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Senol Celik S, Chalkias A, Sariköse S, Nur Arslan H, Bahramifar A, Rahimi-Bashar F, Ait Hssain A, Hashemi S, Vahedian-Azimi A. Effect of peri-intubation non-pharmacological interventions on postoperative laryngeal symptoms: A systematic review with meta-analysis and meta-regression. Intensive Crit Care Nurs 2024; 84:103728. [PMID: 38861781 DOI: 10.1016/j.iccn.2024.103728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Revised: 04/27/2024] [Accepted: 05/22/2024] [Indexed: 06/13/2024]
Abstract
OBJECTIVES To evaluate the effectiveness of peri-intubation non-pharmacological interventions in reducing postoperative sore throat (POST), cough (PEC), and hoarseness in surgical patients. DESIGN A systematic review with meta-analysis and meta-regression. SETTING Elective surgery under general anesthesia in operating rooms. MAIN OUTCOME MEASURES Evaluate the impact of non-pharmacological interventions, including pre-intubation (gargling with Sodium Azulene Sulfonate, licorice, or using Strepsils tablets of honey and lemon lozenge), during-intubation (inflating the TT cuff with normal saline and softening the ETT cuff with warm normal saline), and post-intubation (cold vapor therapy, gargling with honey lemon water, and using green tea gargle), on the occurrence of POST, PEC, and hoarseness. RESULTS Nineteen trials with 2,136 participants were included. Pre-intubation intervention significantly reduced POST immediately after extubation (n = 861; OR: 0.28, 95 % CI: 0.20-0.38, P < 0.001), and 24 h post-extubation (n = 1006; OR: 0.21, 95 % CI: 0.16-0.28, P < 0.001). During-intubation intervention did not show significant effects on POST. Pre-intubation intervention also reduced POST-associated pain score at 24 h post-extubation (n = 440; MD: -0.50, 95 % CI: -0.81 to -0.18, P < 0.001). Post-intubation interventions were effective in reducing POST-associated pain scores at different time points post-extubation (P < 0.05). Pre-intubation intervention significantly reduced PEC (OR: 0.13, 95 % CI: 0.02-0.70, P = 0.02) and hoarseness (OR: 0.36, 95 %CI: 0.15-0.86, P = 0.02) at 24 h post-extubation. However, during-intubation interventions did not reduce hoarseness at 24 h post-extubation. CONCLUSION Pre-intubation non-pharmacological interventions were found to be the most effective in reducing the incidence and severity of POST, PEC, and hoarseness. IMPLICATIONS FOR CLINICAL PRACTICE Implementing pre-intubation non-pharmacological interventions can be beneficial for bedside nurses and healthcare professionals in reducing postoperative complications and nurses can contribute to improving patient comfort and recovery outcomes following surgery. SYSTEMATIC REVIEW PROTOCOL The protocol was registered in the PROSPERO international prospective register of systematic reviews on 2 January 2024 (CRD42023492813).
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Affiliation(s)
| | - Athanasios Chalkias
- Institute for Translational Medicine and Therapeutics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA; Outcomes Research Consortium, Cleveland, OH 44195, USA; Department of Intensive Care Medicine, Tzaneio General Hospital, Piraeus, Greece.
| | - Seda Sariköse
- Koç University, School of Nursing, İstanbul, Turkey.
| | | | - Ali Bahramifar
- Trauma Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Farshid Rahimi-Bashar
- Anesthesia and Critical Care Department, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ali Ait Hssain
- Medical Intensive Care Unit, Hamad General Hospital, PO BOX 3050, Doha, Qatar; Department of Medicine, Weill Cornell Medicine, New York, Doha, Qatar
| | - Saeed Hashemi
- Trauma Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Amir Vahedian-Azimi
- Trauma Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran.
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Sun X, Lan Z, Shi Q, Wu H, Lu G, Qiu Y, Tang Y, Qiao G. Persistent cough after pulmonary resection: Minor issue, major hurdle. Heliyon 2024; 10:e31338. [PMID: 38826748 PMCID: PMC11141375 DOI: 10.1016/j.heliyon.2024.e31338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 05/14/2024] [Accepted: 05/14/2024] [Indexed: 06/04/2024] Open
Abstract
Background Persistent cough is one of the most common complications following pulmonary resection, that impairs patients' quality of life and prolongs recovery time. However, a comprehensive review of persistent cough after pulmonary resection (CAP) has not been performed. Methods A literature search of PubMed/MEDLINE, Web of Science, and Embase database was conducted for persistent-CAP up to June 2023. Subsequent qualitative systematic review focused on definition, risk factors, prevention, and treatment of persistent-CAP. Results Persistent-CAP stands as a prevalent postoperative complication subsequent to pulmonary resection procedures. with an incidence of 24.4-55.0 %. Although persistent-CAP has a minor impact on survival, this condition is of critical importance because it presents a major hurdle in recovery after surgery. In this review, we proposed a systemic definition for persistent-CAP based on available evidence and our own data. Several assessment tools used to assess severity of persistent-CAP are also introduced. Risk factors associated with persistent-CAP are explored, including surgical approaches, resection extent, surgical site, lymph node dissection, postoperative gastroesophageal acid reflux, tracheal intubation anesthesia, preoperative comorbidity, and sex among others. Surgical and anesthesia preventions targeting risk factors to prevent persistent-CAP are elaborated. A number of studies have shown that a multidisciplinary approach can effectively relieve persistent-CAP. Conclusions Although the mechanisms underlying persistent-CAP are still unclear, existing studies demonstrated that persistent-CAP is related to surgical and anesthesia factors. Therefore, in the future, prevention and treatment should be developed based on risk factors to overcome the hurdle of persistent-CAP.
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Affiliation(s)
- Xuefeng Sun
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
- Department of Thoracic Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, China
- Department of Thoracic Surgery, The Second Clinical Medical College of Jinan University, The First Affiliated Hospital of Southern University of Science and Technology, Shenzhen People's Hospital, Shenzhen, China
| | - Zihua Lan
- Department of Thoracic Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, China
- Shantou University Medical College, Shantou, China
| | - Qiuling Shi
- Center for Cancer Prevention Research, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Hansheng Wu
- Department of Thoracic Surgery, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Guojie Lu
- Department of Thoracic Surgery (Respiratory Center Area 1), Guangzhou Panyu Central Hospital, Guangzhou, China
| | - Yuan Qiu
- Department of Thoracic Surgery/Oncology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Disease, China State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou, China
| | - Yong Tang
- Department of Thoracic Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, China
| | - Guibin Qiao
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
- Department of Thoracic Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, China
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Shui W, Hu W, Ma W, Han Y, Hao IY, Zhu S, Sun Y, Deng Z, Gao Y, Heng L, Zhu S. The effects of video double-lumen tubes on intubation complications in patients undergoing thoracic surgery: A randomised controlled study. Eur J Anaesthesiol 2024; 41:305-313. [PMID: 38298060 PMCID: PMC10906194 DOI: 10.1097/eja.0000000000001959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
Abstract
BACKGROUND Tracheal injuries, vocal cord injuries, sore throat and hoarseness are common complications of double-lumen tube (DLT) intubation. OBJECTIVE This study aimed to evaluate the effects of 'video double-lumen tubes' (VDLTs) on intubation complications in patients undergoing thoracic surgery. DESIGN A randomised controlled study. SETTINGT Xuzhou Cancer Hospital, Xuzhou, China, from January 2023 to June 2023. PATIENTS One hundred eighty-two patients undergoing elective thoracic surgery with one-lung ventilation were randomised into two groups: 90 in the DLT group and 92 in the VDLT group. INTERVENTION VDLT was selected for intubation in the VDLT group, and DLT was selected for intubation in the DLT group. A fibreoptic bronchoscope (FOB) was used to record tracheal and vocal cord injuries. MAIN OUTCOME MEASURES The primary outcomes were the incidence of moderate-to-severe tracheal injury and the incidence of vocal cord injury. The secondary outcomes included the incidence and severity of postoperative 24 and 48 h sore throat and hoarseness. RESULTS The incidence of moderate-to-severe tracheal injury was 32/90 (35.6%) in the DLT group, and 45/92 (48.9%) in the VDLT group ( P = 0.077; relative risk 1.38, 95% CI, 0.97 to 1.95). The incidence of vocal cord injury was 31/90 (34.4%) and 34/92 (37%) in the DLT and VDLT groups, respectively ( P = 0.449). The incidence of postoperative 24 h sore throat and hoarseness was significantly higher in the VDLT group than in the DLT group (for sore throat: P = 0.032, relative risk 1.63, 95% CI, 1.03 to 2.57; for hoarseness: P = 0.018, relative risk 1.48, 95% CI, 1.06 to 2.06). CONCLUSION There was no statistically significant difference in the incidence of moderate-to-severe tracheal injury and vocal cord injury between DLTs and VDLTs. While improving the first-attempt success rate, intubation with VDLT increased the incidence of postoperative 24 h sore throat and hoarseness. TRIAL REGISTRATION Chinese Clinical Trial Registry identifier: ChiCTR2300067348.
