scholarly journals Micro- and Macrocirculatory Effects of Landiolol: A Double-Blind, Randomized Study Following Cardiac Surgery

2021 ◽  
Author(s):  
Arnaud Ferraris ◽  
Matthias Jacquet-Lagrèze ◽  
Laure Cazenave ◽  
William Fornier ◽  
Wajma Jalalzai ◽  
...  
Keyword(s):  
Heart Rate ◽  
Cardiac Surgery ◽  
Transpulmonary Thermodilution ◽  
Near Infrared ◽  
Randomized Study ◽  
Vascular Occlusion ◽  
Double Blind Study ◽  
Double Blind ◽  
Left And Right ◽  
Surgical Setting

Abstract Background: Postoperative atrial fibrillation (POAF) increases morbidity and mortality after cardiac surgery. Landiolol, a selective ultra-short-acting betablocker has been recently suggested to prevent POAF in the cardiac surgical setting with a good safety profile. Micro- and detailed macrocirculatory effects of landiolol remain however largely unknown in that setting.Methods: We conducted a prospective, randomized, double-blind study versus placebo in patients undergoing conventional cardiac surgery. Incremental doses of intravenous landiolol from 0.5 to 10 μg-1.kg-1.min-1 or placebo were administrated postoperatively. Microcirculatory variables were assessed by both peripheral near-infrared spectroscopy (NIRS) in combination with a vascular occlusion test and sublingual videomicroscopy. Macrocirculatory variables were obtained from transpulmonary thermodilution and transthoracic echocardiography. Results: Fifty-nine adult patients were allocated to the landiolol group (n=30) or the placebo group (n=29) from January to November 2019. Heart rate significantly decreased in the landiolol group (P<0.01) whereas mean arterial pressure (P=0.05) and stroke volume (P=0.63) were not significantly modified throughout the study. No modification was found in left and right systolic and diastolic ventricular functions except a significant increase in E/A ratio in the landiolol group (P=0.02). No difference was evidenced between groups in microcirculatory parameters at any landiolol dose. POAF occurred in 9 (32%) vs. 5 (17%) patients in placebo and landiolol groups, respectively (P=0.28). Conclusions: Postoperative incremental doses of landiolol up to 10 μg-1.kg-1.min-1 are efficacious to control heart rate without significant alterations in both micro- and macrocirculation following conventional cardiac surgery.

Intraoperative and postoperative effects of vancomycin administration in cardiac surgery patients: A randomized, double-blind study

1992 ◽  
Vol 6 (1) ◽  
pp. 74
Author(s):  
V.A. Romanelli ◽  
M.B. Howie ◽  
P.D. Myerowitz ◽  
A. Rezaei ◽  
D.L. Jackman ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Blind Study ◽  
Double Blind Study ◽  
Double Blind

scholarly journals Near-Infrared Transcranial Radiation for Major Depressive Disorder: Proof of Concept Study

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Paolo Cassano ◽  
Cristina Cusin ◽  
David Mischoulon ◽  
Michael R. Hamblin ◽  
Luis De Taboada ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Near Infrared ◽  
Randomized Study ◽  
Proof Of Concept ◽  
Major Depressive ◽  
Serious Adverse Events ◽  
Double Blind ◽  
Sham Treatment ◽  
New Treatment

Transcranial near-infrared radiation (NIR) is an innovative treatment for major depressive disorder (MDD), but clinical evidence for its efficacy is limited. Our objective was to investigate the tolerability and efficacy of NIR in patients with MDD. We conducted a proof of concept, prospective, double-blind, randomized study of 6 sessions of NIR versus sham treatment for patients with MDD, using a crossover design. Four patients with MDD with mean age 47 ± 14 (SD) years (1 woman and 3 men) were exposed to irradiance of 700 mW/cm2and a fluence of 84 J/cm2for a total NIR energy of 2.40 kJ delivered per session for 6 sessions. Baseline mean HAM-D17scores decreased from 19.8 ± 4.4 (SD) to 13 ± 5.35 (SD) after treatment (t=7.905;df=3;P=0.004). Patients tolerated the treatment well without any serious adverse events. These findings confirm and extend the preliminary data on NIR as a novel intervention for patients with MDD, but further clinical trials are needed to better understand the efficacy of this new treatment. This trial is registered with ClinicalTrials.govNCT01538199.

Phase III double-blind study of depot octreotide versus placebo in the prevention of acute diarrhea during pelvic radiation therapy: Results of North Central Cancer Treatment Group protocol N00CA

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 8506-8506 ◽  
Author(s):  
J. A. Martenson ◽  
J. A. Sloan ◽  
R. L. Deming ◽  
D. B. Wender ◽  
K. J. Stien ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Treatment Group ◽  
Cancer Treatment ◽  
Randomized Study ◽  
Wilcoxon Test ◽  
Phase Iii ◽  
Double Blind Study ◽  
Double Blind ◽  
North Central ◽  
Pelvic Radiation

