Marcos Célio Brocco

Effects of peritoneal lavage with lidocaine on survival of rats with fecal peritonitis.

PURPOSE To study the effects of peritoneal lavage with a 2% lidocaine solution, on the survival of the rats submitted to peritonitis caused by their own feces. METHODS Forty-eight Wistar rats, weighting between 300 g and 330 g (mean, 311,45 +/-9,67 g), were submitted to laparotomy 6 hours following induction of fecal peritonitis. Animals were randomly divided into four groups of 12 each as follows: 1- Control, no therapy; 2- Drying of the abdominal cavity; 3- Peritoneal lavage with saline and drying; 4- Peritoneal lavage with a 2% lidocaine solution and drying. Animals that died were submitted to necropsy and the time of their death recorded; survivors were killed on the post-operation 11th day and necropsied. RESULTS Death occurred within 52 h in all animals of group 1; within 126 h in 100% of those of group 2; within 50 h in 50% of those of group 3. All animals of group 4 survived. Survival on the 11 th day was higher in groups 3 and 4 than in groups 1 and 2 (p<0.001), and higher in group 4 than in group 3 (p<0.01). CONCLUSION Peritoneal lavage with a 2% lidocaine saline solution without adrenaline, prevented the mortality of all animals with fecal peritonitis.

Histological features of peritoneal lavage with ropivacaine in rats with fecal peritonitis

PURPOSE To evaluate the histological features in lungs, peritoneum and liver of rats subjected to fecal peritonitis and treated with peritoneal lavage with 0.2% ropivacaine. METHODS Twenty Wistar rats were subjected to laparotomy 6 h after the fecal peritonitis induction with autogenous stool. Rats were randomly distributed into 4 groups: I - (n=5) Control, no treatment; II - (n=5) Drying of the abdominal cavity; III - (n=5) Abdominal cavity lavage with 3 ml 0.9% saline solution and drying; and IV - (n=5) Abdominal cavity lavage with 3 ml 0.2% ropivacaine and drying. The animals that died underwent necropsy, and the surviving ones were subjected to euthanasia on the 11th day post-surgery. Fragments of liver, lungs and peritoneum were removed for histological evaluation. RESULTS The animals that received peritoneal lavage (groups III and IV) showed greater survival than the drying and control groups. Lavage with ropivacaine prevented death during the observed period. Peritoneal lavage with ropivacaine maintained the architecture of the lung, peritoneum and liver without any important histological alterations. The histopathological findings analyzed correlated with greater survival of group IV. CONCLUSION Treatment of fecal peritonitis in rats with peritoneal lavage using 0.2% ropivacaine demonstrated a reduction in histopathological alterations related to inflammatory response and sepsis.

Efeito da lavagem peritoneal com bupivacaína na sobrevida de ratos com peritonite fecal