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Affiliation(s)
- Weikang Shui
- From the Jiangsu Province Key laboratory of Anaesthesiology, Xuzhou Medical University (WS, WH, YS, ZD, SZ), Department of Anaesthesiology, Xuzhou Cancer Hospital, Xuzhou (WM, YH, SZ, LH, SZ), California State University, Los Angeles, USA (IYH) and Jiangsu University, Zhenjiang, Jiangsu, China (YG)
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Chen Z, Jin Y, Lu G, Jin Y, Feng C, Zhao X. Preoperative Ultrasound-Guided Internal Branch Block of Superior Laryngeal Nerve Reduces Postoperative Sore Throat Caused by Double Lumen Endotracheal Intubation: A Randomized Trial. Anesth Analg 2023; 137:1270-1278. [PMID: 37227947 DOI: 10.1213/ane.0000000000006534] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
BACKGROUND Postoperative sore throat (POST) is one of the more common side effects of tracheal intubation patients under general anesthesia (GA) after extubation using double-lumen endobronchial tubes (DLTs). The internal branches of the superior laryngeal nerve (SLN) block (iSLNB) have been reported to anesthetize the larynx for airway manipulation (such as awake tracheal intubation) and pain treatment efficiently. We hypothesized that ultrasound-guided iSLNB (US-guided iSLNB) combined with GA would ameliorate the incidence and severity of POST and hoarseness. METHODS Patients (n = 82) undergoing thoracoscopic resection of pulmonary nodules/lobes/segments with one-lung ventilation (OLV) under GA were randomized into 2 groups depending on whether performed with iSLNB (S group, n = 41) or not (C group, n = 41) under GA. Patients in the S group received US-guided iSLNB bilaterally before surgery. POST and hoarseness were assessed at 2, 6, and 24 hours after surgery. The primary outcome of this study was the incidence of POST at 6 hours after surgery between groups. RESULTS The overall accumulated incidence of POST was lower in the S goup than in the C group (9/41 vs 20/41; 95% CI, 0.30 [0.11-0.77]; P = .011). The incidence and severity of POST was lower in the S group than in the C group at 2 hours (9/41 vs 20/41; 95% CI, 0.30 [0.11-0.77]; P = .008 and P = .004) and 6 hours after (7/41 vs 17/41; 95% CI, 0.29 [0.10-0.81]; P = .012 and P = .015) surgery. The incidence and severity of POST at 24 hours after surgery was nonsignificant. However, the incidence and severity of hoarseness was comparable between the 2 groups at 2, 6, and 24 hours after surgery. CONCLUSIONS Preoperative US-guided iSLNB could significantly ameliorate the incidence and severity of POST induced by double-lumen bronchial catheter intubation.
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Affiliation(s)
- Zheping Chen
- From the Department of Anesthesiology, the Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yanwu Jin
- From the Department of Anesthesiology, the Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Guodong Lu
- From the Department of Anesthesiology, the Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yuelong Jin
- Department of Epidemiology and Health Statistics, School of Public Health, Wannan Medical College, Wuhu, China
| | - Chang Feng
- From the Department of Anesthesiology, the Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xin Zhao
- From the Department of Anesthesiology, the Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
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Liang J, Liu J, Qiu Z, Sun G, Xiang P, Hei Z, Li X. Effect of Esketamine Gargle on Postoperative Sore Throat in Patients Undergoing Double-Lumen Endobronchial Intubation: A Randomised Controlled Trial. Drug Des Devel Ther 2023; 17:3139-3149. [PMID: 37876501 PMCID: PMC10591602 DOI: 10.2147/dddt.s430077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 10/09/2023] [Indexed: 10/26/2023] Open
Abstract
Background Postoperative sore throat is a frequent adverse event after double-lumen endobronchial tube (DLT) intubation. The aim of this study was to investigate whether esketamine gargle has a preventive effect on the incidence of postoperative sore throat in patients undergoing DLT intubation. Methods This trial included 140 patients undergoing elective thoracic surgery at the third affiliated hospital of Sun Yat-Sen University. Patients were randomly allocated into the following two groups of 70 patients each: the control group, gargling with saline of 30 mL, and the esketamine group, gargling with an esketamine solution of 30 mL (2 mL/50 mg esketamine in 28 mL saline), 5 min prior to anaesthesia induction. The primary outcome was the incidence of sore throat 24 h after surgery. The main secondary outcomes included the incidence of sore throat and hoarseness at 1 h and 48 h after surgery, as well as the intraoperative haemodynamic responses. Results The incidence of sore throat was significantly higher in the control group (47.1%, 33/70 patients) compared with the esketamine group (12.9%, 9/70 patients) at 24 h after surgery (RD, 0.41; 95% confidence interval, 0.26-0.57; p < 0.001). Furthermore, the incidence of sore throat at 1 h (p = 0.027), 24 h (p = 0.019), and seventh day (p = 0.031) as well as hoarseness at 1 h (p = 0.027), 24 h (p = 0.019), and 48 h (p = 0.031) after surgery were reduced in the esketamine group. Significant differences were seen in the peak levels of systolic blood pressure, mean arterial blood pressure, and heart rate between the groups during the intubation (p < 0.05). Besides, no patient developed an adverse reaction to esketamine. Conclusion Preoperative gargling of esketamine can provide an effect against sore throat after DLT intubation without adverse side effects and effectively inhibit sharp elevations in heart rate and blood pressure during double-lumen intubation procedures.
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Affiliation(s)
- Jianfen Liang
- Department of Anesthesiology, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510630, People’s Republic of China
| | - Jun Liu
- Department of Anesthesiology, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510630, People’s Republic of China
| | - Zhuolin Qiu
- Department of Anesthesiology, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510630, People’s Republic of China
| | - Guoliang Sun
- Department of Anesthesiology, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510630, People’s Republic of China
| | - Ping Xiang
- Department of Medical Quality Management, Nanfang Hospital, Southern Medical University, Guangzhou, 510630, People’s Republic of China
| | - Ziqing Hei
- Department of Anesthesiology, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510630, People’s Republic of China
| | - Xiang Li
- Department of Anesthesiology, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510630, People’s Republic of China
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He L, Kang Q, Zhang Y, Chen M, Wang Z, Wu Y, Gao H, Zhong Z, Tan W. Glycyrrhizae Radix et Rhizoma: The popular occurrence of herbal medicine applied in classical prescriptions. Phytother Res 2023. [PMID: 37196671 DOI: 10.1002/ptr.7869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 04/14/2023] [Accepted: 04/25/2023] [Indexed: 05/19/2023]
Abstract
Glycyrrhizae Radix et Rhizoma is a well-known herbal medicine with a wide range of pharmacological functions that has been used throughout Chinese history. This review presents a comprehensive introduction to this herb and its classical prescriptions. The article discusses the resources and distribution of species, methods of authentication and determination chemical composition, quality control of the original plants and herbal medicines, dosages use, common classical prescriptions, indications, and relevant mechanisms of the active content. Pharmacokinetic parameters, toxicity tests, clinical trials, and patent applications are discussed. The review will provide a good starting point for the research and development of classical prescriptions to develop herbal medicines for clinical use.
