Faculty of 1000 evaluation for The learning curve associated with the epidural technique using the Episure™ AutoDetect™ versus conventional glass syringe: an open-label, randomized, controlled, crossover trial of experienced anesthesiologists in obstetric patients.

2013 ◽  
Author(s):  
Timothy Short
Keyword(s):  
Learning Curve ◽  
Crossover Trial ◽  
Open Label ◽  
Randomized Controlled ◽  
Glass Syringe

scholarly journals Intraperitoneal, subcutaneous and intravenous glucagon delivery and subsequent glucose response in rats: a randomized controlled crossover trial

2018 ◽  
Vol 6 (1) ◽  
pp. e000560 ◽  
Author(s):  
Ilze Dirnena-Fusini ◽  
Marte Kierulf Åm ◽  
Anders Lyngvi Fougner ◽  
Sven Magnus Carlsen ◽  
Sverre Christian Christiansen
Keyword(s):  
Blood Glucose ◽  
Crossover Trial ◽  
Artificial Pancreas ◽  
Isotonic Saline ◽  
Severe Hypoglycemia ◽  
Diabetes Mellitus Type 1 ◽  
Open Label ◽  
Glucose Response ◽  
Routes Of Administration ◽  
Randomized Controlled

ObjectiveHypoglycemia is a frequent and potentially dangerous event among patients with diabetes mellitus type 1. Subcutaneous glucagon is an emergency treatment to counteract severe hypoglycemia. The effect of intraperitoneal glucagon delivery is sparsely studied. We performed a direct comparison of the blood glucose response following intraperitoneally, subcutaneously and intravenously administered glucagon.Research design and methodsThis is a prospective, randomized, controlled, open-label, crossover trial in 20 octreotide-treated rats. Three interventions, 1  week apart, in a randomized order, were done in each rat. All 20 rats were given intraperitoneal and subcutaneous glucagon injections, from which 5 rats were given intravenous glucagon injections and 15 rats received placebo (intraperitoneal isotonic saline) injection. The dose of glucagon was 5 µg/kg body weight for all routes of administration. Blood glucose levels were measured before and until 60 min after the glucagon/placebo injections.ResultsCompared with placebo-treated rats, a significant increase in blood glucose was observed 4 min after intraperitoneal glucagon administration (p=0.009), whereas after subcutaneous and intravenous glucagon administration significant increases were seen after 8 min (p=0.002  and p<0.001, respectively). In intraperitoneally treated compared with subcutaneously treated rats, the increase in blood glucose was higher after 4 min (p=0.019) and lower after 40 min (p=0.005) and 50 min (p=0.011). The maximum glucose response occurred earlier after intraperitoneal compared with subcutaneous glucagon injection (25 min vs 35 min; p=0.003).ConclusionsGlucagon administered intraperitoneally gives a faster glucose response compared with subcutaneously administered glucagon in rats. If repeatable in humans, the more rapid glucose response may be of importance in a dual-hormone artificial pancreas using the intraperitoneal route for administration of insulin and glucagon.

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