Twenty patients for abdominal surgery chosen at random were studied for postoperative pain relief with rectus sheath analgesia and meperidine by intramuscular injection. We wished to determine the efficacy of this new method of regional analgesia and to make a comparison it with that of systemic narcotics. At operation after surture of the posterior rectus sheath a specially designed 17 gauge polyethylene tube was positioned within the rectus sheath so that it lay in close proximity to the nerves supplying the surgical wound. The tube was designed to ensure even and uniform distribution of the local analgesics (2% lidocain 5 ml about 6 times on 1 st 24 hrs and 3 times on next 24 hrs) and it was removed after 48 hrs. The rectus sheath analgesia group of 15 patients was compared to a mepridine (50 mg) group of 5 patients. The effect of rectus sheath analgesia on pain relief and the patients ability to cough, to take deep breaths and to sit up were assessed subjectively by the same physician and objectively by each patient. In both groups pulmonary functions were assessed by measurements of arterial gases, tidal volume, minute volume, frequency, vital capacity, timed vital capacity, and peak expiratory flow rate(%). These measurements were assessed before and after operation and on the first and second postoperative days. Rectus sheath analgesia was found to reduce the degree of postoperative lung dysfunction. It is recommended in all debilitated patient with existing airway disease. It is concluded that rectus sheath analgesia is a reliable and simple method of controlling postoperative abdominal pain.
Abdominal Pain ; Analgesia* ; Analgesics ; Cough ; Forced Expiratory Volume ; Gases ; Humans ; Injections, Intramuscular ; Lung* ; Meperidine ; Methods ; Narcotics ; Pain, Postoperative ; Polyethylene ; Tidal Volume ; Vital Capacity ; Wounds and Injuries

PURPOSE: The purpose of this study was to compare the feeling state guided imagery(FSGI) and end state guided imagery(ESGI) on stress and performance of an intramuscular injection of nursing students. METHOD: The design was a time series with a nonequivalent control group pretest-posttest study. Data was collected from the 23 rd to the 25th of Nov. 2004. The subjects of this study were 40 female sophomores (21 for the ESGI, 19 for the FSGI). The instruments used in this study were the Visual Analogue Scale for Stress and the Nursing Skill Performance Check-list on Intramuscular Injection developed by the researchers(10 items). Guided imagery was provided through audiotapes for 8 minutes. A pretest was given before applying the guided imagery, posttest 1 was performed after the intervention, posttest 2 was performed before the intramuscular injection and then evaluation of the performance of the intramuscular injection was done. Data was analyzed using t-test, and Repeated Measures ANOVA. RESULT: The level of stress for those who received the ESGI and FEGI was not significant and the level of the nursing skill performance for those who received the ESGI was significantly higher than that of students who received the FEGI. CONCLUSION: The use of ESGI has an effect on learning psychomotor nursing skills and further research is needed on stress.
Adult ; Education, Nursing, Baccalaureate ; Humans ; *Imagery (Psychotherapy) ; Injections, Intramuscular/*psychology ; Stress, Psychological/*prevention & control ; Students, Nursing/*psychology ; Task Performance and Analysis ; Teaching/methods/standards

OBJECTIVETo investigate the application of facial liposuction and fat grafting in the remodeling of facial contour.

METHODSFrom Nov. 2008 to Mar. 2014, 49 cases received facial liposuction and fat grafting to improve facial contours. Subcutaneous facial liposuction with tumescent technique and chin fat grafting were performed in all the cases, buccal fat pad excision of fat in 7 cases, the masseter injection of botulinum toxin type A in 9 cases, temporal fat grafting in 25 cases, forehead fat grafting in 15 cases.

RESULTSMarked improvement was achieved in all the patients with stable results during the follow-up period of 6 - 24 months. Complications, such as asymmetric, unsmooth and sagging were retreated with acceptance results.

CONCLUSIONCombination application of liposuction and fat grafting can effectively and easily improve the facial contour with low risk.

Adipose Tissue ; transplantation ; Botulinum Toxins, Type A ; administration & dosage ; Chin ; Face ; surgery ; Forehead ; Humans ; Injections, Intramuscular ; Lipectomy ; adverse effects ; methods ; Masseter Muscle ; Neuromuscular Agents ; administration & dosage

AIMTo ascertain the bioactivity and to analyse quantificationally the denervating action of botulinum toxin A (BTXA) in gel.

