RESUMO
The reliability of capillary blood glucose measurements is tremendously important for patients' care and follow-up. Some factors independent of glucose control could however affect readings during ambulatory monitoring of capillary glucose levels in patients with diabetes mellitus. We sought to evaluate the impact of three body lotions commonly used in Cameroon on different strata of glycaemia. We explored their influence over time on measured capillary glucose values. We enrolled 16 participants. Eligible individuals were adult patients with diabetes (n=12) stratified into three levels of capillary glucose values (100 ± 40 mg/dL [5.55 ± 2.22 mmol/L], 200 ± 40 mg/dL [11.1 ± 2.22 mmol/L] and 300 ± 40 mg/dL [16.65 ± 2.22 mmol/L]) and normoglycaemic individuals (n=4). We measured capillary blood glucose before application, immediately after, then 5, 30 and 60 minutes after application of sweet almond oil, corticosteroid cream and hydroquinone lotion. The measurements made on impregnated body lotion-permeated fingers were compared to that of a clean finger. We observed a significant increase (delta [95% confidence interval, CI]: 119.5% [77.4-222.1]) of capillary glucose level immediately after administration of hydroquinone-containing body lotion (p<0.001). Capillary glucose values after the use of corticoid cream and sweet almond oil was stable 5, 30 and 60 minutes after application (p=0.875 and p=0.883 respectively). In the case of the hydroquinone-containing body lotion, there was a significant difference between capillary glucose level at 5 minutes (delta [95%CI]: 81.6% [55.3-214.2]; p<0.001), 30 minutes (delta [95%CI]: 71.6% [21.8-134.6]; p<0.001) and 60 minutes (delta [95%CI]: 58.3% [2.8-133.3]; p=0.013) after application compared to the value obtained from the clean finger. We observed from our study that there were significant variations in capillary blood glucose measurements induced by the use of hydroquinone lotion.
RESUMO
OBJECTIVES: Ketamine and nefopam has been documented to decrease pain intensity and improve rehabilitation after total knee arthroplasty (TKA). We conducted a follow-up study of a previously randomized clinical trial to determine the prevalence and risk factors of chronic pain 1 year after TKA and to assess the role of perioperative administration of ketamine and nefopam. MATERIALS AND METHODS: The original randomized, double-blind trial evaluated postoperative pain in 75 patients scheduled for TKA who received either a 48-hour infusion of ketamine or nefopam compared with placebo. The current study has evaluated patients at 6 and 12 months for the presence of chronic pain defined as a visual analogue scale ≥40 mm during a stair-climbing test. Other outcomes were incidence of neuropathic pain evaluated (DN4 score), active flexion of the knee, and functional outcome (KOOS-PS score). RESULTS: A total of 69 patients completed the trial. The prevalence of chronic pain at 12 months was 17.4% (95% confidence interval [CI], 10.2%-27.9%) without difference between the ketamine (12.5%), nefopam (13.7%), and placebo groups (26.1%). Prevalence of neuropathic pain was 10.2% (95% CI, 3%-17.3%). Ketamine reduced DN4 scores (P=0.02), increased knee flexion (P=0.0007), and KOOS-PS scores (P<0.0001) compared with placebo. A visual analogue scale score ≥60 mm in the postoperative period was the only risk factor associated with the occurrence of chronic pain (odds ratio 4.54; 95% CI, 1.17-17.67). DISCUSSION: After TKA, the intensity of postoperative pain is a risk factor of chronic pain on movement. Intraoperative ketamine seems to improve long-term results of rehabilitation in this setting.
