the Ansatze for both the gauge field and the adjoint scalar were solved, this ensures that zero modes of vortices are minimal excitations of the system. Up to the 1/g{sup 2} order, all profiles are solved. The mass deformed effective action was obtained by integrating out the transverse plane of the vortex string. The effective theory interpolates between the local vortex and the lump. Respecting certain normalization conditions, the effective theory shows a Seiberg-like duality, which agrees with the result of the Kähler quotient construction.

  15. Local anesthetics: interaction with human erythrocyte membranes as studied by {sup 1}H and {sup 31}P nuclear magnetic resonance; Anestesicos locais: interacao com membranas de eritrocitos de sangue humano, estudada por ressonancia magnetica nuclear de {sup 1}H e {sup 31}P

    Energy Technology Data Exchange (ETDEWEB)

    Fraceto, Leonardo Fernandes; Paula, Eneida de [Universidade Estadual de Campinas, SP (Brazil). Inst. de Biologia. Dept. de Bioquimica]. E-mail: depaula@unicamp.br

    2004-02-01

    The literature carries many theories about the mechanism of action of local anesthetics (LA). We can highlight those focusing the direct effect of LA on the sodium channel protein and the ones that consider the interaction of anesthetic molecules with the lipid membrane phase. The interaction between local anesthetics and human erythrocyte membranes has been studied by {sup 1}H and {sup 31}P nuclear magnetic resonance spectroscopy. It was found that lidocaine (LDC) and benzocaine (BZC) bind to the membranes, increase the mobility of the protons of the phospholipids acyl chains, and decrease the mobility and/or change the structure of the polar head groups. The results indicate that lidocaine molecules are inserted across the polar and liquid interface of the membrane, establishing both electrostatic (charged form) and hydrophobic (neutral form) interactions. Benzocaine locates itself a little deeper in the bilayer, between the interfacial glycerol region and the hydrophobic core. These changes in mobility or conformation of membrane lipids could affect the Na{sup +}-channel protein insertion in the bilayer, stabilizing it in the inactivated state, thus causing anesthesia. (author)

  16. Endomorphins: localization, release and action on rat dorsal horn neurons.

    Science.gov (United States)

    Dun, N J; Dun, S L; Wu, S Y; Williams, C A; Kwok, E H

    2000-01-01

    Endomorphin (Endo) 1 and 2, two tetrapeptides isolated from the bovine and human brain, have been proposed to be the endogenous ligand for the mu-opiate receptor. A multi-disciplinary study was undertaken to address the issues of localization, release and biological action of Endo with respect to the rat dorsal horn. First, immunohistochemical studies showed that Endo-1- or Endo-2-like immunoreactivity (Endo-1- or Endo-2-LI) is selectively expressed in fiber-like elements occupying the superficial layers of the rat dorsal horn, which also exhibit a high level of mu-opiate receptor immunoreactivity. Second, release of immunoreactive Endo-2-like substances (irEndo) from the in vitro rat spinal cords upon electrical stimulation of dorsal root afferent fibers was detected by the immobilized antibody microprobe technique. The site of release corresponded to laminae I and II where the highest density of Endo-2-LI fibers was localized. Lastly, whole-cell patch clamp recordings from substantia gelatinosa (SG) neurons of rat lumbar spinal cord slices revealed two distinct actions of exogenous Endo-1 and Endo-2: (1) depression of excitatory and/or inhibitory postsynaptic potentials evoked by stimulation of dorsal root entry zone, and (2) hyperpolarization of SG neurons. These two effects were prevented by the selective mu-opiate receptor antagonist beta-funaltrexamine. The localization of endomorphin-positive fibers in superficial layers of the dorsal horn and the release of irEndo upon stimulation of dorsal root afferents together with the observation that Endo inhibits the activity of SG neurons by interacting with mu-opiate receptors provide additional support of a role of Endo as the endogenous ligand for the mu-opiate receptor in the rat dorsal horn.

  17. 29 CFR 1608.7 - Affirmative action plans or programs under State or local law.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 4 2010-07-01 2010-07-01 false Affirmative action plans or programs under State or local... OPPORTUNITY COMMISSION AFFIRMATIVE ACTION APPROPRIATE UNDER TITLE VII OF THE CIVIL RIGHTS ACT OF 1964, AS AMENDED § 1608.7 Affirmative action plans or programs under State or local law. Affirmative action...

  18. Locality and topology with fat link overlap actions

    CERN Document Server

    Kovács, T G

    2003-01-01

    We study the locality and topological properties of fat link clover overlap (FCO) actions. We find that a small amount of fattening (2-4 steps of APE or 1 step of HYP) already results in greatly improved properties compared to the Wilson overlap (WO). We present a detailed study of the localisation of the FCO and its connection to the density of low modes of $A^\\dagger A$. In contrast to the Wilson overlap, on quenched gauge backgrounds we do not find any dependence of the localization of the FCO on the gauge coupling. This suggests that the FCO remains local in the continuum limit. The FCO also faithfully reproduces the zero mode wave functions of typical lattice instantons, not like the Wilson overlap. After a general discussion of different lattice definitions of the topological charge we also show that the FCO together with the Boulder charge are likely to satisfy the index theorem in the continuum limit. Finally, we present a high statistics computation of the quenched topological susceptibility with the...

  19. Effect of local anesthetic volume (15 vs 40 mL) on the duration of ultrasound-guided single shot axillary brachial plexus block: a prospective randomized, observer-blinded trial

    NARCIS (Netherlands)

    Schoenmakers, K.P.; Wegener, J.T.; Stienstra, R.

    2012-01-01

    BACKGROUND AND OBJECTIVES: One of the advantages of ultrasound-guided peripheral nerve block is that visualization of local anesthetic spread allows for a reduction in dose. However, little is known about the effect of dose reduction on sensory and motor block duration. The purpose of the present st

  20. Effect of local anesthetic volume (15 vs 40 mL) on the duration of ultrasound-guided single shot axillary brachial plexus block: a prospective randomized, observer-blinded trial

    NARCIS (Netherlands)

    Schoenmakers, K.P.; Wegener, J.T.; Stienstra, R.

    2012-01-01

    BACKGROUND AND OBJECTIVES: One of the advantages of ultrasound-guided peripheral nerve block is that visualization of local anesthetic spread allows for a reduction in dose. However, little is known about the effect of dose reduction on sensory and motor block duration. The purpose of the present

  1. Analysis of a spherical tank under a local action

    Science.gov (United States)

    Vinogradov, Yu. N.; Konstantinov, M. V.

    2016-03-01

    A spherical tank, being perfect as far as weight is concerned, is used in spacecraft, where the thin-walled elements (shells) are united by frames. Obviously, local actions on the shell and hence the stress concentration in the shell cannot be avoided. Attempts to make weight structure of the spacecraft perfect inevitably decrease the safetymargin of the components, which is possible only if the stress-strain state of the components is determined with a controlled error. A mathematical model of shell deformation mechanics is proposed for this purpose, and its linear differential equations are obtained with an error that does not exceed the error of Kirchhoff assumptions in the theory of shells. The algorithm for solving these equations contains procedures for estimating the convergence of the Fourier series and the series of the hypergeometric function with a prescribed error, and the problem can be solved analytically.

  2. Local Actions of Melatonin in Somatic Cells of the Testis

    Directory of Open Access Journals (Sweden)

    Mónica Beatriz Frungieri

    2017-05-01

    Full Text Available The pineal hormone melatonin regulates testicular function through the hypothalamic-adenohypophyseal axis. In addition, direct actions of melatonin in somatic cells of the testis have been described. Melatonin acts as a local modulator of the endocrine activity in Leydig cells. In Sertoli cells, melatonin influences cellular growth, proliferation, energy metabolism and the oxidation state, and consequently may regulate spermatogenesis. These data pinpoint melatonin as a key player in the regulation of testicular physiology (i.e., steroidogenesis, spermatogenesis mostly in seasonal breeders. In patients with idiopathic infertility, melatonin exerts anti-proliferative and anti-inflammatory effects on testicular macrophages, and provides protective effects against oxidative stress in testicular mast cells. Consequently, melatonin is also involved in the modulation of inflammatory and oxidant/anti-oxidant states in testicular pathology. Overall, the literature data indicate that melatonin has important effects on testicular function and male reproduction.

  3. A Randomized Controlled Trail Comparing the Efficacy of 0.5% Centbucridine to 2% Lignocaine as Local Anesthetics in Dental Extractions

    Directory of Open Access Journals (Sweden)

    Samir Mansuri

    2011-01-01

    Full Text Available The development of local anesthesia in dentistry has marked the beginning of a new era in terms of pain control. Lignocaine is the most commonly used local anesthetic (LA agent even though it has a vasodilative effect and needs to be combined with adrenaline. Centbucridine is a non-ester, non amide group LA and has not been comprehensively studied in the dental setting and the objective was to compare it to Lignocaine. This was a randomized study comparing the onset time, duration, depth and cardiovascular parameters between Centbucridine (0.5% and Lignocaine (2%. The study was conducted in the dental outpatient department at the Government Dental College in India on patients attending for the extraction of lower molars. A total of 198 patients were included and there were no significant differences between the LAs except those who received Centbucridine reported a significantly longer duration of anesthesia compared to those who received Lignocaine. None of the patients reported any side effects. Centbucridine was well tolerated and its substantial duration of anesthesia could be attributed to its chemical compound. Centbucridine can be used for dental procedures and can confidently be used in patients who cannot tolerate Lignocaine or where adrenaline is contraindicated.

  4. Comparative, double-blind, controlled study of intra-articular hyaluronic acid (Hyalubrix®) injections versus local anesthetic in osteoarthritis of the hip

    Science.gov (United States)

    2009-01-01

    Introduction Comparison of intra-articular bacterial-derived hyaluronic acid (Hyalubrix®) (HA) with local analgesia (mepivacaine) for osteoarthritis (OA) of the hip. Methods A pilot prospective, double-blind, 6-month randomized trial of 42 patients with hip OA. HA or mepivacaine was administered twice (once a month) under ultrasound guidance. Efficacy measurements included the Lequesne's algofunctional index, a visual analog scale for pain, concomitant use of analgesia, patient and physician global measurement, and safety. Results Patients in the HA group exhibited a significantly reduced Lequesne's algofunctional index 3 and 6 months after treatment (P < 0.001) and significantly reduced visual analog scale pain scores 3 and 6 months after treatment (P < 0.05) compared with the local anesthetic group. All primary and secondary measures were significantly improved versus baseline, but other than the above were not different from each other at 3 or 6 months. Adverse effects were minimal. Conclusions This comparative study suggests a beneficial effect and safety of intra-articular HA in the management of hip OA. Trial registration number ISRCTN39397064. PMID:20003205

  5. Side effects of subarachnoid and epidural sufentanil associated with a local anesthetic in patients undergoing labor analgesia

    OpenAIRE

    Salem, Isabel C.F. [UNESP; Fernanda B. Fukushima; Giane Nakamura; Fábio Ferrari; Navarro,Laís C.; Yara Marcondes Machado Castiglia; Eliana Marisa Ganem

    2007-01-01

    JUSTIFICATIVA E OBJETIVOS: A associação do opióide ao anestésico local melhora a qualidade da analgesia de parto e reduz o risco de toxicidade sistêmica pelo anestésico local. Os opióides, entretanto, podem determinar efeitos colaterais. O objetivo desta pesquisa foi comparar os efeitos adversos determinados pelo sufentanil, administrado por via subaracnóidea, associado à bupivacaína, com aquele determinado pelo sufentanil por via peridural, associado à ropivacaína, nas doses utilizadas no Se...

  6. Decoupling Action Potential Bias from Cortical Local Field Potentials

    Directory of Open Access Journals (Sweden)

    Stephen V. David

    2010-01-01

    Full Text Available Neurophysiologists have recently become interested in studying neuronal population activity through local field potential (LFP recordings during experiments that also record the activity of single neurons. This experimental approach differs from early LFP studies because it uses high impendence electrodes that can also isolate single neuron activity. A possible complication for such studies is that the synaptic potentials and action potentials of the small subset of isolated neurons may contribute disproportionately to the LFP signal, biasing activity in the larger nearby neuronal population to appear synchronous and cotuned with these neurons. To address this problem, we used linear filtering techniques to remove features correlated with spike events from LFP recordings. This filtering procedure can be applied for well-isolated single units or multiunit activity. We illustrate the effects of this correction in simulation and on spike data recorded from primary auditory cortex. We find that local spiking activity can explain a significant portion of LFP power at most recording sites and demonstrate that removing the spike-correlated component can affect measurements of auditory tuning of the LFP.

  7. Does pain relief by CT-guided indirect cervical nerve root injection with local anesthetics and steroids predict pain relief after decompression surgery for cervical nerve root compression?

    Science.gov (United States)

    Antoniadis, Alexander; Dietrich, Tobias J; Farshad, Mazda

    2016-10-01

    The relationship of pain relief from a recently presented CT-guided indirect cervical nerve root injection with local anesthetics and steroids to surgical decompression as a treatment for single-level cervical radiculopathy is not clear. This retrospective study aimed to compare the immediate and 6-week post-injection effects to the short- and long-term outcomes after surgical decompression, specifically in regard to pain relief. Patients (n = 39, age 47 ± 10 years) who had undergone CT-guided indirect injection with local anesthetics and steroids as an initial treatment for single cervical nerve root radiculopathy and who subsequently needed surgical decompression were included retrospectively. Pain levels (VAS scores) were monitored before, immediately after, and 6 weeks after injection (n = 34), as well as 6 weeks (n = 38) and a mean of 25 months (SD ± 12) after surgical decompression (n = 36). Correlation analysis was performed to find potential associations of pain relief after injection and after surgery to investigate the predictive value of post-injection pain relief. There was no correlation between immediate pain relief after injection (-32 ± 27 %) and 6 weeks later (-7 ± 19 %), (r = -0.023, p = 0.900). There was an association by tendency between immediate pain relief after injection and post-surgical pain relief at 6 weeks (-82 ± 27 %), (r = 0.28, p = 0.08). Pain relief at follow-up remained high at -70 ± 21 % and was correlated with the immediate pain amelioration effect of the injection (r = 0.37, p = 0.032). Five out of seven patients who reported no pain relief from injection had a pain relief from surgery in excess of 50 %. The amount of immediate radiculopathic pain relief after indirect cervical nerve root injection is associated with the amount of pain relief achieved at long-term follow-up after surgical decompression of single-level cervical radiculopathy

  8. Anesthetics drug pharmacodynamics.

    Science.gov (United States)

    Bischoff, P; Schneider, G; Kochs, E

    2008-01-01

    Anesthesia cannot be defined in an unambiguous manner. The essential components of general anesthesia are absence of consciousness and pain. This translates into two particular qualities: (1) sedation and hypnosis, i.e., mental blockade and (2) analgesia/antinociception, i.e., sensory blockade. Anesthetic actions on these two subcomponents are difficult to separate. On the one hand, very few anesthetics act exclusively on one of these components. On the other hand, these components are closely related to each other. Unconsciousness prevents (conscious) perception of pain, and nociception may serve as an arousal stimulus and change the level of sedation and hypnosis. The art of anesthesia lies in adequate dosing of drugs to reach both mental and sensory blockade. Drug administration can be based on pharmacokinetic considerations. Pharmacokinetic models allow an estimation of what happens to the administered drug in the body. Models with an effect site compartment may facilitate a tailored administration of anesthetic drugs. Finally, the quantification of pharmacodynamic effects allows a precise titration of drugs. Clinical assessment of mental blockade is often dichotomous, and therefore not very helpful to guide drug administration. Several scoring systems exist, but once consciousness is lost they become less reliable, in particular because reaction to stimuli is assessed, which mixes assessment of mental blockade with assessment of sensory blockade. Clinical assessment of analgesia requires a conscious patient, so antinociception is difficult to measure. Several methods of objective quantification on the basis of electrical brain activity are discussed including EEG and evoked potentials. Despite numerous indexes of the hypnotic component of anesthesia, there is no parameter that unambiguously quantifies the level of mental or sensory blockade.

  9. Anesthetics interacting with lipid rafts.

    Science.gov (United States)

    Bandeiras, Cátia; Serro, Ana Paula; Luzyanin, Konstantin; Fernandes, Anabela; Saramago, Benilde

    2013-01-23

    The exact mechanism by which anesthetics induce cell membrane-mediated modifications is still an open question. Although the fluidization effect of the anesthetic molecules on the cellular membrane is widely recognized, it is not known if anesthetics show any preference for specific membrane domains, namely the lipid rafts. The importance of these membrane micro-domains derives from the fact that they have been associated with cell signaling pathways, as well as with specific drug interactions. The objective of this work is to contribute for the elucidation of this question through the comparison of the anesthetic interactions with membranes of various lipid compositions. Liposomes prepared with an equimolar mixture of POPC, sphingomyelin and cholesterol, were chosen as models for lipid rafts. The interactions of these liposomes with two local anesthetics, tetracaine and lidocaine, and one general anesthetic, propofol, were studied. The effect of cholesterol was investigated by comparing anesthetic interactions with POPC/SM liposomes and POPC/SM/CHOL liposomes. The following experimental techniques were used: quartz crystal microbalance with dissipation, differential scanning calorimetry and phosphorus nuclear magnetic resonance. Although the liposomes investigated by the different techniques are not in the same conditions, it is possible to assemble the information obtained from all experimental techniques employed to reach a general conclusion. Tetracaine interacts more with raftlike domains, lidocaine induces stronger modifications on POPC/SM liposomes and the results for propofol are not fully conclusive but it seems to be the least prone to lipid interactions. The results were compared with those obtained with DMPC-containing liposomes, reported in a previous work.

  10. Adherence to guidelines for the management of local anesthetic systemic toxicity is improved by an electronic decision support tool and designated "Reader".

    Science.gov (United States)

    McEvoy, Matthew D; Hand, William R; Stoll, W David; Furse, Cory M; Nietert, Paul J

    2014-01-01

    A hardcopy or paper cognitive aid has been shown to improve performance during the management of simulated local anesthetic systemic toxicity (LAST) when given to the team leader. However, there remains room for improvement to ensure a system that can achieve perfect adherence to the published guidelines for LAST management. Recent research has shown that implementing a checklist via a designated reader may be of benefit. Accordingly, we sought to investigate the effect of an electronic decision support tool (DST) and designated "Reader" role on team performance during an in situ simulation of LAST. Participants were randomized to Reader + DST (n = 16, rDST) and Control (n = 15, memory alone). The rDST group received the assistance of a dedicated Reader on the response team who was equipped with an electronic DST. The primary outcome measure was adherence to guidelines. For overall and critical percent correct scores, the rDST group scored higher than Control (99.3% vs 72.2%, P Reader with an electronic DST improved adherence to guidelines in the management of an in situ simulation of LAST. Such tools are promising in the future of medicine, but further research is needed to ensure the best methods for implementing them in the clinical arena.

  11. Dexmedetomidine as an additive to local anesthetics compared with intravenous dexmedetomidine in peribulbar block for cataract surgery

    Directory of Open Access Journals (Sweden)

    A M Abdelhamid

    2016-01-01

    Full Text Available Background: No studies compared parenteral dexmedetomidine with its use as an adjuvant to ophthalmic block. We compared between adding dexmedetomidine to bupivacaine in peribulbar block and intravenous (IV dexmedetomidine during peribulbar block for cataract surgery. Materials and Methods: A prospective, randomized, double-blind study on 90 patients for cataract surgery under peribulbar anesthesia. Study included three groups; all patients received 10 ml of peribulbar anesthesia and IV infusion of drugs as follows: Group I: Received a mixture of bupivacaine 0.5% (4.5 ml + lidocaine 2% (4.5 ml + normal saline (1 ml + 150 IU hyaluronidase + IV infusion of normal saline, Group II: Received mixture of bupivacaine 0.5% (4.5 ml + lidocaine 2% (4.5 ml + dexmedetomidine 50 μg (1 ml +150 IU hyaluronidase + IV infusion of normal saline and Group III: Received mixture of bupivacaine 0.5% (4.5 ml + lidocaine 2% (4.5 ml + normal saline (1 ml +150 IU hyaluronidase + IV dexmedetomidine 1 μg/kg over 10 min; followed by 0.4 μg/kg/h IV infusion. We recorded onset, duration of block, Ramsay Sedation Score, intra-ocular pressure (IOP, hemodynamics, and adverse effects. Results: There was a significant decrease in the onset of action and increase in the duration of block in Group II as compared with the Group I and Group III. Mean Ramsay Sedation Score was higher in Group III. The IOP showed a significant decrease in Group II and Group III 10 min after injection (P < 0.01. Heart rate showed a significant decrease in Group III in comparison with the two other groups (P < 0.05. Only two patients in Group III developed bradycardia. Conclusion: Dexmedetomidine as an additive shortens onset time, prolong block durations and significantly decreases the IOP with minimal side effects. IV dexmedetomidine, in addition, produces intra-operative sedation with hemodynamic stability.

  12. Robust action recognition using multi-scale spatial-temporal concatenations of local features as natural action structures.

    Directory of Open Access Journals (Sweden)

    Xiaoyuan Zhu

    Full Text Available Human and many other animals can detect, recognize, and classify natural actions in a very short time. How this is achieved by the visual system and how to make machines understand natural actions have been the focus of neurobiological studies and computational modeling in the last several decades. A key issue is what spatial-temporal features should be encoded and what the characteristics of their occurrences are in natural actions. Current global encoding schemes depend heavily on segmenting while local encoding schemes lack descriptive power. Here, we propose natural action structures, i.e., multi-size, multi-scale, spatial-temporal concatenations of local features, as the basic features for representing natural actions. In this concept, any action is a spatial-temporal concatenation of a set of natural action structures, which convey a full range of information about natural actions. We took several steps to extract these structures. First, we sampled a large number of sequences of patches at multiple spatial-temporal scales. Second, we performed independent component analysis on the patch sequences and classified the independent components into clusters. Finally, we compiled a large set of natural action structures, with each corresponding to a unique combination of the clusters at the selected spatial-temporal scales. To classify human actions, we used a set of informative natural action structures as inputs to two widely used models. We found that the natural action structures obtained here achieved a significantly better recognition performance than low-level features and that the performance was better than or comparable to the best current models. We also found that the classification performance with natural action structures as features was slightly affected by changes of scale and artificially added noise. We concluded that the natural action structures proposed here can be used as the basic encoding units of actions and may hold

  13. [Studies on local anesthetics. Part 183: micellization and thermodynamic parameters of heptacainium chloride in the solution of potassium bromide].

    Science.gov (United States)

    Andriamainty, F; Cizmárik, J; Malík, I; Horvat, S

    2008-06-01

    The critical micellar concentration (CMC) of the local anaesthetic agent heptacainium chloride in the solution of KBr was determined by the spectrophotometric method in the UV region of the spectrum at the temperature range of t = 20-40 degrees C and pH = 4.5-5.0. The dependence of CMC on the temperature T turned out forming the U-shape with the minimum at the temperature of t = 25 degrees C. The parabolic dependence of CMC on the temperature T was drawn by the fitting of the values using the polynomial function and the so-called power law equation. The CMC dependence on the temperature T was fitted by the second degree polynomial function. The obtained parabolic equations were applied to the "phase separation model", so the following thermodynamic parameters could be calculated: standard Gibbs free energy (deltaG), enthalpy (deltaH degrees), and entropy (deltaS degrees). The thermodynamic parameters were further used to determine the so-called entropy-enthalpy compensation of the systems under study. The compensation temperature was in the following range: (301 +/- 1-303 +/- 3)K. Then the temperature dependence of the enthalpy (deltaH degrees) and entropy (-TdeltaS degrees) contributions to the standard Gibbs free energy (deltaG degrees) for all prepared concentrations of the compound were calculated.

  14. 脂肪乳用于长效局麻药中毒的救治%Employment of lipid emulsion in the resuscitation for long-acting local anesthetic toxirity

    Institute of Scientific and Technical Information of China (English)

    张鸿飞; 徐世元

    2009-01-01

    There are no effective and convenient therapeutic management on refractory cardiac arrest induced by long-acting local anesthetic toxicity. Although there are no any randomly controlled trials showing the effectiveness of lipid emulsion for anesthetic toxicity resuscitation in human beings mostly because of ethic issues, lipid emulsion has been proved to be effective in animal models undergoing local anesthetic toxicity. This novel approach to treating potentially fatal cardiac toxicity is still at an early stage but holds promise for clinical application. Literatures suggest that lipid emulsion resuscitation should be as a reserve step because of lacking clinical investigative evidence. However, more and more case reports indicate that lipid emulsion should be used earlier in order to avoid local anesthetic toxicity deteriorated. Further work is required to explore mechanism of lipid emulsion on resuscitation of local anesthetic toxicity and optimize the treatment regimens with respect to efficacy and safety of lipid rescue.%长效局麻药(local anesthetic,LA)中毒所致顽固性心跳骤停,目前临床尚无有效便捷的治疗方法.动物研究发现静脉注射脂肪乳(lipid emulsion,LE)可治疗布比卡因所致心跳骤停.因尚缺乏有力的临床研究证据支持,文献建议LE作为LA心脏毒性标准心肺复苏的备用措施.但多例个案报道提示,一旦出现LA毒性症状,应尽早使用LE救治,以避免LA毒性综合征的发展.未来的研究方向应致力于探索LE救治有效性的确切机制,寻求临床适用的最佳使用方法,确立治疗标准.

  15. Concentrating entanglement by local actions: Beyond mean values

    Science.gov (United States)

    Lo, Hoi-Kwong; Popescu, Sandu

    2001-02-01

    Suppose two distant observers Alice and Bob share a pure bipartite quantum state. By applying local operations and communicating with each other using a classical channel, Alice and Bob can manipulate it into some other states. Previous investigations of entanglement manipulations have been largely limited to a small number of strategies and their average outcomes. Here we consider a general entanglement manipulation strategy, and go beyond the average property. For a pure entangled state shared between two separated persons Alice and Bob, we show that the mathematical interchange symmetry of the Schmidt decomposition can be promoted into a physical symmetry between the actions of Alice and Bob. Consequently, the most general (multistep two-way-communications) strategy of entanglement manipulation of a pure state is, in fact, equivalent to a strategy involving only a single (generalized) measurement by Alice followed by one-way communications of its result to Bob. We also prove that strategies with one-way communications are generally more powerful than those without communications. In summary, one-way communications is necessary and sufficient for entanglement manipulations of a pure bipartite state. The supremum probability of obtaining a maximally entangled state (of any dimension) from an arbitrary state is determined, and a strategy for achieving this probability is constructed explicitly. One important question is whether collective manipulations in quantum mechanics can greatly enhance the probability of large deviations from the average behavior. We answer this question in the negative by showing that, given n pairs of identical partly entangled pure states (\\|Ψ>) with entropy of entanglement E(\\|Ψ>), the probability of getting nK [K>E(\\|Ψ>)] singlets out of entanglement concentration tends to zero as n tends to infinity.

  16. 计算机控制局部麻醉系统的应用研究%Application of computer-controlled local anesthetic delivery

    Institute of Scientific and Technical Information of China (English)

    刘艳梅; 刘楠; 李馨

    2013-01-01

      Objective Evaluation on the effect of single tooth anesthesia(STA) computer-controlled local anes-thetic delivery in tooth extraction to the patients with dental anxiety and cardiovascular disease. Methods Two groups were included. In the experimental group, STA was used, and in the control group, hand injection was performed. Anxiety level before and after injection was evaluated with modified dental anxiety scale. The level of pain during injection was assessed with visual analogue scale by patients after injection. Blood pressure and heart rate were observed before, during and after injection. Results The visual analogue scale value showed a statistical difference between the experimental group and the control group. After injection, 86.11% patients in experimental group were decreased about the incidence rate of scores, which was significiantly superior to control group. No changes in blood pressure and heart rate were found before, during and after injection in the experimental group. The blood pressure increased significantly during injection in the control group. Conclusion STA computer-con-trolled local anesthetic delivery can abate the inject pain and anxiety level, reduce the risk in the operation.%  目的评价单颗牙麻醉(STA)计算机辅助口腔局部麻醉技术应用于伴有牙科焦虑的心血管病患者拔牙时的效果。方法试验分为2组,试验组使用STA进行局部麻醉注射,对照组采用手动注射方式。采用改良牙科焦虑量表评定患者局部麻醉前后的牙科焦虑状况。注射后由患者本人用视觉模拟标尺表评价注射时的疼痛程度。监测麻醉前、中、后患者的血压和心率。结果2组注射时的疼痛评分存在统计学差异。试验组麻醉后有86.11%的患者焦虑评分下降,与对照组相比,两者麻醉前后焦虑变化差异显著。试验组麻醉前、中、后血压和心率变化差异无统计学意义。但是,对照组麻醉中

  17. 脂肪酸逆转局麻药心肌毒性的药理机制研究进展%Progress in Pharmacological Mechanism for the Role of Fatty Acid in Reversal of Myocardial Toxicity of Local Anesthetics

    Institute of Scientific and Technical Information of China (English)

    高晶; 刘超

    2014-01-01

    目前尚没有特异的局麻药解毒剂,严重阻碍了临床治疗效果,寻找有效的局麻药解毒剂日益紧迫。本文从脂肪池、能量代谢、NO、离子通道和增溶作用来诠释脂肪酸逆转局麻药心肌毒性的分子药理学机制,并比较了纳米脂质体与普通脂肪乳剂结构和功能上的不同的特点。%At present, there is no specific antidote for local anesthetic toxicity, which seriously hindered therapeutic efficts of clinical treatment. It is increasingly urgent for finding find the effective antidote to local anesthetic. This article at-tempts to interpret the molecular pharmacological mechanism from fat pool, energy metabolism, NO, ion channel and solubili-zation for the role of fatty acids in reversal of myocardial toxicity of local anesthetics. And the different characteristics of the structure and function of nano liposome and fat emulsion were compared.

  18. Exploring the structure of the voltage-gated Na+ channel by an engineered drug access pathway to the receptor site for local anesthetics.

    Science.gov (United States)

    Lukacs, Peter; Gawali, Vaibhavkumar S; Cervenka, Rene; Ke, Song; Koenig, Xaver; Rubi, Lena; Zarrabi, Touran; Hilber, Karlheinz; Stary-Weinzinger, Anna; Todt, Hannes

    2014-08-01

    Despite the availability of several crystal structures of bacterial voltage-gated Na(+) channels, the structure of eukaryotic Na(+) channels is still undefined. We used predictions from available homology models and crystal structures to modulate an external access pathway for the membrane-impermeant local anesthetic derivative QX-222 into the internal vestibule of the mammalian rNaV1.4 channel. Potassium channel-based homology models predict amino acid Ile-1575 in domain IV segment 6 to be in close proximity to Lys-1237 of the domain III pore-loop selectivity filter. The mutation K1237E has been shown previously to increase the diameter of the selectivity filter. We found that an access pathway for external QX-222 created by mutations of Ile-1575 was abolished by the additional mutation K1237E, supporting the notion of a close spatial relationship between sites 1237 and 1575. Crystal structures of bacterial voltage-gated Na(+) channels predict that the side chain of rNaV1.4 Trp-1531 of the domain IV pore-loop projects into the space between domain IV segment 6 and domain III pore-loop and, therefore, should obstruct the putative external access pathway. Indeed, mutations W1531A and W1531G allowed for exceptionally rapid access of QX-222. In addition, W1531G created a second non-selective ion-conducting pore, bypassing the outer vestibule but probably merging into the internal vestibule, allowing for control by the activation gate. These data suggest a strong structural similarity between bacterial and eukaryotic voltage-gated Na(+) channels. © 2014 by The American Society for Biochemistry and Molecular Biology, Inc.

  19. Exploring the Structure of the Voltage-gated Na+ Channel by an Engineered Drug Access Pathway to the Receptor Site for Local Anesthetics*

    Science.gov (United States)

    Lukacs, Peter; Gawali, Vaibhavkumar S.; Cervenka, Rene; Ke, Song; Koenig, Xaver; Rubi, Lena; Zarrabi, Touran; Hilber, Karlheinz; Stary-Weinzinger, Anna; Todt, Hannes

    2014-01-01

    Despite the availability of several crystal structures of bacterial voltage-gated Na+ channels, the structure of eukaryotic Na+ channels is still undefined. We used predictions from available homology models and crystal structures to modulate an external access pathway for the membrane-impermeant local anesthetic derivative QX-222 into the internal vestibule of the mammalian rNaV1.4 channel. Potassium channel-based homology models predict amino acid Ile-1575 in domain IV segment 6 to be in close proximity to Lys-1237 of the domain III pore-loop selectivity filter. The mutation K1237E has been shown previously to increase the diameter of the selectivity filter. We found that an access pathway for external QX-222 created by mutations of Ile-1575 was abolished by the additional mutation K1237E, supporting the notion of a close spatial relationship between sites 1237 and 1575. Crystal structures of bacterial voltage-gated Na+ channels predict that the side chain of rNaV1.4 Trp-1531 of the domain IV pore-loop projects into the space between domain IV segment 6 and domain III pore-loop and, therefore, should obstruct the putative external access pathway. Indeed, mutations W1531A and W1531G allowed for exceptionally rapid access of QX-222. In addition, W1531G created a second non-selective ion-conducting pore, bypassing the outer vestibule but probably merging into the internal vestibule, allowing for control by the activation gate. These data suggest a strong structural similarity between bacterial and eukaryotic voltage-gated Na+ channels. PMID:24947510

  20. Influence of topical application of capsaicin, menthol and local anesthetics on intraoral somatosensory sensitivity in healthy subjects: temporal and spatial aspects.

    Science.gov (United States)

    Naganawa, Takuya; Baad-Hansen, Lene; Ando, Tomohiro; Svensson, Peter

    2015-04-01

    The aim of this study was to investigate temporal and spatial aspects of somatosensory changes after topical application of capsaicin, menthol and local anesthetics (LA) on the gingiva with the use of intraoral palpometers and thermal devices. Sixteen healthy volunteers (eight male, eight female) participated. Four topical preparations (capsaicin, menthol, LA and Vaseline as a control) were randomly applied to the gingiva around the first premolar in the upper jaw via individual oral templates, which allowed spatial mapping of somatosensory changes at and adjacent to the site of application. The topical drugs were applied for 15 min in a randomized and balanced sequence. The perceived preparation-evoked pain intensity was recorded with the use of 0-10 visual analog scales (VAS). Standardized mechanical and thermal stimuli were applied before, during and up to 30 min after the topical applications, and numerical rating scales (NRS) were used to score the perceived intensity of the stimuli. Peak VAS, area under the curve and mean VAS preparation-evoked pain scores for capsaicin, menthol, LA and control were compared with paired t tests. NRS scores for mechanical and thermal test stimuli were analyzed with four-way repeated measurements analyses of variance. Capsaicin evoked significantly higher VAS pain parameters as well as higher NRS scores to heat stimuli than control (P capsaicin caused sensitization to heat stimuli at and adjacent to the application area. In conclusion, this study for the first time demonstrates the time course of capsaicin-evoked heat hyperalgesia in and outside the site of application at the oral mucosa (primary and secondary hyperalgesia).

  1. Comparison of interscalene brachial plexus block and intra-articular local anesthetic administration on postoperative pain management in arthroscopic shoulder surgery

    Directory of Open Access Journals (Sweden)

    Recep Aksu

    2015-06-01

    Full Text Available BACKGROUND AND OBJECTIVES: In this study, the aim was to compare postoperative analgesia effects of the administration of ultrasound-guided interscalene brachial plexus block and intra-articular bupivacaine carried out with bupivacaine. METHODS: In the first group of patients 20 mL 0.25% bupivacaine and ultrasound-guided interscalene brachial plexus block (ISPB were applied, while 20 mL 0.25% bupivacaine was given via intra-articular (IA administration to the second group patients after surgery. Patients in the third group were considered the control group and no block was performed. Patient-controlled analgesia (PCA with morphine was used in all three groups for postoperative analgesia. RESULTS: In the ISPB group, morphine consumption in the periods between 0-4, 6-12 and 12-24 postoperative hours and total consumption within 24 h was lower than in the other two groups. Morphine consumption in the IA group was lower than in the control group in the period from 0 to 6 h and the same was true for total morphine consumption in 24 h. Postoperative VASr scores in the ISPB group were lower than both of the other groups in the first 2 h and lower than the control group in the 4th and 6th hours (p < 0.05. In the IA group, VASr and VASm scores in the 2nd, 4th and 6th hours were lower than in the control group (p < 0.05. CONCLUSION: Interscalene brachial plexus block was found to be more effective than intra-articular local anesthetic injection for postoperative analgesia.

  2. Effect of local anesthetic concentration, dose and volume on the duration of single-injection ultrasound-guided axillary brachial plexus block with mepivacaine: a randomized controlled trial.

    Science.gov (United States)

    Fenten, Maaike G E; Schoenmakers, Karin P W; Heesterbeek, Petra J C; Scheffer, Gert Jan; Stienstra, Rudolf

    2015-09-30

    In what way volume, concentration and dose affect block duration is controversial. The purpose of the present study is to investigate the effect of dose, volume and concentration of mepivacaine on the duration of sensory and motor blockade in ultrasound-guided single shot axillary brachial plexus blockade. In this parallel group randomized trial conducted in the Sint Maartenskliniek Nijmegen, 45 adult patients undergoing minor orthopaedic forearm, wrist or hand surgery were randomized to 3 groups. Group A: 20 mL mepivacaine 1.5 %, Group B: 30 mL mepivacaine 1 % and Group C: 30 mL mepivacaine 1.5 %. Randomization was computer-generated, with allocation concealment by opaque sequentially numbered sealed envelopes. Patients and observers were blinded to group allocation. duration of sensory block. Forty-five patients were randomized, four patients were excluded and replaced, and 15 patients in each group were included in the analysis. Mean (95 % CI) sensory and motor block duration was 256 (230-282) and 254 (226-282) minutes in Group A, 226 (209-243) and 220 (200-240) minutes in Group B and 270 (249-291) and 264 (244-284) minutes in Group C. Duration of sensory and motor block duration differed significantly between groups (p = 0.012 and p = 0.016 respectively). Post-hoc analysis showed a significantly reduced sensory and motor block duration in Group B when compared to Group C of 44 min. No local anesthetic systemic toxicity was reported. When using mepivacaine for axillary brachial plexus block, a higher dose and concentration was associated with a longer duration of sensory and motor blockade, but not a higher volume. The Netherlands National Trial Register NTR3648 . Registered October 3, 2012.

  3. Fight against the greenhouse effect. From the local to the international action; Lutte contre l'effet de serre. De l'action locale a l'action internationale

    Energy Technology Data Exchange (ETDEWEB)

    Mousel, M

    2002-07-01

    In the fight against the greenhouse gases emissions, the local government are directly concerned. This sheet aims to explain the greenhouse effect, the kyoto protocol, the french national policy and to orientate the local actions. (A.L.B.)

  4. Measuring the Degree of Local Administration Action in Economic Development

    Directory of Open Access Journals (Sweden)

    Elena Botezat

    2006-03-01

    Full Text Available The attentive diagnosis of the local economic basis, the deep understanding of the obstacles that confront the economic growth and the investments, the elaboration and the implementation of certain strategies to facilitate the investments are the means by which the local authorities can assure the future of the local community which voted them. The present paper proposes to measure the effectiveness and efficacity of their activity by lying the basis of the methodology of calculating the degree the local authorities imply themselves in the local economic development and its impact upon the financial mana¬gement performance of a certain town. Only a management that sustains the local economic development can lead to the permanent growth of the economic basis, which generates permanent development.

  5. Performative Actions in E-Adoption Processes: Strategic Efforts in a Local Government

    DEFF Research Database (Denmark)

    Hjelholt, Morten

    2015-01-01

    In this paper the concept of performative action is introduced to address how individuals can engage in IT adoption processes. The study investigates how local government employees adopt and localize ideas from a Danish National IT initiative called eDay3. Particularly the actions of a project ma....... Through the use of performative actions the positions are never stable and firm but constantly enacted and changed in discursive practices....

  6. A Meta-Analysis of Local Climate Change Adaptation Actions

    Science.gov (United States)

    Local governments are beginning to take steps to address the consequences of climate change, such as sea level rise and heat events. However, we do not have a clear understanding of what local governments are doing -- the extent to which they expect climate change to affect their...

  7. [Facial locoregional anesthetics: principles and precautions].

