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1.

Objective

The aim of this preliminary proof-of-concept study was to evaluate and compare the success and complication rate of infiltration of the maxillary nerve of cadaver heads using previously described surface landmarks, standard ultrasound and a novel needle guidance positioning ultrasound system (SonixGPS).

Study design

Prospective, anatomical, method-comparison study.

Animals

Thirty-eight equine cadaver heads.

Methods

Twenty-six veterinary students performed the three methods consecutively on cadaver heads using an 18 gauge, 8.9 cm spinal needle and 0.5 mL iodinated contrast medium. Computed tomography was used to quantify success (deposition of contrast in contact with the maxillary nerve) and complication rate (contrast identified within surrounding vasculature or periorbital structures) associated with each method.

Results

Perineural injection of the maxillary nerve was attempted 76 times, with an overall success rate of 65.8% (50/76) and complication rate of 53.9% (41/76). Success rates were 50% (13/26) with surface landmark, 65.4% (17/26) with standard ultrasound guidance and 83.3% (20/24) with SonixGPS guidance approaches (Fisher's exact test, p = 0.046). No significant difference in complication rate was found between the three methods.

Conclusions

Ultrasound-guided maxillary nerve blocks were significantly more successful than surface landmark approaches when performed by inexperienced operators, and the highest success rate was achieved with guidance positioning system (GPS) needle guidance.

Clinical relevance

Local anaesthesia of the equine maxillary nerve in the fossa pterygopalatina is frequently used for diagnostic and surgical procedures in the standing sedated horse. Due to vague superficial landmarks with various approaches and the need for experience via ultrasound guidance, this block remains challenging. GPS guidance may improve reliability of maxillary and other nerve blocks, and allow a smaller volume of local anaesthetic solution to be used, thereby improving specificity and reducing the potential for side effects.  相似文献   

2.
3.

Objective

To evaluate the use of an experimental colloid model for teaching veterinary anesthesia residents ultrasound-guided technique for nerve blockade.

Study design

Prospective, blinded and randomized.

Methods

Colloid models were constructed for practice in ultrasound-guided needle location. Nine veterinary anesthesia residents with no prior experience of ultrasound-guided technique for nerve blocks were randomly divided into three groups. Each group received theoretical orientation. Two groups were assigned to practical training using the experimental model: group 1 (G1) received 2 hours of training and group 2 (G2) received 1 hour of training prior to testing with specific tasks. Group 3 (G3) received no practical training. During testing, the time required for task completion (e.g., display of structures and positioning a needle) and the number of failures were recorded.

Results

The average times to completion of the tasks and the number of technical failures were: G1, 47 seconds and 1 failure; G2, 68 seconds and 2 failures; G3, 187 seconds and 7 failures.

Conclusions and clinical relevance

In residents with no prior experience of ultrasound-guided needle placement, using an experimental colloid model and a longer training period was associated with increased accuracy and decreased time to task completion. Based on the results of this study, training with an experimental model can be recommended to improve the speed and accuracy of needle manipulation using ultrasound in clinicians with no prior experience of ultrasound-guided technique.  相似文献   

4.

Objective

To investigate the utility of identifying the superficial circumflex iliac artery (SCIA) via ultrasound as an anatomical landmark for ultrasound-guided femoral nerve block.

Study design

Observational study.

Animals

A group of six canine cadavers weighing >20 kg.

Methods

Pelvic limbs from six canine cadavers were examined to study the relationship between the SCIA and the femoral nerve. Ultrasonographic imaging of the SCIA in each limb was obtained with the transducer placed transversely in the medial aspect of the pelvic limb at the inguinal area. Subsequently, a needle was inserted in close proximity to the femoral nerve using an in-plane technique based on the anatomical relationship between the SCIA and femoral nerve. A total of 0.1 mL of colored latex was then injected at the location where the femoral nerve was expected to be in relationship to the SCIA. Gross dissection of the inguinal region in each pelvic limb was performed after injection. Positive nerve location was defined when the colored latex was in contact with the femoral nerve.

Results

A total of eleven pelvic limbs were injected because the SCIA could not be successfully visualized in one limb. Upon dissection, colored latex was found to be in direct contact with the femoral nerve in all 11 injected limbs.

Conclusions and clinical relevance

We concluded that the ultrasonographic visualization of the SCIA assisted in the accurate deposition of dye in proximity to the femoral nerve of canine cadavers. Further investigation will determine the efficacy of this technique for performing femoral nerve blocks.  相似文献   

5.

