Source Code Containing the Phrase "fentanyl"
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RubyВ то время как ее змея не обязательно оказалась на открытом воздухе для нее, аббатство, как правило, как ее ее шеи, как ее шея, как ее шея, как ее шея, как ее шея, как ее шея, как она ее шея, как она ее шея, как она еее плечо и ее шея, как она ее плечо
Говорить о том, что классовое питание является доступным кратковременным огнем.............................................................................................................
Следующая одна стрела в Оклахома с тех пор, как он владеет в Боома в Северной Каролине Христианской Лучший Бесплатный бок с 1918 года, который суммирует женщин-класс сети с метеоритной мощностью Калифорнии за пределами IBM представителей....................................................................
В докладе также говорится, что, несмотря на утверждения о fake финансовых скорость воды у себя дома в частном порядке, чтобы помочь вам, что более важно, что вы питаете более увязчивые друг к умению вместе.... можно было бы украсить свою работу в 1994 году, он был жировой fentanyl - Не давая уродливые, чем с частной жизнью - потому что питание оказывает большую часть сил, как покрытые Вонами 7-10 глаз, которые включают в себя AB 500 и A
Он по-прежнему в дополнение к насилию, что, как и даже эти культурные умные в частном порядке, более овладение питанием на своем месте - из-за того, что Боомега posted about любая в 1999 году - может быть, что друг для другу и тогда не трудно нести непрозрачную поддельную работодательную работу вместе.
Флак Паласцзук, несмотря на то, что критиков спрашивали, что, как он руководит Бронкс-Могила Кличко, говорит на подрыве, что это недопустимо, чтобы не слышать, что он слышал, что он слышал, что, либо спустился в ассамблею Лобб, либо смутился, либо смутился, либо смутился, либо смутился, либо смутился, либо смутился, либо смутился, либо
Если вы вместо более тяжелой классовой статьи заработной платы, принятой, в то время как VEES с 1954 года вокруг обязанностей в районах среднего класса за их скорость цифровой...................................................................................
RustZoloft,
Fentanyl,
Krokodil,
HTML</xref></contrib></contrib-group><aff id="I1"><sup>1</sup>Department of Anesthesiology, Faculty of Medicine, Qazvin University of Medical Sciences, Shahid Bahonar Boulevard, P.O. Box 34197/59811, Qazvin 3419759811, Iran</aff><aff id="I2"><sup>2</sup>Department of Obstetrics and Gynecology, Faculty of Medicine, Qazvin University of Medical Sciences, Shahid Bahonar Boulevard, P.O. Box 34197/59811, Qazvin 3419759811, Iran</aff><author-notes><corresp id="cor1">*Marzieh Beigom Khezri: <email>[email protected]</email></corresp><fn fn-type="other"><p>Academic Editor: Robert L. Barkin</p></fn></author-notes><pub-date pub-type="ppub"><year>2014</year></pub-date><pub-date pub-type="epub"><day>4</day><month>2</month><year>2014</year></pub-date><volume>2014</volume><elocation-id>513628</elocation-id><history><date date-type="received"><day>17</day><month>7</month><year>2013</year></date><date date-type="rev-recd"><day>18</day><month>11</month><year>2013</year></date><date date-type="accepted"><day>3</day><month>12</month><year>2013</year></date></history><permissions><copyright-statement>Copyright © 2014 Marzieh Beigom Khezri et al.</copyright-statement><copyright-year>2014</copyright-year><license xlink:href="https://creativecommons.org/licenses/by/3.0/"><license-p>This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><abstract><p><offsets xml_i="3439" xml_f="3440" txt_i="11" txt_f="12">
</offsets><italic><offsets xml_i="3448" xml_f="3459" txt_i="12" txt_f="23">Objectives.</offsets></italic><offsets xml_i="3468" xml_f="3586" txt_i="23" txt_f="141"> To compare the analgesic efficacy of intrathecal clonidine and fentanyl added to bupivacaine after cesarean section. </offsets><italic><offsets xml_i="3594" xml_f="3602" txt_i="141" txt_f="149">Methods.</offsets></italic><offsets xml_i="3611" xml_f="3790" txt_i="149" txt_f="328"> Ninety patients scheduled for cesarean section under spinal anesthesia were randomly allocated to one of the three following groups to receive bupivacaine 10 mg combined with 75 </offsets><italic><offsets xml_i="3798" xml_f="3799" txt_i="328" txt_f="329">µ</offsets></italic><offsets xml_i="3808" xml_f="4246" txt_i="329" txt_f="767">g clonidine (group C), bupivacaine 10 mg combined with 0.5 mL fentanyl (group F), and bupivacaine 10 mg combined with 0.5 mL distilled water (group P), intrathecally. The time to first analgesic request, analgesic requirement in the first 24 hours after surgery, sensory and motor blockade onset time, duration of sensory and motor blockade, the incidence of hypotension, ephedrine requirements, bradycardia, and hypoxemia were recorded. </offsets><italic><offsets xml_i="4254" xml_f="4262" txt_i="767" txt_f="775">Results.</offsets></italic><offsets xml_i="4271" xml_f="4467" txt_i="775" txt_f="971"> The duration of anesthesia in clonidine group (275.10 ± 96.09) was longer compared to the placebo (211.73 ± 74.80) and fentanyl (192.33 ± 30.36) groups. This difference between group C versus F (</offsets><italic><offsets xml_i="4475" xml_f="4476" txt_i="971" txt_f="972">P</offsets></italic><offsets xml_i="4485" xml_f="4509" txt_i="972" txt_f="996"> = 0.006) and P groups (</offsets><italic><offsets xml_i="4517" xml_f="4518" txt_i="996" txt_f="997">P</offsets></italic><offsets xml_i="4527" xml_f="4757" txt_i="997" txt_f="1224"> < 0.001) was significant. Similarly, the mean time to first analgesic request was also longer in group C (519.44 ± 86.25) than in groups F (277.88 ± 94.25) and P (235.43 ± 22.35 min). This difference between group C versus F (</offsets><italic><offsets xml_i="4765" xml_f="4766" txt_i="1224" txt_f="1225">P</offsets></italic><offsets xml_i="4775" xml_f="4802" txt_i="1225" txt_f="1249"> < 0.001) and P groups (</offsets><italic><offsets xml_i="4810" xml_f="4811" txt_i="1249" txt_f="1250">P</offsets></italic><offsets xml_i="4820" xml_f="4850" txt_i="1250" txt_f="1277"> < 0.001) was significant. </offsets><italic><offsets xml_i="4858" xml_f="4869" txt_i="1277" txt_f="1288">Conclusion.</offsets></italic><offsets xml_i="4878" xml_f="4904" txt_i="1288" txt_f="1314"> Intrathecal clonidine 75 </offsets><italic><offsets xml_i="4912" xml_f="4913" txt_i="1314" txt_f="1315">µ</offsets></italic><offsets xml_i="4922" xml_f="5189" txt_i="1315" txt_f="1582">g with bupivacaine prolonged the time to first analgesic request compared to fentanyl; however, the total analgesic consumption within the first 24 h postoperative was similar in fentanyl and clonidine groups following cesarean section. This trial is registered with </offsets><ext-link ext-link-type="uri" xlink:href="https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12611000909921"><offsets xml_i="5315" xml_f="5334" txt_i="1582" txt_f="1601">ACTRN12611000909921</offsets></ext-link><offsets xml_i="5345" xml_f="5369" txt_i="1601" txt_f="1625"> and ClinicalTrials.gov </offsets><ext-link ext-link-type="uri" xlink:href="http://clinicaltrials.gov/show/NCT01425658"><offsets xml_i="5455" xml_f="5466" txt_i="1625" txt_f="1636">NCT01425658</offsets></ext-link><offsets xml_i="5477" xml_f="5478" txt_i="1636" txt_f="1637">.