PubMed · 9469989
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J W Nielsen. 1998-02-02. [Codeine and paracetamol].. https://pubmed.ncbi.nlm.nih.gov/9469989/
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OBJECTIVE: To assess the analgesic efficiency of a continuous iliofascial nerve sheath block after total hip arthroplasty replacement (RPTH). STUDY DESIGN: open and prospective pilot study. PATIENTS AND METHODS: Before induction of general anaesthesia (GA), an iliofascial catheter was inserted (group KT, n = 11) or not (group NKT, n = 10). In the KT group, 30 ml of ropivacaïne 4,75 mg/ml (maximum dose) were injected, and 14 mg/h of ropivacaïne 2 mg/ml were infused during the first 48 postoperative hours. All patients underwent a standardized GA and a multimodal postoperative analgesia with a intravenous PCA morphine, paracetamol and tramadol during the first 48 hours. Postoperative pain assessment which was achieved using visual analogic scores (VAS) at rest (EVAr) and on movement (EVAm), total morphine consumption, and side effects were collected during the first 48 hours. Statistical analysis was performed using a Mann and Whitney test for the quantitative values and a chi 2 exact test for the qualitative values. Data are expressed as median [interquartile range]. RESULTS: Total morphine consumption was lower in the KT group with a total amount of 26 mg [11-48] versus 77.5 mg [55-91] (p = 0.007) at h48. EVAr and EVAm were lower in the KT group at h4, h8, h24, h36 for the EVAr and during the 48 postoperative hours for EVAm. Three patients experienced nausea and/or vomiting in the KT group versus 6 in the NKT group (p = 0.05). CONCLUSION: After RPTH surgery, continuous iliofascial block reduces morphine consumption; provide a better pain relief at rest and on movement than IV multimodal analgesia alone.
Pharmaceuticals are manufactured and used for specific biological functions in veterinary and human medicine. Their detection in the environment and their bioactivity have resulted in concern for potential adverse effects on non-target species. Notwithstanding recent attention for their occurrence in the environment, there are significant research gaps for existing pharmaceuticals with regard to their potential ecological consequences. In this study, the four most abundantly used pharmaceuticals in Korea, namely acetaminophen, carbamazepine, cimetidine, and diltiazem, and six sulfonamide related antibiotics, including sulfamethoxazole, sulfachlorpyridazine, sulfathiazole, sulfamethazine, sulfadimethoxine, and trimethoprim were examined for their acute aquatic toxicity employing a marine bacterium (Vibrio fischeri), a freshwater invertebrate (Daphnia magna), and the Japanese medaka fish (Oryzias latipes). In general, Daphnia was the most susceptible among the test organisms. The most acutely toxic among the chemicals tested in this study was diltiazem, with a median lethal concentration of 8.2 mg/L for D. magna. The resulting acute toxicity of these pharmaceuticals was reasonably predicted by physicochemical descriptors such as pH-dependent distribution coefficient and EHOMO-ELUMO gap. Predicted environmental concentrations (PECs) derived for the test pharmaceuticals in Korea ranged between 0.14 and 16.5 microg/L. Hazard quotients derived from PECs and predicted no effect concentrations (PNECs) for sulfamethoxazole and acetaminophen were 6.3 and 1.8, respectively, suggesting potential environmental concerns and a need for further investigation.
The effect of acetaminophen, a well known analgesic and fever-reducing medicine, on the calcium carbonate crystal growth was investigated under plethostatic conditions. The calcification rates measured was reduced by 9.1-63.2% in the presence of acetaminophen. Kinetic analysis according to a Langmuir-type adsorption isotherm lead to the calculation of an affinity constant K (aff) = 8.33 x 10(2 )dm(3 )mol(-1). The apparent order found from kinetic data was two suggesting a surface diffusion controlled spiral growth mechanism.