scholarly journals Effect of Intravenous High Dose Vitamin C on Postoperative Pain and Morphine Use after Laparoscopic Colectomy: A Randomized Controlled Trial

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Younghoon Jeon ◽  
Jun Seok Park ◽  
Suyoung Moon ◽  
Jinseok Yeo
Keyword(s):  
Postoperative Pain ◽  
Vitamin C ◽  
Laparoscopic Colectomy ◽  
Controlled Trial ◽  
Plasma Concentrations ◽  
Antioxidant Properties ◽  
Morphine Consumption ◽  
High Dose ◽  
Significant Difference ◽  
High Dose Vitamin

Background and Objective. Vitamin C has antioxidant, neuroprotective, and neuromodulating effects. Recently, it showed antinociceptive effect as a result of the antioxidant properties. Therefore, we designed this study to assess the effect of intravenous vitamin C on opiate consumption and pain in patients undergoing laparoscopic colectomy.Methods. A total of 100 patients were enrolled and allocated to receive 50 mg/kg vitamin C or placebo by intravenous infusion immediately after induction of anesthesia. Morphine consumption and scores of pain were assessed at 2, 6, and 24 h after completion of surgery.Results. There were 97 patients included in the analysis. Patients who received vitamin C had higher plasma concentrations of vitamin C at the end of surgery, significantly lower morphine consumption at the 2 h after end of surgery, and significantly lower pain scores at rest during first 24 h postoperatively. There was no significant difference between groups in side effects, fatigue score, or pain score during cough.Conclusion. This study shows high dose vitamin C infusion decreased postoperative pain during the first 24 h and reduced morphine consumption in the early postoperative period. Additional research needed to examine whether higher doses of vitamin C and longer infusion times can amplify these effects.

scholarly journals Safety and Effectiveness of High-Dose Vitamin C in Patients with COVID-19; A Randomized Controlled open-label Clinical Trial ‎

2021 ◽  
Author(s):  
Saeidreza JamaliMoghadamSiahkali ◽  
Besharat Zarezade ◽  
Sogol Koolaji ◽  
Seyed Ahmad Seyed Alinaghi ◽  
Abolfazl Zendehdel ◽  
...  
Keyword(s):  
Vitamin C ◽  
Controlled Trial ◽  
Control Treatment ◽  
Control Group ◽  
P Value ◽  
Case Group ◽  
High Dose ◽  
Open Label ◽  
Significant Difference ◽  
High Dose Vitamin

Abstract Background: To assess the effectiveness of vitamin C treatment against coronavirus disease 2019 (COVID-19)Methods: An open-label, randomized, and controlled trial was conducted on patients with severe COVID-19 infection. The case and control treatment groups each consisted of 30 patients. The control group received lopinavir/ritonavir and hydroxychloroquine and the case group received high-dose of vitamin C (six gr daily) added to the same regimen. Results: There were no statistically significant differences between two groups with respect to age and gender, laboratory results, and underlying diseases. On the 3rd day of hospitalization, the mean core body temperatures was significantly lower and SpO2 was higher In the case group (p value = 0.001, and 0.014, respectively). The median length of hospitalization in case group which was significantly longer than the control group (8.5 days vs. 6.5 days) (p value = 0.0280). There was no significant difference in SpO2 levels at discharge time, the length of ICU stay, and mortality between the two groups.Conclusions: We did not find significantly better outcomes in the group who were treated with high-dose vitamin C in addition to the main treatment regimen at discharge.Trial registration: The project was registered by Iranian Registry of Clinical Trials.IRCT20200411047025N1

High Dose VItamin C Treatment for Patients with Charcot-Marie-Tooth Disease 1A: Results of a Randomized Double-Masked Controlled Trial (S07.006)

Neurology ◽  
2012 ◽  
Vol 78 (Meeting Abstracts 1) ◽  
pp. S07.006-S07.006
Author(s):  
R. Lewis ◽  
D. Herrmann ◽  
M. McDermott ◽  
A. Hoke ◽  
S. Feely ◽  
...  
Keyword(s):  
Vitamin C ◽  
Controlled Trial ◽  
High Dose ◽  
Charcot Marie Tooth ◽  
Charcot Marie Tooth Disease ◽  
High Dose Vitamin ◽  
Tooth Disease

Efficacy of Perioperative Administration of Intravenous Parecoxib on Postoperative Morphine Consumption after Video-Assisted Thoracoscopic Surgery