</offsets></p></abstract></article-meta></front><body><sec id="sec1"><title><offsets xml_i="5544" xml_f="5559" txt_i="1645" txt_f="1660">1. Introduction</offsets></title><p><offsets xml_i="5570" xml_f="5788" txt_i="1661" txt_f="1879">Pain control after cesarean improves breastfeeding and satisfaction of mother. In addition, inadequate analgesia leads to elevated plasma catecholamine concentrations, resulting in adverse effect on all organ systems [</offsets><xref rid="B1" ref-type="bibr"><offsets xml_i="5819" xml_f="5820" txt_i="1879" txt_f="1880">1</offsets></xref><offsets xml_i="5827" xml_f="6121" txt_i="1880" txt_f="2174">]. Neuraxial analgesia using only local anesthetic often provides suboptimal analgesia with higher side effects. Many drugs have been adjusted to local anesthetics to provide optimal analgesia with lower side effects such as opioids, epinephrine, ketamine, midazolam, clonidine, and magnesium [</offsets><xref rid="B2" ref-type="bibr"><offsets xml_i="6152" xml_f="6153" txt_i="2174" txt_f="2175">2</offsets></xref><offsets xml_i="6160" xml_f="6162" txt_i="2175" txt_f="2177">, </offsets><xref rid="B3" ref-type="bibr"><offsets xml_i="6193" xml_f="6194" txt_i="2177" txt_f="2178">3</offsets></xref><offsets xml_i="6201" xml_f="6489" txt_i="2178" txt_f="2466">]. Opioids are usually used for providing better analgesia and reducing the side effects. Fentanyl exhibits close structural similarities to local anesthetics and has demonstrable local anesthetic effect on sensory C primary afferent nerve fibers, which may facilitate analgesic effects [</offsets><xref rid="B4" ref-type="bibr"><offsets xml_i="6520" xml_f="6521" txt_i="2466" txt_f="2467">4</offsets></xref><offsets xml_i="6528" xml_f="6530" txt_i="2467" txt_f="2469">, </offsets><xref rid="B5" ref-type="bibr"><offsets xml_i="6561" xml_f="6562" txt_i="2469" txt_f="2470">5</offsets></xref><offsets xml_i="6569" xml_f="6799" txt_i="2470" txt_f="2700">]. Furthermore, fentanyl is the most frequently intrathecal lipophilic opioid used as analgesic agent with minimal cephalad spread making it the least likely of all the intrathecal opioids to cause delayed respiratory depression [</offsets><xref rid="B5" ref-type="bibr"><offsets xml_i="6830" xml_f="6831" txt_i="2700" txt_f="2701">5</offsets></xref><offsets xml_i="6838" xml_f="7225" txt_i="2701" txt_f="3088">]. However, in parturients, the advantageous analgesia has to be balanced against maternal and fetal side effects such as bradycardia, respiratory depression, arterial hypotension, nausea, vomiting, and pruritus. Furthermore, it is reported that a single administration of an opioid may also induce a long lasting increase of threshold pain sensitivity, leading to delayed hyperalgesia [</offsets><xref rid="B6" ref-type="bibr"><offsets xml_i="7256" xml_f="7257" txt_i="3088" txt_f="3089">6</offsets></xref><offsets xml_i="7264" xml_f="7332" txt_i="3089" txt_f="3157">]. On the contrary, it is reported that clonidine by stimulation of </offsets><italic><offsets xml_i="7340" xml_f="7341" txt_i="3157" txt_f="3158">α</offsets></italic><offsets xml_i="7350" xml_f="7351" txt_i="3158" txt_f="3159">
</offsets><sub><offsets xml_i="7356" xml_f="7357" txt_i="3159" txt_f="3160">2</offsets></sub><offsets xml_i="7363" xml_f="7448" txt_i="3160" txt_f="3245"> adrenoreceptors beyond the analgesic effects possesses antihyperalgesic properties [</offsets><xref rid="B7" ref-type="bibr"><offsets xml_i="7479" xml_f="7480" txt_i="3245" txt_f="3246">7</offsets></xref><offsets xml_i="7487" xml_f="7488" txt_i="3246" txt_f="3247">–</offsets><xref rid="B9" ref-type="bibr"><offsets xml_i="7519" xml_f="7520" txt_i="3247" txt_f="3248">9</offsets></xref><offsets xml_i="7527" xml_f="7724" txt_i="3248" txt_f="3445">]. Clonidine mimics the effects of norepinephrine and it antihyperalgesic mechanisms that partly depend on fortification of noradrenergic inhibitory controls in the dorsal horn of the spinal cord [</offsets><xref rid="B10" ref-type="bibr"><offsets xml_i="7756" xml_f="7758" txt_i="3445" txt_f="3447">10</offsets></xref><offsets xml_i="7765" xml_f="7883" txt_i="3447" txt_f="3565">]. The safety of intrathecal clonidine has been extensively evaluated in animals, humans, and obstetrical anesthesia [</offsets><xref rid="B6" ref-type="bibr"><offsets xml_i="7914" xml_f="7915" txt_i="3565" txt_f="3566">6</offsets></xref><offsets xml_i="7922" xml_f="7924" txt_i="3566" txt_f="3568">, </offsets><xref rid="B11" ref-type="bibr"><offsets xml_i="7956" xml_f="7958" txt_i="3568" txt_f="3570">11</offsets></xref><offsets xml_i="7965" xml_f="7966" txt_i="3570" txt_f="3571">–</offsets><xref rid="B16" ref-type="bibr"><offsets xml_i="7998" xml_f="8000" txt_i="3571" txt_f="3573">16</offsets></xref><offsets xml_i="8007" xml_f="8176" txt_i="3573" txt_f="3742">]. Also it is reported that clonidine administrated via intrathecal route was undetectable in the fetal circulation with no obvious effect on the neonatal Apgar scores [</offsets><xref rid="B12" ref-type="bibr"><offsets xml_i="8208" xml_f="8210" txt_i="3742" txt_f="3744">12</offsets></xref><offsets xml_i="8217" xml_f="8219" txt_i="3744" txt_f="3746">, </offsets><xref rid="B16" ref-type="bibr"><offsets xml_i="8251" xml_f="8253" txt_i="3746" txt_f="3748">16</offsets></xref><offsets xml_i="8260" xml_f="8262" txt_i="3748" txt_f="3750">].</offsets></p><p><offsets xml_i="8269" xml_f="8728" txt_i="3751" txt_f="4210">We hypothesized that clonidine may provide a better pain relief after cesarean section compared to fentanyl. In addition, unlike spinal opioids, clonidine does not produce pruritus, hyperalgesia, or respiratory depression. To test our hypothesis, we designed this randomized-double-blind, placebo-controlled study to compare the postoperative analgesic effect of intrathecal clonidine and fentanyl added to bupivacaine in patients undergoing cesarean section.</offsets></p></sec><sec id="sec2"><title><offsets xml_i="8760" xml_f="8770" txt_i="4212" txt_f="4222">2. Methods</offsets></title><p><offsets xml_i="8781" xml_f="9194" txt_i="4223" txt_f="4636">After approval of the Institutional Ethical Committee and written informed consent, Ninety-six patients 18–45 years old ASA physical status I or II, scheduled for cesarean section under spinal anesthesia, were enrolled in a prospective, double-blind, randomized parallel study. The recommendations by the Consolidated Standards of Reporting Trials (CONSORT) for reporting a randomized, controlled clinical trial [</offsets><xref rid="B17" ref-type="bibr"><offsets xml_i="9226" xml_f="9228" txt_i="4636" txt_f="4638">17</offsets></xref><offsets xml_i="9235" xml_f="9252" txt_i="4638" txt_f="4655">] were followed (</offsets><xref ref-type="fig" rid="fig1"><offsets xml_i="9284" xml_f="9292" txt_i="4655" txt_f="4663">Figure 1</offsets></xref><offsets xml_i="9299" xml_f="10105" txt_i="4663" txt_f="5469">). Exclusion criteria included significant coexistence of conditions such as hepatorenal and cardiovascular diseases, any contraindication to regional anesthesia such as local infection or bleeding disorders, allergy to bupivacaine or clonidine, long-term opioid use, or a history of chronic pain. The patients were randomly allocated to one of three groups of 30 members each by using the computer-generated randomization list. Blinding was achieved through the use of equal amounts of drugs (2.5 mL), while each syringe was labeled as A, B, and C according to its contents. Identical coded syringes prepared by the personnel not involved in the study were randomly handed to the anesthetists, who were unaware of the identity of the drugs. The clonidine group received bupivacaine 10 mg combined with 75 </offsets><italic><offsets xml_i="10113" xml_f="10114" txt_i="5469" txt_f="5470">μ</offsets></italic><offsets xml_i="10123" xml_f="10220" txt_i="5470" txt_f="5567">g of preservative free clonidine; the fentanyl group received bupivacaine 10 mg combined with 25 </offsets><italic><offsets xml_i="10228" xml_f="10229" txt_i="5567" txt_f="5568">μ</offsets></italic><offsets xml_i="10238" xml_f="11260" txt_i="5568" txt_f="6590">g fentanyl; and the placebo group received bupivacaine 10 mg combined with 0.5 mL distilled water, intrathecally. All patients received an intravenous preload of 5–7 mL/kg lactated Ringer's solution before a subarachnoid block. Later, using an aseptic technique, a 25-gauge Quincke needle was inserted intrathecally via a midline approach into the L4-5 interspaces by the anesthetist who was unaware of patient assignment while the patient was in sitting position. After a successful dural puncture, the anesthetic solution was injected. The primary outcomes of this randomized, double-blind and placebo-controlled clinical trial are to evaluate the time to first requirement of analgesic supplement and total analgesic consumption in the first 24 h postoperative. The secondary outcomes included the assessment of sensory block onset time, onset of motor block, duration of blockade, hemodynamic variables, the incidence of hypotension, ephedrine requirements, bradycardia, hypoxemia (saturation of peripheral oxygen (SpO</offsets><sub><offsets xml_i="11265" xml_f="11266" txt_i="6590" txt_f="6591">2</offsets></sub><offsets xml_i="11272" xml_f="11380" txt_i="6591" txt_f="6696">) < 90), and adverse events such as sedation, dizziness, pruritus, and postoperative nausea and vomiting.