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Affiliation(s)
- Luying He
- School of Pharmacy, Lanzhou University, Lanzhou, China
| | - Qianming Kang
- School of Pharmacy, Lanzhou University, Lanzhou, China
| | - Yang Zhang
- School of Pharmacy, Lanzhou University, Lanzhou, China
| | - Man Chen
- Oncology Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Zefei Wang
- School of Pharmacy, Lanzhou University, Lanzhou, China
| | - Yonghui Wu
- School of Pharmacy, Lanzhou University, Lanzhou, China
| | - Hetong Gao
- School of Pharmacy, Lanzhou University, Lanzhou, China
| | - Zhangfeng Zhong
- Macao Centre for Research and Development in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao SAR, China
| | - Wen Tan
- School of Pharmacy, Lanzhou University, Lanzhou, China
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Murugaiyan A, Sahoo AK, Rao PB, Misra S. Effect of 5% EMLA Cream on Postoperative Sore Throat in Adults Following General Endotracheal Anesthesia: A Randomized Placebo-Controlled Study. Anesth Analg 2023; 136:338-345. [PMID: 36638513 DOI: 10.1213/ane.0000000000006269] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Postoperative sore throat (POST) is a distressing complaint in adults after endotracheal intubation. This study aimed to evaluate the effect of topical application of a eutectic mixture of local anesthetics (EMLA) cream over the endotracheal tube (ETT) cuff on the incidence and severity of POST, cough, and hoarseness of voice in adults after surgery. METHODS In this randomized, placebo-controlled study, adult patients 18 to 65 years old, in American Society of Anesthesiologists (ASA) physical status I and II, and of either sex were scheduled to receive 5% EMLA cream (intervention arm) or lubricant gel (placebo-controlled arm) applied over the ETT cuff. POST was graded as none (0), mild (1), moderate (2), or severe (3). A score of ≥2 was considered as significant POST. The incidence of POST at the sixth postoperative hour was the primary outcome. Secondary outcomes included the incidence of POST at 0, second, and 24 hours, and the incidence of significant POST (score ≥2). The incidence and severity of postoperative cough and hoarseness of voice were recorded simultaneously. RESULTS Two hundred and four patients completed the study. The incidence of POST was significantly lower in the EMLA group versus placebo at the sixth postoperative hour (4.9% vs 40.1%; relative risk [RR], 0.12; 95% confidence interval [CI], 0.05-0.29; P < .001); and at 0 hour (74.5% vs 93.1%; RR, 0.8; 95% CI, 0.7-0.9; P < .001) and second hour (51.9% vs 84.3%; RR, 0.61; 95% CI, 0.5-0.75; P < .001) but comparable at 24 hours (1.9% vs 3.9%; RR, 0.5; 95% CI, 0.09-2.67; P = .4). The number needed to treat to prevent POST with EMLA cream application was 5 at 0 hour and 3 at the second and sixth hour. The proportion of patients with significant POST over 24 hours were less in the EMLA group (9.8% vs 43.1%; P < .001). The incidence of postoperative cough and hoarseness of voice was significantly less at the 0, second, and sixth hours in the EMLA group, but comparable at 24 hours. The incidence of severe cough (8.8% vs 31.4%; P < .001) and hoarseness of voice (2% vs 7.4%; P < .001) over 24 hours was less in the EMLA group. CONCLUSIONS The application of EMLA cream over ETT cuff reduces the incidence and severity of POST, cough, and hoarseness of voice in adults after general anesthesia in the early postoperative period compared to lubricant gel.
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Affiliation(s)
- Abishek Murugaiyan
- From the Department of Anesthesiology and Critical Care, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, India
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Chen ZY, Lin YM, Wu JH, Fu YY, Xu XT, Li Y, Chen LH, Xu LM. Does the periportal end of a double-lumen endobronchial tube need to be fixed to prevent dislocation of the cuffed end caused by a change in position? A randomized controlled trial. Ann Med 2023; 55:2247422. [PMID: 37619404 PMCID: PMC10453979 DOI: 10.1080/07853890.2023.2247422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 08/02/2023] [Accepted: 08/08/2023] [Indexed: 08/26/2023] Open
Abstract
OBJECTIVE This study aimed to evaluate the effects on the dislocation and misalignment of the cuffed end of a double-lumen endobronchial tube (DLT) when a patient moves from a horizontal to a lateral position without fixation. METHODS A total of 148 patients who had undergone video-assisted thoracoscope surgery were enrolled and randomly divided into two groups: a group in which the periportal end of the DLT was fixed with tape (group I; n = 74) and a group in which the periportal end of the DLT remained unfixed (group II; n = 74). Both groups were given an intravenous induction for double-lumen endobronchial intubation and then moved from a horizontal position to a lateral position, after which the alignment of the bronchial cuffed end of the DLT was assessed using a fiberoptic bronchoscope. RESULTS After lateral position, the dislocation rate of group I and group II was 44.6% and 20.2%, and the misalignment rate was 27.0% and 8.1%, respectively, the incidence of dislocation and misalignment was significantly lower in group II than in group I after the change to a lateral position (p < 0.05). After lateral position, the total rate of airway injury was 25.7% in group I and 5.4% in group II, the incidence of airway injury was significantly lower in group II than in group I (p < 0.05), as was the incidence of sore throat, hoarseness, and cough on postoperative day 1 (p < 0.05). The average outward dislocation of the periportal end of the DLT in group II was 1.5 cm. CONCLUSION A DLT without periportal fixation is less likely to be displaced and poorly aligned when the patient moves from a horizontal to a lateral position, which could facilitate intra-operative management and reduce the incidence of postoperative complications.
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Affiliation(s)
- Zhi-yuan Chen
- Department of Anesthesiology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Yu-mei Lin
- Department of Anesthesiology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Jian-hua Wu
- Department of Anesthesiology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Yu-yu Fu
- Department of Anesthesiology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Xiao-ting Xu
- Department of Anesthesiology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Yan Li
- Department of Anesthesiology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Li-hong Chen
- Department of Anesthesiology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Li-ming Xu
- Department of Anesthesiology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
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Wang J, Chai B, Zhang Y, Zheng L, Geng P, Zhan L. Effect of postoperative ultrasound-guided internal superior laryngeal nerve block on sore throat after intubation of double-lumen bronchial tube: a randomized controlled double-blind trial. BMC Anesthesiol 2022; 22:276. [PMID: 36050629 PMCID: PMC9434849 DOI: 10.1186/s12871-022-01819-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 08/22/2022] [Indexed: 11/29/2022] Open
Abstract
Background Postoperative sore throat (POST) is one of the main adverse postoperative outcome after tracheal intubation using double-lumen endobronchial tubes (DLTs). The aim of this study was to investigate the effectiveness and safety of ultrasound (US)-guided block of the internal branch of the superior laryngeal nerve (iSLN) for alleviating POST after intubation of DLTs. Methods Patients undergoing thoracic surgery between August 2019 and August 2021 were randomized into two groups depending on whether they received US-guided iSLN block immediately after the operation. In the control group, the patients underwent a thoracic surgery under general anesthesia (GA) with DLTs without any special treatment, while the patients in the experimental group received US-guided iSLN block bilaterally with 2 ml of 0.25% ropivacaine on either side immediately after the operation. The primary outcome was the grading of sore throat at three-time points after the operation, i.e., immediate extubation, 2 h after extubation, and 24 h after extubation. Secondary outcomes included the rate of nausea and vomiting, hoarseness, dyspnea, and choking cough after swallowing saliva at 2 h after extubation. Results The incidence and severity of sore throat were significantly lower in the experimental group than the control group at all time intervals (all P < 0.01). The rate of nausea and vomiting, hoarseness, dyspnea, and choking cough after swallow saliva at 2 h after extubation had no statistical difference (all P > 0.05). Conclusions The use of US-guided iSLN block can be effectively and safely applied to relieve POST after intubation of DLTs on thoracic surgery. Trial registration The study protocol was registered at the Chinese Clinical Trial Registry (http://www.chictr.org.cn, NO. ChiCTR2000032188, 22/04/2020).