JUSTIFICATIVA Y OBJETIVOS: Basados en los conocimientos sobre la accion antiinflamatoria y antibacteriana de los anestesicos locales (AL), el estudio tuvo el objetivo de verificar el efecto del lavado peritoneal con solucion de bupivacaina en la sobrevida de ratones con peritonitis fecal por heces autogenas. METODO: Se usaron 48 ratones de la raza Wistar, con peso entre 300 g y 330 g (311,45 ± 9,67), sometidos a la laparotomia 6 horas despues de la induccion de peritonitis, distribuidos aleatoriamente en 4 grupos: 1 - Control, ningun tratamiento (n = 12); 2 - Secado de la cavidad abdominal (n = 12); 3 - Lavado de la cavidad abdominal con 3 mL de solucion fisiologica a 0,9% y secado (n = 12); 4 - Lavado de la cavidad abdominal con 8 mg.kg-1 (± 0,5 mL) de bupivacaina 0,5%, adicionada a 2,5 mL de solucion fisiologica a 0,9% y secado (n = 12). Los animales que murieron fueron llevados a necropsia y el horario del obito se anoto. Los animales sobrevivientes se sacrificaron al 11o dia del postoperatorio y se realizo la necropsia. RESULTADOS: Hubo un 100% de mortalidad en los animales del Grupo 1 en 52 horas, 100% en los animales del Grupo 2, en 126 horas y un 50% en los animales del Grupo 3 en 50 horas. Los animales del Grupo 4 sobrevivieron. La sobrevida, al 11° dia del postoperatorio, fue mayor en los grupos 3 y 4 con relacion a los grupos 1 y 2 (p < 0,001) y mayor en los Grupo 4 con relacion al Grupo 3 (p < 0,01). CONCLUSIONES: El lavado peritoneal con solucion de bupivacaina diluida en solucion fisiologica fue eficaz para evitar el obito, por 11 dias, en un 100% de los animales con peritonitis fecal.BACKGROUND AND OBJECTIVES Based on the knowledge of the anti-inflammatory and anti-bacterial actions of local anesthetics (LA), the objective of this study was to determine the effects of peritoneal lavage with bupivacaine on survival of mice with fecal peritonitis. METHODS Forty-eight Wistar mice, weighing between 300 and 330 g (311.45 +/- 9.67 g), undergoing laparotomy 6 hours after induction of peritonitis were randomly divided in 4 groups: 1--Control, without treatment (n = 12); 2--Drying of the abdominal cavity (n = 12); 3--Lavage with 3 mL NS and posterior drying of the abdominal cavity (n = 12); and 4--Lavage with 8 mg x kg(-1) (+/- 0.5 mL) of 0.5% bupivacaine added to 2.5 mL of NS followed by drying out of the abdominal cavity (n = 12). Animals that died underwent necropsy and the time of death was recorded. Surviving animals were killed on the 11th postoperative day and underwent necropsy. RESULTS Group 1 presented a 100% mortality rate in 52 hours, 100% mortality rate in Group 2 in 126 hours, and Group 3 presented a 50% mortality rate in 50 hours. Animals in Group 4 survived. Survival on the 11th day was greater in groups 3 and 4 than in Groups 1 and 2 (p < 0.001) and greater in Group 4 than in Group 3 (p< 0.01). CONCLUSIONS Peritoneal lavage with a solution of bupivacaine diluted in NS was effective in preventing death for 11 days in 100% of animals with fecal peritonitis.

Epidural anesthesia using a 0,75% ropivacaine and subarachnoid anesthesia with a 0,5% bupivacaine associated or not with clonidine in hemorroidectomies

PURPOSE To study the safety and efficiency of two anesthetic blockages in hemorrhoidectomy and the effect of clonidine on analgesia. METHODS 80 patients were studied, randomly divided into four groups: l (n=19)- peridural with a 0,75% ropivacaine; 2 (n=21)-peridural with a 0,75% ropivacaine and 150 microg of clonidine; 3 (n=19)- subarachnoid with a 0,5% bupivacaine; 4 (n=21)- subarachnoid with a 0,5% bupivacaine and 50 microg of clonidine. The intensity of pain was evaluated by the visual analogical scale 8, 12 and 24 hours after surgery. The use of vasoconstrictors on the transoperatory and the amount of analgesics within the 24 hours were registered. RESULTS The intensity of pain, 8 hours after surgery, was lesser on group 4, and much lesser on group 4 comparing with groups 1 and 2, 12 hours (p=0,022; p=0,001) and 24 hours (p=0,03; p=0,003). The frequency of vasoconstrictors usage on the transoperatory and the analgesics on the post-operatory showed no difference among the groups. There were no anesthetic complications. CONCLUSIONS The subarachnoid anesthesia with a 0,5% bupivacaine with clonidine, showed better analgesia comparing with the peridural anesthesia with a 0,75% ropivacaine with or without clonidine, however all were safe and efficient. The clonidine aided on the decreasing of pain when subarachnoid anesthesia was used.

Epidural anesthesia with ropivacaine with or without clonidine and postoperative pain in hemorrhoidectomies

PURPOSE To determine the safety, pain intensity correlated with age and body mass index (BMI), epidural anesthesia with ropivacaine and clonidine in hemorrhoidectomy. METHODS Eighty patients, both genders, 20-70 years old, ASA I or II, for hemorrhoidectomy were randomly divided into two groups: Control (n=38), epidural anesthesia with 14 mL of ropivacaine 0.75 % plus 0.0266 mL/kg of 0.9% saline solution; Experimental (n=42) epidural anesthesia with 14 mL of 0.75% ropivacaine plus 4.0 mcg/kg of clonidine. In preoperative and postoperative period were evaluated: systolic blood pressure (SBP), diastolic blood pressure (DBP ), heart rate (HR ), pulse oximetry (SpO2), electrocardiography (ECG), pain intensity (VAS ) in four, eight and, 12 hours and analgesic consumption. RESULTS The VAS values differed between four, eight and 12 hours in the Experimental Group, where correlation of VAS 12h with age (p<0.05) occurred and not with BMI and more patients (p<0.05) did not receive analgesics. SBP, DBP, HR changed similarly in both groups at 15, 30 and 45 min. The ECG and SpO2 remained unchanged. CONCLUSIONS Clonidine (4mcg/kg) in epidural anesthesia with ropivacaine 0.75% in hemorrhoidectomy showed safety and greater analgesia within four hours. The pain at 12 hours showed correlation with age and not with body mass index.