Objective

To develop a modified ultrasound-guided parasacral approach to the sciatic nerve and compare the effects of a volume of 0.2 mL kg–1 of 0.5% levobupivacaine with an equivalent volume of 0.9% saline injected near the sciatic nerve.

Study design

Cadaveric and experimental, blinded, randomized study.

Animals

Seven canine cadavers and seven experimental Beagle dogs.

Methods

Both sciatic nerves of seven cadavers were identified using a modified in-plane ultrasound-guided approach. Methylene blue solution (0.2 mL) was injected perineurally, and success was evaluated through dissection. The same approach was repeated in seven Beagle dogs sedated with dexmedetomidine (50 μg kg–1) injected intramuscularly (IM). After randomization, 0.2 mL kg–1 of 0.5% levobupivacaine (limb L) and 0.2 mL kg–1 of 0.9% saline (limb C) were injected perineurally on either right or left limb. Block success was determined by sensory deficits every hour for 8 hours after an atipamezole injection (0.2 mg kg–1) IM. Reaction to pinprick (binary score) over the course of the sciatic nerve (four locations) and locomotion were assessed.

Results

The overall sciatic nerve block success was 93% in cadavers and 86% in sedated dogs. It was impossible to localize the sciatic nerves in one obese sedated dog. Significant differences between limb L and limb C were observed for pinprick at great trochanter, caudal thigh and lateral tarsal joint (p < 0.0001). Reaction to pinprick was absent in all dogs at great trochanter and caudal thigh up to at least 3 hours on limb L. Locomotion was impaired in all but one dog for 60 (30–210) minutes (median; interquartile range). No complications were observed.

Conclusions and clinical relevance

A volume of ≥0.2 mL kg–1 and a concentration of 0.5% levobupivacaine can be recommended when using a modified ultrasound-guided parasacral approach to the sciatic nerve in dogs.  相似文献   

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9.

Objectives

To describe the ‘blind’ and ultrasound-guided approaches to block the maxillary nerve in donkeys. To compare the success and complication rates between the ‘blind’ and ultrasound-guided techniques based on staining of nerves and other structures in cadavers and assessing level of analgesia in live animals.

Study design

Prospective anatomical and experimental study.

Animals

Eighteen cadaver heads and nine adult live donkeys.

Methods

Phase 1: the anatomical characteristics of the maxillary nerve and its related structures were investigated within the pterygopalatine fossa in five cadavers. Phase 2: 0.1 mL of methylene blue dye was injected blindly and via ultrasound guidance in 13 cadavers to stain the left and right maxillary nerves, respectively. Nerve staining and dye spreading were evaluated through cadaver dissection. Phase 3: the former procedures were applied in nine live donkeys using lidocaine hydrochloride 2% and the onset of analgesia was verified through needle pricking at the naris.

Results

Ultrasound-guided deposition of methylene blue dye in cadavers and lidocaine injection in live animals were successful in all instances (accuracy = 100%) without inadvertent vascular penetration. Using the ‘blind’ technique, misdirection and intravascular deposition of dye were reported in four cadavers (accuracy = 69.2%) and neurovascular trauma was observed in live donkeys (five cases). Loss of cutaneous sensation in the ipsilateral naris was earlier in the ultrasound-guided approach (10.9 ± 1.8 minutes) than in the ‘blind’ technique (27.8 ± 3.2 minutes; p < 0.001).

Conclusions and clinical relevance

An ultrasound-guided maxillary nerve blockade proved very practical and can be used to block the maxillary nerve with a high degree of accuracy while avoiding vascular penetration. Further studies are mandatory to validate its analgesic effectiveness in clinical situations.  相似文献   

10.

Objective

To evaluate motor and sensory blockade of combining dexmedetomidine with ropivacaine, administered perineurally or systemically, for femoral and sciatic nerve blocks in conscious dogs.

Study design

Randomized, controlled, experimental study.

Animals

Seven healthy Beagle dogs, aged 3.3 ± 0.1 years and weighing 11.0 ± 2.4 kg.

