Topical Nasal Anesthesia and Laryngopharyngeal Sensory Testing: A Prospective, Double-Blind Crossover Study

2003 ◽  
Vol 112 (1) ◽  
pp. 14-16 ◽  
Author(s):  
Paul E. Johnson ◽  
Peter C. Belafsky ◽  
Gregory N. Postma
Keyword(s):  
Saline Solution ◽  
Topical Anesthesia ◽  
Nasal Administration ◽  
Sensory Testing ◽  
Double Blind ◽  
Discrimination Testing ◽  
Sensory Score ◽  
Cocaine Hydrochloride ◽  
Laryngeal Adductor Reflex ◽  
Topical Nasal Anesthesia

Laryngopharyngeal sensory discrimination testing (LPSDT) has become a popular means of detecting sensory deficits in patients with voice and/or swallowing complaints. During this procedure, transnasal fiberoptic laryngoscopy (TFL) using a specialized fiberoptic scope is performed in order to deliver discrete pulses of air to the laryngopharyngeal mucosa. Historically, topical anesthesia has been applied to the nasal mucosa to lessen discomfort during TFL. Because of the concern that topical nasal anesthesia could also anesthetize the laryngopharynx, it is usually not used during sensory testing. To prospectively compare LPSDT scores after the nasal administration of cocaine hydrochloride, oxymetazoline hydrochloride, and saline solution, we prospectively evaluated 15 subjects undergoing LPSDT. Each had the procedure performed on 3 separate occasions. Before examination, each patient was administered either 4% cocaine, 0.05% oxymetazoline, or saline solution by atomizer (2 sprays of 1-second duration to each naris). By the conclusion of the study, each patient had undergone sensory testing with each of the test agents. During each examination, the minimal air pulse eliciting the laryngeal adductor reflex was recorded for both sides of the laryngopharynx. Both patient and examiner were blinded to the test agent used. The mean sensory score for saline solution was 3.9 mm Hg. The sensory scores for oxymetazoline and cocaine were 3.4 and 3.5 mm Hg, respectively. When compared to saline solution and oxymetazoline independently, sensory testing of the laryngopharynx during which the nose was anesthetized with cocaine resulted in similar thresholds for eliciting the laryngeal adductor reflex (p = .40 and p = .85). We conclude that topical anesthesia can be applied to the nasal cavity during LPSDT without altering laryngeal sensation.

Diclofenac Sodium in Ureteral Colic: A Double-Blind Comparison Trial with Placebo

1983 ◽  
Vol 11 (5) ◽  
pp. 303-307 ◽  
Author(s):  
A Vignoni ◽  
A Fierro ◽  
G Moreschini ◽  
M Cau ◽  
A Agostino ◽  
...  
Keyword(s):  
Placebo Group ◽  
Saline Solution ◽  
Diclofenac Sodium ◽  
Complete Relief ◽  
Double Blind Study ◽  
Prostaglandin Synthetase ◽  
Double Blind ◽  
Ureteral Colic ◽  
Comparison Trial ◽  
Blind Comparison

A randomized prospective double-blind study of the analgesic effect of 75 mg intramuscular diclofenac sodium (Voltaren®), a potent prostaglandin synthetase inhibitor, versus placebo (saline solution) was carried out in 131 consecutive patients with acute ureteral colic. Diclofenac provided complete relief of pain 25 minutes after the injection in 59% of the cases, while placebo provided relief in 29% (p < 0·01). Forty patients in the placebo group and seventeen patients in the diclofenac group needed an open injection of 75 mg diclofenac intramuscularly after 25 minutes due to persistent pain. Fifty-four of the fifty-seven patients treated with an open injection of diclofenac achieved complete relief of pain after 30 minutes. There were no side-effects of the treatment.

Reducing the Pain of Local 1% Lidocaine Infiltration with a Preceding Bacteriostatic Saline Injection

2011 ◽  
Vol 101 (3) ◽  
pp. 223-230 ◽  
Author(s):  
Stephen L. Barrett ◽  
Jim Maxka ◽  
Jamie N. Mieras ◽  
Kimbal E. Cooper
Keyword(s):  
Benzyl Alcohol ◽  
Visual Analog Scale ◽  
Saline Solution ◽  
Prospective Trial ◽  
Injection Technique ◽  
Medical Procedure ◽  
Analog Scale ◽  
Double Blind ◽  
Scale Scores ◽  
Lidocaine Injection

