经阴道穿刺取卵术中不同镇痛方法的应用效果比较

目的探讨双氯芬酸钠栓与丙泊酚复合地佐辛在经阴道穿刺取卵术中的镇痛效果。方法 2013年2-4月行取卵术的387例患者根据用药情况分为双氯芬酸钠栓组226例（A组）和丙泊酚复合地佐辛组161例（B组）。观察并记录两组在取卵术中的镇痛效果及术后头晕、恶心、呕吐等不良反应情况。结果 B组和A组患者取卵术中镇痛有效率分别为100.00%、99.14%,两者比较差异无统计学意义（χ^2=0.228,P=0.633）。B组患者的头晕发生率、恶心发生率、呕吐发生率、注射部位疼痛发生率和呼吸抑制发生率均较高,与A组比较差异均有显著统计学意义（P〈0.01）。结论经阴道取卵术中使用双氯芬酸钠栓镇痛效果好,不良反应发生率低,对妊娠无影响,使用方便、安全,值得临床推广使用。     

双氯芬酸钠对Nd:YAG激光晶体后囊膜切开术后房水反应的影响

目的 探讨双氯芬酸钠防治兔眼Nd：YAG激光晶体后囊膜切开术后并发症的机制.方法 24只家兔48只眼行Nd：YAG激光晶体后囊膜切开术,其中24只眼于手术前后48 h,每隔4 h滴双氯芬酸钠1滴（手术用药组）另24只眼术后不用药（手术组）.两组均于术后第4、8、12和48h分别采用放射免疫分析法、紫外吸收法检测房水内中等分子量物质（MMS）及花生四烯酸代谢产物—血栓素B2（TXB2）,前列腺素E2（PGE2）,6-酮-前列腺素F1α（6-keto-PGF1α）含量.结果 Nd：YAG激光晶体后囊膜切开术后不同时间手术组房水内各成分含量均升高,与手术用药组比较差异有统计学意义.结论 MMS、PGs与兔眼Nd：YAG激光晶体后囊膜切开术后出现的并发症有关,手术前后应用双氯芬酸钠能降低这些成分的释放,从而减轻手术后的并发症.     

Effects of diclofenac on isradipine pharmacokinetics and platelet aggregation in volunteers

Summary In this open, two-period crossover study in 18 healthy male volunteers, a single oral dose of 50 mg diclofenac was administered alone and on day 7 of multiple oral dosing of 5 mg b.i.d. isradipine to assess a possible pharmacokinetic interaction. The effect of these drugs on ex vivo platelet function was also determined.Serial blood samples were obtained over 12-hour periods on three occasions: after the single diclofenac dose; after the morning dose of isradipine on day 6 and after co-administration of both drugs on day 7 of steady-state isradipine administration. Additional samples were taken at 2 h post dose for determination of ex vivo platelet aggregation. Isradipine plasma concentrations were determined by a gas chromatographic method and diclofenac plasma concentrations by an HPLC method.The pharmacokinetic characteristics of diclofenac were unaltered during co-administration. The maximum plasma concentration of isradipine was increased 19.6% during co-administration from 5.06 to 6.05 ng·ml^–1. This is not expected to be of clinical importance. Isradipine's apparent total body clearance and steady-state AUC remained unchanged. Ex vivo induced platelet aggregation was not affected by any of the treatments.     

The analgesic efficacy of diclofenac dispersible and ibuprofen in postoperative pain after dental extraction

Summary We have compared single oral doses of drinkable diclofenac dispersible (50 mg) with ibuprofen (400 mg) and placebo in a randomized, double-blind, parallel-group trial in 127 adults complaining of at least moderately severe pain after removal of an impacted third molar. Within 40 min both diclofenac and ibuprofen produced significant pain relief that persisted for 6 h. There were no differences between diclofenac and ibuprofen in analgesic efficacy.     

