beta-escin and Postoperative-Complications

Postoperative ileus, a common complication in patients after abdominal surgery, brings no benefit to the recovery of postoperative patients, and treatment targeted at restoring gastrointestinal motility may shorten the hospital stay. Studies have shown that escin accelerates gastrointestinal transit in mice and improves gastrointestinal motility in patients after abdominal surgery. A pilot study of escin's effect on the recovery of gastrointestinal motility was conducted in colorectal cancer patients in anticipation of a multiple-center randomized controlled trial.. A total of 72 postoperative colorectal cancer patients were randomly assigned to four parallel groups on the basis of sealed envelopes-escin 5 mg group (E5 mg), escin 15 mg group (E15 mg), escin 25 mg group (E25 mg), and placebo group-with 18 patients in each group. Escin or placebo was diluted in 500 ml 5% dextrose injection, which was given once daily through the subclavian vein. The first injection took place 6 h after completion of the surgery. The treatment continued for 7 days or stopped at the time of the patient's first bowel movement. Time to recovery of passage of gas (TRPG), time to recovery of gastrointestinal sounds (TRGS), and time to recovery of bowel movements (TRBM) were recorded to evaluate the efficacy of escin.. The TRPGs of the three escin treatment groups were 76.78 + 28.81 h (E5 mg), 72.06 + 14.65 h (E15 mg), and 65.50 + 26.70 h (E25 mg), respectively, with differences of 6.03 +/- 7.64 h (p = 0.436; E5 mg), 10.75 +/- 4.92 h (p = 0.036; E15 mg), and 17.31 +/- 7.20 h (p = 0.022; E25 mg) compared with the placebo group. The TRGSs of the three escin treatment groups were 45.28 +/- 26.15 h (E5 mg), 41.22 +/- 16.98 h (E15 mg), and 40.33 +/- 14.09 h (E25 mg), respectively, with differences of 4.33 +/- 7.12 h (p = 0.547; E5 mg), 8.39 +/- 5.36 h (p = 0.127; E15 mg), and 9.28 +/- 4.87 h (p = 0.065; E25 mg) compared with the placebo group. The TRBMs of the three escin treatment groups were 89.25 +/- 23.77 h (E5 mg), 84.83 +/- 27.91 h (E15 mg), and 84.44 +/- 19.74 h (E25 mg), respectively, with differences of 19.03 +/- 10.13 h (p = 0.069; E5 mg), 23.44 +/- 10.70 h (p = 0.035; E15 mg), and 23.83 +/- 9.63 h (p = 0.019; E25 mg) compared with the placebo group.. The results of this pilot Postoperative Ileus Study of Escin (PISE) showed that escin can shorten the time to recovery of gastrointestinal motility in cancer patients after colorectal surgery.

Topics: Colorectal Surgery; Escin; Female; Gastrointestinal Agents; Gastrointestinal Motility; Humans; Ileus; Male; Middle Aged; Molecular Structure; Pilot Projects; Postoperative Complications; Treatment Outcome

The authors concentrate on the use of enzyme therapy in traumatology. They monitored SET efficiency in the treatment and prophylazis of swelling in the postoperative period after the internal fixation of fractures of long bones and compared it with the effect of standard antiswelling seu antioedematous drugs on the basis of aescin.. A group of 60 patients was followed after the fixation of long bones. The average age was 42 years (range, 12-79 years). Fractures were treated by intrameduilary fixation or by external fixators. The patients were split into two groups. In 30 patients only Phlogenzym was administered for the treatment and prevention of posttraumatic and postoperative swelling. Another 30 patients--the control group--were treated by standard antioedematic drugs on the basis of aescin. The same analgesics were applied in both groups.. The group of patients with systemic enzyme therapy were treated by Phlogenzym in the dosage 3 times 3 tablets in the first three days after operation and subsequently 3 times 2 tablets in the remaining follow-up period. In the postoperative period the changes of operated limb volume was monitored. The circumference of a limb was measured in the area of the largest oedema and 10 cm distally. Then the volume of this part of limb was calculated as the volume of conical frustum. The measurements were performed on postoperative days 1, 3, 5, 7, 10 and 14. The volume value of the 1st day was used as starting value (100%). The values of subsequent measurements were then compared to this starting value in both group of patients. Evaluation of the resorption of traumatic and postoperative haematoma and analgesis effect of Phlogenzym was also made.. In the group of patients who were administered with Phlogenzym after operation the reduction of the posttraumatic and postoperative swelling was continuous and significantly faster in compared with patients of the control group. A remarkable difference was revealed by the measurement on 5th postoperative day--in patients treated by Phlogenzym the starting value of the volume of the operated in limb was reduced on average by almost 8%. In contrast, in the control group treated by standard drugs this value slightly increased above 100%. At the end of the first postoperative week the monitored volume was on average reduced by 12% in the SET group compared with 1.45% in the control group. At the end of the follow-up--on 14th postoperative day the volume was reduced in the SET group by almost 17% compared with 9% in the control group. There was also an evidently good analgesic effect of the drug. The total consumption of analgesics of patients in the SET group was significantly lower, particularly in the early postoperative period. In the course of the follow-up of both groups no marked differences were recorded in the changes of the volume of operated limbs in dependence on the method of fixation applied (intramedullary or external), sex of the patient or on the affected limb (lower or upper). The patients tolerated Phlogenzym very well, only one female patient suffered temporarily from poor digestion which, however, did not require to interrupt the administration of the drug. No other undesirable effects occurred.. Fixation of long bones belongs to the most frequent operations in traumatological and orthopaedic departments of all levels. One of the factors which may have an unfavourable effect on the final result of fixation is a prolonged post-trauma or postoperative swelling. The results of the study prove a clearly positive effect of system enzymotherapy on the reduction of oedema accompanying the trauma and inflammation. The study proved a statistical significance of the acceleration of the reduction of oedema in patients treated by Phlogenzym as compared to the control group treated by a standard antioedematous drugs.. The authors verified that systemic enzyme therapy could influence significantly the results of traumatological surgery. Simple administration per os, efficient oedema reduction and thus accelerated healing, antiophlogistic and analgesic effect--all these advantages justify the application of this therapeutic method what can be recommended as a part of the complex treatment in traumatology with both conservative and surgical approaches.