2021 ◽  
Vol 104 (11) ◽  
pp. 1836-1842
Keyword(s):  
Postoperative Pain ◽  
Pain Score ◽  
Rating Scale ◽  
Thoracoscopic Surgery ◽  
Morphine Consumption ◽  
High Dose ◽  
Video Assisted ◽  
Significant Difference ◽  
Postoperative Morphine ◽  
Video Assisted Thoracoscopic Surgery

Background: Morphine is commonly used to relief pain after video-assisted thoracoscopic surgery (VATS), however high dose morphine is usually related with many complications. Parecoxib is a potent cyclo-oxygenase inhibitor for parenteral administration that has a role in acute pain management addition to opioid protocol. Objective: To investigate the potential benefits of intravenous parecoxib for relieving postoperative pain after VATS. Materials and Methods: The present study was a randomized controlled trial that assigned 22 patients undergoing VATS into two groups to received either parecoxib 40 mg as P group with 11 patients, or placebo using 2 mL of Normal Saline Solution as C group with 11 patients with an intravenous administration at 30 minutes prior to surgery and then 12 hours later. In the postoperative period, all patients received intravenous patient-controlled analgesia (PCA) with morphine. The primary outcome was the total morphine consumption for 24 hours postoperatively. The secondary outcomes were pain score at 2, 6, 12, and 24 hours postoperatively, using a numeric rating scale (NRS, 0 to 10) and the incidence of side effects. Results: The total morphine consumption was significantly lower in P group (26.64±4.41 mg) than C group (39.82±3.87 mg) at 24 hours postoperatively (p<0.001). The NRS pain score at rest and on coughing at 24 hours postoperatively between P group compared with C group were 1.09±1.04 versus 4.45±0.69 (p<0.001) and 2.91±0.83 versus 5.36±0.81 (p<0.001), respectively. The incidences of nausea and vomiting were found in both groups at 2, 6, and 12 hours, postoperatively, but there was no statistically significant difference between both groups (p>0.05). Other adverse events such as sedation, pruritus, dyspepsia, headache, hypotension, and respiratory depression were not found. Conclusion: Perioperative administration of parecoxib was safe and effectively decrease postoperative morphine consumption and pain score at rest and on coughing within 24 hours postoperatively after VATS. Keywords: Intravenous parecoxib; Video-assisted thoracoscopic surgery; Acute postoperative pain

scholarly journals Vitamin C measurement in critical illness: challenges, methodologies and quality improvements

2020 ◽  
Vol 58 (4) ◽  
pp. 460-470 ◽  
Author(s):  
Jake T.B. Collie ◽  
Ronda F. Greaves ◽  
Oliver A.H. Jones ◽  
Glenn Eastwood ◽  
Rinaldo Bellomo
Keyword(s):  
Quality Assurance ◽  
Vitamin C ◽  
Antioxidant Properties ◽  
Metrological Traceability ◽  
External Quality Assurance ◽  
Critically Ill Patient ◽  
High Dose ◽  
External Quality ◽  
Sample Handling ◽  
High Dose Vitamin

AbstractBackgroundThere is renewed interest in high-dose vitamin C interventions in clinical medicine due to its antioxidant properties, safe use and cost-effectiveness. Yet, randomised control trials (RCTs) employing these interventions are failing to include robust analytical methodology and proper sample handling and processing techniques. Consequently, comparisons between studies becomes impossible as there is no metrological traceability and results may be prone to pre-analytical errors.ContentThrough published vitamin C stability studies, method comparison papers and data from vitamin C external quality assurance programs, an assessment was made on the functionality of current methods for critically ill patient samples.SummaryData was obtained from two external quality assurance programs, two papers assessing sample stability and interlaboratory agreement and a publication on vitamin C method comparisons. A shift from spectrophotometric and enzymatic methodologies to high performance liquid chromatography (HPLC) greatly improved the variability and interlaboratory agreement. Therefore, the current analytical performance of vitamin C HPLC methodologies are acceptable for the requirements of a high-dose vitamin C RCTs.OutlookRecommendations across the total testing process of vitamin C have been provided to improve the quality of the results. The harmonisation of sample handling and processing procedures will further improve the reliability of current analytical methodologies.

scholarly journals EFFECTS OF HIGH-DOSE VITAMIN C AND HYALURONIC ACID ON TENDON HEALING

