Disturbance of consciousness caused by dyclonine hydrochloride mucilage: a case report.

BACKGROUND: Dyclonine hydrochloride mucilage is a topical anaesthetic formulated for mucosal surfaces. It is employed frequently for topical anaesthesia of the pharynx prior to endoscopic examinations such as electronic gastroscopy, and few adverse reactions have been reported. This article describes a patient who experienced a transient but severe disturbance of consciousness following oral dyclonine hydrochloride mucilage administration. CASE PRESENTATION: A 75-year-old female presenting with gastrointestinal bleeding was examined by electronic gastroscopy. Six minutes after oral dyclonine hydrochloride mucilage administration, the patient entered a comatose-like state accompanied by loss of limb muscle tone and profuse perspiration. This response was not accompanied by changes in cardiac rhythm, blood pressure, or respiration rate, suggesting an effect on higher brain centres. After ten minutes, the patient's symptoms were alleviated. CONCLUSION: We suggest that sites of dyclonine hydrochloride mucilage use be equipped with appropriate rescue devices for these rare events.

Study on quality standard of compound Yuhong suppository / 药学实践杂志

Objective To establish the quality standard of compound Yuhong suppository. Methods Angelica dahurica, colophony and Sophora flavescens Alt. were identified by thin layer chromatography（TLC）method. The contents of sulfadiazine and dyclonine hydrochloride were determined by HPLC with diode array detection method. The mobile phase was methanol-0.02 mol/L potassium dihydrogen phosphate (adjusted to pH 3.3 with phosphoric acid) for gradient elution. The detection wavelength was 280 nm for sulfadiazine and dyclonine hydrochloride. Results The three Chinese traditional medicines were identified by TLC with clear spots. The linear ranges of sulfadiazine and dyclonine hydrochloride were good in 12.40-99.20 μg/ml (r=0.999 9) and 2.56-20.48 μg/ml (r=0.999 9). The average recovery was (99.21±0.43) % (n=9) and (99.54±0.68) % (n=9). Conclusion This method is accurate, sensitive, and reproducible. It can be used as a standard method for the quality control of compound Yuhong suppository.

Preventive but Not Therapeutic Topical Application of Local Anesthetics Can Inhibit Experimental Epidermolysis Bullosa Acquisita in Mice.

Epidermolysis bullosa acquisita (EBA) is an autoimmune blistering disorder characterized and caused by autoantibodies against type VII collagen (COL7). Although it has been noticed that EBA in both patients and mice is associated with an increased scratching, it is not clear whether and how the scratching contributes to disease manifestation. Hence, we here aimed to validate this clinical observation and also to investigate the potential contribution of increased scratching in EBA pathogenesis in mice. Longitudinal assessment of scratching behavior revealed an increased frequency of scratching as early as 12 hours after injection of anti-COL7 IgG into the skin of mice. Subsequently, scratching events became even more frequent in mice. In contrast, mice injected with a control antibody showed an unaltered scratching behavior throughout the observation period. Based on these observations, we hypothesized that mechanical irritation may promote the induction of inflammation in experimental EBA. To challenge this assumption, the local anesthetic dyclonine hydrochloride was topically applied before injection of anti-COL7 IgG. Dyclonine hydrochloride reduced the scratching events and impaired clinical disease manifestation. In therapeutic experimental settings, i.e. administration of the local anesthetic 24 hours after injection of anti-COL7 IgG, dyclonine hydrochloride only inhibited the scratching behavior, but had no significant effect on clinical disease development. In addition, eosinophils were detected in the skin before the injection of anti-COL7 IgG and significantly increased 48 hours after the antibody injection. Collectively, our results suggest that scratching behavior contributes to the initiation phase of disease manifestation in experimental EBA.

The effectiveness of electro-acupuncture combined with dyclonine hydrochloride in relieving the side effects of gastroscopy: a controlled trial.