    Science.gov (United States)

    Lefort, H; Lacroix, G; Cordier, A; Bey, E; Duhamel, P

    2009-12-01

    Facial locoregional anesthetics (ALR) with nervous blocks are simple and reliable to perform, need little technical resources with a very low iatrogenic risk. These blocks allow anesthesia without deforming wound banks using the same materials as usual local anesthetic procedures. Three principal nervous blocks, in a straight line along the vertical pupil axis, allow managing - even extensive - facial wounds. Few side effects may occur which can be easily prevented. It is a good alternative to local anesthetic for the treatment of extensive and deep areas which is performed with a lower number of injections and a high rate of success. These techniques are easy to learn and practise. These anesthetic techniques allow a nice treatment of different kinds of facial wounds from simple suture to flaps.

  8. INTRAOCULAR PRESSURE, MEAN ARTERIAL BLOOD PRESSURE AND PUPILLARY DIAMETER IN RABBITS ( (Oryctolagus cuniculus SUBJECTED TO RETROBULBAR BLOCK WITH DIFFERENT ANESTHETIC PROTOCOLS

    Directory of Open Access Journals (Sweden)

    Renata Maria Monção da Silva

    2015-10-01

    Full Text Available The aim of this study was to evaluate four protocols of loco regional anesthesia for ophthalmic procedures that could provide safety and life support, in addition to maintain intraocular pressure stable, with eye centralization and eyelid akinesia. 20 New Zealand rabbits were used to perform local anesthesia by retrobulbar block with four protocols: 2% lidocaine with epinephrine, 2% lidocaine without epinephrine associated with tramadol, 1% ropivacaine and bupivacaine 0.5 %. Each animal received an anesthetic volume of 1 mL. All anesthetic protocols used promoted eyelid akinesia and centralization of the eye during the assessment period. The retrobulbar block with the proposed anesthetic protocols proved to be feasible and safe for the maintenance of intraocular pressure, invasive blood pressure and pupillary diameter and can be used in intraocular surgeries, respecting the time of action of each anesthetic. All protocols showed an excellent blockage action but bupivacaine promoted the highest pupil diameter compared to the other drugs tested.

  9. Local Action for Global Change. World Education Reports, Number 29.

    Science.gov (United States)

    Garb, Gillian, Ed.; Baltz, Davis, Ed.

    1991-01-01

    This issue contains five articles that address environmental concerns. "Poverty and Environmental Decline" (Alan Durning) analyzes accelerating environmental decline and discusses the need for action at every level to reverse global deterioration. "Integrated Pest Management (IPM) Made Easy" (Cesar Galvan, Peter Kenmore)…

  10. Graph states under the action of local Clifford group in non-binary case

    CERN Document Server

    Bahramgiri, M; Bahramgiri, Mohsen; Beigi, Salman

    2006-01-01

    We establish a bound on the number of graph states which are neither isomorphic nor equivalent under the action of local Clifford group. Also we study graph states in non-binary case, and translate the action of local Clifford group into transformations on their associated graphs. And finally, we present an efficient algorithm, the first known, to verify whether two graph states are locally equivalent or not.

  11. Governance and Territorial Development. System Actions for Local Authority

    OpenAIRE

    Fundación Canadiense para las Américas, (FOCAL)

    2003-01-01

    This volume presents three papers discussing new models of governance, system abilities and learning within the Territorial Integrated Design (PTI). In particular, the papers analyze: the evolution from Territorial Pacts to Territorial Integrated Pacts; territorial governance and integrated design; and local development and governance. They emphasize those significant innovations concerning these three areas which have proved to be decisive to engender and implement local development projects...

  12. Endothelial Barrier Protection by Local Anesthetics: Ropivacaine and Lidocaine Block Tumor Necrosis Factor-α–induced Endothelial Cell Src Activation

    Science.gov (United States)

    Piegeler, Tobias; Votta-Velis, E. Gina; Bakhshi, Farnaz R.; Mao, Mao; Carnegie, Graeme; Bonini, Marcelo G.; Schwartz, David E.; Borgeat, Alain; Beck-Schimmer, Beatrice; Minshall, Richard D.

    2014-01-01

    Background Pulmonary endothelial barrier dysfunction mediated in part by Src-kinase activation plays a crucial role in acute inflammatory disease. Proinflammatory cytokines, such as tumor necrosis factor-α (TNFα), activate Src via phosphatidylinositide 3-kinase/Akt-dependent nitric oxide generation, a process initiated by recruitment of phosphatidylinositide 3-kinase regulatory subunit p85 to TNF-receptor-1. Because amide-linked local anesthetics have well-established anti-inflammatory effects, the authors hypothesized that ropivacaine and lidocaine attenuate inflammatory Src signaling by disrupting the phosphatidylinositide 3-kinase–Akt–nitric oxide pathway, thus blocking Src-dependent neutrophil adhesion and endothelial hyperpermeability. Methods Human lung microvascular endothelial cells, incubated with TNFα in the absence or presence of clinically relevant concentrations of ropivacaine and lidocaine, were analyzed by Western blot, probing for phosphorylated/activated Src, endothelial nitric oxide synthase, Akt, intercellular adhesion molecule-1, and caveolin-1. The effect of ropivacaine on TNFα-induced nitric oxide generation, co-immunoprecipitation of TNF-receptor-1 with p85, neutrophil adhesion, and endothelial barrier disruption were assessed. Results Ropivacaine and lidocaine attenuated TNFα-induced Src activation (half-maximal inhibitory concentration [IC50] = 8.611 × 10−10 M for ropivacaine; IC50 = 5.864 × 10−10 M for lidocaine) and endothelial nitric oxide synthase phosphorylation (IC50 = 7.572 × 10−10 M for ropivacaine; IC50 = 6.377 × 10−10 M for lidocaine). Akt activation (n = 7; P = 0.006) and stimulus-dependent binding of TNF-receptor-1 and p85 (n = 6; P = 0.043) were blocked by 1 nM of ropivacaine. TNFα-induced neutrophil adhesion and disruption of endothelial monolayers via Src-dependent intercellular adhesion molecule-1- and caveolin-1-phosphorylation, respectively, were also attenuated. Conclusions Ropivacaine and lidocaine

  13. Effect of buprenorphine as an adjunct with plain local anesthetic solution in supraclavicular brachial plexus block on quality and duration of postoperative analgesia

    Directory of Open Access Journals (Sweden)

    Surekha Patil

    2015-01-01

    Full Text Available Background and Aims: Supraclavicular brachial plexus block is ideal for upper limb surgical procedures. Buprenorphine, an agonist antagonist opioid has been used as an adjunct to prolong analgesia. We aimed to evaluate the quality and duration of postoperative analgesia by addition of buprenorphine to local anesthetic solution. Material and Methods: A prospective, randomized, double-blind control study was conducted on 50 healthy patients of ASA Grade I/II of age group 20-70 years scheduled for orthopedic and reconstructive surgery of upper limb under supraclavicular brachial plexus block. Patients were allocated into two groups, 25 in each group viz.: Group B (buprenorphine group received 20 ml 0.5% bupivacaine + 15 ml 2% lignocaine with adrenaline (1:200,000 + 4 ml normal saline + 1500 units hyaluronidase + 3 μg/kg buprenorphine diluted to 1 ml normal saline. Group C (control group received 20 ml 0.5% bupivacaine + 15 ml 2% lignocaine with adrenaline (1:200,000 + 4 ml normal saline + 1500 units hyaluronidase + 1 ml normal saline. The parameters observed were onset and duration of sensory and motor block, quality and duration of analgesia and side-effects. Results: The mean duration of postoperative analgesia was significantly longer in Group B (16.04 ± 3.19 h than in Group C (6.20 ± 0.74 h. There was no difference between two groups on mean onset of sensory block. The mean duration motor block was significantly longer in Group B (4.93 ± 0.94 h than in Group C (2.25 ± 0.62 h [P < 0.05]. The mean duration of sensory block was also significantly longer in Group B (5.71 ± 0.94 h than in Group C (4.94 ± 0.70 h with P < 0.05. Conclusion: Addition of 3 μg/kg buprenorphine to 0.5% bupivacaine for supraclavicular brachial plexus block prolonged duration of postoperative analgesia and sensory blockade without an increase in side effects.

  14. Anesthetic drug midazolam inhibits cardiac human ether-à-go-go-related gene channels: mode of action

    Directory of Open Access Journals (Sweden)

    Vonderlin N

    2015-02-01

    Full Text Available Nadine Vonderlin,1 Fathima Fischer,1 Edgar Zitron,1,2 Claudia Seyler,1 Daniel Scherer,1 Dierk Thomas,1,2 Hugo A Katus,1,2 Eberhard P Scholz1 1Department of Internal Medicine III, University Hospital Heidelberg, 2German Centre for Cardiovascular Research, Partner Site Heidelberg/Mannheim, Heidelberg, Germany Abstract: Midazolam is a short-acting benzodiazepine that is in wide clinical use as an anxiolytic, sedative, hypnotic, and anticonvulsant. Midazolam has been shown to inhibit ion channels, including calcium and potassium channels. So far, the effects of midazolam on cardiac human ether-à-go-go-related gene (hERG channels have not been analyzed. The inhibitory effects of midazolam on heterologously expressed hERG channels were analyzed in Xenopus oocytes using the double-electrode voltage clamp technique. We found that midazolam inhibits hERG channels in a concentration-dependent manner, yielding an IC50 of 170 µM in Xenopus oocytes. When analyzed in a HEK 293 cell line using the patch-clamp technique, the IC50 was 13.6 µM. Midazolam resulted in a small negative shift of the activation curve of hERG channels. However, steady-state inactivation was not significantly affected. We further show that inhibition is state-dependent, occurring within the open and inactivated but not in the closed state. There was no frequency dependence of block. Using the hERG pore mutants F656A and Y652A we provide evidence that midazolam uses a classical binding site within the channel pore. Analyzing the subacute effects of midazolam on hERG channel trafficking, we further found that midazolam does not affect channel surface expression. Taken together, we show that the anesthetic midazolam is a low-affinity inhibitor of cardiac hERG channels without additional effects on channel surface expression. These data add to the current understanding of the pharmacological profile of the anesthetic midazolam. Keywords: midazolam, anesthetics, human ether

  15. Effect of flumazenil on sevoflurane requirements for minimum alveolar anesthetic concentration-awake and recovery status

    National Research Council Canada - National Science Library

    Liang, Peng; Zhou, Cheng; Li, Kai-Yu; Guo, Li-Juan; Liu, Bin; Liu, Jin

    2014-01-01

    .... This study was to detect the effect of GABA receptors on the hypnotic action of volatile anesthetics by evaluation of the effect of intravenous flumazenil on sevoflurane minimum alveolar anesthetic concentration-awake (MAC-Awake...

  16. Transfer Latent SVM for Joint Recognition and Localization of Actions in Videos.

    Science.gov (United States)

    Liu, Cuiwei; Wu, Xinxiao; Jia, Yunde

    2016-11-01

    In this paper, we develop a novel transfer latent support vector machine for joint recognition and localization of actions by using Web images and weakly annotated training videos. The model takes training videos which are only annotated with action labels as input for alleviating the laborious and time-consuming manual annotations of action locations. Since the ground-truth of action locations in videos are not available, the locations are modeled as latent variables in our method and are inferred during both training and testing phrases. For the purpose of improving the localization accuracy with some prior information of action locations, we collect a number of Web images which are annotated with both action labels and action locations to learn a discriminative model by enforcing the local similarities between videos and Web images. A structural transformation based on randomized clustering forest is used to map the Web images to videos for handling the heterogeneous features of Web images and videos. Experiments on two public action datasets demonstrate the effectiveness of the proposed model for both action localization and action recognition.

  17. Performative Actions in E-Adoption Processes: Strategic Efforts in a Local Government

    DEFF Research Database (Denmark)

    Hjelholt, Morten

    2015-01-01

    In this paper the concept of performative action is introduced to address how individuals can engage in IT adoption processes. The study investigates how local government employees adopt and localize ideas from a Danish National IT initiative called eDay3. Particularly the actions of a project...... and variance of the specific local government. Second, a feedback loop re-attaching the localized project to the national reform program in order to maintain and protect the newly formed local practices. The study concludes that individuals actively struggle for social positions in IT adoption processes...

  18. 36 CFR 1010.17 - Actions to eliminate duplication with State and local procedures.

    Science.gov (United States)

    2010-07-01

    ... duplication with State and local procedures. 1010.17 Section 1010.17 Parks, Forests, and Public Property PRESIDIO TRUST ENVIRONMENTAL QUALITY § 1010.17 Actions to eliminate duplication with State and local... fullest extent possible to reduce duplication between NEPA and State and local requirements....

  19. Spatio-temporal action localization for human action recognition in large dataset

    Science.gov (United States)

    Megrhi, Sameh; Jmal, Marwa; Beghdadi, Azeddine; Mseddi, Wided

    2015-03-01

    Human action recognition has drawn much attention in the field of video analysis. In this paper, we develop a human action detection and recognition process based on the tracking of Interest Points (IP) trajectory. A pre-processing step that performs spatio-temporal action detection is proposed. This step uses optical flow along with dense speed-up-robust-features (SURF) in order to detect and track moving humans in moving fields of view. The video description step is based on a fusion process that combines displacement and spatio-temporal descriptors. Experiments are carried out on the big data-set UCF-101. Experimental results reveal that the proposed techniques achieve better performances compared to many existing state-of-the-art action recognition approaches.

  20. Local Action Groups and Rural Sustainable Development. A spatial multiple criteria approach for efficient territorial planning

    DEFF Research Database (Denmark)

    Palmisano, Giovanni Ottomano; Govindan, M.E., PhD.,, Kannan; Boggia, Antonio

    2016-01-01

    Local Action Groups in order to promote the objectives of Rural Sustainable Development within rural municipalities. Each Local Action Group applies the Strengths, Weaknesses, Opportunities and Threats analysis in order to identify for its own rural municipalities the strategic elements to which...... and a Weakness factors and decision alternatives, as well as impossibility of ranking the decision alternatives. Thus, this research aims to overcome the drawbacks of the Strengths, Weaknesses, Opportunities and Threats analysis and to support Local Action Group partnerships in the sustainability evaluation...

  1. Science for action at the local landscape scale

    Science.gov (United States)

    Paul Opddam; Joan Iverson Nassauer; Zhifang Wang; Christian Albert; Gary Bentrup; Jean-Christophe Castella; Clive McAlpine; Jianguo Liu; Stephen Sheppard; Simon Swaffield

    2013-01-01

    For landscape ecology to produce knowledge relevant to society, it must include considerations of human culture and behavior, extending beyond the natural sciences to synthesize with many other disciplines. Furthermore, it needs to be able to support landscape change processes which increasingly take the shape of deliberative and collaborative decision making by local...

  2. Interaction of anesthetics with neurotransmitter release machinery proteins.

    Science.gov (United States)

    Xie, Zheng; McMillan, Kyle; Pike, Carolyn M; Cahill, Anne L; Herring, Bruce E; Wang, Qiang; Fox, Aaron P

    2013-02-01

    General anesthetics produce anesthesia by depressing central nervous system activity. Activation of inhibitory GABA(A) receptors plays a central role in the action of many clinically relevant general anesthetics. Even so, there is growing evidence that anesthetics can act at a presynaptic locus to inhibit neurotransmitter release. Our own data identified the neurotransmitter release machinery as a target for anesthetic action. In the present study, we sought to examine the site of anesthetic action more closely. Exocytosis was stimulated by directly elevating the intracellular Ca(2+) concentration at neurotransmitter release sites, thereby bypassing anesthetic effects on channels and receptors, allowing anesthetic effects on the neurotransmitter release machinery to be examined in isolation. Three different PC12 cell lines, which had the expression of different release machinery proteins stably suppressed by RNA interference, were used in these studies. Interestingly, there was still significant neurotransmitter release when these knockdown PC12 cells were stimulated. We have previously shown that etomidate, isoflurane, and propofol all inhibited the neurotransmitter release machinery in wild-type PC12 cells. In the present study, we show that knocking down synaptotagmin I completely prevented etomidate from inhibiting neurotransmitter release. Synaptotagmin I knockdown also diminished the inhibition produced by propofol and isoflurane, but the magnitude of the effect was not as large. Knockdown of SNAP-25 and SNAP-23 expression also changed the ability of these three anesthetics to inhibit neurotransmitter release. Our results suggest that general anesthetics inhibit the neurotransmitter release machinery by interacting with multiple SNARE and SNARE-associated proteins.

  3. Guidelines for administration of local anesthesia for dermatosurgery and cosmetic dermatology procedures

    Directory of Open Access Journals (Sweden)

    Mysore Venkataram

    2009-08-01

    onset, duration of action, side effects and drug interactions of these agents. Side effects of local anesthetics: Various local and systemic side effects and complications arising from administration of local anesthetics have to be timely recognized and treated effectively. Skin testing prior to administration of local anesthetic is recommended.

  4. Energy use and sustainable development in the 21st century - Local action and national strategies

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-07-01

    This report sums up the conference ''Energy use and sustainable development in the 21st century - Local action and national strategies'' that was held in Oslo in 1999. The purpose of the conference was to stimulate the development of climate- and energy strategies and actions that support a sustainable use of energy locally and regionally. The report discusses important points from the various contributions and from the workshops of the conference.

  5. Is local participation always optimal for sustainable action? The costs of consensus-building in Local Agenda 21.

    Science.gov (United States)

    Brandt, Urs Steiner; Svendsen, Gert Tinggaard

    2013-11-15

    Is local participation always optimal for sustainable action? Here, Local Agenda 21 is a relevant case as it broadly calls for consensus-building among stakeholders. Consensus-building is, however, costly. We show that the costs of making local decisions are likely to rapidly exceed the benefits. Why? Because as the number of participants grows, the more likely it is that the group will include individuals who have an extreme position and are unwilling to make compromises. Thus, the net gain of self-organization should be compared with those of its alternatives, for example voting, market-solutions, or not making any choices at all. Even though the informational value of meetings may be helpful to policy makers, the model shows that it also decreases as the number of participants increase. Overall, the result is a thought provoking scenario for Local Agenda 21 as it highlights the risk of less sustainable action in the future.

  6. Formulações de anestésicos locais de liberação controlada: aplicações terapêuticas Formulaciones de anestésicos locales de liberación controlada: aplicaciones terapéuticas Drug-delivery systems for local anesthetics: therapeutic applications

    Directory of Open Access Journals (Sweden)

    Daniele Ribeiro de Araújo

    2003-09-01

    ésicos locales indican una nueva dirección en el desarrollo de formulaciones anestésicas más eficaces y seguras.BACKGROUND AND OBJECTIVES: Many researchers in the last four decades have been devoted to the development of drug-delivery systems. Since its first application in the pharmaceutical industry, many results have been obtained especially in the molecular manipulation of carriers and their interaction with encapsulated drugs. These new carriers have the advantage of bypassing encapsulated drugs restraining physicochemical properties (such as water or membrane solubility, thus improving pharmacodynamics (therapeutic effect potentiation, pharmacokinetics (control of tissue absorption and distribution and toxic effects (lower local and systemic toxicity. Liposomes and cyclodextrins are among the most important carriers which have shown to be quite advantageous in the development of drug-delivery systems for local anesthetics. This study aimed at reviewing the interaction of local anesthetics with liposomes and cyclodextrins, the development of basic and applied research on the field, in addition to therapeutic applicability of these formulations. CONTENTS: Liposomes have the ability to control drug delivery to target tissues, fractionating drug release in its site of action. Cyclodextrins, on the other hand, change intensity and duration of effects due to low systemic drug absorption. Basic and clinical studies have pointed out that the administration of local anesthetics in liposome or cyclodextrin formulations induces slow release of the drugs, prolonging the anesthetic action and decreasing cardiac and nervous systems toxicity. CONCLUSIONS: Although studies are still in progress, drug-delivery systems are flagging a new direction for the development of safer and more effective local anesthetic formulations.

  7. Investigation of the effects of naratriptan, rizatriptan, and sumatriptan on jugular venous oxygen saturation in anesthetized pigs: implications for their mechanism of acute antimigraine action.

    Science.gov (United States)

    Létienne, Robert; Verscheure, Yvan; John, Gareth W

    2003-10-01

    The effects of naratriptan, rizatriptan, and sumatriptan on arteriovenous oxygen saturation difference and carotid hemodynamics were compared in the anesthetized pig. Oxygen and carbon dioxide partial pressures in systemic arterial and jugular venous blood as well as hemoglobin oxygen saturation were determined by conventional blood gas analysis. Vehicle (n = 19) or naratriptan, rizatriptan, or sumatriptan (0.63, 2.5, 10, 40, 160, 630, and 2,500 microg/kg i.v.; n = 7/group) were infused cumulatively. In naratriptan-, rizatriptan-, and sumatriptan-treated animals, jugular venous oxygen saturation decreased dose dependently (geometric mean ED50 values of 3.1, 17.9, and 16.0 microg/kg, respectively) concomitantly with increases in carotid vascular resistance. Rizatriptan significantly and dose dependently, from 160 microg/kg, increased PvCO2 (P animals studied. Maximal variations in PvCO2 were found to correlate highly with those in PvO2 (P = 0.002), but maximal variations in carotid resistance failed to correlate with those in PvCO2 (P = 0.76) or PvO2 (P = 0.28). The results demonstrate that the triptans investigated robustly produced carotid vasoconstriction, but elicited less consistent decreases in VOS and increases in jugular PvCO2, possibly suggestive of distinct mechanisms. Collectively, the data suggest that triptan-induced increases in arteriovenous oxygen saturation difference and carbon dioxide partial pressure in venous blood draining the head are class effects.

  8. Anesthetizing the obese child

    DEFF Research Database (Denmark)

    Mortensen, Anette; Lenz, Katja; Abildstrøm, Hanne

    2011-01-01

    The prevalence of childhood obesity is increasing. The focus of this review is the special anesthetic considerations regarding the perioperative management of obese children. With obesity the risk of comorbidity such as asthma, obstructive sleep apnea, hypertension, and diabetes increases....... The obese child has an increased risk of perioperative complications especially related to airway management and ventilation. There is a significantly increased risk of difficult mask ventilation and perioperative desaturation. Furthermore, obesity has an impact on the pharmacokinetics of most anesthetic...

  9. A Low Carbon Development Guide for Local Government Actions in China

    Energy Technology Data Exchange (ETDEWEB)

    Zheng, Nina; Zhou, Nan; Price, Lynn; Ohshita, Stephanie

    2011-05-01

    Local level actions are crucial for achieving energy-saving and greenhouse gas emission reduction targets. Yet it is challenging to implement new policies and actions due to a lack of information, funding, and capacity. This is particularly the case in developing countries such as China. Even though national energy intensity and carbon intensity targets have been set, most local governments do not have the knowledge regarding actions to achieve the targets, the cost-effectiveness of policies, the possible impact of policies, or how to design and implement a climate action plan. This paper describes a guidebook that was developed to motivate and provide local governments in China with information to create an action plan to tackle climate change and increase energy efficiency. It provides a simple step-by-step description of how action plans can be established and essential elements to be included - from preparing a GHG emission inventory to implementation of the plan. The guidebook also provides a comprehensive list of successful policies and best practices found internationally and in China to encourage low carbon development in industry, buildings, transportation, electric power generation, agriculture and forestry. This paper also presents indicators that can be used to define low-carbon development, as well as to evaluate the effectiveness of actions taken at an aggregated (city) level, and at a sectoral or end use level. The guidebook can also be used for low carbon development by local governments in other developing countries.

  10. 3D Interest Point Detection using Local Surface Characteristics with Application in Action Recognition

    DEFF Research Database (Denmark)

    Holte, Michael Boelstoft

    2014-01-01

    . The proposed Difference-of-Normals (DoN) 3D IP detector operates on the surface mesh, and evaluates the surface structure (curvature) locally (per vertex) in the mesh data. We present an exam- ple of application in action recognition from a sequence of 3-dimensional geometrical data, where local 3D motion de...

  11. Studies on the Action Potential From a Thermodynamic Perspective

    DEFF Research Database (Denmark)

    Wang, Tian

    and nerves with ganglia. (2) Attempts have been made to measure the temperature change associated with an action potential as well as an oscillation reaction (Briggs-Rauscher reaction) that shares the adiabatic feature. It turns out that some practical issues need to be solved for the temperature measurement...... of the nerve impulses, while the measured temperature change during the oscillation reaction suggests that there are a reversible adiabatic process and a dissipative process. (3) Local anesthetic e↵ect on nerves is studied. Local anesthetic lidocaine causes a significant stimulus threshold shift of the action...

  12. Perivascular action of the local anaesthetic, lidocaine, on pial terminal arterioles: direct observations on the microcirculation.

    OpenAIRE

    Altura, B. M.; Lassoff, S.

    1981-01-01

    Considerable controversy currently exists with respect to whether or not local anaesthetics exert direct action on cerebral arteriolar tone. In situ experiments were therefore undertaken on pial terminal arterioles of rats to determine whether or not perivascular application of lidocaine exerts any action on such cerebral vessels. Vessel size was assessed with an image-splitting television microscope recording system. The vessels studied ranged in size from 25 to 30 micron. Lidocaine was appl...

  13. Raquianestesia contínua com altas doses de anestésicos locais Raquianestesia continua con altas dosis de anestésicos locales Continuous spinal anesthesia with high dose of local anesthetics

    Directory of Open Access Journals (Sweden)

    Luiz Eduardo Imbelloni

    2010-10-01

    been gaining credibility. The objective of this paper is to report the possible safety of the new catheter with a large dose of hyperbaric 0.5% bupivacaine with 1.6% glucose associated with hyperbaric 2% lidocaine with 1.6% glucose. CASE REPORT: Male patient, 78 years old, 85 kg, 168 cm, physical status ASA III, with hypertension, coronary artery disease, and chronic renal failure. The patient was candidate for surgery for huge bilateral inguinal and umbilical hernias, being submitted to preoperative pneumoperitoneum for one week to stretch abdominal cavity. After venoclysis with an 18G catheter, he was monitored with cardioscope, non-invasive blood pressure, and pulse oximetry; he was sedated with 1 mg of midazolam and 100 µg of fentanyl intravenously, and placed in left lateral decubitus. He underwent continuous spinal anesthesia by a median puncture in L3-L4 with a set with a 27G cut-bevel needle and 22G catheter. The total dose of anesthetic used was 25 mg of 0.5% bupivacaine (hyperbaric, with 1.6% glucose, 160 mg of 2% lidocaine (hyperbaric, with 1.6% glucose, and morphine (100 µg. The patient was followed-up until the 30th postoperative day without neurological complaints. CONCLUSIONS: Recently, the poor distribution of the local anesthetic through the microcatheter was attributed as the cause of cauda equina syndrome. This case report showed that, with the administration of high doses of hyperbaric anesthetics through the new catheter, poor distribution or risk of cauda equina syndrome were not observed

  14. Islander innovation: A research and action agenda on local responses to global issues

    Directory of Open Access Journals (Sweden)

    Ilan Kelman

    2015-06-01

    Full Text Available Local economies and livelihoods, cultures, and sustainability around the world are being challenged by wide ranging social and environmental changes. Despite many negative impacts, these changes also bring opportunities to initiate and implement innovations. Island communities are experiencing the forefront of much such action, particularly since they are often highly local and localised societies. Yet in many cases, global changes are being imposed without adequate support to the communities for dealing with those changes. The key question investigated by this paper is: How can local responses to global issues be improved for island communities? Examples of successes and problematic approaches, as well as those exhibiting both, are described in this paper. A research and action agenda on islander innovation is presented for researchers, policy-makers, and practitioners to highlight local responses to global issues.

  15. Enhancing local action planning through quantitative flood risk analysis: a case study in Spain

    OpenAIRE

    2016-01-01

    This article presents a method to incorporate and promote quantitative risk analysis to support local action planning against flooding. The proposed approach aims to provide a framework for local flood risk analysis, combining hazard mapping with vulnerability data to quantify risk in terms of expected annual affected population, potential injuries, number of fatalities, and economic damages. Flood risk is estimated combining GIS data of loads, system response, and consequen...

  16. Effect of anesthetics on the radiosensitivity of a murine tumor

    Energy Technology Data Exchange (ETDEWEB)

    Sheldon, P.W.; Chu, A.M.

    1979-09-01

    The effect of four anesthetics on the single dose of x rays required to locally control 50% of implanted MT tumors was investigated. Compared with unanesthetized animals, no change in radiosensitivity was observed if mice were irradiated under either tribromoethanol or fentanyl-fluanisone-diazepam anesthesia. However, a small but significant degree of radioprotection was observed under chloral hydrate or pentobarbital anesthesia. Hypothermia or increased hypoxia are considered unlikely mechanisms for the protection, a direct chemical action being most probable. The preferred method for immobilizing the mice in order to locally irradiate the tumors was by simple physical restraint (with care taken to minimize physiological stress). However, if anesthesia was a necessity, the present work suggests that for the MT tumor at least the nonprotecting tribromoethanol and fentanyl-fluanisone-diazepam are preferable to the protecting chloral hydrate and pentobarbital. Tribromoethanol is preferable to fetanyl-fluanisone-diazepam in that it produces a smaller drop in temperature. However, it is only a short-acting anesthetic, and prolongation of the state of anesthesia by repeated doses simply prolongs the temperature decline so that there may be no real benefit over fentanyl-fluanisone-diazepam.

  17. Preparation and physico-chemical characterization of inclusion complexes between local anesthetics and hydroxypropyl-{beta}-cyclodextrin; Preparacao e caracterizacao fisico-quimica de complexos de inclusao entre anestesicos locais e hidroxipropil-{beta}-ciclodextrina

    Energy Technology Data Exchange (ETDEWEB)

    Moraes, Carolina Morales; Abrami, Priscila; Goncalves, Marcos Moises; Andreo Filho, Newton [Universidade de Sorocaba, SP (Brazil); Fernandes, Sergio Antonio; Paula, Eneida de [Universidade Estadual de Campinas (UNICAMP), SP (Brazil). Inst. de Biologia. Dept. de Bioquimica; Fraceto, Leonardo Fernandes [UNESP, Sorocaba, SP (Brazil). Dept. de Engenharia Ambiental]. E-mail: leonardo@sorocaba.unesp.br

    2007-07-15

    S(-) Bupivacaine (S(-)BVC) and Lidocaine (LDC) are widely used local anesthetics (LA). Hydroxypropyl {beta}-cyclodextrin (HP-{beta}-CD) is used as a drug-carrier system. The aim of this work was to characterize inclusion complexes between LA and HP-{beta}-CD. The affinity constants determined at different pHs show favourable complexation. The release kinetics experiments showed that S(-)BVC and LDC changed the released profiles in the presence of HP-{beta}-CD. Nuclear magnetic resonance experiments gave information about the interaction between LA and the cyclodextrin cavity. This study focused on the physicochemical characterization of drug-delivery formulations that come out as potentially new therapeutic options for pain treatment. (author)

  18. Effects of mitogen-activated protein kinases on neurotoxicity of local anesthetics%丝裂原活化蛋白激酶家族在局麻药神经毒性中的作用

    Institute of Scientific and Technical Information of China (English)

    李乐; 徐世元; 卢爱珠

    2013-01-01

    背景 局麻药(local anesthetic,LA)广泛用于神经阻滞、镇痛,其可能引起的神经毒性引起了麻醉医生的关注,其中关于此种毒性作用机制的研究取得了较大的进展. 目的 分析总结各种丝裂原活化蛋白激酶家族(mitogen-activated protein kinases,MAPKs)成员在LA神经毒性中的作用. 内容 越来越多的证据证明LA的神经毒性作用可能与细胞凋亡有关.MAPKs是一种广泛存在细胞内的丝氨酸/苏氨酸蛋白激酶,在细胞凋亡过程中发挥重要作用.故MAPK信号通路逐渐成为LA毒性作用研究中的重点,其中关于细胞外信号调节激酶(extracellular signal-regulated kinase,ERK),c-Jun N-末端激酶(c-jun nterminal kinase,JNK)以及p38MAPK信号转导通路的研究较为成熟. 趋向 MAPKs在LA神经毒性的具体机制中发挥重要作用,这为LA的临床应用及毒性作用防治提供依据和理论指导.%Background The potential toxicity is a well-known side effect of local anesthetics (LA) which is widely used in nerve block and analgesia.The mechanisms of local anesthetic toxicity were further investigated.Objective This review summarized the recent studies examining the mitogen-activated protein kinases (MAPKs) signaling pathway and their regulation,and discussed the effects of MAPKs on neurotoxicity of LA.Content Accumulating evidences indicate that neurotoxicity of LA is related to apoptosis.MAPKs,a serine-threonine protein kinase family,play a crucial role in apoptosis of cells.So that the effects of MAPKs signaling pathway on neurotoxicity of LA is becoming a hot issue to be researched.And the impact of extracellular signalregulated kinase (ERK),c-Jun N-terminal kinase (JNK),p38MAPK are more concerned.Trend The MAPKs signaling pathway and their regulation play an important part in the underlying mechanisms of local anesthetic neurotoxicity which could provide evidences and theory for clinical use of LA.

  19. View-invariant human action recognition via robust locally adaptive multi-view learning

    Institute of Scientific and Technical Information of China (English)

    Jia-geng FENG; Jun XIAO

    2015-01-01

    Human action recognition is currently one of the most active research areas in computer vision. It has been widely used in many applications, such as intelligent surveillance, perceptual interface, and content-based video retrieval. However, some extrinsic factors are barriers for the development of action recognition;e.g., human actions may be observed from arbitrary camera viewpoints in realistic scene. Thus, view-invariant analysis becomes important for action recognition algorithms, and a number of researchers have paid much attention to this issue. In this paper, we present a multi-view learning approach to recognize human actions from different views. As most existing multi-view learning algorithms often suffer from the problem of lacking data adaptiveness in the nearest neighborhood graph construction procedure, a robust locally adaptive multi-view learning algorithm based on learning multiple local L1-graphs is proposed. Moreover, an efficient iterative optimization method is proposed to solve the proposed objective function. Experiments on three public view-invariant action recognition datasets, i.e., ViHASi, IXMAS, and WVU, demonstrate data adaptiveness, effectiveness, and efficiency of our algorithm. More importantly, when the feature dimension is correctly selected (i.e.,>60), the proposed algorithm stably outperforms state-of-the-art counterparts and obtains about 6%improvement in recognition accuracy on the three datasets.

  20. BING3D: Fast Spatio-Temporal Proposals for Action Localization

    NARCIS (Netherlands)

    Gati, E.; Schavemaker, J.G.M.; van Gemert, J.C.

    2015-01-01

    The goal of this work is realistic action localization in video with the aid of spatio-temporal proposals. Current proposal generation methods are computationally demanding and are not practical for large-scale datasets. The main contribution of this work is a novel and fast alternative. Our method

  1. Institutional Development to Build a Succesfull Local Collective Action in Forest Management from Arau Watershed Unit

    Directory of Open Access Journals (Sweden)

    Nursidah Nursidah

    2012-04-01

    Full Text Available The study was aimed to build institution model of sustainable forest management, through analysis of action arena, community attributes and forest management rules in Arau Watershed Unit Management Area.  To achieve sustainable forest management, recognition and incorporation of local institutions in forest policy formulation is very important because it had great potential for collective action and had characteristics of common pools resources sustainable management needed.  To achieve a successful local collective action, the institution must be had: the rules in use suitable with local community norms; the organization has power to give reward and punishment as well as recognized and respected by society; specific management according location; rules of the game was made participatory; there are economic incentives for owners and users; there is an instrument for controlling sustainable use; and conflict resolution through negotiations to reach an concencus agreement.  The finding of institutional models  analysis  show  that  co-management  model  between government and local communities, called Nagari Forest Management Model is more suitable, because it gives greater opportunities for indigenous rights recognition to communal forest, until the capacity of villages get better, then the choice of forest management can be shifted into Nagari Community Based Forest Management Model.Keywords: sustainable forest management, institution, collective action, nagari

  2. Action of Certain Groups on Local Cohomology Modules and Cousin Complexes

    Institute of Scientific and Technical Information of China (English)

    M. Tousi; H. Zakeri

    2001-01-01

    The purpose of this paper is to study the action of a finite automorphism group G of a commutative Noetherian ring A on a local cohomology module and on a Cousin complex, and to specify its fixed submodule and subcomplex.We illustrate the use of this by showing that some properties of A pass to AG.

  3. Using Local Stories as a Call to Action on Climate Change Adaptation and Mitigation in Minnesota

    Science.gov (United States)

    Phipps, M.

    2015-12-01

    Climate Generation: A Will Steger Legacy and the University of Minnesota's Regional Sustainability Development Partnerships (RSDP) have developed a novel approach to engaging rural Minnesotans on climate change issues. Through the use of personal, local stories about individuals' paths to action to mitigate and or adapt to climate change, Climate Generation and RSDP aim to spur others to action. Minnesota's Changing Climate project includes 12 Climate Convenings throughout rural Minnesota in a range of communities (tourism-based, agrarian, natural resources-based, university towns) to engage local populations in highly local conversations about climate change, its local impacts, and local solutions currently occurring. Climate Generation and RSDP have partnered with Molly Phipps Consulting to evaluate the efficacy of this approach in rural Minnesota. Data include pre and post convening surveys examining participants' current action around climate change, attitudes toward climate change (using questions from Maibach, Roser-Renouf, and Leiserowitz, 2009), and the strength of their social network to support their current and ongoing work toward mitigating and adapting to climate change. Although the Climate Convenings are tailored to each community, all include a resource fair of local organizations already engaging in climate change mitigation and adaptation activities which participants can participate in, a welcome from a trusted local official, a presentation on the science of climate change, sharing of local climate stories, and break-out groups where participants can learn how to get involved in a particular mitigation or adaptation strategy. Preliminary results have been positive: participants feel motivated to work toward mitigating and adapting to climate change, and more local stories have emerged that can be shared in follow-up webinars and on a project website to continue to inspire others to act.

  4. Evaluation of the anesthetic effect of epinephrine-free articaine and mepivacaine through quantitative sensory testing.

    Science.gov (United States)

    Said Yekta-Michael, Sareh; Stein, Jamal M; Marioth-Wirtz, Ernst

    2015-02-07

    Long lasting anesthesia of the soft tissue beyond the dental treatment affects patients in daily routine. Therefore a sophisticated local anesthesia is needed. The purpose of this study was an evaluation of the clinical use of epinephrine-free local anesthetic solutions in routine short-time dental treatments. In a prospective, single-blind, non-randomized and controlled clinical trial, 31 patients (16 male, 15 female patients) undergoing short-time dental treatment under local anesthesia (plain solutions of articaine 4% and mepivacaine 3%) in area of maxillary canine were tested with quantitative sensory testing QST. Paired-Wilcoxon-testing (signed-rank-test) and Mc Nemar tests have been used for statistical results. Significant differences in all tested parameters to the time of measurements were found. Mepivacaine showed a significantly stronger impact for the whole period of measurement (128 min) on thermal and mechanical test parameters and to the associated nerve fibers. Plain articaine shows a faster onset of action associated with a shorter time of activity in comparison to plain mepivacaine. In addition to this articaine shows a significant low-graded effect on the tested nerve-fibers and therefore a least affected anesthesia to the patient. The clinical use of an epinephrine-free anesthetic solution can be stated as possible option in short dental routine treatments to the frequently used vasoconstrictor containing local anesthetics. Patients may benefit from shorter numbness.

  5. 3D Interest Point Detection using Local Surface Characteristics with Application in Action Recognition

    DEFF Research Database (Denmark)

    Holte, Michael Boelstoft

    2014-01-01

    . The proposed Difference-of-Normals (DoN) 3D IP detector operates on the surface mesh, and evaluates the surface structure (curvature) locally (per vertex) in the mesh data. We present an exam- ple of application in action recognition from a sequence of 3-dimensional geometrical data, where local 3D motion de......In this paper we address the problem of detecting 3D inter- est points (IPs) using local surface characteristics. We con- tribute to this field by introducing a novel approach for detec- tion of 3D IPs directly on a surface mesh without any require- ments of additional image/video information...