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Affiliation(s)
- Jingxian Wang
- Department of Anesthesiology, Lu'an Affiliated Hospital of Anhui Medical University, No.21 West Wanxi Road, Jinan District, Lu'an, 237000, Anhui, China
| | - Bin Chai
- Department of Anesthesiology, Zhongshan Hospital Affiliated to Xiamen University, Xiamen, Fujian, China
| | - Yujie Zhang
- Department of Anesthesiology, Lu'an Affiliated Hospital of Anhui Medical University, No.21 West Wanxi Road, Jinan District, Lu'an, 237000, Anhui, China
| | - Lidong Zheng
- Department of Anesthesiology, Lu'an Affiliated Hospital of Anhui Medical University, No.21 West Wanxi Road, Jinan District, Lu'an, 237000, Anhui, China
| | - Pengcheng Geng
- Department of Anesthesiology, Lu'an Affiliated Hospital of Anhui Medical University, No.21 West Wanxi Road, Jinan District, Lu'an, 237000, Anhui, China
| | - Li Zhan
- Department of Anesthesiology, Lu'an Affiliated Hospital of Anhui Medical University, No.21 West Wanxi Road, Jinan District, Lu'an, 237000, Anhui, China.
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Wang KL, Yu YC, Chen HY, Chiang YF, Ali M, Shieh TM, Hsia SM. Recent Advances in Glycyrrhiza glabra (Licorice)-Containing Herbs Alleviating Radiotherapy- and Chemotherapy-Induced Adverse Reactions in Cancer Treatment. Metabolites 2022; 12:metabo12060535. [PMID: 35736467 PMCID: PMC9227067 DOI: 10.3390/metabo12060535] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 05/31/2022] [Accepted: 06/02/2022] [Indexed: 11/16/2022] Open
Abstract
Cancers represent a significant cause of morbidity and mortality worldwide. They also impose a large economic burden on patients, their families, and health insurance systems. Notably, cancers and the adverse reactions to their therapeutic options, chemotherapy and radiotherapy, dramatically affect the quality of life of afflicted patients. Therefore, developing approaches to manage chemotherapy- and radiotherapy-induced adverse reactions gained greater attention in recent years. Glycyrrhiza glabra (licorice), a perennial plant that is one of the most frequently used herbs in traditional Chinese medicine, has been heavily investigated in relation to cancer therapy. Licorice/licorice-related regimes, used in combination with chemotherapy, may improve the adverse effects of chemotherapy. However, there is little awareness of licorice-containing herbs alleviating reactions to radiotherapy and chemotherapy, or to other induced adverse reactions in cancer treatment. We aimed to provide a descriptive review, and to emphasize the possibility that licorice-related medicines could be used as an adjuvant regimen with chemotherapy to improve quality of life (QoL) and to reduce side effects, thus, improving compliance with chemotherapy. The experimental method involved searching different databases, including PubMed, the Cochrane Library, and Wang Fang database, as of May 2022, to identify any relevant studies. Despite a lack of high-quality and large-scale randomized controlled trials, we still discovered the potential benefits of licorice-containing herbs from published clinical studies. These studies find that licorice-containing herbs, and their active ingredients, reduce the adverse reactions caused by chemotherapy and radiotherapy, and improve the QoL of patients. This comprehensive review will serve as a cornerstone to encourage more scientists to evaluate and develop effective Traditional Chinese medicine prescriptions to improve the side effects of chemotherapy and radiation therapy.
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Affiliation(s)
- Kai-Lee Wang
- Department of Nursing, Ching Kuo Institute of Management and Health, Keelung 20301, Taiwan;
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei 11031, Taiwan; (H.-Y.C.); (Y.-F.C.)
| | - Ying-Chun Yu
- Sex Hormonal Research Center, Department of Obstetrics and Gynecology, China Medical University Hospital, Taichung 40403, Taiwan;
- Graduate Institute of Biomedical Sciences, Center for Tumor Biology, School of Medicine, China Medical University, Taichung 40403, Taiwan
| | - Hsin-Yuan Chen
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei 11031, Taiwan; (H.-Y.C.); (Y.-F.C.)
| | - Yi-Fen Chiang
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei 11031, Taiwan; (H.-Y.C.); (Y.-F.C.)
| | - Mohamed Ali
- Clinical Pharmacy Department, Faculty of Pharmacy, Ain Shams University, Cairo 11566, Egypt;
| | - Tzong-Ming Shieh
- School of Dentistry, China Medical University, Taichung 40403, Taiwan;
| | - Shih-Min Hsia
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei 11031, Taiwan; (H.-Y.C.); (Y.-F.C.)
- Graduate Institute of Metabolism and Obesity Sciences, College of Nutrition, Taipei Medical University, Taipei 11031, Taiwan
- School of Food and Safety, Taipei Medical University, Taipei 11031, Taiwan
- Nutrition Research Center, Taipei Medical University Hospital, Taipei 11031, Taiwan
- Correspondence:
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Soleiman-Meigooni S, Hoseini Yekta N, Sheikhan HR, Aminianfar M, Hamidi-Farahani R, Ahmadi M, Asgari A, Kazemi-Galougahi MH, Rahimi R. Efficacy of a standardized herbal formulation from Glycyrrhiza glabra L. as an adjuvant treatment in hospitalized patients with COVID-19: A Randomized Controlled trial. J Ayurveda Integr Med 2022; 13:100670. [PMID: 36320214 PMCID: PMC9613802 DOI: 10.1016/j.jaim.2022.100670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 03/10/2022] [Accepted: 10/17/2022] [Indexed: 11/15/2022] Open
Abstract
Introduction As no specific pharmacological intervention has been known for COVID-19, medicinal plants may be a suitable candidate for management of this disease. The aim of this study was to investigate the efficacy of a herbal syrup from licorice as an adjuvant treatment in hospitalized patients with COVID-19. Materials and methods 213 hospitalized patients diagnosed with COVID-19 were assigned to receive either standardized licorice syrup as an adjuvant treatment plus standard care [Syrup Group (SYRUP), N = 91], or standard care alone [Standard Group (STANDARD), N = 104], for 7 days. The primary endpoint was duration of hospitalization in survivors. The secondary endpoints included 25% increase in oxygen saturation, C-reactive protein (CRP) difference and lymphocyte difference from baseline, number of death and number of patients transferred to ICU. Results Mean duration of admission was 5.24 days in SYRUP and 7.14 days in STANDARD (p < 0.001). Oxygen saturation increased in 86 of 91 patients (94.5%) in the licorice group, compared to 83 of 104 patients (79.8%) in the control group (p = 0.002). There was no significant difference between the two groups in the number of patients died during hospitalization (p = 0.837). Five patients in SYRUP and 16 patients in STANDARD were transferred to ICU (p < 0.026). Mean reduction in CRP (p < 0.001) and mean increase in the number of lymphocytes (p = 0.008) in SYRUP were significantly higher than STANDARD. Discussion Licorice syrup as an adjuvant treatment demonstrated promising results on duration of hospital admission, O2 saturation as well as inflammatory markers in COVID-19 patients; however, further clinical studies with larger sample size are suggested to achieve more conclusive results.
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Affiliation(s)
| | - Nafiseh Hoseini Yekta
- Department of Persian Medicine, Faculty of Medicine, Aja University of Medical Sciences, Tehran, Iran
| | - Hamid Reza Sheikhan
- Faculty of Agriculture and Natural Resources, Islamic Azad University, Karaj Branch, Karaj, Iran
| | - Mohammad Aminianfar
- Department of Infectious Diseases, Faculty of Medicine, Aja University of Medical Sciences, Tehran, Iran
| | - Ramin Hamidi-Farahani
- Department of Infectious Diseases, Faculty of Medicine, Aja University of Medical Sciences, Tehran, Iran
| | - Mousa Ahmadi
- Department of Infectious Diseases, Faculty of Medicine, Aja University of Medical Sciences, Tehran, Iran
| | - Ali Asgari
- Department of Infectious Diseases, Faculty of Medicine, Aja University of Medical Sciences, Tehran, Iran
| | | | - Roja Rahimi
- Department of Traditional Pharmacy, School of Persian Medicine, Tehran University of Medical Sciences, Tehran, Iran,Corresponding author.