BACKGROUND: The present study aimed to explore the effectiveness of electro-acupuncture (EA) in combination with a local anesthetic used in Western medicine in preventing the side effects of gastroscopy. METHODS: A sample group of 150 patients were divided into three groups based on treatment methods: an EA group, a dyclonine hydrochloride mucilage group, and a combined treatment group. In the EA group, EA stimulation was given at the Hegu, Neiguan, and Zusanli acupoints; in the dyclonine hydrochloride mucilage group, patients took 10 mL of dyclonine hydrochloride mucilage orally; in the combined treatment group, prevention of side effects was attempted by administration of both acupuncture and oral local anesthetic. The incidences of nausea, emesis, salivation, cough, restlessness, and breath holding during gastroscopy were observed and recorded for the three groups. Mean arterial pressure, heart rate, and oxygen saturation were recorded before the examination, and changes in these measures were recorded as the gastroscope passed through the pylorus and after the examination. The visual analogue scale (VAS) values of nausea and emesis, the rate of successful first-pass intubation, and the time of gastroscopy were also recorded. Statistical analysis was performed using R-3.5.3 software. RESULTS: Incidences of side effects (e.g., nausea, emesis, salivation, restlessness, and breath holding) during the examination were lower in the combined treatment group than in the EA group and the dyclonine hydrochloride mucilage group (P<0.05 and P<0.01, respectively). Furthermore, the changes in heart rate and oxygen saturation when the gastroscope passed through the pylorus and after the examination were better in the combined treatment group than in the EA group and dyclonine hydrochloride mucilage group (P<0.01). The VAS values of nausea and emesis, the first-pass success rate, and examination duration were also better for the combined treatment group than for the other two groups (P<0.05 and P<0.01). CONCLUSIONS: EA combined with local anesthesia with dyclonine hydrochloride mucilage can alleviate side effects during gastroscopy, reduce patient pain, and improve the efficiency of the procedure.

Anesthetic efficacy of topical dyclonine hydrochloride mucilage for preputial encircling in children / 临床麻醉学杂志

Objective To investigate the anesthetic efficacy of topical dyclonine hydrochloride mucilage for preputial encircling in children. Methods Sixty children under preputial encircling, 13 patients with redundant prepuce, 47 patients with phimosis, aged 4-12 years, weighing 14-38 kg, falling into ASA physical status Ⅰ or Ⅱ, were randomly divided into two groups with 30 cases each: dyclonine group (group D) and control group (group C). Children with redundant prepuce in group D were smeared evenly 1％ dyclonine hydrochloride mucilage on the anterior 2/3 foreskins, glans and coronary sulcus by anesthesiologists who were assisted by the their parents 30 min before entering the operating room. Children with phimosis in group D were smeared evenly 1％ dyclonine hydrochloride mucilage on the anterior 2/3 foreskins, and then the tube was inserted near the coronary sulcus with the 18# straight indwelling needle. The syringe was injected into the 1％ dyclonine hydrochloride mucilage, and the glans and the coronary sulcus were squeezed repeatedly several times by anesthesiologists who were assisted by the their parents 30 min before entering the operating room. The dosage of dyclonine hydrochloride mucilage for each child was 0.2-0.3 ml/kg. Children in group C were smeared evenly isodose normal saline at the same time. All the children were treated with ketamine and propofol anesthesia after entering. The occurrence of intraoperative body reaction were observed and recorded, HR and MAP were recorded before anaesthesia induction (T0), at the beginning of surgery (T1), at the time of the coronary sulcus was exposed (T2), at the time of ligating (T3), at the time of the excess foreskin was cut (T4), the dosage of ketamine and propofol were recorded, and the occurrence of postoperative recovery time and emergence agitation during recovery period were observed. Results Body dynamic reaction rate in group D was significantly lower than that in group C (P ＜ 0.05), HR and MAP was significantly lower than that in group C at T3-T4 (P ＜ 0.05), the dosage of ketamine and propofol was significantly smaller than that in group C (P ＜ 0.05), the recovery time was significantly shorter than that in group C (P ＜ 0.05), the incidence of emergence agitation was significantly decreased compared with group C (P ＜ 0.05). Conclusion Topical dyclonine hydrochloride mucilage can effectively decrease body movement, lessen cyclic fluctuation, economize general anesthetics, shorten recovery time, reduce emergence agitation in children undergoing preputial encircling.