  6. Local anesthetis and adjuvants in pediatric regional anesthesia.

    Science.gov (United States)

    Mossetti, Valeria; Vicchio, Noemi; Ivani, Giorgio

    2012-06-01

    The pediatric loco-regional techniques are considered very safe and effective, first of all because they target the therapy directly to the site of surgery, decreasing the risks of intravenous analgesia. The quality of local anesthesia is influenced by structural and biophysical characteristics of local anesthetics drug, dose, site of injection, mixture of local anesthetics and possible addition of a vasoconstrictor or an adjuvant to prolong the analgesic effect. In children, unlike adults, small nerve diameters and short distance between Ranvier nodes permit to use large volumes and low concentrations of local anesthetics. The clinical practice has shown that in pediatric population, effective analgesia is obtained by 1% mepivacaine, 1% lidocaine and 0.25% bupivacaine or better 0.2% ropivacaine, 0.2-0.25% levobupivacaine. In addition, levobupivacaine and ropivacaine have a better profile in terms of safety in comparison to bupivacaine and are the local anesthetics of choice for the daily clinical practice also in children as in adults. Among the adjuvant, clonidine and ketamine showed the best pharmacokinetic and pharmacodynamic profiles of effective and safety, improving and prolonging the action of associated local anesthetics. Therefore, the use of enantiomers, in association with adjuvants as clonidine or ketamine, using the multimodal approach of integrated anesthesia, makes the clinical practice effective and safe in the pediatric operating rooms. This review focuses on the overview of local anesthetics and adjuvants used today in locoregional pediatric anesthesia, with an emphasis on the advantages and disadvantages of each drug.

  7. Efeito de anestésicos locais com e sem vasoconstritor em pacientes com arritmias ventriculares Effect of local anesthetics with and without vasoconstrictor agent in patients with ventricular arrhythmias

    Directory of Open Access Journals (Sweden)

    Maria Teresa Fernández Cáceres

    2008-09-01

    Full Text Available FUNDAMENTO: A utilização de anestésicos locais associados a vasoconstritores para tratamento odontológico de rotina de pacientes cardiopatas ainda gera controvérsia, em razão do risco de efeitos cardiovasculares adversos. OBJETIVO: Avaliar e comparar os efeitos hemodinâmicos do uso de anestésico local com vasoconstritor não-adrenérgico em pacientes portadores de arritmias ventriculares, em relação ao uso de anestésico sem vasoconstritor. MÉTODOS: Um estudo prospectivo randomizado avaliou 33 pacientes com sorologia positiva para doença de Chagas' e 32 pacientes com doença arterial coronariana, portadores de arritmia ventricular complexa ao Holter (>10 EV/h e TVNS, 21 do sexo feminino, idade de 54,73 + 7,94 anos, submetidos a tratamento odontológico de rotina com anestesia pterigomandibular. Esses pacientes foram divididos em dois grupos: no grupo I, utilizou-se prilocaína a 3% associada a felipressina 0,03 UI/ml, e no grupo II, lidocaína a 2% sem vasoconstritor. Avaliaram-se o número e a complexidade de extra-sístoles, a freqüência cardíaca e a pressão arterial sistêmica dos pacientes no dia anterior, uma hora antes, durante o procedimento odontológico e uma hora após. RESULTADOS: Não foram observadas alterações hemodinâmicas, nem aumento do número e da complexidade da arritmia ventricular, relacionados ao anestésico utilizado, em ambos os grupos. CONCLUSÃO: Os resultados sugerem que prilocaína a 3% associada a felipressina 0,03 UI/ml pode ser utilizada com segurança em pacientes chagásicos e coronarianos, com arritmia ventricular complexa.BACKGROUND: The routine use of local anesthetics associated to vasoconstrictors for the dental treatment of patients with cardiopathies is still controversial, due to the risk of adverse cardiovascular effects. OBJECTIVE: To evaluate and compare the hemodynamic effects of the use of local anesthetics with a non-adrenergic vasoconstrictor in patients with ventricular

  8. Comparation of Anesthetic Effect of Articaine in the Extraction of Mandibular Posterior Teeth under Local Anesthesia and Periodontal Membrane Anesthesia%阿替卡因两种麻醉方式在下颌后牙拔除术中麻醉效果的对比

    Institute of Scientific and Technical Information of China (English)

    曹静; 张建强; 李岩峰; 高飞

    2013-01-01

    Objective To compare the anesthetic effect of articaine under local anesthesia and periodontal membrane anesthesia on the extraction of mandibular posterior teeth. Methods 204 patients were randomly divided into two groups;local anesthetic group and periodontal membrane anesthetic group. Patients in each group were anesthetized by local anesthesia or periodontal membrane anesthesia. The anesthetic effect was analyzed. Results The excellence rate of periodontal membrane anesthetic group was 84. 3% . Conclusion Periodontal membrane anesthesia for the extraction of mandibular posterior teeth using articaine is more effective than local anesthesia.%目的 比较复方阿替卡因局部浸润麻醉与牙周膜腔麻醉2种方式在下颌后牙拔除术中的麻醉效果.方法 随机选择204名患者,分为局部浸润麻醉组及牙周膜腔麻醉组,采用标尺法由患者对疼痛程度进行打分;口腔医生评价麻醉效果,统计麻醉完全、良好、有效和失败的比例.结果 达到麻醉完全效果的牙周膜腔麻醉与局部浸润麻醉组有显著性差异(P<0.05),两种麻醉方式成功率无显著性差异(P>0.05).结论 用牙周膜腔麻醉效果优于局部浸润麻醉方式.

  9. Vibrational Infrared Lifetime of the Anesthetic nitrous oxide gas in solution

    CERN Document Server

    Chieffo, Logan; Shattuck, Jeffrey; Hong, Mi K; Ziegler, Lawrence; Erramilli, Shyamsunder

    2006-01-01

    The lifetime of the asymmetric fundamental stretching 2218 cm$^{-1}$ vibration of the anesthetic gas nitrous oxide (N$_2$O) dissolved in octanol and olive oil is reported. These solvents are model systems commonly used to assess anesthetic potency. Picosecond time-scale molecular dynamics simulations have suggested that protein dynamics or membrane dynamics play a role in the molecular mechanism of anesthetic action. Ultrafast infrared spectroscopy with 100 fs time resolution is an ideal tool to probe dynamics of anesthetic molecules on such timescales. Pump-probe studies at the peak of the vibrational band yield a lifetime of $55 \\pm 1$ ps in olive oil and $52 \\pm 1 ps$ in octanol. The similarity of lifetimes suggests that energy relaxation of the anesthetic is determined primarily by the hydrophobic nature of the environment, consistent with models of anesthetic action. The results show that nitrous oxide is a good model system for probing anesthetic-solvent interactions using nonlinear infrared spectroscop...

  10. Safety and resiliency in action: Integrating risk management into local development

    Directory of Open Access Journals (Sweden)

    Ebay Jorge S.

    2013-01-01

    Full Text Available This paper examines the efforts of the local government unit (LGU of San Jose de Buenavista, in the Province of Antique in central Philippines to manage risks associated with multiple hazards to protect the people, their livelihoods and local development gains. More specifically, it analyzes the process of pursuing risk management objectives vis-a-vis national and international disaster risk reduction and management (DRRM norms, without loosing sight of local contextual realities that directly influence people’s vulnerabilities and capacities. Risk management initiatives in the LGU revolve around four key areas namely disaster prevention and mitigation, disaster preparedness, emergency response, and recovery and rehabilitation. Binding these initiatives are actions that integrate governance mechanisms with scientific data and sectoral and community participation to develop a comprehensive plan of action and standard operating procedures that will serve as guideposts in the process of building a safer community. The experience of San Jose de Buenavista also suggests that cost saving strategies an be replicated by communities and organizations that have financial limitations to pursue DRRM objectives. This paper contends that risk management is a fundamental development strategy to pursue local development goals and to sustain efforts to protect development gains in the long run. This can be done using a combination of governance, risk assessment, knowledge management, vulnerability reduction and preparedness strategies. Local leadership, people’s participation, environmental resource management and continuous capability building are key elements of the process. Ultimately, risk management must be mainstreamed into local development to develop community resiliency.

  11. Spatiotemporal localization and categorization of human actions in unsegmented image sequences.

    Science.gov (United States)

    Oikonomopoulos, Antonios; Patras, Ioannis; Pantic, Maja

    2011-04-01

    In this paper we address the problem of localization and recognition of human activities in unsegmented image sequences. The main contribution of the proposed method is the use of an implicit representation of the spatiotemporal shape of the activity which relies on the spatiotemporal localization of characteristic ensembles of feature descriptors. Evidence for the spatiotemporal localization of the activity is accumulated in a probabilistic spatiotemporal voting scheme. The local nature of the proposed voting framework allows us to deal with multiple activities taking place in the same scene, as well as with activities in the presence of clutter and occlusion. We use boosting in order to select characteristic ensembles per class. This leads to a set of class specific codebooks where each codeword is an ensemble of features. During training, we store the spatial positions of the codeword ensembles with respect to a set of reference points, as well as their temporal positions with respect to the start and end of the action instance. During testing, each activated codeword ensemble casts votes concerning the spatiotemporal position and extend of the action, using the information that was stored during training. Mean Shift mode estimation in the voting space provides the most probable hypotheses concerning the localization of the subjects at each frame, as well as the extend of the activities depicted in the image sequences. We present classification and localization results for a number of publicly available datasets, and for a number of sequences where there is a significant amount of clutter and occlusion.

  12. Influência de vasoconstritores associados a anestésicos locais sobre a pressão arterial de ratos hipertensos e normotensos Influence of vasoconstrictors associated with local anesthetics on the arterial pressure of hypertensive and normotensive rats

    Directory of Open Access Journals (Sweden)

    Apparecido Neri Daniel

    1999-07-01

    Full Text Available A utilização de anestésicos locais associados a vasoconstritores em pacientes hipertensos é controversa. Neste estudo, verificamos a influência desta associação sobre a pressão arterial caudal (PA em ratos hipertensos DOCA-sal. Após ligeira anestesia com éter, os anestésicos GRUPO I - lidocaína 2% sem vasoconstritor, GRUPO II - lidocaína com fenilefrina, GRUPO III - lidocaína a 2% com noradrenalina, GRUPO IV - prilocaína 3% com felipressina, GRUPO V - mepivacaína 2% com adrenalina e GRUPO VI - mepivacaína com noradrenalina foram injetados na submucosa da boca (anestesia infiltrativa, em ratos DOCA-sal e controles. A PA foi determinada 5 e 15 minutos após a primeira dose do anestésico e também 5 e 15 minutos após a segunda dose. Os dados obtidos indicaram que: a a PA dos ratos DOCA-sal (193,05 ± 4,25 mmHg; n = 43 foi significativamente superior àquela observada nos animais controles (115,64 ± 2,47 mmHg; n = 43 e, b não houve variação significativa nas PA observadas em animais DOCA-sal e controles pela administração dos anestésicos locais testados. Assim, nossos dados experimentais sugerem que a presença de agentes vasoconstritores associados à lidocaína 2%, à prilocaína 3% e à mepivacaína 2% não interferem na PA desses animais, neste modelo experimental de hipertensão.The utilization of local anesthetics associated with vasoconstrictors in hypertensive patients is controversial. The purpose of this investigation was to verify the influence of this association on the arterial pressure (AP in DOCA-salt hypertensive rats. After light ether anesthesia, the anesthetics (Group I - lidocaine 2% without vasoconstrictor; Group II - lidocaine 2% with phenylephrine, Group III - lidocaine 2% with noradrenaline- Group IV - prylocaine 3% with felypressin; Group V - mepivacaine 2% with epinephrine, and Group VI - mepivacaine 2% with norepinephrine were injected into mucobuccal fold (infiltration anesthesia, in DOCA

  13. Enhancing local action planning through quantitative flood risk analysis: a case study in Spain

    Science.gov (United States)

    Castillo-Rodríguez, Jesica Tamara; Escuder-Bueno, Ignacio; Perales-Momparler, Sara; Ramón Porta-Sancho, Juan

    2016-07-01

    This article presents a method to incorporate and promote quantitative risk analysis to support local action planning against flooding. The proposed approach aims to provide a framework for local flood risk analysis, combining hazard mapping with vulnerability data to quantify risk in terms of expected annual affected population, potential injuries, number of fatalities, and economic damages. Flood risk is estimated combining GIS data of loads, system response, and consequences and using event tree modelling for risk calculation. The study area is the city of Oliva, located on the eastern coast of Spain. Results from risk modelling have been used to inform local action planning and to assess the benefits of structural and non-structural risk reduction measures. Results show the potential impact on risk reduction of flood defences and improved warning communication schemes through local action planning: societal flood risk (in terms of annual expected affected population) would be reduced up to 51 % by combining both structural and non-structural measures. In addition, the effect of seasonal population variability is analysed (annual expected affected population ranges from 82 to 107 %, compared with the current situation, depending on occupancy rates in hotels and campsites). Results highlight the need for robust and standardized methods for urban flood risk analysis replicability at regional and national scale.

  14. Anesthetic management of ostriches.

    Science.gov (United States)

    Cornick, J L; Jensen, J

    1992-06-01

    We evaluated and characterized several anesthetic induction protocols used to facilitate intubation and anesthetic maintenance with isoflurane in 7 adult ostriches and 1 juvenile ostrich. Induction protocols included IV administration of zolazepam/tiletamine, IV administration of diazepam/ketamine with and without xylazine, IV administration of xylazine/ketamine, IM administration of carfentanil or xylazine/carfentanil, and mask induction with isoflurane. General anesthesia was maintained with isoflurane in 100% oxygen for various procedures, including proventriculotomy (6 birds), tibial (1 bird) or mandibular (1 bird) fracture repair, and drainage of an iatrogenic hematoma (1 bird). Heart rate and respiratory rate varied greatly among birds. The arterial blood pressure values recorded from 6 of the birds during maintenance of general anesthesia were higher than values recorded for most mammalian species, but were comparable to values reported for awake chickens and turkeys.

  15. Children′s behavioral pain reactions during local anesthetic injection using cotton-roll vibration method compared with routine topical anesthesia: A randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Ali Bagherian

    2016-01-01

    Conclusion: It may be concluded that the cotton-roll vibration method can be more helpful than the routine topical anesthesia in reducing behavioral pain reactions in children during local anesthesia administration.

  16. COMBINED MEDICATIONS OF LOCAL ACTION IN THE TREATMENT OF PAIN AND SORE THROAT SYMPTOMS

    Directory of Open Access Journals (Sweden)

    M. I. Petrovskaya

    2012-01-01

    Full Text Available For relief symptoms of pain and sore throat the prescription of combined topical preparations containing antiseptic and analgesic components is the most appropriate from the pathogenetic point of view. This article discusses the use of local therapy for the treatment of acute inflammatory diseases associated with pain, feeling a tickle in throat. The author introduces the local action drug, which has antiseptic and analgesic effects and is safe and effective in the symptomatic treatment of pharyngitis, tonsillitis and laryngitis in children older than 4 years.

  17. Action and Rhetoric in Seattle's Freedom Patrols: A Study of Protest Activity by a Local Social Movement.

    Science.gov (United States)

    Richardson, Larry S.

    This paper provides a rhetorical analysis of a protest action, namely, the mobilization and action of black citizens in Seattle, Washington, in reaction to the 1965 shooting of a black man (Robert L. Reese) by a local police officer. A description of actions during this time, as reported by two Seattle newspapers, is provided. An extrinsic…

  18. Pain fiber anesthetic reduces brainstem Fos after tooth extraction.

    Science.gov (United States)

    Badral, B; Davies, A J; Kim, Y H; Ahn, J S; Hong, S D; Chung, G; Kim, J S; Oh, S B

    2013-11-01

    We recently demonstrated that pain-sensing neurons in the trigeminal system can be selectively anesthetized by co-application of QX-314 with the TRPV1 receptor agonist, capsaicin (QX cocktail). Here we examined whether this new anesthetic strategy can block the neuronal changes in the brainstem following molar tooth extraction in the rat. Adult male Sprague-Dawley rats received infiltration injection of anesthetic 10 min prior to lower molar tooth extraction. Neuronal activation was determined by immunohistochemistry for the proto-oncogene protein c-Fos in transverse sections of the trigeminal subnucleus caudalis (Sp5C). After tooth extraction, c-Fos-like immunoreactivity (Fos-LI) detected in the dorsomedial region of bilateral Sp5C was highest at 2 hrs (p tooth extraction; reduced Fos-LI was also observed with the conventional local anesthetic lidocaine. Pulpal anesthesia by infiltration injection was confirmed by inhibition of the jaw-opening reflex in response to electrical tooth pulp stimulation. Our results suggest that the QX cocktail anesthetic is effective in reducing neuronal activation following tooth extraction. Thus, a selective pain fiber 'nociceptive anesthetic' strategy may provide an effective local anesthetic option for dental patients in the clinic.

  19. Llama anesthetic programs.

    Science.gov (United States)

    Heath, R B

    1989-03-01

    Llamas are anesthetized conveniently with guaifenesin thiamylal mixes, or, for short periods of time, with xylazine/ketamine. Small individuals must be accurately weighed. Estimating weight without experience is dangerous in this species. The greatest levels of safety and control, especially for critical patients, is afforded by inhalation anesthesia techniques using small animal equipment. All neonates and juveniles can be masked readily but in adults intravenous induction is most satisfactory. Intubation is aided by a long blade laryngoscope. Blood pressure monitoring is best accomplished with an arterial line in the ear artery. However, doppler equipment on the tail or distal leg usually works well.

  20. Anesthetic-Induced Developmental Neurotoxicity

    Institute of Scientific and Technical Information of China (English)

    Jia-RenLiu; Qian Liu; Jing Li; Sulpicio G. Soriano

    2011-01-01

    1 IntroductionMillions of newborn and infants receive anesthetic,sedative and analgesic drugs for surgery and painful procedures on a daily basis.Recent laboratory reports clearly demonstrate that anesthetic and sedative drugs induced both neuroapoptosis and neurocognitive deficits in laboratory models.This issue is of paramount interest to pediatric anesthesiologists and intensivists because it questions the safety of anesthetics used for fetal and neonatal anesthesia[1-2].In an attempt to summarize the rapidly expanding laboratorybased literature on anesthetic-induced developmental neurotoxicity (AIDN),this review will examine published reports on the characterization,mechanisms and alleviation of this phenomenon.

  1. US local action on heat and health: are we prepared for climate change?

    Science.gov (United States)

    O'Neill, Marie S; Jackman, Dana K; Wyman, Michelle; Manarolla, Xico; Gronlund, Carina J; Brown, Daniel G; Brines, Shannon J; Schwartz, Joel; Diez-Roux, Ana V

    2010-04-01

    Global climate change is increasing the frequency of heat waves, hot weather, and temperature variability, which contribute to mortality and illness. Baseline information on local efforts to reduce heat vulnerability, including public advisories; minimizing greenhouse gas emissions; and mitigating urban heat islands, is lacking. We designed a survey about local government programs to prevent health problems and reduce heat exposure during heatwaves and administered it to 285 US communities. Of 70 respondents, 26 indicated that excessive heat events are a significant issue for the local government; 30 had established preventive programs. Local government leadership and public health impacts of heat were cited most frequently as extremely important determinants of preventive programs, followed by implementation costs, economic impacts of hot weather, and greenhouse gas emissions mitigation. Cool paving materials and vegetated roofs were common heat mitigation strategies. Fact sheets and case studies were desired guidance for protecting communities during hot weather. New partnerships and financial resources are needed to support more widespread local action to prevent adverse health consequences of climate change and promote environmental sustainability.

  2. Presenting a Framework to Analyze Local Climate Policy and Action in Small and Medium-Sized Cities

    Directory of Open Access Journals (Sweden)

    Thomas Hoppe

    2016-08-01

    Full Text Available Academic attention to local climate policy usually focuses on large-sized cities. Given the climate challenges ahead this seems unjustified. Small and medium-sized cities (SMCs deserve scholarly attention as well. The main question is: What factors influence climate change policy and local climate actions in SMCs? In this article we present an analytical framework to analyze climate change policy and local climate actions of SMCs. The framework addresses different aspects: policy-input, -throughput, -output, -outcome, characteristics of the local environment, local action arenas, influence by higher government levels, and interaction with climate change issue networks. The framework is used to analyze and compare four case studies of SMCs in the Dutch region of Twente (two urban and two rural municipalities, and addresses both adaptation and mitigation. Results show that both ‘localist’, ‘multi-level’ and issue network membership factors influence local climate policy action. Governance modes discerned concern mostly ‘governing by authority’ and ‘self-governing’. When reflecting on the role of SMCs in climate action the study revealed the importance of local capacity building schemes issued by provincial government, inter-municipal network collaboration, and the potential for local governments to mobilize and organize citizen action.

  3. The effectiveness of diclofenac gel and eutectic mixture of local anesthetic cream on vein puncture pain severity with vein catheter in patient undergoing cesarean section: A randomized, double-blind, placebo-controlled trial.

    Science.gov (United States)

    Khalili, Sediqeh; Safavi, Mahboubeh; Rezaei, Rozita; Bidmeshki, Maria; Shirzad, Fatemeh; Nasiri, Mostafa

    2014-09-01

    This study was aimed to explore the effect of applying diclofenac gel and a eutectic mixture of local anesthetic (EMLA) cream on vein puncture pain severity with vein catheter in the patients undergoing cesarean section. The sample comprised 90 women undergoing elective cesarean section that referred to Imam Ali Hospital's maternity section in Amol city (Northern Iran). Data collection tools included visual analog scale for pain severity and a checklist for short term possible side-effects of diclofenac gel, EMLA cream and Vaseline ointment as placebo. The pain of vein puncture with diclofenac gel and EMLA cream was significantly lower than that with the Vaseline ointment (P = 0.001). Similarly, there was a significant difference between using diclofenac gel and EMLA cream in catheter insertion pain severity (P = 0.006). In addition, there was no short term possible side-effect with using diclofenac gel and Vaseline ointment, but a short term side-effect (blanching) was detected in 20% of subjects with EMLA cream. Compared to Vaseline cream, EMLA cream and diclofenac gel application significantly reduces the pain severity associated with vein catheter insertion. Use of diclofenac gel is preferred compared with EMLA cream, because of economics, more efficiency purpose, and no side-effects.

  4. Anesthetic strategy during endovascular therapy: General anesthesia or conscious sedation? (GOLIATH - General or Local Anesthesia in Intra Arterial Therapy) A single-center randomized trial

    DEFF Research Database (Denmark)

    Simonsen, Claus Z; Sørensen, Leif H; Juul, Niels

    2016-01-01

    RATIONALE: Endovascular therapy after acute ischemic stroke due to large vessel occlusion is now standard of care. There is equipoise as to what kind of anesthesia patients should receive during the procedure. Observational studies suggest that general anesthesia is associated with worse outcomes...... compared to conscious sedation. However, the findings may have been biased. Randomized clinical trials are needed to determine whether the choice of anesthesia may influence outcome. AIM AND HYPOTHESIS: The objective of GOLIATH (General or Local Anestesia in Intra Arterial Therapy) is to examine whether....... Patients with acute ischemic stroke, scheduled for endovascular therapy, are randomized to receive either general anesthesia or conscious sedation. STUDY OUTCOMES: The primary outcome measure is infarct growth after 48-72 h (determined by serial diffusion-weighted magnetic resonance imaging). Secondary...

  5. Equivalence considerations for orally inhaled products for local action-ISAM/IPAC-RS European Workshop report.

    Science.gov (United States)

    Evans, Carole; Cipolla, David; Chesworth, Tim; Agurell, Eva; Ahrens, Richard; Conner, Dale; Dissanayake, Sanjeeva; Dolovich, Myrna; Doub, William; Fuglsang, Anders; García Arieta, Afredo; Golden, Michael; Hermann, Robert; Hochhaus, Günther; Holmes, Susan; Lafferty, Paul; Lyapustina, Svetlana; Nair, Parameswaran; O'Connor, Dennis; Parkins, David; Peterson, Ilse; Reisner, Colin; Sandell, Dennis; Singh, Gur Jai Pal; Weda, Marjolein; Watson, Patricia

    2012-06-01

    The purpose of this article is to document the discussions at the 2010 European Workshop on Equivalence Determinations for Orally Inhaled Drugs for Local Action, cohosted by the International Society for Aerosols in Medicine (ISAM) and the International Pharmaceutical Consortium on Regulation and Science (IPAC-RS). The article summarizes current regulatory approaches in Europe, the United States, and Canada, and presents points of consensus as well as ongoing debate in the four major areas: in vitro testing, pharmacokinetic and pharmacodynamic studies, and device similarity. Specific issues in need of further research and discussion are also identified.

  6. Transplantation of Local Nets and Geometric Modular Action on Robertson-Walker Space-Times

    CERN Document Server

    Buchholz, D; Summers, S J; Buchholz, Detlev; Mund, Jens; Summers, Stephen J.

    2001-01-01

    A novel method of transplanting algebras of observables from de Sitter space to a large class of Robertson-Walker space-times is exhibited. It allows one to establish the existence of an abundance of local nets on these spaces which comply with a recently proposed condition of geometric modular action. The corresponding modular symmetry groups appearing in these examples also satisfy a condition of modular stability, which has been suggested as a substitute for the requirement of positivity of the energy in Minkowski space. Moreover, they exemplify the conjecture that the modular symmetry groups are generically larger than the isometry and conformal groups of the underlying space-times.

  7. Location of the Mesopontine Neurons Responsible for Maintenance of Anesthetic Loss of Consciousness.

    Science.gov (United States)

    Minert, Anne; Yatziv, Shai-Lee; Devor, Marshall

    2017-09-20

    The transition from wakefulness to general anesthesia is widely attributed to suppressive actions of anesthetic molecules distributed by the systemic circulation to the cerebral cortex (for amnesia and loss of consciousness) and to the spinal cord (for atonia and antinociception). An alternative hypothesis proposes that anesthetics act on one or more brainstem or diencephalic nuclei, with suppression of cortex and spinal cord mediated by dedicated axonal pathways. Previously, we documented induction of an anesthesia-like state in rats by microinjection of small amounts of GABAA-receptor agonists into an upper brainstem region named the mesopontine tegmental anesthesia area (MPTA). Correspondingly, lesioning this area rendered animals resistant to systemically delivered anesthetics. Here, using rats of both sexes, we applied a modified microinjection method that permitted localization of the anesthetic-sensitive neurons with much improved spatial resolution. Microinjected at the MPTA hotspot identified, exposure of 1900 or fewer neurons to muscimol was sufficient to sustain whole-body general anesthesia; microinjection as little as 0.5 mm off-target did not. The GABAergic anesthetics pentobarbital and propofol were also effective. The GABA-sensitive cell cluster is centered on a tegmental (reticular) field traversed by fibers of the superior cerebellar peduncle. It has no specific nuclear designation and has not previously been implicated in brain-state transitions.SIGNIFICANCE STATEMENT General anesthesia permits pain-free surgery. Furthermore, because anesthetic agents have the unique ability to reversibly switch the brain from wakefulness to a state of unconsciousness, knowing how and where they work is a potential route to unraveling the neural mechanisms that underlie awareness itself. Using a novel method, we have located a small, and apparently one of a kind, cluster of neurons in the mesopontine tegmentum that are capable of effecting brain-state switching

  8. Dynamic characteristics of the cutaneous vasodilator response to a local external pressure application detected by the laser Doppler flowmetry technique on anesthetized rats

    Science.gov (United States)

    Humeau, Anne; Koitka, Audrey; Saumet, Jean-Louis; L'Huillier, Jean-Pierre

    2003-10-01

    The laser Doppler flowmetry technique has recently been used to report a significant transient increase of the cutaneous blood flow signal when a local non-noxious pressure is applied progressively on the skin (11.1 Pa/s). The present work analyses the dynamic characteristics of this vasodilatory reflex response on anaesthetised rats. A de-noising algorithm using wavelets is proposed to obtain accurate values of these dynamic characteristics. The blood flow peak and the time to reach this peak are computed on the de-noised recordings. The results show that the mean time to reach the peak of perfusion is 85.3 s (time t = 0 at the beginning of the pressure application). The mean peak value is 188.3 arbitrary units (a.u.), whereas the mean value of the perfusion before the pressure application is 113.4 a.u. The mean minimum value obtained at the end of the experiment is 60.7 a.u. This latter value is, on the average, reached 841.3 s after the beginning of the pressure application. The comparison of the dynamic characteristics, computed with the de-noising algorithm on signals obtained in other situations, will give a better understanding on some cutaneous lesions such as those present on diabetic people.

  9. Integrating CBM into Land-Use Based Mitigation Actions Implemented by Local Communities

    Directory of Open Access Journals (Sweden)

    Arturo Balderas Torres

    2014-12-01

    Full Text Available In 2009, the conference of the parties of the United Nations Framework Convention on Climate Change recognized the need to engage communities and indigenous groups into the systems to monitor, report and verify the results of REDD+. Since then, many countries have started to prepare for REDD+ implementation. This article reviews early experiences under development in 11 projects financed by the Alliance Mexico REDD+ located in four Early Action Areas to identify the potential integration of Community Based Monitoring (CBM. The evaluation of the projects is made based on a multi-criteria analysis which considers the potential to produce information relevant for national monitoring systems and the prospects for sustained monitoring practices over time. Results indicate there are challenges to harmonizing monitoring practices and protocols between projects since activities proposed differ greatly from one project to another. Technical specifications for integrating local data into national systems are thus required. The results of these projects can help to identify best practices for planning and implementing REDD+. Findings indicate that in general, resources and capacities to gather, analyse and report information as part of CBM systems are in place in the projects, but usually these reside with non-local experts (i.e., NGOs and Academia; however, there are notable examples where these capacities reside in the communities. If national forest monitoring systems are geared to include information gathered through locally-driven processes REDD+ should promote activities that produce local benefits, but countries would need to build local capacities for managing and monitoring natural resources and would also need to create agreements for sharing and using local data. Otherwise, national systems may need to rely on monitoring practices external to communities, which depend on the continued availability of external financial resources.

  10. Effect of shear connectors on local buckling and composite action in steel concrete composite walls

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Kai, E-mail: kai-zh@purdue.edu [School of Civil Engineering, Purdue University, West Lafayette, IN (United States); Varma, Amit H., E-mail: ahvarma@purdue.edu [School of Civil Engineering, Purdue University, West Lafayette, IN (United States); Malushte, Sanjeev R., E-mail: smalusht@bechtel.com [Bechtel Power Corporation, Frederick, MD (United States); Gallocher, Stewart, E-mail: stewart.gallocher@steelbricks.com [Modular Walling Systems Ltd., Glasgow (United Kingdom)

    2014-04-01

    Steel concrete composite (SC) walls are being used for the third generation nuclear power plants, and also being considered for small modular reactors. SC walls consist of thick concrete walls with exterior steel faceplates serving as reinforcement. These steel faceplates are anchored to the concrete infill using shear connectors, for example, headed steel studs. The steel faceplate thickness (t{sub p}) and yield stress (F{sub y}), and the shear connector spacing (s), stiffness (k{sub s}), and strength (Q{sub n}) determine: (a) the level of composite action between the steel plates and the concrete infill, (b) the development length of steel faceplates, and (c) the local buckling of the steel faceplates. Thus, the shear connectors have a significant influence on the behavior of composite SC walls, and should be designed accordingly. This paper presents the effects of shear connector design on the level of composite action and development length of steel faceplates in SC walls. The maximum steel plate slenderness, i.e., ratio of shear connector spacing-to-plate thickness (s/t{sub p}) ratio to prevent local buckling before yielding is also developed based on the existing experimental database and additional numerical analysis.

  11. From global discourse to local action: the makings of a sexual rights movement?

    Directory of Open Access Journals (Sweden)

    Jonathan Garcia

    Full Text Available This paper focuses on the development of discourses around sexual rights, linking tendencies in official global dialogues with national and local realities. Recognizing some of the factors that have facilitated or impeded discourses and action to promote sexual rights around the world, we explore the principles and processes of framing sexual rights and sexual citizenship. We consider political opportunity and the mobilization of resources as important as cultural and emotional interpretations of sexual rights in conceptualizing a "sexual rights movement". Throughout the paper we question whether a movement based on solidarity can be forged between different social movements (i.e., feminist movements, HIV/AIDS movements, LGBT movements, etc. that are advocating for distinct sexual rights. While theoretically sexual rights range from protection from sexual violation to the celebration of sexual pleasure, in reality the agendas of sexual rights movements are still largely fragmented, heteronormative, and focused on negative rights.

  12. Mutual and asynchronous anticipation and action in sports as globally competitive and locally coordinative dynamics

    Science.gov (United States)

    Fujii, Keisuke; Isaka, Tadao; Kouzaki, Motoki; Yamamoto, Yuji

    2015-11-01

    Humans interact by changing their actions, perceiving other’s actions and executing solutions in conflicting situations. Using oscillator models, nonlinear dynamics have been considered for describing these complex human movements as an emergence of self-organisation. However, these frameworks cannot explain the hierarchical structures of complex behaviours between conflicting inter-agent and adapting intra-agent systems, especially in sport competitions wherein mutually quick decision making and execution are required. Here we adopt a hybrid multiscale approach to model an attack-and-defend game during which both players predict the opponent’s movement and move with a delay. From both simulated and measured data, one synchronous outcome between two-agent (i.e. successful defence) can be described as one attractor. In contrast, the other coordination-breaking outcome (i.e. successful attack) cannot be explained using gradient dynamics because the asymmetric interaction cannot always assume a conserved physical quantity. Instead, we provide the asymmetric and asynchronous hierarchical dynamical models to discuss two-agent competition. Our framework suggests that possessing information about an opponent and oneself in local-coordinative and global-competitive scale enables us to gain a deeper understanding of sports competitions. We anticipate developments in the scientific fields of complex movement adapting to such uncontrolled environments.

  13. Planning Through Stochastic Local Search and Temporal Action Graphs in LPG

    CERN Document Server

    Gerevini, A; Serina, I; 10.1613/jair.1183

    2011-01-01

    We present some techniques for planning in domains specified with the recent standard language PDDL2.1, supporting 'durative actions' and numerical quantities. These techniques are implemented in LPG, a domain-independent planner that took part in the 3rd International Planning Competition (IPC). LPG is an incremental, any time system producing multi-criteria quality plans. The core of the system is based on a stochastic local search method and on a graph-based representation called 'Temporal Action Graphs' (TA-graphs). This paper focuses on temporal planning, introducing TA-graphs and proposing some techniques to guide the search in LPG using this representation. The experimental results of the 3rd IPC, as well as further results presented in this paper, show that our techniques can be very effective. Often LPG outperforms all other fully-automated planners of the 3rd IPC in terms of speed to derive a solution, or quality of the solutions that can be produced.

  14. Effects of anesthetic compounds on responses of earthworms to electrostimulation.

    Science.gov (United States)

    Podolak-Machowska, Agnieszka; Kostecka, Joanna; Librowski, Tadeusz; Santocki, Michal; Bigaj, Janusz; Plytycz, Barbara

    2014-01-01

    Earthworms play an important role in biomedical research, and some surgical procedures require anesthesia. Anesthetic treatments used so far usually induce convulsive body movements connected with extrusion of coelomocyte-containing coelomic fluid that may affect experimental results. Extensive movements connected with the expulsion of coelomic fluid are exploited by immunologists as a method of harvesting immunocompetent coelomocytes from worms subjected to mild electrostimulation (4.5V). The aim of the investigations was to find anesthetic drugs without unintentional coelomocyte depletion. Experiments were performed on adult specimens of Dendrobaena veneta, the coelomocytes of which consist of amoebocytes and riboflavin-storing eleocytes. Earthworm mobility was filmed and extrusion of coelomocytes was quantified by detection of eleocyte-derived riboflavin in immersion fluid. Treatments included earthworms (1) immersed either in physiological saline (controls) or in a solution of one of the tested anesthetic drugs; (2) electrostimulated immediately after anesthesia, and (3) electrostimulated a second time after a 1-hour recovery period. The well-established fish and amphibian anesthetic agent MS-222 induced coelomocyte expulsion. In contrast, solutions of the mammalian local anesthetic drug, prilocaine hydrochloride (0.25-0.5%, 5-10 min) caused temporal earthworm immobilization followed by recovery, thus showing utility as an efficient earthworm anesthetic.

  15. Does Dexmedetomidine Have a Perineural Mechanism of Action When Used as an Adjuvant to Ropivacaine?

    DEFF Research Database (Denmark)

    Andersen, Jakob H; Grevstad, Ulrik; Siegel, Hanna

    2017-01-01

    BACKGROUND: Dexmedetomidine used as an adjuvant to local anesthetics may prolong the duration of peripheral nerve blocks. Whether this is mediated by a perineural or systemic mechanism remains unknown. The authors hypothesized that dexmedetomidine has a peripheral mechanism of action. METHODS: Th...

  16. Androgen actions in mouse wound healing: Minimal in vivo effects of local antiandrogen delivery.

    Science.gov (United States)

    Wang, Yiwei; Simanainen, Ulla; Cheer, Kenny; Suarez, Francia G; Gao, Yan Ru; Li, Zhe; Handelsman, David; Maitz, Peter

    2016-05-01

    The aims of this work were to define the role of androgens in female wound healing and to develop and characterize a novel wound dressing with antiandrogens. Androgens retard wound healing in males, but their role in female wound healing has not been established. To understand androgen receptor (AR)-mediated androgen actions in male and female wound healing, we utilized the global AR knockout (ARKO) mouse model, with a mutated AR deleting the second zinc finger to disrupt DNA binding and transcriptional activation. AR inactivation enhanced wound healing rate in males by increasing re-epithelialization and collagen deposition even when wound contraction was eliminated. Cell proliferation and migration in ARKO male fibroblasts was significantly increased compared with wild-type (WT) fibroblasts. However, ARKO females showed a similar healing rate compared to WT females. To exploit local antiandrogen effects in wound healing, while minimizing off-target systemic effects, we developed a novel electrospun polycaprolactone (PCL) scaffold wound dressing material for sustained local antiandrogen delivery. Using the antiandrogen hydroxyl flutamide (HF) at 1, 5, and 10 mg/mL in PCL scaffolds, controlled HF delivery over 21 days significantly enhanced in vitro cell proliferation of human dermal fibroblasts and human keratinocytes. HF-PCL scaffolds also promoted in vivo wound healing in mice compared with open wounds but not to PCL scaffolds. © 2016 by the Wound Healing Society.

  17. Action Enhances Acoustic Cues for 3-D Target Localization by Echolocating Bats.

    Science.gov (United States)

    Wohlgemuth, Melville J; Kothari, Ninad B; Moss, Cynthia F

    2016-09-01

    Under natural conditions, animals encounter a barrage of sensory information from which they must select and interpret biologically relevant signals. Active sensing can facilitate this process by engaging motor systems in the sampling of sensory information. The echolocating bat serves as an excellent model to investigate the coupling between action and sensing because it adaptively controls both the acoustic signals used to probe the environment and movements to receive echoes at the auditory periphery. We report here that the echolocating bat controls the features of its sonar vocalizations in tandem with the positioning of the outer ears to maximize acoustic cues for target detection and localization. The bat's adaptive control of sonar vocalizations and ear positioning occurs on a millisecond timescale to capture spatial information from arriving echoes, as well as on a longer timescale to track target movement. Our results demonstrate that purposeful control over sonar sound production and reception can serve to improve acoustic cues for localization tasks. This finding also highlights the general importance of movement to sensory processing across animal species. Finally, our discoveries point to important parallels between spatial perception by echolocation and vision.

  18. Action Enhances Acoustic Cues for 3-D Target Localization by Echolocating Bats

    Science.gov (United States)

    Wohlgemuth, Melville J.