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12
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Krepkova LV, Babenko AN, Saybel' OL, Lupanova IA, Kuzina OS, Job KM, Sherwin CM, Enioutina EY. Valuable Hepatoprotective Plants - How Can We Optimize Waste Free Uses of Such Highly Versatile Resources? Front Pharmacol 2021; 12:738504. [PMID: 34867345 PMCID: PMC8637540 DOI: 10.3389/fphar.2021.738504] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 10/27/2021] [Indexed: 11/13/2022] Open
Abstract
Humans used plants for thousand of years as food, drugs, or fuel to keep homes warm. People commonly used fruits and roots, and other parts of the plant were often wasted. This review aims to discuss the potential of rational stem-to-stern use of three highly versatile and valuable plants with hepatoprotective properties. Milk thistle (Silybum marianum L. Gaertn.), artichoke (Cynara cardunculus), and chicory (Cichorium intybus L.) have well-characterized hepatoprotective properties. These plants have been chosen since liver diseases are significant diseases of concern worldwide, and all parts of plants can be potentially utilized. Artichoke and chicory are commonly used as food or dietary supplements and less often as phytodrugs. Various dietary supplements and phytodrugs prepared from milk thistle (MT) fruits/seeds are well-known to consumers as remedies supporting liver functions. However, using these plants as functional food, farm animal feed, is not well-described in the literature. We also discuss bioactive constituents present in various parts of these plants, their pharmacological properties. Distinct parts of MT, artichoke, and chicory can be used to prepare remedies and food for humans and animals. Unused plant parts are potentially wasted. To achieve waste-free use of these and many other plants, the scientific community needs to analyze the complex use of plants and propose strategies for waste-free technologies. The government must stimulate companies to utilize by-products. Another problem associated with plant use as a food or source of phytodrug is the overharvesting of wild plants. Consequently, there is a need to use more active cultivation techniques for plants.
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Affiliation(s)
- Lubov V Krepkova
- Center of Medicine, All-Russian Research Institute of Medicinal and Aromatic Plants (VILAR), Moscow, Russia
| | - Aleksandra N Babenko
- Center of Medicine, All-Russian Research Institute of Medicinal and Aromatic Plants (VILAR), Moscow, Russia
| | - Olga L Saybel'
- Center of Medicine, All-Russian Research Institute of Medicinal and Aromatic Plants (VILAR), Moscow, Russia
| | - Irina A Lupanova
- Center of Medicine, All-Russian Research Institute of Medicinal and Aromatic Plants (VILAR), Moscow, Russia
| | - Olga S Kuzina
- Center of Medicine, All-Russian Research Institute of Medicinal and Aromatic Plants (VILAR), Moscow, Russia
| | - Kathleen M Job
- Division of Clinical Pharmacology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, United States
| | - Catherine M Sherwin
- Department of Pediatrics, Boonshoft School of Medicine, Dayton Children's Hospital, Wright State University, Dayton, OH, United States
| | - Elena Y Enioutina
- Division of Clinical Pharmacology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, United States.,Department of Pharmaceutics & Pharmaceutical Chemistry, College of Pharmacy, University of Utah, Salt Lake City, UT, United States
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Glycyrrhiza Genus: Enlightening Phytochemical Components for Pharmacological and Health-Promoting Abilities. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2021; 2021:7571132. [PMID: 34349875 PMCID: PMC8328722 DOI: 10.1155/2021/7571132] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 06/12/2021] [Accepted: 06/18/2021] [Indexed: 02/06/2023]
Abstract
The Glycyrrhiza genus, generally well-known as licorice, is broadly used for food and medicinal purposes around the globe. The genus encompasses a rich pool of bioactive molecules including triterpene saponins (e.g., glycyrrhizin) and flavonoids (e.g., liquiritigenin, liquiritin). This genus is being increasingly exploited for its biological effects such as antioxidant, antibacterial, antifungal, anti-inflammatory, antiproliferative, and cytotoxic activities. The species Glycyrrhiza glabra L. and the compound glycyrrhizin (glycyrrhizic acid) have been studied immensely for their effect on humans. The efficacy of the compound has been reported to be significantly higher on viral hepatitis and immune deficiency syndrome. This review provides up-to-date data on the most widely investigated Glycyrrhiza species for food and medicinal purposes, with special emphasis on secondary metabolites' composition and bioactive effects.
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14
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Ahmad L. Impact of gargling on respiratory infections. ALL LIFE 2021. [DOI: 10.1080/26895293.2021.1893834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Affiliation(s)
- Lateef Ahmad
- Department of Pharmacy, University of Swabi, Anbar, Pakistan
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15
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Bell RF, Moreira VM, Kalso EA, Yli-Kauhaluoma J. Liquorice for pain? Ther Adv Psychopharmacol 2021; 11:20451253211024873. [PMID: 34349979 PMCID: PMC8287643 DOI: 10.1177/20451253211024873] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 05/25/2021] [Indexed: 12/24/2022] Open
Abstract
Liquorice has a long history of use in traditional Chinese, Ayurvedic and herbal medicine. The liquorice plant contains numerous bioactive compounds, including triterpenes, flavonoids and secondary metabolites, with glycyrrhizin being the main active compound. Liquorice constituents have been found to have anti-inflammatory, antioxidant, antiviral, anticancer, hepatoprotective and neuroprotective properties. In addition, they appear to have antidepressant actions and effects on morphine tolerance. Glycyrrhizin, its metabolite glycyrrhetic (glycyrrhetinic) acid and other liquorice-derived compounds such as isoflavonoids and trans-chalcones, exert potent anti-inflammatory effects via a wide range of mechanisms including high mobility group box 1 protein (HMGB1) inhibition, gap junction blockade and α2A-adrenoceptor antagonism. These properties, together with an increasing body of preclinical studies and a long history of use in herbal medicine, suggest that liquorice constituents may be useful for pain management. Glycyrrhizin is used widely in the confectionary, food and tobacco industries, but has documented adverse effects that may limit clinical use. Whether liquorice plant-derived compounds represent a novel class of analgesics is yet to be established. Having a host of bioactive compounds with a broad range of mechanisms of effect, liquorice is a plant that, in the future, may give rise to new therapies for pain.
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Affiliation(s)
- Rae F Bell
- (Emerita) Regional Centre of Excellence in Palliative Care, Haukeland University Hospital, Jonas Lies vei 65, Bergen 5021, Norway
| | - Vânia M Moreira
- Laboratory of Pharmaceutical Chemistry, Faculty of Pharmacy, University of Coimbra, Coimbra, Portugal
| | - Eija A Kalso
- Department of Pharmacology and SleepWell Research Programme, Faculty of Medicine, University of Helsinki and Department of Anaesthesiology, Intensive Care and Pain Medicine, Helsinki University Hospital, Helsinki, Finland
| | - Jari Yli-Kauhaluoma
- Drug Research Program, Division of Pharmaceutical Chemistry and Technology, Faculty of Pharmacy, University of Helsinki, Helsinki, Finland
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Bahramsoltani R, Rahimi R. An Evaluation of Traditional Persian Medicine for the Management of SARS-CoV-2. Front Pharmacol 2020; 11:571434. [PMID: 33324206 PMCID: PMC7724033 DOI: 10.3389/fphar.2020.571434] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 09/21/2020] [Indexed: 01/12/2023] Open
Abstract
A new coronavirus causing severe acute respiratory syndrome (SARS-CoV-2) has emerged and with it, a global investigation of new antiviral treatments and supportive care for organ failure due to this life-threatening viral infection. Traditional Persian Medicine (TPM) is one of the most ancient medical doctrines mostly known with the manuscripts of Avicenna and Rhazes. In this paper, we first introduce a series of medicinal plants that would potentially be beneficial in treating SARS-CoV-2 infection according to TPM textbooks. Then, we review medicinal plants based on the pharmacological studies obtained from electronic databases and discuss their mechanism of action in SARS-CoV-2 infection. There are several medicinal plants in TPM with cardiotonic, kidney tonic, and pulmonary tonic activities, protecting the lung, heart, and kidney, the three main vulnerable organs in SARS-CoV-2 infection. Some medicinal plants can prevent "humor infection", a situation described in TPM which has similar features to SARS-CoV-2 infection. Pharmacological evaluations are in line with the therapeutic activities of several plants mentioned in TPM, mostly through antiviral, cytoprotective, anti-inflammatory, antioxidant, and anti-apoptotic mechanisms. Amongst the primarily-introduced medicinal plants from TPM, rhubarb, licorice, garlic, saffron, galangal, and clove are the most studied plants and represent candidates for clinical studies. The antiviral compounds isolated from these plants provide novel molecular structures to design new semisynthetic antiviral agents. Future clinical studies in healthy volunteers as well as patients suffering from pulmonary infections are necessary to confirm the safety and efficacy of these plants as complementary and integrative interventions in SARS-CoV-2 infection.
