iothalamate-meglumine and Pain

Four, randomized, double blind comparisons of iohexol versus ionic media for peripheral angiography are summarized. Iohexol is safe, effective, and significantly less painful than ionic media for this indication.

Topics: Angiography; Blood Pressure; Clinical Trials as Topic; Contrast Media; Diatrizoate; Diatrizoate Meglumine; Double-Blind Method; Drug Tolerance; Female; Humans; Iodobenzoates; Iohexol; Iothalamate Meglumine; Male; Middle Aged; Nausea; Pain; Paresthesia; Random Allocation; Triiodobenzoic Acids; United States

Fifty patients were examined by ascending phlebography of both legs in a prospective, double blind, within-patient series. Each leg was randomly allocated to the examination using either iohexol 300 mg I/ml or meglumine iothalamate 280 mg I/ml as the contrast medium. Immediate side effects were recorded in all patients, and delayed effects in 45 patients. Statistical analysis using the chi-square test showed that iohexol produced significantly less immediate pain in the leg than meglumine iothalamate. Iohexol produced significantly less nausea, and vomiting during the injection than meglumine iothalamate. No significant difference was found in the incidence of delayed pain and swelling with either medium. The quality of the films produced by iohexol was significantly better than that obtained with meglumine iothalamate.

Topics: Adult; Aged; Clinical Trials as Topic; Contrast Media; Double-Blind Method; Drug Tolerance; Edema; Female; Flushing; Humans; Iodobenzoates; Iohexol; Iothalamate Meglumine; Leg; Male; Middle Aged; Pain; Phlebography; Random Allocation; Triiodobenzoic Acids

In patients with arteriosclerotic disease in the legs, peripheral angiography was performed double blind with the non-ionic contrast medium Iopamidol and the ionic medium iothalamate meglumine (Conray 60). Iopamidol caused less subjective adverse effects and less changes in blood pressure.

Topics: Aged; Angiography; Blood Pressure; Clinical Trials as Topic; Contrast Media; Double-Blind Method; Female; Heart Rate; Humans; Iopamidol; Iothalamate Meglumine; Iothalamic Acid; Male; Middle Aged; Pain

One hundred patients were examined by ascending phlebography of both legs in a prospective, double-blind, within-patient study. Each leg was randomly allocated to the examination using either lopamidol 61% as the contrast medium. Immediate side effects were recorded in all patients, and delayed effects in 46 patients. Statistical analysis using the chi-square test showed that lopamidol produced significantly less immediate and delayed pain in the foot and the leg than Conray. Iopamidol produced significantly less nausea and vomiting during the injection than Conray. There was no significant difference in the quality of the phlebograms with either of contrast medium.

Topics: Adolescent; Adult; Aged; Clinical Trials as Topic; Contrast Media; Double-Blind Method; Female; Humans; Iopamidol; Iothalamate Meglumine; Iothalamic Acid; Leg; Male; Middle Aged; Pain; Phlebography; Prospective Studies

Topics: Cavernous Sinus; Contrast Media; Humans; Iodamide; Iopamidol; Iothalamate Meglumine; Iothalamic Acid; Metrizamide; Orbit; Pain; Phlebography

The pain reaction to a new low osmolality contrast agent, sodium-methyl-glucamine-ioxaglate, in comparison to the conventional compound methylglucamine-ioxitalamate was tested and statistically evaluated in 12 patients using the visual analogue scale method. The intensity of pain experienced was significantly smaller following intra-arterial injection of the compound of low osmolality as compared to the conventional contrast agent.

Topics: Adult; Aged; Angiography; Clinical Trials as Topic; Contrast Media; Female; Humans; Injections, Intra-Arterial; Iodobenzoates; Iothalamate Meglumine; Male; Meglumine; Middle Aged; Osmolar Concentration; Pain; Random Allocation; Triiodobenzoic Acids

In a group of 51 patients metrizamide was compared in a double-blind fashion to meglumine ioxithalamate, the contrast medium currently in use at our department, with regard to sensations of warmth or pain elicited by the intra-arterial contrast injection. In all arteries of the head and neck metrizamide injections produce less painful reactions than injections of meglumine ioxithalamate. This difference, however, is statistically significant only for the external carotid and for the vertebral arteries, as pain reactions are much less often elicited in other vessels. It is concluded that in neuroradiology the favourable properties of metrizamide with respect to pain responses can best be utilized in 'sensitive' vascular areas (superselective external carotid angiography, spinal angiography, vertebral angiography).