    2016-01-01

    Under natural conditions, animals encounter a barrage of sensory information from which they must select and interpret biologically relevant signals. Active sensing can facilitate this process by engaging motor systems in the sampling of sensory information. The echolocating bat serves as an excellent model to investigate the coupling between action and sensing because it adaptively controls both the acoustic signals used to probe the environment and movements to receive echoes at the auditory periphery. We report here that the echolocating bat controls the features of its sonar vocalizations in tandem with the positioning of the outer ears to maximize acoustic cues for target detection and localization. The bat’s adaptive control of sonar vocalizations and ear positioning occurs on a millisecond timescale to capture spatial information from arriving echoes, as well as on a longer timescale to track target movement. Our results demonstrate that purposeful control over sonar sound production and reception can serve to improve acoustic cues for localization tasks. This finding also highlights the general importance of movement to sensory processing across animal species. Finally, our discoveries point to important parallels between spatial perception by echolocation and vision. PMID:27608186

  19. Activation and inactivation of thyroid hormone by deiodinases: local action with general consequences.

    Science.gov (United States)

    Gereben, B; Zeöld, A; Dentice, M; Salvatore, D; Bianco, A C

    2008-02-01

    The thyroid hormone plays a fundamental role in the development, growth, and metabolic homeostasis in all vertebrates by affecting the expression of different sets of genes. A group of thioredoxin fold-containing selenoproteins known as deiodinases control thyroid hormone action by activating or inactivating the precursor molecule thyroxine that is secreted by the thyroid gland. These pathways ensure regulation of the availability of the biologically active molecule T3, which occurs in a time-and tissue-specific fashion. In addition, because cells and plasma are in equilibrium and deiodination affects central thyroid hormone regulation, these local deiodinase-mediated events can also affect systemic thyroid hormone economy, such as in the case of non-thyroidal illness. Heightened interest in the field has been generated following the discovery that the deiodinases can be a component in both the Sonic hedgehog signaling pathway and the TGR-5 signaling cascade, a G-protein-coupled receptor for bile acids. These new mechanisms involved in deiodinase regulation indicate that local thyroid hormone activation and inactivation play a much broader role than previously thought.

  20. From global framing to local action : translation of climate change impacts in Africa

    Energy Technology Data Exchange (ETDEWEB)

    Ogunseitan, O.A. [Harvard Univ., Cambridge, MA (United States)

    2000-06-01

    There is considerable controversy regarding policy and climate change mitigation in Africa. Its resolution will require integrating local knowledge and values into climate impact assessments. Africa's vulnerability to climate change can be traced to the frequency of socio-ecological devastation that comes from major climate variations on the continent. The incidence of famines, homelessness and disease epidemics that require international assistance are reflections of weak policies and institution action frames used to cope with climate and weather related emergencies. However, the valuation of climate change impacts has a subjective dimension that can be gained only through indigenous experience and an understanding of values associated with life-saving intervention programs. A recent study showed that discount rates applied to future life-saving programs by Africans are very different from the rates applied in developed countries, and that the difference should be reflected in national development programs and transnational initiatives for capacity building. The study suggests that if the boundary institutions responsible for public health security have not been too effective in resolving the policy controversy surrounding Africa's participation in climate change assessments, it is due partly to the limitations imposed by cross-scale issues in framing. It was concluded that efforts to reduce Africa's dependence on global emergency health response systems will necessitate the development of autonomous capacity to adapt to natural disasters. Appropriate frame reflection is needed at the local level. 56 refs., 3 tabs., 1 fig.

  1. A Local Action Plan (PAL to Combat Desertification in Apulia Region: Functional Integration of Existing Territorial Programs

    Directory of Open Access Journals (Sweden)

    Claudia Trotta

    2010-10-01

    Full Text Available In 2006-2007, the Italian National Committee to Combat Drought and Desertification promoted the execution of local action plans in some of the Italian regions. The aims of these plans were: to carry out specific actions at a local scale; to promote the integration of local policies; to involve the local communities in proposing strategies to be adopted; to harmonize the procedures among institutions in charge of adopting the policies. In this framework, ENEA carried out an evaluation of existing policies and programs to be considered in implementing a local action plan to combat desertification in the Apulia region. The application of the environmental and socio-economic measures of the regional Rural Development Plan 2007-2013 (PSR seemed to be an effective tool to positively influence human activities such as agriculture, breeding, and forestry, with the purpose of preserving or improving soil characteristics and overall environmental conditions, and eventually resulting in a reduction of desertification processes. Therefore, we proposed that these measures should be taken into account and effectively integrated into the Local Action Plan of the Apulia region. Additionally, we considered the four priority sectors identified by the National Action Plan (PAN to combat drought and desertification as the guiding principles to carry out our analysis. These sectors were: Soil Protection, Sustainable Water Management, Reduction of the Impact of Productive Activities, and Territorial Equilibrium. We also included Climate Change, in consideration of the alarming and urgent role it has assumed. The desertification-prone province of Foggia was selected as a pilot area in where to evaluate the influences that PSR measures can directly or indirectly have on desertification-related factors, and identify and implement specific actions. The Provincial Coordination Territorial Plan (PTCP of Foggia provided the basic land units for this analysis, the

  2. Neoadjuvant therapy for localized prostate cancer: Examining mechanism of action and efficacy within the tumor

    Science.gov (United States)

    Lou, David Y.; Fong, Lawrence

    2015-01-01

    Objectives Efforts to improve the clinical outcome for patients with localized high-risk prostate cancer have led to the development of neoadjuvant systemic therapies. We review the different modalities of neoadjuvant therapies for localized prostate cancer and highlight emerging treatment approaches including immunotherapy and targeted therapy. Methods We performed a PubMed search of clinical trials evaluating preoperative systemic therapies for treating high-risk prostate cancer published after 2000, and those studies with the highest clinical relevance to current treatment approaches were selected for review. The database at clinicaltrials.gov was queried for neoadjuvant studies in high-risk prostate cancer, and those evaluating novel targeted therapies and immunotherapies are spotlighted here. Results Neoadjuvant chemotherapy has become standard of care for treating some malignancies, including breast and bladder cancers. In prostate cancer, preoperative hormonal therapy or chemotherapy has failed to demonstrate improvements in overall survival. Nevertheless, the emergence of novel treatment modalities such as targeted small molecules and immunotherapy has spawned neoadjuvant clinical trials that provide a unique vantage from which to study mechanism of action and biological potency. Tissue-based biomarkers are being developed to elucidate the biological efficacy of these treatments. With targeted therapy, these can include phospho-proteomic signatures of target pathway activation and deactivation. With immunotherapies, including sipuleucel-T and ipilimumab, recruitment of immune cells to the tumor microenvironment can also be used as robust markers of a biological effect. Such studies can provide insight not only into mechanism of action for these therapies but can also provide paths forward to improving clinical efficacy like with rationally designed combinations and dose selection. Conclusions The use of neoadjuvant androgen-deprivation therapy and

  3. Lack of effect of flurothyl, a non-anesthetic fluorinated ether, on rat brain synaptic plasma membrane calcium-ATPase.

    Science.gov (United States)

    Horn, J L; Janicki, P K; Franks, J J

    1999-01-01

    Plasma membrane Ca2+-ATPase (PMCA), a regulator of intracellular calcium, is inhibited by volatile anesthetics and by xenon and nitrous oxide. Response of a cellular system to anesthetics, particularly to volatile agents, raises the question of non-specific, even toxic, side effects unrelated to anesthetic action. Compounds with chemical and physical properties similar to halogenated anesthetics, but which lack anesthetic effect, have been used to address this question. We have compared the effects of halothane and flurothyl, a non-anesthetic fluorinated ether, on PMCA Ca2+ transport across isolated brain synaptic plasma membranes (SPM). Flurothyl, at concentrations predicted by the Meyer-Overton curve to range from 0.4 to 2.6 MAC (minimum alveolar concentration), had no significant on PMCA activity. In contrast halothane, 1.3 MAC, reduced Ca2+ transport 30 to 40%. These findings provide further evidence for a specific effect of inhalation anesthetics on neuronal plasma membrane Ca2+-ATPase.

  4. Study of the all orders multiplicative renormalizability of a local confining quark action in the Landau gauge

    Energy Technology Data Exchange (ETDEWEB)

    Capri, M.A.L., E-mail: caprimarcio@gmail.com; Fiorentini, D., E-mail: diegofiorentinia@gmail.com; Sorella, S.P., E-mail: silvio.sorella@gmail.com

    2015-05-15

    The inverse of the Faddeev–Popov operator plays a pivotal role within the Gribov–Zwanziger approach to the quantization of Euclidean Yang–Mills theories in Landau gauge. Following a recent proposal (Capri et al., 2014), we show that the inverse of the Faddeev–Popov operator can be consistently coupled to quark fields. Such a coupling gives rise to a local action while reproducing the behaviour of the quark propagator observed in lattice numerical simulations in the non-perturbative infrared region. By using the algebraic renormalization framework, we prove that the aforementioned local action is multiplicatively renormalizable to all orders.

  5. Day-surgery patients anesthetized with propofol have less postoperative pain than those anesthetized with sevoflurane.

    LENUS (Irish Health Repository)

    Tan, Terry

    2012-02-01

    BACKGROUND: There have been recent studies suggesting that patients anesthetized with propofol have less postoperative pain compared with patients anesthetized with volatile anesthetics. METHODS: In this randomized, double-blind study, 80 patients undergoing day-case diagnostic laparoscopic gynecological surgery were either anesthetized with IV propofol or sevoflurane. The primary outcome measured was pain on a visual analog scale. RESULTS: Patients anesthetized with propofol had less pain compared with patients anesthetized with sevoflurane (P = 0.01). There was no difference in any of the other measured clinical outcomes. CONCLUSIONS: The patients anesthetized with propofol appeared to have less pain than patients anesthetized with sevoflurane.

  6. Membrane Localization, Caveolin-3 Association and Rapid Actions of Vitamin D Receptor in Cardiac Myocytes

    Science.gov (United States)

    Zhao, Guisheng; Simpson, Robert U.

    2009-01-01

    The active form of vitamin D, 1alpha, 25-Dihydroxyvitamin D3 (1, 25(OH)2D3), mediates both genomic and rapid non-genomic actions in heart cells. We have previously shown that the vitamin D receptor (VDR) is located in the t-tubular structure of cardiomyocytes. Here we show that VDR specifically interacts with Caveolin-3 in the t-tubules and sarcolemma of adult rat cardiac myocytes. Co-Immunoprecipitation studies using VDR antibodies revealed that Caveolin-3 specifically co-precipitates with the VDR and similarly the VDR is co-precipitated with Caveolin-3 antibody. Confocal immunofluorescence microscopy analysis also showed co-localization of VDR and Caveolin-3 in t-tubules and sarcolemma. The non-genomic effects of the functional VDR were studied in electrically stimulated myocytes isolated from adult rat hearts. Sarcomere shortening and re-lengthening were measured in 1, 25 (OH)2D3 treated cardiac myocytes. A 1nM treatment decreased peak shortening within minutes, suggesting a rapid effect through the membrane-bound VDR. This novel finding of the interaction between VDR and Caveolin-3 is fundamentally important in understanding 1, 25(OH)2D3 signal transduction in heart cells and provides further evidence that VDR plays a role in regulation of heart structure and function. PMID:20015453

  7. Bloqueio combinado para analgesia de parto: a adição de sufentanil ao anestésico local influencia o apgar dos recém-nascidos? Bloqueo combinado para analgesia de parto: ¿la adición de sufentanil al anestésico local influye en el apgar de los reciÿn nacidos? Combined spinal-epidural for labor analgesia: does the addition of sufentanil to the local anesthetic influence apgar scores of the newborns?

    Directory of Open Access Journals (Sweden)

    Domingos Dias Cicarelli

    2007-06-01

    Universidade de São Paulo (USP y evaluar si la utilización de sufentanil asociado al anestésico local en el BC altera el Apgar de los recién nacidos. MÉTODO: Se analizaron las fichas de anestesia en que se realizaron BC para la analgesia de parto durante 12 meses en el Hospital Universitario de la USP. Se registraron el uso y la dosis de sufentanil, la vía de parto utilizada y las puntuaciones de Apgar del 1°, 5° y 10° minutos de los recién nacidos. RESULTADOS: De los 635 BC evaluados, 307 utilizaron sufentanil y anestésico local (Grupo SUF y 328, solo anestésico local (Grupo AL. Ciento veinte y siete (20% fueron realizados a través de la técnica de aguja por dentro de aguja y los otros 508 (80% realizados por la técnica dos punciones. No se verificó diferencia entre el Apgar de los grupos estudiados en el 1°, 5° y 10° minutos. CONCLUSIONES: El sufentanil utilizado en el bloqueo combinado no alteró el Apgar de los recién nacidos.BACKGROUND AND OBJECTIVES: Combined spinal-epidural (CSE is a very common obstetric technique. However, the literature does not present a standardization regarding the technique, doses, and anesthetics used, besides there is also the controversy about the possibility that the addition of opioids to the local anesthetic causes fetal bradycardia and affects its vitality. The aim of this study was to identify the techniques and anesthetics used in the Anesthesiology Service of the Hospital Universitário of Universidade de São Paulo (USP and determine whether the use of sufentanil associated with the local anesthetic affects Apgar scores of newborns. METHODS: The anesthesiology charts of patients submitted to CSE for labor analgesia over a 12-month period at the Hospital Universitário of USP were analyzed. The use and dose of sufentanil, the type of delivery, and Apgar scores in the 1st, 5th, and 10th minutes were recorded. RESULTS: Of the 635 CSE analyzed, 307 used sufentanil and local anesthetic (SUF Group and 328 only local

  8. Anesthetic Maintenance of Thyroid Surgery

    Directory of Open Access Journals (Sweden)

    A. A. Negovsky

    2008-01-01

    Full Text Available Thyroid diseases are most common in endocrinology. Thyrotoxicosis induces dysfunction of virtually all organs and systems, the blood circulatory system being subjected to considerable changes. Cardiovascular diseases affect not only the quality of life in a patient, but significantly increase a risk from surgery that is the only radical treatment. For this reason, most authors consider thyrotoxicosis to be a contraindication to elective surgical intervention. At the same time it is known that drug compensation of thyrotoxicosis may be attained in not all patients. In this case, the results of treatment and a patient’s safety during surgery depend on the type and quality of anesthetic protection. The capabilities of anesthetic maintenance of thyroid surgery have recently expanded substantially. The paper deals with the preparation of patients with thyrotoxicosis for surgical intervention and the perioperative management of these patients. Key words: thyroid, toxic goiter, thyrotoxicosis, premedication, anesthetic mode, sevoflurane, xenon.

  9. An estimation of the minimum effective anesthetic volume of 2% lidocaine in ultrasound-guided axillary brachial plexus block.

    LENUS (Irish Health Repository)

    O'Donnell, Brian D

    2009-07-01

    Ultrasound guidance facilitates precise needle and injectate placement, increasing axillary block success rates, reducing onset times, and permitting local anesthetic dose reduction. The minimum effective volume of local anesthetic in ultrasound-guided axillary brachial plexus block is unknown. The authors performed a study to estimate the minimum effective anesthetic volume of 2% lidocaine with 1:200,000 epinephrine (2% LidoEpi) in ultrasound-guided axillary brachial plexus block.

  10. How To Form and Operate a Local Alliance. A Handbook for Local Action To Improve Science and Technology Education.

    Science.gov (United States)

    Livermore, Arthur H.; And Others

    The growth of local alliances (partnerships of business, industry, labor, professional associations, educators, and other concerned groups) is evidence of a widespread public concern for improving the quality of science and technology education. This document defines the concept of local alliances and discusses aspects of the founding and…

  11. The thermodynamics of general and local anesthesia

    CERN Document Server

    Graesboll, Kaare; Heimburg, Thomas

    2014-01-01

    General anesthetics are known to cause depression of the freezing point of transitions in biomembranes. This is a consequence of ideal mixing of the anesthetic drugs in the membrane fluid phase and exclusion from the solid phase. Such a generic law provides physical justification of the famous Meyer-Overton rule. We show here that general anesthetics, barbiturates and local anesthetics all display the same effect on melting transitions. Their effect is reversed by hydrostatic pressure. Thus, the thermodynamic behavior of local anesthetics is very similar to that of general anesthetics. We present a detailed thermodynamic analysis of heat capacity profiles of membranes in the presence of anesthetics. This analysis is able to describe experimentally observed calorimetric profiles and permits prediction of the anesthetic features of arbitrary molecules. In addition, we discuss the thermodynamic origin of the cutoff-effect of long-chain alcohols and the additivity of the effect of general and local anesthetics.

  12. Aspects of Quantum Non-Locality I: Superluminal Signalling, Action-at-a-Distance, Non-Separability and Holism

    Science.gov (United States)

    Berkovitz, Joseph

    In this paper and its sequel, I consider the significance of Jarrett's and Shimony's analyses of the so-called factorisability (Bell-locality) condition for clarifying the nature of quantum non-locality. In this paper, I focus on four types of non-locality: superluminal signalling, action-at-a-distance, non-separability and holism. In the second paper, I consider a fifth type of non-locality: superluminal causation according to 'logically weak' concepts of causation, where causal dependence requires neither action nor signalling. In this connection, I pay special attention to the difficulties that superluminal causation raises in relativistic space-time. I conclude by evaluating the relevance of Jarrett's and Shimony's analyses for clarifying the question of the compatibility of quantum non-locality with relativity theory. My main conclusions are, first: these analyses are significant for clarifying the questions of superluminal signalling in quantum phenomena and for the compatibility of these phenomena with relativity. But, second, by contrast: these analyses are not very significant for the study of action-at-a distance, superluminal causation, non-separability and holism in quantum phenomena.

  13. The effect of low serum bicarbonate values on the onset of action of local anesthesia with vertical infraclavicular brachial plexus block in patients with End-stage renal failure

    Directory of Open Access Journals (Sweden)

    Al-mustafa Mahmoud

    2010-01-01

    Full Text Available Vertical infraclavicular brachial plexus block is utilized in patients with chronic renal failure at the time of creation of an arterio-venous fistula (AVF. The aim of this study is to test the effect of impaired renal function, with the resulting deranged serum electrolytes and blood gases, on the success rate and the onset of action of the local anesthetics used. In this prospective clinical study, we investigated the effect of the serum levels of sodium, potassium, urea, crea-tinine, pH, and bicarbonate on the onset of action of a mixture of lidocaine and bupivacaine administered to create infraclavicular brachial plexus block. A total of 31 patients were studied. The success rate of the block was 93.5 % (29 patients. The mean onset time for impaired or re-duced sensation was found to be 8.9 ± 4.7 mins and for complete loss of sensation, was 21.2 ± 6.7 mins. There was no significant association with serum sodium, potassium, urea, creatinine or the blood pH level (P> 0.05. The bivariate correlation between serum bicarbonate level and the partial and complete sensory loss was -0.714 and -0.433 respectively, with significant correlation (P= 0.00, 0.019. Our study suggests that infraclavicular block in patients with chronic renal failure carries a high success rate; the onset of the block is delayed in patients with low serum bicarbonate levels.

  14. Costs of anesthetics and other drugs in anesthesia

    Directory of Open Access Journals (Sweden)

    Majstorović Branislava M.

    2012-01-01

    Full Text Available Introduction. Drugs are real and transparent costs of treatment, which are subject to constant monitoring and changes. The study was aimed at measuring and analyzing consumption of anesthetics and other drugs in anesthesia in the Clinical Centre of Serbia. Material and Methods. This paper is part of a five-year (2005-2009, academic, pharmacoeconomic retrospective-prospective study (the 4th phase. We calculated the costs of anesthetics and other drugs in all anesthetized patients at the Institute of Anesthesia and Reanimation, Clinical Center of Serbia in 2006. The data, obtained from the Clinical Centre of Serbia Database, were analyzed by descriptive statistical methods using computer program Microsoft Office Excel 2003 and the Statistical Package for the Social Sciences (SPSS for Windows. Results. The amount of money spent for the application of 33,187 general and 16,394 local anesthesia and 20,614 anesthesiology procedures was 83,322,046.36 RSD (Euros 1,054,705.4, which was 5.93% of the funds allocated for all drugs used at the Clinical Center of Serbia. Of the total fund for drugs, 57.8% was spent for anesthetics (local anesthetics 1.2% and muscle relaxants, whereas 42.2% was spent for other drugs in anesthesia. The highest amount was spent at the Emergency Center (35.8%, then at the Cardio-surgery (11.9% and the Neurosurgery (10.9% because of the large number and length of surgical interventions. Conclusion. There is no space for rationalizing the costs of anesthetics and other drugs in anesthesia.

  15. Risk-informed local action planning against flooding: lessons learnt and way forward for a case study in Spain

    Directory of Open Access Journals (Sweden)

    Castillo-Rodríguez J.T.

    2016-01-01

    Full Text Available After 29 years of the largest flood event in modern times (with the highest recorded rainfall rate at the Iberian Peninsula with 817 mm in 24 hours, the municipality of Oliva faces the challenge of mitigating flood risk through the development and implementation of a local action plan, in line with other existent and ongoing structural measures for flood risk reduction. Located 65 km from Valencia, on the South-Eastern coast of Spain, Oliva is affected by pluvial, river and coastal flooding and it is characterized by a complex and wide-ranging geography and high seasonal variation in population. A quantitative flood risk analysis has been performed to support the definition of flood risk management strategies. This paper shows how hazard, exposure and vulnerability analyses provide valuable information for the development of a local action plan against flooding, for example by identifying areas with highest societal and economic risk levels. It is concluded that flood risk management actions, such as flood warning and monitoring or evacuation, should not be applied homogenously at local scale, but instead actions should be adapted based on spatial clustering. Implications about the impact of education and training on flood risk reduction are also addressed and discusse

  16. From global discourse to local action: the makings of a sexual rights movement?

    Directory of Open Access Journals (Sweden)

    Jonathan Garcia

    2006-12-01

    Full Text Available This paper focuses on the development of discourses around sexual rights, linking tendencies in official global dialogues with national and local realities. Recognizing some of the factors that have facilitated or impeded discourses and action to promote sexual rights around the world, we explore the principles and processes of framing sexual rights and sexual citizenship. We consider political opportunity and the mobilization of resources as important as cultural and emotional interpretations of sexual rights in conceptualizing a "sexual rights movement". Throughout the paper we question whether a movement based on solidarity can be forged between different social movements (i.e., feminist movements, HIV/AIDS movements, LGBT movements, etc. that are advocating for distinct sexual rights. While theoretically sexual rights range from protection from sexual violation to the celebration of sexual pleasure, in reality the agendas of sexual rights movements are still largely fragmented, heteronormative, and focused on negative rights.Este artigo enfoca o desenvolvimento de discursos que circundam os direitos sexuais juntando tendências em diálogos globais oficiais com realidades nacionais e locais. Reconhecendo alguns fatores que têm facilitado ou impedido discursos e ações que promovam direitos sexuais ao redor do mundo, nós exploramos os princípios e processos onde se enquadram os direitos sexuais e a cidadania sexual. Nós consideramos que as oportunidades políticas e a mobilização de recursos são tão importantes para a conceitualização de um movimento pelos direitos sexuais quanto as interpretações culturais e emocionais dos direitos sexuais. Ao longo deste artigo, nós questionamos se um movimento baseado na solidariedade pode ser forjado entre movimentos diferentes (por exemplo, movimentos feministas, HIV/Aids, movimentos GLBT, etc. que estão reivindicando direitos sexuais distintos. Enquanto teoricamente os direitos sexuais v

  17. Genotoxicity of Anesthetics Evaluated In Vivo (Animals)

    Science.gov (United States)

    Braz, Mariana G.; Karahalil, Bensu

    2015-01-01

    The anesthesia has been improved all over the years. However, it can have impact on health, in both patients and animals anesthetized, as well as professionals exposed to inhaled anesthetics. There is continuing effort to understand the possible effects of anesthetics at molecular levels. Knowing the effects of anesthetic agents on genetic material could be a valuable basic support to better understand the possible mechanisms of these agents. Thus, the purpose of this review is to provide an overview on the genotoxic potential, evaluated in animal models, of many anesthetics that have already been used and those currently used in anesthesia. PMID:26199936

  18. Contextual action recognition and target localization with an active allocation of attention on a humanoid robot.

    Science.gov (United States)

    Ognibene, Dimitri; Chinellato, Eris; Sarabia, Miguel; Demiris, Yiannis

    2013-09-01

    Exploratory gaze movements are fundamental for gathering the most relevant information regarding the partner during social interactions. Inspired by the cognitive mechanisms underlying human social behaviour, we have designed and implemented a system for a dynamic attention allocation which is able to actively control gaze movements during a visual action recognition task exploiting its own action execution predictions. Our humanoid robot is able, during the observation of a partner's reaching movement, to contextually estimate the goal position of the partner's hand and the location in space of the candidate targets. This is done while actively gazing around the environment, with the purpose of optimizing the gathering of information relevant for the task. Experimental results on a simulated environment show that active gaze control, based on the internal simulation of actions, provides a relevant advantage with respect to other action perception approaches, both in terms of estimation precision and of time required to recognize an action. Moreover, our model reproduces and extends some experimental results on human attention during an action perception.

  19. The Dilaton Wess-Zumino Action in 6 Dimension from Weyl Gauging: Local Anomalies and Trace Relations

    CERN Document Server

    Coriano, Claudio; Marzo, Carlo; Serino, Mirko

    2013-01-01

    We extend a previous analysis on the derivation of the dilaton Wess-Zumino (WZ) action in $d=4$, based on the method of Weyl gauging, to $6$ dimensions. As in the previous case, we discuss the structure of the same action in dimensional regularization using 6-dimensional Weyl invariants, extracting the dilaton interactions in the most general scheme, with the inclusion of the local anomaly terms. As an application, we present the WZ action for the (2,0) tensor multiplet, which has been investigated in the past in the context of the $AdS_7/CFT_6$ holographic anomaly matching. We then extend to $d=6$ the investigation of fully traced correlation functions of EMT's, formerly presented in $d=4$, showing that their hierarchy is functionally related only to the first 6 correlators. We give the explicit expressions of these in the most general scheme, up to rank-4.

  20. On the use of upper extremity proximal nerve action potentials in the localization of focal nerve lesions producing axonotmesis.

    Science.gov (United States)

    White, J C

    1997-09-01

    Ulnar, median, and radial proximal nerve action potentials (PNAPs) were recorded from the axilla and supraclavicularly, with stimulation of the nerves at the elbow or the radial groove, in 30 control subjects for each nerve. In addition to routine nerve conduction studies, wrist to elbow median nerve action potentials were recorded proximal to the lesion in 76 patients with carpal tunnel syndrome of varying degrees of severity to determine the effect that the distal lesion might have on more proximal nerve conduction. Utilizing this information, PNAPs, standard nerve conduction studies, and needle electrode examinations were carried out in patients with focal elbow area nerve or brachial plexus lesions producing axonotmesis. PNAPs confirmed the site of the lesions producing axonotmesis when localization was possible with standard nerve conduction and/or needle electrode studies and were the sole means by which localization of the lesions producing only sensory axonotmesis was accomplished.

  1. Anesthetic Related Advances with Cyclodextrins

    OpenAIRE

    Mark Welliver; John P. McDonough

    2007-01-01

    Cyclodextrins encapsulate and electrostatically bind to lipophilic molecules. The exterior of cyclodextrins are water-soluble and maintain aqueous solubility despite encapsulation of non-aqueous soluble molecules. This unique ability to encapsulate lipophilic molecules and maintain water solubility confers numerous pharmacologic advantages for both drug delivery and removal. Cyclodextrins, a component part of supramolecular chemistry, may be in its infancy of anesthetic application but recent...

  2. Potent Inhalational Anesthetics for Dentistry.

    Science.gov (United States)

    Satuito, Mary; Tom, James

    2016-01-01

    Nitrous oxide and the volatile inhalational anesthetics have defined anxiety and pain control in both dentistry and medicine for over a century. From curious experimentation to spectacular public demonstrations, the initial work of 2 dentists, Horace Wells and William T. G. Morton, persists to this day in modern surgery and anesthesia. This article reviews the history, similarities, differences, and clinical applications of the most popular inhalational agents used in contemporary dental surgical settings.

  3. LOCAL ACTION GROUPS – A NEW FORM OF PUBLIC-PRIVATE PARTNERSHIP IN RURAL AREAS OF BULGARIA

    Directory of Open Access Journals (Sweden)

    Zornitsa STOYANOVA

    2012-01-01

    Full Text Available Purpose of the paper is to assess the problems of creation and functioning of local action groups as form of public-private partnership. It is based on the survey and data provided by Ministry of Agriculture and Food. Conclusions in this report reflect the results of a research project of the University of National and World Economy, developed by the author team.

  4. Anesthetic management of transcatheter aortic valve implantation

    Directory of Open Access Journals (Sweden)

    Annalisa Franco

    2012-01-01

    Full Text Available Transcatheter aortic valve implantation (TAVI is an emergent technique for high-risk patients with aortic stenosis. TAVI poses significant challenges about its management because of the procedure itself and the population who undergo the implantation. Two devices are currently available and marketed in Europe and several other technologies are being developed. The retrograde transfemoral approach is the most popular procedure; nevertheless, it may not be feasible in patients with significant aortic or ileo-femoral arterial disease. Alternatives include a transaxillary approach, transapical approach, open surgical access to the retroperitoneal iliac artery and the ascending aorta. A complementary approach using both devices and alternative routes tailored to the anatomy and the comorbidities of the single patient is a main component for the successful implementation of a TAVI program. Anesthetic strategies vary in different centers. Local anesthesia or general anesthesia are both valid alternatives and can be applied according to the patient′s characteristics and procedural instances. General anesthesia offers many advantages, mainly regarding the possibility of an early diagnosis and treatment of possible complications through the use of transesophageal echocardiography. However, after the initial experiences, many groups began to employ, routinely, sedation plus local anesthesia for TAVI, and their procedural and periprocedural success demonstrates that it is feasible. TAVI is burdened with potential important complications: vascular injuries, arrhythmias, renal impairment, neurological complications, cardiac tamponade, prosthesis malpositioning and embolization and left main coronary artery occlusion. The aim of this work is to review the anesthetic management of TAVI based on the available literature.

  5. Spatiotemporal Localization and Categorization of Human Actions in Unsegmented Image Sequences

    NARCIS (Netherlands)

    Oikonomopoulos, Antonios; Patras, Ioannis; Pantic, Maja

    2011-01-01

    In this paper we address the problem of localization and recognition of human activities in unsegmented image sequences. The main contribution of the proposed method is the use of an implicit representation of the spatiotemporal shape of the activity which relies on the spatiotemporal localization o

  6. Cross-approximate entropy of cortical local field potentials quantifies effects of anesthesia - a pilot study in rats

    Directory of Open Access Journals (Sweden)

    Schwarz Cornelius

    2010-09-01

    quantification of these effects in terms of XApEn has a similar discriminatory power as changes of spontaneous action potential rates. Thus, XApEn of field potentials recorded from local cortical networks provides valuable information on the anesthetic state of the brain.

  7. Local food between direct sale, short distance and collective action. Interview of Bertil Sylvander

    Directory of Open Access Journals (Sweden)

    Virginie Amilien

    2005-05-01

    Full Text Available VA: Bertil Sylvander, you are one of the fathers of the quality conventions concept concerning products of origin, and you have a great knowledge of socio-economic aspects of agriculture and local food systems, including products with specific origin and labels…this is why you accepted this interview for our Anthropology of Food Issue on Local products. I’ll just start with the plain question: when I say “local products”, what do you think of? BS: well…, in order to answer this question I’d h...

  8. L-NAME加强麻醉大鼠低血压诱发的催产素释放作用%L-NAME augments oxytocin secretion in response to hypotension in anesthetized rats:an implication of nitric oxide action

    Institute of Scientific and Technical Information of China (English)

    曹鲁乡; 汪萌芽; 沈锷

    2000-01-01

    取戊巴比妥麻醉大鼠向侧脑室内分别注射一氧化氮(NO)合酶的底物L-精氨酸和NO合酶抑制剂NG-硝基-L-精氨酸甲酯(L-NAME),用放射免疫法测定血浆中催产素(OT)水平.结果:侧脑室内注射L-精氨酸(100 g/L,10 霯,n=8)和L-NAME(54.0 g/L,5 霯,n=12),对OT的基础分泌无明显影响;侧脑室内注射5 霯 L-NAME(剂量1:27.0 g/L,n=9;剂量2:54.0 g/L,n=8),可进一步增强静脉输注硝普钠引起低血压所诱导的OT分泌升高反应.结果表明L-NAME能加强低血压诱发的OT反射性释放作用,提示NO可能是OT反射性释放的抑制因子.%To detect the effect of nitric oxide (NO)on basal and reflex release of oxytocin (OT),L-arginine(the substrate of NO synthase )and NG-nitro-L-arginine methyl ester (L-NAME,NO synthase inhibitor)were intracerebroventricularly(icv)administrated into the pentobarbital anesthetized rats and the plasma OT level was detected with radioimmunoassay.Injection (icv) of L-arginine(100 g/L,10 μL,n=8)and L-NAME (54.0 g/L,5 μL,n=12) had no significant effect on OT basal secretion.However,the elevated OT secretion in response to hypotension induced by intravenous infusion of sodium nitroprusside was dose-dependently augmented by icv injection of 5 μL L-NAME (dose 1:27.0 g/L,n=9;dose 2:54.0 g/L,n=8).The results indicate that L-NAME does not change basal OT secretion,but enhances OT reflex secretion evoked by hypotension,which suggests that NO may act as an inhibitory factor on reflex release of OT.

  9. How to build science-action partnerships for local land-use planning and management: lessons from Durban, South Africa

    Directory of Open Access Journals (Sweden)

    Jessica Cockburn

    2016-03-01

    Full Text Available The gap between scientific knowledge and implementation in the fields of biodiversity conservation, environmental management, and climate change adaptation has resulted in many calls from practitioners and academics to provide practical solutions responding effectively to the risks and opportunities of global environmental change, e.g., Future Earth. We present a framework to guide the implementation of science-action partnerships based on a real-world case study of a partnership between a local municipality and an academic institution to bridge the science-action gap in the eThekwini Municipal Area, South Africa. This partnership aims to inform the implementation of sustainable land-use planning, biodiversity conservation, environmental management, and climate change adaptation practice and contributes to the development of human capacity in these areas of expertise. Using a transdisciplinary approach, implementation-driven research is being conducted to develop several decision-making products to better inform land-use planning and management. Lessons learned through this partnership are synthesized and presented as a framework of enabling actions operating at different levels, from the individual to the interorganizational. Enabling actions include putting in place enabling organizational preconditions, assembling a functional well-structured team, and actively building interpersonal and individual collaborative capacity. Lessons learned in the case study emphasize the importance of building collaborative capacity and social capital, and paying attention to the process of transdisciplinary research to achieve more tangible science, management, and policy objectives in science-action partnerships. By documenting and reflecting on the process, this case study provides conceptual and practical guidance on bridging the science-action gap through partnerships.

  10. Anesthetic related advances with cyclodextrins.

    Science.gov (United States)

    Welliver, Mark; McDonough, John

    2007-03-02

    Cyclodextrins encapsulate and electrostatically bind to lipophilic molecules. The exterior of cyclodextrins are water-soluble and maintain aqueous solubility despite encapsulation of non-aqueous soluble molecules. This unique ability to encapsulate lipophilic molecules and maintain water solubility confers numerous pharmacologic advantages for both drug delivery and removal. Cyclodextrins, a component part of supramolecular chemistry, may be in its infancy of anesthetic application but recent advances have been described as novel and revolutionary. A review of current research coupled with an understanding of cyclodextrin properties is necessary to fully appreciate the current uses and future potentials of these unique molecules.

  11. Anesthetic Related Advances with Cyclodextrins

    Directory of Open Access Journals (Sweden)

    Mark Welliver

    2007-01-01

    Full Text Available Cyclodextrins encapsulate and electrostatically bind to lipophilic molecules. The exterior of cyclodextrins are water-soluble and maintain aqueous solubility despite encapsulation of non-aqueous soluble molecules. This unique ability to encapsulate lipophilic molecules and maintain water solubility confers numerous pharmacologic advantages for both drug delivery and removal. Cyclodextrins, a component part of supramolecular chemistry, may be in its infancy of anesthetic application but recent advances have been described as novel and revolutionary. A review of current research coupled with an understanding of cyclodextrin properties is necessary to fully appreciate the current uses and future potentials of these unique molecules.

  12. Data for action: collection and use of local data to end tuberculosis.

    Science.gov (United States)

    Theron, Grant; Jenkins, Helen E; Cobelens, Frank; Abubakar, Ibrahim; Khan, Aamir J; Cohen, Ted; Dowdy, David W

    2015-12-01

    Accelerating progress in the fight against tuberculosis will require a drastic shift from a strategy focused on control to one focused on elimination. Successful disease elimination campaigns are characterised by locally tailored responses that are informed by appropriate data. To develop such a response to tuberculosis, we suggest a three-step process that includes improved collection and use of existing programmatic data, collection of additional data (eg, geographic information, drug resistance, and risk factors) to inform tailored responses, and targeted collection of novel data (eg, sequencing data, targeted surveys, and contact investigations) to improve understanding of tuberculosis transmission dynamics. Development of a locally targeted response for tuberculosis will require substantial investment to reconfigure existing systems, coupled with additional empirical data to evaluate the effectiveness of specific approaches. Without adoption of an elimination strategy that uses local data to target hotspots of transmission, ambitious targets to end tuberculosis will almost certainly remain unmet.

  13. Regional anesthetic activity of new decahydroquinolinyl derivative by the experimental model of terminal anesthesia

    Directory of Open Access Journals (Sweden)

    Goncharuk V.V.

    2014-09-01

    Full Text Available anesthesia. Material and Methods. Decahydroquinolinyl derivative under laboratory code PAS-68 synthesized in the A. B. Bekturov Institute of Chemical Sciences under the guidance of K. D. Praliev has been studied. Benzocaine, lido-caine and tetracaine were used as the comparison drugs. Male rabbits of 2,0-3,5 kg weight were used as experimental animals. A threshold of corneal sensitivity to tactile effects (Rainier index was determined by the standard method. Computer prognosis of PAS-68 acute toxicity also was made. Results. The local anesthetic activity of 1 %, 0,5% and 0,25% solutions of PAS-68 were identified as higher than that for lidocaine and benzocaine in similar concentrations (p <0,05 but lower than that for tetracaine (p<0,05. PAS-68 has no local irritating action. The duration of anesthesia, 0,5% and 1 % PAS 68 exceeds that for benzocaine and lidocaine at equivalent concentrations (p<0,05. By this kind of activity PAS-68 is a second to the duration of anesthesia by tetracaine (p<0,05. The latent period of anesthesia induced by PAS-68 is shorter than the latent periods induced by benzocaine, lidocaine and tetracaine. On the base of predictive analysis it was concluded that PAS-68 is of low toxicity. Conclusion. PAS-68 exceeds benzocaine and lidocaine by the local anesthetic activity and duration of anesthesia and is second only to tetracaine. The latent period of anesthesia PAC-68 is shorter than the latent period of benzocaine, lidocaine and tetracaine respectively.

  14. Influence of acepromazine on the cardiovascular actions of dobutamine in isoflurane-anesthetized horses Influência da acepromazina sobre os efeitos cardiovasculares da dobutamina em cavalos anestesiados com isofluorano

    Directory of Open Access Journals (Sweden)

    Eduardo Raposo Monteiro

    2011-03-01

    Full Text Available The influence of acepromazine (ACP on the effectiveness of dobutamine (DBT in increasing blood pressure during isoflurane (ISO anesthesia was evaluated in six horses. On separate occasions, the horses were randomly assigned to receive NaCl 0.9% (Control, ACP 0.025mg kg-1 and ACP 0.05mg kg-1. The experimental treatment was administered prior to induction of anesthesia. Maintenance of anesthesia was performed under conditions of normocapnia with ISO in oxygen. Dobutamine was administered at progressively increasing infusion rates until mean arterial pressure (MAP reached 70mmHg or until a maximum infusion rate of 5.0µg kg-1 min-1. Compared with baseline, DBT increased heart rate, systolic, diastolic and mean blood pressures in all treatments. However, these variables did not differ among treatments. The target MAP (70mmHg was not reached in 2/6, 2/5 and 0/6 horses in the Control, ACP0.025 and ACP0.05 treatments, respectively. The mean dose of DBT to achieve target MAP was 3.5±1.8, 3.7±1.6 and 2.7±1.4µg kg-1 min-1 in the Control, ACP0.025 and ACP0.05 treatments, respectively (P>0.05. Under the conditions of this study, premedication with ACP does not interfere with the effectiveness of DBT in increasing blood pressure in horses anesthetized with ISO.A influência da acepromazina (ACP sobre a capacidade da dobutamina (DBT em elevar a pressão arterial durante a anestesia com isofluorano (ISO foi avaliada em seis equinos. Em ocasiões diferentes, os animais receberam aleatoriamente NaCl 0,9% (Controle, ACP 0,025mg kg-1 e ACP 0,05mg kg-1. O tratamento experimental foi administrado previamente à indução da anestesia. A manutenção da anestesia foi realizada em condições de normocapnia com ISO em oxigênio. A administração de DBT foi iniciada em doses progressivamente crescentes até que o valor de pressão arterial média (PAM atingisse 70mmHg ou até a dose máxima de 5,0µg kg-1 min-1. Comparado ao basal, a administração da DBT

  15. Anxiety in preoperative anesthetic procedures.

    Science.gov (United States)

    Valenzuela Millán, Jaquelyn; Barrera Serrano, José René; Ornelas Aguirre, José Manuel

    2010-01-01

    Preoperative anxiety is a common and poorly evaluated condition in patients who will undergo an anesthetic and surgical intervention. The objective of this study was to determine the prevalence of anxiety in a group of patients undergoing elective surgery, as assessed by the Amsterdam Anxiety Preoperative and Information (AAPI) scale. We studied 135 patients scheduled for elective surgery applying the AAPI scale 24 h before the surgical procedure to evaluate the presence of anxiety and patient characteristics. A descriptive analysis with mean +/- standard deviation for categorical variables was done. For intragroup differences, chi(2) test was used. Pearson correlation for the association between anxiety and postoperative complications was carried out. A value of p =0.05 was considered significant. One hundred six patients were surgically treated, 88% were female (average age 44 +/- 12 years). Some degree of preoperative anxiety was present in 72 patients (76%; p = 0.001) with a grade point average on the AAPI scale equal to 17 +/- 7 points, of which 95 (70%, OR = 5.08; p = 0.002) were females. Results of this study suggest the presence of high levels of preoperative anxiety in patients scheduled for elective surgery. The origin of the anxiety appears to be related to many factors that can be evaluated in pre-anesthetic consultation. Further study is needed to prevent the presence of this disorder.

