Safety of the use of xylometazoline nasal spray in young children undergoing lacrimal surgery: an observational study

2017 ◽  
Vol 28 (3) ◽  
pp. 279-281
Author(s):  
Varajini Joganathan ◽  
Bijan Beigi
Keyword(s):  
Side Effects ◽  
Young Children ◽  
Observational Study ◽  
General Anesthesia ◽  
Retrospective Analysis ◽  
Nasal Spray ◽  
Lacrimal Surgery ◽  
Cardiovascular Side Effects ◽  
Nasal Decongestants ◽  
Recovery From Anesthesia

Purpose: It is common practice to prepare the nasal mucosa with decongestant in children undergoing lacrimal surgery. Xylometazoline 0.05% (Otrivine) nasal spray is commonly used. It has been reported to cause cardiovascular side effects. In the absence of formal guidelines on the safety of the use of nasal decongestants in children, we reviewed our practice to answer the question: How safe is preoperative use of xylometazoline in children undergoing lacrimal surgery? To our knowledge, this is the first study to address the potential side effects of the use of xylometazoline preoperatively in children undergoing lacrimal surgery. Methods: This was a retrospective analysis of medical notes of children undergoing lacrimal surgery with the use of preoperative intranasal xylometazoline 0.05% over a 5-year period. Results: Twenty-nine children, age 1-6 years (mean 3 years), underwent lacrimal surgery under general anesthesia with preoperative use of intranasal xylometazoline. Topical intranasal 1:10,000 adrenaline was used during surgery in all patients. All children were found to have uneventful surgery and recovery from anesthesia. Conclusions: Xylometazoline 0.05% intranasal use for prelacrimal surgery was found to be effective and safe. Addition of sympathomimetic topical adrenaline (1:10,000) did not impose any risks. The type of general anesthesia may influence the cardiovascular side effects anecdotally recorded during xylometazoline use.

scholarly journals Observational study investigating Ectoin® Rhinitis Nasal Spray as natural treatment option of acute rhinosinusitis compared to treatment with Xylometazoline

2021 ◽  
Author(s):  
Nina Werkhäuser ◽  
Andreas Bilstein ◽  
Kathrin Mahlstedt ◽  
Uwe Sonnemann
Keyword(s):  
Side Effects ◽  
Observational Study ◽  
Nasal Spray ◽  
Nasal Mucosa ◽  
Treatment Option ◽  
Symptomatic Relief ◽  
Concomitant Treatment ◽  
Acute Rhinosinusitis ◽  
Nasal Decongestants ◽  
Natural Treatment

Abstract Introduction Symptomatic relief of acute rhinosinusitis is commonly achieved with nasal decongestants. The current observational study investigated the efficacy and safety of treatment of acute rhinosinusitis with Ectoin® Rhinitis Spray compared to or in combination with Xylometazoline-containing decongesting nasal spray. Methods Patients with acute rhinosinusitis applied either Ectoin® Rhinitis Spray, Xylometazoline nasal spray or a combination of both products. Rhinosinusitis symptoms were assessed, and nasal oedema and endonasal redness were determined by rhinoscopy. Patient diaries based on the validated SNOT (Sino Nasal Outcome Test) questionnaire evaluated rhinosinusitis parameters over time and influences of the disease on quality of life. Following treatment, investigators and patients judged the efficacy and tolerability. Results Ectoin® Rhinitis Spray diminished common rhinosinusitis symptoms such as nasal obstruction, nasal secretion, facial pain/headache, and smell/taste impairment. Upon treatment over 7 days, rhinosinusitis sum scores decreased statistically significantly (p < 0.001) by − 64.25%, which was comparable to that achieved with Xylometazoline-containing decongesting nasal spray (− 67.60%). No side effects were observed during treatment with Ectoin® Rhinitis Spray, whereas treatment with Xylometazoline-containing nasal spray resulted in nasal mucosa dryness. Concomitant treatment with both products diminished the development of nasal dryness and required fewer applications of Xylometazoline-containing nasal spray. Conclusion Ectoin® Rhinitis Spray is an effective, natural treatment option for acute rhinosinusitis, which may be used as monotherapy or as add-on treatment with a Xylometazoline-containing nasal spray. The concomitant use of Ectoin® Rhinitis Spray might reduce the needed dose of decongestant nasal spray and counteract bothersome side effects such as dry nasal mucosa. Trial registration The current study was registered in the ClinicalTrials.gov database under the identifier: NCT03693976 (date of registration: Oct 3, 2018).

