scholarly journals Effectiveness of Heparin during Long-Term Tocolysis

2013 ◽  
Vol 2013 ◽  
pp. 1-4
Author(s):  
Tetsunori Inagaki ◽  
Shintaro Makino ◽  
Takashi Yorifuji ◽  
Motoi Sugimura ◽  
Satoru Takeda

Objective. Drip infusion during long-term tocolysis causes mechanical and infectious vasculitis and increases the frequency of peripheral venous catheter exchange (PVC), thereby placing a burden on patients. Our study aim is to confirm whether heparin ameliorates pain due to vasculitis during long-term tocolysis and reduces the frequency of peripheral venous catheter exchange. Design. Prospective study. Setting and Sample. All the patients requiring admission because of the presence of uterine contraction or progressive cervical dilatation from August 2009 to June 2011 at Juntendo University in Japan. Methods. Heparin was used for patients at the time the total number of peripheral venous catheter exchanges exceeded 5 in two weeks, and we evaluated whether heparin reduced the frequency of peripheral venous catheter exchange and improved the visual analog scale (VAS) for patients. The main outcome measures frequency of PVC exchange and VAS. Results. This study demonstrated that heparin reduced the frequency of peripheral venous catheter exchange () and VAS (). No side effects were noted. Conclusion. Heparin could satisfy patients during long-term tocolysis in terms of ameliorating pain due to vasculitis and reducing the PVC exchange frequency.

2014 ◽  
Vol 19 (4) ◽  
pp. 256-261 ◽  
Author(s):  
Stéphanie F. Bernatchez

AbstractPeripheral intravenous (PIV) catheters are the most commonly used catheters in hospitals, with up to 70% of patients requiring a peripheral venous line during their hospital stay. This represents 200 million PIV catheters used per year in acute-care hospitals in the United States alone. These medical devices are also used in other health care settings, such as long-term care facilities and nursing homes, and common indications include the administration of medications, nutrients, and fluids. These catheters require proper maintenance and care to avoid complications such as phlebitis, infiltration, occlusion, local infection, and bloodstream infection. Recently it has been suggested that PIV catheter use may lead to a higher rate of complications than previously thought. This is important because some studies have claimed that the rate of bloodstream infections due to PIV catheters is actually comparable to the rates observed with central venous catheters, rather than much lower as previously thought. Moreover, catheter-related infections are now seen as largely preventable. Our goal was to review the current literature and provide an overview of the various approaches used to manage PIV catheter sites as well as review current recommendations.


1999 ◽  
Vol 90 (2) ◽  
pp. 432-436 ◽  
Author(s):  
Alain Borgeat ◽  
Hans-Ruedi Stirnemann

Background Spinally and epidurally administered morphine is frequently associated with pruritus. Isolated case reports indicate that ondansetron may be effective in this context. This study aims to investigate the effectiveness of ondansetron to treat this side effect. Methods In a prospective, randomized, double-blind, placebo-controlled study, 100 patients with pruritus (> 4 on a visual analog scale, on which 0 represents no pruritus and 10 represents worst pruritus imaginable) after spinal or epidural administration of morphine, received either 8 mg ondansetron intravenously (ondansetron group) in 100 ml NaCl 0.9% or vehicle (placebo group). A decrease of more than 4 points on the visual analog scale 60 min after treatment was considered a success. Changes in levels of pain and sedation, hemodynamic values, and other side effects were checked regularly. The presence or absence of pruritus was assessed for the last time 24 h later. Results The two groups were similar for demographic characteristics, the route of administration of morphine, and severity of pruritus at the beginning of the study. The ondansetron group showed a success rate of 70% versus 30% for the placebo group (P > 0.05). Among the successfully treated patients, three (9%) in the ondansetron group and six (40%) in the placebo group reported the recurrence of pruritus (P < 0.05). Among the successfully treated patients, none complained of residual pruritus 24 h later. No changes in pain or sedation levels were noted. Hemodynamic values remained stable, hemoglobin oxygen saturation did not decrease, and no other side effects were observed. Conclusion The administration of 8 mg ondansetron intravenously is an effective treatment for spinally or epidurally administered morphine-induced pruritus. In this clinical condition the treatment is safe and well tolerated.


2010 ◽  
Vol 28 (15_suppl) ◽  
pp. 9056-9056
Author(s):  
D. C. Bodurka ◽  
A. Jhingran ◽  
L. M. Ramondetta ◽  
P. J. Eifel ◽  
C. H. Crane ◽  
...  

2020 ◽  
pp. 102490792097536
Author(s):  
Sultan Tuna Akgol Gur ◽  
Sinem Dogruyol ◽  
Abdullah Osman Kocak ◽  
Tugba Sanalp Menekse ◽  
Ilker Akbas ◽  
...  

