frequency index (SFx) monitoring to assess the depth of anaesthesia during propofol-opioid total ... more frequency index (SFx) monitoring to assess the depth of anaesthesia during propofol-opioid total intravenous anaesthesia (TIVA). Methods: Thirty-three patients scheduled for laparoscopic cholecystectomy under propofol TIVA were prospectively and randomly allocated to receive either remifentanil (bolus of 1.0 μg/kg, followed by continuous infusion from 0.25 to 0.05 μg/kg/min) [n = 18] or alfentanil (bolus of 10 μg/kg, followed by continuous infusion from 2.0 to 0.5 μg/kg/min) [n = 15]. EEG activity was monitored to achieve the desired depth of anaesthesia, and intravenous propofol was titrated to keep the SFx at 70-80%. The remifentanil and alfentanil groups were compared in relation to the plasma propofol concentration required for an adequate level of hypnosis during maintenance of anaesthesia, Pearson correlation coefficient for the relationship between the plasma propofol concentration and SFx values, recovery parameters, and recall of events during anaesthesia. Results: The study groups were comparable with regard to demographic characteristics, type and duration of surgery, and time to resumption of spontaneous ventilation. No evidence of explicit recall was noted. The mean plasma propofol concentration required for an adequate level of hypnosis during maintenance of anaesthesia was significantly higher in the alfentanil group (3.20 μg/mL) compared with the remifentanil group (2.17 μg/L) [p < 0.05]. In both groups, the Pearson correlation coefficient test showed a linear correlation between SFx values and propofol concentration in the studied propofol concentration range. The mean time to orientation for name and place was significantly shorter (p < 0.05), the mean propofol concentration at orientation for name and place and at the resumption of spontaneous ventilation timepoints was significantly lower (both p < 0.01), and the mean SFx value at resumption of spontaneous ventilation timepoint was significantly higher (p < 0.01) in the remifentanil group.
Bidirectional transport of Na + and Cl ions by the epithelium controls production and composition... more Bidirectional transport of Na + and Cl ions by the epithelium controls production and composition of airway surface liquid and airway transepithelial potential difference and in these ways supports mucociliary transport. Volatile anesthetics are able to inhibit epithelial ion transport processes when applied at high concentration and have been suggested to elicit depression of airway clearance and both these effects could be involved in postoperative pulmonary complications. The goal of these studies was to reveal possible influence of halothane and isoflurane at lower concentrations on electrogenic ion transport in airway epithelium. These studies were performed on the isolated rabbit tracheal wall mounted in the Ussing chamber. The reaction of the preparation to the gentle mechanical stimulation performed as a jet flux was examined without or in the presence of anesthetics at concentration equivalent to 0.5 minimal anesthetic concentration of volatile anesthetics in pulmonary alveoli (MAC), 1 MAC, 2 MAC, 5 MAC and 10 MAC. The volatile anesthetics at concentrations equivalent to 5 and 10 MAC affected airway transepithelial potential difference and influenced hyperpolarization or depolarization reactions which occurred after mechanical stimulation. The above effects were present when Na + transport was inhibited by amiloride. The disturbed epithelial Cl transport may be proposed as an explanation of the action of volatile anesthetics on electrophysiological parameters of the isolated tracheal wall although the influence of anesthetics on tachykinin secretion from C-fiber endings, which are present in the preparation, should also be taken into consideration. The long-lasting action (tens of minutes) of volatile anesthetics on the isolated tracheal wall should be also studied in the future as a model of airway reaction to prolonged volatile anesthesia.
Medical science monitor : international medical journal of experimental and clinical research, Jan 18, 2016
BACKGROUND Controlled induced hypotension guarantees less blood loss and better visibility of the... more BACKGROUND Controlled induced hypotension guarantees less blood loss and better visibility of the surgical site. The impact of hypotension on post-operative cognitive functions is still being discussed. The objective of this study was to evaluate the effects of controlled induced hypotension on the cognitive functions of patients undergoing functional endoscopic sinus surgery (FESS). MATERIAL AND METHODS We allocated 47 patients with a good grade of preoperative cognitive functions evaluated with the Mini-Mental State Examination to 3 groups (1 - mild hypotension, 2 - intermediate hypotension, 3 - severe hypotension) according to the degree of mean intraoperative arterial pressure compared with preoperative blood pressure. Cognitive functions were evaluated preoperatively, 6 h, and 30 h postoperatively with standardized tests: the Stroop Test, Trail Making Test (TMT), and Verbal Fluency Test (VFT). A decrease in the test results and increase in the number of mistakes made were consi...