A study of interleukin 6 (IL-6) and tumor necrosis factor alpha (TNF-α) serum levels in rats subjected to fecal peritonitis and treated with intraperitoneal ropivacaine

PURPOSE The objective of this study was to assess the cytokine serum levels of IL-6 and TNF-α in rats subjected to fecal peritonitis and treated with peritoneal lavage with 0.2% ropivacaine by peritoneal lavage. METHODS We subjected 16 Wistar rats to laparotomy 6 hours after the induction of fecal peritonitis with autogenous stool and subsequently divided the rats randomly into 4 groups: I-control, no treatment; II- drying of the abdominal cavity; III- lavage of the abdominal cavity with 3 mL of 0.9% normal saline and drying; IV- lavage of the abdominal cavity with 3 mL of 0.2% ropivacaine and drying. Six hours following the laparotomy, the animals underwent cardiac puncture, and 1 mL of blood was collected for cytokine assessment before the animals were euthanized. RESULTS The lavage with ropivacaine resulted in smaller TNF-α levels compared with those observed in the other treatment groups (p <0.05). Regarding IL-6, the ropivacaine group showed lower cytokine levels than those observed in groups I and II, but there was no significant difference (p> 0.05) between groups III and IV. CONCLUSION Peritoneal lavage with 0.2% ropivacaine was shown to reduce plasma levels of IL-6 and TNF-α in the treatment of fecal peritonitis in rats.

Effects of peritoneal lavage with bupivacaine on survival of mice with fecal peritonitis

JUSTIFICATIVA Y OBJETIVOS: Basados en los conocimientos sobre la accion antiinflamatoria y antibacteriana de los anestesicos locales (AL), el estudio tuvo el objetivo de verificar el efecto del lavado peritoneal con solucion de bupivacaina en la sobrevida de ratones con peritonitis fecal por heces autogenas. METODO: Se usaron 48 ratones de la raza Wistar, con peso entre 300 g y 330 g (311,45 ± 9,67), sometidos a la laparotomia 6 horas despues de la induccion de peritonitis, distribuidos aleatoriamente en 4 grupos: 1 - Control, ningun tratamiento (n = 12); 2 - Secado de la cavidad abdominal (n = 12); 3 - Lavado de la cavidad abdominal con 3 mL de solucion fisiologica a 0,9% y secado (n = 12); 4 - Lavado de la cavidad abdominal con 8 mg.kg-1 (± 0,5 mL) de bupivacaina 0,5%, adicionada a 2,5 mL de solucion fisiologica a 0,9% y secado (n = 12). Los animales que murieron fueron llevados a necropsia y el horario del obito se anoto. Los animales sobrevivientes se sacrificaron al 11o dia del postoperatorio y se realizo la necropsia. RESULTADOS: Hubo un 100% de mortalidad en los animales del Grupo 1 en 52 horas, 100% en los animales del Grupo 2, en 126 horas y un 50% en los animales del Grupo 3 en 50 horas. Los animales del Grupo 4 sobrevivieron. La sobrevida, al 11° dia del postoperatorio, fue mayor en los grupos 3 y 4 con relacion a los grupos 1 y 2 (p < 0,001) y mayor en los Grupo 4 con relacion al Grupo 3 (p < 0,01). CONCLUSIONES: El lavado peritoneal con solucion de bupivacaina diluida en solucion fisiologica fue eficaz para evitar el obito, por 11 dias, en un 100% de los animales con peritonitis fecal.BACKGROUND AND OBJECTIVES Based on the knowledge of the anti-inflammatory and anti-bacterial actions of local anesthetics (LA), the objective of this study was to determine the effects of peritoneal lavage with bupivacaine on survival of mice with fecal peritonitis. METHODS Forty-eight Wistar mice, weighing between 300 and 330 g (311.45 +/- 9.67 g), undergoing laparotomy 6 hours after induction of peritonitis were randomly divided in 4 groups: 1--Control, without treatment (n = 12); 2--Drying of the abdominal cavity (n = 12); 3--Lavage with 3 mL NS and posterior drying of the abdominal cavity (n = 12); and 4--Lavage with 8 mg x kg(-1) (+/- 0.5 mL) of 0.5% bupivacaine added to 2.5 mL of NS followed by drying out of the abdominal cavity (n = 12). Animals that died underwent necropsy and the time of death was recorded. Surviving animals were killed on the 11th postoperative day and underwent necropsy. RESULTS Group 1 presented a 100% mortality rate in 52 hours, 100% mortality rate in Group 2 in 126 hours, and Group 3 presented a 50% mortality rate in 50 hours. Animals in Group 4 survived. Survival on the 11th day was greater in groups 3 and 4 than in Groups 1 and 2 (p < 0.001) and greater in Group 4 than in Group 3 (p< 0.01). CONCLUSIONS Peritoneal lavage with a solution of bupivacaine diluted in NS was effective in preventing death for 11 days in 100% of animals with fecal peritonitis.