Topics: Angiography; Double-Blind Method; Head; Humans; Iothalamate Meglumine; Metrizamide; Neck; Pain

Metrizamide, a non-ionic contrast medium of low osmolality was compared with meglumine ioxithalamate, the ionic angiographic contrast medium currently in use in our department in a double-blind study. Criteria upon which the comparison was based were: 1) the pain reaction of the patient upon intra-arterial contrast injection, 2) bradycardial reactions upon common carotid injection and 3) the quality of the contrast image. Metrizamide induced significantly less painful sensations than meglumine ioxithalamate in those vessels in which injections of contrast medium are frequently painful (external carotid artery, vertebral artery). No significant difference in the degree of bradycardia was caused by the two contrast media. The degree of bradycardia was also found to be poorly reproducible upon successive injections of the same contrast medium in the same patient, thus raising questions as to the suitability of this method for determining the toxicity of the contrast medium. The quality of the angiograms obtained did not differ significantly with the two media. Spasm, when it occurred during selective external carotid injections, was found to be independent of the contrast agent used, being correlated instead with the depth of distal advance of the catheter tip into the external carotid. Of the 51 patients included in the study, two patients suffered transient neurological deficit after angiography with metrizamide, and one patient suffered a permanent hemiplegia after angiography with meglumine ioxithalamate.

Topics: Aorta, Thoracic; Bradycardia; Carotid Arteries; Catheterization; Cerebral Angiography; Clinical Trials as Topic; Humans; Iothalamate Meglumine; Metrizamide; Pain; Vertebral Artery

The incidence of abdominal pain during hysterosalpingography was assessed from replies to postal questionnaires completed by 42 patients receiving Diaginol Viscous and 23 patients receiving Dimer X: the questionnaires were analysed using a double-blind technique. In the Diaginol Viscous group, 58.5% of patients experienced moderate or severe pain during the injection as compared with an incidence of only 19% in the group receiving Dimer X. In three of tha patients receiving Diaginol Viscous, there was brief loss of consciousness. Radiographic quality was satisfactory with both contrast media. After effects of hysterosalpingography were relatively common and included: lower abdominal pain; vaginal bleeding; temporary difficulty in walking; menstrual disturbances in subsequent periods. No correlation could be demonstrated between the type of medium used and the incidence of these after effects.

Topics: Clinical Trials as Topic; Female; Humans; Hysterosalpingography; Iothalamate Meglumine; Iothalamic Acid; Pain; Uterine Hemorrhage

Intra-arterial lidocaine has been utilized to decrease pain by administration prior to contrast material injections during aortofemoral arteriography in over 600 patients. Because this observation was uncontrolled, a double-blind study was performed in 15 patients comparing the effectiveness of intra-arterial lidocaine and saline in the control of pain from contrast material injections (methylglucamine iothalamate) in pelvic and peripheral arteriography. Two per cent lidocaine was compared with 1% lidocaine in the same manner in an additional 10 patients. Peripheral vein blood samples were obtained in 4 patients to measure the plasma concentration of lidocaine. Intra-arterial lidocaine is safe and effective in reducing pain from intra-arterial contrast agent injections.

Topics: Angiography; Aorta; Clinical Trials as Topic; Contrast Media; Double-Blind Method; Femoral Artery; Humans; Injections, Intra-Arterial; Iothalamate Meglumine; Lidocaine; Pain

Metrizamide and meglumine iocarmate (Dimer-X), which at present are the contrast media for myelography best tolerated by central nervous system, were compared in a double-blind test comprising a total of 86 patients, all with symptoms of lumbar or sacral root involvement. Symptoms appearing were recorded using a standard interview formula 24 hoaurs after myelography. EEG, routine laboratory analyses of CSF and neurologic examinations were also made. In some cases CSF paper electrophoresis, CSF pressure recordings and determination of CSF iodine content were obtained.