Medical Science Monitor International Medical Journal of Experimental and Clinical Research, Jun 1, 2002
The aim of this research was to explain whether different hormonal conditions caused by disturbed... more The aim of this research was to explain whether different hormonal conditions caused by disturbed concentrations of estrogens and progesterone might lead to alteration of CNS reaction following administration of the hypnotic agent thiopental. The investigated factor was the rate of loss of the eyelid reflex after intravenous thiopental administration, since this corresponds with loss of consciousness. The investigation was performed in 24 sexually mature female Chinchilla rabbits divided into 4 groups of 6 rabbits each. The animals were oophorectomized (hypoprogesterone/hypoestrogen), hyperestrogen (sham surgery plus estradiol injections), hyperprogesterone (sham surgery plus 17 alpha-hydroxyprogesterone injections), or normal (sham surgery). Twelve weeks later, thiopental (40 mg/ml) was infused through the intravenous cannula at a constant rate (90 ml/hour) until loss of the eyelid reflex, at which time blood was sampled for determination of thiopental, b-estradiol, progesterone and 17 alpha-hydroxyprogesterone concentrations. The ANOVA and Tukey tests were applied in statistical analysis (p=0.05). Hyperprogesterone rabbits lost consciousness faster (138 +/- 34.6 sec), at a lower plasma thiopental concentration (46.3 +/- 6.6 microg/ml), and required less thiopental (24.63 +/- 6.44 mg/kg) than controls; hypoprogesterone rabbits lost consciousness slower (207.5 +/- 30.9 sec), at a higher plasma thiopental concentration (129.2 +/- 24.9 microg/ml), and required more thiopental (38.51 +/- 2.33 mg/kg) than controls. The time of sleep induction in the control group was 190 +/- 25.7 sec.; the serum thiopental concentration was 77.8 +/- 13.9 microg/ml, and the total thiopental consumption was 35.8 +/- 3.51 mg/kg. Estrogen status has no effect. Various hormonal states are accompanied by different CNS reactions to thiopental. Among the studied groups of sex steroids, only progestins significantly modify the CNS response to barbiturate infusion.
Medical Science Monitor International Medical Journal of Experimental and Clinical Research, Feb 1, 2003
Permissive hypercapnia exerts a protective influence in tissue injury, possibly by attenuating fr... more Permissive hypercapnia exerts a protective influence in tissue injury, possibly by attenuating free radical activity. Increased CO2 concentrations may decrease the production of phagocyte reactive oxygen intermediates (ROI). In this study, we used bronchoalveolar lavage (BAL) to determine whether isooxic permissive hypercapnia due to hypoventilation would influence neutrophil recruitment into alveolar spaces and ROI production of BAL phagocytes, as measured by luminol dependent chemiluminescence. 27 Chinchilla rabbits randomized into three groups: control group (C; n=7), normocapnia (NC; n=10), and hypercapnia (HC; n=10) were anaesthetized with pentobarbitone and intubated. Bronchoalveolar lavage was obtained either after intubation (controls) or after mechanical ventilation lasting 240 minutes under normocapnia or permissive hypercapnia conditions. BAL cells were counted and luminol-dependent chemiluminescence estimations were performed. The BAL neutrophil count was significantly higher in the hypercapnia group than in normocapnia animals. The chemiluminescence of opsonized zymosan-stimulated cells was significantly higher in the normocapnia group than in the controls; the differences between the HC and NC animals, and between the HC and control animals, did not reach statistical significance. In the mechanically ventilated rabbit under pentobarbitone anaesthesia, acute isooxic hypercapnia due to hypoventilation increases neutrophil BAL count, without direct impact on mixed BAL-cell chemiluminescence; moreover, conventional ventilation increases the chemiluminescence of opsonized zymosan-stimulated BAL cells
The aim of this study was to investigate the bioavailability of tramadol hydrochloride after oral... more The aim of this study was to investigate the bioavailability of tramadol hydrochloride after oral administration of Tramadol--50 mg capsules, made in Synteza Pharmaceutical-Chemical Company in Poznań. As a reference preparation of Tramadol was used Tramal--50 mg capsules, (Grünenthal, Germany). The preparations were investigated in 20 healthy volunteers, according to a randomised two-way, cross-over design in the fasted state. Blood samples for determination of tramadol plasma concentrations were collected at pre-defined time points up to 24 h following drug administration. A washout period of one week separated both treatment periods. Tramadol plasma concentrations were determined by means of a validated HPLC method (fluorescence detector, verapamil as an internal standard). Values of 1,226.4 ng h/ml (Tramadol) and 1,397.01 ng x h/ml (Tramal) for the parameter AUC(0-infinity) demonstrate a nearly identical extent of drug absorption. Maximum concentrations--Cmax (217.81 ng/ml and 246.0 ng/ml) and time to reach maximum plasma concentration--Tmax (2.14 and 2.31 h) achieved for Tramadol and reference preparation did not differ significantly. the bioavailability of tramadol hydrochloride after administration of Tramadol is the same as after administration of Tramal, whose clinical efficacy was tested before.