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Affiliation(s)
- Roodabeh Bahramsoltani
- Department of Traditional Pharmacy, School of Persian Medicine, Tehran University of Medical Sciences, Tehran, Iran
- PhytoPharmacology Interest Group (PPIG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Roja Rahimi
- Department of Traditional Pharmacy, School of Persian Medicine, Tehran University of Medical Sciences, Tehran, Iran
- PhytoPharmacology Interest Group (PPIG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
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Fritz AV, Mickus GJ, Vega MA, Renew JR, Brull SJ. Detrimental Effects of Filling Laryngotracheal Airways To Excessive Pressure (DEFLATE-P): a quality improvement initiative. BMC Anesthesiol 2020; 20:46. [PMID: 32093637 PMCID: PMC7038516 DOI: 10.1186/s12871-020-00963-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 02/17/2020] [Indexed: 11/17/2022] Open
Abstract
Background This quality improvement (QI) project was performed at a single center to determine the incidence of postoperative complications associated with use of cuffed airway devices. An educational program was then completed that involved training our anesthesia providers about complications related to excessive cuff pressure and how to utilize a quantitative cuff pressure measurement device (manometer). The impact of this educational initiative was assessed by comparing the incidence of postoperative complications associated with the use of airway devices before and after the training period. Methods After approval by our institution’s Institutional Review Board, a pre-intervention (baseline) survey was obtained from 259 adult patients after having undergone surgery with general anesthesia with the use of an endotracheal tube (ETT) or laryngeal mask airway (LMA). Survey responses were used to determine the baseline incidence of sore throat, hoarseness, and dysphagia. Once these results were obtained, education was provided to the anesthesia department members addressing the complications associated with excessive cuff pressures, appropriate cuff pressures based on manufacturer recommendations, and instructions on the use of a quantitative monitor to determine cuff pressure (manometry). Clinical care was then changed by requiring intraoperative cuff pressure monitoring throughout our institution for all surgical patients. After this educational period, 299 patients completed the same survey describing postoperative airway complications. Results The use of manometry reduced the incidence of moderate-to-severe postoperative sore throat in the pre- vs. post-intervention groups (35 patients vs 31 patients, p = 0.045), moderate to severe hoarseness (30 patients vs 13, patients p = 0.0001), and moderate-to-severe dysphagia (13 patients vs 5 patients, p = 0.03). Conclusion Caring for patients in the perioperative setting frequently entails placement of an airway device. This procedure is associated with several potential complications, including sore throat, coughing, and vocal cord damage. Our quality improvement initiative has shown that intraoperative management of intra-cuff pressure based on manometry is feasible to implement in clinical practice and can reduce postoperative airway complications.
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Affiliation(s)
- Ashley V Fritz
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, 4500 San Pablo Road S, Jacksonville, Florida, 32224, USA.
| | - Gregory J Mickus
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, 4500 San Pablo Road S, Jacksonville, Florida, 32224, USA
| | - Michael A Vega
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, 4500 San Pablo Road S, Jacksonville, Florida, 32224, USA
| | - J Ross Renew
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, 4500 San Pablo Road S, Jacksonville, Florida, 32224, USA
| | - Sorin J Brull
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, 4500 San Pablo Road S, Jacksonville, Florida, 32224, USA
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Ghaemi H, Masoompour SM, Afsharypuor S, Mosaffa-Jahromi M, Pasalar M, Ahmadi F, Niknahad H. The effectiveness of a traditional Persian medicine preparation in the treatment of chronic cough: A randomized, double-blinded, placebo-controlled clinical trial. Complement Ther Med 2020; 49:102324. [PMID: 32147070 DOI: 10.1016/j.ctim.2020.102324] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 01/19/2020] [Accepted: 01/20/2020] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVES The roots and rhizomes of licorice (Glycyrrhiza glabra L.) are used in traditional Persian medicine for the treatment of numerous diseases. A chronic cough is a non-specific reaction to irritation anywhere in the respiratory system. It usually lasts for more than eight weeks. The current study aimed to evaluate the effect of a modified traditional Persian medicine preparation, licorice pastille, in healing a chronic cough. METHODS Through a randomized, double-blinded, placebo-controlled clinical trial was performed in a respiratory disease clinic in Shiraz, Iran; between October 2016 and December 2017. Seventy participants with a chronic cough took part in the trial. The outcome measures were as the daily cough scores (the score being logged via patient symptoms, diary, and the visual analogue scale) and the quality of life measure of chronic cough according to the Leicester Cough Questionnaire. RESULTS At baseline, there were no significant differences in the demographic or clinical (cough score) characteristics between the two groups. There was complete adherence to protocol in both groups but, the drop-out rate was 4 patients in the placebo and 6 ones in the intervention groups. The results at the end of the trial (Week 2) and follow-up (Week 4) demonstrated the efficacy of the licorice pastille in terms of the cough severity score against the placebo group. This item showed a significant decrease in the intervention group (1.2 ± 0.93) comparing to the placebo one (1.8 ± 1.03) at follow-up time. No major side effects were reported during the study and follow-up time. CONCLUSIONS Licorice pastille could be a promising choice in the treatment of a chronic cough of unknown origin.
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Affiliation(s)
- Hajar Ghaemi
- Department of Traditional Pharmacy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Masoom Masoompour
- Non-Communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Suleiman Afsharypuor
- Department of Pharmacognosy, School of Pharmacy, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Mosaffa-Jahromi
- Research Center for Traditional Medicine and History of Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehdi Pasalar
- Research Center for Traditional Medicine and History of Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Fatemeh Ahmadi
- Department of Pharmaceutics, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Hossein Niknahad
- Department of Pharmacology and Toxicology, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
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Kuriyama A, Maeda H. Topical application of licorice for prevention of postoperative sore throat in adults: A systematic review and meta-analysis. J Clin Anesth 2019; 54:25-32. [DOI: 10.1016/j.jclinane.2018.10.025] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 10/02/2018] [Accepted: 10/28/2018] [Indexed: 02/06/2023]
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Kuriyama A, Maeda H, Sun R. Aerosolized corticosteroids to prevent postoperative sore throat in adults: A systematic review and meta-analysis. Acta Anaesthesiol Scand 2019; 63:282-291. [PMID: 30318587 DOI: 10.1111/aas.13275] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 09/12/2018] [Accepted: 09/14/2018] [Indexed: 12/23/2022]
Abstract
BACKGROUND Postoperative sore throat negatively affects patient recovery and satisfaction levels. We conducted a systematic review and meta-analysis to assess the efficacy and safety of aerosolized corticosteroids in the prevention of postoperative sore throat in adults undergoing tracheal intubation for surgery. METHODS We searched Medline, EMBASE, China National Knowledge Infrastructure, and the Cochrane Central Register of Controlled Trials for eligible studies from inception to 13 May 2018. We included randomized controlled trials that assessed the efficacy and safety of aerosolized corticosteroids, compared either with non-analgesic or analgesic controls, in adults undergoing tracheal intubation for surgery. Incidence and severity of sore throat 24 hours postoperatively and adverse events were the primary outcomes. RESULTS Nine randomized controlled trials involving 984 patients were included. Compared with non-analgesic control, aerosolized corticosteroids were associated with a reduced incidence (risk ratio [RR], 0.39; 95% confidence interval [CI], 0.26-0.58) and were likely associated with decreased severity (standardized mean difference [SMD], -0.96; 95% CI, -2.52, 0.59) of postoperative sore throat. Among these, four trials reported that there were no adverse events. Trial sequential analysis (TSA) suggested that the evidence on the incidence of postoperative sore throat, in comparison with the non-analgesic control, was not definitive (TSA-adjusted CI, 0.07-1.98). The GRADE quality of evidence on each outcome was very low. CONCLUSIONS Aerosolized corticosteroids may be superior to non-analgesic methods in preventing postoperative sore throat, but the evidence for efficacy and safety is still limited and not definitive.
