Ultra-low dose of intratecal naloxone to minimize morphine - induced adverse effects

2021 ◽  
Vol 6 (2) ◽  
pp. 186
Author(s):  
JaklineS Hny ◽  
EkramA Osman ◽  
Abdelraheem Mahmoud ◽  
EmadZ Kamel
Keyword(s):  
Adverse Effects ◽  
Low Dose

scholarly journals Analgesic effects of intravenous ketamine after spinal anaesthesia for non-elective caesarean delivery: a randomised controlled trial

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e044168
Author(s):  
Prahlad Adhikari ◽  
Asish Subedi ◽  
Birendra Prasad Sah ◽  
Krishna Pokharel
Keyword(s):  
Postoperative Pain ◽  
Adverse Effects ◽  
Outcome Measures ◽  
Caesarean Delivery ◽  
Low Dose ◽  
Saline Group ◽  
Secondary Outcome ◽  
Pain Scores ◽  
Intravenous Ketamine ◽  
Elective Caesarean Delivery

ObjectivesThis study aimed to determine if low dose intravenous ketamine is effective in reducing opioid use and pain after non-elective caesarean delivery.DesignProspective, randomised, double-blind.SettingTertiary hospital, Bisheshwar Prasad Koirala Institute of Health Sciences, Dharan, NepalParticipants80 patients undergoing non-elective caesarean section with spinal anaesthesia.InterventionsPatients were allocated in 1:1 ratio to receive either intravenous ketamine 0.25 mg/kg or normal saline before the skin incision.Primary and secondary outcome measuresThe primary outcome was the total amount of morphine equivalents needed up to postoperative 24 hours. Secondary outcome measures were postoperative pain scores, time to the first perception of pain, maternal adverse effects (nausea, vomiting, hypotension, shivering, diplopia, nystagmus, hallucination) and neonatal Apgar score at 1 and 5 min, neonatal respiratory depression and neonatal intensive-care referral.ResultsThe median (range) cumulative morphine consumption during the first 24 hours of surgery was 0 (0–4.67) mg in ketamine group and 1 (0–6) mg in saline group (p=0.003). The median (range) time to the first perception of pain was 6 (1–12) hours and 2 (0.5–6) hours in ketamine and saline group, respectively (p<0.001). A significant reduction in postoperative pain scores was observed only at 2 hours and 6 hours in the ketamine group compared with placebo group (p<0.05). Maternal adverse effects and neonatal outcomes were comparable between the two groups.ConclusionsIntravenous administration of low dose ketamine before surgical incision significantly reduced the opioid requirement in the first 24 hours in patients undergoing non-elective caesarean delivery.Trial registration numberNCT03450499.

Hypoglycemia and Cortisol Deficiency Associated With Low-dose Corticosteroid Therapy for Asthma

PEDIATRICS ◽  
1996 ◽  
Vol 97 (6) ◽  
pp. 921-924
Author(s):  
Aaron L. Carrel ◽  
Stephanie Somers ◽  
Robert F. Lemanske ◽  
David B. Allen
Keyword(s):  
Adverse Effects ◽  
Low Dose ◽  
Inhaled Corticosteroids ◽  
Chronic Asthma ◽  
Asthma Therapy ◽  
Biochemical Alterations ◽  
Clinically Significant ◽  
Dose Corticosteroid ◽  
Oral Glucocorticoids ◽  
Cortisol Deficiency

Glucocorticoids are a cornerstone of the anti-inflammatory treatment of asthma. To minimize adverse effects of oral glucocorticoids (OGC), clinicians have used alternate-day oral or inhaled corticosteroids (IC), both generally considered safe for chronic asthma therapy in children. Although reversible growth suppression occasionally occurs, the general consensus is that, despite detectable biochemical alterations, these modes of therapy are not associated with clinically significant adrenal insufficiency.1 We report the occurrence of hypoglycemia due to cortisol deficiency during combination alternate-day oral and inhaled corticosteroids. CASE HISTORY A 3½-year-old boy with asthma was found one morning to be unarousable, limp, and blue around the lips.

scholarly journals Monthly low-dose immunoglobulin infusion as a maintenance therapy for multifocal motor neuropathy may reduce allergic adverse effects: A case report

2010 ◽  
Vol 50 (8) ◽  
pp. 561-565
Author(s):  
Yoshiko Murata ◽  
Tomoko Okamoto ◽  
Yoshiyuki Kondo ◽  
Norio Chihara ◽  
Yoshihiko Furusawa ◽  
...  
Keyword(s):  
Case Report ◽  
Adverse Effects ◽  
Maintenance Therapy ◽  
Low Dose ◽  
Multifocal Motor Neuropathy ◽  
Motor Neuropathy

Does Lead at Low Dose Affect Intelligence in Children?