In a previous study we have provided evidence, that acute experimental hypercapnia due to hypoven... more In a previous study we have provided evidence, that acute experimental hypercapnia due to hypoventilation in the rabbit alters blood-cerebrospinal fluid barrier function in the brain (Pakulski et al. 1998). The purpose of this study therefore was to determine if lidocaine would prevent the observed alterations in the blood-cerebrospinal fluid barrier function. The experiments were conducted in 16 adult Chinchilla rabbits submitted to acute hypercapnia due to mechanical hypoventilation (PaCO2 between 8-9.5 kPa over 180 minutes) under pentobarbital anaesthesia. The studied group (n = 8) was treated by lidocaine infusion 10 mg kg-1 h-1. After 180 minutes of hypercapnia the value of cerebrospinal fluid-blood index of gentamycin concentration, indicating the permeability of the blood-cerebrospinal fluid barrier, was significantly lower in animals treated with lidocaine (4.03 +/- 2.32 vs. 19.05 +/- 5.49; P &lt; 0.01). We conclude that lidocaine may attenuate the increase of blood-cerebrospinal fluid barrier permeability under conditions of experimental acute hypercapnia lasting 180 minutes in the mechanically ventilated rabbit.
Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego
The aim of this study was to investigate the bioavailability of isosorbide mononitrate (IS-5MN) a... more The aim of this study was to investigate the bioavailability of isosorbide mononitrate (IS-5MN) after oral administration of Monocard 20 mg-capsules, made in &quot;Synteza&quot; â Pharmaceutical-Chemical Company in Poznań. Effox 20 mg, coated tablets from Schwarz Pharma, was used as an counterpart of Monocard 20 mg. The concentrations of IS-5MN in healthy volunteers&#39; plasma were determined by using Hewlett Packard gas chromatography. The bioavailability of IS-5MN after oral administration of Monocard 20 mg is the same as after oral administration of Effox 20 mg, whose clinical efficacy was tested before. This conclusion confirms the same value of AUC, tmax, cmax and other pharmacokinetic parameters of Monocard 20 mg and Effox 20 mg.
Summary Periaxial techniques of regional anaesthesia are combined with a risk of serious complica... more Summary Periaxial techniques of regional anaesthesia are combined with a risk of serious complications as hematomas in the epidural space of the spinal canal or intramedullary bleedings in patients receiving medication for anti- thromboembolic prophylaxis. Incidence of hematomas following periaxial regional anaesthesia depends of many factors, as age, needle size, anatomic conditions, drug used etc. Because the risk of bleeding during anti-coagulation therapy is not assessed in prospective studies but is calculated from known pharmacokinetic and pharmacody- namic data, careful risk-benefit analysis in each patient and his individual evaluation shall be mandatory. Clinical experience from last 8 years demonstrate high risk of thrombosis following salicylate withdrawal in patients after fresh stent implantation or instable coronary insufficiency for the elimination of the bleeding risk due to periaxial anaesthesia. General recommendations for the periaxial anaesthesia in patients with...
