• Title/Summary/Keyword: Intravenous infusion

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Oxycodone: A New Therapeutic Option in Postoperative Pain Management (술후 통증조절을 위한 새로운 대안으로서의 Oxycodone)

  • Choi, Byung Moon
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.13 no.4
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    • pp.167-178
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    • 2013
  • Oxycodone is a semi-synthetic opioid synthesized from poppy-derived thebaine. It is a narcotic analgesic generally indicated for relief of moderate to severe pain. Although developed in an attempt to improve on the existing opioids, the adverse effects of oxycodone are those that are typically found in opioids. In recent years, the use of the opioid oxycodone has increased markedly and replacing morphine as the first line choice of opioid in several countries. There are formulations for oral immediate, oral extended release and intravenous use. In 2013, intravenous oxycodone was approved for marketing by Ministry of Food and Drug Safety (MFDS), with the indication of postoperative intravenous patient-controlled analgesia (IV PAC). Simulation study of oxycodone demonstrated that minimum effective analgesic concentration (MEAC) of oxycodone was most quickly reached with higher loading dose and IV PCA with background infusion, which may reduce the necessity of rescue analgesics during immediate postoperative period. Previous studies for postoperative pain management with intravenous oxycodone are limited in sample size, mostly less than 100 patients, which may not be large enough to assess safety of intravenous oxycodone. The effectiveness and tolerability of IV PCA with oxycodone should, therefore, be evaluated in large scale clinical trials in Korean populations.

Clinical Trial of Human Intravenous Immunoglobulin in a Dog with Generalized Pemphigus Foliaceus (개에서 발생한 전신성 낙엽상 천포창에 사람 면역글로불린의 임상적 적용)

  • Park, Seong-Jun
    • Journal of Veterinary Clinics
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    • v.30 no.1
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    • pp.61-65
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    • 2013
  • An American Cocker Spaniel (3-year-old, intact female, 6.0 kg) was referred to the Veterinary Medical Teaching Hospital of Chungnam National University for evaluation of pustules and crusts in the periocular region, dorsal and ventral region of the trunk, and digits. Complete blood count (CBC) revealed leukocytosis with mature neutrophilia, and a serum biochemistry profile revealed hypoalbuminemia. Tape strip tests identified numerous neutrophils and acatholytic cells. Histopathology identified intraepithelial pustules with neutrophils and acantholytic keratinocytes. Definitive diagnosis of pemphigus foliaceus (PF) was made by direct immunofluorescence (DIF) test with goat anti-canine IgG antibody. The human intravenous immunoglobulin (IVIG) was administered at a rate of 15 ml/h over 6 hours for 4 days. After that, the dog was maintained on prednisolone (2.2 mg/kg, PO, SID) and azathioprine (2.0 m/kg, PO, SID). An infusion of IVIG (0.5 g/kg) was repeated 3 days after 4 weeks. After 10 weeks, the dog showed the remarkable regression of lesions.

Effects of the rate and composition of fluid replacement on the pharmacokinetics and pharmacodynamics of intravenous torasemide

  • Kim, Yu-Chul;Lee, Myung-Gull;Kim, So-Hee
    • Proceedings of the PSK Conference
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    • 2003.04a
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    • pp.310.2-311
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    • 2003
  • The effects of differences in the rate and composition of intravenous fluid replacement for urine loss on the pharmacokinetics and pharmacodynamics of torasemide were evaluated using rabbits as the animal model. Each rabbit received 2-h constant intravenous infusion of 1 mg/kg ∼ 1 of torasemide with 0% replacement (treatment I, n = 6), 50% replacement (treatment II, n = 9), and 100% replacement with lactated Ringer's solution (treatment III, n = 8) as well as with 100% replacement with 5% dextrose in water(D-5-W, treatment IV, n=6). (omitted)

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Nitrogen Sparing Effect of Intravenous Amino Acid Solutions (종합 아미노산수액 투여에 의한 Nitrogen balance의 임상적 검토)

  • Park, C.W.;Lim, J.K.;Lee, J.K.;Lee, J.O.;Park, K.W.
    • The Korean Journal of Pharmacology
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    • v.13 no.2
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    • pp.67-73
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    • 1977
  • The nitrogen sparing effect of intravenous 3% amino acid solution was compared with 5% dextrose solution in 30 patients who were undergoing surgical operations or radiation therapy. Infusion of 3% amino acid solution or 5% dextrose solution was given before and immediately after operations or irradiation and continued for 6 days. Infusion of solutions through peripheral vein was well tolerated and not experienced any specific hematologic or blood chemistry change in all patients subjected throughout the experiment. The patients received 3% amino acid solution showed low blood glucose and insulin level, but significantly high blood urea nitrogen and ketone body. In patients receiving amino acids, as compared with those receiving dextrose, mean cumulative six day nitrogen losses were significantly lower($63.95{\pm}2.12$ Gm and $79.12{\pm}2.43Gm$ respectively). The nitrogen sparing effect of amino acids is probably due to decreased glucose and insulin levels allowing greater endogenous fat mobilization.