2018 ◽  
Vol 26 (2) ◽  
pp. 82-85 ◽  
Author(s):  
YASAR MAHSUT DINCEL ◽  
OKTAY ADANIR ◽  
YAVUZ ARIKAN ◽  
AYSEL KARA CAGLAR ◽  
SUZAN CANSEL DOGRU ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Vitamin C ◽  
Late Phase ◽  
Tendon Healing ◽  
High Dose ◽  
Therapeutic Effects ◽  
Sprague Dawley ◽  
Level Of Evidence ◽  
Significant Difference ◽  
High Dose Vitamin

ABSTRACT Objective: To assess the histopathologic and biomechanical effects of hyaluronic acid (HA) and high-dose vitamin C (VC) on rat Achilles tendon healing. Methods: Forty-eight Sprague-Dawley rats were randomized to HA and VC and control groups with equal numbers. Each group was further divided into two subgroups to be sacrificed on Day 15 (n=8) and Day 30 (n=8). The Achilles tendons were cut and repaired. While the control rats remained untreated, HA and VC were administered after repair. The repaired tendons were removed for biomechanical and histopathologic analyses. In the biomechanical tests, the tendons were stretched to failure and maximum forces were measured. For histopathologic examination, the specimens were interpreted semiquantitatively using Movin’s grading scale and Bonar scores. Results: The highest mean forces were obtained in the HA group on Day 15 and in the VC group on Day 30, with a significant difference between HA and VC on Day 15 between control and VC on Day 30 (p<0.05). Histological examination showed both Movin and Bonar scores decreased in all groups on Day 30, with significant improvements in the HA and VC groups (p<0.05). Conclusion: Our results demonstrated that both VC and HA had therapeutic effects on tendon healing, especially in the late phase. Level of Evidence I; High quality randomized trial with statistically significant difference.

scholarly journals High-Dose Vitamin C: Preclinical Evidence for Tailoring Treatment in Cancer Patients

Cancers ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1428
Author(s):  
Manuela Giansanti ◽  
Terry Karimi ◽  
Isabella Faraoni ◽  
Grazia Graziani
Keyword(s):  
Vitamin C ◽  
Plasma Concentrations ◽  
Previous Treatment ◽  
Parp Inhibitors ◽  
High Plasma ◽  
Dna Demethylation ◽  
High Dose ◽  
Antitumor Effects ◽  
Tet Enzymes ◽  
High Dose Vitamin

High-dose vitamin C has been proposed as a potential therapeutic approach for patients with advanced tumors who failed previous treatment with chemotherapy. Due to vitamin C complex pharmacokinetics, only intravenous administration allows reaching sufficiently high plasma concentrations required for most of the antitumor effects observed in preclinical studies (>0.250 mM). Moreover, vitamin C entry into cells is tightly regulated by SVCT and GLUT transporters, and is cell type-dependent. Importantly, besides its well-recognized pro-oxidant effects, vitamin C modulates TET enzymes promoting DNA demethylation and acts as cofactor of HIF hydroxylases, whose activity is required for HIF-1α proteasomal degradation. Furthermore, at pharmacological concentrations lower than those required for its pro-oxidant activity (<1 mM), vitamin C in specific genetic contexts may alter the DNA damage response by increasing 5-hydroxymethylcytosine levels. These more recently described vitamin C mechanisms offer new treatment opportunities for tumors with specific molecular defects (e.g., HIF-1α over-expression or TET2, IDH1/2, and WT1 alterations). Moreover, vitamin C action at DNA levels may provide the rationale basis for combination therapies with PARP inhibitors and hypomethylating agents. This review outlines the pharmacokinetic and pharmacodynamic properties of vitamin C to be taken into account in designing clinical studies that evaluate its potential use as anticancer agent.

scholarly journals High dose vitamin C in sepsis (HDVCIS): study protocol for a randomized controlled trial

2021 ◽  
Author(s):  
Bing Zhao ◽  
Mengjiao Li ◽  
Jian Li ◽  
Leshan Liu ◽  
Yihui Wang ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Vitamin C ◽  
Animal Studies ◽  
Controlled Trial ◽  
Small Scale ◽  
Controlled Clinical Trial ◽  
High Dose ◽  
Clinical Trial Registry ◽  
Double Blind ◽  
High Dose Vitamin