  16. Discriminative Space-time Voting for Joint Recognition and Localization of Actions

    NARCIS (Netherlands)

    Oikonomopoulos, Antonios; Patras, Ioannis; Pantic, Maja

    2010-01-01

    In this paper we address the problem of activity detection in unsegmented image sequences. Our main contribution is the use of an implicit representation of the spatiotemporal shape of the activity which relies on the spatiotemporal localization of characteristic ensembles of feature descriptors. Ev

  17. Developing Evidence for Action on the Postgraduate Experience: An Effective Local Instrument to Move beyond Benchmarking

    Science.gov (United States)

    Sampson, K. A.; Johnston, L.; Comer, K.; Brogt, E.

    2016-01-01

    Summative and benchmarking surveys to measure the postgraduate student research experience are well reported in the literature. While useful, we argue that local instruments that provide formative resources with an academic development focus are also required. If higher education institutions are to move beyond the identification of issues and…

  18. Evaluation of potentional social-economical development of the Local Action Group in area of Poličsko

    OpenAIRE

    Bittner, Patrik

    2013-01-01

    This bachelor thesis deals in the theoretical part with the issues related to regional development, strategic planning, and the Rural Development Pro-gramme (RDP) in connection to the activities of Local Action Groups (LAGs). Next, the study analyzed and evaluated the situation and develop-ments in the socio-economic area within the scope of activity of the LAG Association for Development of the area of Poličsko. LAG strategy for the next planning period of 2014 - 2020 was defined using the S...

  19. In situ formed suspensions for local sustained action of celecoxib following intra-articular administration

    DEFF Research Database (Denmark)

    Larsen, Susan Weng; Frost, Anna Buus; Østergaard, Jesper;

    donor compartment was followed by reverse phase HPLC. After an initial fast release a constant flux was observed. Likewise, a similar constant flux was found for a preformed aqueous suspension of the drug. The highly comparable fluxes observed indicate that the solid celecoxib precipitated from...... of an in situ formed suspension of celecoxib. In the field of IA drug administration the in situ suspension forming drug delivery principle appears promising for the provision of local prolonged drug action. However, for clinical use the reproducibility of the precipitation step in the biological matrix may...

  20. Extracorporeal shockwave: mechanisms of action and physiological aspects for cellulite, body shaping, and localized fat-Systematic review.

    Science.gov (United States)

    Modena, Débora A Oliveira; da Silva, Caroline Nogueira; Grecco, Clovis; Guidi, Renata Michelini; Moreira, Renata Gomes; Coelho, Andresa A; Sant'Ana, Estela; de Souza, José Ricardo

    2017-10-01

    Extracorporeal Shockwave Therapy (ESWT) has had a wide use in rehabilitation, and has presented positive effects in the treatment of unaesthetic affections. The objective of the present study was to search, in the literature, the mechanisms of action and the physiological aspects of shockwaves acting on the biological tissue to improve the condition of cellulite and localized fat. The systematic review of the literature was carried out in the period of September 2016 to February 2017 based on the bibliographic databases such as Lilacs, Medline, PubMed, and SciELO. Fifteen articles were identified in that systematic review, three of which were excluded as they did not make the complete access to the article available or the theme investigated did not encompass the objective of the study. The revision demonstrated that extracorporeal shockwaves present relevant effects on the biological tissue, which leads to the restructuring of skin properties and subcutaneous tissue, thus clinically improving the aspects of cellulite and localized fat.

  1. Knowledge into action? understanding ideological barriers to addressing health inequalities at the local level.

    Science.gov (United States)

    Collins, Patricia A; Abelson, Julia; Eyles, John D

    2007-01-01

    The objective of this study was to explore the presence of ideological barriers to addressing local health inequalities in Hamilton, Ontario, Canada. A survey of active citizens revealed low levels of awareness of the social determinants of health (SDOH) framework, and some incongruence between understanding and attitudes towards the SDOH. Support for addressing health inequalities was associated with awareness of the SDOH framework, liberal value-systems, and a cluster of socio-demographic characteristics. Liberal leaning participants were also more politically active than their conservative counterparts. Ideological barriers included lack of SDOH awareness, narrow understandings of the relative influences of the SDOH, resistance to de-prioritizing healthcare, and conservative values. Advancement of a SDOH policy agenda should incorporate wider dissemination efforts to citizens and local service providers to increase support for this framework, and utilization of existing support and political engagement from liberal-leaning demographics.

  2. Bradykinin as a pain mediator: receptors are localized to sensory neurons, and antagonists have analgesic actions

    Energy Technology Data Exchange (ETDEWEB)

    Steranka, L.R.; Manning, D.C.; DeHaas, C.J.; Ferkany, J.W.; Borosky, S.A.; Connor, J.R.; Vavrek, R.J.; Stewart, J.M.; Snyder, S.H.

    1988-05-01

    Autoradiographic studies localize (/sup 3/H)bradykinin receptor binding sites to the substantia gelatinosa, dorsal root, and a subset of small cells in both the dorsal root and trigeminal ganglia of the guinea pig. (/sup 3/H)Bradykinin labeling is also observed over myocardinal/coronary visceral afferent fibers. The localization of (/sup 3/H)bradykinin receptors to nociceptive pathways supports a role for bradykinin in pain mediation. Several bradkykinin antagonists block bradykinin-induced acute vascular pain in the rat. The bradykinin antagonists also relieve bradykinin- and urate-induced hyperalgesia in the rat paw. These results indicate that bradykinin is a physiologic mediator of pain and that bradykinin antagonists have analgesic activity in both acute and chronic pain models.

  3. Estudo radiológico da dispersão de diferentes volumes de anestésico local no bloqueio de plexo braquial pela via posterior Estudio radiológico de la dispersión de diferentes volúmenes de anestésico local en el bloqueo de plexo braquial por vía posterior Radiological evaluation of the spread of different local anesthetic volumes during posterior brachial plexus block

    Directory of Open Access Journals (Sweden)

    Marcos Guilherme Cunha Cruvinel

    2005-10-01

    aleatoriamente en tres grupos de cinco: Grupo 1: volumen de 20 mL; Grupo 2: volumen de 30 mL; Grupo 3: volumen de 40 mL. En un paciente, sometido al bloqueo continuado del plexo braquial por la vía posterior, la administración de un volumen de 10 mL fue estudiada. En todos, el anestésico usado fue la ropivacaína a 0,375% asociada a solución radiopaca. Fueron hechas radiografías de la región cervical inmediatamente después el bloqueo que fue evaluado a través de la pesquisa de la sensibilidad térmica utilizándose algodón embebido en alcohol, treinta minutos después de su realización y en la sala de recuperación anestésica. RESULTADOS: El comportamiento radiológico y clínico del bloqueo de plexo braquial por vía posterior es muy semejante de aquél descrito con la técnica de Winnie (interescalénico. Invariablemente hay envolvimiento del plexo cervical y de las raíces más altas (C5-C7 del plexo braquial. CONCLUSIONES: Este estudio muestra que la dispersión del anestésico local en el bloqueo del plexo braquial por la vía posterior se da primariamente en las raíces responsables por la inervación del hombroBACKGROUND AND OBJECTIVES: Local anesthetic spread during interscalenic block has been thoroughly studied, however there are few studies on posterior block. This study aimed at evaluating the spread of different local anesthetic volumes during posterior brachial plexus block using contrasted X-rays. METHODS: Participated in this study 16 patients submitted to posterior brachial plexus block, 15 of whom were randomly divided in three groups of five patients: Group 1: 20 mL; Group 2: 30 mL.; Group 3 40 mL. The volume of 10 mL was studied in one patient submitted to continuous posterior brachial plexus block. All patients received 0.375% ropivacaine associated to radio-opaque solution. X-rays of the cervical region were obtained immediately after blockade that were evaluated by thermal sensitivity using cotton soaked in alcohol 30 minutes after being

  4. Nouns, verbs, objects, actions, and abstractions: local fMRI activity indexes semantics, not lexical categories.

    Science.gov (United States)

    Moseley, Rachel L; Pulvermüller, Friedemann

    2014-05-01

    Noun/verb dissociations in the literature defy interpretation due to the confound between lexical category and semantic meaning; nouns and verbs typically describe concrete objects and actions. Abstract words, pertaining to neither, are a critical test case: dissociations along lexical-grammatical lines would support models purporting lexical category as the principle governing brain organisation, whilst semantic models predict dissociation between concrete words but not abstract items. During fMRI scanning, participants read orthogonalised word categories of nouns and verbs, with or without concrete, sensorimotor meaning. Analysis of inferior frontal/insula, precentral and central areas revealed an interaction between lexical class and semantic factors with clear category differences between concrete nouns and verbs but not abstract ones. Though the brain stores the combinatorial and lexical-grammatical properties of words, our data show that topographical differences in brain activation, especially in the motor system and inferior frontal cortex, are driven by semantics and not by lexical class.

  5. Numerical Simulation of Local Scour Around A Large Circular Cylinder Under Wave Action

    Institute of Scientific and Technical Information of China (English)

    赵明; 滕斌

    2001-01-01

    A horizontal two-dimensional numerical model is developed for estimation of sediment transport and sea bed change around a large circular cylinder under wave action. The wave model is based on an elliptic mild slope equation.The wave-induced current by the gradient of radiation stress is considered and a depth integrated shallow water equation is applied to the calculation of the current. The mass transport velocity and the bed shear stress due to streaming are considered, which are important factors affecting the sediment transport around a structure due to waves, especially in reflective areas. Wave-current interaction is taken into account in the model for computing the bed shear stress. The model is implemented by a finite element method. The results of this model are compared with those from other methods and agree well with experimental data.

  6. Explaining the enforcement gap in China: local government support and internal agency obstacles as predictors of enforcement actions in Guangzhou.

    Science.gov (United States)

    Lo, Carlos Wing-Hung; Fryxell, Gerald E; van Rooij, Benjamin; Wang, Wei; Honying Li, Pansy

    2012-11-30

    This study investigates how local government support for enforcement and internal agency obstacles explain the enforcement gap in Guangzhou, China. It was found that agency obstacles associated with insufficient resources and job ambiguity, in particular, affect enforcement officials' perceptions of enforcement difficulty. Somewhat more surprisingly, however, local government support was not found to be a significant predictor of these perceptions. In addition, this study identified four significant relationships associated with specific enforcement actions. First and second, perceptions of enforcement difficulty appear to lead to fewer inspections, but also have a weak positive effect on the frequency of fines levied. Third, poor coordination within the bureau was found to be associated with fewer violations being processed. Fourth, and contrary to expectations, local government support was found to suppress the frequency of inspections while having no significant effect on violations or fines. Overall, these findings suggest that increased local government support for the enforcement of environmental regulation in China may not necessarily lead to more rigorous enforcement, at least if enforcement rigor is measured in terms of inspections, citations and fines.

  7. Nitrogen narcosis and pressure reversal of anesthetic effects in node of Ranvier.

    Science.gov (United States)

    Kendig, J J

    1984-01-01

    To compare sodium channel block by hyperbaric nitrogen with that induced by other anesthetics and to examine the basis for pressure antagonism to anesthetic condition block, voltage clamped nodes of Ranvier were exposed to nitrogen at pressures at 1-14 atm alone and in combination with helium to a total pressure of up to 100 atm. At 7 and 14 atm nitrogen, sodium currents were reversibly depressed without accompanying changes in the current-voltage relation. The curve relating steady-state inactivation (h infinity) to voltage was shifted in the hyperpolarizing direction, as is the case with other general anesthetic agents. The time constant of inactivation (tau h) was slightly decreased at depolarized potentials. The preceding companion paper demonstrated an opposite effect of hyperbaric helium on the properties of sodium inactivation. Addition of helium pressure in the presence of nitrogen at 14 atm did not increase peak sodium current with inactivation maximally removed, but it did shift the h infinity curve back toward control levels, thus increasing sodium current at points on the slope of the curve. It is proposed that these opposing shifts in steady-state inactivation levels are the basis for pressure antagonism to anesthetic conduction block. In the case of inert gases and volatile anesthetic agents, the antagonism may be direct but has not been shown to be so. In the case of the local anesthetic benzocaine, differences in the voltage dependence of anesthetic and pressure-induced changes in tau h indicate the antagonism is indirect.

  8. Growth hormone (GH) and GH-releasing hormone (GHRH): Co-localization and action in the chicken testis.

    Science.gov (United States)

    Martínez-Moreno, Carlos G; López-Marín, Luz M; Carranza, Martha; Giterman, Daniel; Harvey, Steve; Arámburo, Carlos; Luna, Maricela

    2014-04-01

    Growth hormone (GH) gene expression is not confined to the pituitary gland and occurs in many extrapituitary tissues, including the chicken testis. The regulation and function of GH in extrapituitary tissues is, however, largely unknown. The possibility that chicken testicular GH might be regulated by GH-releasing hormone (GHRH), as in the avian pituitary gland, was investigated in the present study. GHRH co-localized with GH in the germinal epithelium and in interstitial zones within the chicken testes, particularly in the spermatogonia and spermatocytes. In testicular cell cultures, exogenous human GHRH1-44 induced (at 1, 10 and 100nM) a dose-related increase in GH release. Western blot analysis showed a heterogeneous pattern in the GH moieties released during GHRH stimulation. 26kDa monomer GH was the most abundant moiety under basal conditions, but 15 and 17kDa isoforms were more abundant after GHRH stimulation. GHRH treatment also increased the abundance of PCNA (proliferating cell nuclear antigen) immunoreactivity in the testes. This may have been GH-mediated, since exogenous GH similarly increased the incorporation of ((3)H)-thymidine into cultured testicular cells and increased their metabolic activity, as determined by increased MTT reduction. Furthermore, GH and GHRH immunoneutralization blocked GHRH-stimulated proliferative activity. In summary, these results indicate that GHRH stimulates testicular GH secretion in an autocrine or paracrine manner. Data also demonstrate proliferative actions of GHRH on testicular cell number and suggest that this action is mediated by local GH production.

  9. Responsibilities and Limits of Local Government Actions against Users of Public Services of Planning and Sustainable Territorial Development in Romania

    Directory of Open Access Journals (Sweden)

    Bogdan Suditu

    2014-02-01

    Full Text Available In the context of the changes that have occurred in the Romanian society, the public authorities are required to play a coordinating role in providing the framework for a sustainable and balanced development of the national territory, and to ensure the quality of life of the citizens. In order to achieve these goals of social responsibility, the public administration authorities must build and adapt the tools of public territorial action based on their specificity and within the existing legal framework and resources,. Thus, the study shows the national and European context that frames the actions of public administration for what concerns the sustainable territorial development. It analyzes the characteristics of administrative-territorial structures of Romania, highlighting their socio-demographic diversity and the territorial forms of institutional cooperation. The approach of these issues is based in the first instance on an analysis of the European strategic documents in the field, as well as on the national regulations concerning the organization and functioning of public administration and territorial planning. The implementation of decentralization and local public autonomy has led to the capitalization of the local potential of some administrative divisions and caused a competition and a difficult cooperation between them. By analogy with the provisions of the quality standards regarding the responsibilities of the organizations towards customers, the study illustrates and analyzes the responsibilities and limits of public administration authorities in promoting sustainable development, territorial equity and the quality of life for the users of public services, i.e. the community members.

  10. Creating Best Practices for the Submission of Actionable Food and Feed Testing Data Generated in State and Local Laboratories.

    Science.gov (United States)

    Wangsness, Kathryn; Salfinger, Yvonne; Randolph, Robyn; Shea, Shari; Larson, Kirsten

    2017-07-01

    Laboratory accreditation provides a level of standardization in laboratories and confidence in generated food and feed testing results. For some laboratories, ISO/IEC 17025:2005 accreditation may not be fiscally viable, or a requested test method may be out of the scope of the laboratory's accreditation. To assist laboratories for whom accreditation is not feasible, the Association of Public Health Laboratories Data Acceptance Work Group developed a white paper entitled "Best Practices for Submission of Actionable Food and Feed Testing Data Generated in State and Local Laboratories." The basic elements of a quality management system, along with other best practices that state and local food and feed testing laboratories should follow, are included in the white paper. It also covers program-specific requirements that may need to be addressed. Communication with programs and end data users is regarded as essential for establishing the reliability and accuracy of laboratory data. Following these suggested best practices can facilitate the acceptance of laboratory data, which can result in swift regulatory action and the quick removal of contaminated product from the food supply, improving public health nationally.

  11. Anesthetizing animals: Similar to humans yet, peculiar?

    Science.gov (United States)

    Kurdi, Madhuri S; Ramaswamy, Ashwini H

    2015-01-01

    From time immemorial, animals have served as models for humans. Like humans, animals too have to undergo several types of elective and emergency surgeries. Several anesthetic techniques and drugs used in humans are also used in animals. However, unlike humans, the animal kingdom includes a wide variety of species, breeds, and sizes. Different species have variable pharmacological responses, anatomy, temperament, behavior, and lifestyles. The anesthetic techniques and drugs have to suit different species and breeds. Nevertheless, there are several drugs and many peculiar anesthetic techniques used in animals but not in human beings. Keeping this in mind, literature was hand searched and electronically searched using the words "veterinary anesthesia," "anesthetic drugs and techniques in animals" using Google search engine. The interesting information so collected is presented in this article which highlights some challenging and amazing aspects of anesthetizing animals including the preanesthetic assessment, preparation, premedication, monitoring, induction of general anesthesia, intubation, equipment, regional blocks, neuraxial block, and perioperative complications.

  12. New productive systems at the local level: from concept to action

    Directory of Open Access Journals (Sweden)

    Claude Courlet

    2013-12-01

    Full Text Available This article highlights the concept of local productive systems in the context of the new emerging economic patterns at the global level. From a development planning perspective, the author shows why the concept of space should not be seen as a neutral support, passively submitted to exogenous constraints that underestimate the importance of the territorial dimension. Instead, the author believes that it can be redefined to foster an economic reconstruction based upon technological innovation and a new kind of industrial development.

  13. Mechanism of inhibitory action of the local anaesthetic trimecaine on the growth of algae (Chlorella vulgaris).

    Science.gov (United States)

    Sersen, F; Král'ová, K

    1994-08-01

    Using the model compound trimecaine, it was found that algicidal effects exhibited by the local anaesthetics of the acetanilide type were caused by two different mechanisms. The first inhibitory mechanism occurring at low concentrations of the anaesthetic is connected with the uncoupling of the photophosphorylations in algal chloroplasts and is accompanied by the enhancement of the oxygen evolving rate in algal photosynthesis. The second mechanism of inhibition of the photosynthesis in algae, taking place at higher concentrations of the anaesthetic, is connected with the damaging of the manganese containing protein on the donor side of photosystem 2 and is accompanied by a decrease of the oxygen evolving rate in algal photosynthesis.

  14. Myostatin from the heart: local and systemic actions in cardiac failure and muscle wasting.

    Science.gov (United States)

    Breitbart, Astrid; Auger-Messier, Mannix; Molkentin, Jeffery D; Heineke, Joerg

    2011-06-01

    A significant proportion of heart failure patients develop skeletal muscle wasting and cardiac cachexia, which is associated with a very poor prognosis. Recently, myostatin, a cytokine from the transforming growth factor-β (TGF-β) family and a known strong inhibitor of skeletal muscle growth, has been identified as a direct mediator of skeletal muscle atrophy in mice with heart failure. Myostatin is mainly expressed in skeletal muscle, although basal expression is also detectable in heart and adipose tissue. During pathological loading of the heart, the myocardium produces and secretes myostatin into the circulation where it inhibits skeletal muscle growth. Thus, genetic elimination of myostatin from the heart reduces skeletal muscle atrophy in mice with heart failure, whereas transgenic overexpression of myostatin in the heart is capable of inducing muscle wasting. In addition to its endocrine action on skeletal muscle, cardiac myostatin production also modestly inhibits cardiomyocyte growth under certain circumstances, as well as induces cardiac fibrosis and alterations in ventricular function. Interestingly, heart failure patients show elevated myostatin levels in their serum. To therapeutically influence skeletal muscle wasting, direct inhibition of myostatin was shown to positively impact skeletal muscle mass in heart failure, suggesting a promising strategy for the treatment of cardiac cachexia in the future.

  15. Awake craniotomy anesthetic management using dexmedetomidine, propofol, and remifentanil.

    Science.gov (United States)

    Prontera, Andrea; Baroni, Stefano; Marudi, Andrea; Valzania, Franco; Feletti, Alberto; Benuzzi, Francesca; Bertellini, Elisabetta; Pavesi, Giacomo

    2017-01-01

    Awake craniotomy allows continuous monitoring of patients' neurological functions during open surgery. Anesthesiologists have to sedate patients in a way so that they are compliant throughout the whole surgical procedure, nevertheless maintaining adequate analgesia and anxiolysis. Currently, the use of α2-receptor agonist dexmedetomidine as the primary hypnotic-sedative medication is increasing. Nine patients undergoing awake craniotomy were treated with refined monitored anesthesia care (MAC) protocol consisting of a combination of local anesthesia without scalp block, low-dose infusion of dexmedetomidine, propofol, and remifentanil, without the need of airways management. The anesthetic protocol applied in our study has the advantage of decreasing the dose of each drug and thus reducing the occurrence of side effects. All patients had smooth and rapid awakenings. The brain remained relaxed during the entire procedure. In our experience, this protocol is safe and effective during awake brain surgery. Nevertheless, prospective randomized trials are necessary to confirm the optimal anesthetic technique to be used.

  16. Policy, systems, and environmental approaches for obesity prevention: a framework to inform local and state action.

    Science.gov (United States)

    Lyn, Rodney; Aytur, Semra; Davis, Tobey A; Eyler, Amy A; Evenson, Kelly R; Chriqui, Jamie F; Cradock, Angie L; Goins, Karin Valentine; Litt, Jill; Brownson, Ross C

    2013-01-01

    The public health literature has not fully explored the complexities of the policy process as they relate to public health practice and obesity prevention. We conducted a review of the literature across the policy science and public health fields, distilled key theories of policy making, and developed a framework to inform policy, systems, and environmental change efforts on obesity prevention. Beginning with a conceptual description, we focus on understanding three domains of the policy process: the problem domain, the policy domain, and the political domain. We identify key activities in the policy process including the following: (a) assessing the social and political environment; (b) engaging, educating and collaborating with key individuals and groups; (c) identifying and framing the problem; (d) utilizing available evidence; (e) identifying policy solutions; and (f) building public support and political will. The article provides policy change resources and case studies to guide and support local and state efforts around obesity prevention.

  17. Implementing China`s Agenda 21: From National Strategy to Local Actions

    Energy Technology Data Exchange (ETDEWEB)

    Gan, Lin

    1998-12-01

    This report analyses the process of adaptation of the Chinese governmental policy in response to sustainable development. It reviews the historical roots from which response to sustainable development arises. By examining the policy-making and implementation processes of China`s Agenda 21, the author studies (1) the dynamic forces that contribute to the establishment of the national and regional Agenda 21 and the relationships between different institutional preferences, arrangements and their obstacles, (2) the driving forces that pro-active responses to implement Agenda 21 projects, and the role of local governments in the process, (3) the relationship between international environmental aid and national capacity building for the environment, (4) the obstacles and conflicting interests that limit the implementation of Agenda 21 and sustainable development in China. 22 refs., 2 tabs.

  18. Effect of anesthetics on bending elasticity of lipid membranes

    Science.gov (United States)

    Yi, Zheng; Michihiro, Nagao; Bossev, Dobrin

    2008-03-01

    Change in physical and chemical properties of bio-membranes is of great interest for understanding the mechanism of anesthetic action on membranes. Hypothetically the anesthetic alters the lipid membrane structure (promoting pore formation across membranes or at least switching transmembrane channels) and therefore the biophysical properties of the membrane. We have used neutron spin echo (NSE) spectroscopy to study the effect of anesthetic molecule, lidocaine, on the bending elasticity (BE) of lipid membranes. BE of lipid bilayers made of (1,2-Dimyristoyl-sn-Glycero-3-Phosphocholine) DMPC and 1,2-Dipalmitoyl-sn-Glycero-3-Phosphocholine (DPPC) have been measured at different temperatures and different in the fluid (Lα) phase. Using Zilman-Granek theory the BE were obtained from the decay of the NSE intermediate scattering function. We have found that in the presence of lidocaine the BE of DMPC and DPPC bilayers increases. The results were correlated with those from differential scanning calorimetry. Increase in the lidocaine concentration leads to decrease in the liquid/crystalline transition temperature.

  19. Beyond Knowledge: Service Learning and Local Climate Change Research Engagement Activities that Foster Action and Behavior Change

    Science.gov (United States)

    Low, R.; Mandryk, C.; Gosselin, D. C.; Haney, C.

    2013-12-01

    Climate change engagement requires individuals to understand an abstract and complex topic and realize the profound implications of climate change for their families and local community. In recent years federal agencies have spent millions of dollars on climate change education to prepare a nation for a warming future. The majority of these education efforts are based on a knowledge deficit model. In this view 'educate' means 'provide information'. However cognitive and behavioral research and current action demonstrate that information alone is not enough; knowledge does not necessarily lead to action. Educators are speaking to deaf ears if we rely on passive and abstract information transfer and neglect more persuasive and affective approaches to communication. When climate change is presented abstractly as something that happens in the future to people, environments, animals somewhere else it is easy to discount. People employ two separate systems for information processing: analytical-rational and intuitive-experiential Authentic local research experiences that engage both analytical and experiential information processing systems not only help individuals understand the abstraction of climate change in a concrete and personally experienced manner, but are more likely to influence behavior. Two on-line, graduate-level courses offered within University of Nebraska's Masters of Applied Science program provide opportunities for participants to engage in authentic inquiry based studies climate change's local impacts, and work with K-12 learners in promoting the scientific awareness and behavioral changes that mitigate against the negative impacts of a changing climate. The courses are specifically designed to improve middle and high school (grades 6-12) teachers' content knowledge of climate processes and climate change science in the context of their own community. Both courses provide data-rich, investigative science experiences in a distributed digital

  20. Electrocardiographic effects of toluene in the anesthetized rat.

    Science.gov (United States)

    Vidrio, H; Magos, G A; Lorenzana-Jimenez, M

    1986-01-01

    The influence of inhalation of near lethal quantities of toluene on some ECG parameters, as well as the possible cardiac sensitizing effect of the solvent, were determined in chloralose-anesthetized rats. These actions were compared with those of its close analogue benzene. Both solvents produced tachycardia; toluene increased the duration of QRS and specially PR, while benzene decreased P wave duration. No other systematic changes in ECG morphology or evidence of arrhythmia were observed. Toluene appeared to decrease the number of ectopic beats induced by epinephrine, in contrast to benzene, which increased it markedly. These results suggest that toluene administered by inhalation up to near lethal doses is devoid of untoward ECG effect in the chloralose-anesthetized rat, its only action being a decrease in intraventricular and particularly AV conduction. It does not share the myocardial sensitizing properties of benzene and in fact appears to elicit some protection from the arrhythmogenic effects of epinephrine, although no definite conclusions as to this action can be derived due to limitations in the experimental model used.

  1. Inhibitory Action of Ethanolic Extract of Seeds of Moringa oleifera Lam. On Systemic and Local Anaphylaxis.

    Science.gov (United States)

    Mahajan, Shailaja G; Mehta, Anita A

    2007-10-01

    The current study characterizes the mechanism by which the seed extract of Moringa oleifera Lam (Moringaceae) decreases the mast cell-mediated immediate type hypersensitivity reaction. The immediate type hypersensitivity reaction is involved in many allergic diseases such as asthma and allergic rhinitis. Moringa oleifera, a shrub widely used in the traditional medicine in India, has been reported to possess anti-cancer, hypotensive, anti-arthritic, and anti-inflammatory activities. In the present study, the effects of the ethanolic extract of seeds of Moringa oleifera (MOEE-herbal remedy) on systemic and local anaphylaxis were investigated. The potential anti-anaphylactic effect of MOEE was studied in a mouse model of Compound 48/80-induced systemic anaphylactic shock. Passive cutaneous anaphylaxis activated by anti IgE-antibody was also used to assess the effect of MOEE. In addition, rat peritoneal mast cells (RPMC) were used to investigate the effect of MOEE on histamine release induced by compound 48/80. When administered 1 hr before 48/80 injection, MOEE at doses of 0.001-1.000 g/kg completely inhibited the inducible induced anaphylactic shock. MOEE significantly inhibited passive cutaneous anaphylaxis activated by anti-IgE antibody at a dose of 1 g/kg. When MOEE extract was given as pretreatment at concentrations ranging 0.1-100 mg/ml, the histamine release from the mast cells that was induced by the 48/80 was reduced in a dose-dependent manner. These results suggest a potential role for MOEE as a source of anti-anaphylactic agents for use in allergic disorders.

  2. Child with aplastic anemia: Anesthetic management

    Directory of Open Access Journals (Sweden)

    Manpreet Kaur

    2012-01-01

    Full Text Available Aplastic anemia is a rare heterogeneous disorder of hematopoietic stem cells causing pancytopenia and marrow hypoplasia with the depletion of all types of blood cells. This results in anemia, neutropenia and thrombocytopenia, which pose a challenge to both surgical and anesthetic management of such cases. We report a child with aplastic anemia who sustained traumatic ulcer on the arm and underwent split-thickness skin grafting under general anesthesia. There are only two case reports on anesthetic considerations in aplastic anemia patients in the literature. The anesthetic management is challenging because of the rarity of the disease, associated pancytopenia and immunosuppression.

  3. Structures and dynamics of transnational cooperation networks: evidence based on Local Action Groups in the Veneto Region, Italy

    Directory of Open Access Journals (Sweden)

    Elena Pisani

    2014-12-01

    Full Text Available The paper assesses the structures and dynamics of transnational cooperation projects promoted by Local Action Groups (LAGs in different periods (from LEADER II to LEADER Axis using Social Network Analysis (SNA in a specific case study: the Veneto Region in Italy. The classical indexes of SNA have been critically examined, and the paper also presents innovative indexes that can capture the peculiarity of transnational cooperation: disaggregated densities of the network and transnational centrality of the node. These indexes are useful in order to quantify how transnational a network actually is, and to measure the power-information that each actor (LAG can acquire through its transnational contacts. The methodology can become a tool for Managing Authorities to implement new forms of evaluation of transnational cooperation of LAGs.

  4. The bonding of anesthetics and antibiotics on the carboxymethylcellulose

    Directory of Open Access Journals (Sweden)

    Rodić-Grabovac Branka B.

    2007-01-01

    Full Text Available The preparation of biologically active material is one of the most interesting trends in the chemical modification of cellulose. The possibility of obtaining biologically active cellulosic material by sorption of procaine hydrochloride and gentamicin sulphate on CMC was investigated in this paper. The sorption of therapeutics on CMC samples with different degree of substitution was carried out in water solutions of anesthetic and antibiotic, while the desorption was done in 0.95% NaCl solution. The amount of bonded and released therapeutics was determined by UV spe-ctrophotometry. It was found that degree of substitution of car-boxymethylcellulose and concentration of chemotherapeutic water solution have significant influence on the amount of bonded anesthetic and antibiotic. The maximum amount of bonded chemotherapeutic was 72.15 mg of procaine hydrochloride and 165.49 mg of gentamicin sulphate per gram CMC. In both cases the amounts of bonded chemotherape-utics correspond to the concentration of local anesthetic and antibiotic preparation that are used in therapeutic purposes.

  5. Anesthetic Efficacy in Irreversible Pulpitis: A Randomized Clinical Trial.

    Science.gov (United States)

    Allegretti, Carlos E; Sampaio, Roberta M; Horliana, Anna C R T; Armonia, Paschoal L; Rocha, Rodney G; Tortamano, Isabel Peixoto

    2016-01-01

    Inferior alveolar nerve block has a high failure rate in the treatment of mandibular posterior teeth with irreversible pulpitis. The aim of this study was to compare the anesthetic efficacy of 4% articaine, 2% lidocaine and 2% mepivacaine, all in combination with 1:100,000 epinephrine, in patients with irreversible pulpitis of permanent mandibular molars during a pulpectomy procedure. Sixty-six volunteers from the Emergency Center of the School of Dentistry, University of São Paulo, randomly received 3.6 mL of local anesthetic as a conventional inferior alveolar nerve block (IANB). The subjective signal of lip numbness, pulpal anesthesia and absence of pain during the pulpectomy procedure were evaluated respectively, by questioning the patient, stimulation using an electric pulp tester and a verbal analogue scale. All patients reported the subjective signal of lip numbness. Regarding pulpal anesthesia success as measured with the pulp tester, the success rate was respectively 68.2% for mepivacaine, 63.6% for articaine and 63.6% for lidocaine. Regarding patients who reported no pain or mild pain during the pulpectomy, the success rate was, respectively 72.7% for mepivacaine, 63.6% for articaine and 54.5% for lidocaine. These differences were not statistically significant. Neither of the solutions resulted in 100% anesthetic success in patients with irreversible pulpitis of mandibular molars.

  6. 静脉麻醉药抑制利多卡因致大鼠惊厥作用的比较%Comparisons of anticonvulsant action of intravenous anesthetics against lidocaine-induced convulsion in rats

    Institute of Scientific and Technical Information of China (English)

    王春平; 张山; 刘红梅; 韩倩

    2012-01-01

    Objective To compare the anticonvulsant action of midazolam, propofol, etomidate and thiopental on lidocaine-induced convulsion in rats. Methods Thirty-six male Wistar rats weighing (250±20) g were equally randomized into 6 groups: (1) control group (group C); (2) lidocaine group (group L: lidocaine 4 mg ·k1 ·min-1 until convulsion); (3) lidocaine and propofol group (group P, lidocaine and propofol 12.5 mg/kg), (4) lidocaine and etomidate group (group E: lidocaine and etomidate 1. 85 mg/kg) , (5) lidocaine and midazolam group (group M: lidocaine and midazolam 0. 65 mg/kg) , (6) lidocaine and thiopental group (group T: lidocaine and thiopental 30. 85 mg/kg). Animals were decapitated 2 hours after convulsion and the brains were removed. One side of hippocampus was obtained for detecting expressions of c-fos protein. The other side was obtained to measure the concentration of nitric oxide (NO) and the activity of nitric oxide synthase (N()S). Results The c-fos positive cells, the concentration of NO and the activity of NOS increased significantly in group L compared with group C (P<0. 05). The c-fos positive cells, the NO concentration and the activity of NO.S were significantly lower in groups P, M, E and T compared with group L (P<0. 05), and especially in groups M and T. Conclusion Propofol, midazolam, etomidate and thiopental can inhibit lidocaine-induced convulsion in rats and it is more significant by midazolam and thiopental.%目的 比较静脉麻醉药丙泊酚、依托咪酯、咪达唑仑及硫喷妥钠拮抗利多卡因致大鼠惊厥的作用.方法 雄性Wistar大鼠36只,体重(250±20)g,随机均分为六组:空白对照组(C组)、利多卡因组(L组:利多卡因4 mg· kg- 1·min-1)、利多卡因+丙泊酚组(P组:利多卡因+丙泊酚12.5ng/kg)、利多卡因+依托咪酯组(E组:利多卡因+依托咪酯1.85mg/kg)、利多卡因+咪达唑仑组(M组:利多卡因+咪达唑仑0.65mg/kg)和利多卡因+硫喷妥钠组(T组:

  7. Mimicry of the Legal: Translating de jure Land Formalization Processes Into de facto Local Action in Jambi Province, Sumatra

    Directory of Open Access Journals (Sweden)

    Yvonne Kunz

    2016-06-01

    Full Text Available In Indonesia, as in many other countries of the global South, processes to formalize rights over land have been implemented with the intention to reduce deforestation, decrease poverty and increase tenure security. Literature on de jure processes of land formalization is widely available. There is a gap, however, on the discrepancy of de jure land titling procedures and de facto strategies to legitimize land claims. Led by the theoretical concepts of “law as process” and “politics of scale”, this study closes this gap by analyzing the impact of national tenure formalization processes on de facto local patterns of land titling. Using empirical material from 16 villages in Jambi province, we show that the outcomes of the state-led land reforms and land tenure formalization processes are imitated and translated into locally feasible actions. We refer to these translation processes as “mimicry of the legal”. The land formalization endeavors fostering mimicry of the legal allow for resource exploitation and rent-seeking behavior.

  8. Localization of chondromodulin-I at the feto-maternal interface and its inhibitory actions on trophoblast invasion in vitro

    Science.gov (United States)

    2011-01-01

    Background Chondromodulin-I (ChM-I) is an anti-angiogenic glycoprotein that is specifically localized at the extracellular matrix of the avascular mesenchyme including cartilage and cardiac valves. In this study, we characterized the expression pattern of ChM-I during early pregnancy in mice in vivo and its effect on invasion of trophoblastic cells into Matrigel in vitro. Results Northern blot analysis clearly indicated that ChM-I transcripts were expressed in the pregnant mouse uterus at 6.5-9.5 days post coitum. In situ hybridization and immunohistochemistry revealed that ChM-I was localized to the mature decidua surrounding the matrix metalloproteinase-9 (MMP-9)-expressing trophoblasts. Consistent with this observation, the expression of ChM-I mRNA was induced in decidualizing endometrial stromal cells in vitro, in response to estradiol and progesterone. Recombinant human ChM-I (rhChM-I) markedly inhibited the invasion through Matrigel as well as the chemotactic migration of rat Rcho-1 trophoblast cells in a manner independent of MMP activation. Conclusions This study demonstrates the inhibitory action of ChM-I on trophoblast migration and invasion, implying the potential role of the ChM-I expression in decidual cells for the regulated tissue remodeling and angiogenesis at feto-maternal interface. PMID:21849085

  9. Anesthetizing animals: Similar to humans yet, peculiar?

    OpenAIRE

    Madhuri S Kurdi; Ramaswamy, Ashwini H

    2015-01-01

    From time immemorial, animals have served as models for humans. Like humans, animals too have to undergo several types of elective and emergency surgeries. Several anesthetic techniques and drugs used in humans are also used in animals. However, unlike humans, the animal kingdom includes a wide variety of species, breeds, and sizes. Different species have variable pharmacological responses, anatomy, temperament, behavior, and lifestyles. The anesthetic techniques and drugs have to suit differ...

  10. 78 FR 27405 - Anesthetic and Analgesic Drug Products Advisory Committee; Notice of Meeting

    Science.gov (United States)

    2013-05-10

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Anesthetic and Analgesic Drug Products Advisory Committee; Notice of Meeting AGENCY: Food and Drug Administration, HHS. ACTION: Notice. This notice announces a forthcoming meeting of a public advisory...

  11. 76 FR 78283 - Anesthetic and Analgesic Drug Products Advisory Committee; Notice of Meeting

    Science.gov (United States)

    2011-12-16

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Anesthetic and Analgesic Drug Products Advisory Committee; Notice of Meeting AGENCY: Food and Drug Administration, HHS. ACTION: Notice. This notice announces a forthcoming meeting of a public advisory...

