Background: Propofol is a short-acting intravenous sedative widely used for procedural sedation and general anesthesia. However, pain during propofol injection is a distressing adverse effect. This study was designed to investigate whether transcutaneous electrical nerve stimulation (TENS) could reduce pain during propofol injection compared to sham TENS. Methods: In a randomized controlled trial, 80 patients were allocated to two groups: the active TENS group received electrical stimulation via two electrodes on the venous cannulation site, whereas the sham TENS group received no stimulus. After 20 min following TENS, propofol 0.5 mg/kg pain was injected intravenously and pain was evaluated using a four-point score (0 = none, 1 = mild, 2 = moderate, 3 = severe). Adverse effects associated with TENS were also recorded. Results: The overall incidence of pain during propofol injection was 47.5% in the TENS group and 87.5% in the sham group (P < 0.001). The incidence of moderate pain was significantly lower in the TENS group (7.5%) than in the sham TENS group (42.5%) (P < 0.001). There were no complications associated with TENS. Conclusion: Pre-treatment with TENS significantly reduced the incidence and intensity of pain during propofol injection.
Objectives: Mountain ginseng pharmacopuncture (MGP) is a pharmacopuncture made by distilling extract from mountain cultivated ginseng or mountain wild ginseng. This pharmacopuncture is injected intravenously, which is a quick, lossless way of strongly tonifying Qi function. The present study was undertaken to evaluate a 4-week, repeated, intravenous injection, toxicity test of MGP in Sprague-Dawley (SD) rats. Methods: Twenty male and female 6-week-old SD rats were used as subjects. We divided the SD rats into 4 groups: the high-dosage (10 mL/kg), medium-dosage (5 mL/kg), low-dosage (2.5 mL/kg) and control (normal saline) groups. MGP or normal saline was injected intravenously into the caudal vein of the rats once daily for 4 weeks. Clinical signs, body weights, and food consumption were monitored during the observation period, and hematology, serum biochemistry, organ weight, necropsy, and histological examinations were conducted once the observations had been completed. Results: No mortality was observed in any of the groups during the observation period. No changes due to MGP were observed in the experimental groups regarding clinical signs, body weights, food consumption, hematology, serum biochemistry, organ weight and necropsy. No histological changes due to MGP were observed in any of the male or female rats in the high-dosage group. Conclusion: During this 4-week, repeated, intravenous injection, toxicity test of MGP in SD rats, no toxic changes due to MGP were observed in any of the male or female rats in the high-dosage group. Thus, we suggest that the high and the low doses in a 13-week, repeated test should be 10 mL/kg and 2.5 mL/kg, respectively.
Trousseau's syndrome is an unexplained thrombotic event that precedes the diagnosis of an occult visceral malignancy or appears concomitantly with the tumor. Upper extremity deep vein thrombosis is prevalent in patients with a central venous catheter. Furthermore, a peripheral intravenous injection may cause upper extremity deep vein thrombosis as well. However, a deep vein thrombosis has not been reported in the form of Trousseau's syndrome with a catastrophic clinical course triggered by a single peripheral intravenous injection. A 48-year-old man presented with a swollen left arm on which he was given intravenous fluid at a local clinic due to flu symptoms. Contrast computed tomgraphy scans showed thromboses from the left distal brachial to the innominate vein. The patient developed multiple cerebral infarctions despite anticoagulation treatment. He was diagnosed with stomach cancer by endoscopic biopsy to evaluate melena and had a persistently positive lupus anticoagulant. After recurrent and multiple thromboembolic events occurred with treatment, he died on day 20.
Jo, Su-jeong;Choi, Young-doo;Jung, Chan-yung;Kim, Kap-sung;Lee, Seung-deok
Journal of Pharmacopuncture
/
v.18
no.3
/
pp.57-62
/
2015
Objectives: The purpose of this study was to examine the single-dose intravenous toxicity of Guseonwangdo-go glucose 5% pharmacopuncture (GWG5). Methods: Forty Sprague-Dawley rats were divided into four groups of five males and five females per group: an intravenous (IV) injection of 1.0 mL of normal saline solution per animal was administered to the control group; IV injections of 0.1, 0.5, and 1.0 mL of GWG5 per animal were administered to the experimental groups (G: 0.1, G: 0.5, and G: 1.0). Observation of clinical signs and body weight measurements were carried out for 14 days following the injections. At the end of the observation period, hematological, biochemical, and histopathological tests, as well as necropsy examinations, were performed on the injected parts. Results: No mortalities or adverse clinical signs were observed in any of the groups. The body weights of all groups continuously increased. In the hematological and the biochemical tests, females in G-0.1 had minimal changes, but those changes were not dose dependent. On necropsy examination, no abnormalities were observed. In the histopathological test, focal inflammatory cell infiltrations were observed in two female rats, one in the control group and one in G-1.0. Also, one female rat in the control group had an epidermis crust. These changes were concluded to have been caused by the insertion of the needle into a vein. Conclusion: The above findings suggest that the lethal dose of GWG5 administered via IV injection is more than 1.0 mL per animal in both male and female rats. Further studies are needed to establish more detailed evidence of its toxicity.
