1.Endoscopic sinus surgery perioperative outcomes after intravenous tranexamic acid:A double blind randomized controlled trial
Jenna Marie C. Quiroga ; Peter Simon R. Jarin
Philippine Journal of Otolaryngology Head and Neck Surgery 2018;33(1):6-11
Objective:
To determine the effect of a single intravenous dose of tranexamic acid on intraoperative bleeding, duration of surgery and surgical field visualization during endoscopic sinus surgery.
Methods:
Study Design: Double-blind, randomized, placebo-controlled trial.
Setting: Tertiary Government Hospital in Quezon City
Participants: 10 patients aged 18-75 years old diagnosed with chronic rhinosinusitis with or without nasal polyposis and unresponsive to medical treatment, who underwent endoscopic sinus surgery from September 2016 to August 2017, were randomly allocated to treatment group and control group respectively. The “odd” numbers were assigned to the treatment group (intravenous Tranexamic acid) given 1 dose of 100mg/ml (500mg tranexamic acid per 5 ml) tranexamic acid slow intravenous drip 1 hour prior to the procedure, while the “even” numbers assigned to the control group received the same amount of normal saline solution.
Results:
The mean duration of surgery of the tranexamic group was 185 minutes (standard deviation, SD 55.23) and the control group was 122.6 minutes (SD 42.03) showing no significant difference (p=.08). The mean blood loss of the tranexamic group was less at 240ml (SD 108.39) compared with the control group at 290ml (SD 74.16), although there was no statistically significant difference (p=.42). Intraoperative surgical field assessed by the surgeon based on the Boezart grading scale showed that 2 (40%) of the tranexamic group had higher bleeding score compared with the placebo group. However, this was not found to be statistically significant (p=.460). Due to the small sample size, a type II error occurred with alpha level of 0.05 and estimated power of 0.0885, with not enough basis to refute that a single dose of intravenous tranexamic acid has no effect in improving surgical field visualization during endoscopic sinus surgery. No drug side effects were noted after administration until after surgery.
Conclusion
Single dose intravenous tranexamic acid in functional endoscopic sinus surgery decreased mean intraoperative blood loss (but this was statistically insignificant), but its effect on surgical field visualization cannot totally be assessed due to small sample size. There was also no change in the observed duration of surgery. No untoward side effects associated were noted from administration of the drug until after the surgery finished.
Administration, Intravenous
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Tranexamic Acid
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Sinusitis
3.Postoperative patient controlled analgesia in elderly Koreans: epidural versus intravenous administration.
Shin Hyung KIM ; Yang Sik SHIN ; Young Jun OH ; In Hye PARK ; Yong Seon CHOI
Korean Journal of Anesthesiology 2013;65(4):365-367
No abstract available.
Aged
;
Administration, Intravenous*
;
Analgesia, Patient-Controlled*
;
Humans
4.Light and electron microscopic study of tumor cells in carcinoma of cervix uteri after intravenous administration of cisplatin and 5 - fluorouracil.
Jung Jea SEO ; Jong Ha PARK ; Seong Hye KIM ; Yun Jung PARK ; Young Chul YOO ; Hung Jong LEE ; Jong In KIM ; Tae Sung LEE ; Kwon Gyu PARK
Korean Journal of Obstetrics and Gynecology 1993;36(7):2188-2197
No abstract available.
Administration, Intravenous*
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Cervix Uteri*
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Cisplatin*
;
Female
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Fluorouracil*
5.Vancomycin-induced Hypersensitivity Reaction with Slow Infusion : A case report.
Cheol Sueng YANG ; Min Seok KOO ; Ho Sung KWAK ; Myung Ae LEE ; Hyun Ha LEE
Anesthesia and Pain Medicine 2008;3(3):183-185
Vancomycin is a bacteriocidal antibiotic experiencing a resurgence of utility because of increasing clinical problems with methicillinresistant staphylcoccal infections. Vancomycin can cause two types of hypersensitivity reactions, the red man syndrome and anaphylaxis. There is a consensus that slow intravenous administration of vancomycin should minimize the risk of infusion related adverse effects. We report a case of vancomycin hypersensitivity reaction with slow infusion of vancomycin.
