ABSTRACT
Abstract Background: Rocuronium causes pain and withdrawal movement during induction of anesthesia. In this study, palonosetron was investigated to have analgesic effect on the reduction of rocuronium-induced withdrawal movement. Methods: 120 patients were randomly assigned to one of three groups to receive either saline, lidocaine 20 mg, or palonosetron 0.075 mg with a tourniquet applied two minutes before thiopental sodium (5 mg.kg-1) was given intravenously. After loss of consciousness, rocuronium (0.6 mg.kg-1) was injected and the withdrawal movement was estimated by 4-point scale in a double-blind manner. Results: The overall incidence of rocuronium withdrawal movement was 50% with lidocaine (p = 0.038), 38% with palonosetron (p = 0.006) compared with 75% for saline. The incidence of no pain to mild pain was significantly lower in the lidocaine and palonosetron groups (85% and 92% respectively) than in the saline group (58%). However, there was no significant difference in withdrawal movement between the lidocaine and palonosetron groups. There was no severe movement with palonosetron. Conclusion: Pretreatment of palonosetron with venous occlusion may attenuate rocuronium-induced withdrawal movement as effective as the use of lidocaine. It suggested that peripheral action of palonosetron was effective to reduce rocuronium-induced withdrawal movement.
Resumo Justificativa: Rocurônio provoca dor e reflexo de retirada durante a indução da anestesia. Neste estudo, avaliamos se palonosetron tem efeito analgésico para reduzir esse movimento induzido por rocurónio. Métodos: Cento e vinte pacientes foram randomicamente designados para um de três grupos para receber solução salina, lidocaína (20 mg) ou palonosetron (0.075 mg), com aplicação de torniquete dois minutos antes da administração intravenosa de tiopental sódico (5 mg.kg-1). Após a perda de consciência, rocurônio (0.6 mg.kg-1) foi injetado e o reflexo de retirada foi avaliado com o uso de uma escala de quatro pontos, de modo duplo-cego. Resultados: A incidência global do reflexo de retirada induzido por rocurônio foi de 50% para lidocaína (p = 0,038), 38% para palonosetron (p = 0,006), em comparação com 75% para solução salina. A incidência de dor ausente ou leve foi significativamente menor nos grupos lidocaína e palonosetron (85% e 92%, respectivamente) que no grupo solução salina (58%). Porém, não houve diferença significativa no reflexo de retirada entre os grupos lidocaína e palonosetron. Não houve movimento grave com palonosetron. Conclusão: O pré-tratamento com palonosetron com oclusão venosa pode atenuar o reflexo de retirada induzido por rocurônio de modo tão eficaz como o uso de lidocaína. Sugeriu-se que a ação periférica de palonosetron foi eficaz para reduzir o reflexo de retirada induzido por rocurônio.
Subject(s)
Humans , Adult , Aged , Young Adult , Neuromuscular Nondepolarizing Agents/adverse effects , Serotonin 5-HT3 Receptor Antagonists/therapeutic use , Rocuronium/adverse effects , Palonosetron/therapeutic use , Movement/drug effects , Double-Blind Method , Prospective Studies , Middle AgedABSTRACT
Background: The importance in asthma management of monitoring of peak expiratory flow rate (PEFR) has been emphasized. Objective: For effective asthma management in Korean children, we established reference ranges for the PEFR in children 4–18 years of age. Methods: The Mini Wright Peak Flow Meter (MWPFM) and spirometry were used in this study. All tests were conducted using a standardized method recommended by the American Thoracic Society. Results: From a total sample of 2,389 children, 826 (34.5%) were excluded based on our exclusion criteria. For both sexes, the PEFR increased with height, age, weight, sitting height and body surface area (BSA). Height and BSA were found to be better predictors of PEFR than the other parameters. The correlation coefficient between FEV1 and PEFR using the MWPFM was 0.886 (p < .001). The reference values of PEFR for height in our study were higher for both sexes than for those previously reported in Korea (p < .005). When we compared our results with those from other countries, the values for boys of the same height were lower than those for European children, but higher than those for African and Turkish children (p < .001). Conclusions: We have established reference values for PEFR obtained by MWPFM in Korean children in Seoul, and have provided the percentile curves for PEFR as a function of height to assist clinical practices in treating children with asthma in Korea.
ABSTRACT
The aim of this study was to understand the natural course of egg allergy and to identify the prognos-tic factors for tolerance. A retrospective study that included 106 children with atopic dermatitis and egg allergy diag-nosed at less than 2 years of age was conducted using medical records and parental telephone interviews. Toler-ance was defined as the absence of an allergic reaction in response to the parental introduction of cooked eggs to the diet of children whose egg white specific IgE level had decreased to less than 1.5 kUA/l. The median age of tol-erance to egg allergy was 4 years. Kaplan-Meier analysis predicted that 41% of children had developed tolerance to egg allergy by age 3, while 60% of children had developed tolerance by age 5. The age at the diagnosis of egg allergy was the only significant prognostic factor of egg allergy tolerance identified by the Cox proportional regression model.