Search PubMed⌕ Search

Biomedical subjects

H Bouaziz

Publications and source records attributed to H Bouaziz.

At least 37 records · Page 2Linked to original sources
PubMed2001

Resveratrol decreases hyperalgesia induced by carrageenan in the rat hind paw.

The effect of resveratrol, an aryl hydrocarbon receptor (AhR) antagonist, known to inhibit inducible cyclooxygenase-2 (COX2) and its transcription were examined in a model of hyperalgesia induced by carrageenan in the rat. Pretreatment with resveratrol did not reverse swelling and edema, but reversed the hyperalgesia induced by local tissue injury provoked by carrageenan. This reversal, occurring at resveratrol concentrations as low as 2 mg/kg, lasted for at least 48 hours. The link with COX2 activity inhibition and COX2 gene transcription, as well as a potential AhR inhibitory effect, remain to be established.

Animals↗
PubMed2001

[Oculomotor paralysis and spinal anesthesia].

We describe a case of a parturient scheduled for Caesarean section in whom diplopia from abducens (sixth cranial) nerve palsy followed spinal anaesthesia performed with a 25 gauge Whitacre needle. After delivery, the patient experienced neckache, diplopia and postural headache successively. These symptoms were related to the dural puncture. Despite two consecutive epidural blood patches, no improvement of diplopia was observed. In 8 months, the nerve palsy had completely resolved.

Abducens Nerve Diseases↗
PubMed2001

[Comparison between 1.5% lidocaine with adrenaline and 1.5% plain mepivacaine in axillary brachial plexus block].

OBJECTIVES: To evaluate the distribution of sensory blockade, the onset time and the duration of the axillary plexus block obtained after the administration of 40 mL of 1.5% lignocaine with adrenaline or 40 mL of plain 1.5% mepivacaine. STUDY DESIGN: Prospective, randomised, comparative, double blind study. PATIENTS AND METHODS: One hundred and fifty five patients undergoing hand surgery were randomised into two groups: in group L, 73 patients were given 1.5% lignocaine with 1/200,000 adrenaline and in group M, 82 patients received 1.5% mepivacaine. The entire volume was injected on the first evoked motor activity obtained for a current less than 0.5 mA. Sensory and motor block of each of the four major nerves of the hand and forearm were assessed using light touch and motor strength respectively. The block was considered complete when all nerves were anaesthetised (median, radial, musculocutaneous and ulnar). RESULTS: The percentage of complete sensitive blockade was 22% in group L and 24% in group M. Complete motor blockade was respectively 27% in group L and 40% in group M. The median time required to obtain a complete sensory blockade was 18 min for both group. The median time required to obtain a complete motor blockade was 17 min in-group L and 16 min in-group M. The duration of the sensory blockade was not different for both groups (i.e., 255 +/- 76 min versus 231 +/- 70 min in group L and M respectively. The duration of the motor blockade was longer in group L compared to group M (199 +/- 64 min versus 231 +/- 74 min respectively, p < 0.05). CONCLUSION: Following axillary plexus block, 1.5% mepivacaine improves neither the extension nor the duration of sensory blockade achieved by 1.5% lignocaine with adrenaline.

Anesthetics, Local↗
PubMed2001

Lack of peripheral analgesia mediated by intraplantar administration of neostigmine in carrageenan-injected rats.