Anesthetic efficacy of oral dyclonine hydrochloride mucilage combined with laryngopharyngeal spray of lidocaine in infant esophagus dilatation / 临床麻醉学杂志

Objective To study the anesthetic effect of oral dyclonine hydrochloride mucilage combined with laryngopharyngeal spray of lidocaine in infant esophagus dilatation.Methods Eighty infants with anastomotic stenosis after surgical correction of esophageal atresia under esophagus dila-tation assisted with gastroscope,51 males and 29 females,age 6 months to 3 years,weighing 5-12 kg,ASA physical status Ⅰ or Ⅱ,were randomly divided into four groups with 20 cases each:general anesthesia group (group A),general anesthesia combined with dyclonine surface anesthesia group (group B),general anesthesia combined with lidocaine surface anesthesia (group C),general anesthesia combined with dyclonine and lidocaine surface anesthesia group (group D).Infants in group B and group D were given 1 % dyclonine hydrochloride mucilage 0.2-0.3 ml/kg by their parents who were guided by the anesthesiologist at 10-15 min before entering the operating room,followed by slow intravenous injection of penehyclidine hydrochloride 0.01-0.02 mg/kg, propofol 2-2.5 mg/kg, remifentanil 1 μg/kg.After the induction,the children of group C and group D were exposed to 2% lidocaine 0.1 5-0.2 ml/kg through laryngoscope under laryngoscope to spray the laryngeal mucosa surface.All the children were converted to oxygen supply (6 L/min)asing double nasal high flow af-ter the mask was added to the stable breathing.Anesthesia was maintained by propofol 6 mg·kg-1·h-1,remifentanil 0.1 μg·kg-1·h-1infusion.In the case of somatic or choking during the operation,propofol and (or)remifentanil were inj ected into the pump to deepen the anesthesia. The occurrence of intraoperative oxygen saturation (SpO2<94%),cough and body reaction were ob-served and recorded,and the occurrence of postoperative recovery time and emergence agitation during recovery period were observed.Results The patients with oxygen saturation in group D de-creased,the incidence of cough was significantly lower than that of groups A and B (P<0.05 ), without significant difference in group C, body dynamic reaction rate was significantly lower compared with the other three groups (P<0.05),the recovery time was significantly shorter com-pared with the other three groups (P<0.05),the incidence of emergence agitation significantly de-creased (P<0.05).Conclusion Oral dyclonine hydrochloride mucilage combined with laryngopha-ryngeal spray of lidocaine can effectively decrease hypoxemia,cough,body movement,shorten recov-ery time,reduce emergence agitation in infants undergoing the esophageal dilatation.

Efficacy of using combination of phloroglucinol and dyclonine hydrochloride mucilage in preventing cath-eter-related bladder discomfort during recovery from anesthesia in the patients undergoing general anes-thesia / 临床麻醉学杂志

