scholarly journals Sedation Characteristics of Intranasal Alfaxalone in Adult Yucatan Swine

2021 ◽  
Author(s):  
Chiara E Hampton ◽  
Catherine Takawira ◽  
Juliet M Ross ◽  
Chin-Chi Liu
Keyword(s):  
Intranasal Administration ◽  
Crossover Design ◽  
Limiting Factor ◽  
Sedative Agent ◽  
Clinical Procedures ◽  
Sedation Scores ◽  
To Receive ◽  
Higher Doses ◽  
Randomized Crossover Study ◽  
Available Volume

Compared with intravenous and intramuscular methods, intranasal administration of sedatives is a less invasive and nonpainful technique. In this prospective, randomized, crossover study, we evaluated the sedative characteristics of 2 doses(1 and 2 mg/kg) of alfaxalone administered intranasally to 7 adult Yucatan swine. We compared sedation scores before andafter administration of alfaxalone and between groups by using a composite sedation scoring system (range, 0 to 12, with12 being the highest level of sedation)). Pigs were randomly assigned to receive 2 doses of intranasal alfaxalone (1 mg/kg[A1]); 2 mg/kg [A2]) as 2 separate events in a crossover design with a 60-d washout period. Categories scored were posture,palpebral droop, uninhibited behavior, drowsiness, and acceptance of anesthetic facemask. Sedation scores were collected before sedation was administered and then every 3 min for 30 min afterward. Instilled volumes (mean ± 1 SD) were 5.7 ± 0.5 and 11.3 ± 0.8 mL for A1 and A2, respectively. Both alfaxalone doses produced significant increases in sedation scores compared with baseline. Median sedation scores for A1 (6; range, 4–12) were not different from those for A2 (6; range, 6 to 12). Intranasal administration of alfaxalone as the sole sedative agent increased sedation scores from baseline, achieving peak sedation at 6 to 9 min after instillation of A2. However, sedation scores were similar between the 2 groups, and neither dose produced sufficient sedation to facilitate handling or the performance of any clinical procedures. Given the concentration of alfaxalone solution currently available, volume is the major limiting factor regarding testing higher doses of this drug for its use as a sole sedative agent in swine.

Sedative effects of alfaxalone and hydromorphone with or without midazolam in cats: a pilot study

2021 ◽  
pp. 1098612X2199615
Author(s):  
Emily P Wheeler ◽  
Amanda L Abelson ◽  
Jane C Lindsey ◽  
Lois A Wetmore
Keyword(s):  
Pilot Study ◽  
Significant Positive Correlation ◽  
Time Correlation ◽  
Catheter Placement ◽  
Blinded Study ◽  
Sedative Effects ◽  
Sedation Scores ◽  
Adult Cats ◽  
To Receive

Objectives The aim of this pilot study was to compare the quality of sedation and ease of intravenous (IV) catheter placement following sedation using two intramuscular (IM) sedation protocols in cats: hydromorphone, alfaxalone and midazolam vs hydromorphone and alfaxalone. Methods This was a prospective, randomized and blinded study. Cats were randomly assigned to receive an IM injection of hydromorphone (0.1 mg/kg), alfaxalone (1.5 mg/kg) and midazolam (0.2 mg/kg; HAM group), or hydromorphone (0.1 mg/kg) and alfaxalone (1.5 mg/kg; HA group). Sedation scoring (0–9, where 9 indicated maximum sedation) was performed at 0, 5, 10, 15 and 20 mins from the time of injection. At 20 mins, an IV catheter placement score (0–10, where 10 indicated least resistance) was performed. Results Twenty-one client-owned adult cats were included in this study. Sedation and IV catheter placement scores were compared between groups using Wilcoxon rank sum tests. Peak sedation was significantly higher ( P = 0.002) in the HAM group (median 9; range 7–9) than in the HA group (median 7; range 3–9), and IV catheter placement scores were significantly higher ( P = 0.001) in the HAM group (median 9.5; range 7–10) compared with the HA group (median 7; range 4–9). Spearman correlations were calculated between IV catheter placement score and sedation scores. There was a significant positive correlation of average sedation over time (correlation 0.83; P <0.001) and sedation at 20 mins (correlation 0.76; P <0.001) with a higher, more favorable IV catheter placement score. Conclusions and relevance These preliminary results suggest that the addition of midazolam to IM alfaxalone and hydromorphone produced more profound sedation and greater ease of IV catheter placement than IM alfaxalone and hydromorphone alone.