Administration, Intravenous
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Anaphylaxis
;
Consensus
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Hypersensitivity
;
Vancomycin
6.Oral versus Intravenous Antibiotic treatment for Osteomyelitis in Adults: A Systematic Review and Meta-Analysis
Ramon Jr B. Larrazabal ; Harold Henrison C. Chiu ; Marlon S. Arcegono ; Cybele Lara R. Abad
Philippine Journal of Internal Medicine 2020;58(4):146-153
BACKGROUND: The worldwide incidence of osteomyelitis is approximately 21.8 cases per 100,000 person-years. The cornerstone of treatment is prolonged (4-6 weeks) intravenous antibiotic administration. This entails additional cost, inconvenience, and added manpower from the healthcare system. Thus, studies have explored the possible use of oral antibiotics as alternatives to improve patient compliance and reduce costs. Our meta-analysis aimed to compare the efficacy of oral versus intravenous antibiotics in treating adult patients with osteomyelitis.
MATERIALS AND METHODS: Electronic databases (PubMed, Medline, EMBASE, Cochrane Central Register of Controlled Trials, Google Scholar, and Research Gate) from 1966 to April 2020 were searched using the terms “oral antibiotics”, “osteomyelitis”, “randomized controlled trial”. Only studies that directly compared oral versus intravenous antibiotics and confirmed osteomyelitis through biopsy and/or imaging were included. Primary outcome is remission (resolution of symptoms with no relapse and bacteriologic eradication); secondary outcomes, (a) relapse (persistence of the pathogen after treatment) and (b) adverse events. The validity of included studies was assessed using the Cochrane Handbook for Systematic Reviews of Interventions. We performed a random-effects model in Review Manager Version 5.3 with 95% confidence interval. The I 2 test was used to assess heterogeneity.
RESULTS: Seven of 89 trials comprised of 1,282 patients were included in the final analysis. All studies included patients with osteomyelitis of the lower extremities. Oral antibiotics used were Ciprofloxacin, Ofloxacin, and Co-trimoxazole; intravenous antibiotics used were deemed appropriate by the infectious disease specialist. Patients were only given either oral or intravenous antibiotics. Results showed an 8% increase in remission rates [RR 1.08 (0.81 to 1.44, 95% CI, Z = 0.52, p=0.60)] with no heterogeneity (I2 = 0%) in the intravenous antibiotics group. However, this was not statistically significant. Furthermore, there was a 62% decrease in relapse rates in the intravenous antibiotics group [RR 1.62 (0.85 to 3.07, 95% CI, Z = 1.47, p = 0.14)] with no heterogeneity (I2 = 0%) but was not statistically significant.
CONCLUSION: Oral are comparable to intravenous antibiotics in treating osteomyelitis in terms of remission and relapse rates. However, larger and double-blinded trials should be done to generate more robust data to validate these claims.
Osteomyelitis
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Administration, Intravenous '
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Parenteral Nutrition
7.The research on a pocket microcontroller system for target controlled infusion.
Yu-Ke CHENG ; Xin-An ZHANG ; Yan-Wu ZHANG ; Qun-Ling WU ; Jian-Hong DOU ; Rou-Shong WANG
Chinese Journal of Medical Instrumentation 2005;29(3):177-178
This paper present a microcontroller system for target controlled infusion according to pharmacodynamic parameters of intravenous anesthetics. It can control the depth of anesthesia by adjusting the level of plasma concentrations. The system has the advantages of high precision, extended function and easy operation. It has been now used in the clinical anesthesia.
Algorithms
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Anesthesia, Intravenous
;
instrumentation
;
methods
;
Anesthetics, Intravenous
;
administration & dosage
;
pharmacokinetics
;
Computer Systems
;
Humans
;
Infusions, Intravenous
;
Microcomputers
;
Software Design
8.Priming technique can alleviate the withdrawal responses associated with intravenous administration of rocuronium.
