Background and Aims: There are limited data on the effect of ampule size on drug dosing. The objective of this study is to determine the effect of ampule size on perioperative opioid dosing and ...post-anesthesia care unit (PACU) outcomes.
Material and Methods: This was a retrospective review of patients undergoing robotically assisted laparoscopic radical prostatectomy before and after a 5-ml fentanyl ampule was discontinued. The primary outcome was intraoperative opioid administration divided into fentanyl at induction of anesthesia, total fentanyl, and total opioid. Secondary outcomes observed in PACU included the opioid administered, visual analog scale (VAS) pain scores, postoperative nausea and vomiting, and length of stay in PACU.
Results: A total of 100 patients (50 PRE and 50 POST) were included. In the intraoperative opioid administration, mean (SD) of fentanyl at induction was 117.0 (49.3) in PRE group and 85.0 (35.4) μg in POST group (P < 0.01). The total fentanyl requirement was 247.0 (31.0) in PRE group and 158.5 (85.1) μg in POST group (P < 0.01). The total opioid in intravenous morphine equivalents (IVME) was 34.1 (5.8) in PRE group and 23.2 (6.8) mg in POST group (P < 0.01). Among the secondary outcomes, mean (SD) of IVME of opioid was 7.7 (8.2) in PRE group and 9.9 (8.1) mg in POST group (P = 0.18). The VAS pain score on arrival was 0.7 (1.4) in PRE group and 3.8 (3.3) in POST group (P < 0.01). The cumulative VAS pain score was 2.3 (2.0) in PRE group and 3.3 (2.2) in POST group (P < 0.01). The length of stay was significantly more in POST group, 193.8 (75.8) minutes, as compared with PRE group, 138.6 (61.0) minutes (P < 0.01).
Conclusions: A change in the ampule size significantly affected intraoperative dosing, PACU pain scores, and PACU length of stay in patients undergoing robotically assisted laparoscopic radical prostatectomy under general anesthesia. This was explained by clinician's desire to conserve the drug and avoid the complex process of narcotic waste disposal.
ABSTRACT Gyropsylla spegazziniana is one of the most important pest of yerba mate by sap-sucking that lead to leaves deformation and there are no insecticides registered for its control. The present ...study describes a new technique to be used in bioassays with the insect. Galls were collected from infested yerba mate plants. In the laboratory, the galls were partially opened and distributed in plastic containers. The emerged adults were transferred to plastic containers with the perforated bottom and a central opening in the lid, and subjected to spraying. After that, insects were transferred to yerba mate seedlings in plastic cages and maintained in laboratory to daily assessment. The use of a lid with central opening prevented the insects escaping, and avoiding the previous anesthetic to spraying. The mortality was less than 10% after 10 days. The technique was considered adequate for maintenance and performance of laboratory bioassays.
Epinephrine autoinjectors provide potentially life-saving therapy for pediatric and adult subjects with systemic allergic reactions, including anaphylaxis. However, the cost of these devices, ...specifically the EpiPen (Mylan, Canonsburg, Pa), is increasing exponentially. Epinephrine autoinjectors are commonly prescribed in the United States but are not readily available worldwide. Alternatives for the self-administration of epinephrine exist and should be considered for patients who cannot afford or do not have access to these devices. The epinephrine prefilled syringe, stored in an eyeglass or pencil case, is a safe and viable option for the self-administration of epinephrine. Epinephrine prefilled syringes may not be as ideal as using autoinjectors but are superior to patients living without access to this medication.
