buprenorphine and Hemorrhage

To determine whether physiological, haematological, biochemical or electrolyte variables can predict severe haemorrhage in cats.. Randomized crossover study whereby each cat underwent mild and severe haemorrhage, with a 2 month period between events.. A group of six domestic cats aged 21 ± 1 months and weighing 4.9 ± 1.2 kg, mean ± standard deviation.. Cats were anaesthetized (buprenorphine, alfaxalone, isoflurane in oxygen at a fixed end-tidal concentration of 1.7%) before the haemorrhage event. In total, 34 variables were measured twice (prehaemorrhage and posthaemorrhage). The difference and percent change for each variable were compared between haemorrhage events (paired t test). Significant variables were placed into 13 different ratios (posthaemorrhage value of one variable divided by a posthaemorrhage value of a second variable) and compared (paired t test), and Cohen's d (d) was calculated. Receiver operating characteristic curves were plotted and cut-off values for weak, moderate and strong indicators of severe haemorrhage were obtained.. The blood loss was 4.5 ± 1.1 mL kg. and clinical relevance Cats subjected to mild and severe haemorrhage demonstrated statistically and clinically relevant changes whereby four ratios could be created to make up the CABSS. The ratios detected and quantified the presence of severe haemorrhage in anaesthetized cats.

Topics: Anesthesia; Anesthetics; Animals; Blood Pressure; Buprenorphine; Cat Diseases; Cats; Cross-Over Studies; Hemorrhage; Isoflurane; Pregnanediones; Severity of Illness Index

The effect of analgesia on physiological systems has received little attention in trauma research. Our aim was to examine the effect of two different analgesics, buprenorphine and carprofen, on adenosine, lidocaine, and magnesium (ALM) resuscitation in a rat model of laparotomy and non-compressible hemorrhage. Male Sprague-Dawley rats were randomly assigned to Saline Carprieve, ALM Carprieve, Saline Buprenorphine, or ALM Buprenorphine (all n = 10). Anesthetized animals underwent surgical placement of chronic catheters and laparotomy, then hemorrhage was induced by liver resection (60% left lateral lobe). After 15 min, animals received 0.7 mL/kg 3% NaCl ± ALM bolus, and after 60 min, 4 h 0.5 mL/kg/h 0.9% NaCl±ALM drip with 72 h monitoring. Carprieve groups received 5 mg/kg s.c. every 24 h and Buprenorphine groups received 0.05 mg/kg Temgesic every 6 to 12 h. Survival, hemodynamics, blood chemistry, and hematology were measured. ALM Carprieve led to 100% survival compared to 40% survival in ALM Buprenorphine group (P = 0.004). In Saline-treated rats, buprenorphine reduced median survival time by 91% (22 h to 2 h). Recovery of mean arterial pressure (MAP) at 60 min was lower in the buprenorphine versus Carprieve groups (83% vs. 101% for ALM and 62% vs. 95% for Saline groups). Buprenorphine was also associated with higher blood lactates and potassium. No analgesic-related differences were found in total white cells, lymphocytes, platelet count, hyperthermia, weight loss, or pica. We conclude that reduced survival and MAP recovery appears to a buprenorphine effect on cardiovascular function. Until the underlying mechanisms can be elucidated, buprenorphine should be used with caution in small and possibly large models of trauma and shock.

Topics: Adenosine; Analgesia; Analgesics, Opioid; Animals; Biomedical Research; Buprenorphine; Disease Models, Animal; Hemorrhage; Lidocaine; Magnesium; Male; Random Allocation; Rats; Rats, Sprague-Dawley; Resuscitation; Survival Rate; Wounds and Injuries

Cause of death rulings in cases when the concentration of a drug or drugs is higher than observed following therapeutic use are generally straightforward "drug deaths." However, when toxicology testing identifies drug concentrations consistent with therapeutic use or detects no drugs at all, then the cause of death determination is more complicated. Given the rapidity and protean manifestations of anaphylaxis, it should be considered in deaths where no other cause of death is apparent in a suspected drug death. This article reports two cases where an anaphylactic reaction was observed following either the actual or alleged use of therapeutic formulations of buprenorphine intravenously.

