3.The Effect of Pretreatment with Thiopental on Reducing Pain Induced by Rocuronium Injection.
Jong Taek PARK ; Jae Chan CHOI ; Young Soo YOO ; Young Bok LEE ; Soon Yul KIM ; Hyun Kyo LIM
Yonsei Medical Journal 2005;46(6):765-768
We examined whether pretreatment with a small dose of thiopental was effective in reducing pain induced by the intravenous injection of rocuronium. Withdrawal movement was used to assess pain reduction. Ninety patients were randomly assigned to one of two groups: patients in the control group were pretreated with 2 mL saline, and those in the thiopental group were pretreated with 2 mL (50 mg) thiopental. Thiopental 5 mg/kg was injected intravenously. After a loss of consciousness, the upper arm was compressed with a rubber tourniquet, and the pretreatment drugs were administered. Thirty seconds later the tourniquet was removed and 0.6 mg/kg rocuronium was administered. Withdrawal movement was assessed using a four-grade scale: no movement, movement limited to the wrist, to the elbow or to the shoulder. The frequency of withdrawal movement in the group pretreated with thiopental was lower than in the control group (34 vs. 13, p 0.05). We concluded that pretreatment with 2 mL (50 mg) thiopental is effective in reducing pain caused by the intravenous injection of rocuronium.
Thiopental/*therapeutic use
;
Pain Measurement
;
Pain/chemically induced/*prevention & control
;
Neuromuscular Nondepolarizing Agents/*adverse effects
;
Middle Aged
;
Male
;
Injections, Intravenous
;
Humans
;
Female
;
*Anesthetics, Intravenous
;
Androstanols/*adverse effects
;
Adult
4.The Effect of Anti-TNF-alpha on Refractory Uveitis.
Suk Kyue CHOI ; Young Jung ROH ; Min Ho KIM
Journal of the Korean Ophthalmological Society 2007;48(2):273-278
PURPOSE: To investigate the effects of Anti-TNF-alpha (infliximab, Remicade(R), Shering-Plough) on refractory uveitis. METHODS: A retrospective observational survey was conducted on 12 eyes of 10 patients with refractory uveitis. These patients had no response to immunosuppresants or systemic steroid therapy and were intolerable due to drug toxicity. After an intravenous injection of Anti-TNF-alpha, best corrected visulal acuity was measured. Improvement in inflammation was then observed at the first, third and last month of follow-up. RESULTS: Patients were observed for a mean period of 15 months. They received anti-TNF-alpha intravenously, ranging from one to eleven infusions. After infusion with Anti-TNF-alpha, remission of intraocular inflammation was evident in all patients within 9.7 days. Best corrected visual acuity also improved at the first, third, and last month of follow-up. Two patients were infected by tuberculosis and mumps respectively. CONCLUSIONS: There was an effect on refractory uveitis with anti-TNF-alpha therapy. Many participants may also require further evaluation after treatment.
Drug-Related Side Effects and Adverse Reactions
;
Follow-Up Studies
;
Humans
;
Inflammation
;
Injections, Intravenous
;
Mumps
;
Retrospective Studies
;
Tuberculosis
;
Uveitis*
;
Visual Acuity
5.Experimental model of histamine-induced anaphylactoid reaction on beagle dogs.
Zhiguo WANG ; Danqiao WANG ; Youhua YU ; Yikui LI ; Yu SUI ; Haifeng CUI
China Journal of Chinese Materia Medica 2011;36(14):1842-1844
OBJECTIVETo establish animal model of histamine-induced anaphylactoid reactions on Beagle dogs through intravenous injection of histamine phosphate injection.
METHODAnaphylactoid reactions was determined according to the changes of praxiology and blood pressure of Beagle dogs after one intravenous injection of histamine phosphate injection.
RESULTIt showed that typical anaphylactoid reactions be caused by histamine phosphate injection on Beagle dogs, and the response of the high-dose group was more obvious than that of the low-dose group.
CONCLUSIONIntravenous injection of histamine phosphate injection could simulate Beagle dogs to bring typical clinical anaphylactoid reaction, that could be used as a sensitive animal model to evaluate anaphylactoid reaction of traditional Chinese medicine injections (TCMIs) in the pre-clinical experiments of both TCMIs and their composition.
Anaphylaxis ; chemically induced ; Animals ; Disease Models, Animal ; Dogs ; Dose-Response Relationship, Drug ; Drugs, Chinese Herbal ; adverse effects ; Female ; Histamine ; administration & dosage ; adverse effects ; analogs & derivatives ; Injections, Intravenous ; Male
6.Studies on hypersensitivity and pharmacokinetics of paclitaxel microemulsion.