The aim of the work was to study the influence of pregnancy induced arterial hypertension (PIH) o... more The aim of the work was to study the influence of pregnancy induced arterial hypertension (PIH) on hermetic aspects of the blood-brain barrier. Neurological consultation was followed by cranial computed tomography which revealed changes within structures of central nervous system. The observations were performed in 6 pregnant women, assigned to control group--C, and study group--G. All women had caesarean section performed in conductive anaesthesia. The method included collection of 15 ml venous blood and 4 ml cerebrospinal fluid (CSF). Albumin and immunoglobulin G (IgG) serum concentrations, micro-albumin and IgG CSF concentrations, and permeability indexes for albumin and IgG--Qalb and QIqG, were estimated. In contrast to group C, increased Qalb and QIgG indexes proved lack of integrity of blood-brain barrier in the group G. Control cranial CT scans revealed partial subsidence of changes after 3-5 days, and complete subsidence after 9-14 days.
Brain has its own unique and effective protection system that controls the process of active tran... more Brain has its own unique and effective protection system that controls the process of active transport of chemical substances from blood to neurons and cerebrospinal fluid. The above mentioned system is called the blood brain barrier. As far as morphology is concerned the barrier consists of several membranes isolating the following compartments of the intracranial space: brain tissues, blood and cerebrospinal fluids. One of those membranes-blood/brain tissues barrier, has been described in the first part of this work. Structure and function of the blood/CSF barrier and CSF/brain tissues barrier are described in the second part.
Proceedings of the European Dialysis and Transplant Association. European Dialysis and Transplant Association, 1979
Haemofiltrate was administered into the duodenum of 5 ambulatory dogs through an implanted silast... more Haemofiltrate was administered into the duodenum of 5 ambulatory dogs through an implanted silastic catheter at a rate of 5-10 ml/min. None of the dogs presented signs of discomfort or suffered from regurgitation or diarrhoea. All 5 dogs had solid stools, enhanced diuresis and no change in body weight over a time period of 8 hours. Filtration rates between 5 and 10 ml/min were obtained in 7 dogs after connecting an Amicon in-line Ultrafilter with an external a.v. shunt. The intestinal recycling rate via the duodenal tube as a rule was 2 ml/min lower than the free flow ultrafiltration. Recirculation of autologous haemofiltrate in 5 uraemic dogs indicated unselective reabsorption of all electrolytes and small molecules. In 5 experiments with intestinal substitution of ultrafiltrate by a potassium-free Ringer's lactate solution, correction of acidosis and decrease in plasma potassium, creatinine and BUN was achieved.
The aim of this study was to examine the phonological functioning (reading speed and accuracy) of... more The aim of this study was to examine the phonological functioning (reading speed and accuracy) of hospital patients under general anaesthesia administered during colonoscopy. In this study the 'Łatysz' non-word reading test was used to measure the impact of selected anaesthetics on the phonological aspect of language processing (defined as decoding without referring to the meaning) in a group of 22 anaesthetised patients compared to 23 non-anaesthetised patients from university clinics. Compared to the preoperative performance, a decrease in reading accuracy and reading speed was observed only in the Anaesthesia Group - AG (in the subjects aged ≥ 35 years) 1.5 h after the administration of anaesthetics. Postoperatively, the AG were significantly slower and less accurate than the Control Group - CG - after 1.5 h. After 3 h, the AG had regained their baseline values both in reading accuracy and reading speed. During the last assessment session, the AG pronounced 82% of the wor...
Revista española de anestesiología y reanimación, 2013
Emergencies can occur at any time during pregnancy. In addition to obstetricians and midwives, an... more Emergencies can occur at any time during pregnancy. In addition to obstetricians and midwives, anesthesiologists should also be familiar with pregnancy-related emergencies. The aim of this study was to assess the basic and advanced knowledge regarding the management of pregnancy-related emergencies of anesthesiologists. An anonymous questionnaire was distributed to anesthesiologists at two conferences (S1, n = 87; S2, n = 35), and to other groups comprising doctors during specialization (DS, n = 28) and postgraduate doctors (PD, n = 130). Ultimately, 280 doctors were included in the survey. The first part of the questionnaire collected demographics, and a second one evaluated both their basic and advanced knowledge by taxonomy. Basic knowledge regarding the management of pregnancy-related emergencies of the tested group was poorer compared with advanced knowledge. The DS group had better basic management skills than anesthesiology specialists and the PD group. Significantly worse re...