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The Trial of Continuous Intravenous Infusion of Ketamine in Patients with Phantom Limb Pain -A case report- (환지통 환자에서 Ketamine 지속 정주에 의한 치료 경험 -증례보고-)

  • Cheong, Yong Kwan;Lee, Cheol;Son, Yong;Song, Yoon Kang;Kim, Tai Yo;Lee, Seung Woo
    • The Korean Journal of Pain
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    • v.19 no.2
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    • pp.233-236
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    • 2006
  • Phantom limb pain is a painful sensation from an absent limb. The onset of pain is generally early, with 75% of patients developing pain within the first few days after amputation. The frequency and duration of attacks tend to be reduced with time, although the prevalence and intensity remain constant. We report here a case of a 38-year-old man who exhibited the signs and symptoms of phantom limb pain due to the above-knee amputations of both legs. He was not responded to opioid therapy and a continuous intravenous infusion of ketamine, an N-methyl-D-aspatate receptor antagonist, reduced his severe pain.

The Effect of IV Infusion of Phenytoin for Glossopharyngeal Neuralgia -A case report- (설인신경통 환자에서 Phenytoin 정주의 효과 -증례 보고-)

  • Lee, Young-Bok;Yoon, Kyung-Bong;Lee, Kwang-Ho;Han, Yi-Keong
    • The Korean Journal of Pain
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    • v.12 no.1
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    • pp.119-122
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    • 1999
  • Glossopharyngeal neuralgia is a rare syndrome that involves episodic bursts of pain in the sensory distributuion of the ninth cranial nerve. The nature of the pain is characterized by excruciating shock-like pain in the region of the tonsillar fossa or pharynx and can radiate to the ear or the angle of the jaw. Like trigeminal neuralgia, glossopharyngeal neuralgia typically responds to anticonvulsant agents such as carbamazepine. However, dose of carbamazepine needs to be increased gradually to avoid side effects. If the patient can not tolerate until effective carbamazepine level is reached, phenytoin can be administered intravenously at the same time that oral carbamazepine therapy is begun. We present fifty-three year old female patient suffering from glossopharyngeal neuralgia who did not respond to initial carbamazepine therapy, but responded to concomitant intravenous infusion of phenytoin.

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A Simple and Easy Method to Prevent Intravenous Fluid Heat Loss in Hypothermia (저체온 환자 치료에서 정맥주입 수액의 열손실을 막는 간단한 방법에 관한 고찰)

  • Lee, Sun Hwa;Choi, Yoon Hee;Lee, Dong Hoon
    • Journal of Trauma and Injury
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    • v.26 no.4
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    • pp.255-260
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    • 2013
  • Purpose: For the treat hypothermia patients, active warming might be needed. In most emergency departments, IV warm saline infusion is used for treatments. However, during IV warm saline infusion, heat loss from the warm saline may occur and aggravate hypothermia. Thus, in this study, we conducted an experiment on conserving heat loss from warm saline by using a simple method. Methods: Four insulation methods were used for this study. 1) wrapping the set tube for the administration of the IV fluid with a cotton bandage, 2) wrapping the set tube for the administration of the IV fluid with a cotton bandage with aluminum foil, 3) wrapping the warm saline bag and tube with a cotton bandage, and 4) wrapping the warm saline bag and tube with a cotton bandage with aluminum foil. Intravenous fluid was preheated to a temperature between $38-40^{\circ}C$. The temperatures of the saline bag temperature and the distal end of the IV administration set were measured every ten minutes for an hour. The infusion rate was 1000 cc/hr, and to obtain an accurate infusion rate, we used an infusion pump. Results: The mean initial temperature of the saline bag was $39.11^{\circ}C$. An hour later, the fluid temperature at the distal end of the fluid temperature ranged from $39.11^{\circ}C$ to $34.3^{\circ}C$. Without any insulation, the initial temperature of the pre-heated warm saline, $39^{\circ}$ had decreased to $34.8^{\circ}C$ after having been run through the 170-cm-long IV administration tube, and after 1-hour, the temperature was $29.63^{\circ}C$. As we expected, heat loss was prevented most by wrapping both the saline bag and the IV administration set with a cotton bandage and aluminum foil. Conclusion: Wrapping both the saline bag and the IV administration set with a cotton bandage and aluminum foil can prevent heat loss during IV infusion in Emergency departments.