Abstract Sepsis is an inflammatory syndrome with life-threatening organ dysfunction resulting from a dysregulated host response to infection. Although the treatment for sepsis has improved a lot in the last 30 years, sepsis related mortality remains high. In the recent 10 years, high dose intravenous injection of vitamin C, the first line antioxidant of human, has received more and more attention in the field of critical care, its beneficial effect has been demonstrated by several small scale clinical trial and animal studies, but the effect of high dose vitamin C on sepsis in a larger trial seems warranted in further study. Here we will conduct a prospective, multi-center, double-blind, adaptive sample size, randomized, placebo-controlled, clinical trial named as HDVCIS. The trial protocol has been approved by Clinical Trail Ethics Committee of Ruijin Hospital of Shanghai JiaoTong University School of Medicine. This trial has been registered in Chinese Clinical Trial Registry (ChiCTR1800017633) in August 7, 2018. Patients will be recruited from 4 medical centers in China. Its object is to testify the efficacy and safety of high dose vitamin C in the treatment of sepsis.

scholarly journals Safety and effectiveness of high-dose vitamin C in patients with COVID-19: a randomized open-label clinical trial

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Saeidreza JamaliMoghadamSiahkali ◽  
Besharat Zarezade ◽  
Sogol Koolaji ◽  
SeyedAhmad SeyedAlinaghi ◽  
Abolfazl Zendehdel ◽  
...  
Keyword(s):  
Vitamin C ◽  
Controlled Trial ◽  
Water Soluble ◽  
Control Treatment ◽  
Control Group ◽  
Case Group ◽  
High Dose ◽  
Open Label ◽  
Mean Body Temperature ◽  
Significant Difference

Abstract Background Vitamin C is an essential water-soluble nutrient that functions as a key antioxidant and has been proven to be effective for boosting immunity. In this study, we aimed to assess the efficacy of adding high-dose intravenous vitamin C (HDIVC) to the regimens for patients with severe COVID-19 disease. Methods An open-label, randomized, and controlled trial was conducted on patients with severe COVID-19 infection. The case and control treatment groups each consisted of 30 patients. The control group received lopinavir/ritonavir and hydroxychloroquine and the case group received HDIVC (6 g daily) added to the same regimen. Results There were no statistically significant differences between two groups with respect to age and gender, laboratory results, and underlying diseases. The mean body temperature was significantly lower in the case group on the 3rd day of hospitalization (p = 0.001). Peripheral capillary oxygen saturations (SpO2) measured at the 3rd day of hospitalization was also higher in the case group receiving HDIVC (p = 0.014). The median length of hospitalization in the case group was significantly longer than the control group (8.5 days vs. 6.5 days) (p = 0.028). There was no significant difference in SpO2 levels at discharge time, the length of intensive care unit (ICU) stay, and mortality between the two groups. Conclusions We did not find significantly better outcomes in the group who were treated with HDIVC in addition to the main treatment regimen at discharge. Trial registration irct.ir (IRCT20200411047025N1), April 14, 2020

scholarly journals High-dose vitamin-C induced prolonged factitious hyperglycemia in a peritoneal dialysis patient: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Olivier Lachance ◽  
François Goyer ◽  
Neill K. J. Adhikari ◽  
Marie-Hélène Masse ◽  
Jean-François Bilodeau ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Vitamin C ◽  
Point Of Care ◽  
Low Cost ◽  
Controlled Trial ◽  
Study Drug ◽  
Peritoneal Dialysis Patient ◽  
High Dose ◽  
Stage Renal Disease ◽  
High Dose Vitamin

Abstract Background High-dose vitamin C is increasingly used for sepsis and more recently for coronavirus disease 2019 (COVID-19) infections. Proponents argue that the low cost and near perfect safety profile of vitamin C support its early adoption. Yet, adverse events might be underreported and underappreciated. Case presentation We report a 73-year-old non-diabetic white man with end-stage renal disease on peritoneal dialysis admitted to the intensive care unit with septic shock that was suspected to be due to peritonitis. The patient was enrolled in LOVIT (Lessening Organ Dysfunction with VITamin C; ClinicalTrials.gov identifier: NCT03680274), a randomized placebo-controlled trial of high-dose intravenous vitamin C. He developed factitious hyperglycemia, as measured with a point-of-care glucometer, that persisted for 6 days after discontinuation of the study drug, confirmed to be vitamin C after unblinding. He also had short-lived iatrogenic coma because of hypoglycemia secondary to insulin administration. These events triggered a protocol amendment. Conclusions Although factitious hyperglycemia has been reported before using certain glucometers in patients treated with high-dose vitamin C, the persistence of this phenomenon for 6 days after the discontinuation of the therapy is a distinguishing feature. This case highlights the importance of monitoring glucose with a core laboratory assay for up to a week in specific populations, such as patients on peritoneal dialysis.

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