frequency index (SFx) monitoring to assess the depth of anaesthesia during propofol-opioid total ... more frequency index (SFx) monitoring to assess the depth of anaesthesia during propofol-opioid total intravenous anaesthesia (TIVA). Methods: Thirty-three patients scheduled for laparoscopic cholecystectomy under propofol TIVA were prospectively and randomly allocated to receive either remifentanil (bolus of 1.0 μg/kg, followed by continuous infusion from 0.25 to 0.05 μg/kg/min) [n = 18] or alfentanil (bolus of 10 μg/kg, followed by continuous infusion from 2.0 to 0.5 μg/kg/min) [n = 15]. EEG activity was monitored to achieve the desired depth of anaesthesia, and intravenous propofol was titrated to keep the SFx at 70-80%. The remifentanil and alfentanil groups were compared in relation to the plasma propofol concentration required for an adequate level of hypnosis during maintenance of anaesthesia, Pearson correlation coefficient for the relationship between the plasma propofol concentration and SFx values, recovery parameters, and recall of events during anaesthesia. Results: The study groups were comparable with regard to demographic characteristics, type and duration of surgery, and time to resumption of spontaneous ventilation. No evidence of explicit recall was noted. The mean plasma propofol concentration required for an adequate level of hypnosis during maintenance of anaesthesia was significantly higher in the alfentanil group (3.20 μg/mL) compared with the remifentanil group (2.17 μg/L) [p < 0.05]. In both groups, the Pearson correlation coefficient test showed a linear correlation between SFx values and propofol concentration in the studied propofol concentration range. The mean time to orientation for name and place was significantly shorter (p < 0.05), the mean propofol concentration at orientation for name and place and at the resumption of spontaneous ventilation timepoints was significantly lower (both p < 0.01), and the mean SFx value at resumption of spontaneous ventilation timepoint was significantly higher (p < 0.01) in the remifentanil group.
Bidirectional transport of Na + and Cl ions by the epithelium controls production and composition... more Bidirectional transport of Na + and Cl ions by the epithelium controls production and composition of airway surface liquid and airway transepithelial potential difference and in these ways supports mucociliary transport. Volatile anesthetics are able to inhibit epithelial ion transport processes when applied at high concentration and have been suggested to elicit depression of airway clearance and both these effects could be involved in postoperative pulmonary complications. The goal of these studies was to reveal possible influence of halothane and isoflurane at lower concentrations on electrogenic ion transport in airway epithelium. These studies were performed on the isolated rabbit tracheal wall mounted in the Ussing chamber. The reaction of the preparation to the gentle mechanical stimulation performed as a jet flux was examined without or in the presence of anesthetics at concentration equivalent to 0.5 minimal anesthetic concentration of volatile anesthetics in pulmonary alveoli (MAC), 1 MAC, 2 MAC, 5 MAC and 10 MAC. The volatile anesthetics at concentrations equivalent to 5 and 10 MAC affected airway transepithelial potential difference and influenced hyperpolarization or depolarization reactions which occurred after mechanical stimulation. The above effects were present when Na + transport was inhibited by amiloride. The disturbed epithelial Cl transport may be proposed as an explanation of the action of volatile anesthetics on electrophysiological parameters of the isolated tracheal wall although the influence of anesthetics on tachykinin secretion from C-fiber endings, which are present in the preparation, should also be taken into consideration. The long-lasting action (tens of minutes) of volatile anesthetics on the isolated tracheal wall should be also studied in the future as a model of airway reaction to prolonged volatile anesthesia.
Medical science monitor : international medical journal of experimental and clinical research, Jan 18, 2016
BACKGROUND Controlled induced hypotension guarantees less blood loss and better visibility of the... more BACKGROUND Controlled induced hypotension guarantees less blood loss and better visibility of the surgical site. The impact of hypotension on post-operative cognitive functions is still being discussed. The objective of this study was to evaluate the effects of controlled induced hypotension on the cognitive functions of patients undergoing functional endoscopic sinus surgery (FESS). MATERIAL AND METHODS We allocated 47 patients with a good grade of preoperative cognitive functions evaluated with the Mini-Mental State Examination to 3 groups (1 - mild hypotension, 2 - intermediate hypotension, 3 - severe hypotension) according to the degree of mean intraoperative arterial pressure compared with preoperative blood pressure. Cognitive functions were evaluated preoperatively, 6 h, and 30 h postoperatively with standardized tests: the Stroop Test, Trail Making Test (TMT), and Verbal Fluency Test (VFT). A decrease in the test results and increase in the number of mistakes made were consi...