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Affiliation(s)
- Akira Kuriyama
- Emergency and Critical Care Center; Kurashiki Central Hospital; Okayama Japan
| | - Hirokazu Maeda
- Department of Emergency Medicine; Sugita Genpaku Memorial Obama Municipal Hospital; Fukui Japan
| | - Rao Sun
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College; Huazhong University of Science and Technology; Hubei China
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Li N, Zhou T, Wu F, Wang R, Zhao Q, Zhang JQ, Yang BC, Ma BL. Pharmacokinetic mechanisms underlying the detoxification effect of Glycyrrhizae Radix et Rhizoma (Gancao): drug metabolizing enzymes, transporters, and beyond. Expert Opin Drug Metab Toxicol 2019; 15:167-177. [DOI: 10.1080/17425255.2019.1563595] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- Na Li
- Department of Chinese Materia Medica, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ting Zhou
- Department of Pharmacology, School of Pharmacy, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Fei Wu
- Engineering Research Center of Modern Preparation Technology of TCM of Ministry of Education, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Rui Wang
- Engineering Research Center of Modern Preparation Technology of TCM of Ministry of Education, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Qing Zhao
- Department of Pharmacology, School of Pharmacy, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ji-Quan Zhang
- Engineering Research Center of Modern Preparation Technology of TCM of Ministry of Education, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Bai-Can Yang
- Department of Chinese Materia Medica, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Bing-Liang Ma
- Department of Pharmacology, School of Pharmacy, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Kuriyama A, Maeda H. Preoperative intravenous dexamethasone prevents tracheal intubation-related sore throat in adult surgical patients: a systematic review and meta-analysis. Can J Anaesth 2019; 66:562-575. [PMID: 30617677 DOI: 10.1007/s12630-018-01288-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 09/04/2018] [Accepted: 10/10/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Postoperative sore throat related to tracheal intubation negatively affects patient recovery and satisfaction. Previous reviews suggested that intravenous dexamethasone diminishes postoperative sore throat. Nevertheless, they comprised a small number of studies with inconsistencies in outcome reporting. We performed a systematic review and meta-analysis to assess the efficacy and safety of preoperative intravenous dexamethasone in preventing postoperative sore throat in adult patients. METHODS We searched PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials from inception to August 24, 2018. We included randomized-controlled trials that assessed the efficacy and safety of intravenous dexamethasone in adult surgical patients who required general anesthesia and endotracheal intubation. Our primary outcomes were the incidence and severity of sore throat at 24 hr after surgery/extubation and adverse events. We pooled the data using a random-effects model. We conducted a trial sequential analysis (TSA) on the incidence of sore throat. RESULTS We included 15 randomized-controlled trials involving 1,849 patients. In comparison with non-analgesic methods, intravenous dexamethasone was associated with a reduced incidence (risk ratio, 0.62; 95% confidence interval [CI], 0.51 to 0.75) and severity (standardized mean difference, - 1.06; 95% CI, - 1.80 to - 0.33) of postoperative sore throat. Serious adverse events were not associated with intravenous dexamethasone administration in the four studies where this was assessed. The TSA indicated that the evidence regarding the incidence of postoperative sore throat is adequate. CONCLUSIONS Our study indicates that preoperative intravenous administration of dexamethasone alleviates postoperative sore throat more effectively than non-analgesic methods. TRIAL REGISTRATION PROSPERO (CRD42018086697); registered 29 January, 2018.
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Affiliation(s)
- Akira Kuriyama
- Emergency and Critical Care Center, Kurashiki Central Hospital, 1-1-1 Miwa Kurashiki, Okayama, 710-8602, Japan.
| | - Hirokazu Maeda
- Department of Emergency Medicine, Sugita Genpaku Memorial Obama Municipal Hospital, Fukui, Japan
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Kuriyama A, Maeda H, Sun R, Aga M. Topical application of corticosteroids to tracheal tubes to prevent postoperative sore throat in adults undergoing tracheal intubation: a systematic review and meta-analysis. Anaesthesia 2018; 73:1546-1556. [PMID: 29574683 DOI: 10.1111/anae.14273] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2018] [Indexed: 12/17/2022]
Affiliation(s)
- A. Kuriyama
- Emergency and Critical Care Centre; Kurashiki Central Hospital; Kurashiki Japan
| | - H. Maeda
- Department of Emergency Medicine; Sugita Genpaku Memorial Obama Municipal Hospital; Fukui Japan
| | - R. Sun
- Department of Anaesthesiology; Tongji Hospital; Tongji Medical College; Huazhong University of Science and Technology; Hubei China
| | - M. Aga
- Department of Respiratory Medicine; Kurashiki Central Hospital; Kurashiki Japan
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Farhang B, Grondin L. The Effect of Zinc Lozenge on Postoperative Sore Throat: A Prospective Randomized, Double-Blinded, Placebo-Controlled Study. Anesth Analg 2017; 126:78-83. [PMID: 28953493 DOI: 10.1213/ane.0000000000002494] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Postoperative sore throat (POST) is commonly seen after endotracheal intubation, and oral zinc prevents oral mucositis associated with chemotherapy. This study is designed to evaluate the effects of administration of zinc lozenges on POST. METHODS Seventy-nine patients undergoing low- or moderate-risk surgery with endotracheal intubation were randomly assigned into 2 groups: Control group received placebo and zinc group received 40-mg zinc lozenges 30 minutes preoperatively. Patients were assessed for incidence and severity (4-point scale, 0-3) of POST at 0, 2, 4, and 24 hours postoperatively. The primary outcome was incidence of POST at 4 hours after surgery. The secondary outcomes were the incidence of POST at 0, 2, and 24 hours and the severity of POST. RESULTS At 4 hours, there was a significantly lower incidence of POST in the zinc group, 7%, than the control group, 29% (P = .046). The incidence of POST at 0 hour was 0% in zinc group and 24% in control group (P = .004). The highest incidence of POST occurred at the second hour after surgery, with the rate of 10% in the zinc group and 34% in the control group (P = .0495). The incidence of POST at 24 hours was 13% in zinc group and 24% in control group (not significant). The severity of POST was significantly lower in the zinc group for mild (P = .003) and moderate (P = .004) POST. CONCLUSIONS The administration of a single dose of 40-mg zinc lozenge 30 minutes preoperatively is effective to reduce both incidence of POST in the first 4 hours and severity of mild and moderate POST in the immediate postoperative period.
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Affiliation(s)
- Borzoo Farhang
- From the Department of Anesthesiology, University of Vermont College of Medicine, Burlington, Vermont
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25
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Blind Intubation through Self-pressurized, Disposable Supraglottic Airway Laryngeal Intubation Masks. Anesthesiology 2017; 127:307-316. [DOI: 10.1097/aln.0000000000001710] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Abstract
Background
Supraglottic airway devices commonly are used for securing the airway during general anesthesia. Occasionally, intubation with an endotracheal tube through a supraglottic airway is indicated. Reported success rates for blind intubation range from 15 to 97%. The authors thus investigated as their primary outcome the fraction of patients who could be intubated blindly with an Air-Qsp supraglottic airway device (Mercury Medical, USA). Second, the authors investigated the influence of muscle relaxation on air leakage pressure, predictors for failed blind intubation, and associated complications of using the supraglottic airway device.
