Efficacy and Safety of Remimazolam Tosilate versus Propofol for General Anesthesia in Cirrhotic Patients Undergoing Endoscopic Variceal Ligation

Background: The recurrent variceal bleeding is still very high with a very poor prognosis. The combination of a non-selective beta-blocker and endoscopic variceal ligation (EVL) is still a standard therapy for the prevention, but many patients showed no response to propranolol. Carvedilol is a new, non-selective beta-blocker having intrinsic alpha-blocker activity, but the data about the efficacy and safety of carvedilol is still very limited. This study is aimed at assessing the efficacy and safety of carvedilol combined with EVL in the prevention of recurrent variceal bleeding. Patients and methods: 33 patients having variceal bleeding were enrolled. All patients received carvedilol and were performed the EVL until variceal eradication. All the patients were followed after 9 months. Results: rate of variceal eradication of oesophageal varices was 87.88%; the recurrence rate of variceal bleeding was 12.12% after 9 months. The side effects of carvedilol were rare and not severe, including vertiges, headache, and orthostatic hypertension. Conclusion: Carvedilol combined with EVL appeared as a relatively safe and effective in the prevention of recurrent variceal bleeding in patients of cirrhosis. Key words: carvedilol, variceal bleeding, EVL

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P.086 Efficacy and safety of entecavir (ETV) and lamivudine (LVD) in compensated, cirrhotic patients with chronic hepatitis B

Journal of Clinical Virology ◽

10.1016/s1386-6532(06)80269-6 ◽

2006 ◽

Vol 36 ◽

pp. S87

Author(s):

H. Senturk ◽

E. Schiff ◽

H. Brett-Smith ◽

R. Zink

Keyword(s):

Chronic Hepatitis ◽

Hepatitis B ◽

Chronic Hepatitis B ◽

Efficacy And Safety ◽

Cirrhotic Patients

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Preliminary Evaluation of the Efficacy and Safety of Brimonidine for General Anesthesia

10.21203/rs.3.rs-774585/v1 ◽

2021 ◽

Author(s):

Bin Chen ◽

Xiaohui Wang ◽

Mengrou Shi ◽

Xin Li ◽

Ting Zhang ◽

...

Keyword(s):

General Anesthesia ◽

Effective Dose ◽

Intraperitoneal Injection ◽

Chloral Hydrate ◽

Lethal Dose ◽

Preliminary Evaluation ◽

Efficacy And Safety ◽

Sleeping Time ◽

Analgesic Effects ◽

Hypnotic Effect

Abstract Background:To determine the hypnotic and analgesic effects of brimonidine, and evaluate its efficacy and safety for general anesthesia. Potentiation of pentobarbital sleeping time with brimonidine was observed in mice, as was analgesic activity of brimonidine.Methods:The median effective dose (ED50)and lethal dose (LD50) of intraperitoneally injected brimonidine were determined in hypnotized mice. In addition, LD50 of intravenously injected brimonidine, ED50 of intravenously , intramuscularly and intrarectally injected brimonidine in hypnotized rabbits were determined. The synergistic anesthetic effect of brimonidine and chloral hydrate on rabbits was evaluated. Results:Intraperitoneal injection of 10 mg/kg brimonidine enhanced the hypnotic effect of a threshold dose of pentobarbital. Intraperitoneal injection brimonidine produced dose-related analgesic effects in mice. ED50 of intraperitoneally administered brimonidine in hypnotized mice was 75.7 mg/kg, and LD50 was 379 mg/kg. The ED50 of intravenous, intramuscular and intrarectal brimonidine for hypnosis in rabbits were 5.2 mg/kg, 8.8 mg/kg and 8.7mg/kg, respectively, and LD50 of intravenous brimonidine was 146 mg/kg. Combined intravenous administration of 0.6 mg/kg brimonidine and 0.03 g/kg chloral hydrate had a synergistic anesthetic effects.Conclusions:Brimonidine elicited hypnotic and analgesic effects after systemic administration, and exhibited safety. Brimonidine enhanced the effects of other types of narcotics when combined.

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Efficacy and Safety of Fospropofol Disodium for Injection in General Anesthesia Induction for Adult Patients: A Phase 3 Trial

Frontiers in Pharmacology ◽

10.3389/fphar.2021.687894 ◽

2021 ◽

Vol 12 ◽

Author(s):

Chao-Meng Wu ◽

Wen-Sheng Zhang ◽

Jin Liu ◽

Wei-Yi Zhang ◽

Bo-Wen Ke

Keyword(s):

Adverse Events ◽

General Anesthesia ◽

Success Rate ◽

Blood Pressure Reduction ◽

Intervention Group ◽

Adult Patients ◽

Anesthesia Induction ◽

Efficacy And Safety ◽

Serious Adverse Events ◽

Study Drug Administration

Background: Fospropofol disodium for injection (FospropofolFD) is a prodrug that is metabolized into propofol to produce a general anesthesia effect when administered intravenously.Objective: This study aimed to assess the efficacy and safety of FospropofolFD in comparison with propofol medium/long-chain fat emulsion injections (propofol-MCT/LCT) for general anesthesia induction in adult patients undergoing elective surgeries.Setting: Nine academic medical centers in China.Method: This multicenter, randomized, double-blind, double-simulated, controlled, and non-inferiority trial evaluated 540 eligible adult patients randomly assigned (2:1) to the intervention (20 mg/kg FospropofolFD) or control (2 mg/kg propofol-MCT/LCT) groups.Main Outcome Measure: The primary efficacy endpoint was the success rate, defined as a Modified Observer’s Assessment of Alertness/Sedation Scale score of 1 within 5 min after study drug administration. The safety endpoints consisted of adverse events (AEs) related to consciousness, cognitive function, hemodynamic status, liver and kidney function, and blood tests.Results: A total of 347 (96.3%) and 175 (97.2%) patients in the intervention and control groups, respectively, completed the study. The success rate for the primary outcome was 97.7% for both study drugs. The most frequent AEs in the intervention group were abnormal feeling (62.0%), blood pressure reduction (13.5%), and injection site pain (13.3%). No AEs related to consciousness and mental and cognitive functions or serious adverse events were reported.Conclusion: FospropofolFD (20 mg/kg) is not inferior to propofol-MCT/LCT (2 mg/kg) in general anesthesia induction for American Society of Anesthesiologists (ASA) physical status I-II adult patients undergoing elective surgeries. It is safe and effective for clinical use under anesthesiologist monitoring.Impact on Practice Statement: FospropofolFD can produce a general anesthesia effect and reduce the incidence of pain at the site of injection.

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