Background: Acute musculoskeletal pain is one of the common causes of emergency admissions. Topical analgesics are an easily tolerated option in the treatment of these pains. Objective: This study aimed to compare the efficacy of topical capsaicin and topical non-steroidal anti-inflammatory drugs in acute musculoskeletal injuries. Methods: In this prospective, randomized, controlled, double-blinded study, patients were allocated to two groups—the topical non-steroidal anti-inflammatory drug (n = 60) and topical capsaicin (n = 59). For both groups, the first dose treatment was applied as a thin layer in the emergency department to a maximum area of 5 × 5 cm. The remaining doses were administered at home by the patients for 72 h. The initial visual analog scale scores were compared with the 60th and 120th minute as well as the 24th and 72nd hour values. Differences between the visual analog scale scores, clinical response to the treatment, and side effects were evaluated. Results: The proportional reduction in visual analog scale scores for topical capsaicin was significantly higher, especially at 36 and 72 h. These rates were 0.75 (95% confidence interval: 0.77–1.42; p = 0.029) and 9.08 (95% confidence interval: 1.02–17.14; p = 0.028) at 36 h, respectively. At 72 h, they were 1.27 (95% confidence interval: 0.48–2.05; p = 0.002) and 17.07 (95% confidence interval: 8.39–25.76; p < 0.001), respectively. In the topical capsaicin group, the clinical response to treatment was significantly higher (p = 0.001). Treatment-related systemic side effects were experienced only in the topical non-steroidal anti-inflammatory drug group (1.7%). Conclusion: Topical capsaicin can be used safely in patients presenting to the emergency department with acute pain with its high analgesic efficacy and absence of systemic side effects.


1987 ◽  
Vol 73 (6) ◽  
pp. 575-584 ◽  
Author(s):  
Raffaele Marolda ◽  
Filiberto Belli ◽  
Augusto Prada ◽  
Fabrizio Villani ◽  
Carlo Gambacorti-Passerini ◽  
...  

Toxicity and clinical effects of a new brand of recombinant interleukin 2 (rIL2, Bioleukin™, Biogen, Geneva) were evaluated by a phase I study in 12 patients with stage III melanoma. Escalating doses from 100 μg/m2 to 800 μg/m2 were administered thrice a day with bolus injections given via a peripheral venous catheter for up to a maximum of 7 days. All patients showed malaise, fever and chills and mild gastrointestinal side effects. A modest electrolyte imbalance (hypocalcemia and hypokalemia) was detected in all 12 patients. Renal toxicity as judged by serum creatinine was not observed, and hepatic toxicity was moderate with the possible exception of one patient who had an unclear previous history of liver dysfunction. Mild, transient leukopenia was found in several patients, whereas thrombocytopenia developed in 4 patients; no anemia was observed. Cutaneous rash was seen in half of the patients treated. Fluid retention was minimal, with a weight gain associated to treatment that never exceeded 10% of pretreatment body weight. Electrocardiographic alterations developed in 2 patients in the form of ventricular and supraventricular extrasystoles. In 2 patients given the highest dose of rIL2, a significant reduction in transfer lung factor for carbon monoxide was seen, indicating alterations in pulmonary functions. Other dose-related toxicities were thrombocytopenia and malaise. All side effects disappeared 2-3 days after the end of rIL2 administration. No major responses were seen in association with the 4-8 days of treatment given in this study.


Author(s):  
Thanh Xuan Nguyen

TÓM TẮT Đặt vấn đề: Gây tê ngoài màng cứng để giảm đau trong và sau mổ được áp dụng rộng rãi trên thế giới từ nhiều thập niên qua. Kết quả của nhiều công trình nghiên cứu cho thấy phương pháp này làm giảm những biến chứng trong và sau mổ, giảm tỉ lệ tử vong sau mổ của các phẫu thuật nặng. Nghiên cứu nhằm đánh giá hiệu quả và các tác dụng phụ của gây tê ngoài màng cứng trong phẫu thuật ung thư đại, trực tràng. Phương pháp: Nghiên cứu mô tả cắt ngang trên 28 bệnh nhân được gây tê ngoài màng cứng trong mổ ung thư đại, trực tràng có phối hợp gây mê nội khí quản. Sinh hiệu và tình trạng sức khỏe của bệnh nhân được theo dõi trước và sau khi tiêm thuốc giảm đau. Ghi nhận mức độ giảm đau theo Visual Analog Scale (VAS), mức độ liệt vận động theo Bromage và các tác dụng phụ sau mổ. Kết quả: Hiệu quả giảm đau sau mổ tốt, tại các thời điểm sau mổ VAS đều ≤ 1,5. Tỉ lệ các biến chứng: tụt huyết áp: 7,14%, đau đầu: 7,14%, lạnh run: 10,71%, buồn nôn, nôn: 17,86%. Kết luận: Kỹ thuật gây tê ngoài màng cứng phối hợp với gây mê toàn thân là kỹ thuật giảm đau hiệu quả và an toàn cho phẫu thuật vùng bụng trong mổ và 24 giờ sau mổ. ABSTRACT THE EFFICIENCY OF SPINAL EPIDURAL ANESTHESIA FOR LAPAROSCOPIC COLORECTAL CANCER SURGERY Background: Epidural anesthesia for pain relief during and after surgery has been widely applied in the world for decades. The results of many studies show that this method reduces intra - and postoperative complications and reduces the postoperative mortality rate of major surgery. The study aimed to evaluate epidural anesthesia’s effectiveness and side effects in colorectal cancer surgery. Methods: A cross - sectional descriptive study on 28 patients receiving epidural anesthesia in surgery for colorectal cancer in combination with endotracheal anesthesia. The patient’s vital signs and health status were monitored before and after the injection of pain medication. Record the level of pain relief according to the Visual Analog Scale (VAS), the degree of motor paralysis according to Bromage, and the side effects after surgery. Results: Good postoperative pain relief effect, at all times after surgery, VAS was ≤ 1.5. Rate of complications: hypotension: 7.14%, headache: 7.14%, shiver: 10.71%, nausea, vomiting: 17.86%. Conclusion: The epidural anesthesia combined with general anesthesia is an effective and safe analgesia technique for abdominal surgery during surgery and 24 hours after surgery. Keywords: Epidural anesthesia, colorectal cancersurgery


