Glutamine prevents the biliary lithogenic effect of total parenteral nutrition in rats.

Long-term total parenteral nutrition (TPN) is known to be associated with pigment gallstones. The objectives of this study were to identify the lithogenic effects of TPN and to determine whether glutamine (GLN)-enriched TPN can prevent such changes. Eighteen male Wistar rats were randomly divided into three groups of six animals.

Glutamine prevents parenteral nutrition-induced increases in intestinal permeability.

In addition to its role in absorbing nutrients, the intestinal mucosa provides an important barrier against toxins and bacteria in the bowel lumen. This study evaluated changes in rat jejunal permeability and histology after total parenteral nutrition (TPN) or TPN supplemented with glutamine. Lactulose and mannitol were used to measure jejunal permeability, and fixed stained histologic specimens were used to measure mucosal dimensions.

Evaluation of intravenous ketorolac administered by bolus or infusion for treatment of postoperative pain. A double-blind, placebo-controlled, multicenter study.

Background: Ketorolac is a nonsteroidal analgesic that may provide postoperative analgesia without opioid-related side effects. This double-blind, randomized, multicenter study evaluated the analgesic efficacy and safety of intravenous ketorolac in 207 patients during the first 24 h after major surgery.

Methods: Subjects were assigned to receive one of three analgesic regimens: a ketorolac infusion, ketorolac boluses, or placebo.

Intermittent sequential pneumatic compression in prevention of venous stasis associated with pneumoperitoneum during laparoscopic cholecystectomy.

Objectives: To determine whether pneumoperitoneum and reverse Trendelenburg's position used during laparoscopy impede common femoral venous flow and whether calf-length intermittent sequential pneumatic compression (ISPC) overcomes this impedance.

Design: Using Doppler ultrasonography, peak systolic velocities in the common femoral vein were measured in patients undergoing laparoscopic cholecystectomy with peritoneal insufflation of carbon dioxide. Measurements were obtained during three intervals: preoperatively with the patients in the supine position; after induction of general anesthesia with the patients in the supine position; and after insufflation to 13 to 15 mm Hg with the patients in the 30 degrees reverse Trendelenburg position (both with and without ISPC).

Comparison of ketorolac and meperidine in patients with postoperative pain--impact on health care utilization.

A double-blind, randomized study was conducted to compare the effects of intramuscular ketorolac tromethamine and meperidine hydrochloride, and subsequent oral pain medication, on health care utilization and postoperative recovery. Following abdominal hysterectomy or cholecystectomy, 210 patients (aged 18 to 70 years; 189 women, 21 men) were randomly assigned to therapy and evaluated for efficacy, safety, nursing care requirements, functional independence, recovery milestones, and quality of life. The patients received 30 mg of ketorolac intramuscularly every 3 to 6 hours as needed, followed by 10 mg of ketorolac every 4 to 6 hours, or 100 mg of meperidine intramuscularly every 3 to 6 hours as needed, followed by acetaminophen/codeine (600 mg/60 mg) orally every 4 to 6 hours.