A high-performance liquid chromatography—diode array detection method was developed and validated to simultaneously determine tramadol (TMD), metamizole (MTZ), ropivacaine (RPV), and bupivacaine ...(BPV) in the presence of 4-methylaminoantypirine (4-MAA), the metabolite of MTZ, in analgesic mixtures samples used in Patient Controlled Analgesia (PCA). Chromatographic separation is achieved with a C-18 column using a mixture of ACN—methanol—water adjusted to pH 3.0 with NaH2PO4 0.05M (10:25:65 v/v) in an isocratic mobile phase at a flow rate of 0.8 mL/min. 0.5 mg/mL of Na2SO3 in the water of the mobile phase was necessary to prevent the fast MTZ hydrolysis process to 4-MAA. Ultraviolet-diode array detection was used and chromatograms were registered at the wavelength of 230 nm. The method was linear in the range of 2.2–80.0 mg/L for TMD, 4.1–140.0 mg/L for MTZ, 2.3–40.0 mg/L for RPV, and 2.9–40.0 mg/L for BPV. Validation of the method was made in terms of accuracy, intra- and interday precision, as well as quantification and detection limits. The hydrolysis of MTZ to 4-MAA was studied and verified by mass spectrometry. The developed method was used successfully to evaluate the chemical stability of binary analgesic TMD mixtures with MTZ, RPV, or BPV. The mixtures were tested at standard concentrations used in PCA and in different storage conditions. When mixtures contained MTZ, a chromatographic peak from the metabolite 4-MAA was always detected in the chromatograms.
Particle contamination of medications obtained from glass ampules can pose serious hazards to patients. Particle contamination may be reduced by using a filter needle when obtaining medication from ...glass ampules prior to administration. The purpose of this article is 2-fold, to educate nursing staff caring for neonates about (1) the potential risk and resultant complications related to particle contamination and the benefit of utilizing a filter needle when obtaining medication from glass ampules, prior to administration of the medication to patients, and (2) the construction of a unit-specific filter needle protocol. The article promotes the continued change in nursing practice regarding nurses erring on the side of safety, with the ultimate goal of improving patient safety and outcome.
일회용량의 유리앰플을 딸때 생기는 유리조각에 의한 오염 채정혜; Jung Hae Chae; 김원옥 ...
Korean journal of anesthesiology,
10/1990, Letnik:
23, Številka:
5
Journal Article
Recenzirano
Single dose glass ampules have been developed for ease of administration, accuracy of measurement of dosage, sterility and use in prepackaged kits. Glass particle contamination of the contents of ...single dose glass ampules can occur upon opening. In our study, we determined whether different ampule size, different aspiration techniques or different methods of ampule opening had any effect on glass particle contamination. Different ampule sizes (1, 2, 20 ml), different aspiration techniques (19G, 22G needle) and different methods of ampule opening (one point ampule, cutting with circular etching, cutting with one plane etching) were evaluated. There was no signifcant difference in the number of particles aspirated by any given aspiration technique, ampule size and method of ampule opening. But intravenous glass particle administration is associated with patholagic responses, so the use of a filter needle, and in-line filter devices and a low pressure infusion system is advised.
The heating characteristics, heating parameters, and sterilizing effect of a new type of sterilizer (microwave sterilizer) for the head space of ampules were investigated. A thermographic analysis of ...the temperature of the head space of the ampules revealed that this system can heat both the solution and the head space to the same level of accuracy, and that the neck of the ampules is a cold spot when they are heated with this device. The two hot-air heaters (X1 and X2) were used for heating the head space of the ampules, and the microwave output (X3) was used for heating the solution within them. Multiple regression analysis was conducted to examine the relationship between the temperature of the cold spot of the head space (Y) and these three parameters (X1, X2, and X3), using ampules containing physiological saline. This analysis yielded the following relationship: Y=0.357X1-0.023X2+0.026X3+4.164 (R=0.998). The following biological indicators were put into the cold spot of the ampule head to evaluate the sterilizing effectiveness of this device: spores of Aspergillus niger (for the low temperature range from 60 to 100°C), spores of Bacillus subtilis (for the medium temperature range from 101 to 120°C), and spores of Bacillus stearothermophilus (for the high temperature range from 121 to 140°C). Challenge tests for these three temperature ranges indicated that this microwave sterilizing system can adequately sterilize the head space of ampules in all temperature ranges.
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