Effect of Lidocaine on Reducing Injury in a Rat Electrical Burn Model

Prevention of Surgical Site Infections and Biofilms: Pharmacokinetics of Subcutaneous Cefazolin and Metronidazole in a Tumescent Lidocaine Solution

BACKGROUND

Tumescent anesthesia antibiotic delivery (TAAD) consists of subcutaneous infiltration of antibiotic(s) dissolved tumescent lidocaine anesthesia. Tumescent lidocaine anesthesia contains lidocaine (≤ 1 g/L), epinephrine (≤ 1 mg/L), sodium bicarbonate (10 mEq/L) in 0.9% saline. Our aim was to measure cefazolin and metronidazole concentrations over time in subcutaneous tumescent interstitial fluid (TISF) after TAAD, in serum after TAAD and after intravenous antibiotic delivery (IVAD). We hypothesize that the pharmacokinetic/pharmacodynamic profiles of TAAD + IVAD are superior to IVAD alone for the prevention of surgical site infections and biofilms.

METHODS

Concentrations of cefazolin and metronidazole in TISF and serum following TAAD and in serum following IVAD were compared in 5 female volunteers. Subjects received cefazolin or cefazolin plus metronidazole by IVAD alone and by TAAD alone. One subject also received concomitant IVAD and TAAD of these 2 antibiotics. Sequential samples of serum or subcutaneous TISF were assayed for antibiotic concentration.

RESULTS

Cefazolin (1 g) by TAAD resulted in an area under the curve of the concentration-time profile and a maximum concentration (Cmax) in subcutaneous tissue that were 16.5 and 5.6 times greater than in serum following 1 g by IVAD. Metronidazole (500 mg) by TAAD resulted in an area under the curve and Cmax that were 8.1 and 24.7 times greater in TISF, than in serum after 500 mg by intravenous delivery. IVAD + TAAD resulted in superior antibiotic concentrations to IVAD alone.

CONCLUSIONS

TAAD + IVAD produced superior antibiotic bioavailability in both subcutaneous interstitial fluid and serum compared with IVAD alone. There was no evidence that TAAD of cefazolin and metronidazole poses a significant risk of harm to patients.

Changes in FABP1 and gastrin receptor expression in the testes of rats that have undergone electrical injury

Testicular trauma may occur due to accidental electrical injury. The aim of this study was to investigate alterations in the levels of fatty acid-binding protein 1 (FABP1) and gastrin receptor (gastrin R) in the testes following electrical injury. Sprague-Dawley rats were divided into control, fatal electrocution (220 V, 50 Hz, 60 sec) and electrical injury (220 V, 50 Hz, 60 sec) groups (n=8 per group). The animals in the fatal electrocution and electrical injury groups were deeply anesthetized with sodium pentobarbital prior to each treatment, in which the current was delivered via an anode connected to the left foreleg and a cathode to the right hindleg. The rats that survived were subsequently sacrificed by cervical dislocation. Control animals received cervical dislocation alone. Immunohistochemical analysis was performed to evaluate the protein expression of FABP1 and gastrin R in the testes. Sections were evaluated by digital image analysis. The expression levels of FABP1 and gastrin R were significantly increased following electrical injury, supported by an increase in the integrated optical density (IOD) when compared with that in the control group (P<0.05). However, no significant difference was found in FABP1 and gastrin R expression levels between the fatal electrocution and control groups. In summary, the protein expression levels of FABP1 and gastrin R were found to be significantly altered by electrical injury, suggesting that these two proteins may be important in underlying mechanisms of testicular injury during electrical injury. The findings indicate that such alterations would be reflected in abnormal testicular function.

A comparative study of internal laser-assisted and conventional liposuction: a look at the influence of drugs and major surgery on laboratory postoperative values

BACKGROUND

Liposuction is a type of aesthetic surgery that has been performed on humans for decades. There is not much literature addressing the subject matter of pre- and post-surgery blood parameters, although this information is rather interesting. Documentation on patients who received laser-assisted liposuction treatment is particularly scarce. Until now, there has been no literature showing values of platelets, lymphocytes, and neutrophils after liposuction.

PURPOSE

The aim of the work is to analyze and interpret values of platelets, lymphocytes and neutrophils in patient blood before and after liposuction, a surgery in which an extraordinarily large amount of potent drugs are used. Moreover, the aim is to compare values changes in patients of conventional and laser-assisted liposuction.

MATERIAL AND METHODS

We evaluated standard blood samples in patients prior to and after liposuction. This paper covers the number of platelets, lymphocytes, and neutrophils. A total of 54 patients were examined. Moreover, we compared the change in postoperative values in laser-assisted liposuction patients with the change of values in conventional liposuction patients. A paired two-sided Student's t-test was used for statistical evaluation. P < 0.005 was acknowledged to be statistically significant.

RESULTS

Values of platelets were raised both in conventional and in laser-assisted liposuction patients, but this difference was statistically non-significant and levels of platelets were still normal and within the range of blood levels in healthy patients. Values of neutrophils rose by up to 79.49% ± 7.74% standard deviation (SD) and values of lymphocytes dropped by up to 12.68% ± 5.61% SD. The before/after variances of conventional tumescent local anesthesia liposuction and variations in laser-assisted liposuction were similar for all measured parameters; they also showed no statistically significant differences between before and after surgery. The mean value of total operation time without laser-assistance was 3 hours 42 minutes (± 57 minutes SD, range 2 hours 50 minutes to 5 hours 10 minutes). Surgeries with laser-assistance were on average 16 minutes shorter with a mean duration of 3 hours 26 minutes (± 45 minutes SD, range 2 hours 40 minutes to 4 hours 10 minutes). The difference was not statistically significant (P < 0.06). The mean value of aspirate volume for liposuctions performed without laser support was 2,618 mL (± 633.7 SD, range 700 mL to 3,500 mL). Mean aspirate volume for liposuctions with laser assistance was increased by up to 61 mL (2,677 mL ± 499.5 SD, range 1,800 mL to 3,500 mL). The difference was not statistically significant (P < 0.71).

CONCLUSION

We conclude that conventional liposuction and laser-assisted liposuction have a similar influence on platelets, lymphocytes, and neutrophils in patients. Moreover, laser-assisted liposuction seems to be less time consuming than conventional liposuction.