METHODS36 Sprague-Dawley rats were randomized into four groups. In group A - D, the gastrocnemius muscle of one leg was randomly selected to receive injection of BTXA solution 5U in 0.1 ml, BTXA gel 12.5U in 0.1 ml, BTXA gel 5U in 0.1 ml and BTXA gel 2U in 0.1 ml respectively, while the gastrocnemius muscle of other leg was injected with 0.1 ml of saline solution in group A and 0.1 ml of gel in group B to group D as control. Compound muscle action potential (CMAP) of both gastrocnemius muscles were measured and the amplitudes were recorded before injections, and 5 days, 2 weeks, 3 weeks, 1 month, 2 months and 3 months after the injections respectively.

RESULTSThe reduction of CMAP amplitude was significantly different at various time (P < 0.01), and CMAP amplitude decreased significantly after the treatment of BTXA (P < 0.01). The reduction of CMAP amplitude was significantly dif ferent in group A to I) (P < 0.01), and more reduction was found in group A and B (P < 0.01), and the reduction was higher in group C than in group D (P < 0.05). However, there were no significant differences in the reduction of CMAP amplitude between group A and group B.

CONCLUSIONBioactivity of BTXA in gel was showed and the denervating action of BTXA in gel was demonstrated in a dosage and time dependent manner.

Animals ; Botulinum Toxins, Type A ; administration & dosage ; Dosage Forms ; Female ; Gels ; Injections, Intramuscular ; Mice ; Muscle Denervation ; methods ; Muscle, Skeletal ; innervation ; Rats ; Rats, Sprague-Dawley ; Solutions

OBJECTIVETo study the pharmacokinetics of matrine (MT) intramuscular administration in rat.

METHODPlasma concentration of matrine was determined by HPLC under the following conditions: column (Shim-pack VP-ODS, 4. 6 mm x 150 mm, 5 m); eluent (acetonitrile-0.02 mol ammonium acetate buffer-triethylamine 30: 70: 0.04); flow rate was 1 mL x min(-1) and ultraviolet detection wavelength was set at 220 nm; column temperature 40 degrees C; aliquot injected 20 microL. All data of concentration-time of matrine were treated with pharmacokinetics program DAS 2. 1. 1.

RESULTA simple, sensitive and reliable method for determining matrine in rat plasma by HPLC was established. The plasma concentration time profiles of MT fitted in with two-compartment models well, and the main pharmacokinetic parameters found for MT after i. m. infusion were as follows: C(max) = 21.113 9 mg x L(-1), t(max) = 0.75 h, t1/2alpha 1.34 h, t1/2beta = 3.509 h, AUC(0-t) = 90.984 mg x h(-1) x L(-1), AUC(0-infinity) = 100.346 mg x h(-1) x L(-1).

CONCLUSIONCompare with oral administration, the matrine is absorbed well and distributes fast with intramuscular administration; the absolute bioavailability of matrine is higher. According to this, the pharmacological action is also stronger and duration is longer.

Alkaloids ; administration & dosage ; pharmacokinetics ; Animals ; Chromatography, High Pressure Liquid ; methods ; Female ; Injections, Intramuscular ; Male ; Quinolizines ; administration & dosage ; pharmacokinetics ; Rats ; Rats, Sprague-Dawley

AIMTo quantify progesterone (P) and one of its metabolites 20alpha-hydroxy-4-pregnen-3-one (20alpha-OHP) in rat plasma and uterus after im administration of progesterone.

METHODSPlasma and uterus samples were prepared by liquid-liquid extraction and separated through Shimadzu VP-ODS column (150 mm x 4.6 mm ID, 5 microm). The mobile phase consisted of acetonitrile and water (60: 40, adjusted to pH 4.0 with phosphoric acid). The detector was set at 240 nm. Norgestrel was used as the internal standard.

RESULTSCmax of P in plasma was (508 +/- 62) microg x L(-1), Tmax was (3.2 +/- 0.4) h, T1/2 (ke) was (10 +/- 4) h and mean AUC0-48h was (5886 +/- 1573) microg x L(-1) x h. The maximum concentration of P in uterus was (1.7 +/- 1.1) microg x g(-1) and the peak time was (5.2 +/- 1.11) h. 20alpha-OHP showed a similar Tmax with P.

CONCLUSIONThe method is accurate and convenient. It can be used to determine P and its main metabolite 20alpha-OHP simultaneously for studying their preclinical pharmacokinetics.