Medical Science Monitor International Medical Journal of Experimental and Clinical Research, Jun 1, 2002
The aim of this research was to explain whether different hormonal conditions caused by disturbed... more The aim of this research was to explain whether different hormonal conditions caused by disturbed concentrations of estrogens and progesterone might lead to alteration of CNS reaction following administration of the hypnotic agent thiopental. The investigated factor was the rate of loss of the eyelid reflex after intravenous thiopental administration, since this corresponds with loss of consciousness. The investigation was performed in 24 sexually mature female Chinchilla rabbits divided into 4 groups of 6 rabbits each. The animals were oophorectomized (hypoprogesterone/hypoestrogen), hyperestrogen (sham surgery plus estradiol injections), hyperprogesterone (sham surgery plus 17 alpha-hydroxyprogesterone injections), or normal (sham surgery). Twelve weeks later, thiopental (40 mg/ml) was infused through the intravenous cannula at a constant rate (90 ml/hour) until loss of the eyelid reflex, at which time blood was sampled for determination of thiopental, b-estradiol, progesterone and 17 alpha-hydroxyprogesterone concentrations. The ANOVA and Tukey tests were applied in statistical analysis (p=0.05). Hyperprogesterone rabbits lost consciousness faster (138 +/- 34.6 sec), at a lower plasma thiopental concentration (46.3 +/- 6.6 microg/ml), and required less thiopental (24.63 +/- 6.44 mg/kg) than controls; hypoprogesterone rabbits lost consciousness slower (207.5 +/- 30.9 sec), at a higher plasma thiopental concentration (129.2 +/- 24.9 microg/ml), and required more thiopental (38.51 +/- 2.33 mg/kg) than controls. The time of sleep induction in the control group was 190 +/- 25.7 sec.; the serum thiopental concentration was 77.8 +/- 13.9 microg/ml, and the total thiopental consumption was 35.8 +/- 3.51 mg/kg. Estrogen status has no effect. Various hormonal states are accompanied by different CNS reactions to thiopental. Among the studied groups of sex steroids, only progestins significantly modify the CNS response to barbiturate infusion.
Medical Science Monitor International Medical Journal of Experimental and Clinical Research, Feb 1, 2003
Permissive hypercapnia exerts a protective influence in tissue injury, possibly by attenuating fr... more Permissive hypercapnia exerts a protective influence in tissue injury, possibly by attenuating free radical activity. Increased CO2 concentrations may decrease the production of phagocyte reactive oxygen intermediates (ROI). In this study, we used bronchoalveolar lavage (BAL) to determine whether isooxic permissive hypercapnia due to hypoventilation would influence neutrophil recruitment into alveolar spaces and ROI production of BAL phagocytes, as measured by luminol dependent chemiluminescence. 27 Chinchilla rabbits randomized into three groups: control group (C; n=7), normocapnia (NC; n=10), and hypercapnia (HC; n=10) were anaesthetized with pentobarbitone and intubated. Bronchoalveolar lavage was obtained either after intubation (controls) or after mechanical ventilation lasting 240 minutes under normocapnia or permissive hypercapnia conditions. BAL cells were counted and luminol-dependent chemiluminescence estimations were performed. The BAL neutrophil count was significantly higher in the hypercapnia group than in normocapnia animals. The chemiluminescence of opsonized zymosan-stimulated cells was significantly higher in the normocapnia group than in the controls; the differences between the HC and NC animals, and between the HC and control animals, did not reach statistical significance. In the mechanically ventilated rabbit under pentobarbitone anaesthesia, acute isooxic hypercapnia due to hypoventilation increases neutrophil BAL count, without direct impact on mixed BAL-cell chemiluminescence; moreover, conventional ventilation increases the chemiluminescence of opsonized zymosan-stimulated BAL cells
The aim of this study was to investigate the bioavailability of tramadol hydrochloride after oral... more The aim of this study was to investigate the bioavailability of tramadol hydrochloride after oral administration of Tramadol--50 mg capsules, made in Synteza Pharmaceutical-Chemical Company in Poznań. As a reference preparation of Tramadol was used Tramal--50 mg capsules, (Grünenthal, Germany). The preparations were investigated in 20 healthy volunteers, according to a randomised two-way, cross-over design in the fasted state. Blood samples for determination of tramadol plasma concentrations were collected at pre-defined time points up to 24 h following drug administration. A washout period of one week separated both treatment periods. Tramadol plasma concentrations were determined by means of a validated HPLC method (fluorescence detector, verapamil as an internal standard). Values of 1,226.4 ng h/ml (Tramadol) and 1,397.01 ng x h/ml (Tramal) for the parameter AUC(0-infinity) demonstrate a nearly identical extent of drug absorption. Maximum concentrations--Cmax (217.81 ng/ml and 246.0 ng/ml) and time to reach maximum plasma concentration--Tmax (2.14 and 2.31 h) achieved for Tramadol and reference preparation did not differ significantly. the bioavailability of tramadol hydrochloride after administration of Tramadol is the same as after administration of Tramal, whose clinical efficacy was tested before.