Oral or rectal diclofenac for laparoscopic sterilization

In the UK, perioperative non-steroidal anti-inflammatory drugs are commonly administered via the rectal route even though suppositories are unpopular with patients. This prospective, randomised, double-blind study compares the analgesic effectiveness of diclofenac 100 mg given either orally or rectally to 42 ASA grades 1 and 2 patients scheduled to undergo day-case laparoscopic sterilization by the application of Filshie clips. General anaesthesia was induced with fentanyl 2 μg kg⁻¹ and propofol and maintained with isoflurane and nitrous oxide in oxygen. No difference was observed between the two groups in postoperative pain scores, morphine requirement, nausea and vomiting rates and time to achievement of street fitness. One patient in the rectal group and none in the oral group required in-patient admission. We conclude that oral and rectal diclofenac are of equal effectiveness in this approach to day-case laparoscopic sterilization.     

Indomethacin and diclofenac sodium increase sodium and water excretion after extracellular volume expansion in the rabbit

The renal effects of an acute extracellular fluid volume expansion (50 ml Ringer/kg body weight/60 min) were studied in aldosterone-treated (100 μg/kg), anesthetized rabbits with and without pretreatment with either indomethacin (3.0 mg/kg) or diclofenac sodium (3.0 mg/kg), two different inhibitors of renal prostaglandin (PG) biosynthesis. In controls (n = 7), the volume expansion increased urine flow from 1.5 ± 0.24 to 6.1 ± 0.5 (S.E.) ml/min/100 g kidney weight and sodium excretion from 0.15 ± 0.03 to 0.99 ± 0.10 mmol/min/100 g. PAH and insulin clearance increased by 42 and 58%, respectively, while plasma renin activity and urinary excretion of PGF_2α-like immunoreactivity were reduced (P < 0.05). In aninals pretreated with indomethacin (n = 6) or diclofenac sodium (n = 6), the diuresis and the natriuresis following volume expansion were significantly increased about two-fold over controls, whereas PAH and inulin clearance, plasma renin activity and hematocrit did not differ from controls. Both drugs were found to reduce urinary excretion of PGF_2α-like immunoreactivity by 75–95% throughout the experiment. The results indicate that diclofenac sodium, indomethacin and extracellular volume expansion enhance sodium and water excretion partly by suppression of a PG sensitive reabsorption process in the kidney.     

Physico-chemical characterisation and intrinsic dissolution studies of a new hydrate form of diclofenac sodium: comparison with anhydrous form

Diclofenac sodium is a non-steroidal anti-inflammatory drug widely used in painful and inflammatory diseases. In standard conditions, by exposure to relative humidity even below 60% at 25 °C, the anhydrous form DS gives rise to a hydrate species DSH, a tetrahydrate form different from that obtained by crystallisation from water and previously described. The method of preparation and the physico-chemical properties of the hydrate form were investigated. Data from FTIR spectroscopy, X-ray powder diffraction and thermal analysis were used for the identification and the characterisation of DSH. DS and DSH were easily differentiated by their IR spectra, X-ray patterns and thermal behaviour. DSH stability was followed at room temperature over a period of 1 year and under different conditions of temperature to verify the tendency to solid–solid transition and to study its existence range. Solubility and intrinsic dissolution studies were performed to compare the physico-chemical properties of DS and DSH. Differences in solubility and intrinsic dissolution rates were pointed out: these studies showed that DS dissolved faster than DSH. Storage under uncontrolled environmental conditions or contact with water vapour during manufacturing process could thus influence the performance of the final dosage form.     

双氯芬酸二乙胺软膏治疗创伤性尾骨痛的临床研究

目的研究双氯芬酸二乙胺软膏在创伤性尾骨痛治疗中的镇痛作用和安全性。方法 67例门诊创伤性尾骨痛的患者随机分为两组,治疗组局部外用双氯芬酸二乙胺软膏,对照组口服双氯芬酸钠缓释胶囊。应用视觉模拟疼痛评分（VAS）、疼痛程度主诉分级法（VRS）和局部压痛评分法等评估两组康复进程中的疼痛差异、用药情况及不良反应。结果治疗组与对照组镇痛效果无明显差别,但显效率高,不良反应比对照组明显减少。结论双氯芬酸二乙胺具有良好的镇痛作用,使用方便,副作用少,可作为创伤性尾骨痛镇痛治疗的首选。