Topics: Adult; Aerophagy; Aged; Blood Cell Count; Clinical Trials as Topic; Contrast Media; Female; Headache; Humans; Iodobenzoates; Iothalamate Meglumine; Iothalamic Acid; Male; Metrizamide; Middle Aged; Myelography; Pain; Spinal Cord Diseases

This article presents a technically simple and more accurate approach to flexor hallucis longus (FHL) tenography than any we found reported in the literature.. Tenography is used to evaluate and treat tenosynovitis. Standard FHL tenography protocol involves either direct percutaneous access of the FHL synovial sheath posterior to the medial malleolus or indirect filling of the FHL sheath from an injection of the flexor digitorum longus (FDL) tendon sheath, which often communicates with the FHL tendon sheath. However, with these methods, difficulty entering the FHL sheath may be encountered. We adapted our technique to access the FHL sheath as it courses below the sustentaculum talus. Our early experience with five cases using this technique reflects a 100% success rate with accurate needle placement within the FHL tendon sheath, thereby improving procedural efficiency.

Topics: Adult; Ankle Injuries; Contrast Media; Female; Fluoroscopy; Humans; Iothalamate Meglumine; Magnetic Resonance Imaging; Pain; Retrospective Studies; Tendons; Tenosynovitis

Five asymptomatic subjects underwent provocative injections of the lateral atlanto-axial and atlanto-occipital joints.. This study isolated and stimulated the lateral atlanto-axial and atlanto-occipital joints via fluoroscopically guided intra-articular injections to determine if they are potential pain generators. If they are pain generators, preliminary pain pattern maps will be constructed.. The cervical zygapophyseal joints (C2-3 to C6-7) are potential pain generators as demonstrated by referred pain induced via isolated intra-articular joint injections in normal subjects. Tentative referral patterns based on direct mechanical stimulation of the lateral atlanto-axial and atlanto-occipital joints have not been reported.. Five volunteers without histories of upper cervical pain underwent two joint injections each. In all five subjects, the left atlanto-occipital and right lateral atlanto-axial joints were stimulated via injection of contrast medium causing distension of the joint capsule.. Referred pain was produced with all ten injections. The lateral atlanto-axial injections resulted in consistent referral patterns, whereas the atlanto-occipital referral patterns varied significantly. A tentative composite diagram of the experimentally induced pain was created for each joint.. This study confirms the nociceptive ability of these cervical synovial joints. This study may assist the clinician in the differential diagnosis of head and neck pain.

Topics: Adult; Atlanto-Axial Joint; Atlanto-Occipital Joint; Extravasation of Diagnostic and Therapeutic Materials; Female; Fluoroscopy; Humans; Injections, Intra-Articular; Iothalamate Meglumine; Male; Nociceptors; Pain; Pain Measurement

The pain patterns evoked by stimulation of normal cervical zygapophyseal joints were determined in five volunteers. Under fluoroscopic control, joints at segments C2-3 to C6-7 were stimulated by distending the joint capsule with injections of contrast medium. Each joint produced a clinically distinguishable, characteristic pattern of pain, which enabled the construction of pain charts that putatively could be of value in determining the segmental location of symptomatic joints in patients presenting with cervical zygapophyseal pain.

Topics: Cervical Vertebrae; Humans; Iothalamate Meglumine; Joints; Neck; Pain; Pain Measurement

This paper describes a new approach to the neurolytic block of the celiac plexus through the anterior abdominal wall using CT guidance. In 5 patients, CT guidance was used for needle placement and visualization of the spread of the injection. Once the pain has been relieved on completion of the neurolytic block, the radiologist proceeds with the biopsy. Pain relief was obtained in 80% of the cases after 2 weeks and in 60% after 6 months. No serious complications were observed. The anterior approach is simple and is useful in those patients with upper chronic abdominal pain scheduled for biopsy of the pancreas, and in those terminally ill patients who cannot tolerate the prone position.

