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Biomedical subjects

M Vercauteren

Publications and source records attributed to M Vercauteren.

At least 19 recordsLinked to original sources

Isobolographic analysis of the interaction between epidural sufentanil and bupivacaine in rats.

The present study was performed to evaluate the nature of the interaction between epidurally administered sufentanil and bupivacaine in producing antinociception in rats. Rats in which epidural catheters had been inserted received epidural injections with bupivacaine and sufentanil. Nociception was tested by use of the tail-withdrawal reaction (TWR) test and the hot-plate test. Isobolographic analyses were performed with fixed and variable dose ratio treatment schedules based on the ED50s and the highest inactive concentrations of the compounds in both tests. In the TWR test, a synergistic interaction was obtained between the two compounds independent of whether a variable dose ratio regimen (with either 0.08 microgram/rat sufentanil or 80 micrograms/rat bupivacaine as the preset component) or a fixed dose ratio of 1/1,000 sufentanil/bupivacaine (based on the individual ED50s) was used. In the hot-plate test, a synergistic interaction was observed only in the variable dose ratio regimen with 0.08 microgram/rat sufentanil as the preset component and in the fixed dose ratio regimen of 1/1,000 sufentanil/bupivacaine (a ratio based on the ED50 values of the TWR test) but not with a ratio of 1/200, as demonstrated by the ED50s of both drugs in the hot-plate test. The interaction between epidurally administered bupivacaine and sufentanil seems to be synergistic for both tests when variable and fixed dose ratios are used. The synergism could be more easily demonstrated in the TWR test. For drugs with a segmental action, the hot-plate test seems to be less optimal. The necessity of a minimal critical amount of bupivacaine to obtain synergism may have clinical implications.

Analgesia, Epidural

Secular changes in growth and maturation: an update.

Secular changes in growth and maturation in recent decades have been reviewed for various populations. The secular increase in attained height during the growth period is continuing in most countries, but has slowed down. The increase in adult stature over the past decades has varied between 0.3 and 3.0 cm/decade. The secular trend in the tempo of growth (earlier menarche and peak height velocity, and shortening of the growth cycle) has come to a halt in some populations, but is continuing or has been reversed in others. The secular trend in attained height and in the tempo of growth is usually more pronounced in children from low socioeconomic backgrounds, in those with poorly educated parents or in those from rural areas. It is concluded that updates of growth standards are required in all populations. More marked secular changes appear to occur in the lower height centiles, which may have direct implications on the future definition of 'short stature' in a population.

Body Height

Intravenous regional anesthesia. Evaluation of 4 different additives to prilocaine.

Intravenous regional anesthesia (IVRA) is an effective method of producing anesthesia of the extremities. Disadvantages are the rapid loss of anesthesia after the deflation of the tourniquet and the rapid development of postoperative pain. This study compared the effect of four different additives to prilocaine with saline on the development of a complete sensory block, on the return of sensory function after deflation of the tourniquet and on the development of postoperative pain after IVRA for minor orthopedic surgery of the arm. Seventy-five patients, ASA class 1 or 2, were randomly divided into 5 groups. All patients received 30 ml. of prilocaine 1%, together with 5 ml. of additive. In group 1, the additive was saline, in group 2 bupivacaine 0.25%, in group 3 clonidine 150 micrograms in saline, in group 4 sufentanil 25 micrograms in saline and in group 5 tenoxicam 20 mg. The development of a complete sensory block proved significantly faster in the patients receiving sufentanil (4.8 min.) as compared to plain prilocaine (7.5 min.). The return of the sensory function was comparable for all groups. Postoperative pain scores were significantly better in the clonidine and tenoxicam groups.

Adjuvants, Anesthesia

Secular changes in growth.

Secular changes in growth have occurred in almost all industrialized countries during the last century. Almost all of the secular increase seen in adult height occurs during childhood. These changes can be considered to be indicators of the changes in the nutritional, hygienic and health status of a population. The secular trend in adult height has slowed down since the second world war, but is still continuing in most industrialized countries.

Adolescent

Successful treatment of postherpetic neuralgia with oral ketamine.

OBJECTIVE: To demonstrate the possibilities of the use of oral ketamine in the treatment of postherpetic neuralgia. SETTING: A pain clinic in a university hospital. PATIENT: A patient with postherpetic neuralgia of the ophthalmic nerve. INTERVENTION: Subcutaneous and later oral ketamine after classical treatment had failed. RESULTS: A complete recovery was accomplished without any sign of side effects. CONCLUSIONS: Oral ketamine may provide an alternative in the treatment of postherpetic neuralgia. The possible mechanism of action by its N-methyl-D-aspartate (NMDA) blocking properties is discussed.

Administration, Oral

The time course of a sixth nerve paresis following epidural anesthesia.

An isolated sixth nerve palsy is seldom seen following epidural anesthesia. An unintentional puncture through the dura may cause a leak of cerebrospinal fluid resulting in a shift of the cerebral content. This may cause a stretching of the sixth cranial nerve giving an abduction palsy. The palsy is benign and resolves completely within two months. The time course of a case will be described.