Topics: Adolescent; Adult; Aged; Bromelains; Child; Drug Combinations; Edema; Escin; Fracture Fixation, Intramedullary; Fractures, Bone; Humans; Middle Aged; Postoperative Complications; Rutin; Trypsin

Beta-escin is highly effective in reducing postoperative edemas and swellings. It was tried to demonstrate the effect of beta-escin using the thermometry. The temperature of soft tissues and bones can be measured with the help of the thermometry, in this way the circulation of the skin can be determined. In 65 test persons so-called normal thermograms were established, using the infraredthermometer KT 41, which makes registrations without touching the skin. In 53 patients the temperature of the skin was checked after surgery of the hand. 27 patients received beta-escin (Reparil); 26 patients without medication served as controls. In every case the temperature of the operated hand was compared to the other hand. Among the patients, who received escin, the temperature of the operated hand rose for two days following surgery; afterwards it fell quickly. Among the controls the skin-temperature rose up to the 4. day after surgery and decreased slowly. These results demonstrate clearly that after using beta-escin there is a quick reduction of postoperative inflammation and edema.

Topics: Adult; Edema; Escin; Hand; Humans; Postoperative Care; Postoperative Complications; Saponins; Skin Temperature; Thermography; Water

Eight prospective, controlled, randomised studies on the incidence of postoperative thrombosis in gynaecological patients receiving various drugs for prevention of thromboembolism are analysed. In all patients diagnosis had been established by objective means. The rate of thrombosis in patients without drug prophylaxis has been found to vary between 14 and 29%. Infusions of dextran as well as administration of low-dose subcutaneous heparin significantly reduce the incidence of deep vein thrombosis, even as compared to postoperative oral anticoagulation with cumarins. No difference has been found between dextran and oral anticoagulants, when cumarin adminstration was started before operation, nor between dextran and heparin. Aescin did not show any prophylactic effect. High age, severe leg-vein varicosis as well as surgery for malignant disease increase the risk of thrombosis. No significant influence of overweight, previous deep venous thrombosis, epidural anaesthesia or vaginal operation as compared to abdominal approach could be demonstrated. There are no properly controlled, prospective, randomised studies on the incidence of postoperative fatal pulmonary embolism as influenced by drugs in gynaecological surgery.

Topics: Age Factors; Anesthesia; Dextrans; Escin; Female; Genital Diseases, Female; Heparin; Humans; Obesity; Postoperative Complications; Thromboembolism; Thrombophlebitis; Varicose Veins

Postoperative peritoneal adhesions are common, serious complications of general abdominal and gynecologic surgery that can lead to chronic abdominal pain, intestinal obstruction, and infertility. As yet, there are no ideal drugs that may be prescribed for patients to prevent adhesion formation effectively. In this study the effects of escin, a natural drug, on the various steps of adhesion formation were investigated. The effects of escin on increased vascular permeability induced by acetic acid in a mouse model of acute inflammation, granuloma formation in a subchronic inflammatory rat model, gastrointestinal transit in rats with intestinal paralysis, intestinal motility in postoperative patients, and postoperative adhesion formation in a rat model were observed. It was shown that escin could inhibit acute inflammation and granuloma formation, cause acceleration of gastrointestinal transit, help recover intestinal motility, and attenuate the formation of postoperative adhesions. The findings suggest that escin attenuates the formation of postoperative adhesions by inhibiting inflammation and promoting gastrointestinal transit. Thus it may be concluded that both inhibition of inflammation and increased gastrointestinal motility during the early postoperative period have a positive effect on decreasing the formation of adhesions.

