sodium-bicarbonate and Pharyngitis

The aim of this study was to determine the time to onset of pain relief from a single dose of a tablet formulation of paracetamol (acetaminophen) containing sodium bicarbonate (PSC).. A single oral dose of PSC or placebo was randomly administered to patients with acute sore throat under double-blind conditions. Patients rated their pain relief using a conventional categorical relief scale every 5 minutes during the first hour postdose to determine the time to onset of pain relief. They continued evaluations of pain relief at less frequent intervals to 6 hours postdose to confirm the overall analgesia of PSC compared with placebo. To determine if food had any effect on the onset of action of PSC, time to onset of analgesia by PSC was compared between patients in the fed and fasted states. Patients were randomized 3:1 to PSC:placebo based on whether they had eaten food within 2 hours of baseline. Adverse events were recorded by questioning throughout the study period.. A total of 241 patients were enrolled. Both treatment groups were well matched for age (mean, 20 years), sex (male:female ratio, approximately 1:1.5), sore throat duration (mean, 3 days) and severity (mean score, 8). PSC separated significantly from placebo beginning at 15 minutes postdose (P < or = 0.03). There was no difference for onset of analgesia between PSC in the fed and fasted states. PSC showed significantly greater total pain relief over 30 minutes, 1 hour, and 6 hours compared with placebo (all, P < 0.05). Both treatments were well tolerated and there were no serious adverse events.. PSC was effective beginning 15 minutes postdose and well tolerated compared with placebo in this population of adults with acute onset of sore throat pain.

Topics: Acetaminophen; Acute Disease; Administration, Oral; Adult; Analgesia; Analgesics, Non-Narcotic; Double-Blind Method; Drug Combinations; Female; Follow-Up Studies; Humans; Male; Pain; Pain Measurement; Pharyngitis; Sodium Bicarbonate; Treatment Outcome

We sought to determine the benefits of using alkalinized lidocaine 40 mg to fill the cuff of a tracheal tube (ETT) in combination with water-soluble gel lubrication to prevent post-intubation sore throat.. The work included an in vitro study of the diffusion of alkalinized lidocaine solution through the low-pressure, high-volume cuff of an ETT. We also performed a randomized controlled study (n=20 patients in each group) that included a group who received an alkalinized lidocaine-filled ETT cuff with lubrication of the tube using water-soluble gel (Group G), and two control groups who received an alkalinized lidocaine-filled cuff with ETT lubrication with water (Group W) or an air-filled cuff with ETT lubrication with water (Group C).. Water-soluble gel lubrication (Group G) produced a lower incidence of sore throat during the 24-h post-extubation period than lubrication with water alone in the cuffs filled with alkalinized lidocaine (Group W), and compared with the air control group. The ability of lidocaine to pass through the cuff of an ETT when water-soluble gel and/or water alone was used as a lubricant was similar, as determined by lidocaine plasma concentrations (C(max) 45 ng x ml(-1)). Cough and restlessness before tracheal extubation were decreased in patients with the alkalinized lidocaine-filled cuffs compared with the air-filled cuffs. After extubation, nausea, vomiting, dysphonia and hoarseness were greater for patients with air-filled cuffs compared with the lidocaine-filled cuffs. No significant difference between the groups was recorded in arterial blood pressure and heart rate. In vitro data suggest that the lower the NaHCO(3) injection volume, the greater the release of lidocaine across a low-pressure, high-volume cuff.. These data show benefits of using an alkalinized lidocaine-filled ETT cuff in combination with water-soluble gel lubrication in preventing post-intubation sore throat.

Topics: Adult; Anesthesia Recovery Period; Anesthesia, General; Anesthetics, Local; Female; Gels; Humans; Hydrogen-Ion Concentration; Intubation, Intratracheal; Lidocaine; Lubrication; Male; Middle Aged; Pharyngitis; Postoperative Complications; Sodium Bicarbonate; Solubility

We sought to evaluate the effect of filling an endotracheal tube cuff with 40 mg lidocaine alone (Group L) or alkalinized lidocaine (Group LB) in comparison to an Air Control group (Group C) on adverse emergence phenomena in a randomized controlled study (n = 25 in each group). The incidence of sore throat was decreased for Group LB in comparison to Group L during the 24 postextubation hours. The difference between Group L and Group C remained significant in the two postextubation hours only. Plasma lidocaine levels increased when lidocaine was alkalinized (C(max) were 62.5 +/- 34.0 ng/mL and 3.2 +/- 1.0 ng/mL for Groups LB and L, respectively). Cough and restlessness before tracheal extubation were decreased in Group LB compared with Group L and in Group L compared with Group C. Nausea, postoperative vomiting, dysphonia, and hoarseness were increased after extubation in Group C compared with the liquid groups, and a better tolerance was recorded with Group LB compared with Group L. The increase of arterial blood pressure and cardiac frequencies during the extubation period was less in the liquid groups than in the control group and less in Group LB compared with Group L. We concluded that use of intracuff alkalinized lidocaine is an effective adjunct to endotracheal intubation.. Use of 40 mg of alkalinized lidocaine, rather than lidocaine or air, to fill the endotracheal tube cuff reduces the incidence of sore throat in the postoperative period. This approach also decreases hemodynamic effects, restlessness, dysphonia, and hoarseness.

Topics: Anesthesia Recovery Period; Anesthesia, General; Anesthetics, Local; Cough; Double-Blind Method; Female; Humans; Hydrogen-Ion Concentration; Intubation, Intratracheal; Lidocaine; Male; Middle Aged; Pain, Postoperative; Patient Satisfaction; Pharyngitis; Postoperative Nausea and Vomiting; Respiration, Artificial; Sodium Bicarbonate