Effect of Subarachnoid Bupivacaine Block on Anesthetic Requirements for Thiopental in Rats 

1998 ◽  
Vol 88 (4) ◽  
pp. 1036-1042 ◽  
Author(s):  
Sunil Eappen ◽  
Igor Kissin
Keyword(s):  
Local Anesthetic ◽  
Direct Action ◽  
Afferent Input ◽  
Crossover Design ◽  
Hemodynamic Parameters ◽  
Motor Responses ◽  
Withdrawal Reflex ◽  
Corneal Reflex ◽  
To Receive ◽  
The Brain

Background Subarachnoid bupivacaine blockade has been reported to reduce thiopental and midazolam hypnotic requirements in patients. The purpose of this study was to examine if local anesthetically induced lumbar intrathecal blockade would reduce thiopental requirements for blockade of motor responses to noxious and nonnoxious stimuli in rats. Methods After intrathecal and external jugular catheter placement, rats were assigned randomly to two groups in a crossover design study, with each rat to receive either 10 microl of 0.75% bupivacaine or 10 microl of normal saline intrathecally. The doses of intravenously administered thiopental required to ablate the eyelid reflex, to block the withdrawal reflex of a front limb digit, and to block the corneal reflex were compared. In two separate groups of animals, hemodynamic parameters and concentrations of thiopental in the brain were compared between intrathecally administered bupivacaine and saline. Results The thiopental dose required to block the described responses was decreased with intrathecally administered bupivacaine versus intrathecally administered saline from (mean +/- SD) 40 +/- 5 to 24 +/- 4 mg/kg (P &lt; 0.001) for the eyelid reflex, from 51 +/- 6 to 29 +/- 6 mg/kg (P &lt; 0.005) for front limb withdrawal, and from 67 +/- 8 to 46 +/- 8 mg/kg (P &lt; 0.01) for the corneal reflex. The concentration of thiopental in the brain at the time of corneal reflex blockade for the group given bupivacaine was significantly lower than in the group given saline (24.1 vs. 35.8 microg/g, P = 0.02). Conclusion This study demonstrates that lumbar intrathecally administered local anesthetic blockade decreases anesthetic requirements for thiopental for a spectrum of end points tested. This effect is due neither to altered pharmacokinetics nor to a direct action of the local anesthetic on the brain; rather, it is most likely due to decreased afferent input.

Comparison of single-shot nebuliser protocol between dexmedetomidine and ketamine in children undergoing magnetic resonance imaging

2021 ◽  
pp. 175045892110374
Author(s):  
K Geetha ◽  
Shibani Padhy ◽  
K Karishma
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Deep Sedation ◽  
Rapid Onset ◽  
Single Shot ◽  
Efficacy And Safety ◽  
Resonance Imaging ◽  
Sedation Scores ◽  
To Receive ◽  
Group D

Background Sedation for magnetic resonance imaging mandates deep sedation to ensure patient immobility. The nebulised route of drug delivery carries the advantage of good bioavailability and safety profile. We aimed to compare the efficacy and safety of nebulised dexmedetomidine and ketamine for sedation in children undergoing magnetic resonance imaging. Methods A total of 71 children, aged two to eight years scheduled for outpatient magnetic resonance imaging were randomly allocated to receive nebulised dexmedetomidine 2 μg/kg (group D) or nebulised ketamine 2 mg/kg (group K) 30min before magnetic resonance imaging. Results Nebulised dexmedetomidine (2 μg/kg) resulted in faster onset and significantly better sedation scores with rapid clear-headed recovery. Ketamine resulted in better venepuncture scores but was associated with more neuropsychological events at recovery. Conclusion Nebulised dexmedetomidine at 2 μg/kg provides rapid onset of satisfactory sedation, with good parental separation and a quicker and more clear-headed recovery, allowing for a smooth magnetic resonance imaging experience.