scholarly journals Epidural versus general anesthesia for open pyloromyotomy in infants: a retrospective observational study

2020 ◽  
Author(s):  
Philipp Opfermann ◽  
Caspar Wiener ◽  
Werner Schmid ◽  
Markus Zadrazil ◽  
Martin Metzelder ◽  
...  
Keyword(s):  
Observational Study ◽  
General Anesthesia ◽  
Retrospective Observational Study

scholarly journals Obstetric anesthesia services in Israel snapshot (OASIS) study: a 72 hour cross-sectional observational study of workforce supply and demand

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Gal Schtrechman-Levi ◽  
Alexander Ioscovich ◽  
Jacob Hart ◽  
Jacob Bar ◽  
Ronit Calderon-Margalit ◽  
...  
Keyword(s):  
Observational Study ◽  
General Anesthesia ◽  
Activity Index ◽  
Supply And Demand ◽  
Waiting Times ◽  
Obstetric Anesthesia ◽  
Quality And Safety ◽  
Cross Sectional ◽  
Vaginal Deliveries ◽  
Safety Outcomes

Abstract Background We planned an observational study to assess obstetric anesthesia services nationwide. We aimed to assess the effect of the anesthesia workload/workforce ratio on quality and safety outcomes of obstetric anesthesia care. Methods Observers prospectively collected data from labor units over 72 h (Wednesday, Thursday and Friday). Independent variables were workload (WL) and workforce (WF). WL was assessed by the Obstetric Anesthesia Activity Index (OAAI), which is the estimated time in a 24-h period spent on epidurals and all cesarean deliveries. Workforce (WF) was assessed by the number of anesthesiologists dedicated to the labor ward per week. Dependent variables were the time until anesthesiologist arrival for epidural (quality measure) and the occurrence of general anesthesia for urgent Cesarean section, CS, (safety measure). This census included vaginal deliveries and unscheduled (but not elective) CS. Results Data on 575 deliveries are from 12 maternity units only, primarily because a major hospital chain chose not to participate; eight other hospitals lacked institutional review board approval. The epidural response rate was 94.4%; 321 of 340 parturients who requested epidural analgesia (EA) received it. Of the 19 women who requested EA but gave birth without it, 14 (77%) were due to late arrival of the anesthesiologist. Median waiting times for anesthesiologist arrival ranged from 5 to 28 min. The OAAI varied from 4.6 to 25.1 and WF ranged from 0 to 2 per shift. Request rates for EA in hospitals serving predominantly orthodox Jewish communities and in peripheral hospitals were similar to those of the entire sample. More than a fifth (13/62; 21%) of the unscheduled CS received general anesthesia, and of these almost a quarter (3/13; 23%) were attributed to delayed anesthesiologist arrival. Conclusions Inadequate WF allocations may impair quality and safety outcomes in obstetric anesthesia services. OAAI is a better predictor of WL than delivery numbers alone, especially concerning WF shortage. To assess the quality and safety of anesthetic services to labor units nationally, observational data on workforce, workload, and clinical outcomes should be collected prospectively in all labor units in Israel.

scholarly journals Cardiooncology—dealing with modern drug treatment, long-term complications, and cancer survivorship

2021 ◽  
Author(s):  
Claudia de Wall ◽  
Johann Bauersachs ◽  
Dominik Berliner
Keyword(s):  
Side Effects ◽  
Checkpoint Inhibitors ◽  
Heart Diseases ◽  
Tumor Therapy ◽  
Treatment Strategies ◽  
Tumor Treatment ◽  
Cardiac Side Effects ◽  
Cardiovascular Side Effects ◽  
Modern Drug