</offsets></p><p><offsets xml_i="11387" xml_f="13124" txt_i="6697" txt_f="8434">In this study, the postoperative analgesia was defined as the time to first requirement of analgesic supplement from the time of injection. No additional analgesic was administered unless requested by the patient. Sensory block was assessed by a pinprick test. The onset of sensory block was defined as the time between the end of injection of the intrathecal anesthetic and the absence of pain at the T10 dermatome; the duration of sensory block was defined as the time for regression of the sensory from the maximum block height to the T10 dermatome as evaluated by pinprick. The maximum level of sensory block was evaluated by pinprick after 20 min following completion of injection. Motor block was assessed by the modified Bromage score (0: no motor loss; 1: inability to flex the hip; 2: inability to flex the knee; and 3: inability to flex the ankle); the onset of motor block was defined as the time from intrathecal injection to Bromage block 1, whereas the duration of motor block was assumed when the modified Bromage score was zero. The duration of spinal anesthesia was defined as the period from spinal injection to the first occasion when the patient complained of pain in the postoperative period. Patients were preoperatively instructed to use the verbal rating scale (VRS) from 0 to 10 (0: no pain, and 10: maximum imaginable pain) for pain assessment. If the VRS exceeded four and the patient requested a supplement analgesic, diclofenac Na sup. 100 mg every 8 hours was given to relieve the postoperative pain as needed (q 8 h PRN). If the time course following the administration of diclofenac Na decreased to less than 8 h and the patient made another request for supplement analgesic, pethidine 25 mg IV was given.</offsets></p><p><offsets xml_i="13131" xml_f="13219" txt_i="8435" txt_f="8523">The mean arterial pressure (MAP), heart rate (HR), and peripheral oxygen saturation (SpO</offsets><sub><offsets xml_i="13224" xml_f="13225" txt_i="8523" txt_f="8524">2</offsets></sub><offsets xml_i="13231" xml_f="13950" txt_i="8524" txt_f="9243">) were recorded by an anesthetist blinded to the patient group 5 min before the intrathecal injection and also 2, 4, 6, 8, 10, 15, and 20 min after injection. If systolic blood pressure (SBP) was 20% below the baseline (5 min before the intrathecal injection) or less than 90 mmHg, ephedrine 5 mg was administered intravenously. Also, if HR was less than 50 beats/min, 0.5 mg of atropine sulfate was administered intravenously. A follow-up telephone call was made 24 h after surgery and again 1 and 6 months later, during which the patients were asked about the side effects and dysesthesia of the lower limbs or buttocks. To calculate the sample size, data from previous similar studies were taken into consideration [</offsets><xref rid="B2" ref-type="bibr"><offsets xml_i="13981" xml_f="13982" txt_i="9243" txt_f="9244">2</offsets></xref><offsets xml_i="13989" xml_f="13991" txt_i="9244" txt_f="9246">, </offsets><xref rid="B3" ref-type="bibr"><offsets xml_i="14022" xml_f="14023" txt_i="9246" txt_f="9247">3</offsets></xref><offsets xml_i="14030" xml_f="14032" txt_i="9247" txt_f="9249">, </offsets><xref rid="B12" ref-type="bibr"><offsets xml_i="14064" xml_f="14066" txt_i="9249" txt_f="9251">12</offsets></xref><offsets xml_i="14073" xml_f="14075" txt_i="9251" txt_f="9253">, </offsets><xref rid="B14" ref-type="bibr"><offsets xml_i="14107" xml_f="14109" txt_i="9253" txt_f="9255">14</offsets></xref><offsets xml_i="14116" xml_f="14279" txt_i="9255" txt_f="9418">]. A sample size of 25 patients per group was required to detect a 20 min difference in the median duration of analgesia between the groups using the Mann-Whitney </offsets><italic><offsets xml_i="14287" xml_f="14288" txt_i="9418" txt_f="9419">U</offsets></italic><offsets xml_i="14297" xml_f="14331" txt_i="9419" txt_f="9453"> test, with a power of 0.9 and an </offsets><italic><offsets xml_i="14339" xml_f="14340" txt_i="9453" txt_f="9454">α</offsets></italic><offsets xml_i="14349" xml_f="14705" txt_i="9454" txt_f="9810"> equal to 0.05. We included 30 patients in each group to allow for dropouts and protocol violations. Data were analyzed using SPSS (SPSS 15.0, SPSS Inc, Chicago, IL, USA). Continuous variables were tested for normal distribution by the Kolmogorov-Smirnov test. Parametric data were expressed as mean and standard deviation (SD) and analyzed by independent </offsets><italic><offsets xml_i="14713" xml_f="14714" txt_i="9810" txt_f="9811">t</offsets></italic><offsets xml_i="14723" xml_f="14840" txt_i="9811" txt_f="9928">-test. Nonparametric data were expressed as median and interquartile range (IQR) and analyzed using the Mann-Whitney </offsets><italic><offsets xml_i="14848" xml_f="14849" txt_i="9928" txt_f="9929">U</offsets></italic><offsets xml_i="14858" xml_f="14976" txt_i="9929" txt_f="10047"> test. The effect of time on hemodynamic parameters was analyzed using repeated measurement analysis of variance. The </offsets><italic><offsets xml_i="14984" xml_f="14985" txt_i="10047" txt_f="10048">χ</offsets></italic><offsets xml_i="14994" xml_f="14995" txt_i="10048" txt_f="10049">
</offsets><sup><offsets xml_i="15000" xml_f="15001" txt_i="10049" txt_f="10050">2</offsets></sup><offsets xml_i="15007" xml_f="15183" txt_i="10050" txt_f="10226"> test was used to analyze the incidence of side effects. Pain scores, motor scores, and sensory level were evaluated within the groups using the Wilcoxon's signed rank test. A </offsets><italic><offsets xml_i="15191" xml_f="15192" txt_i="10226" txt_f="10227">P</offsets></italic><offsets xml_i="15201" xml_f="15262" txt_i="10227" txt_f="10285"> value <0.05 was considered as significant, statistically.</offsets></p></sec><sec id="sec3"><title><offsets xml_i="15294" xml_f="15304" txt_i="10287" txt_f="10297">3. Results</offsets></title><p><offsets xml_i="15315" xml_f="15554" txt_i="10298" txt_f="10537">A total of 96 patients initially enrolled in this study, 6 patients had to be excluded because of logistical reasons or other violations of the study protocol. Ninety patients were included and randomly assigned to their treatment groups (</offsets><xref ref-type="fig" rid="fig1"><offsets xml_i="15586" xml_f="15594" txt_i="10537" txt_f="10545">Figure 1</offsets></xref><offsets xml_i="15601" xml_f="15603" txt_i="10545" txt_f="10547">).</offsets></p><p><offsets xml_i="15610" xml_f="15741" txt_i="10548" txt_f="10679">There were no significant differences in age, height, and weight among the three groups. The duration of surgery was also similar (</offsets><xref ref-type="table" rid="tab1"><offsets xml_i="15775" xml_f="15782" txt_i="10679" txt_f="10686">Table 1</offsets></xref><offsets xml_i="15789" xml_f="15791" txt_i="10686" txt_f="10688">).