BACKGROUND AND OBJECTIVE: The aim of the study was to test the peripheral analgesic action of neostigmine. Intraplantar administration of neostigmine was studied in carrageenan-injected rats. METHODS: After assessing baseline values (T0) for paw circumference and the paw withdrawal threshold on both hind paws, the right hind paw was injected with 0.2 mL of 1% carrageenan and the left hind paw with 0.2 mL of saline (0.9% NaCl). Two hours later (T1), both hindpaws were tested for inflammation (paw circumference) and for hyperalgesia (paw withdrawal threshold) and subsequently 20 microg of neostigmine was injected in the right hind paw. The paw withdrawal threshold was tested again 10 (T2), 20 (T3) and 60 min (T4) and paw circumference 60 min (T4) after neostigmine injection. RESULTS: Carrageenan injection in the right hindpaw was associated with a decrease in the paw withdrawal threshold reflecting mechanical hyperalgesia (P < 0.001) and an increase in paw circumference reflecting oedema (P < 0.001) in the right hind paw when compared with the left side from T1 to T4. Neostigmine had no effect on paw circumference and the paw withdrawal threshold at measuring points T2, T3 and T4 when compared with T1 in the right hindpaw. CONCLUSION: Our results support the lack of peripheral analgesic effect of neostigmine.

Analgesics↗
PubMed2000

Effect of CO(2) pneumoperitoneum on early cellular markers of retinal ischemia in rabbits with alpha-chymotrypsin-induced glaucoma.

BACKGROUND: Increased intraperitoneal pressure in the head-down position is associated with a significant increase in intraocular pressure (IOP) in rabbits with alpha-chymotrypsin-induced glaucoma. Also, the retinal cells are weakened by the induction of increased IOP, and/or glaucoma, even when IOP is controlled by adequate therapy; therefore, these cells need to be protected from any additional aggression. Actin and vimentin are proteins of the retinal cell cytoskeleton that react readily in response to retinal injuries, including ischemia and glaucoma. Early changes in these cytoskeleton proteins determine the morphological changes observed after retinal damage. Therefore, we set out to investigate intracytoplasmic changes in vimentin and actin after a 4-h CO(2) pneumoperitoneum in the head-down position in rabbits with alpha-chymotrypsin-induced glaucoma. METHODS: Twenty-one rabbits with alpha-chymotrypsin-induced glaucoma in one eye received general anesthesia for 4 h in the head-down position and were randomly allocated to have (a) no pneumoperitoneum, (b) a 10 mmHg CO(2) pneumoperitoneum, or (c) a 20 mmHg CO(2) pneumoperitoneum. At the end of the trial, both the right glaucomatous and the left control eyes were enucleated and investigated immunocytochemically for alterations in vimentin and actin, and morphologically for retinal layer disorganization. RESULTS: Except for the preexisting morphological changes induced by glaucoma, both the control and the glaucomatous eyes in all rabbits appeared normal in terms of retinal layer organization and the distribution of intracellular vimentin and actin whatever the intraperitoneal pressure level applied. CONCLUSION: In rabbits with alpha-chymotrypsin-induced glaucoma, a 4-h CO(2) pneumoperitoneum of </=20 mmHg in the head-down position did not induce either retinal layer disorganization or alteration of actin or vimentin.

Actins↗
PubMed2000

[Postoperative pain and surgical treatment of trapeziometacarpal osteoarthritis of the thumb after ambulatory surgery].

OBJECTIVE: The course of pain and the incidence of the side effects from analgesics were evaluated for 15 days in 26 consecutive outpatients who underwent a surgical cure of trapeziometacarpal osteoarthritis of the thumb under regional block. STUDY DESIGN: Prospective study. METHODS: The analgesic regimen prescribed at discharge consisted on a regular administration of a combination of ketoprofen (50 mg.6.h-1) plus the association of acetaminophen and propoxyphene (two tablets.6.h-1). Patients were asked to evaluate their pain using a numerical rating scale graduated from 0 to 10. Data were collected during a telephone interview at day 4, 8 and 15. RESULTS: Overall, patients scrupulously followed the medical prescription. At day four, 80% of patients still needed analgesics. The mean period during which NSAID, acetaminophen and propoxyphene were maintained was 4 and 6 days respectively. Fifty percent of patients reported severe pain during postoperative day 1 and 2. Moderate pain was reported at day 3 and 4 in respectively 54% and 42% of cases. Beyond this period, most patients indicated pain of weak intensity (71% at day 8). Epigastric pain has been noticed for 27% of patients. CONCLUSION: The surgical correction of trapeziometacarpal osteoarthritis of the thumb is frequently performed according to an ambulatory setting. The fact that 50% of patients reported severe pain during the early postoperative period emphasize the inadequacy of our postoperative pain management for this surgical procedure.

