Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Injectables”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 955 records · Page 53Linked to original sources
PubMed1980

Effect of measured calcium chloride injections on the membrane potential and internal pH of snail neurones.

1. Ion-sensitive micro-electrodes were used to measure changes in intracellular pH (pHi) and internal chloride which resulted from the pressure injection of calcium chloride into identified Helix aspersa neurones. The internal chloride measurement allowed the quantity of calcium chloride injected to be estimated. 2. Application of the metabolic inhibitor carbonyl cyanide m-chlorophenyl hydrazone (CCmP) to a calcium-loaded cell caused an increase in the membrane potential comparable to the effect of injecting calcium itself. The effect was not observed in normal cells. 3. When injected in the presence of CCmp, calcium caused a much larger and longer-lasting effect on the membrane potential than that observed in untreated cells. 4. The injection of ruthenium red can increase and/or prolong the hyperpolarization caused by a given quantity of injected calcium. The pHi changes following calcium injection were biphasic and slower than normal. 5. In seven experiments, both hydrogen chloride and calcium chloride were injected into the same cell. The relative changes in pHi corresponded to the production of one hydrogen ion for each calcium ion injected. 6. The relationship between the quantity of calcium injected and the size of the induced hyperpolarization suggested that at least three calcium ions acting cooperatively are required to activate a potassium 'channel'. 7. Injection of barium chloride hyperpolarized the membrane after a delay of about 1 min. After several injections of barium the cell lost this response while retaining its normal response to calcium injection. Injection of barium also caused a slowly developing (biphasic) fall in pHi. 8. We conclude that injected calcium is normally rapidly taken up by mitochondria in exchange for hydrogen ions. If this uptake process is blocked by ruthenium red or CCmP, the calcium is taken up by a second, slower, process which also releases hydrogen ions. When pre-loaded, but not otherwise, the mitochondria will release calcium ions on treatment with CCmP. Injection of barium does not directly affect the membrane conductance, but causes the release of calcium from intracellular binding sites.

Animals↗
PubMed2004

Epidurography contrast patterns with fluoroscopic guided lumbar transforaminal epidural injections:a prospective evaluation.

BACKGROUND: Lumbar transforaminal epidural injections have been utilized in the treatment of radicular pain with proven success. It was postulated that interlaminar epidural injections result in a dorsal flow of contrast while transforaminal epidural steroid injections showed good ventral flow limited to one single spinal motion segment. There have been no published studies evaluating epidurography/contrast patterns utilizing fluoroscopy. OBJECTIVE: To evaluate the pattern and spread of epidural contrast during fluoroscopically guided lumbar transforaminal epidural steroid injections. DESIGN: A prospective study of case series of 20 consecutive patients receiving lumbar transforaminal epidural injections. METHODS: Patients had either herniated nucleus pulposus or lumbar spinal stenosis. All patients received their injection by one of five physicians trained in this technique. Once the needle tip was felt to be in the anterior epidural space anteroposterior and a lateral radiographs were obtained after a total of 2 mL of iopamidol (Isovue) contrast was injected. Epidurograms were reviewed by a physician trained in fluoroscopic injections. Patterns were recorded as unilateral, bilateral, dorsal or ventral. Ventral flow, both cephalad and caudal, and number of lumbar intervertebral levels of flow were recorded as well. RESULTS: Ventral contrast flow occurred in all 20 injections. Unilateral contrast flow was noted in all injections. The mean number of levels of flow of contrast cephalad and caudad from the injection site were 1.13 and 0.6 levels, respectively, but these differences were not statistically significant. There were no significant differences in contrast flow noted between patients with herniated nucleus pulposus or lumbar spinal stenosis. Vascular injection patterns were noted with 2 injections, which required repositioning of the needles. CONCLUSION: Contrast appeared ventrally and unilaterally in all injections. Dorsal flow occurred in 20% of these injections. No contrast flow crossed the midline. The observed contrast flow patterns should be studied clinically to determine whether they have any effect on clinical outcome. Intravascular injections were noted in 10% of cases.

Journal Article↗
PubMed2003

Joint and soft tissue injections in the community: questionnaire survey of general practitioners' experiences and attitudes.

OBJECTIVES: To investigate the numbers and types of joint and soft tissue injections performed by general practitioners (GPs) and to explore attitudes to training in joint and soft tissue injection and perceived barriers to performing injections. METHODS: A self administered questionnaire was mailed to a random sample of 410 (30%) of 1367 GPs in Northern Ireland. Two mailings were used to increase the response rate. Questions explored the GPs' demographic characteristics, types and numbers of injections performed, previous training experience, attitudes towards training, and perceived barriers. RESULTS: The overall response rate was 75%. Practitioners who were men, worked in a "rural" or "mixed" locality, and had had a previous post in rheumatology, orthopaedics, or sports medicine were more likely to perform joint and soft tissue injections. Forty six per cent of GPs did not currently perform any injections; 5% of GPs performed most of the injections in the community. Injections into the shoulder, knee, and lateral epicondylitis were found to be the most commonly performed injections. The GPs preferred to train on "real patients" rather than "mannequin models". Those GPs who had trained on "real patients" were more likely to perform injections. The main perceived barrier to performing joint and soft tissue injections in the community was the "inability to maintain injection skills". CONCLUSION: Postgraduate training, methods of training, and the ability to maintain injection skills seemed to be determinants affecting GP confidence and the amount of joint and soft tissue injections that they performed. Most injections were performed by a few GPs in the community. These findings may have implications for the developing role of GP specialists in primary care trusts.