Efecto del lavado peritoneal con bupivacaína en la sobrevida de ratones con peritonitis fecal

JUSTIFICATIVA Y OBJETIVOS: Basados en los conocimientos sobre la accion antiinflamatoria y antibacteriana de los anestesicos locales (AL), el estudio tuvo el objetivo de verificar el efecto del lavado peritoneal con solucion de bupivacaina en la sobrevida de ratones con peritonitis fecal por heces autogenas. METODO: Se usaron 48 ratones de la raza Wistar, con peso entre 300 g y 330 g (311,45 ± 9,67), sometidos a la laparotomia 6 horas despues de la induccion de peritonitis, distribuidos aleatoriamente en 4 grupos: 1 - Control, ningun tratamiento (n = 12); 2 - Secado de la cavidad abdominal (n = 12); 3 - Lavado de la cavidad abdominal con 3 mL de solucion fisiologica a 0,9% y secado (n = 12); 4 - Lavado de la cavidad abdominal con 8 mg.kg-1 (± 0,5 mL) de bupivacaina 0,5%, adicionada a 2,5 mL de solucion fisiologica a 0,9% y secado (n = 12). Los animales que murieron fueron llevados a necropsia y el horario del obito se anoto. Los animales sobrevivientes se sacrificaron al 11o dia del postoperatorio y se realizo la necropsia. RESULTADOS: Hubo un 100% de mortalidad en los animales del Grupo 1 en 52 horas, 100% en los animales del Grupo 2, en 126 horas y un 50% en los animales del Grupo 3 en 50 horas. Los animales del Grupo 4 sobrevivieron. La sobrevida, al 11° dia del postoperatorio, fue mayor en los grupos 3 y 4 con relacion a los grupos 1 y 2 (p < 0,001) y mayor en los Grupo 4 con relacion al Grupo 3 (p < 0,01). CONCLUSIONES: El lavado peritoneal con solucion de bupivacaina diluida en solucion fisiologica fue eficaz para evitar el obito, por 11 dias, en un 100% de los animales con peritonitis fecal.BACKGROUND AND OBJECTIVES Based on the knowledge of the anti-inflammatory and anti-bacterial actions of local anesthetics (LA), the objective of this study was to determine the effects of peritoneal lavage with bupivacaine on survival of mice with fecal peritonitis. METHODS Forty-eight Wistar mice, weighing between 300 and 330 g (311.45 +/- 9.67 g), undergoing laparotomy 6 hours after induction of peritonitis were randomly divided in 4 groups: 1--Control, without treatment (n = 12); 2--Drying of the abdominal cavity (n = 12); 3--Lavage with 3 mL NS and posterior drying of the abdominal cavity (n = 12); and 4--Lavage with 8 mg x kg(-1) (+/- 0.5 mL) of 0.5% bupivacaine added to 2.5 mL of NS followed by drying out of the abdominal cavity (n = 12). Animals that died underwent necropsy and the time of death was recorded. Surviving animals were killed on the 11th postoperative day and underwent necropsy. RESULTS Group 1 presented a 100% mortality rate in 52 hours, 100% mortality rate in Group 2 in 126 hours, and Group 3 presented a 50% mortality rate in 50 hours. Animals in Group 4 survived. Survival on the 11th day was greater in groups 3 and 4 than in Groups 1 and 2 (p < 0.001) and greater in Group 4 than in Group 3 (p< 0.01). CONCLUSIONS Peritoneal lavage with a solution of bupivacaine diluted in NS was effective in preventing death for 11 days in 100% of animals with fecal peritonitis.