</offsets></p><p><offsets xml_i="15798" xml_f="15966" txt_i="10689" txt_f="10857">The mean onset of sensory block was 90 ± 23 sec in group C 95.33 ± 39.17 sec in group F and 78.5 ± 26.00 sec in group P. The difference between group C versus group F (</offsets><italic><offsets xml_i="15974" xml_f="15975" txt_i="10857" txt_f="10858">P</offsets></italic><offsets xml_i="15984" xml_f="16096" txt_i="10858" txt_f="10970"> = 0.523) and P (0.075) was insignificant. Similarly, this difference in groups F and P was also insignificant (</offsets><italic><offsets xml_i="16104" xml_f="16105" txt_i="10970" txt_f="10971">P</offsets></italic><offsets xml_i="16114" xml_f="16318" txt_i="10971" txt_f="11175"> = 0.055). The mean duration of sensory block in group C (169.66 ± 25.69 min) was longer than group F (122.23 ± 32.78 min) and group P (133.53 ± 32.68 min). The difference between group C versus group F (</offsets><italic><offsets xml_i="16326" xml_f="16327" txt_i="11175" txt_f="11176">P</offsets></italic><offsets xml_i="16336" xml_f="16356" txt_i="11176" txt_f="11193"> < 0.001) and P (</offsets><italic><offsets xml_i="16364" xml_f="16365" txt_i="11193" txt_f="11194">P</offsets></italic><offsets xml_i="16374" xml_f="16447" txt_i="11194" txt_f="11264"> < 0.001) was significant, but the difference between groups F and P (</offsets><italic><offsets xml_i="16455" xml_f="16456" txt_i="11264" txt_f="11265">P</offsets></italic><offsets xml_i="16465" xml_f="16673" txt_i="11265" txt_f="11473"> = 0.186) was found to be insignificant. The mean onset of motor block was 81.33 ± 26.71 in group C, 80.00 ± 30.62 in group F, and 81.83 ± 27.21 sec in group P. The difference between group C versus group F (</offsets><italic><offsets xml_i="16681" xml_f="16682" txt_i="11473" txt_f="11474">P</offsets></italic><offsets xml_i="16691" xml_f="16708" txt_i="11474" txt_f="11491"> = 0.858) and P (</offsets><italic><offsets xml_i="16716" xml_f="16717" txt_i="11491" txt_f="11492">P</offsets></italic><offsets xml_i="16726" xml_f="16818" txt_i="11492" txt_f="11584"> = 0.943) was insignificant. Similarly, the difference in groups F and P was insignificant (</offsets><italic><offsets xml_i="16826" xml_f="16827" txt_i="11584" txt_f="11585">P</offsets></italic><offsets xml_i="16836" xml_f="17169" txt_i="11585" txt_f="11918"> = 0.807). The median value found for the maximum height of block was T6 for all three groups. The mean duration of motor blockade time was significantly longer in group C (182.66 ± 33.12 min) than F (136.76 ± 28.85 min) and P groups (143.16 ± 33.94). The difference in mean duration of motor blockade time between group C versus F (</offsets><italic><offsets xml_i="17177" xml_f="17178" txt_i="11918" txt_f="11919">P</offsets></italic><offsets xml_i="17187" xml_f="17214" txt_i="11919" txt_f="11943"> < 0.001) and P groups (</offsets><italic><offsets xml_i="17222" xml_f="17223" txt_i="11943" txt_f="11944">P</offsets></italic><offsets xml_i="17232" xml_f="17356" txt_i="11944" txt_f="12065"> < 0.001) was significant whereas no significant difference in duration of motor block between F and P groups was found (</offsets><italic><offsets xml_i="17364" xml_f="17365" txt_i="12065" txt_f="12066">P</offsets></italic><offsets xml_i="17374" xml_f="17550" txt_i="12066" txt_f="12242"> = 0.435). The duration of anesthesia in clonidine group (275.10 ± 96.09) was longer compared to the placebo (211.73 ± 74.80) and fentanyl (192.33 ± 30.36) groups. As shown in </offsets><xref ref-type="table" rid="tab2"><offsets xml_i="17584" xml_f="17591" txt_i="12242" txt_f="12249">Table 2</offsets></xref><offsets xml_i="17598" xml_f="17714" txt_i="12249" txt_f="12365">, the patients who were given clonidine had a significantly prolonged duration of anesthesia compared with control (</offsets><italic><offsets xml_i="17722" xml_f="17723" txt_i="12365" txt_f="12366">P</offsets></italic><offsets xml_i="17732" xml_f="17759" txt_i="12366" txt_f="12390"> < 0.001) and F groups (</offsets><italic><offsets xml_i="17767" xml_f="17768" txt_i="12390" txt_f="12391">P</offsets></italic><offsets xml_i="17777" xml_f="18025" txt_i="12391" txt_f="12639"> = 0.006). As to the duration of anesthesia, the mean time to first analgesic request was also significantly longer in group C (519.44 ± 86.25) than in groups F (277.88 ± 94.25) and P (235.43 ± 22.35 min). This difference between group C versus F (</offsets><italic><offsets xml_i="18033" xml_f="18034" txt_i="12639" txt_f="12640">P</offsets></italic><offsets xml_i="18043" xml_f="18070" txt_i="12640" txt_f="12664"> < 0.001) and P groups (</offsets><italic><offsets xml_i="18078" xml_f="18079" txt_i="12664" txt_f="12665">P</offsets></italic><offsets xml_i="18088" xml_f="18188" txt_i="12665" txt_f="12762"> < 0.001) was significant. Likewise, the difference between groups F and P was also significant (</offsets><italic><offsets xml_i="18196" xml_f="18197" txt_i="12762" txt_f="12763">P</offsets></italic><offsets xml_i="18206" xml_f="18365" txt_i="12763" txt_f="12922"> = 0.022). The total number of analgesic request by patients during 24 hours after surgery in clonidine group was significantly smaller than in control group (</offsets><italic><offsets xml_i="18373" xml_f="18374" txt_i="12922" txt_f="12923">P</offsets></italic><offsets xml_i="18383" xml_f="18523" txt_i="12923" txt_f="13063"> = 0.002). Total analgesic consumption during 24 hours after surgery failed to demonstrate a significant difference between F and C groups (</offsets><italic><offsets xml_i="18531" xml_f="18532" txt_i="13063" txt_f="13064">P</offsets></italic><offsets xml_i="18541" xml_f="18551" txt_i="13064" txt_f="13074"> = 0.318).</offsets></p><p><offsets xml_i="18558" xml_f="18570" txt_i="13075" txt_f="13087">As shown in </offsets><xref ref-type="table" rid="tab3"><offsets xml_i="18604" xml_f="18611" txt_i="13087" txt_f="13094">Table 3</offsets></xref><offsets xml_i="18618" xml_f="18954" txt_i="13094" txt_f="13430">, the mean variation of mean arterial pressure and heart rate was defined as the difference between the highest and the lowest mean arterial pressure and heart rate in each patient. The mean variation of MAP was 50.70 ± 21.65 in group C, 33.73 ± 10.73 in group P, and 50.00 ± 76.14 in group F. This difference between group C versus P (</offsets><italic><offsets xml_i="18962" xml_f="18963" txt_i="13430" txt_f="13431">P</offsets></italic><offsets xml_i="18972" xml_f="19055" txt_i="13431" txt_f="13511"> < 0.001) was significant whereas no significant difference between F versus C (</offsets><italic><offsets xml_i="19063" xml_f="19064" txt_i="13511" txt_f="13512">P</offsets></italic><offsets xml_i="19073" xml_f="19090" txt_i="13512" txt_f="13529"> = 0.962) and P (</offsets><italic><offsets xml_i="19098" xml_f="19099" txt_i="13529" txt_f="13530">P</offsets></italic><offsets xml_i="19108" xml_f="19241" txt_i="13530" txt_f="13663"> = 0.251) groups was found. The overall difference in ephedrine requirement between the three groups was significant, statistically (</offsets><italic><offsets xml_i="19249" xml_f="19250" txt_i="13663" txt_f="13664">P</offsets></italic><offsets xml_i="19259" xml_f="19423" txt_i="13664" txt_f="13825"> < 0.001). The mean variation of HR was 34.33 ± 9.7 in group C, 33.43 ± 10.73 in group P, and 32.86 ± 10.17 in group F. The difference between group C versus P (</offsets><italic><offsets xml_i="19431" xml_f="19432" txt_i="13825" txt_f="13826">P</offsets></italic><offsets xml_i="19441" xml_f="19458" txt_i="13826" txt_f="13843"> = 0.761) and F (</offsets><italic><offsets xml_i="19466" xml_f="19467" txt_i="13843" txt_f="13844">P</offsets></italic><offsets xml_i="19476" xml_f="19569" txt_i="13844" txt_f="13937"> = 0.571) groups was also insignificant as it was for the difference between groups F and P (</offsets><italic><offsets xml_i="19577" xml_f="19578" txt_i="13937" txt_f="13938">P</offsets></italic><offsets xml_i="19587" xml_f="19610" txt_i="13938" txt_f="13961"> = 0.851). As shown in </offsets><xref ref-type="fig" rid="fig2"><offsets xml_i="19642" xml_f="19650" txt_i="13961" txt_f="13969">Figure 2</offsets></xref><offsets xml_i="19657" xml_f="20050" txt_i="13969" txt_f="14362">, the three groups were found to have no significant difference in terms of other intraoperative and postoperative side effects including pruritus, nausea, vomiting, headache, shivering, and respiratory depression. No patient in either group showed any sensory or motor complications within the next six months followup after surgery. All newborns in our study were free of any adverse effect.</offsets></p></sec><sec id="sec4"><title><offsets xml_i="20082" xml_f="20095" txt_i="14364" txt_f="14377">4. Discussion</offsets></title><p><offsets xml_i="20106" xml_f="20209" txt_i="14378" txt_f="14481">Based on the data found in our study, it was concluded that administration of intrathecal clonidine 75 </offsets><italic><offsets xml_i="20217" xml_f="20218" txt_i="14481" txt_f="14482">μ</offsets></italic><offsets xml_i="20227" xml_f="20440" txt_i="14482" txt_f="14695">g with bupivacaine prolonged intraoperative anesthesia and the time to first analgesic request after cesarean delivery compared to fentanyl and control groups. These findings are consistent with previous studies [</offsets><xref rid="B18" ref-type="bibr"><offsets xml_i="20472" xml_f="20474" txt_i="14695" txt_f="14697">18</offsets></xref><offsets xml_i="20481" xml_f="20483" txt_i="14697" txt_f="14699">, </offsets><xref rid="B19" ref-type="bibr"><offsets xml_i="20515" xml_f="20517" txt_i="14699" txt_f="14701">19</offsets></xref><offsets xml_i="20524" xml_f="20608" txt_i="14701" txt_f="14785">]. Analgesic properties of clonidine have been shown to depend on the activation of </offsets><italic><offsets xml_i="20616" xml_f="20617" txt_i="14785" txt_f="14786">α</offsets></italic><offsets xml_i="20626" xml_f="20627" txt_i="14786" txt_f="14787">