AbstractModern treatment strategies have improved prognosis and survival of patients with malignant diseases. The key components of tumor treatment are conventional chemotherapy, radiotherapy, targeted therapies, and immunotherapy. Cardiovascular side-effects may occur in the early phase of tumor therapy or even decades later. Therefore, knowledge and awareness of acute and long-lasting cardiac side effects of anti-cancer therapies are essential. Cardiotoxicity impairs quality of life and overall survival. The new cardiologic subspecialty ‘cardio-oncology’ deals with the different cardiovascular problems arising from tumor treatment and the relationship between cancer and heart diseases. Early detection and treatment of cardiotoxicity is of crucial importance. A detailed cardiac assessment of patients prior to administration of cardiotoxic agents, during and after treatment should be performed in all patients. The current review focusses on acute and long-term cardiotoxic side effects of classical cytotoxic and selected modern drug treatments such as immune checkpoint inhibitors and discusses strategies for the diagnosis of treatment-related adverse cardiovascular effects in cancer patients.

One-Class-Based Intelligent Classifier for Detecting Anomalous Situations During the Anesthetic Process

2020 ◽  
Author(s):  
Alberto Leira ◽  
Esteban Jove ◽  
Jose M Gonzalez-Cava ◽  
José-Luis Casteleiro-Roca ◽  
Héctor Quintián ◽  
...  
Keyword(s):  
Side Effects ◽  
Anomaly Detection ◽  
General Anesthesia ◽  
Closed Loop ◽  
Real Data ◽  
Successful Performance ◽  
Final Model ◽  
Detection Techniques ◽  
Adverse Side Effects ◽  
Operative Recovery

Abstract Closed-loop administration of propofol for the control of hypnosis in anesthesia has evidenced an outperformance when comparing it with manual administration in terms of drug consumption and post-operative recovery of patients. Unlike other systems, the success of this strategy lies on the availability of a feedback variable capable of quantifying the current hypnotic state of the patient. However, the appearance of anomalies during the anesthetic process may result in inaccurate actions of the automatic controller. These anomalies may come from the monitors, the syringe pumps, the actions of the surgeon or even from alterations in patients. This could produce adverse side effects that can affect the patient postoperative and reduce the safety of the patient in the operating room. Then, the use of anomaly detection techniques plays a significant role to avoid this undesirable situations. This work assesses different one-class intelligent techniques to detect anomalies in patients undergoing general anesthesia. Due to the difficulty of obtaining real data from anomaly situations, artificial outliers are generated to check the performance of each classifier. The final model presents successful performance.

scholarly journals The electrophysiological effects of cannabidiol on action potentials and transmembrane potassium currents in rabbit and dog cardiac ventricular preparations

2021 ◽  
Author(s):  
Leila Topal ◽  
Muhammad Naveed ◽  
Péter Orvos ◽  
Bence Pászti ◽  
János Prorok ◽  
...  
Keyword(s):  
Side Effects ◽  
Action Potentials ◽  
Oral Intake ◽  
Potassium Currents ◽  
Delayed Rectifier ◽  
Cardiac Repolarization ◽  
Cardiovascular Side Effects ◽  
Channel Inhibition ◽  
Repolarization Reserve ◽  
Electrophysiological Effects

AbstractCannabis use is associated with known cardiovascular side effects such as cardiac arrhythmias or even sudden cardiac death. The mechanisms behind these adverse effects are unknown. The aim of the present work was to study the cellular cardiac electrophysiological effects of cannabidiol (CBD) on action potentials and several transmembrane potassium currents, such as the rapid (IKr) and slow (IKs) delayed rectifier, the transient outward (Ito) and inward rectifier (IK1) potassium currents in rabbit and dog cardiac preparations. CBD increased action potential duration (APD) significantly in both rabbit (from 211.7 ± 11.2. to 224.6 ± 11.4 ms, n = 8) and dog (from 215.2 ± 9.0 to 231.7 ± 4.7 ms, n = 6) ventricular papillary muscle at 5 µM concentration. CBD decreased IKr, IKs and Ito (only in dog) significantly with corresponding estimated EC50 values of 4.9, 3.1 and 5 µM, respectively, without changing IK1. Although the EC50 value of CBD was found to be higher than literary Cmax values after CBD smoking and oral intake, our results raise the possibility that potassium channel inhibition by lengthening cardiac repolarization might have a role in the possible proarrhythmic side effects of cannabinoids in situations where CBD metabolism and/or the repolarization reserve is impaired.

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