Topics: Aged; Celiac Plexus; Humans; Iothalamate Meglumine; Male; Mepivacaine; Middle Aged; Nerve Block; Pain; Punctures; Tomography, X-Ray Computed

RCM have been observed to cause--during arthrography--the appearance of a slow onset painful symptomatology with the clinical characteristics of a slight and transient acute arthritis. These substances are supposed to set in a production of humoral mediators of inflammation with algogenic action--PGE2 in particular. During arthrography of the knee the release of synovial fluid PGE2 after RCM introduction was studied. Two RCM were compared: meglumine iothalamate and iopamidol. Twenty patients underwent arthrography of the knee: synovial fluid PGE2 concentration was measured both before and 15' after RCM introduction with 125I-RIA method. Results show a significant increase in PGE2 concentration after both iothalamate (p less than 0.0001) and iopamidol (p less than 0.01) --especially in iothalamate--treated patients (p less than 0.01). A physiopathologic mechanism about post-arthrographic pain and, more generally, about RCM toxicity is thus hypothesized.

Topics: Arthrography; Dinoprostone; Humans; Iopamidol; Iothalamate Meglumine; Knee Joint; Pain; Prostaglandins E; Radioimmunoassay; Synovial Fluid

In 41 patients peripheral angiography was performed with the non-ionic contrast medium metrizamide (Amipaque) and the ionic iothalamate meglumine (Conray 60). Amipaque was found to give less subjective adverse effects and less changes in blood pressure.

Topics: Adult; Aged; Angiography; Arteriosclerosis; Blood Pressure; Double-Blind Method; Drug Evaluation; Female; Heart Rate; Humans; Iothalamate Meglumine; Leg; Male; Metrizamide; Middle Aged; Pain; Paresthesia

Aortofemoral runoff angiography was performed 63 times in a total of 21 patients, each of whom was injected three times with different contrast materials (60% methylglucamine iothalamate, 78%) sodium methylglucamine iothalamate, and 76% sodium methylglucamine diatrizoate). Neither the examiner nor the patient was aware which contrast material was being given. Significantly fewer patients reported severe injection pain with methylglucamine iothalamate than with the other two agents.

Topics: Aortography; Contrast Media; Diatrizoate Meglumine; Femoral Artery; Humans; Iothalamate Meglumine; Pain

The adverse effects in a series of 50 lumbar myelographies with Amipaque were compared with those in a corresponding series, examined with Dimer-X. Side effects occurred in 58% of the cases examined with Amipaque and in 68% of the Dimer-X series. No seizures occurred in 58% of the cases examined with Amipaque and in 68% of the Dimer-X series. No seizures occurred in either series but slight fibrillations of fasciculations appeared in 2 Dimer-X patients. Hyperreflexia of the legs was recorded in 22% of the Amipaque and in 36% of the Dimer-X cases. Other adverse reactions to the media were mild to moderate. Some burst activity, but no definite paroxysmal abnormality was noted in EEG recordings in 2 Amipaque cases. The low epileptogenicity of Amipaque has ensured a wider safety margin of lumbar myelography.

Topics: Adult; Aged; Brain; Diazepam; Drug Evaluation; Electroencephalography; Female; Fever; Headache; Humans; Iodobenzoates; Iothalamate Meglumine; Iothalamic Acid; Lumbosacral Region; Male; Metrizamide; Middle Aged; Myelography; Nausea; Pain; Premedication; Seizures

Lumbar myelography with dimeglumine iocarmate was performed in 90 cases premedicated with diazepam (Valium). EEG was performed before, as well as 3 and 24 hours after myelography. The use of diazepam interfered to some extent with the interpretation of the EEG. In 3 cases EEG abnormalities occurred 3 hours after myelography, most probably ascribable to Dimer-X. No further changes were found in the 24-hour recording. Immediate side effects were few and mild and seizures did not appear. The EEG abnormalities were equally distributed among patients with and without side effects.

Topics: Adolescent; Adult; Aged; Electroencephalography; Female; Headache; Humans; Iothalamate Meglumine; Iothalamic Acid; Male; Middle Aged; Myelography; Nausea; Pain; Seizures; Time Factors