8506 Background: A randomized study (Int J Rad Oncol Biol Phys 54:195–202, 2002) demonstrated a beneficial effect for octreotide in the treatment of diarrhea in patients receiving pelvic radiation therapy. This North Central Cancer Treatment Group study was undertaken to determine the effectiveness of depot octreotide in the prevention of diarrhea during pelvic radiation therapy. Methods: Patients receiving pelvic radiation therapy, with a planned minimum dose of 45 Gy at 1.70–2.1 Gy per day, were eligible for this study. The study was designed for a Wilcoxon test, with 112 evaluable patients, to have 85% power to detect a further one grade decrease in diarrhea over and above that experienced by patients treated with placebo. Between June 13, 2002 and October 28, 2005, 120 evaluable patients were randomly allocated, in double blind fashion, to receive octreotide (62 patients) or placebo (58 patients), prior to the fourth radiation therapy fraction. Octreotide dosing: Octreotide, 100 micrograms subcutaneously on day 1 followed by depot octreotide, 20 milligrams intramuscularly on days 2 and 29. Results: Grade 0, 1, 2 and 3 diarrhea was observed in 17%, 32%, 26% and 26% of patients treated with octreotide and 18%, 34%, 22%, and 26% of patients treated with placebo (P=0.86). Grade 0, 1, 2 and 3 tenesmus was observed in 55%, 30%, 11% and 4% of patients treated with octreotide and 76%, 16%, 4%, and 4% of patients treated with placebo (P=0.04). No other statistically significant differences in toxicity were observed. Conclusions: Octreotide, as administered in this study, did not decrease diarrhea during pelvic radiation therapy. [Table: see text]

Analgesic and Hemodynamic Effects of Intrathecal Clonidine as the Sole Analgesic Agent during First Stage of Labor 

1999 ◽  
Vol 91 (2) ◽  
pp. 388-396 ◽  
Author(s):  
Astrid Chiari ◽  
Christine Lorber ◽  
James C. Eisenach ◽  
Eckart Wildling ◽  
Claus Krenn ◽  
...  
Keyword(s):  
Heart Rate ◽  
Fetal Heart Rate ◽  
Fetal Heart ◽  
Maternal Blood ◽  
Labor Analgesia ◽  
Double Blind Study ◽  
Double Blind ◽  
Intrathecal Clonidine ◽  
Dose Dependent ◽  
First Stage Of Labor

Background Intrathecal clonidine produces dose-dependent postoperative analgesia and enhances labor analgesia from intrathecal sufentanil. The authors evaluated the dose-response potency of intrathecally administered clonidine by itself during first stage of labor with respect to analgesia and maternal and fetal side effects. Methods Thirty-six parturients requesting labor analgesia were included in this prospective, randomized, double-blind study. Parturients with &lt; 6 cm cervical dilatation received either 50, 100, or 200 microg intrathecal clonidine. The authors recorded visual analog pain score (VAPS), maternal blood pressure and heart rate, ephedrine requirements, and sedation at regular intervals and fetal heart rate tracings continuously. Duration of analgesia was defined as time from intrathecal clonidine administration until request for additional analgesia. Results Clonidine produced a reduction in VAPS with all three doses. The duration of analgesia was significantly longer in patients receiving 200 microg (median, 143; range, 75-210 min) and 100 microg (median, 118; range, 60-180 min) than 50 microg (median, 45; range, 25-150 min), and VAPS was lower in the 200-microg than in the 50-microg group. In the 200-microg group, hypotension required significantly more often treatment with ephedrine than in the other groups. No adverse events or fetal heart rate abnormalities occurred. Conclusions Fifty to 200 microg intrathecal clonidine produces dose-dependent analgesia during first stage of labor. Although duration and quality of analgesia were more pronounced with 100 and 200 microg than with 50 microg, the high incidence of hypotension requires caution with the use of 200 microg for labor analgesia.

scholarly journals Intrathecal chloroprocaine or hyperbaric prilocaine for ambulatory knee surgery? A prospective randomized study

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
E Guntz ◽  
C Vasseur ◽  
D Ifrim ◽  
A Louvard ◽  
J F Fils ◽  
...  
Keyword(s):  
Side Effects ◽  
Knee Arthroscopy ◽  
Randomized Study ◽  
Sensory Block ◽  
Double Blind Study ◽  
Double Blind ◽  
Number Of Patients ◽  
Prolonged Duration ◽  
Registration Number ◽  
Dermatomal Level

Abstract Purpose The aim of this study was to compare intrathecal 1% chloroprocaine with 2% hyperbaric prilocaine in the setting of ambulatory knee arthroscopy. We hypothesized that complete resolution of the sensory block was faster with chloroprocaine. Methods Eighty patients scheduled for knee arthroscopy were included in this prospective randomized double-blind study. Spinal anesthesia was performed with either chloroprocaine (50 mg) or hyperbaric prilocaine (50 mg). Characteristics of sensory and motor blocks and side effects were recorded. Results Mean time to full sensory block recovery was shorter with chloroprocaine (169 (56.1) min vs 248 (59.4)). The characteristics of the sensory blocks were similar at the T12 dermatome level between the two groups. Differences appeared at T10: the percentage of patients with a sensory block was higher, onset quicker and duration longer with hyperbaric prilocaine. The number of patients with a sensory block at T4 dermatome level in both groups was minimal. Times to full motor recovery were identical in both groups (85 (70–99) vs 86 (76–111) min). Time to spontaneous voiding was shorter with chloroprocaine (203 (57.6) min vs 287.3 (47.2) min). Incidence of side effects was low in both groups. Conclusions When considering the characteristics of the sensory block, the use of chloroprocaine may allow an earlier discharge of patients. Cephalic extension was to a higher dermatomal level and the sensory block at T10 level was of prolonged duration with hyperbaric prilocaine, suggesting that the choice between the two drugs should also be performed based on the level of the sensory block requested by the surgery. This study is registered in the US National Clinical Trials Registry, registration number: NCT030389, the first of February 2017, Retrospectively registered.

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