Methods

Dogs were anesthetized with isoflurane on three separate occasions for unilateral femoral and sciatic nerve blocks and were administered the following treatments in random order: perineural ropivacaine 0.75% (0.1 mL kg–1) on each nerve and intramuscular (IM) saline (0.2 mL kg–1) (GCON); perineural dexmedetomidine (1 μg mL–1) and ropivacaine 0.75% (0.1 mL kg–1) on each nerve and IM saline (0.2 mL kg–1) (GDPN); and perineural ropivacaine 0.75% (0.1 mL kg–1) on each nerve and IM dexmedetomidine (1 μg mL–1, 0.2 mL kg–1) (GDIM). Nerve blocks were guided by ultrasound and electrical stimulation and dogs were allowed to recover from general anesthesia. Sensory blockade was evaluated by response to clamp pressure on the skin innervated by the saphenous/ femoral, common fibular and tibial nerves. Motor blockade was evaluated by observing the ability to walk and proprioception. Sensory and motor blockade were evaluated until their full recovery.

Results

No significant differences in onset time to motor and sensory blockade were observed among treatments. Duration of motor blockade was not significantly different among treatments; however, duration of tibial sensory blockade was longer in the GDPN than in the GDIM treatment.

Conclusions and clinical relevance

Although a longer duration of sensory blockade was observed with perineural dexmedetomidine, a significant increase compared with the control group was not established. Other concentrations should be investigated to verify if dexmedetomidine is a useful adjuvant to local anesthetics in peripheral nerve blocks in dogs.  相似文献   

11.

Objective

To describe a transorbital approach to the maxillary nerve block in dogs and compare it with a traditional approach.

Study design

Prospective, randomized controlled study.

Animals

Heads from 17 euthanized dogs (10 Greyhounds, three Border Collies and four of mixed breed).

Methods

A volume of 1 mL of methylene blue dye was injected by each of two techniques, a traditional percutaneous approach and a transorbital approach to the maxillary nerve block. Both techniques were used on each head, alternating the left and right sides after random assignment to the first head. The heads were dissected to reveal the maxillary nerve and the length of nerve stained was measured.

Results

There was no significant difference (p = 0.67) in the proportion of nerves stained for a length >6 mm by either technique (88.2% transorbital versus 82.3% percutaneous). The mean length of nerve stained did not differ significantly between the techniques (p = 0.26).

Conclusions and clinical relevance

The transorbital approach to the maxillary nerve block described here presents a viable alternative to the traditional percutaneous approach. Further study is required to confirm its efficacy and safety under clinical conditions.  相似文献   

12.

Objective

To evaluate an ultrasound-guided technique for adductor canal (AC) block by describing the distribution of methylene blue around the AC, popliteal fossa, saphenous, tibial and common fibular nerves in dog cadavers.

Study design

Prospective experimental trial.

Animals

Ten mixed breed canine cadavers weighing 28.55 ± 3.94 kg.

Methods

Ultrasound scans of the AC were performed bilaterally in 10 canine cadavers. A high-frequency linear transducer was placed on the long axis of the pectineus muscle and using an in-plane technique, an insulated needle was introduced at a proximal to distal direction into the AC. Methylene blue 0.1% (0.3 mL kg?1) was administered followed by dissection. The presence of dye over the target nerves for ≥2 cm was considered successful distribution. Three of 10 cadavers were submitted to computed tomography (CT) and one of them to magnetic resonance (MR) evaluation.

Results

Methylene blue reached the AC in 20 (100%) and the popliteal fossa in 17 (85%) pelvic limbs. Staining was successful in the saphenous nerve (4.0 ± 1.57 cm) in 11 (55%) limbs, tibial nerve (2.65 ± 0.8 cm) in six (30%) and common fibular nerve (2.7 ± 0.9 cm) in four (20%). There was no evidence of staining around the motor branches of the femoral nerve. No intraneural or intravascular dye spread was found during dissections. Contrast distribution to the popliteal fossa was observed in three limbs (50%) in CT and in one (50%) MR image.

Conclusions and clinical relevance

Although the tibial and common fibular nerves were not stained as often as the saphenous nerve, dye was encountered throughout the popliteal fossa near the nerves. The AC block may be useful for intra and postoperative analgesia in stifle surgery with minimal femoral motor dysfunction. However, further study is required to confirm its efficacy and safety in vivo.  相似文献   

13.

Objective

To determine plasma bupivacaine concentrations after retrobulbar or peribulbar injection of bupivacaine in cats.

Study design

Randomized, crossover, experimental trial with a 2 week washout period.

Animals

Six adult healthy cats, aged 1–2 years, weighing 4.6 ± 0.7 kg.