  12. 78 FR 29142 - Anesthetic and Analgesic Drug Products Advisory Committee; Notice of Meeting

    Science.gov (United States)

    2013-05-17

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Anesthetic and Analgesic Drug Products Advisory Committee; Notice of Meeting AGENCY: Food and Drug Administration, HHS. ACTION: Notice. This notice announces a forthcoming meeting of a public advisory...

  13. 77 FR 67380 - Anesthetic and Analgesic Drug Products Advisory Committee; Notice of Meeting

    Science.gov (United States)

    2012-11-09

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Anesthetic and Analgesic Drug Products Advisory Committee; Notice of Meeting AGENCY: Food and Drug Administration, HHS. ACTION: Notice. This notice announces a forthcoming meeting of a public advisory...

  14. Comparison Effcacy of Local Anesthetic Tetracaineand Lidocaine in Nasal Endoscopy%局麻药物丁卡因与利多卡因在鼻内镜中的疗效比较

    Institute of Scientific and Technical Information of China (English)

    张良

    2016-01-01

    Objective To determine whether there is a difference in the efficacy between atomized 1% tetracaine and 2% lidocaine as a topical anesthetic prior to transnasal endoscopy.Methods A total of 100 patients received oxymetazoline and were randomized to receive either 1%tetracaine or 2% lidocaine prior to transnasal endoscopy. Immediately following the procedure, participants completed a survey assessing level of discomfort and other adverse symptoms pertaining to the procedure using a 10-point visual analog scale. Results There were no significant differences in scores between the lidocaine and tetracaine groups. There were also no signiifcant differences between genders in overall scores and in the lidocaine and tetracaine subgroups. Older patients demonstrated significantly less discomfort or a sensation of bad taste overall. In contrast to patients receiving lidocaine, older patients receiving tetracaine experienced signiifcantly less overall pain and discomfort, unpleasant taste, and dyspnea. Conclusion In patients undergoing transnasal endoscopy, use of either 1%tetracaine or 2%lidocaine has similar effect. Tetracaine may be a better choice in older patients.%目的鼻内镜常用于耳鼻咽喉科的诊断与治疗。患者通常在该手术之前进行局部麻醉,以减轻不适,提高可视化。在优化术中患者体验方面,哪种局部麻醉是最有效的,目前还没有共识。因此,本研究的目的是为了明确雾化1%丁卡因和作为鼻内镜前局部麻醉药的2%利多卡因之间的疗效是否存在差异。方法共有100例患者在鼻内镜前接受羟甲唑啉,并随机分组,分别接受1%丁卡因或2%利多卡因。手术后,患者立即进行调查量表的评分以及与手术有关不良症状级别的评估。结果利多卡因和丁卡因组之间的各条目评分没有明显统计学差异。在全部人群中不同性别之间的各条目评分之间没有统计学差异,在利多卡因组和丁卡因组

  15. Effects on Conduction of the Action Potential of Sciatic Nerve in Rana catesbeiana under Different Anesthetic Agents%不同麻醉药物对牛蛙坐骨神经干动作电位传导速度的影响

    Institute of Scientific and Technical Information of China (English)

    郝凯凯; 李馨; 李刚; 王延峰

    2015-01-01

    The effects of different kinds of lidocaine hydrochloride,chloral hydrate and sodium barbital on the con-duction velocity of sciatic nerve of Rana catesbeiana in vitro were investigated by means of the extra cellular record-ing action potential. The isolated sciatic nerves were stimulated by single square pulses from RM6220C Physiological Signals Recording System. The results were as follows:three anesthetics decreased conduction velocity of sciatic nerve of Rana catesbeiana,with the increasing of time,conduction velocity decreased continuously,with time de-pendent. But lidocaine hydrochloride and chloral hydrateacted fast,sodium barbital reacted slowly.%使用RM6220 C型多道生理信号采集处理系统,采用细胞外引导动作电位的方法,观察和比较三种麻醉药物水合氯醛、盐酸利多卡因和巴比妥钠对牛蛙坐骨神经干动作电位传导速度的影响。结果:三种麻醉药物对牛蛙坐骨神经干动作电位传导均有抑制作用,并随着作用时间的增长而增强,呈时间依赖性。水合氯醛和盐酸利多卡因起效较快,而巴比妥钠起效慢。

  16. Anesthetic blister induction to identify biopsy site prior to Mohs surgery.

    Science.gov (United States)

    Zaiac, Martin; Tongdee, Emily; Porges, Leeor; Touloei, Khasha; Prodanovich, Srdjan

    2015-05-01

    Wrong-site surgery in dermatology often occurs due to difficulty finding the initial biopsy site prior to Mohs surgery. Patients frequently present for Mohs surgery weeks to months following the initial biopsy site. Visualization of the biopsy site may become difficult at presentation due to healing. To investigate the utility of anesthetic blister induction at a suspected biopsy site to identify the location prior to Mohs surgery. The proposed technique is visualization of a blister that is induced by local anesthetic administration at the proposed biopsy site. The addition of this technique among others such as curettage, dermoscopy, and UV fluorescence can prevent wrong-site surgery. A biopsy site of a squamous cell carcinoma on a patient was compared via photography for visibility at the time of initial biopsy, weeks following biopsy, and post-anesthetic blister induction. The biopsy site was easier to locate with the assistance of a blister that formed as a result of local anesthetic administration. Blister induction by local anesthetic administration can assist in accurately identifying healed or obscured biopsy sites.

  17. INTRATHECAL PETHIDINE AS A SOLE ANESTHETIC AGENT FOR LOWER LIMB SURGERIES

    Directory of Open Access Journals (Sweden)

    Pandu Naik

    2015-09-01

    Full Text Available BACKGROUND : The discovery of opioid receptors and ligand in the brain and spinal cord lead to the feasibility of their intrathecal use. Pethidine is the only narcotic that has been shown to be effective intrathecally for surgery. This is because it as a phenyl - piperidine derivative and has a structure and action similar to that of local anesthetic. METHODS : It is a prospective study of 50 patients belonging to ASA grade I and II physical status were administered intra thecal Pethidine (preservative free 1mg/kg body weight for lower limb surgeries. The time of onset and level of sensory blockade, onset and degree of motor blockade, hemodynamic parameters, time for regression of sensory and motor blockade, duration of po stoperative analgesia and side effects were assessed in the patients. RESULTS : Majority of the procedures performed were below knee amputation or external fixation. The mean duration of onset of sensory block was 6.55 mins (SD: ± 0.79 and onset of motor blo ck was 8.39mins (SD: ± 0.83. Peak level of sensory block was attained at L1 level in majority of patients (82%. Degree of motor block was II degree in 66% of patients. Mean time required for motor recovery was 62.2 mins (SD: ±5.0. This was followed by sen sory regression at 94.6mins (SD:±7.3. Mean duration of postoperative analgesia was 333 minutes (SD: ±29.9. Side effects observed were hypotension, nausea, vomiting, sedation, and pruritus. CONCLUSION : Pethidine (preservative free 1mg/kg body weight can b e used intrathecally as a sole anesthetic agent to provide prolonged postoperative analgesia associated with hemodynamic stability and early ambulation in patients undergoing lower limb surgeries.

  18. Collective action and symbolic capital in the artisanal fisheries: An analysis of the Local Food Systems of Reloncaví Estuary (Los Lagos), Chile

    OpenAIRE

    Saavedra Gallo, Gonzalo; Macías Vázquez, Alfredo

    2016-01-01

    In a post-industrial economy, it is as important to understand “material” productive processes in the local community as the processes through which global value chains “expropriate” or “co-opt” common immaterial assets. However, the literature on collective action and the management of common goods generally focuses on matters of the control and governance of material resources. The article commences with an analysis of the relations between the production of value, collective action and the...

  19. Action! Local CCPITs!

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    @@ Zhejiang Province China Council for the Promotion of International Trade (CCPIT) Zhejiang sub-council visited and researched nearly a hundred companies in 9 cities and 31 counties. It found that the impact of financial crisis is far from over, and still spreading. In January this year, Zhejiang's exports continued to decline with 10.7% down, while imports decreased by 36.8%. At the same time, the decline in the export of pro-cessing trade is greater than the general decline in trade. For a considerable period of time, it is rather difficult to reverse the de-cline in processing trade exports. Exports in major markets like Europe, the United States, Japan and others continued to fall. In January, exports in some of the emerging markets including Russia and the Middle East also began to fall.

  20. The modifying effect of anesthetic technique on the metabolic and endocrine responses to anesthesia and surgery

    DEFF Research Database (Denmark)

    Kehlet, H

    1988-01-01

    and the widespread use of the term "stress free anesthesia" in surgery is therefore not valid. However, continuous administration of local anesthetic agents in the epidural space is the most effective technique in so far as reduction of the stress response is concerned. The clinical implication of a variable...... reduction in the stress response to surgery by different anesthetic techniques remains largely unsettled, since only few controlled studies have been published on the clinical effects of pain relief and general anesthesia. However, a vast amount of data exist from controlled studies comparing regional...... anesthesia with local anesthetics and general anesthesia. The cumulative experience from these studies have demonstrated an advantageous effect on postoperative morbidity parameters such as blood loss, postoperative thromboembolic complications, pulmonary infective complications, gastrointestinal motility...

  1. Effects of progestins on local estradiol biosynthesis and action in the Z-12 endometriotic epithelial cell line.

    Science.gov (United States)

    Beranič, Nataša; Rižner, Tea Lanišnik

    2012-11-01

    Endometriosis is a common estrogen-dependent gynecological disease. In patients with endometriosis estradiol can be synthesized locally in the endometriotic lesions from inactive precursors of adrenal or ovarian origin, via the aromatase pathway. These increased estradiol levels stimulate proliferation of endometriotic tissue. The progestins have been used in the therapy of endometriosis for more than 40 years but their pharmacological action is still not understood in detail. In the present study we therefore aimed to evaluate the effects of three progestins most commonly used in the therapy of endometriosis; medroxyprogesterone acetate, dydrogesterone and dienogest on expression of all genes encoding enzymes of the aromatase pathway and estrogen receptors in the Z-12 model epithelial cell line of peritoneal endometriosis, by qPCR and Western blotting. Our results show that application of medroxyprogestrone acetate, dydrogesterone and dienogest significantly decreases HSD17B1 and CYP19A1 expression and significantly increases HSD17B2 expression. Dydrogesterone and dienogest also significantly suppress ESR1 and ESR2 transcription, whereas medroxyprogestrone acetate and dydrogesterone significantly reduce mRNA levels of GPER. Our results thus suggest that in peritoneal endometriosis the beneficial effects of these progestins can be explained by lower HSD17B1 and higher HSD17B2 mRNA and protein levels, which lead to reduced local E2 biosynthesis. Although progestins significantly decrease CYP19A1 mRNA levels, the protein itself was not detectable by Western blotting. As progestins down-regulate expression of ESR1, ESR2 and GPER, they might also prevent E2-mediated proliferation.

  2. Innovative use of resources and diversification of the economic structure of rural areas on the basis of local action group MROGA experience

    Directory of Open Access Journals (Sweden)

    Ewelina Dzikowska

    2012-09-01

    Full Text Available One of the tasks of local action groups is to support diversification of the economic structure of rural areas. Projects which make use of local resources in unique, non-standard ways (with reference to the achievements of the French school of Economie de la Proximie may be called innovative. Analysis was applied to one of the local action groups from the Łódź voivodeship – MROGA Association for the Local Community Development. The aim of this analysis was to estimate the potential of this structure as regards innovative use of local resources in diversification of the local economy by creating non-agricultural jobs. The case study method was applied; analysis of secondary materials was carried out (the local development strategy and competition documentation regarding to the development of local economy in the area supported by this organization. The selected association (realising own projects contributes to the innovative development of rural economy. Moreover, in supported area, new non-agricultural workplaces are created in which local resources are also used in a non-standard way.

  3. Science communication and vernal pool conservation: a study of local decision maker attitudes in a knowledge-action system.

    Science.gov (United States)

    McGreavy, Bridie; Webler, Thomas; Calhoun, Aram J K

    2012-03-01

    In this study, we describe local decision maker attitudes towards vernal pools to inform science communication and enhance vernal pool conservation efforts. We conducted interviews with town planning board and conservation commission members (n = 9) from two towns in the State of Maine in the northeastern United States. We then mailed a questionnaire to a stratified random sample of planning board members in August and September 2007 with a response rate of 48.4% (n = 320). The majority of survey respondents favored the protection and conservation of vernal pools in their towns. Decision makers were familiar with the term "vernal pool" and demonstrated positive attitudes to vernal pools in general. General appreciation and willingness to conserve vernal pools predicted support for the 2006 revisions to the Natural Resource Protection Act regulating Significant Vernal Pools. However, 48% of respondents were unaware of this law and neither prior knowledge of the law nor workshop attendance predicted support for the vernal pool law. Further, concerns about private property rights and development restrictions predicted disagreement with the vernal pool law. We conclude that science communication must rely on specific frames of reference, be sensitive to cultural values, and occur in an iterative system to link knowledge and action in support of vernal pool conservation. Copyright © 2011 Elsevier Ltd. All rights reserved.

  4. Stable inhibition of brain synaptic plasma membrane calcium ATPase in rats anesthetized with halothane.

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    Franks, J J; Horn, J L; Janicki, P K; Singh, G

    1995-01-01

    The authors recently showed that plasma membrane Ca(2+)-ATPase (PMCA) activity in cerebral synaptic plasma membrane (SPM) is diminished in a dose-related fashion during exposure in vitro to halothane, isoflurane, xenon, and nitrous oxide at clinically relevant partial pressures. They have now extended their work to in vivo studies, examining PMCA pumping in SPM obtained from control rats decapitated without anesthetic exposure, from rats decapitated during halothane anesthesia, and from rats decapitated after recovery from halothane anesthesia. Three treatment groups were studied: 1) C, control rats that were decapitated without anesthetic exposure, 2) A, anesthetized rats exposed to 1 minimum effective dose (MED) for 20 min and then decapitated, and 3) R, rats exposed to 1 MED for 20 min and then decapitated after recovery from anesthesia, defined as beginning to groom. Plasma membrane Ca(2+)-ATPase pumping and Ca(2+)-dependent ATPase hydrolytic activity, as well as sodium-calcium exchanger activity and Na+-K+-ATPase hydrolytic activity, were assessed in cerebral SPM. In addition, halothane effect on smooth endoplasmic reticulum Ca(2+)-ATPase (SERCA) was examined. Plasma membrane Ca(2+)-ATPase transport of Ca2+ into SPM vesicles from anesthetized rats was reduced to 71% of control (P SPM from rats killed while anesthetized with halothane, compared with rats killed without anesthesia or after recovery from anesthesia. The studies described in this report, in conjunction with previously reported inhibition of PMCA activity in vitro by a wide range of anesthetic agents, indicate a relationship between inhibition of PMCA and action of inhalational anesthetics.

  5. Sevoflurane: a new inhalational anesthetic agent.

    Science.gov (United States)

    Wallin, R F; Regan, B M; Napoli, M D; Stern, I J

    1975-01-01

    Laboratory screening of a series of halogenated methyl isopropyl ethers revealed sevoflurane (fluoromethyl-1,1,1,3,3,3,-hexafluroro-2-propyl ether) as a potent nonexplosive inhalational anesthetic agent. Sevoflurance, a pleasant-smelling liquid, boils at 58.5 degrees C at 760 torr and has a vapor pressure of 200 torr at 25 degrees C. It is nonflammable in air and has lower flammability limits of 11 vols percent in O2 and 10 vols percent in N2O. Sevoflurane exhibits limited chemical reactivity in vitro; it is subject to slight but measurable hydrolysis, and reacts with soda lime to form traces of related ethers. It provides rapid anesthetic induction and recovery consistent with its low distribution coefficients (blood:gas, 0.6; corn oil:gas, 41.6; olive oil:gas, 53.4). In dogs, anesthetic concentrations of sevoflurane did not produce spontaneous cardiac arrhythmias and did not sensitize the heart to epinephrine. Electroencephalographic patterns were similar to those observed during anesthesia with halothane. In rats, small increases in the urinary excretion of inorganic fluoride ion occurred during the first 24 hours after anesthesia. Subacute studies in dogs and rats, using closed-circle absorption with soda lime, revealed no toxicologically significant changes in animals anesthetized frequently for 2 weeks. Sevoflurane appears to be a unique volatile anesthetic agent worthy of further study.

  6. The Role of Temperature in the Action of Mepivacaine

    OpenAIRE

    Dabarakis, Nikolaos; Tsirlis, Anastasios; Parisis, Nikolaos; Tsoukalas, Dimitrios

    2006-01-01

    The role of temperature in the action of local anesthetics was studied in 20 healthy young volunteers with plain 3% mepivacaine injected periapically twice in their maxillary first premolar, the first time with the solution at a temperature of 20°C and the second time at 4°C. The pulpal response was measured with a pulp tester every minute. The onset of pulp anesthesia was found to be of no statistical difference between 20°C and 4°C. On the other hand, mepivacaine at a temperature of 4°C was...

  7. local

    Directory of Open Access Journals (Sweden)

    Abílio Amiguinho

    2005-01-01

    Full Text Available The process of socio-educational territorialisation in rural contexts is the topic of this text. The theme corresponds to a challenge to address it having as main axis of discussion either the problem of social exclusion or that of local development. The reasons to locate the discussion in this last field of analysis are discussed in the first part of the text. Theoretical and political reasons are there articulated because the question is about projects whose intentions and practices call for the political both in the theoretical debate and in the choices that anticipate intervention. From research conducted for several years, I use contributions that aim at discuss and enlighten how school can be a potential locus of local development. Its identification and recognition as local institution (either because of those that work and live in it or because of those that act in the surrounding context are crucial steps to progressively constitute school as a partner for development. The promotion of the local values and roots, the reconstruction of socio-personal and local identities, the production of sociabilities and the equation and solution of shared problems were the dimensions of a socio-educative intervention, markedly globalising. This scenario, as it is argued, was also, intentionally, one of transformation and of deliberate change of school and of the administration of the educative territoires.

  8. Recognition of anesthetic barbiturates by a protein binding site: a high resolution structural analysis.

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    Simon Oakley

    Full Text Available Barbiturates potentiate GABA actions at the GABA(A receptor and act as central nervous system depressants that can induce effects ranging from sedation to general anesthesia. No structural information has been available about how barbiturates are recognized by their protein targets. For this reason, we tested whether these drugs were able to bind specifically to horse spleen apoferritin, a model protein that has previously been shown to bind many anesthetic agents with affinities that are closely correlated with anesthetic potency. Thiopental, pentobarbital, and phenobarbital were all found to bind to apoferritin with affinities ranging from 10-500 µM, approximately matching the concentrations required to produce anesthetic and GABAergic responses. X-ray crystal structures were determined for the complexes of apoferritin with thiopental and pentobarbital at resolutions of 1.9 and 2.0 Å, respectively. These structures reveal that the barbiturates bind to a cavity in the apoferritin shell that also binds haloalkanes, halogenated ethers, and propofol. Unlike these other general anesthetics, however, which rely entirely upon van der Waals interactions and the hydrophobic effect for recognition, the barbiturates are recognized in the apoferritin site using a mixture of both polar and nonpolar interactions. These results suggest that any protein binding site that is able to recognize and respond to the chemically and structurally diverse set of compounds used as general anesthetics is likely to include a versatile mixture of both polar and hydrophobic elements.

  9. Anesthetic Techniques and Cancer Recurrence after Surgery

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    Vincenzo Fodale

    2014-01-01

    Full Text Available Many of the most common anesthetics are used in surgical oncology, yet effects on cancer cells are still not known. Anesthesia technique could differentially affect cancer recurrence in oncologic patients undergoing surgery, due to immunosuppression, stimulation of angiogenesis, and dissemination of residual cancer cells. Data support the use of intravenous anesthetics, such as propofol anesthesia, thanks to antitumoral protective effects inhibiting cyclooxygenase 2 and prostaglandins E2 in cancer cells, and stimulation of immunity response; a restriction in the use of volatile anesthetics; restriction in the use of opioids as they suppress humoral and cellular immunity, and their chronic use favors angiogenesis and development of metastases; use of locoregional anesthesia compared with general anesthesia, as locoregional appears to reduce cancer recurrence after surgery. However, these findings must be interpreted cautiously as there is no evidence that simple changes in the practice of anesthesia can have a positive impact on postsurgical survival of cancer patients.

  10. Efeitos adversos do sufentanil associado ao anestésico local pelas vias subaracnóidea e peridural em pacientes submetidas à analgesia de parto Efectos adversos del sufentanil asociado al anestésico local por las vías subaracnoidea y peridural en pacientes sometidas a la analgesia de parto Side effects of subarachnoid and epidural sufentanil associated with a local anesthetic in patients undergoing labor analgesia

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    Isabel C.F. Salem

    2007-04-01

    la duración del período de trabajo de parto después de la analgesia, al Apgar de los recién nacidos, a la existencia de hipotensión arterial, bradicardia, náusea, vómito, prurito y retención urinaria. La sedación fue más frecuente en las pacientes de G2, en M1 (50% con diferencia estadística significativa. CONCLUSIONES: El sufentanil en las dosis utilizadas, administrado por vía subaracnoidea o peridural, asociado a los anestésicos locales, determinó similitud en la duración del trabajo de parto después de la analgesia y en el Apgar de los recién nacidos. La sedación fue el efecto adverso más frecuente en las pacientes que recibieron el opioide por vía peridural.BACKGROUND AND OBJECTIVES: The association of an opioid with a local anesthetic improves the quality of labor analgesia and reduces the risk of systemic toxicity of the local anesthetic. However, opioids are not devoid of side effects. The aim of this study was to compare the side effects of subarachnoid sufentanil associated with bupivacaine to those caused by epidural sufentanil associated with ropivacaine in the doses used in the Anesthesiology Department in pregnant women undergoing labor analgesia. METHODS: Sixty pregnant women, ASA physical status I and II, ages between 15 and 42 years, at term and with healthy fetuses, undergoing labor analgesia were enrolled in this study. They were randomly divided in two groups: G1 - combined spinal epidural anesthesia - 0.5% bupivacaine (2.5 mg and subarachnoid sufentanil (5 µg; G2 - Epidural Block - 0.2% ropivacaine (20 mg, and epidural sufentanil (10 µg. Complementary doses of 0.2% ropivacaine (12 mg were administered whenever necessary, and 1% ropivacaine (50 mg was administered for labor resolution. Patients were evaluated after analgesia (M1 regarding the presence of hypotension, maternal bradycardia, pruritus, nausea, vomiting, respiratory depression, and sedation. They were also evaluated postoperatively (M2 regarding the presence of

  11. Duality of Educational Policy as Global and Local: The Case of the Gender Equity Agenda in National Principles and State Actions

    Science.gov (United States)

    Ham, Seung-Hwan; Paine, Lynn W.; Cha, Yun-Kyung

    2011-01-01

    This study provides cross-national empirical evidence that substantiates the dialectic relationship between global and local contexts with regard to educational gender equity both as a national principle and as a priority for state action. Cross-national data on educational gender equity policies across 160 countries were gathered from…

  12. Opioid Actions in Primary-Afferent Fibers—Involvement in Analgesia and Anesthesia

    Directory of Open Access Journals (Sweden)

    Tsugumi Fujita

    2011-01-01

    Full Text Available Opioids inhibit glutamatergic excitatory transmission from the periphery by activating G-protein coupled opioid receptors in the central terminals of primary-afferent neurons in the spinal substantia gelatinosa, resulting in antinociception. Opioid receptor activation in the peripheral terminals of primary-afferent neurons inhibits the production of action potentials in response to nociceptive stimuli given to the periphery, leading to antinociception. Opioids also exhibit a local anesthetic effect without opioid receptor activation in peripheral nerve fibers. This review article will focus on analgesia and anesthesia produced by the actions of opioids on primary-afferent fibers.

  13. Ensaio mecânico da resistência ao impacto do cimento ósseo puro e associado a duas drogas anestésicas locais Mechanical essay of impact resistance of acrylic bone cement used singly or the cement in combination with two local anesthetic drugs

    Directory of Open Access Journals (Sweden)

    Vincenzo Giordano

    2007-07-01

    resistência entre os cimentos Simplex® e Biomecânica® para as medicações lidocaína (p = 0,13 e bupivacaína (p = 0,63. No cimento Simplex®, a associação com a bupivacaína apresentou resistência significativamente maior do que com a lidocaína e o polímero puro (p = 0,001 e p = 0,012, respectivamente. Não existe diferença significativa na resistência entre a lidocaína e o polímero puro para o cimento Simplex® (p = 0,39. No cimento Biomecânica®, a associação com a bupivacaína apresentou resistência significativamente maior do que com a lidocaína e o polímero puro (p = 0,0001 e p = 0,0001, respectivamente. Não existe diferença significativa na resistência entre a lidocaína e o polímero puro para o cimento Biomecânica® (p = 0,37. CONCLUSÃO: Nas condições estudadas, não há redução significativa da resistência ao impacto na combinação de cimento ortopédico com anestésicos locais.OBJECTIVE: To investigate the mechanical behavior of cement-local anesthetic combinations in vitro. METHODS: Two bone cements were tested (Simplex® and Biomecânica® with two anesthetic drugs (lidocaine and bupivacaine. Anesthetic drugs were added in powder form. The authors compared six groups based on the association between the cement and the drugs. Two grams of anesthetic were mixed with 40 g of acrylic cement powder. 60 prismatic molds were made, measuring 5 x 120 x 30 mm (n = 30 and 5 x 60 x 30 mm (n = 30. The molds were tested on a pendulum impact resistance apparatus. Statistical analysis was performed to verify the effect of bone cement (Simplex® and Biomecânica® and the medication (lidocaine, bupivacaine, and no combination on the strength of the molds, with a level of significance alpha = 5%. RESULTS: Statistical comparison showed a significant influence of the medication on bone strength (p = 0.0001. Tukey multiple comparison test demonstrated better strength with bupivacaine. CONCLUSION: Cement-bone combination does not harm the strength

  14. Inhaled anesthetics have hyperalgesic effects at 0.1 minimum alveolar anesthetic concentration.

    Science.gov (United States)

    Zhang, Y; Eger, E I; Dutton, R C; Sonner, J M

    2000-08-01

    We investigated the hyperalgesic (antianalgesic) effect of the inhaled anesthetics isoflurane, halothane, nitrous oxide, and diethyl ether, or the nonimmobilizer 1, 2-dichlorohexafluorocyclobutane at subanesthetic partial pressures (or, for the nonimmobilizer, subanesthetic partial pressures predicted from lipid solubility) in rats. Hyperalgesia was assessed as a decrease in the time to withdrawal of a rat hind paw exposed to heat. All four anesthetics, including nitrous oxide and diethyl ether, produced hyperalgesia at low partial pressures, with a maximal effect at 0.1 minimum alveolar anesthetic concentration (MAC) required to prevent response to movement in 50% of animals, and analgesia (an increased time to withdrawal of the hind paw) at 0. 4 to 0.8 MAC. The nonimmobilizer had neither analgesic nor hyperalgesia effects. We propose that inhaled anesthetics with a higher MAC-Awake (the MAC-fraction that suppresses appropriate responsiveness to command), such as nitrous oxide and diethyl ether, can be used as analgesics because patients are conscious at higher anesthetic partial pressures, including those which have analgesic effects, whereas anesthetics with a lower MAC-Awake do not produce analgesic effects at concentrations that permit consciousness. The inhaled anesthetics isoflurane, halothane, nitrous oxide, and diethyl ether produce antianalgesia at subanesthetic concentrations, with a maximal effect at approximately one-tenth the concentration required for anesthesia. This effect may enhance perception of pain when such small concentrations are reached during recovery from anesthesia.

  15. Articaine: a review of its use for local and regional anesthesia

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    Snoeck M

    2012-06-01

    Full Text Available Marc SnoeckDepartment of Anaesthesia, Canisius-Wilhelmina Hospital, Nijmegen, The NetherlandsAbstract: Articaine is an intermediate-potency, short-acting amide local anesthetic with a fast metabolism due to an ester group in its structure. It is effective with local infiltration or peripheral nerve block in dentistry, when administered as a spinal, epidural, ocular, or regional nerve block, or when injected intravenously for regional anesthesia. In comparative trials, its clinical effects were not generally significantly different from those of other short-acting local anesthetics like lidocaine, prilocaine, and chloroprocaine, and there is no conclusive evidence demonstrating above-average neurotoxicity. Articaine proved to be suitable and safe for procedures requiring a short duration of action in which a fast onset of anesthesia is desired, eg, dental procedures and ambulatory spinal anesthesia, in normal and in special populations.Keywords: articaine, regional anesthesia, pharmacodynamics, pharmacokinetics, therapeutic use, tolerability, neurotoxicity

  16. Pediatric psychopharmacology and local anesthesia: potential adverse drug reactions with vasoconstrictor use in dental practice.

    Science.gov (United States)

    Waits, Joe; Cretton-Scott, Erika; Childers, Noel K; Sims, Pamela J

    2014-01-01

    Pain management is important when dealing with pediatric dental patients. The use of local anesthetics can be especially challenging for children taking psychotropic medications. The purpose of this paper was to identify pertinent information regarding drug interactions between vasoconstrictor/local anesthetic combinations and medications for the management of psychiatric or behavior disorders in children. Many of the reported interactions are controversial, largely theoretical with very limited clinical evidence, and not well defined. However, when considering the potential for significant increased blood pressure when local anesthesia containing a vasoconstrictor is used, a thorough under standing of the pharmacological actions of medications used to treat psychiatric or behavioral disorders and vasoconstrictors can help dental professionals minimize the potential risk of drug interactions in their practice.

  17. Evaluation of prilocaine for the reduction of pain associated with transmucosal anesthetic administration.

    Science.gov (United States)

    Kramp, L. F.; Eleazer, P. D.; Scheetz, J. P.

    1999-01-01

    This investigation evaluated the use and efficacy of prilocaine HCl (4% plain Citanest) for minimizing pain associated with the intraoral administration of local anesthesia. Clinical anecdotes support the hypothesis that prilocaine without a vasoconstrictor reduces pain during injection. To determine relative injection discomfort, use of 4% plain prilocaine was compared with use of 2% lidocaine with 1:100,000 epinephrine and 2% mepivacaine with 1:20,000 levonordefrin. Prior to routine endodontic procedures, 150 adult patients received 0.3 to 1.8 mL of local anesthetic via the same gauge needle without the use of a topical local anesthetic. Injection methods included buccal infiltration, labial infiltration, palatal infiltration, and inferior alveolar nerve block. Following each injection, patients were asked to describe the level of discomfort by scoring on a visual analog scale of 1 to 10, where 1 = painless and 10 = severe pain. Analyses via 2-way analysis of variance revealed no interaction between anesthetic and site of injection. However, there were statistically significant differences among the injection sites. Post hoc analysis revealed that prilocaine was associated with significantly less pain perception when compared to mepivacaine and lidocaine. These results suggest that differences in initial pain perception during transmucosal injection may be a function of the local anesthetic use, and prilocaine can produce less discomfort than the others tested. Images Figure 1 PMID:10853565

  18. Advances in local anesthesia in dentistry.

    Science.gov (United States)

    Ogle, Orrett E; Mahjoubi, Ghazal

    2011-07-01

    Local pain management is the most critical aspect of patient care in dentistry. The improvements in agents and techniques for local anesthesia are probably the most significant advances that have occurred in dental science. This article provides an update on the most recently introduced local anesthetic agents along with new technologies used to deliver local anesthetics. Safety devices are also discussed, along with an innovative method for reducing the annoying numbness of the lip and tongue following local anesthesia.

  19. Analysis of efficacy of two types of local anesthetic in tension-free inguinal hernia repair%腹股沟疝无张力修补术中局麻药物选择的效果分析

    Institute of Scientific and Technical Information of China (English)

    周涛; 麻涛; 田文; 李晨; 菅雁兵; 肖西平; 周彬; 彭喆

    2014-01-01

    Objective To investigate the advantages of combined application of lidocaine and ropivacaine in local anesthesia of tension-free inguinal hernia repair.Methods From January 2012 to December 2013, 172 patients with inguinal hernia were randomly divided into 2 groups:88 patients in lidocaine+ropivacaine group (test group) and 84 patients in lidocaine group (control group) , all of whom received tension-free repair . Clinical data were analyzed retrospectively by using SPSS 17.0 software.The operation time, analgesic duration, time to ambulation, hospital stay were compared by using the t test , while postoperative use of analgesic and anesthesia satisfaction of patients were compared by using χ2 test.P <0.05 was considered statistically significant.Results Operation time of the test group was (41 ±8) minutes, which was not significantly shorter than that of the control group [(43 ±7) minutes (t=1.742, P=0.083)].The analgesic duration of the test group was (7.4 ±1.6) hours, which was longer than that of [(4.8 ±1.8) hours] the control group, (t=10.023, P<0.001).There were 18 patients using painkillers in the test group 24 hours after operation, significantly less than 31 patients in the control group (χ2 =5.709, P=0.017).The mean time to ambulation of the test group was (4.6 ±0.8) hours, which was significantly shorter than that of the control group[(6.7 ±1.4) hours (t=12.147, P<0.001)].The mean discharge time of the test group was (2.7 ±0.4) days, which was significantly shorter than that of the control group [(3.6 ±0.5) days (t=13.065, P<0.001)].74 patients were satisfied with the aesthetic effect in the test group, in contrast to 57 patients in the control group of (χ2 =6.238, P=0.013). Conclusion Local anesthesia of ropivacaine combined with lidocaine in tension-free inguinal hernia repair is an effective and safe method with simple operation and minimal invasion , by which patients could gain less pain, faster recovery, and less complications and costs

  20. Anesthetic technique for inferior alveolar nerve block: a new approach

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    Dafna Geller Palti

    2011-02-01

    Full Text Available BACKGROUND: Effective pain control in Dentistry may be achieved by local anesthetic techniques. The success of the anesthetic technique in mandibular structures depends on the proximity of the needle tip to the mandibular foramen at the moment of anesthetic injection into the pterygomandibular region. Two techniques are available to reach the inferior alveolar nerve where it enters the mandibular canal, namely indirect and direct; these techniques differ in the number of movements required. Data demonstrate that the indirect technique is considered ineffective in 15% of cases and the direct technique in 13-29% of cases. OBJECTIVE: The aim of this study was to describe an alternative technique for inferior alveolar nerve block using several anatomical points for reference, simplifying the procedure and enabling greater success and a more rapid learning curve. MATERIAL AND METHODS: A total of 193 mandibles (146 with permanent dentition and 47 with primary dentition from dry skulls were used to establish a relationship between the teeth and the mandibular foramen. By using two wires, the first passing through the mesiobuccal groove and middle point of the mesial slope of the distolingual cusp of the primary second molar or permanent first molar (right side, and the second following the oclusal plane (left side, a line can be achieved whose projection coincides with the left mandibular foramen. RESULTS: The obtained data showed correlation in 82.88% of cases using the permanent first molar, and in 93.62% of cases using the primary second molar. CONCLUSION: This method is potentially effective for inferior alveolar nerve block, especially in Pediatric Dentistry.

  1. Anesthetic management for Cesarean delivery in parturients with a diagnosis of dwarfism.

    Science.gov (United States)

    Lange, Elizabeth M S; Toledo, Paloma; Stariha, Jillian; Nixon, Heather C

    2016-08-01

    The literature on the anesthetic management of parturients with dwarfism is sparse and limited to isolated case reports. Pregnancy complications associated with dwarfism include an increased risk of respiratory compromise, an increased risk of Cesarean delivery, and an unpredictable degree of anesthesia with neuraxial techniques. Therefore, we conducted this retrospective review to evaluate the anesthetic management of parturients with a diagnosis of dwarfism. We used a query of billing data to identify short statured women who underwent a Cesarean delivery during May 1, 2008 to May 1, 2013. We then hand searched the electronic medical record for qualifying patients with heights dwarfism. The extracted data included patient demographics and obstetric and anesthetic information. We identified 13 women with dwarfism who had 15 Cesarean deliveries in total. Twelve of the women had disproportionate dwarfism, and ten of the 15 Cesarean deliveries were due to cephalopelvic disproportion. Neuraxial anesthesia was attempted in 93% of deliveries. The dose chosen for initiation of neuraxial anesthesia was lower than the typical doses used in parturients of normal stature. Neuraxial anesthetic complications included difficult neuraxial placement (64%), high spinal (7%), inadequate surgical level (13%), and unrecognized intrathecal catheter (7%). The data collected suggest that females with a diagnosis of dwarfism may have difficult neuraxial placement and potentially require lower dosages of local anesthetic for both spinal and epidural anesthesia to achieve adequate surgical blockade.

  2. Exploring microsolvation of the anesthetic propofol

    NARCIS (Netherlands)

    Leon, I.; Cocinero, E. J.; Millan, J.; Jaeqx, S.; Rijs, A. M.; Lesarri, A.; Castano, F.; Fernandez, J. A.

    2012-01-01

    Propofol (2,6-diisopropylphenol) is a broadly used general anesthetic. By combining spectroscopic techniques such as 1- and 2-color REMPI, UV/UV hole burning, infrared ion-dip spectroscopy (IRIDS) obtained under cooled and isolated conditions with high-level ab initio calculations, detailed

  3. Administration and monitoring of intravenous anesthetics

    NARCIS (Netherlands)

    Sahinovic, Marko M.; Absalom, Anthony R.; Struys, Michel M. R. F.

    2010-01-01

    Purpose of review The importance of accuracy in controlling the dose-response relation for intravenous anesthetics is directly related to the importance of optimizing the efficacy and quality of anesthesia while minimizing adverse drug effects. Therefore, it is important to measure and control all

  4. Impact of hyaluronidase on anesthetic distribution in retrobulbar region following sub-Tenon anesthesia

    Directory of Open Access Journals (Sweden)

    Šurbatović Maja

    2008-01-01

    Full Text Available Background/Aim. Sub-Tenon's block is nowadays commonly used in ophthalmic surgery because of its safety and efficacy. The aim of this study was to investigate the distribution of the anesthetic solution with different amounts of hyaluronidase in the retrobulbar space, following an injection into the Sub-Tenon's space. Methods. In this experimental study, 40 pig cadaver heads were used (80 eyeballs. The material was divided into four groups (of 20 eyeballs each. Each group was administered 4.5 ml of a mixture of 2% lignocaine, 0.5% bupivacaine, and 0.5 ml of Indian ink, with different amounts of hyaluronidase - 15 IU/ml, 75 IU/ml, 150 IU/ml, except the control one. Samples of retrobulbar tissue were analyzed using the standard histopathological procedure. After that, they were also analyzed using the Adobe Photoshop program® (Windows, USA. The retrobulbar space was divided into eight zones by four perpendicular lines, which crossed in the centre of the optic nerve. The presence of ink in fat and muscle tissues and in the sheath of the optic nerve was observed. Results. The presence of the local anesthetic solution was significantly higher in inferonasal and superonasal quadrants of the fat and muscle tissues (p < 0.01. The distribution in optic nerve sheath is similar in each quadrant. Distribution of local anesthetic in each zone of the muscle tissue (I-VIII was strongly influenced by the amount of hyaluronidase added. In the fat tissue, the distribution of local anesthetic under the influence of hyaluronidase was significantly higher (p < 0.05 in the areas which were distant from the place of injection (I-IV. The distribution in the optic nerve sheath is significantly higher (p < 0.01 in the group with 150 IU/ml of hyaluronidase. Conclusions. Following a sub-Tenon block local anesthetic was present in the retrobulbar space in a high percentage of the cases. The presence of local anesthetic solution in retrobulbar space depends on the amount of

  5. CARDIOPROTECTION BY VOLATILE ANESTHETICS: FROM BENCH TO BEDSIDE AND BACK

    OpenAIRE

    Sedlić, Filip; Šepac, A; Muravyeva, M; Bošnjak, Željko

    2011-01-01

    Ischemia and reperfusion (I/R) injury of the heart can be ameliorated by volatile anesthetics (VAs). Application of VAs prior to the ischemic event triggers endogenous cardioprotective program that persists even after anesthetic removal, and it is called anesthetic-induced preconditioning (APC) (1). VAs can also reduce infarct size if applied during the reperfusion period (anesthetic postconditioning), where they can also exert protection by the direct effects on cardiac cel...