Jae In LEE ; Se Hun LIM ; Sang Eun LEE ; Young Hwan KIM ; Jeong Han LEE ; Kun Moo LEE ; Soon Ho CHEONG ; Young Kyun CHOE ; Young Jae KIM ; Chee Mahn SHIN
Korean Journal of Anesthesiology 2009;56(6):628-633
BACKGROUND: Intravenous injection of rocuronium is associated with withdrawal responses which are attributable to the pain from the injection of rocuronium. Several methods have been proposed to abolish and attenuate rocuronium-induced pain. We hypothesized priming dose of rocuronium could reduce withdrawal responses associated with administering a second large dose of rocuronium for tracheal intubation. We compared the efficacy of the priming dose technique of rocuronium with intravenous lidocaine as a pre-treatment for the prevention of withdrawal responses associated with rocuronium injection. METHODS: We recruited 150 patients aged between 18 and 60 years, ASA physical status 1 or 2, who were going to undergo elective surgery requiring general anesthesia. Patients were allocated into three groups. Group C received normal saline, Group L received lidocaine 1 mg/kg, and Group P received rocuronium 0.06 mg/kg 2 minutes before administering a second large dose of rocuronium for tracheal intubation. After the loss of consciousness, rocuronium 0.6 mg/kg was administered intravenously over 10 seconds for tracheal intubation. The withdrawal responses to the injection of rocuronium were evaluated. RESULTS: The incidence of withdrawal responses associated with rocuronium injection for tracheal intubation was 56, 50, 24% in group C, group L, and group P, respectively. The incidence of withdrawal responses was lower in group P than group C and group L, but there was no difference between group L and group C. CONCLUSIONS: Priming dose technique is a useful clinical method to alleviate withdrawal responses associated with rocuronium injection.
Administration, Intravenous
;
Aged
;
Androstanols
;
Anesthesia, General
;
Humans
;
Incidence
;
Injections, Intravenous
;
Intubation
;
Lidocaine
;
Unconsciousness
9.Thalamonal-N2O-O2 Anesthesia for Orthopedic Surgery .
Korean Journal of Anesthesiology 1978;11(3):209-213
Orthopedic surgery was performed under Thalamonal-N2O-O2 anesthesia by an intravenous injection of a small dose of Thalamonal and N2O inhalation. Respiratory rate was compared before and after intravenous administration of nalorphine at the end of operation. From 22 cases, the following results were obtained: 1) Average dose of Thalamonal during induction of anesthesia was 1.67ml/10kg. During induction, rigidity of chest wall developed in 5 cases, 2) Intermittent injections of Thalamonal for maintenance of anesthesia were needed at. each 43. 8 min. interval, and average dose of Thalamonal was 0. 013 ml/kg/30min. 3) After injection of nalorphine, average rate of respiration per minute increased from 15. 1 to 21. 1(39. 9%) 4) 21 cases among 22 cases recovered promptly after discontinuation of N2O, and recovery was delayed in 1 case. Self extubation was seen in 3 cases.
Administration, Intravenous
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Anesthesia*
;
Inhalation
;
Injections, Intravenous
;
Nalorphine
;
Orthopedics*
;
Respiration
;
Respiratory Rate
;
Thoracic Wall
10.Effect of Mixed Intravenous Administration of Succinylcholine and Pancuronium on the Intraocular Pressure ( IOP ) .
Korean Journal of Anesthesiology 1979;12(4):456-459
Succinylcholine has been reported to cause elevation of intraocular pressure(IOP.) IOP measurements, following single and mixed intravenous administration of succinylcholine and pancuronium, given immediately after thiopental, were made in 40 surgical patients, to assess the effect of pacuronium on the succinylcholine induced increase in IOP. The major findings of this study were as follows; 1) Tbiopental showed significant lowering effect on IOP. 2) A single intravenous injection of succinylcholine(1mg/kg) caused a slight rise of lOP. 3) A single intravenous injection of pancuronium(4mg) caused a slight decrease of IOP. 4) A mixed intravenous injection of succinylcholine and pancuronium increased the IOP more significantly than succinylcholine alone, This also means that pancuronium do not inhibit succinylcholine induced increase In IOP. 5) Tracheal intubation caused a rise of IOP significantly.
Administration, Intravenous*
;
Humans
;
Injections, Intravenous
;
Intraocular Pressure*
;
Intubation
;
Pancuronium*
;
Succinylcholine*
;
Thiopental