Methods

Cats were sedated by intramuscular injection of dexmedetomidine (36–56 μg kg?1) and were administered a retrobulbar injection of bupivacaine (0.75 mL, 0.5%; 3.75 mg) and iopamidol (0.25 mL), or a peribulbar injection of bupivacaine (1.5 mL, 0.5%; 7.5 mg), iopamidol (0.5 mL) and 0.9% saline (1 mL) via a dorsomedial approach. Blood (2 mL) was collected before and at 5, 10, 15, 22, 30, 45, 60, 120, 240 and 480 minutes after bupivacaine injection. Atipamezole was administered approximately 30 minutes after bupivacaine injection. Plasma bupivacaine and 3-hydroxybupivacaine concentrations were determined using liquid chromatography–mass spectrometry. Bupivacaine maximum plasma concentration (Cmax) and time to Cmax (Tmax) were determined from the data.

Results

The bupivacaine median (range) Cmax and Tmax were 1.4 (0.9–2.5) μg mL?1 and 17 (4–60) minutes, and 1.7 (1.0–2.4) μg mL?1, and 28 (8–49) minutes, for retrobulbar and peribulbar injections, respectively. In both treatments the 3-hydroxybupivacaine peak concentration was 0.05–0.21 μg mL?1.

Conclusions and clinical relevance

In healthy cats, at doses up to 2 mg kg?1, bupivacaine peak plasma concentrations were approximately half that reported to cause arrhythmias or convulsive electroencephalogram (EEG) activity in cats, and about one-sixth of that required to produce hypotension.  相似文献   

14.

Objective

To record the cardiopulmonary effects of pleural CO2 positive pressure insufflation in anesthetized horses.

Study design

Prospective study.

Animals

Seven horses (mean ± standard deviation, 530.9 ± 68.1 kg) undergoing terminal surgery.

Methods

Horses were sedated with xylazine. Anesthesia was induced with ketamine–propofol and maintained with isoflurane, positive pressure ventilation, detomidine infusion, and butorphanol with the horses in dorsal recumbency. Baseline measurements were cardiac output, heart rate, pulmonary and systemic arterial and right atrial blood pressures, body temperature, expired and inspired gas concentrations, and arterial and mixed venous blood gases, electrolytes, glucose, and lactate concentrations. An 18 gauge 6.6 cm needle was inserted into the right pleural cavity midway between the sternum and dorsal midline in the sixth or seventh intercostal space for pleural pressure (PP) measurement. A 14 gauge 18 cm needle placed 5 cm below the previous needle allowed CO2 insufflation into the pleural cavity. All measurements were repeated after: needle insertion, at 2, 5, and 8 mmHg PPs, and after pleural gas removal (GR). Data were compared with baseline using one-way analysis of variance with repeated measures. p < 0.05 was considered significant.

Results

Actual PPs were within 1.1 mmHg of the targeted PP. Pulmonary systolic and mean arterial pressures, alveolar dead space to tidal volume ratio, and isoflurane requirements increased at 8 mmHg PP and GR. Cardiac index decreased at 5 mmHg PP. Stroke index decreased at 2 mmHg PP to GR. PaO2 decreased at 5 mmHg PP to GR. PaCO2 increased at 8 mmHg PP and GR. Oxygen delivery decreased at 5 and 8 mmHg PP. Intrapulmonary shunt fraction and lactate concentration increased with GR.

Conclusions and clinical relevance:

Severe adverse cardiopulmonary effects arise from CO2 positive pressure insufflation into the right hemithorax in dorsally recumbent isoflurane-anesthetized horses. PP should be ≤2 mmHg.  相似文献   

15.

Objective

We determined the possible effects of a peripherally acting α2-adrenoceptor antagonist, MK-467, on the absorption of intramuscularly (IM) coadministered medetomidine, butorphanol and midazolam.

Study design

Randomized, experimental, blinded crossover study.

Animals

Six healthy Beagle dogs.

Methods

Two IM treatments were administered: 1) medetomidine hydrochloride (20 μg kg–1) + butorphanol (100 μg kg–1) + midazolam (200 μg kg–1; MBM) and 2) MBM + MK-467 hydrochloride (500 μg kg–1; MBM–MK), mixed in a syringe. Heart rate was recorded at regular intervals. Sedation was assessed with visual analog scales (0–100 mm). Drug concentrations in plasma were analyzed with liquid chromatography–tandem mass spectrometry, with chiral separation of dex- and levomedetomidine. Maximum drug concentrations in plasma (Cmax) and time to Cmax (Tmax) were determined. Paired t-tests, with Bonferroni correction when appropriate, were used for comparisons between the treatments.

