Patient Tolerance to Intravenous Potassium Chloride with and without Lidocaine

Hypokalemia is a common electrolyte abnormality. Intravenous repletion therapy with potassium chloride (KCl) in concentrations > 80-100 mEq/L is not recommended due to patient intolerance. Since this guideline at times may be clinically impractical, this study was designed to examine use of peripheral vein infusions of high concentration KCl therapy. Tolerance to KG 20 mEq/65 ml iv with and without lidocaine 50 mg was evaluated in 18 hypokalemic subjects in a randomized, placebo-controlled, double-blind study. Subjective and objective assessments of adverse effects were determined throughout the infusion period. Pain was assessed by both verbal descriptor and visual analog scales and correlated significantly following infusion of KCl with or without lidocaine. Multivariant analysis demonstrated differences in pain perception between solutions, with significantly less pain following KCl with lidocaine versus KCl infusions. Transient adverse effects occurred in both groups, but the incidence was not statistically different. Use of concentrated iv KCl infusions may benefit hypokalemic patients with hypervolemia and/or severe potassium deficits. Addition of lidocaine clearly improves patient tolerance to intravenous KCl replacement.

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Consumption by Healthy Adults of Pasteurized Milk with a High Concentration of Bacillus cereus: A Double-Blind Study

Journal of Food Protection ◽

10.4315/0362-028x-59.7.723 ◽

1996 ◽

Vol 59 (7) ◽

pp. 723-726 ◽

Cited By ~ 21

Author(s):

LEO P. M. LANGEVELD ◽

WILLEM A. VAN SPRONSEN ◽

EMERENTIA C. H. VAN BERESTEIJN ◽

SERVÉ H. W. NOTERMANS

Keyword(s):

Bacillus Cereus ◽

Healthy Adults ◽

Double Blind Study ◽

High Concentration ◽

Healthy Human ◽

Double Blind ◽

Pasteurized Milk ◽

Human Volunteers ◽

Pure Cultures ◽

Gastrointestinal Complaints

A double-blind experiment with 34 healthy human volunteers, aged between 20 and 60 years, was conducted to obtain information about the allowable concentration of B. cereus in pasteurized milk. During a period of 3 weeks the subjects were exposed to B. cereus naturally present in pasteurized milk following storage for 3 to 14 days at 7.5°C. Of 259 milk exposures, gastrointestinal complaints were observed in 18 cases. According to total numbers of B. cereus ingested per exposure the complaints per number of exposures were distributed as follows: < 106: 5 in 132; 106 to 107: 2 in 32; 107 to 108 : 2 in 26; and > 108: 9 in 69. Symptoms, however, were not typical of those caused by B. cereus. There was a weak significance (P ≤ 0.1) for symptoms when > 108 B. cereus cells were ingested. Milk with 106 to 107 B. cereus cells per ml showed a very low diarrheal enterotoxin titer. Pure cultures of B. cereus strains isolated from samples with high B. cereus concentrations also showed a low production of enterotoxin. It can be concluded that for healthy adults the probability of become diseased from cold-stored pasteurized milk is small. From the results no evidence is obtained that B. cereus concentrations less than 105/ml will cause intoxication.

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Use of Warm Local Anaesthetic Solution for Caudal Blocks

Anaesthesia and Intensive Care ◽

10.1177/0310057x9202000409 ◽

1992 ◽

Vol 20 (4) ◽

pp. 453-455 ◽

Cited By ~ 8

Author(s):

E. T. M. Lim ◽

K. Y. Chong ◽

B. Singh ◽

W. Jong

Keyword(s):

Adverse Effects ◽

Local Anaesthetic ◽

Room Temperature ◽

Double Blind Study ◽

Double Blind ◽

Anaesthetic Solution ◽

Group A ◽

Group B ◽

Local Anaesthetic Solution ◽

Speed Of Onset

A double-blind study was undertaken to investigate the effect of prewarmed local anaesthetic solution on the latency of onset of caudal blocks. Forty-four (ASA I-II) patients were allocated into two equal groups. In Group A, the local anaesthetic solutions were injected at room temperature (25°C), while in Group B, they were injected at 37°C. All the caudal blocks were performed using 20 ml of lignocaine 1.5% with adrenaline 1:200,000. The speed of onset of perianal analgesia was found to be significantly faster (39%) with the prewarmed local anaesthetic solution (P < 0.05). No adverse effects were observed.