In a previous study we have provided evidence, that acute experimental hypercapnia due to hypoven... more In a previous study we have provided evidence, that acute experimental hypercapnia due to hypoventilation in the rabbit alters blood-cerebrospinal fluid barrier function in the brain (Pakulski et al. 1998). The purpose of this study therefore was to determine if lidocaine would prevent the observed alterations in the blood-cerebrospinal fluid barrier function. The experiments were conducted in 16 adult Chinchilla rabbits submitted to acute hypercapnia due to mechanical hypoventilation (PaCO2 between 8-9.5 kPa over 180 minutes) under pentobarbital anaesthesia. The studied group (n = 8) was treated by lidocaine infusion 10 mg kg-1 h-1. After 180 minutes of hypercapnia the value of cerebrospinal fluid-blood index of gentamycin concentration, indicating the permeability of the blood-cerebrospinal fluid barrier, was significantly lower in animals treated with lidocaine (4.03 +/- 2.32 vs. 19.05 +/- 5.49; P &lt; 0.01). We conclude that lidocaine may attenuate the increase of blood-cerebrospinal fluid barrier permeability under conditions of experimental acute hypercapnia lasting 180 minutes in the mechanically ventilated rabbit.
Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego
The aim of this study was to investigate the bioavailability of isosorbide mononitrate (IS-5MN) a... more The aim of this study was to investigate the bioavailability of isosorbide mononitrate (IS-5MN) after oral administration of Monocard 20 mg-capsules, made in &quot;Synteza&quot; â Pharmaceutical-Chemical Company in Poznań. Effox 20 mg, coated tablets from Schwarz Pharma, was used as an counterpart of Monocard 20 mg. The concentrations of IS-5MN in healthy volunteers&#39; plasma were determined by using Hewlett Packard gas chromatography. The bioavailability of IS-5MN after oral administration of Monocard 20 mg is the same as after oral administration of Effox 20 mg, whose clinical efficacy was tested before. This conclusion confirms the same value of AUC, tmax, cmax and other pharmacokinetic parameters of Monocard 20 mg and Effox 20 mg.
Summary Periaxial techniques of regional anaesthesia are combined with a risk of serious complica... more Summary Periaxial techniques of regional anaesthesia are combined with a risk of serious complications as hematomas in the epidural space of the spinal canal or intramedullary bleedings in patients receiving medication for anti- thromboembolic prophylaxis. Incidence of hematomas following periaxial regional anaesthesia depends of many factors, as age, needle size, anatomic conditions, drug used etc. Because the risk of bleeding during anti-coagulation therapy is not assessed in prospective studies but is calculated from known pharmacokinetic and pharmacody- namic data, careful risk-benefit analysis in each patient and his individual evaluation shall be mandatory. Clinical experience from last 8 years demonstrate high risk of thrombosis following salicylate withdrawal in patients after fresh stent implantation or instable coronary insufficiency for the elimination of the bleeding risk due to periaxial anaesthesia. General recommendations for the periaxial anaesthesia in patients with...