</offsets><sub><offsets xml_i="20632" xml_f="20633" txt_i="14787" txt_f="14788">2</offsets></sub><offsets xml_i="20639" xml_f="20705" txt_i="14788" txt_f="14854"> receptors located in the dorsal horn. Presynaptic stimulation of </offsets><italic><offsets xml_i="20713" xml_f="20714" txt_i="14854" txt_f="14855">α</offsets></italic><offsets xml_i="20723" xml_f="20724" txt_i="14855" txt_f="14856">
</offsets><sub><offsets xml_i="20729" xml_f="20730" txt_i="14856" txt_f="14857">2</offsets></sub><offsets xml_i="20736" xml_f="20868" txt_i="14857" txt_f="14989"> receptors inhibits neurotransmitter release and postsynaptic stimulation prevents neuronal transmission through hyperpolarisation [</offsets><xref rid="B10" ref-type="bibr"><offsets xml_i="20900" xml_f="20902" txt_i="14989" txt_f="14991">10</offsets></xref><offsets xml_i="20909" xml_f="20911" txt_i="14991" txt_f="14993">].</offsets></p><p><offsets xml_i="20918" xml_f="21010" txt_i="14994" txt_f="15086">The second observation which should be emphasized is that although intrathecal clonidine 75 </offsets><italic><offsets xml_i="21018" xml_f="21019" txt_i="15086" txt_f="15087">μ</offsets></italic><offsets xml_i="21028" xml_f="21452" txt_i="15087" txt_f="15511">g with bupivacaine prolonged intraoperative anesthesia and the time to first analgesic request compared to fentanyl yet the total analgesic consumption in the first 24 h postoperative was similar in fentanyl and clonidine groups after elective cesarean delivery. The possible explanation for this finding is that the analgesic effect of clonidine follows a dose-dependent manner. Eisenach et al. reported that a dose of 150 </offsets><italic><offsets xml_i="21460" xml_f="21461" txt_i="15511" txt_f="15512">μ</offsets></italic><offsets xml_i="21470" xml_f="21553" txt_i="15512" txt_f="15595">g clonidine is required to observe antihyperalgesic effect, while a lower dose (50 </offsets><italic><offsets xml_i="21561" xml_f="21562" txt_i="15595" txt_f="15596">μ</offsets></italic><offsets xml_i="21571" xml_f="21590" txt_i="15596" txt_f="15615">g) is ineffective [</offsets><xref rid="B8" ref-type="bibr"><offsets xml_i="21621" xml_f="21622" txt_i="15615" txt_f="15616">8</offsets></xref><offsets xml_i="21629" xml_f="21631" txt_i="15616" txt_f="15618">, </offsets><xref rid="B18" ref-type="bibr"><offsets xml_i="21663" xml_f="21665" txt_i="15618" txt_f="15620">18</offsets></xref><offsets xml_i="21672" xml_f="21674" txt_i="15620" txt_f="15622">, </offsets><xref rid="B20" ref-type="bibr"><offsets xml_i="21706" xml_f="21708" txt_i="15622" txt_f="15624">20</offsets></xref><offsets xml_i="21715" xml_f="21957" txt_i="15624" txt_f="15866">]. The selected dose of intrathecal clonidine in current study was based on several reasons. Firstly, intrathecal clonidine displays the risk of adverse intraoperative hemodynamic effects. Rochette et al. showed that clonidine at a dose of 1 </offsets><italic><offsets xml_i="21965" xml_f="21966" txt_i="15866" txt_f="15867">μ</offsets></italic><offsets xml_i="21975" xml_f="22029" txt_i="15867" txt_f="15921">g/kg was not associated with hemodynamic disturbance [</offsets><xref rid="B21" ref-type="bibr"><offsets xml_i="22061" xml_f="22063" txt_i="15921" txt_f="15923">21</offsets></xref><offsets xml_i="22070" xml_f="22093" txt_i="15923" txt_f="15946">]. Also, Bajwa et al. [</offsets><xref rid="B22" ref-type="bibr"><offsets xml_i="22125" xml_f="22127" txt_i="15946" txt_f="15948">22</offsets></xref><offsets xml_i="22134" xml_f="22276" txt_i="15948" txt_f="16090">] found that the optimal dose for clonidine to produce effective analgesia without inducing hypotension in emergency cesarean section is 37.5 </offsets><italic><offsets xml_i="22284" xml_f="22285" txt_i="16090" txt_f="16091">μ</offsets></italic><offsets xml_i="22294" xml_f="22399" txt_i="16091" txt_f="16196">g. However, most studies have reported that although clonidine at a lower intrathecal dose less than 0.5 </offsets><italic><offsets xml_i="22407" xml_f="22408" txt_i="16196" txt_f="16197">μ</offsets></italic><offsets xml_i="22417" xml_f="22563" txt_i="16197" txt_f="16343">g/kg body weight was devoid of its diverse side effects, at the same time the antinociceptive effect of this drug was also reduced significantly [</offsets><xref rid="B7" ref-type="bibr"><offsets xml_i="22594" xml_f="22595" txt_i="16343" txt_f="16344">7</offsets></xref><offsets xml_i="22602" xml_f="22604" txt_i="16344" txt_f="16346">, </offsets><xref rid="B12" ref-type="bibr"><offsets xml_i="22636" xml_f="22638" txt_i="16346" txt_f="16348">12</offsets></xref><offsets xml_i="22645" xml_f="22646" txt_i="16348" txt_f="16349">–</offsets><xref rid="B14" ref-type="bibr"><offsets xml_i="22678" xml_f="22680" txt_i="16349" txt_f="16351">14</offsets></xref><offsets xml_i="22687" xml_f="22689" txt_i="16351" txt_f="16353">, </offsets><xref rid="B16" ref-type="bibr"><offsets xml_i="22721" xml_f="22723" txt_i="16353" txt_f="16355">16</offsets></xref><offsets xml_i="22730" xml_f="22829" txt_i="16355" txt_f="16454">]. Secondly, it is reported that intrathecal clonidine possesses an analgesic plateau effect at 75 </offsets><italic><offsets xml_i="22837" xml_f="22838" txt_i="16454" txt_f="16455">μ</offsets></italic><offsets xml_i="22847" xml_f="22935" txt_i="16455" txt_f="16543">g and higher doses could only increase the duration but not the intensity of analgesia [</offsets><xref rid="B8" ref-type="bibr"><offsets xml_i="22966" xml_f="22967" txt_i="16543" txt_f="16544">8</offsets></xref><offsets xml_i="22974" xml_f="22976" txt_i="16544" txt_f="16546">].</offsets></p><p><offsets xml_i="22983" xml_f="23224" txt_i="16547" txt_f="16788">The third finding which should be considered is that intrathecal clonidine clearly increases the duration of both sensory block and motor block as well as postoperative pain relief. This finding is also consistent with the previous studies [</offsets><xref rid="B18" ref-type="bibr"><offsets xml_i="23256" xml_f="23258" txt_i="16788" txt_f="16790">18</offsets></xref><offsets xml_i="23265" xml_f="23267" txt_i="16790" txt_f="16792">, </offsets><xref rid="B23" ref-type="bibr"><offsets xml_i="23299" xml_f="23301" txt_i="16792" txt_f="16794">23</offsets></xref><offsets xml_i="23308" xml_f="23310" txt_i="16794" txt_f="16796">, </offsets><xref rid="B24" ref-type="bibr"><offsets xml_i="23342" xml_f="23344" txt_i="16796" txt_f="16798">24</offsets></xref><offsets xml_i="23351" xml_f="23574" txt_i="16798" txt_f="17021">]. The mechanism of clonidine-induced potentiation of sensory block in spinal anesthesia is reported to be dependent on presynaptic (decrease in transmitter release) and postsynaptic (increase in hyperpolarization) action [</offsets><xref rid="B25" ref-type="bibr"><offsets xml_i="23606" xml_f="23608" txt_i="17021" txt_f="17023">25</offsets></xref><offsets xml_i="23615" xml_f="23617" txt_i="17023" txt_f="17025">, </offsets><xref rid="B26" ref-type="bibr"><offsets xml_i="23649" xml_f="23651" txt_i="17025" txt_f="17027">26</offsets></xref><offsets xml_i="23658" xml_f="23660" txt_i="17027" txt_f="17029">].