- Email: [email protected]
The prostaglandin inhibitory effect and analgesic potency of flurbiprofen ester incorporated in lipid emulsion(IV)
S52
EFFECT OF INTRAVENOUS INDOMETHACIN INJECTION ON BLOOD PRES SURE AND HEART RATE. M.A.K. Mattila and uni,:::::;""l':"i~j E. Kuopio Department of Anesthesiology, Hospital, SF-70210 Kuopio, Finland Aim of investigation: Intravenous indomethacin has proved to be effective in prevention of postoperative pain. Because individual components of prostaglandin cascade affect on blood pressure, vascular resistance and heart rate, it is logical that also an acute blockade of cyclooxygenase enzyme can result in changes of arterial blood pressure and heart rate. The aim of this study was to illuminate the circulatory consequencies of intravenous indomethacin in a typical clinical situation. Methods: 25 mg of intravenous indomethacin (ConfortidR Inj, Dumex AS, Copenhagen) was given postoperativelywithin 10 minutes using a syringepump followed by a continuous infusion of 5 mg/h. The material included 52 patients, who were administered a single dose lumbar epidural analgesia for soft tissue surgery. Blood pressure and heart rate were measured non-invasively every other minute for 30 minutes with an automatic device, Sentron. Results: Compared with the pretreatment values, there was a statistically significant increase during the initial injection of 9.6 mmHg in systolic and 9.0 mmHg in diastolic blood pressure in an average. This increase was, however, clinically not dangerous, because the increase was not more than 31 mmHg in any of the patients. Simultaneously the heart rate decreased by 8.7 beats per minute in an average, which was a significant change compared to the initial values. During the steady state phase the circulatory parameters returned to their original levels. Conclusions: The effective blockade of the prostaglandin synthesis can be seen in the acute circulatory changes during the initial injection period. Clinically these phenomena are not an obstacle for the use of indomethacin in prevention of postoperative pain. 99 Poster ANALGESIC THE PROSTAGLANDIN INHIBITORY EFFECT AND Non Room 3 POTENCY OF FLURBIPROFEN ESTER INCORPORATED IN LIPID EMLJLL-_Board 66 SION(IV). T. Momose, Department of Anesthesiology, Nagoya National Hospital, Nagoya 460, Japan. Aim of Investigation: Recently, there have bean frequent attempts to formulate lipid microspheric drugs since these intravenously injectables can, minimize the latent drug-related adverse reaction, enhance the drug's targetability to specific tissues and sustain a superior efficacy at diminished dosages. In this study, the prostaglandin inhibitory action and the analgesic potency of intravenous Flurbiprofen(Fp) emulsion have been determined in 168 volunteer surgical patients. Methods: A venous cut-down was made and dextranomerum (contained in a small cotton bag) was applied to the open wound for 2 hours in anesthetized patients undergoing operation. Prostaglandin was extracted from the cotton bag and measured by radioimmunoassayusing the antibody PGFzo. The test drugs had been administered 10 minutes before making cut-down. The changes in the Fp plasma concentrations were determined also hourly by sampling. The degree of post-operative pain was determined by hourly interviews. Results: The mean value of PGF20 was 4206pg in the control group, 202Opg in the Fp emulsion group and 1751pg in the IV aspirin group. A plasma half-life(T4) of Fp was about 4 hours. Conclusions: The optimal dose of 50mg of Fp emulsion for the postoperative pain was found to have a higher effective rate than the IV aspirin. The correlation of prostaglandin inhibition with analgesic scores will be presented.
EFFECT OF INTRAVENOUS INDOMETHACIN INJECTION ON BLOOD PRES SURE AND HEART RATE. M.A.K. Mattila and uni,:::::;""l':"i~j E. Kuopio Department of Anesthesiology, Hospital, SF-70210 Kuopio, Finland Aim of investigation: Intravenous indomethacin has proved to be effective in prevention of postoperative pain. Because individual components of prostaglandin cascade affect on blood pressure, vascular resistance and heart rate, it is logical that also an acute blockade of cyclooxygenase enzyme can result in changes of arterial blood pressure and heart rate. The aim of this study was to illuminate the circulatory consequencies of intravenous indomethacin in a typical clinical situation. Methods: 25 mg of intravenous indomethacin (ConfortidR Inj, Dumex AS, Copenhagen) was given postoperativelywithin 10 minutes using a syringepump followed by a continuous infusion of 5 mg/h. The material included 52 patients, who were administered a single dose lumbar epidural analgesia for soft tissue surgery. Blood pressure and heart rate were measured non-invasively every other minute for 30 minutes with an automatic device, Sentron. Results: Compared with the pretreatment values, there was a statistically significant increase during the initial injection of 9.6 mmHg in systolic and 9.0 mmHg in diastolic blood pressure in an average. This increase was, however, clinically not dangerous, because the increase was not more than 31 mmHg in any of the patients. Simultaneously the heart rate decreased by 8.7 beats per minute in an average, which was a significant change compared to the initial values. During the steady state phase the circulatory parameters returned to their original levels. Conclusions: The effective blockade of the prostaglandin synthesis can be seen in the acute circulatory changes during the initial injection period. Clinically these phenomena are not an obstacle for the use of indomethacin in prevention of postoperative pain. 99 Poster ANALGESIC THE PROSTAGLANDIN INHIBITORY EFFECT AND Non Room 3 POTENCY OF FLURBIPROFEN ESTER INCORPORATED IN LIPID EMLJLL-_Board 66 SION(IV). T. Momose, Department of Anesthesiology, Nagoya National Hospital, Nagoya 460, Japan. Aim of Investigation: Recently, there have bean frequent attempts to formulate lipid microspheric drugs since these intravenously injectables can, minimize the latent drug-related adverse reaction, enhance the drug's targetability to specific tissues and sustain a superior efficacy at diminished dosages. In this study, the prostaglandin inhibitory action and the analgesic potency of intravenous Flurbiprofen(Fp) emulsion have been determined in 168 volunteer surgical patients. Methods: A venous cut-down was made and dextranomerum (contained in a small cotton bag) was applied to the open wound for 2 hours in anesthetized patients undergoing operation. Prostaglandin was extracted from the cotton bag and measured by radioimmunoassayusing the antibody PGFzo. The test drugs had been administered 10 minutes before making cut-down. The changes in the Fp plasma concentrations were determined also hourly by sampling. The degree of post-operative pain was determined by hourly interviews. Results: The mean value of PGF20 was 4206pg in the control group, 202Opg in the Fp emulsion group and 1751pg in the IV aspirin group. A plasma half-life(T4) of Fp was about 4 hours. Conclusions: The optimal dose of 50mg of Fp emulsion for the postoperative pain was found to have a higher effective rate than the IV aspirin. The correlation of prostaglandin inhibition with analgesic scores will be presented.