PEDIATRICS ◽  
1981 ◽  
Vol 68 (6) ◽  
pp. 894-896
Author(s):  
Herbert L. Needleman ◽  
David Bellinger ◽  
Alan Leviton
Keyword(s):  
Adverse Effects ◽  
Low Dose ◽  
Intelligence Test ◽  
Pediatric Clinic ◽  
Study Find ◽  
Group Data ◽  
Low Levels ◽  
The One ◽  
The Individual

Ernhart et al, on the basis of their own follow-up data and an incorrect critique of a single study, find reason to question the entire literature documenting the adverse effects of low levels of lead. They assert that, if effects exist, they are minimal. To reach this sweeping conclusion, they contradict or ignore the findings of the earlier study by Perino and Ernhart, misread a table from the one study they single out for criticism, and draw debatable conclusions from their own data. We conclude by calling the readers' attention to this sentence: "While the effects of subclinical lead intoxication may not be noted in the individual cases seen in a pediatric clinic, analysis of group data indicate quite clearly (emphasis added) that performance on an intelligence test is impaired."

Perinatal oral exposure to low doses of bisphenol A, S or F impairs gut barrier and immune functions in female offspring mice

2019 ◽  
Author(s):  
Yann Malaisé ◽  
Corinne Lencina ◽  
Christel Cartier ◽  
Maïwenn Olier ◽  
Sandrine Ménard ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Immune Responses ◽  
Bisphenol A ◽  
Low Dose ◽  
Intestinal Barrier ◽  
Female Offspring ◽  
Oral Exposure ◽  
Gut Barrier ◽  
Cellular Immune Responses ◽  
Cellular Immune

Abstract Background Bisphenol A (BPA), one of the highest-volume chemicals produced worldwide, has been identified as an endocrine disruptor. Many peer-reviewing studies have reported adverse effects of low dose BPA exposure, particularly during perinatal period (gestation and/or lactation). We previously demonstrated that perinatal oral exposure to BPA (via gavage of mothers during gestation and lactation) has long-term consequences on immune response and intestinal barrier functions. Due to its adverse effects on several developmental and physiological processes, BPA was removed from consumer products and replaced by chemical substitutes such as BPS or BPF, that are structurally similar and not well studied compare to BPA. Here, we aimed to compare perinatal oral exposure to these bisphenols (BPs) at two doses (5 and 50 mg/kg body weight (BW)/day (d)) on gut barrier and immune system in female offspring mice at adulthood (Post Natal Day PND70). Methods Pregnant female mice were orally exposed to BPA, BPS or BPF at 5 or 50 μg/kg BW/d from 15th day of gravidity to weaning of pups at PostNatal Day (PND) 21. Gut barrier function and the humoral and cellular immune responses of adult offspring (PND70) were analysed at intestinal and systemic levels. Results In female offspring, perinatal oral BP exposure led to adverse effects on intestinal barrier and immune response that were dependant of the BP nature (A, S or F) and dose of exposure. Stronger impacts were observed with BPS at the dose of 5µg/kg BW/d on inflammatory markers in feces associated with an increase of anti-E. coli IgG, revealing a defect of gut barrier. BPA and BPF exposure induced prominent changes at low dose in offspring mice, in term of gut barrier functions and cellular immune responses, provoking an intestinal and systemic Th1/Th17 inflammation. Conclusion These findings provide, for the first time, a comparative study of long-time consequences of BPA, S and F perinatal exposure by oral route in offspring mice. This work warms that it is mandatory to consider immune markers and dose in risk assessment associated to new BPA’s alternatives. Keywords: Bisphenol A, Bisphenol S, Bisphenol F, Immune responses, Perinatal exposure, Intestine, Th1/Th17, immunoglobulin, cytokines

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