Objective To evaluate the efficacy of phloroglucinol combined with dyclonine hydrochloride mucilage in preventing catheter-related bladder discomfort (CRBD)during recovery from anesthesia in patients under general anesthesia.Methods A total of 120 male patients scheduled for laparoscopic cholecystectomy under general anesthesia,aged 18-60 years,weighing 46-80 kg, ASA physical status I or II,were randomly divided into 3 groups (n=40 in each group):group of combination of phloroglucinol and dyclonine hydrochloride mucilage (group P),sufentanil group (group S)and control group (group C).After induction of general anesthesia,the patients in group P were tracheally incubated and then inj ected with 5 ml dyclonine hydrochloride mucilage per urethra.In the meantime,for patients of groups S and C,equal volume of normal saline was inj ected and paraffin oil was used to lubricate for urethral catheterization.The catheter was clamped and then reopened 30 min later.At 15 min before the end of surgery,80 mg Phloroglucinol,0.10 μg/kg sufentanil and an equal volume of normal saline were injected intravenously in group P,group S and group C,respec-tively.The catheter was removed when the patients were fully awake.The awakening time and extu-bation time were recorded.In addition,Riker sedation-agiation scale (SAS)score was documented at 5 min (T1),15 min (T2),30 min (T3),1 h (T4)and 2 h (T5)after extubation.The occurrence and severity of CRBD within 2 h after surgery,as well as occurrence of nausea and vomiting and respira- tory depression were recorded.Results Compared with group C,the SAS score at T1-T4and inci-dence and severity CRBD were decreased,whereas the emergence time and extubation time were pro-longed in group S.The SAS score at T1-T5,incidence and severity of CRBD were decreased (P<0.05),and no significant change was found in emergence time and extubation time in group P.Com-pared with group S,the SAS score at T1-T4was increased,whereas the SAS score at T5,incidence and severity of CRBD were decreased,and the emergence time and extubation time were shortened in group P (P<0.05).There was no significant difference in the incidence of nausea and vomiting,re-spiratory depression and extubation time among the three groups. Conclusion Dyclonine hydrochloride mucilage injected per urethra combined with phloroglucinolol injected intravenously at 1 5 min before the end of surgery can reduce the incidence and severity of CRBD during the recovery from anesthesia in the patients under general anesthesia.

A single-center randomized controlled study of the effect of dyclonine hydrochloride mucilage on bubble removing in bowel preparation / 中华消化内镜杂志

Objective To evaluate the effect of two dosages of the dyclonine hydrochloride mucilage on removing bubbles in bowel preparation before colonoscopy. Methods Data of 774 patients who received colonoscopy from November 2015 to April 2016 in People's Hospital of Xinjiang Uygur Autonomous Region were randomly divided into groups A, B and C. As the control group, group A only used four boxes of polyethylene glycol ( PEG) for bowel preparation and drank 50 mL water after bowel preparation;group B was given 10 mL dyclonine hydrochloride mucilage with 50 mL water after four boxes of PEG for bowel preparation;group C was given 20 mL dyclonine hydrochloride mucilage with 50 mL water after four boxes of PEG. Intestinal cleanliness, intraluminal gas bubbles and satisfaction were graded by endoscopic physicians. Polyps of less than 5 mm were recorded and adverse reactions were observed. Results There were no significant differences in intestinal cleanliness among groups A, B and C (P>0. 05).The intraluminal gas bubbles grading, physician satisfaction and detection rate of polyps of less than 5 mm of groups B and C were significantly better than those of group A( P<0. 01) , and group C was superior to group B in these variables ( P<0. 01) . The proportion of levelⅠandⅡin foam evaluation in group C was higher than that in group B ( P<0. 01) . Conclusion Dyclonine hydrochloride mucilage can eliminate the bubbles inside the intestine, and the effect of 20 mL dyclonine hydrochloride mucilage for bowel preparation is superior to 10 mL.

Assessment of the clinical effect of dyclonine combined with propofol in the application of painless gastros-copy / 实用医学杂志

Objective To investigate the safety and feasibility of dyclonine combined with propofol in the application of painless gastroscopy. Methods A total of 90 patients received the painless gastroscopy in our hospi-tal were enrolled from September to December 2016. They were divided into 3 groups according to the random number table(n=30):Dyclonine+propofol(DP)group,Fentanyl+propofol(FP)group,Propofol(P)group. The hemodynamic changes,adverse reaction,propofol dosage,time of gastroscopy examination and time of conscious recovery were observed and recorded. Results Compared with P group,the incidence of hypertension,tachycardia, choking cough,body movement and the dosage of propofol in DP group and FP group were significantly decreased (P<0.05,respectively). Compared with DP group,the incidence of respiratory depression,the time of gastroscopy examination and the time of Conscious recovery in FP group and P group were significantly increased (P < 0.01 , respectively). Compared with FP group,the incidence of nausea and vomiting in DP and P group were significantly decreased (P < 0.05 ,respectively). Conclusions Dyclonine combined with propofol reduced the incidence of cardiovascular response,choking cough,body movement,respiratory depression,and nausea and vomiting,with the reduced dosage of propofol ,the shorten gastroscopy examination time and the recovery time. Therefore ,dyclo-nine combined with propofol is a safe and feasible anaesthesia management for the painless gastroscopy.