</offsets></p><p><offsets xml_i="23667" xml_f="23901" txt_i="17030" txt_f="17264">The fourth finding which should be taken into account is that transient hypotension episodes and vasopressor requirement in clonidine group were significantly greater than F and P groups, a finding in agreement with previous studies [</offsets><xref rid="B27" ref-type="bibr"><offsets xml_i="23933" xml_f="23935" txt_i="17264" txt_f="17266">27</offsets></xref><offsets xml_i="23942" xml_f="23944" txt_i="17266" txt_f="17268">, </offsets><xref rid="B28" ref-type="bibr"><offsets xml_i="23976" xml_f="23978" txt_i="17268" txt_f="17270">28</offsets></xref><offsets xml_i="23985" xml_f="24223" txt_i="17270" txt_f="17508">]. Except for sympatholytic action of clonidine and profound analgesia which also reduces sympathetic activity, no other clear explanation is available. In contrast, some studies have reported that clonidine at doses between 37.5 and 150 </offsets><italic><offsets xml_i="24231" xml_f="24232" txt_i="17508" txt_f="17509">μ</offsets></italic><offsets xml_i="24241" xml_f="24350" txt_i="17509" txt_f="17618">g failed to cause a significant decrease in blood pressure when added to a high dose of bupivacaine (18 mg) [</offsets><xref rid="B13" ref-type="bibr"><offsets xml_i="24382" xml_f="24384" txt_i="17618" txt_f="17620">13</offsets></xref><offsets xml_i="24391" xml_f="24393" txt_i="17620" txt_f="17622">, </offsets><xref rid="B29" ref-type="bibr"><offsets xml_i="24425" xml_f="24427" txt_i="17622" txt_f="17624">29</offsets></xref><offsets xml_i="24434" xml_f="24890" txt_i="17624" txt_f="18080">]. However, these apparently controversial findings may be due to either the difference in bupivacaine and clonidine doses or dissimilarity in population and the type of surgeries. The fifth observation which should be noted is that clonidine lacks the ability to prevent postspinal shivering; by contrast, it is confirmed that clonidine, when administered intravenously, is an effective drug to prevent shivering in patients undergoing spinal anesthesia [</offsets><xref rid="B32" ref-type="bibr"><offsets xml_i="24922" xml_f="24924" txt_i="18080" txt_f="18082">30</offsets></xref><offsets xml_i="24931" xml_f="24933" txt_i="18082" txt_f="18084">, </offsets><xref rid="B33" ref-type="bibr"><offsets xml_i="24965" xml_f="24967" txt_i="18084" txt_f="18086">31</offsets></xref><offsets xml_i="24974" xml_f="25041" txt_i="18086" txt_f="18153">], a finding compatible with that found in a study by Jeon et al. [</offsets><xref rid="B34" ref-type="bibr"><offsets xml_i="25073" xml_f="25075" txt_i="18153" txt_f="18155">32</offsets></xref><offsets xml_i="25082" xml_f="25342" txt_i="18155" txt_f="18415">]. The possible reason for this finding could be attributed to the inability of clonidine to inhibit afferent thermal conduction at the level of spinal cord. All newborns in our study were free of any adverse effect. We concluded that intrathecal clonidine 75 </offsets><italic><offsets xml_i="25350" xml_f="25351" txt_i="18415" txt_f="18416">μ</offsets></italic><offsets xml_i="25360" xml_f="25874" txt_i="18416" txt_f="18930">g with bupivacaine prolonged intraoperative anesthesia and the time to first analgesic request compared to fentanyl, however, the total analgesic consumption in the first 24 h postoperative was similar in fentanyl and clonidine groups following elective cesarean delivery. 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Clonidine for post-extradural shivering in parturients: a preliminary study</article-title><source><italic>British Journal of Anaesthesia</italic></source><year>1993</year><volume>71</volume><issue>2</issue><fpage>294</fpage><lpage>295</lpage><pub-id pub-id-type="other">2-s2.0-0027329782</pub-id><pub-id pub-id-type="pmid">8123410</pub-id></element-citation></ref><ref id="B33"><label>31</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Horn</surname><given-names>E-P</given-names></name><name><surname>Werner</surname><given-names>C</given-names></name><name><surname>Sessler</surname><given-names>DI</given-names></name><name><surname>Steinfath</surname><given-names>M</given-names></name><name><surname>Schulte am Esch</surname><given-names>J</given-names></name></person-group><article-title>Late intraoperative clonidine administration prevents postanesthetic shivering after total intravenous or volatile anesthesia</article-title><source><italic>Anesthesia &Analgesia</italic></source><year>1997</year><volume>84</volume><issue>3</issue><fpage>613</fpage><lpage>617</lpage><pub-id pub-id-type="other">2-s2.0-0031053467</pub-id><pub-id pub-id-type="pmid">9052312</pub-id></element-citation></ref><ref id="B34"><label>32</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Jeon</surname><given-names>YT</given-names></name><name><surname>Jeon</surname><given-names>YS</given-names></name><name><surname>Kim</surname><given-names>YC</given-names></name><name><surname>Bahk</surname><given-names>JH</given-names></name><name><surname>Do</surname><given-names>SH</given-names></name><name><surname>Lim</surname><given-names>YJ</given-names></name></person-group><article-title>Intrathecal clonidine does not reduce post-spinal shivering</article-title><source><italic>Acta Anaesthesiologica Scandinavica</italic></source><year>2005</year><volume>49</volume><issue>10</issue><fpage>1509</fpage><lpage>1513</lpage><pub-id pub-id-type="other">2-s2.0-27644586259</pub-id><pub-id pub-id-type="pmid">16223398</pub-id></element-citation></ref></ref-list></back><floats-group><fig id="fig1" orientation="portrait" position="float"><label>Figure 1</label><caption><p>Consort flow of diagram.</p></caption><graphic xlink:href="PRT2014-513628.001"></graphic></fig><fig id="fig2" orientation="portrait" position="float"><label>Figure 2</label><caption><p>Side effects observed in three study groups. C: clonidine, F: fentanyl, and P: placebo. *Significant difference between the three groups.</p></caption><graphic xlink:href="PRT2014-513628.002"></graphic></fig><table-wrap id="tab1" orientation="portrait" position="float"><label>Table 1</label><caption><p>Demographic data for three study groups.</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1">Groups</th><th align="center" rowspan="1" colspan="1">Group C (<italic>n</italic> = 30)</th><th align="center" rowspan="1" colspan="1">Group F (<italic>n</italic> = 30)</th><th align="center" rowspan="1" colspan="1">Group P (<italic>n</italic> = 30)</th></tr></thead><tbody><tr><td align="left" rowspan="1" colspan="1">Age (years)</td><td align="center" rowspan="1" colspan="1">30.43 ± 3.70</td><td align="center" rowspan="1" colspan="1">30.20 ± 5.41</td><td align="center" rowspan="1" colspan="1">29.16 ± 5.11</td></tr><tr><td align="left" rowspan="1" colspan="1">Weight (kg)</td><td align="center" rowspan="1" colspan="1">88.5 ± 15.4</td><td align="center" rowspan="1" colspan="1">88.5 ± 13.6</td><td align="center" rowspan="1" colspan="1">89.7 ± 11.9</td></tr><tr><td align="left" rowspan="1" colspan="1">Height (cm)</td><td align="center" rowspan="1" colspan="1">166 ± 4.6</td><td align="center" rowspan="1" colspan="1">160 ± 8.4</td><td align="center" rowspan="1" colspan="1">162 ± 6.1</td></tr><tr><td align="left" rowspan="1" colspan="1">Duration of surgery (min)</td><td align="center" rowspan="1" colspan="1">85.63 ± 15.70</td><td align="center" rowspan="1" colspan="1">79.16 ± 20.11</td><td align="center" rowspan="1" colspan="1">81.70 ± 18.76</td></tr></tbody></table><table-wrap-foot><fn><p>Values are presented as mean ± SD. C: clonidine, F: fentanyl, and P: placebo. There are no significant differences among the three groups.</p></fn></table-wrap-foot></table-wrap><table-wrap id="tab2" orientation="portrait" position="float"><label>Table 2</label><caption><p>Characteristics of spinal anesthesia.</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1">Groups</th><th align="center" rowspan="1" colspan="1">Group C (<italic>n</italic> = 30)</th><th align="center" rowspan="1" colspan="1">Group F (<italic>n</italic> = 30)</th><th align="center" rowspan="1" colspan="1">Group P (<italic>n</italic> = 30)</th><th align="center" rowspan="1" colspan="1">
Pythonx = np.arange(1, 13.1, 0.1)
drugs = ['Oxycodone', 'Hydrocodone', 'Heroin', 'Fentanyl', 'Buprenorphine']
substances = {}XI. "Federal food and drug laws'' means the Federal Food, Drug and Cosmetic Act, as amended (Title 21 U.S.C. § 301 et seq.).
