In SISO cases, firocoxib reduced a biomarker of endotoxaemia as compared with flunixin meglumine while continuing to provide similar levels of pain control.

Device-related costs of using CWI for pain management after abdominal laparotomy are partly counterbalanced by a reduction in resource consumption. The cost-effectiveness analysis suggests that CWI is the dominant treatment strategy for managing postoperative pain (i.e. more effective and less costly) in comparison with i.v.-PCA. When compared with EDA, CWI is less costly with almost equivalent efficacy. This economic evaluation may be useful for clinicians to design algorithms for pain management after major abdominal surgery.

The suitability of tetrodotoxin (TTX) for studies of the neural control of vascular smooth muscle (VSM) tone in the microcirculation was evaluated by determining 1) whether TTX blockade of neural input to adrenergically innervated VSM is reversible and 2) whether TTX depresses active VSM tone directly. Diameters of rat mesenteric veins and third- and fourth-order arterioles of the hamster cheek pouch were measured by image splitting. VSM transmembrane potentials (Em) were measured with microelectrodes in rat mesenteric veins. In the veins TTX suffusion (10(-6) g/ml) resulted in dilation and reversible Em hyperpolarization. TTX also reversibly blocked the venoconstrictor response to perivascular nerve stimulation. TTX had no effect on the resting tone of hamster arterioles or on arteriolar constriction in response to increased oxygen availability. TTX did not affect the response to norepinephrine in either preparation. This study indicates that TTX specifically and reversibly blocks VSM responses to neural activation but that it has no direct depressant effect on resting VSM tone or active constriction in response to nonneural activation.

Orthopedic injuries constitute the majority of wounds sustained by U.S. soldiers in recent conflicts. The risk of infection is considerable with fracture fixation devices. In this pilot study, we examined the use of unique bactericidal micron-thin sol-gel films on fracture fixation devices and their ability to prevent and eradicate infections. External fixation was studied with micron-thin sol-gel coated percutaneous pins releasing triclosan and inserted medially into rabbit tibiae. A total of 11 rabbits received percutaneous pins that were either uncoated or sol-gel/triclosan coated. Internal fracture fixation was also studied using sol-gel coated intramedullary (IM) nails releasing vancomycin in the intramedullary tibiae. Six sheep received IM nails that were coated with a sol-gel film that either contained vancomycin or did not contain vancomycin. All animals were challenged with Staphylococcus aureus around the implant. Animals were euthanized at 1 month postoperative. Rabbits receiving triclosan/sol-gel coated percutaneous pins did not show signs of infection. Uncoated percutaneous pins had a significantly higher infection rate. In the sheep study, there were no radiographic signs of osteomyelitis with vancomycin/sol-gel coated IM nails, in contrast to the observations in the control cohort. Hence, the nanostructured sol-gel controlled release technology offers the promise of a reliable and continuous delivery system of bactericidals from orthopedic devices to prevent and treat infection.