20-alpha-Dihydroprogesterone ; blood ; pharmacokinetics ; Animals ; Area Under Curve ; Chromatography, High Pressure Liquid ; methods ; Female ; Injections, Intramuscular ; Progesterone ; blood ; metabolism ; pharmacokinetics ; Rats ; Rats, Wistar ; Uterus ; metabolism

Adult ; Botulinum Toxins ; administration & dosage ; pharmacology ; Humans ; Injections, Intramuscular ; Male ; Muscle Spasticity ; chemically induced ; diagnosis ; Neuromuscular Agents ; administration & dosage ; pharmacology ; Transcranial Magnetic Stimulation ; methods

OBJECTIVE: To explore the effects of different analgesia methods after UPPP. METHOD: Ninety cases of patients uvulopalatopharyngoplasty were divided into 3 groups randomly, and 30 cases in each group. The group A was the blank control group without any analgesia measures. The cases in group B were treated with intramuscular injection of parecoxib sodium 40 mg after surgery immediately, and continued injecting 40 mg after 12 hours, 24 hours and 36 hours respectively. 100 mg tramadol replaced 40 mg parecoxib sodium in group C. The VAS scoring was performed after surgery 12, 24, 36, 48, 72, 96 hours in 3 groups, and we observed adverse reaction such as lethargy, nausea, vomiting, dizziness, skin rash and so on. RESULT: The group B and C reduced the pain significantly compared with blank control group. The pain scores in group B were significantly decreased than that in group C (P<. 05). CONCLUSION The analgesic effect of parecoxib sodium after UPPP is significant and better than tramadol. It is worthy to use widely in clinical due to its better effect and less side effect.
Analgesia ; methods ; Analgesics ; therapeutic use ; Humans ; Injections, Intramuscular ; Isoxazoles ; therapeutic use ; Pain Measurement ; Pain, Postoperative ; Palate ; surgery ; Pharynx ; surgery ; Tramadol ; therapeutic use ; Uvula ; surgery

A sensitive and selective liquid chromatography-tandem mass spectrometric (LC-MS/MS) method was developed and validated for the determination of betamethasone in human plasma. The analyte was isocratically eluted on a Venusil XBP C8 column (200 mm x 3.9 mm ID, 5 microm) with methanol-water mol x L(-1) ammonium formate) (80:20) at a flow rate of 0.4 mL x min(-1), and detected (containing 5 mmol x L(-1) ammonium formate) (80:20) at a flow rate of 0.4 mL x min(-1), and detected with a triple quad LC-MS/MS using ESI with positive ionization. Ions monitored in the multiple reaction monitoring (MRM) mode were m/z 393.3-->355.2 for betamethasone and m/z 361.3-->343.2 for prednisolone (IS). Betamethasone was extracted from 0.5 mL human plasma with ethyl acetate. The average recovery is 88.24% and the low limit of quantitation (LLOQ) was 0.5 ng x mL(-1). The 3-day validation study demonstrated excellent precision and accuracy across the calibration range of 0.5-80.0 ng x mL(-1). The method was successfully applied to the pharmacokinetic study of compound betamethason injection in healthy Chinese volunteers.
Anti-Inflammatory Agents ; blood ; pharmacokinetics ; Area Under Curve ; Betamethasone ; blood ; pharmacokinetics ; Chromatography, Liquid ; methods ; Humans ; Injections, Intramuscular ; Male ; Spectrometry, Mass, Electrospray Ionization ; methods ; Tandem Mass Spectrometry ; methods ; Young Adult

PURPOSE: To investigate the therapeutic effectiveness of ultrasound (US)-guided trigger point injection for myofascial trigger points (MTrPs) in the internal rotator muscles of the shoulder in post-mastectomy patients. MATERIALS AND METHODS: This pilot study was a non-controlled, prospective, clinical trial. Nineteen post-mastectomy patients with a diagnosis of at least one active MTrP in the subscapularis and/or pectoralis muscles were included. We performed trigger point injections into the subscapularis muscle deep behind the scapula as well as the pectoralis muscle for diagnostic and therapeutic purpose by the newly developed US-guided method. RESULTS: Visual analogue scale and range of motion of the shoulder for external rotation and of abduction showed significant improvement immediately after the first injection and 3 months after the last injection compared with baseline (p<0.05 for both). Duration from onset to surgery and duration of myofascial pain syndrome in the good responder group were significantly shorter than in the bad responder group (p<0.05). Patients did not report any complications related to the procedure or serious adverse events attributable to the treatment. CONCLUSION: In post-mastectomy patients with shoulder pain, US-guided trigger point injections of the subscapularis and/or pectoralis muscles are effective for both diagnosis and treatment when the cause of shoulder pain is suspected to originate from active MTrPs in these muscles, particularly, the subscapularis.
Adult ; Aged ; Anesthetics, Local/administration & dosage/therapeutic use ; Female ; Humans ; Injections, Intramuscular/methods ; Lidocaine/administration & dosage/therapeutic use ; Mastectomy ; Middle Aged ; Muscle, Skeletal/drug effects/ultrasonography ; Myofascial Pain Syndromes/drug therapy ; Pectoralis Muscles/drug effects/*ultrasonography ; Trigger Points/*ultrasonography