High dose therapy (autologus transplant)

2007 ◽  
pp. 261-268
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Suppression ◽  
Limiting Factor ◽  
High Dose ◽  
Cure Rate ◽  
High Dose Therapy ◽  
Dose Therapy ◽  
Normal Tissues ◽  
Higher Doses

Principles and uses 262 Conditioning 264 Nursing issues of high dose therapy 266 Many haematological cancers are treated more effectively by higher doses of chemotherapy and radiotherapy than by lower doses. Continuing to escalate the dose given will theoretically increase the cure rate. However, the dose-limiting factor is the toxicity to normal tissues. The first tissue to be seriously affected is the bone marrow. Bone marrow suppression results in:...

scholarly journals Lack of Efficacy of Propofol in the Treatment of Early Postoperative Nausea and Vomiting

1998 ◽  
Vol 26 (4) ◽  
pp. 366-370 ◽  
Author(s):  
I. Harper ◽  
E. Della-Marta ◽  
H. Owen ◽  
J. Plummer ◽  
A. Ilsley
Keyword(s):  
Low Dose ◽  
Dose Range ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Test Drug ◽  
Gynaecological Surgery ◽  
Treatment Groups ◽  
Sedation Scores ◽  
To Receive ◽  
Rescue Antiemetic

The anti-nauseant efficacy of low-dose propofol was investigated in a blinded, randomized trial. Patients who complained of nausea and/or vomiting following laparoscopic gynaecological surgery and who requested antiemetic were randomly assigned to receive placebo, propofol 3 mg, propofol 9 mg or propofol 27 mg by intravenous injection. Nausea, vomiting and sedation were recorded by a blinded observer for 90 minutes following administration of the test drug, prior to discharge, and 24 hours following surgery. Rescue antiemetic (droperidol 1.0 mg IV) was available from 10 minutes after administration of test drug. Propofol failed to reduce nausea scores and did not reduce the incidence of vomiting. Numbers of patients receiving rescue antiemetic were similar in the four treatment groups. In the first 10 minutes following test drug administration, sedation scores were increased by propofol in a dose-related manner. We conclude that, in the dose range studied, propofol is ineffective for the treatment of nausea and vomiting occurring soon after laparoscopic gynaecological surgery.

Prevention of cisplatin-induced emesis: a double-blind multicenter randomized crossover study comparing ondansetron and ondansetron plus dexamethasone.

1991 ◽  
Vol 9 (4) ◽  
pp. 675-678 ◽  
Author(s):  
F Roila ◽  
M Tonato ◽  
F Cognetti ◽  
E Cortesi ◽  
G Favalli ◽  
...  
Keyword(s):  
Side Effects ◽  
Crossover Study ◽  
Receptor Antagonist ◽  
Treatment Preference ◽  
Complete Protection ◽  
Double Blind ◽  
Significant Difference ◽  
Antiemetic Activity ◽  
To Receive ◽  
Randomized Crossover Study

Ondansetron (OND) is a new 5-HT3 receptor antagonist that give complete protection from emesis/nausea in approximately 50% of cisplatin (CDDP)-treated patients. To evaluate if dexamethasone (DEX) added to OND increases antiemetic efficacy, we carried out a double-blind randomized crossover study to compare the antiemetic activity of OND with OND plus DEX. One hundred two chemotherapy-naive patients (44 women and 58 men) scheduled to receive CDDP chemotherapy at doses greater than or equal to 50 mg/m2 entered the study. Eighty-nine patients completed both cycles with the following results: complete protection from emesis/nausea was obtained in 57/59 patients (64.0%/66.3%) with OND and in 81/79 (91.0%/88.8%) with OND plus DEX (P = .0005/P = .0021). At the end of the study, 53% of the patients expressed a treatment preference, and of these, 74% chose OND plus DEX compared with 26% who preferred OND alone, a statistically significant difference (P less than .003). Side effects were very mild and not significantly different between the two treatments. We conclude that OND plus DEX is more efficacious than OND in protecting patients from CDDP-induced emesis and nausea.