Physiological Factors Depressing Feed Intake and Saliva Secretion in Goats Fed on Dry Forage

  • Sunagawa, K.;Ooshiro, T.;Nakamura, N.;Ishii, Y.;Nagamine, I.;Shinjo, A
    • Asian-Australasian Journal of Animal Sciences
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    • v.20 no.1
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    • pp.60-69
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    • 2007
  • Ruminants eating dry forage secrete large volumes of saliva which results in decreased plasma volume (hypovolemia) and the loss of $NaHCO_3$ from the blood. The present research investigated whether or not hypovolemia and the loss of $NaHCO_3$ from the blood in goats brought about by dry forage feeding actually depresses feed intake and saliva secretion, respectively. The present experiment consisted of three treatments (NI, ASI, MI). In the control treatment (NI), a solution was not infused. In the ASI treatment, i.v. infusion of artificial parotid saliva was initiated 1 h before feeding and continued for the entire 2 h feeding period. In the MI treatment, iso-osmotic mannitol solution was infused. The NI treatment showed that hematocrit and plasma total protein concentration were increased due to decreased circulating plasma volume brought about by feeding. In the ASI treatment, the fluid and $NaHCO_3$ that were lost from the blood because of a feeding-induced acceleration of saliva secretion was replenished with an intravenous infusion of artificial parotid saliva. This replenishment lessened the levels of suppression on both feeding and parotid saliva secretion. When only the lost fluid was replenished with an intravenous infusion of iso-osmotic mannitol solution in the MI treatment, the degree of feeding suppression was lessened but the level of saliva secretion suppression was not affected. These results indicate that the marked suppression of feed intake during the initial stages of dry forage feeding was caused by a feeding-induced hypovolemia while the suppression of saliva secretion was brought about by the loss of $NaHCO_3$ from the blood due to increased saliva secretion during the initial stages of feeding.

Phase II Clinical Study on the GEMOX Regimen as Second-line Therapy for Advanced Ovarian Cancer

  • Yuan, Shao-Fei;Zhang, Lian-Ping;Zhu, Lin-Jia;Chen, Wen-Jun;Zheng, Wei-E;Xiong, Jian-Ping
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.6
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    • pp.3949-3953
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    • 2013
  • Aim: To investigate the effectiveness and adverse effects of gemcitabine by fixed-dose rate infusion plus oxaliplatin (GEMOX regimen) as second-line therapy for advanced ovarian cancer. Methods: 64 patients with advanced ovarian cancer were divided into an experimental group (44 cases) and a control group (20 cases). The experimental group was treated with continuous intravenous infusion of gemcitabine at 1000 $mg/m^2$ with a fixed-dose rate of 10 $mg/m^2/min$, on days 1 and 8 and oxaliplatin at 100 $mg/m^2$ on day 1, IVGTT, repeated every 3 weeks. The control group was treated with intravenous infusion of gemcitabine at 1000 $mg/m^2$ within 30 min on days 1 and and oxaliplatin at 100 $mg/m^2$ on day 1, IVGTT, again repeated every 3 weeks. CT scans or MRI were used for review every 1-2 cycles. Results: The effective rate in the experimental group was significantly high than control group (43.2% vs 35.0%; P < 0.05), with no obvious difference of hematologic or non-hematologic toxicity between the two groups (P > 0.05). Conclusion: GEMOX regimen is very effective to treat advanced ovarian cancer, with low toxicity, good tolerance and improved life quality in patients.

Pain alleviation in patients undergoing cardiac surgery; presternal local anesthetic and magnesium infiltration versus conventional intravenous analgesia: a randomized double-blind study

  • Kamel, Emad Zarief;Abd-Elshafy, Sayed Kaoud;Sayed, Jehan Ahmed;Mostafa, Mohammed Mahmoud;Seddik, Mohamed Ismail
    • The Korean Journal of Pain
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    • v.31 no.2
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    • pp.93-101
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    • 2018
  • Background: Magnesium is one of the effective, safe local anesthetic adjuvants that can exert an analgesic effect in conditions presenting acute and chronic post-sternotomy pain. We studied the efficacy of continuous infusion of presternal magnesium sulfate with bupivacaine for pain relief following cardiac surgery. Methods: Ninety adult patients undergoing valve replacement cardiac surgery randomly allocated into three groups. In all patients; a presternal catheter was placed for continuous infusion of either 0.125% bupivacaine and 5% magnesium sulfate (3 ml/h for 48 hours) in group 1, or 0.125% bupivacaine only in the same rate in group 2, versus conventional intravenous paracetamol and ketorolac in group 3. Rescue analgesia was iv $25{\mu}g$ fentanyl. Postoperative Visual Analog Scale (VAS) and fentanyl consumption during the early two postoperative days were assessed. All patients were followed up over two months for occurrence of chronic post-sternotomy pain. Results: VAS values showed high significant differences during the first 48 hours with the least pain scale in group 1 and significantly least fentanyl consumption ($30.8{\pm}7{\mu}g$ in group 1 vs. $69{\pm}18{\mu}g$ in group 2, and $162{\pm}3$ in group 3 respectively). The incidence of chronic pain has not differed between the three groups although it was more pronounced in group 3. Conclusions: Continuous presternal bupivacaine and magnesium infusion resulted in better postoperative analgesia than both presternal bupivacaine alone or conventional analgesic groups.