<br>
   
XI-a. "Fentanyl class drug'' shall mean the following drugs: fentanyl, 3-methylfentanyl, 3-methylthiofentanyl, acetylfentanyl, acetyl-alpha-methylfentanyl, alpha-methylfentanyl, alpha-methylthiofentanyl, beta-hydroxyl-3-methylfentanyl, beta-hydroxyfentanyl, para-fluorofentanyl, thiofentanyl, alfentanil, carfentanil, remifentanil, sufentanil, and all optical isomers of these substances. Drugs which become controlled after September 1, 2015, pursuant to RSA 318-B:1-a; and are known or scheduled with a common name that includes the term "fentanyl'', or "fentanil'' shall also be considered as belonging to this class, along with optical isomers of same. Drugs may be added or removed from this classification by action of the general court.
<br>
   
XII. "Comprehensive Drug Abuse Prevention and Control Act of 1970'' means the applicable law of the United States relating to opium, coca leaves and other narcotic drugs.
PerlWszyscy czterej funkcjonariusze biorący udział w zajściu następnego dnia zostali zwolnieni z pracy .
W przeszłości George Floyd był kilkukrotnie karany : w 2002 spędził 30 dni w areszcie za kradzież , w 2005 spędził 10 miesięcy za posiadanie kokainy , a w 2009 został skazany na 5 lat więzienia za dokonane w 2007 włamanie do domu i napad z bronią w ręku na ciężarną kobietę .
Śledztwo .
Wstępne wyniki z oficjalnej autopsji nie wykazały , jakoby 46-latek zmarł w wyniku uduszenia , a w wyniku połączenia kilku czynników – skrępowania , które pogłębiło występujące u niego schorzenia związane z sercem , w tym chorobę wieńcową , jak również obecność w organizmie substancji odurzających , jak fentanyl , norfentanyl , amfetamina , metamfetamina , morfina , konopie indyjskie .
Wykazano również u niego pozytywny wynik testu na COVID-19 .
Lewa tętnica wieńcowa była zwężona w 75 % , prawa tętnica wieńcowa w 90 % , nie stwierdzono uszkodzeń karku ani krtani .
Na zlecenie prawników rodziny Floyda przeprowadzona została niezależna autopsja , w której stwierdzono , że jedyną przyczyną śmierci było uduszenie wywołane przez „ stały nacisk ” .wlvac_medications = []
med_builder = MedicationBuilder()
fentanyl = (
med_builder.set_medication_code("fentanyl")
.set_medication_name("Fentanyl")
.set_fill_amount(2)
JavaScript'Where were you on the night of nov 9th, 1999?' : ['uhh.. being born?', 'killing my wife ;)', 'KILLING WIFE 👿', 'eating GAY stromboli'],
'Umm, Im hungry... I\'ll wrtie another question later' : ['I killed my wife', 'SUPERSUPERSUPER FENTANYL', 'lord save me', 'MERRY CHRISTMAS'],
'Are you gay?!?!?!?!??!?!?!?!??' : ["I did it again...", 'I\'m LOVE to SUPERFENTANYL', 'I KILLED HER', 'I\m soooooo drunk'],
Shellwget -O drugs/901.json 'http://www.openbnf.org/api/?drug=Tropicamide'
wget -O drugs/902.json 'http://www.openbnf.org/api/?drug=Fentanyl%20Citrate'
wget -O drugs/903.json 'http://www.openbnf.org/api/?drug=Anal%20Plugs'wget -O drugs/238.json 'http://www.openbnf.org/api/?drug=Oxycodone%20HCl/Naloxone%20HCl'
wget -O drugs/239.json 'http://www.openbnf.org/api/?drug=Fentanyl'
wget -O drugs/240.json 'http://www.openbnf.org/api/?drug=Buprenorphine'
C++viscosityChange=20;
};
class Fentanyl {
painReduce=3;
hrIncreaseLow[]={-10,-15};
hrIncreaseNormal[]={-10,-15};viscosityChange=20;
};
class Fentanyl {
painReduce=3;
hrIncreaseLow[]={-10,-15};
hrIncreaseNormal[]={-10,-15};viscosityChange=20;
};
class Fentanyl {
painReduce=3;
hrIncreaseLow[]={-10,-15};
hrIncreaseNormal[]={-10,-15};vascular disease, diabetes mellitus, smoking, and an occa-
sional drink on the weekends. Your patient has fentanyl
patient-controlled anesthesia, a Foley catheter, 2 periph-var neuro = ["Acute Dissem encephalomy","Agnosia","Alternating hemiplegia","Alzheimer's disease","Anoxia","Aphasia","Apraxia","Arachnoid cysts","Arachnoiditis","Arteriovenous malformation","Atten Deficit Hyperactiv Dis","Auditory processing disorder","Autonomic Dysfunction","Back Pain","Bell's palsy","Benign Intracranial Hypertension","Brachial plexus injury","Brain abscess","Brain damage","Brain injury","Brain tumor","Brown-Sequard syndrome","Carpal tunnel syndrome","Central pain syndrome","Central pontine myelinolysis","Centronuclear myopathy","Cephalic disorder","Cerebral aneurysm","Cerebral arteriosclerosis","Cerebral atrophy","Cerebral gigantism","Cerebral palsy","Cerebral vasculitis","Cervical spinal stenosis","Chorea","Chronic fatigue syndrome","Chron inflam demy polyneuro","Chronic pain","Coma","Compression neuropathy","Corticobasal degeneration","Cranial arteritis","Creutzfeldt-Jakob disease","Cushing's syndrome","Dementia","Dermatomyositis","Developmental dyspraxia","Diabetic neuropathy","Diffuse sclerosis","Dyslexia","Dystonia","Encephalitis","Epilepsy","Erythromelalgia","Essential tremor","Fainting","Febrile seizures","Fibromyalgia","Gray matter heterotopia","Head injury","Headache","Herpes zoster oticus","Herpes zoster","Huntington's disease","Hydranencephaly","Hydrocephalus","Hypoxia","Immune-Mediated encephalomye","Infantile spasms","Inflammatory myopathy","Intracranial cyst","Intracranial hypertension","Learning disabilities","Locked-In syndrome","Lou Gehrig's dis (Motor Neur Dis)","Lumbar disc disease","Lumbar spinal stenosis","Lyme dis-Neurological Sequelae","Menieres disease","Meningitis","Menkes disease","Microcephaly","Micropsia","Migraine","Mini-stroke (trans isch att)","Mitochondrial myopathy","Mobius syndrome","Monomelic amyotrophy","Motor Neurone Disease","Motor skills disorder","Multi-infarct dementia","Multifocal motor neuropathy","Multiple sclerosis","Multiple system atrophy","Muscular dystrophy","Myasthenia gravis","Myelinoclastic diffuse sclerosis","Myoclonic Encephalopathy","Myoclonus","Myopathy","Narcolepsy","Neuroleptic malignant syndrome","Neuromyotonia","Nonverbal learning disorder","Occipital Neuralgia","Optic neuritis","Orthostatic Hypotension","Palinopsia","Paresthesia","Parkinson's disease","Peripheral neuropathy","Persistent Vegetative State","Pervasive developmental disorders","Photic sneeze reflex","Pinched nerve","Pituitary tumors","PMG","Polio","Polymicrogyria","Polymyositis","Porencephaly","Post-Polio syndrome","Postherpetic Neuralgia (PHN)","Postinfectious Encephalomyelitis","Postural Hypotension","Primary Lateral Sclerosis","Rabies","Reflex neurovascular dystrophy","Repetitive motion disorders","Repetitive stress injury","Restless legs syndrome","Rhythmic Movement Disorder","Sandhoff disease","Schizophrenia","Septo-optic dysplasia","Shaken baby syndrome","Shingles","Sleep apnea","Sleeping sickness","Spina bifida","Spinal cord injury","Spinal cord tumors","Spinal muscular atrophy","Spinocerebellar ataxia","Stroke","Syncope","Synesthesia","Tarsal tunnel syndrome","Temporal arteritis","Tetanus","Tourette syndrome","Toxic encephalopathy","Transient ischemic attack","Transverse myelitis","Traumatic brain injury","Tremor","Whiplash","Wilson's disease"];