Topics: Adult; Animals; Capillary Permeability; Disease Models, Animal; Escin; Female; Gastrointestinal Transit; Granuloma; Humans; Ileus; Injections, Intravenous; Male; Mice; Middle Aged; Postoperative Complications; Rats; Rats, Sprague-Dawley; Tissue Adhesions

The effectiveness of low-dose heparin has been compared with other methods of thrombo-embolism prophylaxis, on the basis of 892 gynaecological operations. No case of acute venous thrombosis or lethal pulmonary embolism was established in the Infukoll-M-40 group. No effective prophylaxis against thrombo-embolism was obtainable from acetylsalicylic acid (Micristin). More postoperative bleeding was recorded from the low-dose heparin group. Two far-reaching thromboses and three cases of lethal pulmonary embolism occurred in the wake of low-dose heparin prophylaxis. The most favourable effect, in terms of preventing postoperative leg thrombosis and pulmonary embolism, was recorded from low-molecular dextran (Infukoll M 40). Anaphylactoid reactions, such as bronchospasm, flush, urticaria, and hypotension, were not observed. A therapy standard for gynaecological operations is recommended, with reference being made to the authors' own findings.

Topics: Aspirin; Dextrans; Dose-Response Relationship, Drug; Escin; Female; Genital Diseases, Female; Heparin; Humans; Postoperative Complications; Thromboembolism

Topics: Cerebrospinal Fluid; Escin; Humans; Intracranial Pressure; Postoperative Complications; Pseudotumor Cerebri; Saponins

Topics: Drug Evaluation; Edema; Escin; Humans; Postoperative Complications; Saponins; Wounds and Injuries

A case of acute renal insufficiency after therapy with gentamycin and beta-Aescin is reported. The role of these two agents in the causation of the acute renal failure is discussed. Renal function was restored using the REDY-Hemodialization System.

Topics: Acute Kidney Injury; Adult; Drug Interactions; Escin; Gentamicins; Humans; Male; Postoperative Complications; Renal Dialysis; Saponins

Topics: Bacterial Infections; Edema; Escin; Humans; Postoperative Complications; Saponins; Surgery, Plastic

Based on the frequency of subclinical, postoperative thrombosis which we detected using radio-iodine-tagged fibrinogen (125I-fibrinogen) in 2 comparable test groups of 100 female patients each, we were able to compare the effectiveness of Aescin (Reparil) to the untreated group. Whereas only 16 patients in the Reparil group were thrombose-positive we found 27 such cases in the control group. The analysis of these data shows Reparil to be of distinct advantage when compared to the untreated group.

Topics: Adolescent; Adult; Blood Coagulation Tests; Child; Drug Evaluation; Escin; Female; Fibrinogen; Humans; Middle Aged; Postoperative Complications; Saponins; Thrombosis

An experimental oedema of the bladder wall was produced by electric coagulation current in 130 rats. The amount of oedema was calculated by determination of the difference between the weight of the freshly excised wet bladder and that after drying to constant weight. Thus, oedema of a fairly constant and reproducible amount could be produced. The effect of three different drugs on such oedema was tested (Na-Aescinat, 6-methylprednisolone, alpha-Chymotrase). After the application of Na-Aescinat and 6-methylprednisolone no significant oedema could be measured after 48 h. Using alpha-Chymotrase, there was no measurable influence on the oedema.

Topics: Animals; Chymotrypsin; Edema; Electrocoagulation; Escin; Male; Methylprednisolone; Organ Size; Postoperative Complications; Rats; Urinary Bladder; Urinary Bladder Diseases

Renal tolerance of the preparation beta-aescin (Reparil) was tested in cases of oedema following fresh soft tissue crush injuries of the extremities and surgical and reconstructive operations on the hand. Forty in-patients with healthy kidneys were treated with 10 mg beta-aescin intravenously twice daily for six days after operations on the hand and after accident surgery. During this period the following tests were carried out every day and two days after cessation of treatment: urea content in urine and serum, creatinine in serum, creatinine clearance, albumin in urine, urine osmolarity and blood and urine sugar. All values obtained were within the normal range. No impairment of total renal function was observed. Taking the stated dosage instructions and contra-indications into consideration, beta-aescin can thus be administered without hesitation.

Topics: Adolescent; Adult; Creatinine; Edema; Escin; Extremities; Female; Hand Injuries; Humans; Kidney; Long-Term Care; Male; Middle Aged; Postoperative Complications; Urea

The incidence of acute renal failure following cardiac surgery was markedly increased during the last years in our medical center. There was no correlation to known etiologic factors such as preexisting disease, hemolysis, low perfusion rates, post-operative low output syndrome etc. Post-operative renal failure was mainly seen in children between 2 and 10 years and was noted after 3-4 days of normal renal function. Peritoneal dialysis was carried out in 39% of out patients and the overall mortality was 10.7%. Careful analysis of our cases exhibited a correlation of the post operative acute renal failure to the intravenous application of Aescin. After abandoning this drug from our post-operative therapy we did not observe a similar case since almost one year.

Topics: Acute Kidney Injury; Child; Child, Preschool; Escin; Female; Heart Diseases; Humans; Peritoneal Dialysis; Postoperative Complications; Saponins; Time Factors

Topics: Drug Therapy; Edema; Escin; Humans; Postoperative Complications; Saponins; Surgical Procedures, Operative