Acetaminophen↗
PubMed2000

Analgesic effect of low-dose intrathecal morphine and bupivacaine in laparoscopic cholecystectomy.

We assessed the peri-operative analgesic efficiency of low-dose intrathecal morphine combined with a low dose of bupivacaine after elective laparoscopic cholecystectomy since postoperative pain in such procedures, although less than after a conventional open technique, may be significant, particularly during the first 12-24 h. After informed consent, 34 ASA I or II patients were randomly allocated to one of two groups to receive either a lumbar intrathecal injection of morphine (75 or 100 microg) combined with 5 mg of isobaric bupivacaine (spinal group) or a subcutaneous injection of a saline solution (control group). Intra-operatively, opioid requirements, blood pressure response and heart rate changes after insufflation were recorded. Postoperatively, morphine requirements, pain scores and opioid-related side-effects were assessed by a physician blinded to the randomisation. Intra-operative opioid requirements did not differ significantly between groups. Mean (SD) postoperative morphine requirements were significantly lower in the spinal group [13 (10) vs. 23 (10) mg; p = 0.04] as were postoperative pain scores (p < 0.001). Side-effects were of comparable incidence and severity between groups. Low-dose intrathecal morphine combined with low-dose bupivacaine provided effective postoperative analgesia for elective laparoscopic cholecystectomy.

Adult↗
PubMed2000

Sufentanil does not prolong the duration of analgesia in a mepivacaine brachial plexus block: a dose response study.

UNLABELLED: To date, results of studies evaluating the efficacy of opioids and local anesthetic combinations in the brachial plexus are inconclusive. We examined whether increasing sufentanil in doses of 5, 10, and 20 microg decreased onset time or increased duration of an axillary brachial plexus block. Ninety-two patients scheduled for carpal tunnel release under axillary brachial plexus block were enrolled in the study. Patients were randomized to receive axillary plexus block with 40 mL 1.5% mepivacaine and saline (Group 1), sufentanil 5 microg (Group 2), 10 microg (Group 3), or 20 microg (Group 4). Onset and duration of sensory and motor block were measured. Opioid-related side effects were recorded. The addition of sufentanil did not improve speed of onset or increase the duration of sensory or motor block. Paradoxically, duration of sensory and motor block was longest in the control group: sensory, 241 min (188-284) and motor, 234 min (128-305), and decreased with increasing doses of sufentanil in Group 4: sensory, 216 min (115-315) and motor, 172 min (115-260) (P < 0.05). Side effects occurred in 55% of patients belonging to Groups 2 and 4, and in 60% of the patients in Group 3. In contrast, only 10% of the patients reported side effects in the control group. We conclude that sufentanil added to mepivacaine does not increase the onset or prolong the duration of an axillary plexus block. Furthermore, the addition of sufentanil was associated with a frequent incidence of side effects. IMPLICATIONS: This study demonstrates that the addition of sufentanil in a dose-dependent manner to 1.5% mepivacaine in the axillary plexus does not improve onset or duration of blockade, and that this admixture is associated with an increased incidence of side effects.

Adult↗
PubMed2000

Sedation with sufentanil and midazolam decreases pain in patients undergoing upper limb surgery under multiple nerve block.

Multiple nerve blocks may be painful and a source of discomfort. We assessed the efficacy of sufentanil 5 microg combined with midazolam 1 mg in decreasing pain in outpatients after a midhumeral multiple nerve stimulation technique. Visual analog scores for pain were significantly lower in those patients who received sedation before the block, both at the time of block performance (14 +/- 1 vs 27 +/- 2 mm, P < 0.0001) and at discharge (11 +/- 1 vs 24 +/- 2 mm, P < 0. 0001). We conclude that the association of sufentanil and midazolam produced minimal sedation while significantly reducing pain experienced by patients undergoing multiple nerve stimulation.