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Daily Oral Administration of the Novel Androgen 11β-MNTDC Markedly Suppresses Serum Gonadotropins in Healthy Men

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgaa032 ◽

2020 ◽

Vol 105 (3) ◽

pp. e835-e847 ◽

Cited By ~ 1

Author(s):

Fiona Yuen ◽

Arthi Thirumalai ◽

Cindy Pham ◽

Ronald S Swerdloff ◽

Bradley D Anawalt ◽

...

Keyword(s):

Adverse Effects ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Lipoprotein Cholesterol ◽

Double Blind Study ◽

Serious Adverse Events ◽

Double Blind ◽

Healthy Men ◽

Drug Concentrations ◽

Serum Gonadotropin

Abstract Background 11β-methyl-19-nortestosterone (11β-MNT) is a modified testosterone (T) with androgenic and progestational activity. A single oral dose of the prodrug, 11β-MNT dodecylcarbonate (11β-MNTDC), was well tolerated in healthy men. Methods We conducted a randomized, double-blind study at 2 academic medical centers. 42 healthy men (18–50 years) were randomized to receive oral placebo or 11β-MNTDC, 200 or 400 mg daily, for 28 consecutive days. Primary outcome (safety and tolerability) measures were assessed twice per week. Subjects underwent serial blood sampling over 24 hours on days 1 and 28 to assess secondary outcomes: pharmacokinetics (serum drug concentrations); pharmacodynamics of 11β-MNTDC (serum sex steroids and gonadotropins); and mood and sexual function (via validated questionnaires). Results There were no serious adverse events. No participants discontinued because of an adverse event or laboratory test abnormality. 11β-MNTDC resulted in a dose-related increase in serum 11β-MNTDC and 11β-MNT concentrations sustained over 24 hours. Administration of 11β-MNTDC resulted in a marked suppression of serum gonadotropins, T, calculated free T, estradiol, and SHBG over the treatment period (P < 0.01). Adverse effects that may be related to 11β-MNTDC included weight gain, acne, headaches, fatigue, and mild mood changes, with 5 men reporting decreased libido and 3 decreased erectile/ejaculatory function. Serum low-density lipoprotein cholesterol, weight (~2 kg), hematocrit, and hemoglobin increased and serum high-density lipoprotein cholesterol decreased in both 11β-MNTDC groups. Conclusion Daily oral 11β-MNTDC for 28 days in healthy men markedly suppressed serum gonadotropin and T concentrations without serious adverse effects. These results warrant further evaluation of 11β-MNTDC as a potential male oral contraceptive.

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Self-perception of side effects by adolescents in a chlorhexidine-fluoride-based preventive oral health program

Journal of Applied Oral Science ◽

10.1590/s1678-77572006000400015 ◽

2006 ◽

Vol 14 (4) ◽

pp. 291-296 ◽

Cited By ~ 7

Author(s):

Ana Rita Duarte Guimaraes ◽

Marco Aurélio Peres ◽

Ricardo de Sousa Vieira ◽

Rodrigo Melin Ferreira ◽

Maria Letícia Ramos-Jorge ◽

...

Keyword(s):

Oral Health ◽

Side Effects ◽

Adverse Effects ◽

Health Program ◽

Double Blind Study ◽

Chi Square ◽

Double Blind ◽

Chi Square Test ◽

Plaque Control ◽

Descriptive Scale

OBJECTIVE: The objective of this study was to evaluate the incidence of adverse effects reported by adolescents following 14 days of use of a mouthrinse containing 0.05% NaF+0.12% chlorhexidine. METHODS: This double-blind study was developed as part of a randomized clinical trial. The adolescents enrolled to the study were randomly divided into two groups to use either: 0.05% NaF+0.12% chlorhexidine (G1, n=85) or 0.05% NaF (G2, n=85). Both groups used a 10mL solution of the mouthwash during 1 minute daily for 2 weeks under supervision. After that period, the subject's acceptance of taste was measured using a verbal descriptive scale (Labeled Magnitude Scale - LMS)11. Participants were also interviewed regarding the occurrence of possible adverse effects during treatment (temporary palate disorders, tooth staining or unpleasant taste). The proportional differences between the groups were tested using the chi-square test. RESULTS: Palate changes were reported by 26% of participants of each group; 17.7% of G1 and 32% of G2 reported an unpleasant taste (p = 0.062), while staining was reported by 55% of G1 and 68.9% of G2 (p = 0.117). Absenteeism rates were similar in both groups (G1= 2.58 ± 2.69; G2=2.81 ± 2.39), p=0.362. CONCLUSION: adherence was high in both groups and side effects reported by subjects were not perceived by them as being important. Since subjects' acceptance and compliance is fundamental to the success of an oral health program, chlorhexidine-fluoride could be a useful resource in a program of plaque control.