Background: Lidocaine injection for local anesthesia is a common podiatric medical procedure. We tested the hypothesis that injection of bacteriostatic saline solution containing 0.9% benzyl alcohol before the lidocaine infiltration can reduce the burning caused by lidocaine injection. Methods: This double-blind prospective trial involved 45 participants who each received four injections in two areas of the dorsum of the foot and rated the perceived pain on a visual analog scale. The order of the injections was designed to disguise the control and intervention arms of the study. Results: The sensation of the lidocaine injection after the injection of saline was reduced significantly (P = .028). The percentage of lidocaine injections with visual analog scale scores of 0 increased by 36% after preinjection with bacteriostatic saline solution containing 0.9% benzyl alcohol. Conclusions: The fact that 40% of the intervention visual analog scale pain scores for lidocaine injections were 0 suggests that a near painless lidocaine injection technique is an achievable goal and that the present technique is a simple and inexpensive method of reducing the pain of lidocaine injections. (J Am Podiatr Med Assoc 101(3): 223–230, 2011)

Neuroprotective Effect of Reduced Glutathione on Oxaliplatin-Based Chemotherapy in Advanced Colorectal Cancer: A Randomized, Double-Blind, Placebo-Controlled Trial

2002 ◽  
Vol 20 (16) ◽  
pp. 3478-3483 ◽  
Author(s):  
Stefano Cascinu ◽  
Vincenzo Catalano ◽  
Luigi Cordella ◽  
Roberto Labianca ◽  
Paolo Giordani ◽  
...  
Keyword(s):  
Saline Solution ◽  
Neuroprotective Effect ◽  
Controlled Trial ◽  
Sensory Nerve ◽  
Clinical Activity ◽  
Double Blind ◽  
Double Blind Placebo ◽  
To Receive ◽  
Infusion Period ◽  
Toxicity Criteria

PURPOSE: We performed a randomized, double-blind, placebo-controlled trial to assess the efficacy of glutathione (GSH) in the prevention of oxaliplatin-induced neurotoxicity. PATIENTS AND METHODS: Fifty-two patients treated with a bimonthly oxaliplatin-based regimen were randomized to receive GSH (1,500 mg/m2 over a 15-minute infusion period before oxaliplatin) or normal saline solution. Clinical neurologic evaluation and electrophysiologic investigations were performed at baseline and after four (oxaliplatin dose, 400 mg/m2), eight (oxaliplatin dose, 800 mg/m2), and 12 (oxaliplatin dose, 1,200 mg/m2) cycles of treatment. RESULTS: At the fourth cycle, seven patients showed clinically evident neuropathy in the GSH arm, whereas 11 patients in the placebo arm did. After the eighth cycle, nine of 21 assessable patients in the GSH arm suffered from neurotoxicity compared with 15 of 19 in the placebo arm. With regard to grade 2 to 4 National Cancer Institute common toxicity criteria, 11 patients experienced neuropathy in the placebo arm compared with only two patients in the GSH arm (P = .003). After 12 cycles, grade 2 to 4 neurotoxicity was observed in three patients in the GSH arm and in eight patients in the placebo arm (P = .004). The neurophysiologic investigations (sural sensory nerve conduction) showed a statistically significant reduction of the values in the placebo arm but not in the GSH arm. The response rate was 26.9% in the GSH arm and 23.1% in the placebo arm, showing no reduction in activity of oxaliplatin. CONCLUSION: This study provides evidence that GSH is a promising drug for the prevention of oxaliplatin-induced neuropathy, and that it does not reduce the clinical activity of oxaliplatin.

A Double-Blind Randomized Comparison of the Effect and Tolerance of Varidase® versus Saline when Instilled in the Urinary Bladder in Patients with Catheter Problems

1986 ◽  
Vol 14 (2) ◽  
pp. 91-94 ◽  
Author(s):  
Håkan Andersson
Keyword(s):  
Urinary Bladder ◽  
Normal Saline ◽  
Saline Solution ◽  
Saline Group ◽  
Necrotic Tissue ◽  
Urinary Catheters ◽  
Double Blind ◽  
Treatment Groups ◽  
Blood Clots

Thirty-eight patients with problems with their urinary catheters were randomly treated with Varidase® or normal saline solution once a day for 10 days. Photographs were taken by using a cystoscope before treatment, at day 10 and day 24 after the commencement of treatment. The photographs were evaluated according to the occurrence of pus, debris, coagula and rubor. In the Varidase® group the improvements from baseline to day 10 and day 24 were statistically significant (p < 0·05) in all parameters while there were no statistically significant improvements in the saline group. Comparing the two treatment groups, regarding the changes from baseline to day 10 and day 24, it was statistically demonstrated that Varidase® was significantly more effective than saline in all parameters (p < 0·05). In conclusion, this study shows that Varidase® effectively cleans the urinary bladder from pus, fibrin, necrotic tissue and blood clots.

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