The aim of the work was to study the influence of pregnancy induced arterial hypertension (PIH) o... more The aim of the work was to study the influence of pregnancy induced arterial hypertension (PIH) on hermetic aspects of the blood-brain barrier. Neurological consultation was followed by cranial computed tomography which revealed changes within structures of central nervous system. The observations were performed in 6 pregnant women, assigned to control group--C, and study group--G. All women had caesarean section performed in conductive anaesthesia. The method included collection of 15 ml venous blood and 4 ml cerebrospinal fluid (CSF). Albumin and immunoglobulin G (IgG) serum concentrations, micro-albumin and IgG CSF concentrations, and permeability indexes for albumin and IgG--Qalb and QIqG, were estimated. In contrast to group C, increased Qalb and QIgG indexes proved lack of integrity of blood-brain barrier in the group G. Control cranial CT scans revealed partial subsidence of changes after 3-5 days, and complete subsidence after 9-14 days.
Brain has its own unique and effective protection system that controls the process of active tran... more Brain has its own unique and effective protection system that controls the process of active transport of chemical substances from blood to neurons and cerebrospinal fluid. The above mentioned system is called the blood brain barrier. As far as morphology is concerned the barrier consists of several membranes isolating the following compartments of the intracranial space: brain tissues, blood and cerebrospinal fluids. One of those membranes-blood/brain tissues barrier, has been described in the first part of this work. Structure and function of the blood/CSF barrier and CSF/brain tissues barrier are described in the second part.
Proceedings of the European Dialysis and Transplant Association. European Dialysis and Transplant Association, 1979
Haemofiltrate was administered into the duodenum of 5 ambulatory dogs through an implanted silast... more Haemofiltrate was administered into the duodenum of 5 ambulatory dogs through an implanted silastic catheter at a rate of 5-10 ml/min. None of the dogs presented signs of discomfort or suffered from regurgitation or diarrhoea. All 5 dogs had solid stools, enhanced diuresis and no change in body weight over a time period of 8 hours. Filtration rates between 5 and 10 ml/min were obtained in 7 dogs after connecting an Amicon in-line Ultrafilter with an external a.v. shunt. The intestinal recycling rate via the duodenal tube as a rule was 2 ml/min lower than the free flow ultrafiltration. Recirculation of autologous haemofiltrate in 5 uraemic dogs indicated unselective reabsorption of all electrolytes and small molecules. In 5 experiments with intestinal substitution of ultrafiltrate by a potassium-free Ringer's lactate solution, correction of acidosis and decrease in plasma potassium, creatinine and BUN was achieved.
The aim of this study was to examine the phonological functioning (reading speed and accuracy) of... more The aim of this study was to examine the phonological functioning (reading speed and accuracy) of hospital patients under general anaesthesia administered during colonoscopy. In this study the 'Łatysz' non-word reading test was used to measure the impact of selected anaesthetics on the phonological aspect of language processing (defined as decoding without referring to the meaning) in a group of 22 anaesthetised patients compared to 23 non-anaesthetised patients from university clinics. Compared to the preoperative performance, a decrease in reading accuracy and reading speed was observed only in the Anaesthesia Group - AG (in the subjects aged ≥ 35 years) 1.5 h after the administration of anaesthetics. Postoperatively, the AG were significantly slower and less accurate than the Control Group - CG - after 1.5 h. After 3 h, the AG had regained their baseline values both in reading accuracy and reading speed. During the last assessment session, the AG pronounced 82% of the wor...
Revista española de anestesiología y reanimación, 2013
Emergencies can occur at any time during pregnancy. In addition to obstetricians and midwives, an... more Emergencies can occur at any time during pregnancy. In addition to obstetricians and midwives, anesthesiologists should also be familiar with pregnancy-related emergencies. The aim of this study was to assess the basic and advanced knowledge regarding the management of pregnancy-related emergencies of anesthesiologists. An anonymous questionnaire was distributed to anesthesiologists at two conferences (S1, n = 87; S2, n = 35), and to other groups comprising doctors during specialization (DS, n = 28) and postgraduate doctors (PD, n = 130). Ultimately, 280 doctors were included in the survey. The first part of the questionnaire collected demographics, and a second one evaluated both their basic and advanced knowledge by taxonomy. Basic knowledge regarding the management of pregnancy-related emergencies of the tested group was poorer compared with advanced knowledge. The DS group had better basic management skills than anesthesiology specialists and the PD group. Significantly worse re...
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Papers by Leon Drobnik