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A Comparative Study of Three Nebulized Medications for the Prevention of Postoperative Sore Throat in the Pediatric Population

The Open Anesthesia Journal ◽

10.2174/2589645801812010085 ◽

2018 ◽

Vol 12 (1) ◽

pp. 85-93 ◽

Cited By ~ 1

Author(s):

Raham Hasan Mostafa ◽

Ashraf Nabil Saleh ◽

Mostafa Mansour Hussein

Keyword(s):

Adverse Effects ◽

Sore Throat ◽

Pediatric Population ◽

Study Data ◽

P Value ◽

Double Blind Study ◽

Postoperative Sore Throat ◽

Double Blind ◽

Medication Delivery ◽

Vital Component

Background: The delivery of aerosolized drugs is a vital component of treatment for many respiratory disorders. We used this mode of medication delivery as a pre-emptive strategy to alleviate a Postoperative Sore Throat (POST) in children receiving general anesthesia. Objectives: The primary aim of the study was to compare the effects of prophylactic ketamine, magnesium sulfate and dexamethasone nebulization, on the intensity of POST. Methods: Through a prospective, randomized, double-blind study, data were collected from children (6-16 years) undergoing surgeries from March 2018 to May 2018. The patients were allocated into 3 equivalent groups (36 patients each). Preoperative nebulization was performed for all patients. Group M received 40 mg/kg magnesium sulphate, group K received 1 mg/kg ketamine, and group D received 0.16 mg dexamethasone. The primary outcome of the study was the incidence and intensity of POST at the 4th postoperative hour. The secondary outcomes included evaluation of adverse effects specifically nausea, vomiting, postoperative cough and postoperative sedation. Results: Patients in the K group had the lowest incidence of POST compared to patients in groups M and D, specifically, at the 4th - postoperative hour (p-value = 0.003). Conclusions: Preoperative nebulization with ketamine was more effective in reducing the intensity of POST in pediatric patients postoperatively without systemic adverse effects.

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The Comparison of Plasma Cortisol Levels between 0.125% Bupivacaine and 5 mg Continuous Oxycodone in Lower Extremity Orthopedic Surgery

Journal of Anesthesiology and Clinical Research ◽

10.37275/jacr.v2i2.162 ◽

2022 ◽

Vol 2 (2) ◽

pp. 222-242

Author(s):

Zulkifli ◽

Agustina Br Haloho ◽

Legiran ◽

Pirma I.R.M

Keyword(s):

Cortisol Level ◽

Orthopedic Surgery ◽

Lower Limb ◽

Pain Perception ◽

System Response ◽

Double Blind Study ◽

Double Blind ◽

Significant Difference ◽

Duration Of Surgery ◽

Cortisol Levels

Introduction: Pain is a problem often encountered in postoperative patients. Study has shown after a procedure, 80% patients experience acute pain. This postoperative pain will affect patient’s quality of life therefore necessitating quick and proper treatment. Tissue trauma during surgery will have influence on body system, including endocrine. One of endocrine system response is cortisol secretion. Cortisol levels may be attenuated by bupivacaine and oxycodone. The aim of this study was to determine the efficacy of bupivacaine0,125% and oxycodone 5 mg on pain perception measured by cortisol in patients undergoing orthopedic surgery of the lower limb. Methods: A randomized clinical trial, double-blind study was performed at Mohammad Hoesin General Hospital in Palembang, South Sumatra, from November to May 2021. There were forty samples and divided into two groups (bupivacaine 0,125% and oxycodone 5 mg). Groups were divided by block randomization by computerized random number generator. Blinding were done by making analgesic has the same packages to prevent knowledge of which intervention is being done. Data were analyzed using independent t-test, ANOVA, Mann-Whitney and Chi Square with SPSS version 22.0. Results: There were no statistically significant differences between the two groups on age, gender, body mass index and duration of surgery. In bupivacaine group, cortisol level decreased from 12.94±6.99 µg/dl to 11.32±5.42 µg/dl meanwhile oxycodone group cortisol levels increased from 11.81±8.47 µg/dl to 11.82±7.56 µg/dl. There were no significant difference between two groups relating to cortisol levels. Conclusions: No significant difference was found on administration of bupivacaine 0,125% and oxycodone 5 mg as epidural analgesia on cortisol level in postoperative orthopedic surgery of the lower limb patient.