Adult↗
PubMed2000

Comparative ventricular electrophysiologic effect of racemic bupivacaine, levobupivacaine, and ropivacaine on the isolated rabbit heart.

BACKGROUND: Numerous local anesthetics have an asymmetric tetrahedron carbon, which confers stereoselective differences between the isomers. The authors attempted to quantify the depressant effect of racemic bupivacaine, levobupivacaine, and ropivacaine on myocardial ventricular conduction and on myocardial contractility. METHODS: The authors studied the pharmacokinetics (outflow concentration) and pharmacodynamics (QRS widening) of the three drugs infused in an isolated rabbit heart preparation. All data were fitted simultaneously with use of mixed-effect modeling, thus allowing precise statistical comparison between the three drug parameters. The rate dependence of QRS widening was fitted separately. RESULTS: Racemic bupivacaine, levobupivacaine, and ropivacaine induced a calculated maximum increase in QRS duration in the ratio 1:0.4:0.3. Css50, the dose which caused half the maximum increase in QRS duration at steady state, was similar for all three drugs (22 micrometer free concentration). A rate dependence of QRS widening was observed, which was in the ratio 1:0.5:0.25 for racemic bupivacaine, levobupivacaine, and ropivacaine, respectively. CONCLUSIONS: In the isolated rabbit heart, racemic bupivacaine, levobupivacaine, and ropivacaine induce an increase in QRS duration in the respective ratio of 1:0.4:0.3, which was rate dependent in approximately the same ratio.

Amides↗
PubMed1999

Audit of ketoprofen prescribing after orthopedic and general surgery.

PURPOSE: In 1994, we developed a practice guideline which stated that ketoprofen should be used in every adult patient after surgical procedures for which at least moderate pain was anticipated. The dose recommended was 50 mg every six hours i.v. in the operating room followed by oral administration as soon as possible for three days. The purpose of this study was to evaluate the success of the guideline implementation. METHODS: In 1995, an audit performed by a research pharmacist assistant under the supervision of the authors analysed prospectively the files of patients scheduled for orthopedic or general surgery during a one-month period. The compliance of the nurses was also recorded. RESULTS: Of 185 patients operated upon during the period, seven were transferred to the ICU and were not evaluated. Ketoprofen was not prescribed to 112 (63%) of the 177 remaining patients, either because minor pain was expected (n = 55) or because one or several contra-indications to its use were detected. In cases where ketoprofen was used although theoretically contraindicated (11%), review of the medical records and interviews of anesthesiologists showed that prescription was guided by a risk/benefit analysis. In 18% of cases, nurses did not administer at least one dose of ketoprofen although medical prescription requested regular administration. CONCLUSION: Although the use of NSAIDs is still controversial, implementation by anesthesiologists of a practice guideline introducing ketoprofen for postoperative analgesia was successful and the nursing non-compliance rate to follow written orders was modest.

Administration, Oral↗
PubMed1999

Haemodynamic changes associated with portal triad clamping are suppressed by prior hepatic pedicle infiltration with lidocaine in humans.