Abducens Nerve

[Reference values of the height and weight growth and growth rate of Belgian boys and girls 3-18 years of age].

BACKGROUND: Belgian growth standards have until now been based on cross-sectional studies. This paper describes the first Belgian longitudinal growth standards for height and height velocity and recent cross-sectional standards of weight-for-age. POPULATION AND METHODS: The study was conducted between 1955 and 1975, initially on 259 Belgian boys and girls born in Brussels between 1955 and 1958. Only 48 boys and 50 girls were still being checked for height and weight at the end of the study. The distance charts show the classical centile lines; the height standards are provided with growth curves for the typical early average and late-maturing child in the population. The velocity charts show centiles for whole-year increments in height. Individual-type velocity curves are also provided. RESULTS: Comparison between these standards and those for British children shows that the Belgian children (essentially the girls) are taller than the British, probably due to more rapid maturation.

Adolescent

Spinal sufentanil in rats: Part I: Epidural versus intrathecal sufentanil and morphine.

Male Wistar rats were injected epidurally or intrathecally with increasing doses of sufentanil or morphine in order to determine differences in potency, onset and duration of analgesia and supra-spinal side-effects. For sufentanil, only small differences in the lowest ED50-values for analgesia and supra-spinal side-effects were observed between the two spinal routes. Given intrathecally, sufentanil had a somewhat faster onset but a shorter duration of action than did epidural sufentanil. However, intrathecal morphine when compared to epidural morphine had a faster onset with a greater potency and a longer duration of action. The stronger opioid activity of intrathecal morphine was also reflected in a reduced safety ratio for the blockade of the cornea reflex. These differences between the two opioids, with regard to their optimal route of spinal administration, are discussed in terms of lipophilicity and optimal clinical use.

Analgesia, Epidural

Spinal sufentanil in rats: Part II: Effect of adding bupivacaine to epidural sufentanil.

Male Wistar rats were injected epidurally with various doses of sufentanil, bupivacaine or sufentanil combined with bupivacaine either 40 or 80 micrograms. Addition of 80 micrograms bupivacaine to sufentanil produced a 2.2- to 3-fold decrease of the lowest ED50 for a tail withdrawal reaction latency greater than 6 and greater than or equal to 10 s. The potentiation was already present at low doses. Whereas both 0.16 microgram sufentanil and 80 micrograms bupivacaine were inactive, the combination of the two drugs resulted in a deep analgesia in all animals. Because the addition of low doses of bupivacaine to sufentanil did not increase the ED50's for side-effects, higher specificity ratios were obtained as compared to sufentanil given alone. These results were discussed with regard to the potentiation of the analgesic properties of epidurally administered lipophilic opioids by local anaesthetics.

Analgesia, Epidural

Spinal sufentanil in rats: Part III: Effect of diluent volume on epidural sufentanil.

Male Wistar rats were injected epidurally with various doses of sufentanil in 3 different dilution volumes, in order to determine differences in the lowest ED50 values for analgesia and side-effects. The lowest ED50 for both a TWR latency greater than 6 and greater than or equal to 10 s was significantly lower in the 20-microliters group as compared to the 2-microliters group. With an injection of 5 microliters, intermediate values were obtained. With regard to the side-effects, there was a trend towards increased systemic resorption with larger diluent volumes in spite of a better and more selective spinal effect, as evidenced by increasing specificity ratios. In terms of duration of analgesia at fixed doses of sufentanil, different results were obtained. At low doses of sufentanil, a pronounced diluent volume effect was present and the duration of analgesia increased as a function of the volume. At higher doses of sufentanil, however, the volume effect faded away and no differences were observed as a function of the diluent.

Analgesia, Epidural

Transcutaneous electrical stimulation (TCES) for the treatment of adolescent idiopathic scoliosis: preliminary results.

The authors report on the results of a preliminary study on the treatment of progressive idiopathic scoliosis by electrical surface stimulation. The study, involving 30 spinal curvatures, showed stabilization of the median primary curvature (30 degrees) in the course of treatment, the median duration of which was 12 months. Overall, 73.2% of the curvatures treated, responded favorably (stabilization or regression of the curve); however, 26.8% of the curvatures progressed in spite of the transcutaneous electrical stimulation treatment. The only complication noted was contact eczema in 20% of the cases. The authors feel that surface electrical stimulation treatment can be regarded as an acceptable alternative to a brace in the treatment of idiopathic scoliosis, and at this stage it deserves a place in the conservative therapeutic approach to idiopathic scoliosis.

Adolescent

Comparison of epidural sufentanil plus clonidine with sufentanil alone for postoperative pain relief.

Sufentanil 25 micrograms plus clonidine 1 microgram/kg administered epidurally was compared with epidural sufentanil 50 micrograms alone in a double-blind fashion for pain relief in 40 patients after abdominal surgery. The duration of complete pain relief was significantly longer in those who received the mixture. Oxygen saturation was reduced 10 and 20 minutes after sufentanil alone, but remained stable after sufentanil and clonidine. There were significant decreases in arterial blood pressure in the latter group that were maximum between 20 and 120 minutes after administration.

Adult