Objectives: This study used repeated intravenous injections of Saeng Maek San (SMS) injection in Sprague-Dawley (SD) rats to assess the toxicity and the stability of SMS. Methods: Six-week-old male and female SD rats reared by Orient bio Inc were chosen for this pilot study. They were randomly split into four groups: Group 1 (G1), the control group (0.3 mL of normal saline solution/day/animal), and Groups 2, 3 and 4 (G2, G3 and G4), the experimental groups (0.1, 0.2 and 0.3 mL/day/animal of SMS), respectively. Each animal received an intravenous injection of SMS once a day for four weeks. Clinical signs, body weight changes, and food consumption were monitored during the observation period, and urinalysis and hematology were conducted after four weeks of SMS or saline administration. Results: No deaths occurred in any of the four groups during the observation period. Compared to the control group, male and female rats in groups 3 and 4 (0.2 and 0.3 mL/animal/day) showed hemoglobinuria, but the low-dosage group (G2, 0.1 mL/animal/day) showed no significant changes in the clinical signs test. No significant changes due to SMS were observed in the experimental groups regarding body weight changes, food consumption urinalysis, or hematology. Conclusion: During this study, no mortalities were observed in any of the experimental groups and no hemoglobinuria was observed in the low dosage group (0.1 mL/animal/day) while it was intermittently observed in groups 3 and 4 (0.2 and 0.3 mL/animal/day). Thus, we suggest that the no-observed adverse-effect level (NOAEL) is 0.1 mL/animal/day in male and female SD rats.
Importance: The intravenous administration of adipose tissue-derived mesenchymal stem cells (AdMSCs) in veterinary medicine is an attractive treatment option. On the other hand, it can result in severe complications, including pulmonary thromboembolism (PTE). Objective: The present study assessed the occurrence of PTE after the intravenous infusion of canine AdMSCs (cAdMSCs) into experimental animals. Methods: Five-week-old male BALB/c hairless mice were categorized into groups labeled A to G. In the control group (A), fluorescently stained 2×106 cAdMSCs were diluted in 200 µL of suspension and injected into the tail vein as a single bolus. The remaining groups included the following: group B with 5×106 cells, group C with 3×106 cells, group D with 1×106 cells, group E with 1×106 cells injected twice with a one-day interval, group F with 2×106 cells in 100 µL of suspension, and group G with 2×106 cells in 300 µL of suspension. Results: Group D achieved a 100% survival rate, while none of the subjects in groups B and C survived (p = 0.002). Blood tests revealed a tendency for the D-dimer levels to increase as the cell dose increased (p = 0.006). The platelet count was higher in the low cell concentration groups and lower in the high cell concentration groups (p = 0.028). A histological examination revealed PTE in most deceased subjects (96.30%). Conclusions and Relevance: PTE was verified, and various variables were identified as potential contributing factors, including the cell dose, injection frequency, and suspension volume.
Lee, Jong Min;Lee, JuHee;Jang, Yeon Soo;Kim, Yeon Hee
Journal of Korean Critical Care Nursing
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v.11
no.2
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pp.11-20
/
2018
Purpose : This study aimed to investigate the incidence of intravenous extravasation and the risk factors associated with the use of peripheral intravenous catheters in adults. Method : This prospective observational study included 203 adult patients admitted to the general ward who received non-chemotherapy vesicant drug infusion treatments. Data were analyzed using frequencies, percentage, means, standard deviations, and odds ratios (ORs) from multiple logistic regressions. Results : The incidence of extravasation was 43.3%. Risk factors for intravenous extravasation included continuous injections (OR=5.35, 95% CI [1.38, 20.83]), and parenteral nutrition (OR=3.53, 95% CI [1.43, 8.73]). Conclusion : The present findings revealed that gastrointernal medicine problems, continuous injection, and parenteral nutrition were related to intravenous extravasation. Further research is necessary to reduce the incidence of extravasation related to peripheral intravenous catheterization in adults, and to prevent secondary complications. Finally, patients should be provided appropriate and continuous care based on the type of intravenous infusion.