scholarly journals Efficacy of Low Dose Levobupivacaine (0.1%) for Axillary Plexus Block using Multiple Nerve Stimulation

2008 ◽  
Vol 36 (6) ◽  
pp. 850-854 ◽  
Author(s):  
X. Zhao ◽  
Y.-W. Wang ◽  
H. Chen ◽  
Z. Zhang ◽  
X.-M. You ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Motor Block ◽  
Hand Surgery ◽  
Sensory Block ◽  
Sensory Blockade ◽  
Significant Difference ◽  
Brachial Plexus Blockade ◽  
Plexus Block ◽  
To Receive ◽  
Higher Doses

The purpose of this study was to investigate if low doses of levobupivacaine (0.1%) produce complete sensory blockade in preoperative axillary brachial plexus block and to compare the effect of different doses of levobupivacaine on sensory and motor blockade. A total of 110 patients scheduled for elective forearm or hand surgery were randomly allocated to receive 36 ml or 72 ml of levobupivacaine 0.1% or 36 ml of levobupivacaine 0.25%. In each group, volumes were equally distributed in the four nerve territories. In all patients, the sensory and motor block was assessed at five, 10, 20 and 30 minutes after the placement of axillary block. Complete sensory block was obtained in 94.4% of patients receiving 36 ml of levobupivacaine 0.1%, 92.1% of those receiving 72 ml of levobupivacaine 0.1%, and 97.1% of those receiving 36 ml of levobupivacaine 0.25%. There was no significant difference either in the onset of the sensory and motor block or duration of the sensory and motor block. This study demonstrates that 36 ml of levobupivacaine 0.1% (36 mg) is as effective as higher doses and volumes in axillary brachial plexus blockade.

scholarly journals Comparison of Pharmacokinetics and Safety of Voriconazole Intravenous-to-Oral Switch in Immunocompromised Adolescents and Healthy Adults

2011 ◽  
Vol 55 (12) ◽  
pp. 5780-5789 ◽  
Author(s):  
Timothy A. Driscoll ◽  
Haydar Frangoul ◽  
Eneida R. Nemecek ◽  
Donald K. Murphey ◽  
Lolie C. Yu ◽  
...  
Keyword(s):  
Body Weight ◽  
Steady State ◽  
Oral Treatment ◽  
Area Under The Curve ◽  
Pharmacokinetic Data ◽  
Young Adolescents ◽  
Dosing Regimens ◽  
Oral Switch ◽  
To Receive ◽  
Higher Doses

ABSTRACTThe current voriconazole dosing recommendation in adolescents is based on limited efficacy and pharmacokinetic data. To confirm the appropriateness of dosing adolescents like adults, a pharmacokinetic study was conducted in 26 immunocompromised adolescents aged 12 to <17 years following intravenous (IV) voriconazole to oral switch regimens: 6 mg/kg IV every 12 h (q12h) on day 1 followed by 4 mg/kg IV q12h, then switched to 300 mg orally q12h. Area under the curve over a 12-hour dosing interval (AUC0–12) was calculated using a noncompartmental method and compared to the value for adults receiving the same dosing regimens. On average, the AUC0–12in adolescents after the first loading dose on day 1 and at steady state during IV treatment were 9.14 and 22.4 μg·h/ml, respectively (approximately 34% and 36% lower, respectively, than values for adults). At steady state during oral treatment, adolescents also had lower average exposure than adults (16.7 versus 34.0 μg·h/ml). Larger intersubject variability was observed in adolescents than in adults. There was a slight trend for some young adolescents with low body weight to have lower voriconazole exposure. It is likely that these young adolescents may metabolize voriconazole more similarly to children than to adults. Overall, with the same dosing regimens, voriconazole exposures in the majority of adolescents were comparable to those in adults. The young adolescents with low body weight during the transitioning period from childhood to adolescence (e.g., 12 to 14 years old) may need to receive higher doses to match the adult exposures. Safety of voriconazole in adolescents was consistent with the known safety profile of voriconazole.