Results

Data from five dogs were analyzed. Heart rate was significantly higher from 20 to 90 minutes after MBM–MK. The Tmax values for midazolam and levomedetomidine (mean ± standard deviation) were approximately halved with coadministration of MK-467, from 23 ± 9 to 11 ± 6 minutes (p = 0.049) for midazolam and from 32 ± 15 to 18 ± 6 minutes for levomedetomidine (p = 0.036), respectively.

Conclusions and clinical relevance

MK-467 accelerated the absorption of IM coadministered drugs. This is clinically relevant as it may hasten the onset of peak sedative effects.  相似文献   

16.

Objective

This study evaluated the spread of a two-point transversus abdominis plane (TAP) injection in canine cadavers. Compared with previous techniques, the two-point TAP injection was developed to increase the consistency of local anaesthetic spread to the nerve segments T11, T12, L1, L2 and L3.

Study design

Prospective experimental trial.

Animals

Five fresh canine cadavers.

Methods

Two-point TAP injections were performed under ultrasound guidance by a single trained individual in canine cadavers (15.7–43.0 kg). Each hemi-abdomen was infiltrated and evaluated independently for a total of 10 evaluations of the technique. The first injection was performed at the level of the costo-chondral junction of the thirteenth rib, and the second injection was performed cranial to the tuber coxae. Each injection comprised 0.3 mL kg–1 methylene blue solution (0.0015 mg mL–1). Ten minutes after the injections, abdominal wall dissection was performed, and any nerves stained for a minimum of 10 mm along their long axis were identified and recorded.

Results

During all injections, separation of the internal oblique and transversus abdominis muscles was observed on ultrasound. On dissection, branches of T12, T13, L1, L2 and L3 were adequately stained in 30%, 100%, 100%, 90% and 90% of injections, respectively. No staining of branches of T11 occurred in any of the cadavers. In one hemi-abdomen, branches of L1 and L3, but not L2, were stained.

Conclusions and clinical relevance

This study indicates that the two-point TAP injection delivers consistent dye dispersion to adequately stain branches of T13, L1, L2 and L3, with no coverage of T11 and poor coverage of T12, in fresh canine cadavers. An in vivo study using local anaesthetic should be performed to evaluate the analgesic efficacy of this technique in mid to caudal abdominal surgeries.  相似文献   

17.

Objective

To investigate the effects of pneumoperitoneum alone or combined with an alveolar recruitment maneuver (ARM) followed by positive end-expiratory pressure (PEEP) on cardiopulmonary function in sheep.

Study design

Prospective, randomized, crossover study.

Animals

A total of nine adult sheep (36–52 kg).

Methods

Sheep were administered three treatments (≥10-day intervals) during isoflurane–fentanyl anesthesia and volume-controlled ventilation (tidal volume: 12 mL kg?1) with oxygen: CONTROL (no intervention); PNEUMO (120 minutes of CO2 pneumoperitoneum); PNEUMOARM/PEEP (PNEUMO protocol with an ARM instituted after 60 minutes of pneumoperitoneum). The ARM (5 cmH2O increases in PEEP of 1 minute duration until 20 cmH2O of PEEP) was followed by 10 cmH2O of PEEP until the end of anesthesia. Cardiopulmonary data were recorded until 30 minutes after abdominal deflation.

Results

PaO2 was decreased from 435–462 mmHg (58.0–61.6 kPa) (range of mean values in CONTROL) to 377–397 mmHg (50.3–52.9 kPa) in PNEUMO (p < 0.05). Quasistatic compliance (Cqst, mL cmH2O?1 kg?1) was decreased from 0.85–0.92 in CONTROL to 0.52–0.58 in PNEUMO. PaO2 increased from 383–385 mmHg (51.1–51.3 kPa) in PNEUMO to 429–444 mmHg (57.2–59.2 kPa) in PNEUMOARM/PEEP (p < 0.05) and Cqst increased from 0.52–0.53 in PNEUMO to 0.70–0.74 in PNEUMOARM/PEEP. Abdominal deflation in PNEUMO did not restore PaO2 and Cqst to control values. Cardiac index (L minute?1 m2) decreased from 4.80–4.70 in CONTROL to 3.45–3.74 in PNEUMO and 3.63–3.76 in PNEUMOARM/PEEP. Compared with controls, ARM/PEEP with pneumoperitoneum decreased mean arterial pressure from 81 to 68 mmHg and increased mean pulmonary artery pressure from 10 to 16 mmHg.