Topics: Adult; Anaphylaxis; Buprenorphine; Edema; Eosinophils; Female; Forensic Pathology; Forensic Toxicology; Giant Cells; Hemorrhage; Humans; Hypertrophy; Illicit Drugs; Injections, Intravenous; Larynx; Lung; Macrophages; Muscle, Smooth; Narcotics; Substance Abuse, Intravenous; Tryptases

The purposes of this study were to determine 1) whether magnetic resonance imaging (MRI)-based T2 mapping and measurements of limb volume can differentiate injured and uninjured tissue after blunt trauma to rat hindlimbs and 2) whether administration of buprenorphine influences these assessments. Male Wistar rats (age, 3 to 4 mo) underwent blunt contusion injury to the posterior aspect of the hindlimb; MRI was conducted at 6, 12, 24, 48, 72, and 96 h after injury. The imaging results showed that administration of buprenorphine had no effect on the T2 value {area under the receiver operating characteristic [ROC] curve: with drug, 0.869 [95% confidence interval (CI), 0.78 to 0.96]; without drug, 0.809 [95% CI, 0.72 to 0.90]} but did influence limb volume [area under the ROC curve; without drug, 0.954 (95% CI, 0.92 to 0.99); with drug, 0.713 (95% CI, 0.61 to 0.82)]. When using MRI to determine the extent of injury or to track injury over time, calculated limb volumes may lose sensitivity to detect injury, due to the intrinsic increase in volume from morphine-derived drugs. During administration of morphine derivatives, T2 maps may provide more accurate assessments of muscle tissue injury both initially after injury and over time.

Topics: Analgesics, Opioid; Animals; Buprenorphine; Disease Models, Animal; Edema; Hemorrhage; Hindlimb; Inflammation; Magnetic Resonance Imaging; Male; Predictive Value of Tests; Rats; Rats, Wistar; ROC Curve

As deafness surgery is subject to the two imperatives of safety and reduction of bleeding, local anaesthesia constitutes a very satisfactory solution. The concomitant administration of Midazolam and Buprenorphine relaxes the patient and ensures analgesia and anterograde amnesia, allowing the surgeon to operate under excellent conditions. Over the last 6 months, except in one subject under the age of 16 years and one psychologically very fragile patient, all surgical operations for deafness, regardless of their importance, have been performed under local anaesthesia improved by means of diazanalgesia. It is probable that in the future, numerous cophosurgeons will adopt a similar protocol.

Topics: Adolescent; Adult; Aged; Anesthesia, Local; Buprenorphine; Clinical Protocols; Hearing Disorders; Hemorrhage; Humans; Intraoperative Period; Midazolam; Middle Aged; Tympanoplasty

The majority of hemorrhages occurring during open prostatectomy are induced during the steps for removal of adenoma. However, the hemorrhage during transurethral prostatic resection (TURP) usually takes place at its initial stage, and approx. 50% of the amount of the hemorrhage during the operation occurred within 30 minutes after initiating the operation. When the resection of the adenoma advanced near the surgical capsule, the amount of hemorrhage decreased sharply. This was interpreted to indicate that many of the blood vessels are cut at the initial stage of the operation and that the steps for resection are processed at that stage without special attempt to stop the hemorrhage. We have discussed some aspects for improvement of the methodology for the operation of this kind. The postoperative progress of hemorrhage revealed that the operative cases can be classified into three groups; one was the group with smooth hemostasis since immediately after the operation (Type I and II) and the others were the group with satisfactory hemostasis during the operation and yet with resumption of substantial hematuria (Type III and IV) and the group with continued hemorrhage of substantial amount since immediately after the operation (Type V). It was demonstrated that those showing hematuria of more than 2% at 2-4 hours after the operation and 0.5-1.9% at 6-8 hours after the operation can be rated as falling under the latter two groups and that the check at an early stage and early counter-treatment would induce favorable postoperative progress.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Buprenorphine; Hematuria; Hemorrhage; Humans; Intraoperative Complications; Male; Morphine; Postoperative Complications; Prostatectomy; Prostatic Hyperplasia