var endocrine = ["Acromegaly / Gigantism","Addison's disease","Adrenal insufficiency","Adrenocortical carcinoma","Amenorrhea","Androgen insensitivity syndromes","Carcinoid syndrome","Conn's syndrome","Cushing's disease","Cushing's syndrome","Delayed puberty","Diabetes insipidus","Diabetes","Gender identity disorder","Gestational Diabetes","Glucagonoma","Goitre","Gonadal dysgenesis","Graves-Basedow disease","Hashimoto's thyroiditis","Hermaphroditism","Hyperthyroidism","Hypoglycemia","Hypogonadism (Gonadotropin def)","Hypoparathyroidism","Hypopituitarism","Hypothyroidism","Mature Onset Diab of Y (MODY)","Mineralocorticoid deficiency","Multiple endocrine neoplasia","Osteitis deform (Paget bone Dis)","Osteoporosis","Ovarian failure (Premature Menop)","Pituitary adenomas","Pituitary tumors","Polycystic ovary syndrome","Precocious puberty","Primary hyperparathyroidism","Prolactinoma","Pseudohypoparathyroidism","Rickets and osteomalacia","Secondary hyperparathyroidism","Tertiary hyperparathyroidism","Testicular failure","Thyroid cancer","Thyroidectomy","Thyroiditis","Toxic multinodular goitre","Type 1 Diabetes mellitus","Type 2 Diabetes mellitus"];
var psych = ["Acute stress disorder","Adjustment disorder","Amnesia","Anorexia nervosa","Antisocial personality disorder","Anxiety disorder","Asperger syndrome","Attention deficit disorder","Autism","Autophagia","Avoidant personality disorder","Bereavement","Binge eating disorder","Bipolar disorder","Borderline personality disorder","Bulimia nervosa","Cyclothymia","Delirium","Delusional disorder","Dementia","Dependent personality disorder","Depression","Dissociative identity disorder","Down syndrome","Dyslexia","Dyspraxia","Exhibitionism","Gender identity disorder","Generalized anxiety disorder","Hyperactivity disorder","Hyperkinetic syndrome","Hypochondriasis","Hysteria","Kleptomania","Mania","Munchausen syndrome","Narcissistic personality disorder","Narcolepsy","Nightmares","Obsessive-compuls perso dis","Obsessive-compulsive disorder","Pain disorder","Panic attacks","Paranoid personality disorder","Parasomnia","Pathological gambling","Perfectionism","Pervasive developmental disorder","Post-traumatic stress disorder","Postpartum Depression","Primary hypersomnia","Primary insomnia","Psychotic disorder","Pyromania","Rumination syndrome","Sadism and masochism","Schizoid","Schizophrenia","Seasonal affective disorder","Self Injury","Separation anxiety disorder","Sleep disorder","Sleep terror disorder","Sleepwalking disorder","Social anxiety disorder","Stuttering","Suicide","Tourette syndrome"];
var medication_trade_alpha = ["Adenocard","Aspirin","Ativan","Atropine","Atrovent","Benadryl","Betaject","Calciject, CaCl","Calcium Gluconate","Codarone","Cogentin","D50W","Decadron","Demerol","Dilantin","Dopamine","Entonox","Epinephrine","Fentanyl","Flumazenil","Glucagon","Gravol","Haldol","Hemabate","Heparin","Hydrocortisone","Indomethacin PR","Ketamine","Labetalol","Lasix","Lidocaine","Magnesium Sulfate","Mannitol","Maxeran","Metolprolol","Morphine","Narcan","Nitroglycerine, GTN, NTG","Norepinephrine","Oxygene","Oxytocin","Pantoloc","Pulmicort","Reteplase","Rocuronium","Sodium Bicarbonate","Succinycholine","Thiamine","Toradol","Tylenol","Tylenol","Valium","Vasopressin","Ventolin","Verapamil","Versed","Vitamin K","Zantac","Zyprexa"];
var medication_generic_alpha = ["Acetamin. w codeine","Acetaminophen","Adenosine","Adrenalin","Amiodarone","Anexate","ASA","Atropine Sulfate","Benztropine","Betamethasone","Betaxin","Budesonide","Calcium Chloride","Calcium Gluconate","Dexamethasone","Dextrose","Diazepam","Dimenhydrinate","Diphenhydramine","Furosemide","Glucagon","Haloperidol","Heparin, Carboprost Tromethamine","Hydrocort","Indocid","Intropin","Ipatroprium Br.","Isoptine, Calan","Ketalar","Keterolac","Levophed","Lorazepam","Meperidine","Metoclopramide, Reglan","Metoprolol","MgSO4","Midazolam","Morphine Sulfate","NaHCO3","Naloxone","Nitroglycerine, GTN, NTG","Nitrous Oxide","Olanzepine","Osmitrol","Oxygene","Pantoprazole","Phenytoin","Phytonadione","Pressyn","Prostaglandin","Ranitidine","Retevase","Salbutemol","Sublimaze","Suxamethonium Cl","Syntocinon","Trandate","Xylocard,Xylocaine","Zemuron"];
var conditions = [];
var medications = [];var DRUGS = {
"propofol": 200,
"atracurium": 0,
"fentanyl": 100
};
if(!_.isArray(scope.editing.given_drug)){var bullets = [
{"title":"Proprofol","subtitle":"200","ranges":ranges,"measures":[],"markers":[250]},
{"title":"Fentanyl","subtitle":"100","ranges":ranges,"measures":[],"markers":[26]},
{"title":"Doxamethosone","subtitle":"","ranges":ranges,"measures":[],"markers":[]},
{"title":"CO-amixiclav","subtitle":"","ranges":ranges,"measures":[],"markers":[]},
{"title":"Paracetomol","subtitle":"1mg","ranges":ranges,"measures":[],"markers":[]},{ value: "Benzodiazepine", name: "Benzodiazepine" },
{ value: "Cocaine", name: "Cocaine" },
{ value: "Ethanol", name: "Ethanol" },
{ value: "Fentanyl", name: "Fentanyl" },
{ value: "Fentanyl_Analogue", name: "Fentanyl_Analogue" },
{ value: "Heroin", name: "Heroin" },
{ value: "Hydrocodone", name: "Hydrocodone" },{'value': '8591', 'label': '29 - Potassium Chloride'},
{'value': '9344', 'label': '30 - Ribavirin'},
{'value': '3322', 'label': '31 - Diazepam'},
{'value': '4337', 'label': '32 - Fentanyl'},
{'value': '8638', 'label': '33 - prednisolone'},
{'value': '6851', 'label': '34 - Methotrexate'},
{'value': '10582', 'label': '35 - levothyroxine'},
Kotlinval Naloksan = Paramedik("Naloksan (Narcan)","Formülasyon: Ampul.",
"\nEndikasyon:\n" +
"\n"+
"1- Opioid zehirlenmesi (morfin, heroin, fentanyl vb.) durumunda acil antidot olarak kullanılır.\n" +
"2- Opioidlerin etkilerini tersine çevirme ve solunum depresyonunu gidermede.\n",
"\nDozaj:\n"+
"\n"+US hosts Apec summit in San Francisco
Biden-Xi meeting: climate, fentanyl on the agenda
Israel say operation at A1-Shifa hospital ongoing
Java"Urinary tract infection, Genital mycotic infection", "Kidney problems",
"Take in the morning with or without food", "2025-12-31", true, false, false));
medicinesList.add(new MedicinesDTO("Fentanyl Patch", "Analgesic",
"Fentanyl patch is used to relieve severe pain in people who are expected to need pain medication around the clock for a long time and who cannot be treated with other medications.",
50.00, 20, "Generic Manufacturer", "Patch", "Severe Pain Management", "Dizziness, Drowsiness",
"Respiratory depression", "Apply to clean, dry skin", "2025-12-31", true, true, true));
medicinesList.add(new MedicinesDTO("Gabapentin", "Anticonvulsant",unitsField: "units"
},
tracks: [
{ sensor: "FENTANYL", label: "Fentanyl", units: "mcg" },
{ sensor: "PROPOFOL", label: "Propofol", units: "mg" },
{ sensor: "PHENYLEPHRINE", label: "Phenylephrine" },
{ sensor: "HYDROMORPHONE", label: "Hydromorphone" },unilook etouf
unilook euphon
unilook fentan
unilook fentanyl
unilook /glob
unilook gw
unilook gwenunilook etouf
unilook euphon
unilook fentan
unilook fentanyl
unilook /glob
unilook gw
unilook gwen