  6. Recording large-scale neuronal ensembles with silicon probes in the anesthetized rat.

    Science.gov (United States)

    Schjetnan, Andrea Gomez Palacio; Luczak, Artur

    2011-10-19

    Large scale electrophysiological recordings from neuronal ensembles offer the opportunity to investigate how the brain orchestrates the wide variety of behaviors from the spiking activity of its neurons. One of the most effective methods to monitor spiking activity from a large number of neurons in multiple local neuronal circuits simultaneously is by using silicon electrode arrays. Action potentials produce large transmembrane voltage changes in the vicinity of cell somata. These output signals can be measured by placing a conductor in close proximity of a neuron. If there are many active (spiking) neurons in the vicinity of the tip, the electrode records combined signal from all of them, where contribution of a single neuron is weighted by its 'electrical distance'. Silicon probes are ideal recording electrodes to monitor multiple neurons because of a large number of recording sites (+64) and a small volume. Furthermore, multiple sites can be arranged over a distance of millimeters, thus allowing for the simultaneous recordings of neuronal activity in the various cortical layers or in multiple cortical columns (Fig. 1). Importantly, the geometrically precise distribution of the recording sites also allows for the determination of the spatial relationship of the isolated single neurons. Here, we describe an acute, large-scale neuronal recording from the left and right forelimb somatosensory cortex simultaneously in an anesthetized rat with silicon probes (Fig. 2).

  7. Addition of lacal anesthetics to contrast media. Pt. 2. Increase of acute mortality in mice with intravenous contrast administration

    Energy Technology Data Exchange (ETDEWEB)

    Nilsson, P.; Almen, T.; Golman, K.; Jonsson, K.; Nyman, U.

    The acute intravenous toxicity (i.v. LD/sub 50/) of solutions of the ratio 1.5 contrast media metrizoate or diatrizoate and the ratio 3.0 contrast medium metrizamide was determined in mice with and without the addition of local anesthetics to the solutions. The two local anesthetics mepivacaine or lidocaine were added to final concentrations up to 2.0 mg/ml of the contrast medium solutions. This corresponds to clinically used concentrations. All additions of local anesthetics to the solutions increased the mortalities caused by the contrast medium solutions. Addition of local anesthetics to a final concentration of 2 mg/ml approximately doubled the acute intravenous toxicity of the contrast media. The ratio 3 contrast media produce less hypertonic solutions than the ratio 1.5 contrast media and should be preferred for angiography because they cause less pain and do not require the addition of local anesthetics which increase the acute toxicity of the solutions.

  8. Local Action Plans for Forest Fire Prevention in Greece: Existing situation and a Proposed Template based on the Collaboration of Academics and Public Policy Makers

    Science.gov (United States)

    Papanikolaou, Dimitrios; Arvanitakis, Spyridon; Papanikolaou, , Ioannis; Lozios, Stylianos; Diakakis, Michalis; Deligiannakis, Georgios; Dimitropoulou, Margarita; Georgiou, Konstantinos

    2013-04-01

    Wildfires are a major hazard in Greece suffering on average 1,509 wildfires and 36,151 burned hectares of forestlands every year. Since 1998 the Greek Fire Service is responsible for wildfires suppression and response, while prevention and mitigation yearly directives are also being released by the General Secretariat of Civil Protection. The 3013/2002 Act introduced a major transfer of responsibilities from the national to local municipal and regional authorities, which are accompanied by supplementary financial support. Significant new features were established such as the operation of local coordination councils, the foundation of municipality civil protection offices, the establishment of the annually prevention planning for forest fires and the development of local action plans. The University of Athens has developed a Local Action Plan template for municipality administrative levels, integrating scientific techniques and technologies to public government management. The Local Action Plan for Forest Fire Prevention is the main handbook and primary tool of every municipality for reducing the risk of wildfires. Fire prevention and risk analysis are the principal aims of this Plan, which also emphasizes on the important role of the volunteer organizations on forest fire prevention. The 7 chapters of the Action Plan include the legal framework, the risk analysis parameters, the risk analysis using GIS, the prevention planning, the manpower and available equipment of services involved, along with operational planning and evaluation of the previous year's forest fire prevention actions. Multiple information layers, such as vegetation types, road network, power lines and landfills are combined in GIS environment and transformed into qualitative multiparameter as well as quantitative combinational fire hazard maps. These maps are essential in wildfire risk analysis as they display the areas that need the highest attention during the fire season. Moreover, the separate

  9. Development of three Drosophila melanogaster strains with different sensitivity to volatile anesthetics

    Institute of Scientific and Technical Information of China (English)

    LIU Jin; HU Zhao-yang; YE Qi-quan; DAI Shuo-hua

    2009-01-01

    Background The mechanisms of action for volatile anesthetics remain unknown for centuries partly owing to the insufficient or ineffective research models. We designed this study to develop three strains derived from a wild-type Drosophila melanogaster with different sensitivities to volatile anesthetics, which may ultimately facilitate molecular and genetic studies of the mechanism involved.Methods Median effective doses (ED50) of sevoflurane in seven-day-old virgin female and male wild-type Drosophila melanogaster were determined. The sensitive males and females of percentile 6-10 were cultured for breeding sensitive offspring (S1). So did median ones of percentile 48-52 for breeding median offspring (M1), resistant ones of percentile 91-95 for breeding resistant offspring (R1). Process was repeated through 31 generations, in the 37th generation, S37,M37 and R37 were used to determine ED50 for enflurane, isoflurane, sevoflurane, desflurane, halothane, methoxyflurane,chloroform and trichloroethylene, then ED50 values were correlated with minimum alveolar concentration (MAC) values in human.Results From a wild-type Drosophila melanogaster we were able to breed three strains with high, median and low sevoflurane requirements. The ratio of sevoflurane requirements of three strains were 1.20:1.00:0.53 for females and 1.22:1.00:0.72 for males. Strains sensitive, median and resistant to sevoflurane were also sensitive, median and resistant to other volatile anesthetics. For eight anesthetics, ED50 values in three strains correlated directly with MAC values in human.Conclusions Three Drosophila me/anogaster strains with high, median and low sensitivity to volatile anesthetics, but with same hereditary background were developed. The ED50 are directly correlated with MAC in human for eight volatile anesthetics.

  10. Awake craniotomy anesthetic management using dexmedetomidine, propofol, and remifentanil

    Directory of Open Access Journals (Sweden)

    Prontera A

    2017-03-01

    Full Text Available Andrea Prontera,1 Stefano Baroni,2 Andrea Marudi,2 Franco Valzania,3 Alberto Feletti,1 Francesca Benuzzi,4 Elisabetta Bertellini,2 Giacomo Pavesi1 1Department of Neurosurgery, Nuovo Ospedale Civile SAgostino-Estense, 2Department of Anesthesiology, Nuovo Ospedale Civile SAgostino-Estense, 3Department of Neurology, Nuovo Ospedale Civile S Agostino-Estense, 4Department of Neuroscience, University of Modena and Reggio Emilia, Modena, Italy Introduction: Awake craniotomy allows continuous monitoring of patients’ neurological functions during open surgery. Anesthesiologists have to sedate patients in a way so that they are compliant throughout the whole surgical procedure, nevertheless maintaining adequate analgesia and anxiolysis. Currently, the use of α2-receptor agonist dexmedetomidine as the primary hypnotic–sedative medication is increasing.Methods: Nine patients undergoing awake craniotomy were treated with refined monitored anesthesia care (MAC protocol consisting of a combination of local anesthesia without scalp block, low-dose infusion of dexmedetomidine, propofol, and remifentanil, without the need of airways management.Results: The anesthetic protocol applied in our study has the advantage of decreasing the dose of each drug and thus reducing the occurrence of side effects. All patients had smooth and rapid awakenings. The brain remained relaxed during the entire procedure.Conclusion: In our experience, this protocol is safe and effective during awake brain surgery. Nevertheless, prospective randomized trials are necessary to confirm the optimal anesthetic technique to be used. Keywords: dexmedetomidine, awake surgery, anesthesia

  11. Clinical application of thoracic paravertebral anesthetic block in breast surgeries

    Directory of Open Access Journals (Sweden)

    Sara Socorro Faria

    2015-04-01

    Full Text Available INTRODUCTION: Optimum treatment for postoperative pain has been of fundamental importance in surgical patient care. Among the analgesic techniques aimed at this group of patients, thoracic paravertebral block combined with general anesthesia stands out for the good results and favorable risk-benefit ratio. Many local anesthetics and other adjuvant drugs are being investigated for use in this technique, in order to improve the quality of analgesia and reduce adverse effects. OBJECTIVE: Evaluate the effectiveness and safety of paravertebral block compared to other analgesic and anesthetic regimens in women undergoing breast cancer surgeries. METHODS: Integrative literature review from 1966 to 2012, using specific terms in computerized databases of articles investigating the clinical characteristics, adverse effects, and beneficial effects of thoracic paravertebral block. RESULTS: On the selected date, 16 randomized studies that met the selection criteria established for this literature review were identified. Thoracic paravertebral block showed a significant reduction of postoperative pain, as well as decreased pain during arm movement after surgery. CONCLUSION: Thoracic paravertebral block reduced postoperative analgesic requirement compared to placebo group, markedly within the first 24 h. The use of this technique could ensure postoperative analgesia of clinical relevance. Further studies with larger populations are necessary, as paravertebral block seems to be promising for preemptive analgesia in breast cancer surgery.

  12. Tourism Pedagogy and Visitor Responsibilities in Destinations of Local-Global Significance: Climate Change and Social-Political Action

    Directory of Open Access Journals (Sweden)

    Tazim Jamal

    2017-06-01

    Full Text Available This paper examines the issue of climate change pedagogy and social action in tourism, with particular interest in globally-significant destinations under threat from climate change. Little is understood of the role and responsibility of visitors as key stakeholders in climate change-related action or the potential of such sites to foster environmental learning, as well as social and political action on climate change. Drawing on insights from Aldo Leopold and John Dewey, it is argued here that destinations that are valued intrinsically for their ecological and cultural importance are (or ought to be sites of enjoyment and pedagogy, facilitating experiential learning, care, responsibility and civic action towards their conservation. An exploratory case study of visitors to the Great Barrier Reef offers corroborative insights for such a “reef ethic” as described in this paper, related to visitor experience, learning and action in this World Heritage Area. The results of this paper support the need for a stronger pedagogic role to be adopted by tourism experience providers and site managers to facilitate climate change literacy and responsible action (hence facilitating global environmental citizenship. Their responsibility and that of reef visitors is discussed further.

  13. Local anesthesia: a review.

    Science.gov (United States)

    Malamed, S F; Sykes, P; Kubota, Y; Matsuura, H; Lipp, M

    1992-01-01

    Local anesthetics are the most widely administered drugs in dentistry. Significant advances have been made in past decades that have greatly increased both the safety and the efficacy of these important drugs. This paper reviews the history of local anesthesia, pharmacokinetics and clinical implications, techniques, complications, and future directions in the quest for more effective pain control in dentistry.

  14. Combined low dose local anesthetics and opioids versus single use ...

    African Journals Online (AJOL)

    2014-09-24

    Sep 24, 2014 ... it allows early recognition of symptoms caused by ... postoperative pain score, less demand for analgesics ... Combined low dose LA and opioids for transurethral surgery. 257 ..... blocks after the intrathecal administration of an LA. .... organ blood volume during spinal anesthesia in elderly men with cardiac.

  15. Evaluation of local anesthetic and antipyretic activities of Cinchona ...

    African Journals Online (AJOL)

    yeast-induced pyrexia in rats, using aspirin (300 mg/kg) as reference. Results: C. ... Materials. Xylocaine, sodium chloride, Brewer's yeast, and ... Preparation of C. officinalis extract ..... Flavonoid glucosides are hydrolyzed and thus activated.

  16. Hemodynamic Changes during Epidural Anesthesia with Various Local Anesthetics

    Directory of Open Access Journals (Sweden)

    Ye. M. Shifman

    2008-01-01

    Full Text Available Central hemodynamic stability during gynecological laparoscopic operations remains an important problem of anes-thesiological monitoring. Subjects and methods. Fifty-eight patients who had undergone various gynecological laparoscopic operations were examined. According to the mode of anesthesia, the patients were divided into 2 groups: 1 29 patients who received epidural anesthesia with ropivacaine; 2 29 who had epidural anesthesia using lidocaine. The indices of cardiac performance (stroke volume, stroke index, and cardiac output, blood (diastolic, systolic, and mean pressure, vascular parameters (linear blood flow velocity, total peripheral vascular resistance were determined by volumetric compression oscillometry. Results. The study indicated that all the modes of anesthesia demonstrated the satisfactory condition of the cardiovascular system, but the highest stability of hemodynamic parameters was recorded in the epidural ropivacaine group. In this group, there were steady-state reductions in diastolic, systolic, mean blood pressures, and total vascular peripheral resistance and increases in stroke index, stroke volume, and linear blood flow velocity. Conclusion. Epidural anesthesia using ropivacaine during gynecological surgical endoscopic interventions is the method of analgesia causing minimal hemodynamic disorders. Key words: hemodynamics, epidural anesthesia, laparoscopic gynecological operations.

  17. Urotensin Ⅱ inhibits carotid sinus baroreflex in anesthetized male rats

    Institute of Scientific and Technical Information of China (English)

    Yu-ming WU; Hong-mei XUE; Lin XIAO; Rui-rong HE

    2007-01-01

    Aim: To study the effects of urotensin Ⅱ (UV) on the carotid sinus baroreflex (CSB). Methods: The functional curve of carotid sinus baroreflex was measured by recording changes in arterial pressure in anesthetized male rats with perfused isolated carotid sinus. Results: UⅡ at the concentration of 3 nmol/L had no effect on the CSB, while at the concentration of 30, 300 and 3000 nmol/L inhibited the CSB, shifting the functional curve of the baroreflex upward and to the right. There was a marked decrease in peak slope and reflex decrease in blood pressure. These effects of UⅡ were concentration-dependent. Pretreatment with verapamil (an antagonist of the L-type calcium channel, 10 μmol/L) partially eliminated the above effects of UⅡ (300 nmol/L) on the CSB. Pretreatment with BIM-23127 (3 μmol/L),an antagonist of human and rat UⅡ receptors, abolished the actions of UⅡ on the CSB. Pretreatment with, NG-nitro-L-arginine methyl ester (L-NAME) 100 μmol/L did not affect the inhibitory effects of UⅡ (300 nmol/L) on the CSB. Conclusion: These data suggest that UⅡ exerts an inhibitory action on the isolated CSB. Such an action of UV is predominantly mediated by the UⅡ receptors in vascular smooth muscles, resulting in the opening of L-type calcium channels.

  18. Opioid induced hyperalgesia in anesthetic settings.

    Science.gov (United States)

    Lee, Hyeon Jeong; Yeomans, David C

    2014-11-01

    Pain is difficult to investigate and difficult to treat, in part, because of problems in quantification and assessment. The use of opioids, combined with classic anesthetics to maintain hemodynamic stability by controlling responses to intraoperative painful events has gained significant popularity in the anesthetic field. However, several side effects profiles concerning perioperative use of opioid have been published. Over the past two decades, many concerns have arisen with respect to opioid-induced hyperalgesia (OIH), which is the paradoxical effect wherein opioid usage may decrease pain thresholds and increase atypical pain unrelated to the original, preexisting pain. This brief review focuses on the evidence, mechanisms, and modulatory and pharmacologic management of OIH in order to elaborate on the clinical implication of OIH.

  19. Hypoxic pulmonary vasoconstriction: physiology and anesthetic implications.

    Science.gov (United States)

    Lumb, Andrew B; Slinger, Peter

    2015-04-01

    Hypoxic pulmonary vasoconstriction (HPV) represents a fundamental difference between the pulmonary and systemic circulations. HPV is active in utero, reducing pulmonary blood flow, and in adults helps to match regional ventilation and perfusion although it has little effect in healthy lungs. Many factors affect HPV including pH or PCO2, cardiac output, and several drugs, including antihypertensives. In patients with lung pathology and any patient having one-lung ventilation, HPV contributes to maintaining oxygenation, so anesthesiologists should be aware of the effects of anesthesia on this protective reflex. Intravenous anesthetic drugs have little effect on HPV, but it is attenuated by inhaled anesthetics, although less so with newer agents. The reflex is biphasic, and once the second phase becomes active after about an hour of hypoxia, this pulmonary vasoconstriction takes hours to reverse when normoxia returns. This has significant clinical implications for repeated periods of one-lung ventilation.

  20. Heart rate effects of intraosseous injections using slow and fast rates of anesthetic solution deposition.

    Science.gov (United States)

    Susi, Louis; Reader, Al; Nusstein, John; Beck, Mike; Weaver, Joel; Drum, Melissa

    2008-01-01

    The authors, using a crossover design, randomly administered, in a single-blind manner, 3 primary intraosseous injections to 61 subjects using: the Wand local anesthetic system at a deposition rate of 45 seconds (fast injection); the Wand local anesthetic system at a deposition rate of 4 minutes and 45 seconds (slow injection); a conventional syringe injection at a deposition rate of 4 minutes and 45 seconds (slow injection), in 3 separate appointments spaced at least 3 weeks apart. A pulse oximeter measured heart rate (pulse). The results demonstrated the mean maximum heart rate was statistically higher with the fast intraosseous injection (average 21 to 28 beats/min increase) than either of the 2 slow intraosseous injections (average 10 to 12 beats/min increase). There was no statistically significant difference between the 2 slow injections. We concluded that an intraosseous injection of 1.4 mL of 2% lidocaine with 1 : 100,000 epinephrine with the Wand at a 45-second rate of anesthetic deposition resulted in a significantly higher heart rate when compared with a 4-minute and 45-second anesthetic solution deposition using either the Wand or traditional syringe.

  1. Anesthetic doses blocking adrenergic (stress) and cardiovascular responses to incision--MAC BAR.

    Science.gov (United States)

    Roizen, M F; Horrigan, R W; Frazer, B M

    1981-05-01

    The reaction to stress, while vital to the conscious animal, may be detrimental to the surgical patient. To assess the stress-ablating action of different anesthetics (halothane, enflurane, morphine, and spinal) and anesthetic doses, we studied the responses in plasma norepinephrine, muscle movement, pupil diameter, heart rate, and blood pressure to induction of anesthesia and incision in 170 unpremedicated healthy adults. The age-adjusted dose (mean +/- SD) of anesthesia that blocked the adrenergic response in 50 per cent of individuals who had a skin incision (MAC BAR) was 1.45 +/- 0.08 MAC for halothane, 1.60 +/- 0.13 MAC for enflurane, or 1.13 +/- 0.09 +/- mg/kg for morphine sulfate (each anesthetic was given with 60 per cent nitrous oxide). No patient with a level of spinal anesthesia that blocked the pain of incision had an adrenergic response to incision. Increasing doses of halothane and morphine were associated with less of a cardiovascular response to incision (as measured by rate-pressure product); this was not true for enflurane. No patient with an adequate level of spinal anesthesia had a cardiovascular response to skin incision. The changes in heart rate, blood pressure, rate-pressure product, and plasma norepinephrine content that occurred with induction of anesthesia tended to equalize these values between patients, regardless of anesthetic dose, and for all individual and combined anesthetics. That is, if a patient's heart rate while awake was below 63 beats/min, heart rate tended to rise 58 per cent of the difference between heart rate while awake and 63 beats/min, and vice versa. Similarly, the change in blood pressure with induction averaged 75 per cent of the difference between systolic blood pressure while awake and 88 torr. The average for the change in rate-pressure product with induction was 79 per cent of the difference between rate-pressure product while awake and 5917 torr.beats/min. It was concluded that all the anesthetics tested can

  2. Influence of the weight of juveniles Matrinxã (“Brycon cephalus” and Tambaqui (“Colossoma macropomum” to the anesthetic action of the eugenol Influência do peso de juvenis de matrinxã ("Brycon cephalus" e tambaqui ("Colossoma macropomum" à ação anestésica do eugenol

    Directory of Open Access Journals (Sweden)

    Elitieri Batista dos Santos Neto

    2007-10-01

    Full Text Available It was evaluated the influence of the weight in the effect of the anesthetic eugenol for juveniles of matrinxã and tambaqui. For that, it was used a total of 69 matrinxãs and 49 tambaquis. The animals were anesthetized individually, weighed and observed during the induction and the recover of the anesthesia. For the induction it was used the concentration of the anesthetic's 50 mg/L, previously diluted in alcohol. The obtained weights were gathered in five classes and no difference statistics was observed for the times of induction and recovery among them.Foi avaliada a influência do peso de juvenis de matrinxã e tambaqui sobre a ação do anestésico eugenol. Para isso, foram utilizados 69 matrinxãs e 49 tambaquis. Os animais foram individualmente anestesiados, pesados e observados durante a indução e a recuperação da anestesia. Para a indução foi utilizada a concentração de 50 mg/L do anestésico, previamente diluído em álcool. Os pesos obtidos foram reunidos em cinco classes, não sendo observada diferença estatística para os tempos de indução e de recuperação entre elas.

  3. Participation of the GABAergic system in the anesthetic effect of Lippia alba (Mill.) N.E. Brown essential oil

    Energy Technology Data Exchange (ETDEWEB)

    Heldwein, C.G.; Silva, L.L. [Departamento de Farmácia Industrial, Universidade Federal de Santa Maria, Santa Maria, RS (Brazil); Reckziegel, P. [Departamento de Fisiologia e Farmacologia, Universidade Federal de Santa Maria, Santa Maria, RS (Brazil); Barros, F.M.C. [Departamento de Farmácia Industrial, Universidade Federal de Santa Maria, Santa Maria, RS (Brazil); Bürger, M.E.; Baldisserotto, B. [Departamento de Fisiologia e Farmacologia, Universidade Federal de Santa Maria, Santa Maria, RS (Brazil); Mallmann, C.A. [Departamento de Medicina Veterinária Preventiva, Universidade Federal de Santa Maria, Santa Maria, RS (Brazil); Schmidt, D.; Caron, B.O. [Departamento de Ciências Agronômicas e Ambientais, Universidade Federal de Santa Maria, Campus de Frederico Westphalen, Frederico Westphalen, RS (Brazil); Heinzmann, B.M. [Departamento de Farmácia Industrial, Universidade Federal de Santa Maria, Santa Maria, RS (Brazil)

    2012-04-05

    The objective of this study was to identify the possible involvement of the GABAergic system in the anesthetic effect of Lippia alba essential oil (EO). We propose a new animal model using silver catfish (Rhamdia quelen) exposed to an anesthetic bath to study the mechanism of action of EO. To observe the induction and potentiation of the anesthetic effect of EO, juvenile silver catfish (9.30 ± 1.85 g; 10.15 ± 0.95 cm; N = 6) were exposed to various concentrations of L. alba EO in the presence or absence of diazepam [an agonist of high-affinity binding sites for benzodiazepinic (BDZ) sites coupled to the GABA{sub A} receptor complex]. In another experiment, fish (N = 6) were initially anesthetized with the EO and then transferred to an anesthetic-free aquarium containing flumazenil (a selective antagonist of binding sites for BDZ coupled to the GABA{sub A} receptor complex) or water to assess recovery time from the anesthesia. In this case, flumazenil was used to observe the involvement of the GABA-BDZ receptor in the EO mechanism of action. The results showed that diazepam potentiates the anesthetic effect of EO at all concentrations tested. Fish exposed to diazepam and EO showed faster recovery from anesthesia when flumazenil was added to the recovery bath (12.0 ± 0.3 and 7.2 ± 0.7, respectively) than those exposed to water (9.2 ± 0.2 and 3.5 ± 0.3, respectively). In conclusion, the results demonstrated the involvement of the GABAergic system in the anesthetic effect of L. alba EO on silver catfish.

  4. Participation of the GABAergic system in the anesthetic effect of Lippia alba (Mill. N.E. Brown essential oil

    Directory of Open Access Journals (Sweden)

    C.G. Heldwein

    2012-05-01

    Full Text Available The objective of this study was to identify the possible involvement of the GABAergic system in the anesthetic effect of Lippia alba essential oil (EO. We propose a new animal model using silver catfish (Rhamdia quelen exposed to an anesthetic bath to study the mechanism of action of EO. To observe the induction and potentiation of the anesthetic effect of EO, juvenile silver catfish (9.30 ± 1.85 g; 10.15 ± 0.95 cm; N = 6 were exposed to various concentrations of L. alba EO in the presence or absence of diazepam [an agonist of high-affinity binding sites for benzodiazepinic (BDZ sites coupled to the GABA A receptor complex]. In another experiment, fish (N = 6 were initially anesthetized with the EO and then transferred to an anesthetic-free aquarium containing flumazenil (a selective antagonist of binding sites for BDZ coupled to the GABA A receptor complex or water to assess recovery time from the anesthesia. In this case, flumazenil was used to observe the involvement of the GABA-BDZ receptor in the EO mechanism of action. The results showed that diazepam potentiates the anesthetic effect of EO at all concentrations tested. Fish exposed to diazepam and EO showed faster recovery from anesthesia when flumazenil was added to the recovery bath (12.0 ± 0.3 and 7.2 ± 0.7, respectively than those exposed to water (9.2 ± 0.2 and 3.5 ± 0.3, respectively. In conclusion, the results demonstrated the involvement of the GABAergic system in the anesthetic effect of L. alba EO on silver catfish.

  5. Participation of the GABAergic system in the anesthetic effect of Lippia alba (Mill.) N.E. Brown essential oil.

    Science.gov (United States)

    Heldwein, C G; Silva, L L; Reckziegel, P; Barros, F M C; Bürger, M E; Baldisserotto, B; Mallmann, C A; Schmidt, D; Caron, B O; Heinzmann, B M

    2012-05-01

    The objective of this study was to identify the possible involvement of the GABAergic system in the anesthetic effect of Lippia alba essential oil (EO). We propose a new animal model using silver catfish (Rhamdia quelen) exposed to an anesthetic bath to study the mechanism of action of EO. To observe the induction and potentiation of the anesthetic effect of EO, juvenile silver catfish (9.30 ± 1.85 g; 10.15 ± 0.95 cm; N = 6) were exposed to various concentrations of L. alba EO in the presence or absence of diazepam [an agonist of high-affinity binding sites for benzodiazepinic (BDZ) sites coupled to the GABA A receptor complex]. In another experiment, fish (N = 6) were initially anesthetized with the EO and then transferred to an anesthetic-free aquarium containing flumazenil (a selective antagonist of binding sites for BDZ coupled to the GABA A receptor complex) or water to assess recovery time from the anesthesia. In this case, flumazenil was used to observe the involvement of the GABA-BDZ receptor in the EO mechanism of action. The results showed that diazepam potentiates the anesthetic effect of EO at all concentrations tested. Fish exposed to diazepam and EO showed faster recovery from anesthesia when flumazenil was added to the recovery bath (12.0 ± 0.3 and 7.2 ± 0.7, respectively) than those exposed to water (9.2 ± 0.2 and 3.5 ± 0.3, respectively). In conclusion, the results demonstrated the involvement of the GABAergic system in the anesthetic effect of L. alba EO on silver catfish.

  6. Locality or non-locality in quantum mechanics: hidden variables without ''spooky action-at-a-distance''

    Energy Technology Data Exchange (ETDEWEB)

    Aharonov, Y. [Texas A and M Univ., College Station, TX (United States); South Carolina Univ., Columbia, SC (United States). Dept. of Physics and Astronomy; Tel Aviv Univ. (Israel). School of Physics and Astronomy; Botero, A. [South Carolina Univ., Columbia, SC (United States). Dept. of Physics and Astronomy; Centro Internacional de Fisica, Ciudad Univ., Bogota (Colombia); Scully, M. [Texas A and M Univ., College Station, TX (United States); Max-Planck-Institut fuer Quantenoptik (MPQ), Garching (Germany)

    2001-02-01

    The folklore notion of the ''Non-Locality of Quantum Mechanics'' is examined from the point of view of hidden-variables theories according to Belinfante's classification in his Survey of Hidden Variables Theories. It is here shown that in the case of EPR, there exist hidden variables theories that successfully reproduce quantum-mechanical predictions, but which are explicitly local. Since such theories do not fall into Belinfante's classification, we propose an expanded classification which includes similar theories, which we term as theories of the ''third'' kind. Causal implications of such theories are explored. (orig.)

  7. Child with aplastic anemia: Anesthetic management

    OpenAIRE

    Manpreet Kaur; Babita Gupta; Aanchal Sharma; Sanjeev Sharma

    2012-01-01

    Aplastic anemia is a rare heterogeneous disorder of hematopoietic stem cells causing pancytopenia and marrow hypoplasia with the depletion of all types of blood cells. This results in anemia, neutropenia and thrombocytopenia, which pose a challenge to both surgical and anesthetic management of such cases. We report a child with aplastic anemia who sustained traumatic ulcer on the arm and underwent split-thickness skin grafting under general anesthesia. There are only two case reports on anest...

  8. Presenting a Framework to Analyze Local Climate Policy and Action in Small and Medium-Sized Cities

    NARCIS (Netherlands)

    Hoppe, Thomas; van der Vegt, Arjen; Stegmaier, Peter

    2016-01-01

    Academic attention to local climate policy usually focuses on large-sized cities. Given the climate challenges ahead this seems unjustified. Small and medium-sized cities (SMCs) deserve scholarly attention as well. The main question is: What factors influence climate change policy and local climate

  9. 全身麻醉药在脊髓内的作用机制%Subcortical mechanisms of general anesthetics

    Institute of Scientific and Technical Information of China (English)

    杨静; 张宏

    2008-01-01

    The spinal cord plays an important role in two general anesthetic end-points: analgesia and immobility in response to a noxious stimulus. The spinal components that may contribute to anesthetic actions include the central termination of sensory primary afferent neurons, interneurones and the cell bodies and initial axon segments of motor neurons, which are contained in dorsal horn and ventral horn respectively. Different general anesthetics have both presynaptic and postsynaptic effects to produce analgesia and immobility via multitude of cellular and subcellular sites identified as potential targets of anaesthetic action, such as diverse ligand-gated ion channels etc. This review will focus on anesthetic targets and molecular mechanisms mediated analgesia and immobility of general anesthetics in spinal cord.%脊髓是全身麻醉药抑制伤害性刺激体动反应和抗伤害效应的重要作用部位,含有不同配体门控离子受体等多个可能介导麻醉效应的靶点.不同药物在脊髓内经各自特异靶点通过多种分子机制发挥作用.现就全身麻醉药制动和镇痛效应在脊髓内的作用位点和分子机制作一综述.

  10. Anesthetic management of laparoscopic pheochromocytoma surgery: A case report

    Directory of Open Access Journals (Sweden)

    Hakan Akelma

    2014-06-01

    Full Text Available Pheochromocytoma is a neuroendocrine tumor of the adrenal medulla chromaffin cells. It has a variable clinic indicating symptoms such as hypertension, headache, sweating, palpitations, and anxiety. Determination of vanillylmandelic acid in urine and metanephrines are accepted as the most sensitive tests for diagnosis. Computerized tomography and magnetic resonance imaging cad be used for tumor localization. Anesthetic induction and surgical manipulations usually lead to the catastrophic release of catecholamines. Thus, accurate preoperative pharmacological preparation is vital in these patients. Treatment is a complete surgical resection of the primary tumor and, if possible, metastases after banning dangerous fluctuations in hemodynamic through α-blockers. Today, laparoscopic adrenalectomy has begun to replace open surgery as a standard treatment method in many adrenal diseases. J Clin Exp Invest 2014; 5 (2: 443-446

  11. Use of pethidine as an intravenous regional anesthetic.

    Science.gov (United States)

    el-Bakry, M S; el-Shafei, S B; Seyam, E M; el-Kobbia, N M; Ebrahim, U H

    1989-06-01

    Pethidine 100 mg in 30-40 ml saline was given in a group of patients by the conventional technique of intravenous regional anesthesia. Fourty percent of the patients did not feel any form of pain or discomfort, 26.7% experienced only vague sensations which did not call for additional drugs but 13.3% felt some form of pain or discomfort for which diazepam was given and was enough for surgery to be completed. In the rest of the patients (20%) there was intolerable pain for which patients were given general anesthesia. This last category was operated upon for recent fractures or digital conditions and it is known that intravenous regional anesthesia using conventional local anesthetics for such patients usually fails. In a control group in which 30-40 ml saline without pethidine were injected, there was complete failure of the technique.

  12. Implementing Local Climate Change Adaptation and Mitigation Actions: The Role of Various Policy Instruments in a Multi-Level Governance Context

    Directory of Open Access Journals (Sweden)

    E. Carina H. Keskitalo

    2016-01-01

    Full Text Available Recently, considerable focus, e.g., in the fifth IPCC (Intergovernmental Panel on Climate Change Assessment Report (2014 has been trained on why adaptation and mitigation have not been developed more than at present, with relatively few local government actions taken compared with, for example, more discursive policy agreement on the importance of the issue of climate change. Going beyond a focus on general limits and barriers, this comment suggests that one important issue is that climate change has not yet been sufficiently integrated into the state regulative structure of legislation and policy-making. A comparison between three cases suggests that local developments that are not supported in particular by binding regulation are unlikely to achieve the same general level of implementation as issues for which such regulative demands (and thereby also requirements for prioritization exist. This constitutes an important consideration for the development of adaptation and mitigation as policy areas, including on the local level.

  13. The Journey toward Voluntary Public Health Accreditation Readiness in Local Health Departments: Leadership and Followership Theories in Action.

    Science.gov (United States)

    Carman, Angela L

    2015-01-01

    Local health department directors' intent on getting their organizations ready for accreditation must embrace the blurring of leader/follower lines and create an accreditation readiness team fueled not by traditional leader or follower roles but by teamship.

  14. Hypotensive property of Chenopodium ambrosioides in anesthetized normotensive rats.

    Science.gov (United States)

    Assaidi, Asmae; Legssyer, Abdelkhaleq; Berrichi, Abdelbasset; Aziz, Mohammed; Mekhfi, Hassane; Bnouham, Mohammed; Ziyyat, Abderrahim

    2014-02-20

    The leaves of Chenopodium ambrosioides L. (Chenopodiaceae) are widely used in Moroccan traditional medicine to treat diabetes and hypertension. The goal of the present work is to investigate the hypotensive properties of different extract and fractions of the plant in anesthetized normotensive rats and to elucidate the mechanism underlying this effect. The hypotensive effect of aqueous extract (AqE) of the leaves of C. ambrosioides L., methanolic (MF), ethyl acetate (AcF), and aqueous (AqF) Soxhlet fractions, administrated intravenously, was evaluated in anesthetized rats. The recorded signals of blood pressure and heart rate were visualized and analyzed by using an acquisition card "National Instrument" and software Labview 6.1. Intravenous administration of AqE of the leaves of C. ambrosioides L. induces a dose-dependent hypotension. A similar effect was obtained with MF, AcF, and AqF. Atropine (1 mg/kg), used to block cholinergic system, significantly reduced the hypotensive response to MF and AcF suggesting the presence of the cholinomimetic-muscarinic components in these fractions. However, the blood pressure lowering effect of MF and AcF in rats pretreated with L-NAME 20 mg/kg was unchanged showing that the release of NO is not implicated in the hypotensive action of this plant. The present study demonstrates that extracts from leaves of C. ambrosioides induce hypotensive effect that may be partially associated with its cardiac effects. These results may partly explain the traditional use of leaves of C. ambrosioides L. for the treatment of disorders such as hypertension.

  15. The farmer as a landscape steward: Comparing local understandings of landscape stewardship, landscape values, and land management actions.

    Science.gov (United States)

    Raymond, Christopher M; Bieling, Claudia; Fagerholm, Nora; Martin-Lopez, Berta; Plieninger, Tobias

    2016-03-01

    We develop a landscape stewardship classification which distinguishes between farmers' understanding of landscape stewardship, their landscape values, and land management actions. Forty semi-structured interviews were conducted with small-holder (100 acres) in South-West Devon, UK. Thematic analysis revealed four types of stewardship understandings: (1) an environmental frame which emphasized the farmers' role in conserving or restoring wildlife; (2) a primary production frame which emphasized the farmers' role in taking care of primary production assets; (3) a holistic frame focusing on farmers' role as a conservationist, primary producer, and manager of a range of landscape values, and; (4) an instrumental frame focusing on the financial benefits associated with compliance with agri-environmental schemes. We compare the landscape values and land management actions that emerged across stewardship types, and discuss the global implications of the landscape stewardship classification for the engagement of farmers in landscape management.

  16. The Role of Temperature in the Action of Mepivacaine

    Science.gov (United States)

    Dabarakis, Nikolaos; Tsirlis, Anastasios; Parisis, Nikolaos; Tsoukalas, Dimitrios

    2006-01-01

    The role of temperature in the action of local anesthetics was studied in 20 healthy young volunteers with plain 3% mepivacaine injected periapically twice in their maxillary first premolar, the first time with the solution at a temperature of 20°C and the second time at 4°C. The pulpal response was measured with a pulp tester every minute. The onset of pulp anesthesia was found to be of no statistical difference between 20°C and 4°C. On the other hand, mepivacaine at a temperature of 4°C was found to have a statistically significant longer duration of action. Our conclusion is that the drop in temperature of mepivacaine from 20°C to 4°C provides a longer duration of pulpal anesthesia. PMID:17175822

  17. What is the optimal anesthetic protocol for measurements of cerebral autoregulation in spontaneously breathing mice?

    Science.gov (United States)

    Wang, Zhenghui; Schuler, Beat; Vogel, Olga; Arras, Margarete; Vogel, Johannes

    2010-12-01

    Autoregulation, an important feature of the cerebral circulation, is affected in many diseases. Since genetically modified mice are a fundamental tool in biomedical research, including neuro(bio)logy also in this specie measurements of cerebral autoregulation (CA) are mandatory. However, this requires anesthesia that unfortunately significantly impacts cerebral perfusion and consequently might distort CA measurements directly or by altering arterial pCO(2). The latter can be avoided by artificial ventilation but requires several control measurements of blood gases, each consuming at least 100 μl of blood or 5% of a mouse's blood volume. To avoid such diagnostic hemorrhage, we systematically analyzed the effect of different common anesthetic protocols used for rodents in spontaneously breathing mice on CA measured with Laser speckle perfusion imaging. Halothane, Isoflurane and Pentobarbital abrogated CA and Ketamin/Xylazine as well as Chloralose had a moderate reproducibility. In contrast, the rather rarely used anesthetic Ethomidate applied in low doses combined with local anesthetics had the best reproducibility. Although with this anesthesia the lower CA limit was lower than with Ketamin/Xylazine and Chloralose as reported in the handful of papers so far dealing with CA in mice, we suggest Ethomidate as the anesthetic of choice for CA measurements in spontaneously breathing mice.

  18. Are one or two dangerous? Lidocaine and topical anesthetic exposures in children.

    Science.gov (United States)

    Curtis, Liesl A; Dolan, Teresa Sullivan; Seibert, H Edward

    2009-07-01

    Topical anesthetics are found in a variety of prescription and non-prescription preparations, from teething gels to hemorrhoid creams. In 2003, there were 8576 exposures to local/topical anesthetics reported to the American Association of Poison Control Centers, with 67% of cases in the age group younger than 6 years old. This report reviews the available literature involving topical anesthetic exposures in children younger than 6 years old, including the National Library of Medicine's Pub Med database (limited to English language) and data from POISINDEX. Additionally, we reviewed the American Association of Poison Control Centers' annual reports from 1983 to 2003. There were 7 deaths in this age range from topical anesthetics. Although the number of deaths is low, the fact that there have been deaths reveals the serious nature of the toxicity that can result from these readily available non-prescription analgesics. Toxicity may result from topical absorption, ingestion, or aspiration. Additionally, toxicity can result from unintentional as well as therapeutic mishaps. Although the number of cases is limited, these medications can be toxic at low doses-which, in children younger than 6 years of age, may amount to as little as a teaspoon.