2021 ◽  
Vol 79 ◽  
pp. S1645-S1646
Author(s):  
H. Haapiainen ◽  
T.J. Murtola ◽  
H. Huhtala ◽  
A.J. Kaipia ◽  
M. Raitanen

Author(s):  
ALESSA FAHIRA ◽  
ALLYSA SORAYA ◽  
ARMAND ACHMADSYAH ◽  
RANI WARDANI HAKIM

Objective: Osteoarthritis (OA) is a chronic disease caused by inflammation of the tissue and bony structure of the joint, which affects more than 235 million people worldwide. Due to the adverse effects caused by the long-term use of standard treatment of OA, the attempt to find natural remedies to treat chronic diseases continues to rise. Curcuma longa is known to have anti-inflammatory effects, which may impact the pathophysiology of OA. While many randomized controlled trials show the efficacy of Curcuma longa extract in the treatment of OA, there has been no comprehensive review of this evidence. Methods: We systematically searched PubMed, Cochrane, Scopus, ProQuest, EBSCOhost, and ScienceDirect for randomized controlled trials that evaluated Curcuma longa extract (CE extract) vs. control (placebo or other therapy). Three trials were identified. Data were then extracted from the studies and summarized descriptively. Results: Across all trials, Curcuma longa therapy was proven to reduce Visual Analog Scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores significantly compared to the control group. Adverse effects were less likely to appear in patients treated with Curcuma longa extract compared to other groups. Conclusion: CL extract is beneficial as an alternative medication for OA treatment, shown by the reduced scores of the Visual Analog Scale (VAS) and WOMAC in all studies we reviewed.


2010 ◽  
Vol 112 (6) ◽  
pp. 1271-1276 ◽  
Author(s):  
Kai Zhang ◽  
Sanjay Bhatia ◽  
Michael Y. Oh ◽  
David Cohen ◽  
Cindy Angle ◽  
...  

Object Deep brain stimulation (DBS) of the ventral intermediate nucleus of the thalamus (VIM) has proven to be efficacious in the treatment of essential tremor (ET). The authors report on long-term follow-up of a series of patients treated at 1 institution by 1 neurosurgeon. Methods Thirty-four patients with ET received unilateral or bilateral VIM DBS. The tremor and handwriting components of the Fahn-Tolosa-Marin clinical tremor rating scale were assessed pre- and postoperatively. Visual analog scale scores for overall patient satisfaction and tremor control were recorded. Stimulation parameters at different intervals after surgery were also recorded. Results The average follow-up period was 56.9 months. The average tremor score improved from 3.27 preoperatively to 0.64 postoperatively (on stimulation; p < 0.001) and the average handwriting score improved from 2.94 to 0.89 (p < 0.001). The average visual analog scale score for overall satisfaction was 8.12 and for tremor control was 1.43. Overall, there was an 80.4% improvement in tremor and 69.7% improvement in handwriting. In 12 patients both tremor and handwriting scores were compared between 57.3 months and 90.7 months after surgery and no significant changes were discovered. Comparison of stimulation parameters at onset and at 1–3, 3–5, 5–7, and > 7 years after surgery showed significant differences, with a gradual increase in stimulation parameters within 5 years after surgery. The overall hardware-related complication rate was 23.5%. Conclusions Deep brain stimulation of the VIM is an efficient and safe treatment for ET. Tremor and handwriting improvements in long-term follow-up are stable. The patients' perception of their outcome is quite good. However, tolerance may develop in some patients requiring changes in stimulation parameters.


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