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Efficacy of Lignocaine in Alleviating Potassium Chloride Infusion Pain

Anaesthesia and Intensive Care ◽

10.1177/0310057x9202000214 ◽

1992 ◽

Vol 20 (2) ◽

pp. 196-198 ◽

Cited By ~ 1

Author(s):

E. T. M. Lim ◽

S. T. Kloo ◽

W. A. Tweed

Keyword(s):

Adverse Effect ◽

Potassium Chloride ◽

Bolus Dose ◽

Isotonic Saline ◽

Injection Pain ◽

Double Blind Study ◽

Double Blind ◽

Group A ◽

Set Up ◽

Group B

A double-blind study was set up to investigate the effect of pretreatment with lignocaine on the incidence of potassium chloride infusion pain. Twenty-eight patients were randomly allocated into two equal groups. Patients in both groups were hypokalaemic and were scheduled for replacement consisting of potassium chloride 20 mmol diluted to 100 ml in dextrose 5% solution administered over two hours. Group A (lignocaine) patients were pretreated with a bolus dose lignocaine 3 ml 1%, Group B (control) received isotonic saline 3 ml. The incidence of potassium chloride infusion pain was significantly reduced in Group A. There was no adverse effect reported. This study demonstrates the efficacy of bolus dose of lignocaine in alleviating injection pain for the duration of a two-hour continuous infusion.

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Clinical Benefits and Tolerability of Increased Fill Volumes in Japanese Peritoneal Dialysis Patients

Peritoneal Dialysis International ◽

10.1177/089686080102100505 ◽

2001 ◽

Vol 21 (5) ◽

pp. 455-461 ◽

Cited By ~ 11

Author(s):

Atsushi Fukatsu ◽

Yasuhiro Komatsu ◽

Hachiro Senoh ◽

Hironobu Miyai ◽

Yoshinori Tanaka ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Effective Means ◽

Random Order ◽

Japanese Patients ◽

Double Blind Study ◽

Double Blind ◽

Patient Tolerance ◽

Fill Volume ◽

Clinical Benefits ◽

Solute Clearance

Background Increasing fill volume is an effective means of improving clearances in patients on peritoneal dialysis (PD). Since Japanese PD patients are physically smaller than their Western counterparts, there is some concern that PD patients in Japan may be unable to tolerate larger fill volumes. Objective To determine patient tolerance and changes in solute clearance and net ultrafiltration resulting from increased fill volumes in Japanese patients on PD. Design Prospective double-blind study, randomizing patients to three different fill volumes (2.5% dextrose solution: 1.5 L, 2.0 L, or 2.5 L) administered in random order on three different occasions separated by 1 week. Results Twenty-one patients with a mean age of 55.4 ± 2.1 years and a mean body surface area of 1.66 ± 0.03 m2 were studied. On a scale of 0 to 10, patients’ mean discomfort scores were 2.14 ± 0.59, 3.48 ± 0.54, and 3.81 ± 0.63 ( p = 0.047) at the end of the 1.5-L, 2.0-L, and 2.5-L dwells, respectively. There were no reports of cramps or shortness of breath with any fill volume. Patients were able to correctly guess the actual fill volume for only 34 of the 63 total exchanges (54.0%). Increasing fill volume resulted in an incremental improvement in peritoneal creatinine clearance, from 3.74 ± 0.16 to 4.49 ± 0.21 ( p < 0.001, 2.0 L vs 1.5 L) to 5.12 ± 0.20 mL/minute ( p < 0.001, 2.5 L vs 2.0 L) for 1.5-L, 2.0-L, and 2.5-L dwells, respectively. Peritoneal urea clearance also increased significantly, from 5.65 ± 0.13 to 7.04 ± 0.17 ( p < 0.001, 2.0 L vs 1.5 L) and 8.16 ± 0.29 mL/minute ( p < 0.001, 2.5 L vs 2.0 L), with incremental increases in fill volume. Similarly, net ultrafiltration in a 4-hour dwell increased significantly with fill volume, from 255.24 ± 24 mL with 1.5 L, to 356 ± 24 ( p < 0.004, 2.0 L vs 1.5 L) and 392 ± 29 mL ( p < 0.086, 2.5 L vs 2.0 L) in patients receiving 2.0 L and 2.5 L, respectively. Conclusion Increasing the fill volume results in improvement in solute clearance and net ultrafiltration in Japanese PD patients, with minimal increase in patient discomfort. A large percentage of patients were unable to identify the actual fill volume.

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