scholarly journals Absorption of Folic Acid from Different Delivery Forms: A Randomized, Crossover Study

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 970-970
Author(s):  
Prasad Devarshi ◽  
Ryan Grant ◽  
Meredith Wilcox ◽  
Moneka Ali ◽  
Lisa Sanders ◽  
...  
Keyword(s):  
Folic Acid ◽  
Crossover Study ◽  
Water Soluble ◽  
Serum Folate ◽  
Women Of Childbearing Age ◽  
Childbearing Age ◽  
Maximum Serum ◽  
Study Product ◽  
To Receive ◽  
Randomized Crossover Study

Abstract Objectives Folate, or folic acid, is a water-soluble B vitamin that plays a role in single carbon transfer reactions, which are involved in the synthesis and metabolism of nucleotides and amino acids. It has been established that adequate folic acid intake helps decrease the prevalence of neural tube defects during conception and early pregnancy. The objective of this study was to assess the bioavailability of folic acid from Prenatal Multi Gummies and Folic Acid tablets in women of childbearing age. Methods Eleven healthy, adult, premenopausal women of childbearing age (18–44 years) were recruited for a single-blind, randomized, crossover study. Each participant was randomly assigned to receive a single dose (2 gummies or 2 tablets) of Prenatal Multi Gummies or Folic Acid tablets (containing ∼800 µg folic acid) and then crossed over to receive the other study product after a wash-out period of ∼7 days. The study product was consumed along with a low folic acid breakfast meal. Blood samples were collected for the analysis of serum folate at t = −0.5, 1, 2, 4, 6 and 8 hours where t = 0 is the time of study product consumption. Results The mean serum folate total area under the curve (AUC0–8 hours) was 239.67 ± 24.50 h × ng/mL for the Prenatal Multi Gummies and 255.23 ± 30.17 h × ng/mL for the Folic Acid tablets. For both study products, the dose-adjusted net incremental AUC was significantly greater than 0 h × ng/mL (P ≤ 0.001). The maximum serum folate concentration (Cmax) was 47.69 ± 5.65 ng/mL for the Prenatal Multi Gummies and 52.45 ± 5.86 ng/mL for the Folic Acid tablets, and the median time to maximum serum concentration (Tmax) was 1.00 h for each product (interquartile limits for both included 1.00 to 1.08 hours). Conclusions In conclusion, folic acid contained in the Prenatal Multi Gummies and Folic Acid tablets was absorbed from both the Prenatal Multi Gummies and the Folic Acid tablets. Funding Sources This study was funded by Pharmavite LLC.

Clinical comparison of pain perception rates between computerized local anesthesia and conventional syringe in pediatric patients

2005 ◽  
Vol 29 (3) ◽  
pp. 239-243 ◽  
Author(s):  
Alma Luz San Martin-Lopez ◽  
Luis David Garrigos-Esparza ◽  
Gabriela Torre-Delgadillo ◽  
Antonio Gordillo-Moscoso ◽  
Juan Francisco Hernandez-Sierra ◽  
...  
Keyword(s):  
Analogue Scale ◽  
Pain Perception ◽  
Pediatric Patients ◽  
Anesthetic Management ◽  
Crossover Design ◽  
Anesthetic Techniques ◽  
Heart Rate Monitoring ◽  
Injection Device ◽  
To Receive ◽  
Injection Procedure

The purpose of this study was to evaluate pain perception rates in pediatric patients by comparing computerized injection device and traditional injection procedure. In a clinical trial, by using a crossover design, sixty-four patients were randomly assigned to receive, in consecutive sessions, dental anesthetic techniques with either traditional or computerized device. Visual Analogue Scale qualification and heart rate monitoring as physiologic indicator of pain response were used for the evaluation. Results showed that traditional syringe injections were more painful than computerized injection device (p&lt;0.001). Results suggested that computerized injection device reduces pain perception compared to the traditional syringe during the dental anesthetic management.

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