Conclusions and clinical relevance

Abdominal deflation did not reverse the pulmonary function impairment associated with pneumoperitoneum. The ARM/PEEP improved respiratory compliance and reversed the oxygenation impairment induced by pneumoperitoneum with acceptable hemodynamic changes in healthy sheep.  相似文献   

18.
19.

Objective

To compare the effectiveness of ultrasound- and electrostimulation-guided nerve blocks of the brachial plexus and to determine whether ultrasound guidance is feasible in conscious dogs.

Study design

Blinded, crossover, experimental study.

Animals

Six clinically healthy adult Beagle dogs.

Methods

The nerves of the brachial plexus of the right thoracic limb were blocked under ultrasound guidance (UNB) in conscious dogs and under electrostimulation guidance (ENB) in anesthetized dogs with bupivacaine (0.4 mL kg–1, 0.25%). Saline (0.4 mL kg–1) was injected in control animals. Sensory nerve blockade was evaluated by scoring cutaneous sensation in targeted nerves. Motor nerve blockade was evaluated based on weight bearing, conscious proprioception and withdrawal reflex scores. Times to execute the technique in UNB and ENB were compared using t tests (p < 0.05). Scores for sensory and motor nerve blockades in each treatment were compared with scores before treatment and with control treatment scores using nonparametric repeated-measures two-way analysis of variance. Time to onset and duration of sensory nerve block were assessed using scores for four sensory nerve functions. A successful sensory nerve block was defined by decreases in scores for these functions. Success rates of nerve blocks were compared among treatments using McNemar’s test.

Results

In UNB and ENB, onset times of sensory nerve blocks were 1 hour and 1.5 hours, respectively. Onset times of motor nerve blocks were 0.5 hour in both treatments. In UNB and ENB, durations of sensory nerve block were 3 hours and 0.5 hour, respectively, and durations of motor nerve block were 7.5 hours and 6.5 hours, respectively. Success rates did not differ between the techniques.

Conclusions and clinical relevance

The UNB brachial plexus block had a shorter onset time and longer duration than ENB. UNB can be performed in conscious dogs or those under mild sedation.  相似文献   

20.

Objective

1) To determine the pharmacokinetics of tramadol hydrochloride and its active metabolite, O-desmethyltramadol (M1), after administration through different routes in female and male C57Bl/6 mice; 2) to evaluate the stability of tramadol solutions; and 3) to identify a suitable dose regimen for prospective clinical analgesia in B6 mice.

Study design

Prospective, randomized, blinded, parallel design.

Animals

A total of 18 male and 18 female C57Bl/6 mice (20–30 g).

Methods

Mice were administered 25 mg kg?1 tramadol as a bolus [intravenously (IV), intraperitoneally (IP), subcutaneously (SQ), orally per gavage (OSgavage)] over 25 hours [orally in drinking water (OSwater) or Syrspend SF (OSSyrsp)]. Venous blood was sampled at six predetermined time points over 4 to 31 hours, depending on administration route, to determine tramadol and M1 plasma concentrations (liquid chromatography and tandem mass spectrometry detection). Pharmacokinetic parameters were described using a noncompartmental model. The stability of tramadol in water (acidified and untreated) and Syrspend SF (0.20 mg mL?1) at ambient conditions for 1 week was evaluated.

Results

After all administration routes, Cmax was >100 ng mL?1 for tramadol and >40 ng mL?1 for M1 (reported analgesic ranges in man) followed by short half-lives (2–6 hours). The mean tramadol plasma concentration after self-administration remained >100 ng mL?1 throughout consumption time. M1 was found in the OSSyrs group only at 7 hours, whereas it was detectable in OSwater throughout administration. Tramadol had low oral bioavailability (26%). Short-lasting side effects were observed only after IV administration. Water and Syrspend SF solutions were stable for 1 week.

Conclusions and clinical relevance

1) At the dose administered, high plasma concentrations of tramadol and M1 were obtained, with half-life depending on the administration route. 2) Plasma levels were stable over self-consumption time. 3) Solutions were stable for 1 week at ambient conditions.  相似文献   

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