Kim, Yu-Jong;Jo, Su-Jeong;Choi, Young-Doo;Kim, Eun-Jung;Kim, Kap-Sung;Lee, Seung-Deok
Journal of Pharmacopuncture
/
v.17
no.3
/
pp.25-30
/
2014
Objectives: This study was performed to evaluate the single-dose intravenous toxicity of Guseonwangdo-go glucose 20% pharmacopuncture. Methods: Forty Sprague-Dawley rats were divided into four groups of five males and five females per group: an intravenous (IV) injection of 1.0 mL of normal saline solution per animal was administered to group 1 (G1, control group); an IV injections of 0.1, 0.5, and 1.0 mL of Guseonwangdo-go glucose pharmacopuncture per animal were administered to experimental groups 2, 3, and 4 (G2, G3, and G4), respectively. General symptoms, body weights, hematological and biochemical test results, and necropsy histopathological observation were recorded in all groups. In the statistical analyses, significance was determined by using the one-way analysis of variance (ANOVA). The significance level was 0.05 in all comparisons. Results: For 14 days, no deaths or abnormalities were observed in any of the 4 groups. The body weights of all groups continuously increased during the observation period. In the hematological test, the WBC count was significantly increased in female rats of G4 compared to the control group, but this difference was considered not to be statistically meaningful. No significant biochemical changes were observed. On necropsy, crust formation was observed in one rat of the control group, and granulation tissues were observed around the injection site in one rat of G4; these changes were concluded to have been caused by injection of the needle into a vein. Conclusion: The findings suggest that the lethal dose of Guseonwangdo-go glucose pharmacopuncture is more than 1.0 mL per animal in both male and female rats. Thus, we can conclude that Guseonwangdo-go glucose pharmacopuncture injection is relatively safe to use in acute toxicity tests. Further studies are needed to establish more detailed evidences of its toxicity.
Park, Jae-Sik;Lee, Zee-Ihn;Jang, Jae-Hee;Ahn, Dong-Kuk
The Korean Journal of Physiology and Pharmacology
/
v.6
no.3
/
pp.149-154
/
2002
The blood pressure (BP) is regulated by the nervous system and humoral factors, such as renin- angiotensin system, vasopressin and others. In the present study, we examined the central effects of glutamate and GABA on the cardiovascular regulation by injection of these substances into the lateral ventricle and also investigated the relationship between these central effects and the action of angiotensin II (Ang). Male Sprague Dawley rats, $350{\sim}400$ g, were anesthetized with urethane and instrumented with an arterial catheter for direct measurement of BP and heart rate (HR), and an guide cannula in the lateral ventricle for drug injection. A glass microelectode was inserted into the rostral ventrolateral medulla (RVLM) for recording single unit spikes. Barosensitive neurons were identified by changes of single unit spikes in RVLM following intravenous injection of nitroprusside and phenylephrine. The effects of GABA and glutamate injected into the lateral ventricle were studied in single neuronal activity of the RVLM in addition to changes in BP and heart rate, and compared the results before and after treatment with intravenous losartan, nonpeptide Ang II-type 1 receptor antagonist (1 mg/100 g BW). Intracerebroventricular administration of GABA decreased systolic blood pressure (SBP) and HR, but increased the firing rates in the RVLM. However, intracerebroventricular glutamate injection produced effects opposite to GABA. After pretreatment of intravenous losartan, the central effects of GABA on BP and firing rate in the RVLM were significantly attenuated and that of glutamate showed a tendency of attenuation. These results suggested that central GABA and glutamate regulated BP and firing rates in RVLM were inversely related to BP change. The central effects of GABA or glutamate on the autonomic nervous function were modulated by humoral factor, Ang II, by maintaining BP.
Pulmonary embolism from metallic mercury is rare. It may occur after a deliberate intravenous injection of mercury as a suicide gesture, in the presence of drug abuse or severe psychiatric disturbance, with the hope of increasing athletic and sexual performance, and accidentally during right heart catheterization while sampling blood with mercury containing syringes. We have experienced the first case of pulmonary embolism associated with intravenous mercury injection in Korea. The blood mercury level remain elevated within the toxic range to date. This may be due to the continued absorption of embolized mercury. Multifocal areas of patchy perfusion defects are in both upper lung fields on perfusion scan of lung. Few of the abnormalities of respiratory or renal function reported previously were demonstrated. We report the case of a young male patient presenting with a clinical picture of pulmonary embolism, in whom widespread deposit of metallic mercury were demonstrated throughout both lungs and elsewhere in the body.
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