Portal triad clamping (PTC) reduces venous return of blood to the heart. However, the decrease in cardiac index (CI) is associated with an unexpected increase in mean arterial pressure (MAP) and the 40% increase in systemic vascular resistance is greater than anticipated in compensation for the 10% decrease in CI. We hypothesized that a reflex elicited in the peritoneum accounted for this unanticipated haemodynamic response. Twenty patients undergoing liver resection were allocated randomly to have hepatic pedicle infiltration before PTC with either lidocaine 200 mg or placebo. MAP was recorded, and plasma osmolality and plasma concentrations of vasopressin, epinephrine, norepinephrine, dopamine, renin and endothelin were measured. After PTC, MAP increased significantly in the placebo group but decreased significantly in the lidocaine group. Plasma concentrations of vasopressin, epinephrine and norepinephrine increased significantly in the placebo group. Plasma concentrations of vasopressin decreased significantly in the lidocaine group, while plasma concentrations of epinephrine and norepinephrine were unchanged. A subsequent study in eight patients found that neither haemodynamic nor hormonal changes associated with PTC in the placebo group were altered by administration of lidocaine 200 mg i.m. before PTC.

Adolescent↗
PubMed1999

The age-related effects of epidural lidocaine, with and without epinephrine, on spinal cord blood flow in anesthetized rabbits.

UNLABELLED: The effect of epidural or spinal epinephrine when added to local anesthetics on spinal cord blood flow (SCBF)are controversial. We evaluated the effects of epidural lidocaine, with or without epinephrine, on spinal cord blood flow in young and adult rabbits receiving 2% plain lidocaine, 2% lidocaine with epinephrine (1:200,000), or saline epidurally. Colored microspheres were injected through the left ventricle 10 min before and 7.5 and 30 min after epidural injection. The organs (brain, heart, kidneys, and the L6-7 segment of the spinal cord) were analyzed for regional blood flow determination. A significant decrease in mean arterial pressure was observed after the administration of lidocaine, with or without epinephrine, in both adult and young animals compared with saline. SCBF did not change over time in adult rabbits. Conversely, a significant decrease in SCBF was observed in the two groups of young rabbits receiving lidocaine. This decrease correlated with the decrease in mean arterial pressure but did not correlate with the use of epinephrine. We conclude that any reduction in blood pressure occurring in pediatric patients receiving a combined epidural-general anesthetic may result in decreased SCBF. IMPLICATIONS: In young rabbits, any decrease in blood pressure was followed by a decrease in spinal cord blood flow, a decrease that did not correlate to the use of epinephrine and was not observed in adult animals. These data suggest that blood pressure should be monitored closely to promptly treat any decrease in blood pressure when combined epidural-general anesthesia is used in children.

Aging↗
PubMed1999

Reduction of blood loss and transfusion requirement by aprotinin in posterior lumbar spine fusion.

UNLABELLED: Aprotinin reduces blood loss in many orthopedic procedures. In posterior lumbar spine fusion, blood loss results primarily from large vein bleeding and also occurs after the wound is closed. Seventy-two patients undergoing posterior lumbar spine fusion were randomly assigned to large-dose aprotinin therapy or placebo. All patients donated three units of packed red blood cells (RBCs) preoperatively. Postoperative blood loss was harvested from the surgical wound in patients undergoing two- and/or three-level fusion for reinfusion. The target hematocrit for RBC transfusion was 26% if tolerated. Total (intraoperative and 24 h postoperative) blood loss, transfusion requirements, and percentage of transfused patients per treatment group were significantly smaller in the aprotinin group than in the placebo group (1935 +/- 873 vs 2809 +/- 973 mL per patient [P = 0.007]; 42 vs 95 packed RBCs per group [P = 0.001]; 40% vs 81% per group [P = 0.02]). Hematological assessments showed an identically significant (a) intraoperative increase in both thrombin-antithrombin III complexes (TAT) and in activated factor XII (XIIa) and (b) decrease in activated factor VII (VIIa), indicating a similar significant effect on coagulation in patients of both groups (P = 0.9 for intergroup comparisons of postoperative VIIa, XIIa, and TAT). Intraoperative activation of fibrinolysis was significantly less pronounced in the aprotinin group than in the placebo group (P < 0.0001 for intergroup comparison of postoperative D-dimer levels). No adverse drug effects (circulatory disturbances, deep venous thrombosis, alteration of serum creatinine) were detected. Although administered intraoperatively, aprotinin treatment dramatically reduced intraoperative and 24-h postoperative blood loss and autologous transfusion requirements but did not change homologous transfusion in posterior lumbar spine fusion. IMPLICATIONS: In our study, aprotinin therapy significantly decreased autologous, but not homologous, transfusion requirements in posterior lumbar spine fusion.

