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Blind Fashion (blind + fashion)
Selected AbstractsSparing the larynx during gynecological laparoscopy: a randomized trial comparing the LMA SupremeÔ and the ETTACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 2 2010W. ABDI Background: We designed a prospective randomized single-blind study to compare efficiency and post-operative upper airway morbidity when the laryngeal mask airway (LMA) SupremeÔ is used as an alternative to the endotracheal tube (ETT). Methods: One hundred and thirty-eight elective pelvic laparoscopic ASA I,II female patients were assigned to receive either the LMA Supreme® or the ETT for airway management. Balanced anesthesia and ventilation techniques were standardized to control end-tidal CO2 and BIS value in the range 4.5,5 kPa and 40,50, respectively, and to maintain adequate hemodynamic stability. A single surgeon blinded to the airway management technique performed all surgical procedures. The ventilation efficiency of each airway was evaluated. Anesthesia- and surgery-related times were calculated and anesthesia details were recorded. Post-operative pain and pharyngolaryngeal morbidity were measured in a blind fashion using a numerical rating scale (NRS) (0,100). Results: Surgery duration was similar in both groups. Airway management duration was shorter with the LMA Supreme®. Post-operative pharyngolaryngeal morbidity incidence and all symptoms' intensity were significantly increased after ETT as compared with LMA Supreme® anesthesia. At the end of the PACU stage, the incidence and mean NRS of post-operative hoarseness were reduced when LMA Supreme® was used as an alternative to the ETT (16% vs. 47%; P<0.01 and 9 vs. 19, P<0.01, respectively). Conclusion: We demonstrated that choosing an LMA Supreme® was an efficient pharyngolaryngeal morbidity-sparing strategy. Moreover, we showed that the LMA Supreme® and the ETT were equally effective airways for a routine gynecological laparoscopy procedure. [source] Long-lasting infiltration anaesthesia by lidocaine-loaded biodegradable nanoparticles in hydrogel in ratsACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 9 2009Q.-Q. YIN Background: Infiltration of a long-lasting anaesthetic is helpful during the post-operative period. The recently developed local drug delivery system, biodegradable nanoparticles in a thermo-sensitive hydrogel (nanogel system), may possibly provide an extended duration of drugs. Therefore, we evaluated whether prolonged infiltration anaesthesia could be achieved by loading lidocaine into this delivery system. Methods: Thirty male rats were randomized into five groups of six rats each: saline; 2% hydrochloride lidocaine solution; lidocaine-loaded nanogel system and its compositing formulations, namely lido,nano gel; lido,nano; and lidogel. Durations of local anaesthesia with subcutaneously injected agents were measured by tail flick latency tests in a randomized, blind fashion. Results: Lido,nano gel produced effective anaesthesia for 360±113 min, compared with 150±33 min by lidogel, 180±37 min by lido,nano, and 110±45 min by lidocaine solution (P<0.001, means±SD), and elicited complete sensory blockade for 300±114 min, compared with 75±37 min by lidogel, 105±53 min by lido,nano, and 60±33 min by lidocaine solution (P<0.001, means±SD) without severe skin/systemic toxicity. Conclusion: Lidocaine-loaded biodegradable nanoparticles in hydrogel produced prolonged infiltration anaesthesia in rats without severe toxicity, indicating a possible way to develop long-lasting local anaesthetics. [source] Single-nucleotide polymorphisms in the IL-4 and IL-13 promoter region in aggressive periodontitisJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 6 2007J. R. Gonzales Abstract Introduction: IL-4 and IL-13 polymorphisms have been shown to influence the susceptibility to systemic diseases. In this study, possible associations between the IL-4 ,590 C,T, IL-4 ,34 C,T, IL-13 ,1112 C,T and IL-13 ,1512 A,C promoter polymorphisms were investigated in subjects with generalized aggressive periodontitis (AgP) compared with healthy individuals. Material and Methods: Fifty-eight patients with diagnosis of generalized AgP and 51 matched healthy controls participated in the study. Blood samples were collected and DNA isolated. Molecular