Lei HE ; Gui-ling WANG ; Qiang ZHANG
Acta Pharmaceutica Sinica 2003;38(3):227-230
AIMTo evaluate the hypersensitivity reaction of the blank paclitaxel microemulsion and study the O/W paclitaxel microemulsion's pharmacokinetics in rats.
METHODSAn alternative paclitaxel microemulsion was prepared with small particle size. The hypersensitivity reaction of the blank microemulsion was investigated in guinea pigs. In pharmacokinetic study, 5 rats were given i.v. Taxol or paclitaxel microemulsion. Blood samples were collected at 0, 0.25, 0.5, 1, 2, 4, 6, 8, 10, 12, 14 h and the concentration of paclitaxel in plasma was determined by HPLC method. The data obtained were processed using 3P87 program.
RESULTSThe mean size of the microemulsion is 17.2 nm. The preparation of blank microemulsion did not show any hypersensitivity, while the injection of commercial product showed significant hypersensitivity. The concentration-time curve of paclitaxel microemulsion and commercial injection (Taxol) fitted a two-compartment model. The K10, K12, K21 and AUC of paclitaxel microemulsion were 0.571.h-1, 1.441.h-1, 3.081.h-1 and 34.98 mg.h.L-1. Those of commercial injection were 1.291.h-1, 1.271.h-1, 0.511.h-1 and 21.85 mg.h.L-1.
CONCLUSIONThe blank paclitaxel preparation of micoemulsion reduced the hypersensitivity in guinea pigs compared with the blank commercial injection. The paclitaxel microemulsion has relatively longer circulating time in rats.
Animals ; Antineoplastic Agents, Phytogenic ; administration & dosage ; adverse effects ; pharmacokinetics ; Drug Hypersensitivity ; etiology ; Emulsions ; Female ; Guinea Pigs ; Injections, Intravenous ; Male ; Paclitaxel ; administration & dosage ; adverse effects ; pharmacokinetics ; Rats
7.Suspected Anaphylactic Reaction Associated with Microemulsion Propofol during Anesthesia Induction.
Se Jin LEE ; Soon Im KIM ; Bo Il JUNG ; Su Myung LEE ; Mun Gyu KIM ; Sun Young PARK ; Sang Ho KIM ; Si Young OK
Journal of Korean Medical Science 2012;27(7):827-829
Although rare, intraoperative anaphylaxis can lead to significant morbidity and mortality. Aquafol(R) (Daewon Pharmaceutical Co. Ltd., Seoul, Korea), a microemulsion propofol, was developed to eliminate lipid solvent-related adverse events, and was used in clinical anesthesia since 2009 with little data about severe side effects such as anaphylaxis. A healthy 16-yr-old male patient who had past medical history with two previous operations of no complications developed cardiovascular shock with generalized erythema following administration of microemulsion propofol during anesthesia induction. Intravenous injection of epinephrine and steroid rescued him. He remained in a stable state without any problems postoperatively and was discharged. Clinicians should consider this rare but serious complication during induction of anesthesia with propofol.
Adolescent
;
Anaphylaxis/*chemically induced/drug therapy
;
Anesthetics, Intravenous/*administration & dosage/adverse effects
;
Bronchodilator Agents/therapeutic use
;
Dexamethasone/therapeutic use
;
Emulsions/chemistry
;
Epinephrine/therapeutic use
;
Glucocorticoids/therapeutic use
;
Humans
;
Injections, Intravenous
;
Male
;
Propofol/*administration & dosage/adverse effects
8.Intravenous injection rate and site of fentanyl affect the incidence and onset time of fentanyl-induced cough.
Ye-ming CHEN ; Wen-ting CHEN ; Shi-wei LIANG ; Miao-ning GU
Journal of Southern Medical University 2009;29(2):339-340
OBJECTIVETo explore the effect of intravenous injection rate and site of fentanyl on the incidence and onset time of fentanyl-induced cough.
METHODSeventy-five ASA class I or II patients were randomized into 3 groups and received intravenous fentanyl administration at 4 microg/kg in different manners. In group A, fentanyl was injected within 2 s into the forearm veins; in group B, fentanyl was injected in 2 s through the dorsal foot veins or the great saphenous vein anterior to the ankle; in group C, fentanyl was injected in 15 s by the same route as in group A.
RESULTSThe incidence of cough was 44%, 52% and 8%, with cough onset time of 16.1-/+2.7 s, 21.9-/+3.7 s and 23.3-/+3.2 s in groups A, B and C, respectively. Compared with group A, group B had a delayed onset of cough (P<0.05), and group C had both a lowered incidence of cough (P<0.05) and delayed onset of cough (P<0.05).