Methods
The authors enrolled 1,000 adults having elective surgery with endotracheal intubation. After routine induction of general anesthesia, a supraglottic airway device was inserted and patients were ventilated intermittently. Air leak pressure was measured before and after full muscle relaxation. Up to two blind intubation attempts were performed.
Results
The supraglottic airway provided adequate ventilation and oxygenation in 99% of cases. Blind intubation succeeded in 78% of all patients (95% CI, 75 to 81%). However, the success rate was inconsistent among the three centers (P < 0.001): 80% (95% CI, 75 to 85%) at the Institute of Anesthesia and Pain Therapy, Kantonsspital Winterthur, Winterthur, Switzerland; 41% (95% CI, 29 to 53%) at the Department of Anesthesiology and Intensive Therapy, Medical University of Lodz, Lodz, Poland; and 84% (95% CI, 80 to 88%) at the Institute of Anesthesiology, University Hospital Zurich, Zurich, Switzerland. Leak pressure before relaxation correlated reasonably well with air leak pressure after relaxation.
Conclusions
The supraglottic airway device reliably provided a good airway and allowed blind intubation in nearly 80% of patients. It is thus a reasonable initial approach to airway control. Muscle relaxation can be used safely when unparalyzed leak pressure is adequate.
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Li HX, Xue FS, Liu YY, Yang GZ. Assessing effects of intubating stylet use on early postoperative pharyngeal pain. J Clin Anesth 2017. [PMID: 28625458 DOI: 10.1016/j.jclinane.2017.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Hui-Xian Li
- Department of Anesthesiology, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fu-Shan Xue
- Department of Anesthesiology, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
| | - Ya-Yang Liu
- Department of Anesthesiology, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Gui-Zhen Yang
- Department of Anesthesiology, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Seo H, Kim E, Son JD, Ji S, Min SW, Park HP. A prospective randomised study of a rigid video-stylet vs. conventional lightwand intubation in cervical spine-immobilised patients. Anaesthesia 2016; 71:1341-1346. [DOI: 10.1111/anae.13606] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2016] [Indexed: 12/12/2022]
Affiliation(s)
- H. Seo
- Department of Anaesthesiology and Pain Medicine; Dankook University Hospital; Cheonan Korea
| | - E. Kim
- Department of Anaesthesiology and Pain Medicine; Daegu Catholic University Hospital; Daegu Korea
| | - J. D. Son
- Department of Anaesthesiology and Pain Medicine; Seoul National University Hospital; Seoul Korea
| | - S. Ji
- Department of Anaesthesiology and Pain Medicine; Seoul National University Hospital; Seoul Korea
| | - S. W. Min
- Department of Anaesthesiology and Pain medicine; SMG-SNU Boramae Medical Center; Seoul Korea
| | - H. P. Park
- Department of Anaesthesiology and Pain Medicine; Seoul National University Hospital; Seoul Korea
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Robertson JJ. Managing Pharyngeal and Oral Mucosal Pain. CURRENT EMERGENCY AND HOSPITAL MEDICINE REPORTS 2016. [DOI: 10.1007/s40138-016-0101-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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El-Boghdadly K, Bailey CR, Wiles MD. Postoperative sore throat: a systematic review. Anaesthesia 2016; 71:706-17. [DOI: 10.1111/anae.13438] [Citation(s) in RCA: 122] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2016] [Indexed: 12/14/2022]
Affiliation(s)
- K. El-Boghdadly
- Department of Anesthesia; Toronto Western Hospital; Toronto Ontario Canada
| | - C. R. Bailey
- Department of Anaesthetics; Evelina London Children's Hospital; Guys and St. Thomas’ NHS Foundation Trust; London UK
| | - M. D. Wiles
- Department of Anaesthetics; Sheffield Teaching Hospital NHS Foundation Trust; Sheffield UK
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Abstract
Liquorice foliage
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Hosseinzadeh H, Nassiri-Asl M. Pharmacological Effects of Glycyrrhiza spp. and Its Bioactive Constituents: Update and Review. Phytother Res 2015; 29:1868-86. [PMID: 26462981 DOI: 10.1002/ptr.5487] [Citation(s) in RCA: 137] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Revised: 07/25/2015] [Accepted: 09/15/2015] [Indexed: 01/26/2023]
Abstract
The roots and rhizomes of various species of the perennial herb licorice (Glycyrrhiza) are used in traditional medicine for the treatment of several diseases. In experimental and clinical studies, licorice has been shown to have several pharmacological properties including antiinflammatory, antiviral, antimicrobial, antioxidative, antidiabetic, antiasthma, and anticancer activities as well as immunomodulatory, gastroprotective, hepatoprotective, neuroprotective, and cardioprotective effects. In recent years, several of the biochemical, molecular, and cellular mechanisms of licorice and its active components have also been demonstrated in experimental studies. In this review, we summarized the new phytochemical, pharmacological, and toxicological data from recent experimental and clinical studies of licorice and its bioactive constituents after our previous published review.
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Affiliation(s)
- Hossein Hosseinzadeh
- Pharmaceutical Research Center, Department of Pharmacodynamics and Toxicology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Marjan Nassiri-Asl
- Cellular and Molecular Research Center, Department of Pharmacology, School of Medicine, Qazvin University of Medical Sciences, P.O. Box: 341197-5981, Qazvin, Iran
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Shergis JL, Wu L, May BH, Zhang AL, Guo X, Lu C, Xue CC. Natural products for chronic cough: Text mining the East Asian historical literature for future therapeutics. Chron Respir Dis 2015; 12:204-11. [PMID: 25901012 DOI: 10.1177/1479972315583043] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Chronic cough is a significant health burden. Patients experience variable benefits from over the counter and prescribed products, but there is an unmet need to provide more effective treatments. Natural products have been used to treat cough and some plant compounds such as pseudoephedrine from ephedra and codeine from opium poppy have been developed into drugs. Text mining historical literature may offer new insight for future therapeutic development. We identified natural products used in the East Asian historical literature to treat chronic cough. Evaluation of the historical literature revealed 331 natural products used to treat chronic cough. Products included plants, minerals and animal substances. These natural products were found in 75 different books published between AD 363 and 1911. Of the 331 products, the 10 most frequently and continually used products were examined, taking into consideration findings from contemporary experimental studies. The natural products identified are promising and offer new directions in therapeutic development for treating chronic cough.
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Affiliation(s)
- Johannah Linda Shergis
- Traditional and Complementary Medicine Research Program, School of Health Sciences and Health Innovations Research Institute (HIRi), RMIT University, Bundoora, Victoria, Australia
| | - Lei Wu
- Guangdong Provincial Hospital of Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences, and The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Brian H May
- Traditional and Complementary Medicine Research Program, School of Health Sciences and Health Innovations Research Institute (HIRi), RMIT University, Bundoora, Victoria, Australia
| | - Anthony Lin Zhang
- Traditional and Complementary Medicine Research Program, School of Health Sciences and Health Innovations Research Institute (HIRi), RMIT University, Bundoora, Victoria, Australia
| | - Xinfeng Guo
- Guangdong Provincial Hospital of Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences, and The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Chuanjian Lu
- Guangdong Provincial Hospital of Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences, and The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Charlie Changli Xue
- Traditional and Complementary Medicine Research Program, School of Health Sciences and Health Innovations Research Institute (HIRi), RMIT University, Bundoora, Victoria, Australia Guangdong Provincial Hospital of Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences, and The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China
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Intubation with VivaSight or conventional left-sided double-lumen tubes: a randomized trial. Can J Anaesth 2015; 62:762-9. [DOI: 10.1007/s12630-015-0329-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Accepted: 01/19/2015] [Indexed: 10/24/2022] Open
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