analyses were performed by PCR-RFLP in a blind fashion. Genotype and allele frequencies among study groups were compared using Fisher's exact test (, value: 0.05). Pearson's ,2 test was used for analysis of Hardy,Weinberg equilibrium. Results: The frequency of the IL-4 ,590 T/T and IL-4 ,34 T/T genotypes differed significantly between groups (p=0.05, 0.02, respectively), although the allele frequencies were similar. There was a higher frequency of the IL-4 ,590 T/T and IL-4 ,34 T/T genotypes in patients with AgP compared with controls. The genotype and allele frequencies of the IL-13 polymorphisms did not differ between groups. Conclusions: This study demonstrated an association between the IL-4 ,590 T/T and IL-4 ,34 T/T genotypes and AgP. Further research is necessary to prove if there is an association of these polymorphisms with AgP, and if the polymorphisms have a functional effect. [source] Propofol,ketamine vs propofol,fentanyl combinations for deep sedation and analgesia in pediatric patients undergoing burn dressing changes,PEDIATRIC ANESTHESIA, Issue 1 2008ZEYNEP TOSUN MD Summary Background:, The aim of this study was to compare propofol,ketamine (PK) and propofol,fentanyl (PF) combinations for deep sedation and analgesia in pediatric burn wound dressing changes. Methods:, Thirty-two ASA physical status II and III inpatients with a second degree total burn surface area ranging from 5% to 25% were studied in a randomized, double blind fashion. Heart rate, systolic arterial pressure, peripheral oxygen saturation, respiratory rate and Ramsey sedation scores of all patients were recorded perioperatively. Patients were randomly assigned to receive either PK or PF: PK group (n = 17) received 1 mg·kg,1 ketamine + 1.2 mg·kg,1 propofol, and PF group (n = 15) received 1 ,g·kg,1 fentanyl + 1.2 mg·kg,1 propofol for induction. Additional propofol (0.5,1 mg·kg,1) was administered when the patients showed discomfort in both groups. If the patient showed discomfort and/or increase in heart rate or systolic arterial pressure, despite additional propofol dose, additional bolus of 0.5,1 mg·kg,1 ketamine or 0.5,1 ,g·kg,1 fentanyl was administered. Results:, There were no significant differences in heart rate, systolic arterial pressure, peripheral oxygen saturation, respiratory rate and sedation scores during the procedure between the groups. Restlessness during the procedure was seen in seven (47%) patients in Group PF and one (5.9%) patient in Group PK (P = 0.013). Conclusions:, Both propofol,ketamine and propofol,fentanyl combinations provided effective sedation and analgesia during dressing changes in pediatric burn patients. But propofol,ketamine combination was superior to propofol,fentanyl combination because of more restlessness in patients given propofol,fentanyl. [source] Urine NGAL and IL-18 are Predictive Biomarkers for Delayed Graft Function Following Kidney TransplantationAMERICAN JOURNAL OF TRANSPLANTATION, Issue 7 2006C. R. Parikh Delayed graft function (DGF) due to tubule cell injury frequently complicates deceased donor kidney transplants. We tested whether urinary neutrophil gelatinase-associated lipocalin (NGAL) and interleukin-18 (IL-18) represent early biomarkers for DGF (defined as dialysis requirement within the first week after transplantation). Urine samples collected on day 0 from recipients of living donor kidneys (n = 23), deceased donor kidneys with prompt graft function (n = 20) and deceased donor kidneys with DGF (n = 10) were analyzed in a double blind fashion by ELISA for NGAL and IL-18. In patients with DGF, peak postoperative serum creatinine requiring dialysis typically occurred 2,4 days after transplant. Urine NGAL and IL-18 values were significantly different in the three groups on day 0, with maximally elevated levels noted in the DGF group (p < 0.0001). The receiver,operating characteristic curve for prediction of DGF based on urine NGAL or IL-18 at day 0 showed an area under the curve of 0.9 for both biomarkers. By multivariate analysis, both urine NGAL and IL-18 on day 0 predicted the trend in serum creatinine in the posttransplant period after adjusting for effects of age, gender, race, urine output and cold ischemia time (p < 0.01). Our results indicate that urine NGAL and IL-18 represent early, predictive biomarkers of DGF. [source] | ||||||||||