Adult↗
PubMed1999

No enhancement of sensory and motor blockade by neostigmine added to mepivacaine axillary plexus block.

BACKGROUND: Intrathecal neostigmine induces analgesia but also several side effects. Recently, 500 microg neostigmine administered intraarticularly was shown to produce postoperative analgesia without side effects. The authors' goal was to determine whether 500 microg neostigmine added to mepivacaine in axillary plexus block prolongs postoperative analgesia. In addition, they wanted to determine the incidence of side effects in patients undergoing hand surgery. METHODS: Sixty-nine outpatients scheduled for carpal tunnel syndrome repair with axillary plexus block were randomly assigned to one of three groups that received saline solution in the axillary plexus and subcutaneously (group 1), 500 microg neostigmine in the axillary plexus and saline solution subcutaneously (group 2), or saline solution in the axillary plexus and 500 microg neostigmine subcutaneously (group 3). Sensory and motor block in the four hand nerve distributions were assessed every 5 min for 30 min The duration of the sensory and motor blocks were assessed after operation. Side effects were also recorded. RESULTS: Neostigmine had no effect on sensory and motor block in any of the four nerve distributions, nor did it increase the median duration of sensory block (215 min; range, 120-330 min) compared with group 1 (247 min; range, 190-287 min) or group 3 (236 min; range, 160-280 min). Motor block was slightly shorter (P = 0.045) in group 3 (190 min; range, 135-285 min) compared with group 1 (218 min; range, 145257 min) and group 2 (215 min; range, 105-343 min). Gastrointestinal side effects occurred in 30% of patients in both neostigmine groups but not in group 1 (P < 0.05). CONCLUSIONS: This study suggests that 500 microg neostigmine added to mepivacaine in axillary plexus block does not prolong postoperative sensory block, but it does cause a relatively high incidence of side effects. These two findings raise doubts about the use of neostigmine associated with local anesthetics for plexus neural block.

Adult↗
PubMed1999

The lateral approach to the sciatic nerve at the popliteal fossa: one or two injections?

UNLABELLED: It has not been proven whether one or multiple nerve stimulations and injections provide a higher rate of complete sensory block in both major sciatic nerve sensory distributions below the knee when a popliteal sciatic nerve block is performed using the lateral approach. This prospective, randomized, single-blinded study compared the success rate of the sciatic nerve block using this approach when one or both major components of this nerve (i.e., tibial nerve and common peroneal nerves) are stimulated in 50 patients undergoing foot or ankle surgery. In Group 1 STIM, 24 patients received a single injection of 20 mL of a mixture of 2% lidocaine and 0.5% bupivacaine with 1:200,000 epinephrine after foot inversion had been elicited. In Group 2 STIM (n = 26), 10 mL of the same solution was injected after stimulation of each sciatic nerve component. For patients with complete sensory motor block, there was no difference in onset between groups. However, Group 2 STIM showed a greater success rate compared with the Group 1 STIM (2 STIM: 88% vs 1 STIM :54%; P = 0.007). When two stimulations were used, the onset time of anesthesia in the cutaneous distribution of the common peroneal nerves was shorter than in the tibial nerve (17.5 vs 30 min; P < 0.0001). We conclude that a two-stimulation technique provides a better success rate than a single-injection technique when a popliteal sciatic nerve block is performed using the lateral approach with 20 mL of local anesthetic. IMPLICATIONS: A better success rate is achieved with a double stimulation technique than with a single injection for the sciatic nerve block via the lateral approach at the popliteal fossa when 20 mL of local anesthetics is used.

Adult↗