A single-center randomized controlled study of the effect of dyclonine hydrochloride mucilage on bubble removing in bowel preparation / 中华消化内镜杂志

Objective To evaluate the effect of two dosages of the dyclonine hydrochloride mucilage on removing bubbles in bowel preparation before colonoscopy. Methods Data of 774 patients who received colonoscopy from November 2015 to April 2016 in People's Hospital of Xinjiang Uygur Autonomous Region were randomly divided into groups A, B and C. As the control group, group A only used four boxes of polyethylene glycol ( PEG) for bowel preparation and drank 50 mL water after bowel preparation;group B was given 10 mL dyclonine hydrochloride mucilage with 50 mL water after four boxes of PEG for bowel preparation;group C was given 20 mL dyclonine hydrochloride mucilage with 50 mL water after four boxes of PEG. Intestinal cleanliness, intraluminal gas bubbles and satisfaction were graded by endoscopic physicians. Polyps of less than 5 mm were recorded and adverse reactions were observed. Results There were no significant differences in intestinal cleanliness among groups A, B and C (P>0. 05).The intraluminal gas bubbles grading, physician satisfaction and detection rate of polyps of less than 5 mm of groups B and C were significantly better than those of group A( P<0. 01) , and group C was superior to group B in these variables ( P<0. 01) . The proportion of levelⅠandⅡin foam evaluation in group C was higher than that in group B ( P<0. 01) . Conclusion Dyclonine hydrochloride mucilage can eliminate the bubbles inside the intestine, and the effect of 20 mL dyclonine hydrochloride mucilage for bowel preparation is superior to 10 mL.

Assessment of the clinical effect of dyclonine combined with propofol in the application of painless gastros-copy / 实用医学杂志

Objective To investigate the safety and feasibility of dyclonine combined with propofol in the application of painless gastroscopy. Methods A total of 90 patients received the painless gastroscopy in our hospi-tal were enrolled from September to December 2016. They were divided into 3 groups according to the random number table(n=30):Dyclonine+propofol(DP)group,Fentanyl+propofol(FP)group,Propofol(P)group. The hemodynamic changes,adverse reaction,propofol dosage,time of gastroscopy examination and time of conscious recovery were observed and recorded. Results Compared with P group,the incidence of hypertension,tachycardia, choking cough,body movement and the dosage of propofol in DP group and FP group were significantly decreased (P<0.05,respectively). Compared with DP group,the incidence of respiratory depression,the time of gastroscopy examination and the time of Conscious recovery in FP group and P group were significantly increased (P < 0.01 , respectively). Compared with FP group,the incidence of nausea and vomiting in DP and P group were significantly decreased (P < 0.05 ,respectively). Conclusions Dyclonine combined with propofol reduced the incidence of cardiovascular response,choking cough,body movement,respiratory depression,and nausea and vomiting,with the reduced dosage of propofol ,the shorten gastroscopy examination time and the recovery time. Therefore ,dyclo-nine combined with propofol is a safe and feasible anaesthesia management for the painless gastroscopy.