  19. Upper airway collapsibility in anesthetized children.

    Science.gov (United States)

    Litman, Ronald S; McDonough, Joseph M; Marcus, Carole L; Schwartz, Alan R; Ward, Denham S

    2006-03-01

    We sought to establish the feasibility of measuring upper airway narrowing in spontaneously breathing, anesthetized children using dynamic application of negative airway pressure. A secondary aim was to compare differences in upper airway collapsibility after the administration of sevoflurane or halothane. Subjects were randomized to either drug for inhaled anesthetic induction. Each was adjusted to their 1 MAC value (0.9% for halothane and 2.5% for sevoflurane) and a blinded anesthesia provider held the facemask without performing manual airway opening maneuvers but with inclusion of an oral airway device. Inspiratory flows were measured during partial upper airway obstruction created by an adjustable negative pressure-generating vacuum motor inserted into the anesthesia circuit. Critical closing pressure of the pharynx (Pcrit) was obtained by plotting the peak inspiratory flow of the obstructed breaths against the corresponding negative pressure in the facemask and extrapolating to zero airflow using linear correlation. Fourteen children were enrolled, seven in each anesthetic group. Two children in the halothane group did not develop flow-limited airway obstruction despite negative pressures as low as -9 cm H2O. Pcrit for sevoflurane ranged from -6.7 to -11.6 (mean +/- sd, -9.8 +/- 1.9) cm H2O. Pcrit for halothane ranged from -8.1 to -33 (mean +/- sd, -19.4 +/- 9.3) cm H2O (sevoflurane versus halothane, P = 0.048). We conclude that when using dynamic application of negative airway pressure, halothane appears to cause less upper airway obstruction than sevoflurane at equipotent concentrations.

  20. Digital block with or without the addition of epinephrine in the anesthetic solution.

    Science.gov (United States)

    dos Reis Júnior, Almiro; Quinto, Denise

    2016-01-01

    Review of various techniques for digital blocks with local anesthetic, with or without epinephrine. Description of various procedures and comparison of results reported in the literature, mainly on latency and quality of anesthesia, details on vasoconstrictor effect of epinephrine, intraoperative bleeding, necessity of tourniquet use, duration of anesthesia and postoperative analgesia, blood flow and digital SpO2 behavior, local and systemic complications, and also approaches and drugs to be used in certain situations of ischemia. The advantages of adding epinephrine to the anesthetic solution are minor when compared to the risks of the procedure, and it seems dangerous to use a vasoconstrictor in the fingers, unless the safety of the technique and the possibility of discarding the tourniquet are definitely proven. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  1. [Digital block with or without the addition of epinephrine in the anesthetic solution].

    Science.gov (United States)

    Reis Júnior, Almiro Dos; Quinto, Denise

    2016-01-01

    Review of various techniques for digital blocks with local anesthetic, with or without epinephrine. Description of various procedures and comparison of results reported in the literature, mainly on latency and quality of anesthesia, details on vasoconstrictor effect of epinephrine, intraoperative bleeding, necessity of tourniquet use, duration of anesthesia and postoperative analgesia, blood flow and digital SpO2 behavior, local and systemic complications, and also approaches and drugs to be used in certain situations of ischemia. The advantages of adding epinephrine to the anesthetic solution are minor when compared to the risks of the procedure, and it seems dangerous to use a vasoconstrictor in the fingers, unless the safety of the technique and the possibility of discarding the tourniquet are definitely proven. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  2. Gestational trophoblastic disease with hyperthyroidism: Anesthetic management

    Directory of Open Access Journals (Sweden)

    Puneet Khanna

    2012-01-01

    Full Text Available The coexistence of hyperthyroidism with gestational trophoblastic disease is a known albeit rare clinical condition. We herein report the successful anesthetic management of such a case in our institute. There are only few case reports in literature of this association. Often, the diagnosis of hyperthyroid state is retrospective one, as it can be missed in the emergency scenario of patient requiring molar evacuation. This case report highlights the perioperative management and optimization of hyperthyroid state prior to surgical evacuation of the invasive hydatidiform mole.

  3. Anesthetic considerations in Sheldon-Hall syndrome.

    Science.gov (United States)

    Anderson, Thomas Anthony; Kasser, James R; Holzman, Robert S

    2014-05-01

    Arthrogryposis is characterized by multiple, nonprogressive joint contractures which may be caused by maternal disorders such as oligohydramnios as well as fetal akinesia resulting from primary disorders of muscle, connective tissue, or neurologic tissue. Its prevalence is about 1 : 3000. Distal arthrogryposis (DA) is a heterogenous group of genetic disorders with a characteristic flexion of the joints of the hands and feet divided into different types with additional features. Sheldon-Hall Syndrome (SHS), also known as distal arthrogryposis type 2A (DA2A), has some nonorthopedic features of specific importance to anesthetic care.

  4. Mimosa pudica, Dionaea muscipula and anesthetics.

    Science.gov (United States)

    De Luccia, Thiago Paes de Barros

    2012-09-01

    Some studies showed that anesthetics reduce the response of physical stimuli in Mimosa pudica and in Venus Flytrap (Dionaea muscipula), peculiar plants that have the ability to respond to touch stimuli. In this research we tested the effects of ketamine, lidocaine, diethyl ether, and amlodipine on the movements of Mimosa pudica and Venus Flytrap. With a literature review, we tried to bring elements to theorize about the interaction of these substances with these plants. The angular displacement in Mimosa´s petiole and in Dionaea leaves is what was measured to compare the drugs group with control groups.

  5. Understanding How and Why Cities Engage with Climate Policy: An Analysis of Local Climate Action in Spain and Italy.

    Directory of Open Access Journals (Sweden)

    Sonia De Gregorio Hurtado

    2015-10-01

    The results of the analysis show a trend towards an increasing awareness on climate mitigation (highly focused on energy efficiency and the promotion of cleaner energy sources, while adaptation remains an incipient local policy area in both countries. The analysis identifies also the beneficial influence of national and international climate city networks.

  6. Transition Management, Action Research and Actor Roles: Understanding local sustainability transitions : Transitiemanagement, actieonderzoek en rollen van actoren: lokale duurzaamheidstransities begrijpen

    NARCIS (Netherlands)

    J.M. Wittmayer (Julia)

    2016-01-01

    markdownabstractThis thesis is about the local scale of urban neighbourhoods, towns and cities and its interaction with global problems and sustainability questions. At this scale, we most notably interact with these problems and thereby question current role understandings, actor relations and

  7. The Journey toward Voluntary Public Health Accreditation Readiness in Local Health Departments: Leadership and Followership Theories in Action

    Directory of Open Access Journals (Sweden)

    Angela eCarman

    2015-03-01

    Full Text Available Local health department directors’ intent on getting their organizations ready for accreditation must embrace the blurring of leader/follower lines and create an accreditation readiness team fueled not by traditional leader or follower roles but by teamship.

  8. Environmental education with a local focus: The development of action competency in community leaders through participation in an environmental leadership program

    Science.gov (United States)

    Cairns, Karen Jean

    2001-07-01

    This dissertation is a historical and theoretical examination of environmental education to promote community leadership in local environmental issues. It begins with an overview of the history of environmental education, historical perspectives of the beginning of the field, ongoing differences in perspectives of practitioners, and its relationship to the larger field of education. Using a prevalent definition of environmental education as education with an aim of promoting actions, which are environmentally responsible and careful, I examine a variety of educational approaches and their results in achieving this objective. Reasons for using a local focus in terms of promotion of community sustainability are explored, and the literature review ends with a discussion of the value of community action through participatory democratic processes. The dissertation is divided into five chapters, covering an introduction to the purpose and significance of the study, literature review, methodology, results and analysis, and conclusion and implications of the research. Two programs, one at a city or urban level and one at a state level, and outcomes for their participants are explored and compared through data collected from interviews, field observation, and program documents. Findings demonstrated the value of a local focus for environmental education programs, plus the importance of experiential learning, or learning through some sort of personal connection and involvement. Examples of the types of experiential learning involved are tours or field trips, role-playing, and games illustrating concepts. Results emphasized the importance of educational process over content, information, or factual knowledge. The urban leadership program demonstrated the value of a local focus and experiential process in increasing motivation for action. The state program demonstrated the value of education of environmental leaders in democratic processes, especially collaboration, inclusion

  9. Age, minimum alveolar anesthetic concentration, and minimum alveolar anesthetic concentration-awake.

    Science.gov (United States)

    Eger, E I

    2001-10-01

    Two defining effects of inhaled anesthetics (immobility in the face of noxious stimulation, and absence of memory) correlate with the end-tidal concentrations of the anesthetics. Such defining effects are characterized as MAC (the concentration producing immobility in 50% of patients subjected to a noxious stimulus) and MAC-Awake (the concentration suppressing appropriate response to command in 50% of patients; memory is usually lost at MAC-Awake). If the concentrations are monitored and corrected for the effects of age and temperature, the concentrations may be displayed as multiples of MAC for a standard age, usually 40 yr. This article provides an algorithm that might be used to produce such a display, including provision of an estimate of the effect of nitrous oxide. Two defining effects of inhaled anesthetics (immobility in the face of noxious stimulation, and absence of memory) correlate with the end-tidal concentrations of the anesthetics. Thus, these defining effects may be monitored and the results displayed if the concentrations are known and corrected for the effects of age and temperature.

  10. A Unitary Anesthetic Binding Site at High Resolution

    Energy Technology Data Exchange (ETDEWEB)

    Vedula, L. Sangeetha; Brannigan, Grace; Economou, Nicoleta J.; Xi, Jin; Hall, Michael A.; Liu, Renyu; Rossi, Matthew J.; Dailey, William P.; Grasty, Kimberly C.; Klein, Michael L.; Eckenhoff, Roderic G.; Loll, Patrick J.; (Drexel-MED); (UPENN)

    2009-10-21

    Propofol is the most widely used injectable general anesthetic. Its targets include ligand-gated ion channels such as the GABA{sub A} receptor, but such receptor-channel complexes remain challenging to study at atomic resolution. Until structural biology methods advance to the point of being able to deal with systems such as the GABA{sub A} receptor, it will be necessary to use more tractable surrogates to probe the molecular details of anesthetic recognition. We have previously shown that recognition of inhalational general anesthetics by the model protein apoferritin closely mirrors recognition by more complex and clinically relevant protein targets; here we show that apoferritin also binds propofol and related GABAergic anesthetics, and that the same binding site mediates recognition of both inhalational and injectable anesthetics. Apoferritin binding affinities for a series of propofol analogs were found to be strongly correlated with the ability to potentiate GABA responses at GABA{sub A} receptors, validating this model system for injectable anesthetics. High resolution x-ray crystal structures reveal that, despite the presence of hydrogen bond donors and acceptors, anesthetic recognition is mediated largely by van der Waals forces and the hydrophobic effect. Molecular dynamics simulations indicate that the ligands undergo considerable fluctuations about their equilibrium positions. Finally, apoferritin displays both structural and dynamic responses to anesthetic binding, which may mimic changes elicited by anesthetics in physiologic targets like ion channels.

  11. A Unitary Anesthetic Binding Site at High Resolution

    Energy Technology Data Exchange (ETDEWEB)

    L Vedula; G Brannigan; N Economou; J Xi; M Hall; R Liu; M Rossi; W Dailey; K Grasty; et. al.

    2011-12-31

    Propofol is the most widely used injectable general anesthetic. Its targets include ligand-gated ion channels such as the GABA{sub A} receptor, but such receptor-channel complexes remain challenging to study at atomic resolution. Until structural biology methods advance to the point of being able to deal with systems such as the GABA{sub A} receptor, it will be necessary to use more tractable surrogates to probe the molecular details of anesthetic recognition. We have previously shown that recognition of inhalational general anesthetics by the model protein apoferritin closely mirrors recognition by more complex and clinically relevant protein targets; here we show that apoferritin also binds propofol and related GABAergic anesthetics, and that the same binding site mediates recognition of both inhalational and injectable anesthetics. Apoferritin binding affinities for a series of propofol analogs were found to be strongly correlated with the ability to potentiate GABA responses at GABA{sub A} receptors, validating this model system for injectable anesthetics. High resolution x-ray crystal structures reveal that, despite the presence of hydrogen bond donors and acceptors, anesthetic recognition is mediated largely by van der Waals forces and the hydrophobic effect. Molecular dynamics simulations indicate that the ligands undergo considerable fluctuations about their equilibrium positions. Finally, apoferritin displays both structural and dynamic responses to anesthetic binding, which may mimic changes elicited by anesthetics in physiologic targets like ion channels.

  12. A Unitary Anesthetic-Binding Site at High Resolution

    Energy Technology Data Exchange (ETDEWEB)

    Vedula, L.; Brannigan, G; Economou, N; Xi, J; Hall, M; Liu, R; Rossi, M; Dailey, W; Grasty, K; et. al.

    2009-01-01

    Propofol is the most widely used injectable general anesthetic. Its targets include ligand-gated ion channels such as the GABAA receptor, but such receptor-channel complexes remain challenging to study at atomic resolution. Until structural biology methods advance to the point of being able to deal with systems such as the GABA{sub A} receptor, it will be necessary to use more tractable surrogates to probe the molecular details of anesthetic recognition. We have previously shown that recognition of inhalational general anesthetics by the model protein apoferritin closely mirrors recognition by more complex and clinically relevant protein targets; here we show that apoferritin also binds propofol and related GABAergic anesthetics, and that the same binding site mediates recognition of both inhalational and injectable anesthetics. Apoferritin binding affinities for a series of propofol analogs were found to be strongly correlated with the ability to potentiate GABA responses at GABA{sub A} receptors, validating this model system for injectable anesthetics. High resolution x-ray crystal structures reveal that, despite the presence of hydrogen bond donors and acceptors, anesthetic recognition is mediated largely by van der Waals forces and the hydrophobic effect. Molecular dynamics simulations indicate that the ligands undergo considerable fluctuations about their equilibrium positions. Finally, apoferritin displays both structural and dynamic responses to anesthetic binding, which may mimic changes elicited by anesthetics in physiologic targets like ion channels.

  13. Anesthetic Management of a Child with Mitochondrial Neurogastrointestinal Encephalopathy

    Science.gov (United States)

    Casarez, Vianey Q.; Zavala, Acsa M.; Owusu-Agyemang, Pascal; Hagan, Katherine

    2015-01-01

    Mitochondrial neurogastrointestinal encephalomyopathy (MNGIE) is an autosomal recessive disorder associated with deficiency of thymidine phosphorylase (TP). Associated manifestations include visual and hearing impairments, peripheral neuropathies, leukoencephalopathy, and malnutrition from concomitant gastrointestinal dysmotility and pseudoobstruction. Given the altered metabolic state in these patients, specific consideration of medication selection is advised. This case report will describe the anesthetic management used in a 10-year-old girl with MNGIE. She had multiple anesthetics while undergoing allogeneic hematopoietic stem cell transplantation. This case report will discuss the successful repeated use of the same anesthetic in this pediatric patient, with the avoidance of volatile anesthetic agents, propofol, and muscle relaxant. PMID:26124966

  14. Anesthetic Management of a Child with Mitochondrial Neurogastrointestinal Encephalopathy

    Directory of Open Access Journals (Sweden)

    Vianey Q. Casarez

    2015-01-01

    Full Text Available Mitochondrial neurogastrointestinal encephalomyopathy (MNGIE is an autosomal recessive disorder associated with deficiency of thymidine phosphorylase (TP. Associated manifestations include visual and hearing impairments, peripheral neuropathies, leukoencephalopathy, and malnutrition from concomitant gastrointestinal dysmotility and pseudoobstruction. Given the altered metabolic state in these patients, specific consideration of medication selection is advised. This case report will describe the anesthetic management used in a 10-year-old girl with MNGIE. She had multiple anesthetics while undergoing allogeneic hematopoietic stem cell transplantation. This case report will discuss the successful repeated use of the same anesthetic in this pediatric patient, with the avoidance of volatile anesthetic agents, propofol, and muscle relaxant.

  15. Mechanism of Anesthetic Toxicity: Metabolism, Reactive Oxygen Species, Oxidative Stress, and Electron Transfer

    OpenAIRE

    2011-01-01

    There is much literature on the toxic effects of anesthetics. This paper deals with both the volatiles and locals. Adverse effects appear to be multifaceted, with the focus on radicals, oxidative stress (OS), and electron transfer (ET). ET functionalities involved are quinone, iminoquinone, conjugated iminium, and nitrone. The non-ET routes involving radicals and OS apparently pertain to haloalkanes and ethers. Beneficial effects of antioxidants, evidently countering OS, are reported. Knowled...

  16. Methemoglobin levels in generally anesthetized pediatric dental patients receiving prilocaine versus lidocaine.

    Science.gov (United States)

    Gutenberg, Lauren L; Chen, Jung-Wei; Trapp, Larry

    2013-01-01

    The purpose of this study was to measure and compare peak methemoglobin levels and times to peak methemoglobin levels following the use of prilocaine and lidocaine in precooperative children undergoing comprehensive dental rehabilitation under general anesthesia. Ninety children, 3-6 years of age, undergoing dental rehabilitation under general anesthesia were enrolled and randomly assigned into 3 equal groups: group 1, 4% prilocaine plain, 5 mg/kg; group 2, 2% lidocaine with 1:100,000 epinephrine, 2.5 mg/kg; and group 3, no local anesthetic. Subjects in groups 1 and 2 were administered local anesthetic prior to restorative dental treatment. Methemoglobin levels (SpMET) were measured and recorded throughout the procedure using a Masimo Radical-7 Pulse Co-Oximeter (Masimo Corporation, Irvine, Calif, RDS-1 with SET software with methemoglobin interface). Data were analyzed using chi-square, one-way analysis of variance (ANOVA), and Pearson correlation (significance of P < .05). Group 1 had a significantly higher mean peak SpMET level at 3.55% than groups 2 and 3 at 1.63 and 1.60%, respectively. The mean time to peak SpMET was significantly shorter for group 3 at 29.50 minutes than that of group 1 at 62.73 and group 2 at 57.50 minutes. Prilocaine, at 5 mg/kg in pediatric dental patients, resulted in significantly higher peak SpMET levels than lidocaine and no local anesthetic. In comparison to no local anesthetic, the administration of prilocaine and lidocaine caused peak SpMET levels to occur significantly later in the procedure.

  17. TECHNOLOGY AND ANALYSIS DEVELOPMENT OF STOMATOLOGICAL MATRIX SYSTEM OF MULTIFUNCTIONAL ACTION DELIVERY

    Directory of Open Access Journals (Sweden)

    T. F. Marinina

    2014-01-01

    Full Text Available Timeliness of double-layer matrix system (of stomatological medicated films with antiinflammatory, local anesthetic, regenerative, anti-edematous action was shown. One layer of the system includes lidocaine hydrochloride and kalanchoe sap, another contains furacilin and urea. The best possible polymer carriers of preparations under study which provide their sufficient release from matrix system. Signified antimicrobic activity of double-layer system and osmotic activity were established. Double-layer matrix systems offered may be used in stomatology with for treatment and preventive measures of different diseases of parodontium tissues

  18. Safety, efficacy, and patient acceptability of lidocaine hydrochloride ophthalmic gel as a topical ocular anesthetic for use in ophthalmic procedures

    Directory of Open Access Journals (Sweden)

    Michael A Page

    2009-10-01

    Full Text Available Michael A Page, Frederick W FraunfelderDepartment of Ophthalmology (Casey Eye Institute, Oregon Health and Science University, Portland, OR, USAPurpose: To review the current literature on safety, efficacy, and measures of surgeon and patient satisfaction with lidocaine hydrochloride gel as a tool for ocular anesthesia.Methods: Pubmed search using keywords “lidocaine gel,” “ophthalmic,” and “surgery” and compiling cross-references. Twenty-six total references were reviewed, including 15 prospective randomized controlled trials (RCTs, total N = 933, average N = 62, 6 nonrandomized prospective studies (total N = 234, average N = 39, 2 animal studies, 1 microbiologic study, and 2 letters to the editor.Results: The RCTs and nonrandomized prospective studies evaluated a number of measures including timing of onset of anesthesia, duration of anesthesia, intraoperative and postoperative pain, need for additional anesthetic applications, intracameral lidocaine levels, and adverse effects. Control groups received topical drops, subconjunctival anesthetic, retrobulbar anesthetic, or sham gel. Lidocaine gel was shown to be at least as effective for pain control as alternative therapies in all studies, with longer duration of action than topical drops. Patient and surgeon satisfaction were high, and adverse effects were rare and comparable to those for anesthetic drop formulations. Surgical settings included cataract, pterygium, trabeculectomy, strabismus, intravitreal injection, vitrectomy, and penetrating keratoplasty.Conclusions: Lidocaine gel is a safe, effective, and potentially underutilized tool for ophthalmic surgery.Keywords: lidocaine, gel, topical, ophthalmic, ocular, anesthetic

  19. The City of Whitehorse local action plan (LAP) to reduce energy and greenhouse gas emissions for city operations and the community

    Energy Technology Data Exchange (ETDEWEB)

    Brown, G.; Crist, B.; Hnatiuk, D.; Schweiger, S.; Tuck, W.; Turner, J.; White, G. [City of Whitehorse, YT (Canada)

    2004-02-01

    The City of Whitehorse has created a Local Action Plan (LAP) within its community to reduce energy consumption and greenhouse gas emissions while stimulating the local economy. The city hired a Climate Change Coordinator in 1995 to initiative the five-step Partners for Climate Protection (PCP) program organized through the Federation of Canadian Municipalities. The five milestones of the PCP are to: (1) profile energy use and emissions from city and community-based sources, (2) establish reduction targets for city operations and the community, (3) develop and finalize a LAP that reduces energy use and emissions, (4) implement the LAP, and (5) monitor, verify and report greenhouse gas emissions. The economic benefits of implementing the LAP include: energy costs can be reduced by improving energy efficiency of city buildings, water and sewage systems, and vehicle fleet; local economic development can be stimulated by implementing new technologies and improving existing infrastructure; the need for road expansion can be reduced when peak vehicle traffic is reduced; and, tourism can preserve a viable downtown and improve the local economy. The social and health benefits of implementing the LAP include: community leadership; development of a more liveable community; reduced traffic congestion and increased mobility; preserved green spaces; increase public awareness of climate change; improved air quality; improved health; and, contribution to sustainable development. 31 refs., 6 tabs., 10 figs., 8 appendices.

  20. Collective action and symbolic capital in the artisanal fisheries: An analysis of the Local Food Systems of Reloncaví Estuary (Los Lagos, Chile

    Directory of Open Access Journals (Sweden)

    Saavedra Gallo, Gonzalo

    2016-06-01

    Full Text Available In a post-industrial economy, it is as important to understand “material” productive processes in the local community as the processes through which global value chains “expropriate” or “co-opt” common immaterial assets. However, the literature on collective action and the management of common goods generally focuses on matters of the control and governance of material resources. The article commences with an analysis of the relations between the production of value, collective action and the rentier nature of contemporary capitalism and its entrepreneurial ideology. Then, we present a detailed analysis of the case of mytilid seed capture in the Reloncaví Estuary (Los Lagos Region, Chile. This case shows us the failure of modernisation policies which are based on converting local producers into modern entrepreneurs. To adopt a successful value strategy, a very different problem must be addressed, namely the difficulties of local communities in managing successfully their own common immaterial values. Faced with the dichotomous logic of neoliberalism, communities must reunite these immaterial values and the associated common material resources, and modulate the friction between them.En una economía postindustrial, es importante comprender los procesos productivos “materiales” en la comunidad local como procesos a través de los cuales las cadenas globales de valor “expropian” o “cooptan” los activos inmateriales comunes. Sin embargo, la literatura sobre acción colectiva y gestión de los bienes comunes generalmente se focaliza en el control y la gobernanza de los recursos materiales. Este artículo comienza con un análisis de las relaciones entre la producción del valor, la acción colectiva y la naturaleza rentista de capitalismo contemporáneo y su ideología emprendedora. A continuación, presentamos un análisis detallado del caso del cultivo de semillas de mitílidos en el Estuario de Reloncaví (Los Lagos, Chile

  1. 21 CFR 868.6100 - Anesthetic cabinet, table, or tray.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Anesthetic cabinet, table, or tray. 868.6100 Section 868.6100 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... tray. (a) Identification. An anesthetic cabinet, table, or tray is a device intended to store...

  2. Relationship between pre-anesthetic and intra-anesthetic airway resistance in patients undergoing general anesthesia: A prospective observational study

    Science.gov (United States)

    Ikeda, Takamitsu; Uchida, Kanji; Yamauchi, Yasuhiro; Nagase, Takahide; Oba, Koji; Yamada, Yoshitsugu

    2017-01-01

    Surgery patients in Japan undergo routine spirometry testing prior to general anesthesia. The use of a flow sensor during general anesthesia has recently become common. However, it is not certain whether the information derived from flow-volume curves is being adequately used for mechanical ventilation management during general anesthesia. So far, there have been no attempts to calculate airway resistance using flow-volume curves. Therefore, we performed a prospective, observational study to investigate the relationship between pre-anesthetic and intra-anesthetic airway resistance in patients scheduled for surgery under general anesthesia. We calculated pre-anesthetic and intra-anesthetic airway resistance in each patient, based on the slopes of flow-volume curves obtained prior to and during general anesthesia. We also calculated endotracheal tube resistance to correct the intra-anesthetic airway resistance values calculated. A total of 526 patients were included in the study, and 98 patients had a forced expiratory volume in the first second/forced vital capacity ratio of mechanical ventilation (p = 0.48). Pre-anesthetic and intra-anesthetic airway resistance values were closer to each other in patients without airflow obstruction, with a mean difference < 1.0 cmH2O L-1s-1, than in those with airflow obstruction, although these respiratory parameters were significantly different (p < 0.001). Intra-anesthetic airway resistance was not related to the FEV1/FVC ratio, regardless of the degree to which the FEV1/FVC ratio reflected pre-anesthetic airway resistance. As compared with patients with airflow obstruction, the mean difference between pre-anesthetic and intra-anesthetic airway resistance was small in patients without airflow obstruction. PMID:28212451

  3. Report on public health actions and vaccination strategies to monitor measles epidemic in Local Health Unit A in Rome, Italy

    Directory of Open Access Journals (Sweden)

    Antonietta Spadea

    2012-03-01

    Full Text Available

    Abstract:
    Background: between May 2010 and october 2011 the unit of Preventive Medicine for the developmental ages of district IV, Health unit aSL rM/a, received 136 measles case notifications from the unit of Epidemiology and Prophylaxis of Infectious diseases.
    Methods: in accordance with the infectious diseases monitoring protocol, we introduced a series of preventive measures, such as monitoring subjects in contact with measles-infected patients, recommend- ing the administration of two Measles Mumps and rubella (MMr doses four weeks apart, and informing paediatricians, families and school teachers about the measles epidemic.
    Results: all the activities above led to an increased number of MMr doses administered and a significant improvement of measles immunization coverage among residents of the district IV health unit of rome. concerning MMr 1, in a sample cohort consisting of children ≤24 months, the immunization coverage increased from 77% on the 31/12/09 to 88% on the 31/12/11. Instead, for MMr 2, in a cohort of children ≤6 years, the same ratio improved from 51% on the 31/12/09 to 65% on the 31/12/11.
    Discussion: the results indicate a material increase in the immunization coverage once our public health actions and vaccination strategies had been implemented among young residents of district IV aSL rM/a...

  4. Retinoic acid exerts dual regulatory actions on the expression and nuclear localization of interferon regulatory factor-1.

    Science.gov (United States)

    Luo, Xin M; Ross, A Catharine

    2006-05-01

    Interferon regulatory factor-1 (IRF-1), a transcription factor and tumor suppressor involved in cell growth regulation and immune responses, has been shown to be induced by all-trans retinoic acid (ATRA). However, the factors controlling the cellular location and activity of IRF-1 are not well understood. In this study, we examined the expression of IRF-1 and its nuclear localization, DNA-binding activity, and target gene expression in human mammary epithelial MCF10A cells, a model of breast epithelial cell differentiation and carcinogenesis. Following initial treatment with ATRA, IRF-1 mRNA and protein were induced within 2 hrs, reached a peak (>30-fold induction) at 8 hrs, and declined afterwards. IRF-1 protein was predominantly cytoplasmic during this treatment. Although a second dose of ATRA or Am580 (a related retinoid selective for retinoic acid receptor-alpha [RARalpha]), given 16 hrs after the first dose, restimulated IRF-1 mRNA and protein levels to a similar level to that obtained by the first dose, IRF-1 was predominantly concentrated in the nucleus after restimulation. ATRA and Am580 also increased nuclear RARalpha, whereas retinoid X receptor-alpha (RXRalpha)--a dimerization partner for RARalpha, was localized to the nucleus upon second exposure to ATRA. However, ATRA and Am580 did not regulate the expression or activation of signal transducer and activator of transcription-1 (STAT-1), a transcription factor capable of inducing the expression of IRF-1, indicating an STAT-1-independent mechanism of regulation by ATRA and Am580. The increase in nuclear IRF-1 after retinoid restimulation was accompanied by enhanced binding to an IRF-E DNA response element, and elevated expression of an IRF-1 target gene, 2',5'-oligoadenylate synthetase-2. The dual effect of retinoids in increasing IRF-1 mRNA and protein and in augmenting the nuclear localization of IRF-1 protein may be essential for maximizing the tumor suppressor activity and the immunosurveillance

  5. It all started in Falköping, Sweden: Safe Communities - global thinking and local action for safety.

    Science.gov (United States)

    Svanström, Leif

    2012-01-01

    After constructing the Safe Community model and applying it in Falköping Municipality, Sweden, a first step was taken to establish a Swedish network for knowledge exchange between Safe Communities. Falköping was the first to be involved, and was then joined by Lidköping and Motala. Later, there followed Harstad in Norway, and some communities in Australia. Criteria were developed to define the concept operationally. In 1986, collaboration was embarked upon with the World Health Organization, and since 1991 there have been annual conferences on Safe Communities. Many academic centres around the world are now involved. Certification of communities started in 1989, and 272 communities have now been designated as a Safe Community (20 February 2011). The regional organisations, especially the Asian and European networks, embrace more than half of the designated communities. A global organisation has been considered, but the strength of the movement lies in local engagement and regional networking.

  6. Watershed regulation and local action: analysis of the Senegal River watershed management by a regional organisation and public participation

    Directory of Open Access Journals (Sweden)

    A. M. Sène

    2007-06-01

    Full Text Available Several social scientists have dealt with the usefulness of a participative approach in development plans. The call for sustainable development has increased the focus on this type of approach in a very classical way, which is the case for the creation of new water tanks. Most of these scientists have also pinpointed the major difficulties and failures faced during the execution of this new approach in developing countries. This study is a concrete example which underlines the lack of this type of approach as far as water management in the Senegal River is concerned, mainly in relation to watershed. We base our study on the analysis and criticism of the regional organization OMVS (Organization for the Development of the Senegal River which is in charge of water management in the Senegal River. The results of the study can, therefore, be summed up as follows: (i An on-site direct observation, individual interviews, group discussion and information analysis point out the lack of participation of local people in water management in the Senegal River and, in general, the harmful socio-economic impacts resulting from it. (ii The reasons for this lack of participative approach are mainly due to the model set up by the OMVS in terms of water management in the Senegal River, a model that has excluded or tackled in a very light way the issue of public participation in decision-making through out its juridical and regulation instruments. (iii Elements of consideration on some measures, which could possibly improve the level of participation of local people in river water management.

  7. Huntington's disease: review and anesthetic case management.

    Science.gov (United States)

    Cangemi, C F; Miller, R J

    1998-01-01

    Huntington's disease is a dominantly inherited progressive autosomal disease that affects the basal ganglia. Symptoms appear later in life and manifest as progressive mental deterioration and involuntary choreiform movements. Patients with Huntington's disease develop a progressive but variable dementia. Dysphagia, the most significant related motor symptom, hinders nutrition intake and places the patient at risk for aspiration. The combination of involuntary choreoathetoid movements, depression, and apathy leads to cachexia. Factors of considerable concern to the anesthesiologist who treats patients with Huntington's disease may include how to treat frail elderly people incapable of cooperation, how to treat patients suffering from malnourishment, and how to treat patients with an increased risk for aspiration or exaggerated responses to sodium thiopental and succinylcholine. The successful anesthetic management of a 65-yr-old woman with Huntington's disease who presented for full-mouth extractions is described.

  8. Obstetric use of nitroglycerin: Anesthetic implications

    Science.gov (United States)

    Saroa, Richa; Sachan, Shikha; Palta, Sanjeev; Gombar, Satinder; Sahai, Nitika

    2013-01-01

    Nitroglycerin has been used in anesthetic practice for induced hypotension and managing perioperative hypertension and myocardial ischemia. Contrary to the continuous low dose infusions (5-20 mcg/min) used for the same, intravenous bolus dosages are sometimes administered at the behest of obstetricians for removal of retained placenta. Use of nitroglycerine in managing retained placenta is undertaken as a last resort when other measures fail to relax the uterine smooth muscles. Intravenous nitroglycerine relaxes smooth muscle cells by releasing nitric oxide thus causing prompt cervico-uterine relaxation. However, administration of nitroglycerine in this manner is not without risks which should be kept in mind while using it for obstetric purposes. We hereby report a case of 22-year-old female scheduled for manual removal of placenta where unpredictable and unexpected hypoxemia was observed following nitroglycerine administration. PMID:24015145

  9. Obstetric use of nitroglycerin: Anesthetic implications

    Directory of Open Access Journals (Sweden)

    Richa Saroa

    2013-01-01

    Full Text Available Nitroglycerin has been used in anesthetic practice for induced hypotension and managing perioperative hypertension and myocardial ischemia. Contrary to the continuous low dose infusions (5-20 mcg/min used for the same, intravenous bolus dosages are sometimes administered at the behest of obstetricians for removal of retained placenta. Use of nitroglycerine in managing retained placenta is undertaken as a last resort when other measures fail to relax the uterine smooth muscles. Intravenous nitroglycerine relaxes smooth muscle cells by releasing nitric oxide thus causing prompt cervico-uterine relaxation. However, administration of nitroglycerine in this manner is not without risks which should be kept in mind while using it for obstetric purposes. We hereby report a case of 22-year-old female scheduled for manual removal of placenta where unpredictable and unexpected hypoxemia was observed following nitroglycerine administration.

  10. Renal effects of methoxyverapamil in anesthetized rats.

    Science.gov (United States)

    Brown, B; Churchill, P

    1983-05-01

    The purpose of these experiments was to determine the renal effects of methoxyverapamil (D-600). Three groups of rats were anesthetized with sodium pentobarbital and given 0, 0.85 or 1.69 nmol/min of methoxyverapamil i.v. Increases in urine flow and Na, K and Ca excretory rates occurred, in an apparently dose-dependent manner. Plasma Na and arterial renin concentration decreased at both doses and, at the higher dose, mean arterial blood pressure and effective renal plasma flow decreased while plasma K increased. Plasma Ca, glomerular filtration rate, filtration fraction and total renal plasma flow were not affected. The findings that methoxyverapamil increased urine flow and electrolyte excretion without changing glomerular filtration rate are consistent with the hypothesis that methoxyverapamil acts directly on tubular reabsorptive mechanisms. These effects, and the effect on plasma renin concentration, could contribute to the beneficial effects of this and other Ca entry antagonists in the treatment of hypertension.

  11. The experimental study of the specific pharmacological action of «Artproment» combined gel

    Directory of Open Access Journals (Sweden)

    О. S. Shpychak

    2014-08-01

    Full Text Available The preclinical experimental research concerning the study of the specific pharmacological action of "ArtpromentÒ" gel has been done. The gel developed contains propolis phenolic hydrophobic drug, articaine hydrochloride, menthol and rosemary oil in its composition. The medicine is planned to application in sports medicine with the purpose of treating traumatic injuries of organs of the locomotor apparatus accompanied with sport traumas (bruises, dislocations, sprains, ruptures of ligaments, tendons, etc.. In this work the pharmacological, physiological, instrumental methods of research and methods of mathematical statistics have been used. The study of the analgesic and local anesthetic action of the gel developed was conducted at the premises of the Central Research Laboratory of NUPh under the supervision of Doctor of Pharmacy, professor L.V.Iakovlieva on the model of tail thermoirritation in white rats weighing 180.0-200.0 g. The analgesic and local anesthetic actions were estimated by the ability of the medicine studied to change the pain threshold (duration of the latent period, sеc. in animals of the test group comparing to the control group in the dose of 25 mg/cm2 and the base in the dose of 30 mg/cm2 after application to the tail. The results of the experiment testify that when studying the influence of the combined gel on the course of the experimental nociceptive response of the central origin the significant analgesic action of "ArtpromentÒ" medicine has been determined; its highest intensity was observed in 2.5 and 3.5 hours after application and is 52 % and 59 %, respectively. Despite the fact that the progress of the pain syndrome in the model of tail thermoirritation is mediated by the central nervous system, it is possible to conclude that the developed gel has an expressed analgesic and local anesthetic action. The medicine shows the significant anti-edema action at the level of the reference medicine "Diclofen-gel" on the

  12. The effects of propofol on local field potential spectra, action potential firing rate, and their temporal relationship in humans and felines

    Directory of Open Access Journals (Sweden)

    Sara eHanrahan

    2013-04-01

    Full Text Available Propofol is an intravenous sedative hypnotic, which, acting as a GABAA agonist, results in neocortical inhibition. While propofol has been well studied at the molecular and clinical level, less is known about the effects of propofol at the level of individual neurons and local neocortical networks. We used Utah Electrode Arrays (UEAs to investigate the effects of propofol anesthesia on action potentials (APs and local field potentials (LFPs. UEAs were implanted into the neocortex of two humans and three felines. The two human patients and one feline received propofol by bolus injection, while the other two felines received target-controlled infusions. We examined the changes in LFP power spectra and AP firing at different levels of anesthesia. Increased propofol concentration correlated with decreased high-frequency power in LFP spectra and decreased AP firing rates, and the generation of large amplitude spike-like LFP activity; however, the temporal relationship between APs and LFPs remained relatively consistent at all levels of propofol. The probability that an AP would fire at this local minimum of the LFP increased with propofol administration. The propofol-induced suppression of neocortical network activity allowed LFPs to be dominated by low-frequency spike-like activity, and correlated with sedation and unconsciousness. As the low-frequency spike-like activity increased and the AP-LFP relationship became more predictable firing rate encoding capacity is impaired. This suggests a mechanism for decreased information processing in the neocortex that accounts for propofol-induced unconsciousness.

  13. “Robo-Tripping”: Dextromethorphan Abuse and its Anesthetic Implications

    Science.gov (United States)

    Linn, Kelly A; Long, Micah T; Pagel, Paul S

    2014-01-01

    Introduction: We describe a patient scheduled for elective surgery who regularly consumed approximately 12 to 15 times the maximum recommended daily dose of dextromethorphan. We describe the clinical pharmacology of dextromethorphan and discuss its anesthetic implications. Case Presentation: A 30-year-old man with a history of a nasal fracture was scheduled to undergo an elective septorhinoplasty. He reported daily consumption of large quantities (1440 to 1800 mg) of dextromethorphan for six years. He was previously treated for dextromethorphan dependency on several occasions with urine dextromethorphan levels exceeding 2000 ng/mL. He described marked dissociative effects when abusing the drug, but had abstained from use for 48 hours before his elective surgery. Considering that dextromethorphan has a relatively short half-life and that the patient did not suffer major withdrawal symptoms after voluntarily discontinuing the drug, the authors proceeded with the case while recognizing that the drug has significant neuropsychiatric and sympathetic nervous system stimulant effects resulting from its actions as a N-methyl-D-aspartate receptor antagonist. Conclusions: Anesthesiologists need to be aware of dextromethorphan’s clinical pharmacology because recreational abuse of the drug has become increasingly common in adolescents and young adults. PMID:25793175

  14. Cleft lip and palate: recommendations for dental anesthetic procedure based on anatomic evidences.

    Science.gov (United States)

    Trindade-Suedam, Ivy Kiemle; Gaia, Bruno Felipe; Cheng, Cheong Kuo; Trindade, Paulo Alceu Kiemle; Bastos, José Carlos da Cunha; Mattos, Beatriz Silva Câmara

    2012-02-01

    Patients with cleft lip and palate usually present dental anomalies of number, shape, structure and position in the cleft area and the general dentist is frequently asked to restore or extract those teeth. Considering that several anatomic variations are expected in teeth adjacent to cleft areas and that knowledge of these variations by general dentists is required for optimal treatment, the objectives of this paper are: 1) to describe changes in the innervation pattern of anterior teeth and soft tissue caused by the presence of a cleft, 2) to describe a local anesthetic procedure in unilateral and bilateral clefts, and 3) to provide recommendations to improve anesthetic procedures in patients with cleft lip and palate. The cases of 2 patients are presented: one with complete unilateral cleft lip and palate, and the other with complete bilateral cleft lip and palate. The patients underwent local anesthes