CONCLUSIONSThe rate of fentanyl injection through the same peripheral venous access at the same dose may affect the incidence and onset time of cough. At the same dose and injection rate of fentanyl, forearm venous access of injection resulted in earlier onset of cough than lower limb venous access, but the incidence is similar.
Adjuvants, Anesthesia ; administration & dosage ; adverse effects ; Adolescent ; Adult ; Aged ; Cough ; chemically induced ; Female ; Fentanyl ; administration & dosage ; adverse effects ; Humans ; Injections, Intravenous ; adverse effects ; Male ; Middle Aged ; Time Factors ; Young Adult
9.Effects of local infiltration of analgesia and tranexamic acid in total knee replacements: safety and efficacy in reducing blood loss and comparability to intra-articular tranexamic acid.
Harish SIVASUBRAMANIAN ; Cheryl Marise Peilin TAN ; Lushun WANG
Singapore medical journal 2024;65(1):16-22
INTRODUCTION:
The use of periarticular (PA) tranexamic acid (TXA) and its efficacy in comparison with intra-articular (IA) TXA have not been well explored in the literature. This retrospective cohort study aimed to compare the effects of IA and PA TXA with analgesic components in reducing blood loss and improving immediate postoperative pain relief and functional outcomes in patients after unilateral primary total knee arthroplasty (TKA).
METHODS:
A total of 63 patients underwent TKA, and they were divided into the IA TXA delivery group ( n = 42) and PA TXA delivery group ( n = 21). All patients were administered 1 g of TXA. They also received pericapsular infiltration consisting of 0.5 mL of adrenaline, 0.4 mL of morphine, 1 g of vancomycin, 1 mL of ketorolac and 15 mL of ropivacaine. Outcomes for blood loss and surrogate markers for immediate functional recovery were measured.
RESULTS:
Of the 63 patients, 54% were female and 46% male. The mean drop in postoperative haemoglobin levels in the PA and IA groups was 2.0 g/dL and 1.6 g/dL, respectively, and this was not statistically significant ( P = 0.10). The mean haematocrit drop in the PA and IA groups was 6.1% and 5.3%, respectively, and this was also not statistically significant ( P = 0.58). The postoperative day (POD) 1 and discharge day flexion angles, POD 1 and POD 2 visual analogue scale (VAS) scores, gait distance on discharge and length of hospitalisation stay were largely similar in the two groups.
CONCLUSION
Our study showed that both IA and PA TXA with analgesic components were equally efficient in reducing blood loss and improving immediate postoperative pain relief and functional outcomes.
Humans
;
Male
;
Female
;
Tranexamic Acid/adverse effects*
;
Arthroplasty, Replacement, Knee/adverse effects*
;
Antifibrinolytic Agents/adverse effects*
;
Retrospective Studies
;
Postoperative Hemorrhage
;
Blood Loss, Surgical/prevention & control*
;
Administration, Intravenous
;
Analgesia
;
Analgesics/therapeutic use*
;
Pain, Postoperative/drug therapy*
;
Injections, Intra-Articular
10.Pseudoanaphylactoid reaction analysis of Chinese herbal injections in Beagle dogs.
Aihua LIANG ; Chunying LI ; Ran HAO ; Chunyu CAO ; Yan YI ; Ting LIU ; Hua YANG ; Hong YI ; Jing GUO
China Journal of Chinese Materia Medica 2010;35(17):2328-2333
OBJECTIVETo investigate the preclinical evaluation method of pseudoanaphylactoid reactions for Chinese herbal injections.
METHODBeagle dogs were divided into control group (C), 0.5% tween 80 group (T), Yuxincao injection containing 0.5% tween 80 (YT), distilled solution from Yuxincao (Y). Various groups of Beagle dogs were given 3 mL x kg(-1) of the test articles intravenously. The anaphylactoid reactions were observed immediately, while blood pressure, respiratory frequencies and heart rates were tested at 10 min and 30 min after administration.
RESULTA variety of symptoms that range from cutaneous and mucosa signs to bronchospasma and cardiovascular collapse, including angioedema at lip, conjunctiva, ear and circumoral skin, somnolence, lethargy, breathless or dyspnea, severe hypotension etc were observed in T and TY groups from immediately post-injection to at least 30 min after administration. These reactions occurred at both first injection or repeated injections at 24 weeks intervals, manifesting that it was pseudoanaphylactoid reaction mediated by non-immune mechanisms.
CONCLUSIONBeagle dogs could be used as an animal model for preclinical evaluation of pseudoanaphylactoid reactions of Chinese herbal injection with sensitivity, reproducibility, and high clinic consistency.
Anaphylaxis ; chemically induced ; etiology ; immunology ; Animals ; Dogs ; Drugs, Chinese Herbal ; administration & dosage ; adverse effects ; Injections, Intravenous ; Male ; Models, Animal ; Random Allocation