Simultaneous Determination of Neomycin Sulfate and Hydrochloric Dyclonine in Compound Twain Oint-ments by HPLC-DAD-ELSD / 中国药师

Objective:To establish an HPLC-DAD-ELSD method for the simultaneous determination of neomycin sulfate and hy-drochloric dyclonine in compound Twaln ointments. Methods:The assay was performed on an Agilent ZOR BAXSB-C18 column(250 mm × 4. 6 mm, 5μm) with acetonitrile-water as the mobile phase with gradient elution at a flow rate of 1. 0 ml·min-1 . The detection wavelength of DAD was 282 nm. The evaporator temperature of ELSD was set at 50℃ and the nebulizer temperature was set at 60℃with the gas flow rate of 1. 6 L·min-1 . The column temperature was kept at 35℃. Results:The linear range of neomycin sulfate was 141. 54-323. 52 μg·mL-1(r=0. 999 6) with the average recovery of 98. 87%(RSD=0. 95%, n=9). The linear range of hydro-chloric dyclonine was 28. 00-64. 00 μg·mL-1(r=0. 999 6) with the average recovery of 99. 57%(RSD=1. 10%, n=9). Conclu-sion:The method is accurate, sensitive and reproducible, and under the same chromatographic conditions, the determination of all the active ingredients in compound Twaln ointments is achieved, which provides basis for the quality control.

An observation on effect and safety of application of dyclonine in orotracheal intubation / 中国中西医结合急救杂志

Objective To explore the efficacy and safety of dyclonine hydrochloride mucilage applied as a lubricant for orotracheal intubation. Methods A prospective study was conducted,144 patients with respiratory failure(RF)and clear consciousness admitted into Emergency Department of Xingtai People's Hospital in December 2010 to June 2013 for orotracheal intubation were randomly divided into experimental and control groups(each, 72 cases). Topical spray anesthesia onto the throat wall was applied for all the patients before orotracheal intubation. In the experimental group,the patients received 1%hydrochloric acid dyclonine mucilage as a lubricant,while in the control group,they received paraffin oil as a lubricant before the insertion of tracheal tube. The operating procedure of the insertion was in accord to the rules of orotracheal intubation in both groups. The changes of heart rate,systolic blood pressure,diastolic blood pressure,pulse oxygen saturation(SpO2),success rate of once tracheal intubation,incidence of choking cough,the time of tracheal intubation and dyclonine adverse reactions were observed. Results The heart rate,systolic and diastolic blood pressures were significantly higher and SpO2 was obviously lower after the intubation in both groups than those before the procedure,and the changes were more significant in the control group〔heart rate(bpm):135.2±9.9 vs. 98.1±8.1,systolic blood pressure(mmHg,1 mmHg=0.133 kPa):145.6±20.8 vs. 138.8±22.1,diastolic blood pressure(mmHg):96.1±17.6 vs. 82.9±22.8,SpO2:0.643±0.128 vs. 0.749±0.102, all P<0.05〕;the success rate of once tracheal intubation in experimental group was significantly higher than that in the control group〔98.6%(71 cases)vs. 84.7%(61 cases),P<0.01〕,the incidence of choking cough was obviously lower than that in the control group〔36.1%(26 cases)vs. 52.8%(38 cases),P<0.05〕,the time for insertion of tracheal tube in experimental group was also significantly shorter than that of control group(minutes:1.9±0.9 vs. 2.3±1.1,P<0.05). No drug adverse reactions occurred. Conclusion Compared with paraffin oil,dyclonine hydrochloride mucilage as a lubricant for tracheal intubation is a simpler and easier operation which has the advantages of having better anesthesia,effectively reducing the irritation of the throat wall,improving the success rate of intubation,being more tolerable by the patients,reducing the adverse reaction rate during insertion of tube and having no occurrence of drug adverse reactions,therefore dyclonine can be applied in tracheal intubation.

Preparation and Quality Control of Jumazhitong Film / 中国药房

OBJECTIVE:To prepare jumazhitong film and establish its quality control method.METHODS:The jumazhitong film former was made with PVOH-124 as the base,the content of the principal agent-dyclonine hydrochloride was determined by HPLC.RESULTS:Good linear relation was achieved when the detection concentration range of dyclonine hydrochloride was 40.8～408?g/ml(r=0.9 998),the average recovery was 101.3%(RSD=1.3%,n=6).CONCLUSION:The preparing technique of jumazhitong film former is simple,its quality is stable and the control method is feasible.