Clinical Competence↗
PubMed1979

Peripheral nerve injection injury: an experimental study.

In an attempt to answer questions regarding nerve injection injuries, we injected 11 agents in current use and commonly administered by intramuscular injection into the sciatic nerves of adult Wistar rats. Equal volumes of normal saline were used as control. We harvested the sciatic nerves at various times after injection and examined them by both light and electron microscopy. We performed myelinated nerve fiber counts and constructed histograms. Any impairment of motor function was also noted. We gave injections to 79 animals a total of 158 times; 116 injections were directly into the nerve fascicle (intrafascicular) and 42 were into the epineural tissue (extrafascicular). The results revealed considerable variation in the degree of nerve fiber injury according to the agent injected. Minimal damage resulted from the injection of iron-dextran, meperidine, and cephalothin, and maximal nerve injury followed the injection of penicillin, diazepam, and chlorpromazine. The site of injection was crucial. Intrafascicular injection was invariably associated with severe nerve injury, but, with few exceptions, extrafascicular injection resulted in minimal damage. The quantity of drug injected was also important in determining the degree of injury. Large, heavily myelinated fibers were more susceptible to injection injury than smaller, thinly myelinated nerve fibers. The effect of the injected drug seemed to be related to injury of the nerve fiber unit--both the axon and the Schwann cell with its myelin sheath. Regeneration in damaged nerves was a constant finding; even the most severely injured nerves, with total axonal degeneration, underwent subsequent regeneration.

Animals↗
PubMed2004

Two- and three-dimensional ultrasound in the development of a needle-free injection system.

Ultrasound was used to assess a needle-free injection device for both intradermal and subcutaneous injections. The aim of this study was, first, to differentiate intradermal from subcutaneous injections, both in vivo and in vitro using 2D ultrasound, and second, to quantify the amount of injectate that actually arrives within the dermis or subcutaneous tissues using volume measurements derived from high-resolution 3D ultrasound data sets, using a freehand system (Stradx), developed by the Cambridge University Departments of Engineering and Radiology. For the in vitro study the devices were filled with dye and injected into a pig preparation. The injection site was examined with high-resolution ultrasound and subsequently dissected to locate the injected dye with respect to the dermis. For the in vivo study, 8 volunteers received needle-free injections of normal saline. High-resolution 2D images and 3D data sets were obtained of the injected sites. Proprioceptive information for the 3D data sets was produced using an optically tracked freehand system. Segmentation of the 3D data sets gave an estimation of the volume of injected material (injectate) within the dermis. The results demonstrated that 2D ultrasound could identify the location of the injectate in the in vitro experiments and successfully distinguished an intradermal from a subcutaneous injection. In the in vivo study, 2D ultrasound clearly demonstrated the injectate location within the volunteers' dermis but was less able to demonstrate the dispersion of injectate within the subcutaneous tissues.

Animals↗
PubMed2000

Quantitative analysis of subretinal injections in the rat.

BACKGROUND: Experimental therapeutic approaches to retinal degenerations often require the subretinal injection of a therapeutic agent. The injected volume and the age of the animal can influence the proportion of the retinal surface affected by the subretinal injection. We have investigated the quantitative effect of a single injection in the subretinal space. METHODS: Normal and Royal College of Surgeons rats aged 1 week, 3 weeks or 2 months received subretinal transscleral injections of 1, 3, 5 or 10 microl China ink. After 24 h, animals were killed, injected eyes were enucleated and fixated, and the retinas flattened. An image analyzing program was used to measure the total retinal surface and the retinal surface affected by the dye. RESULTS: The mean retinal surface affected by the injection ranged from 5.24+/-2.76 mm2 to 14.8+/-2.3 mm2, depending on animal age and injected volume. The injection affected 8.79+/-0.89 to 36.9+/-8.13% of total retinal surface. There was no statistically significant difference between normal and Royal College of Surgeons rats. Intravitreal leakage of the dye was more frequent with increasing injection volumes. CONCLUSION: The retinal surface affected by a single subretinal injection increases with the injected volume, but this increase is not proportional. Higher volumes lead to a loss of injected solution, either in the vitreous body or through the sclerotomy. In 2-month-old rats, a 3-microl subretinal injection appears to have the best reproducibility, with 20-30% of retinal surface covered by the injected dye.

Animals↗
PubMed2006

Lack of effect of corticosteroid injection at the shoulder joint on blood glucose levels in diabetic patients.

The effect of systemic glucocorticosteroids on the metabolism of glucose is well known; however, there are no reports on the effect of intraarticular steroids on the metabolism of glucose in diabetic patients. Controlled or near controlled diabetic patients who have self-monitoring devices for home monitoring of blood glucose with shoulder pain were offered an intraarticular crystalloid steroid injection of 35 mg of methylprednisolone acetate (MPA) at the shoulder joint after failure of pharmacological and physical therapy. Patients were asked to record blood glucose levels before and 2 h after breakfast, lunch, and supper (six times a day) every other day during 1 week before the injection and during the day of the injection, the next day and every other day for 2 weeks after the injection. Fructosamine levels were obtained just before the injection and 2 weeks after the injection. Wilcoxon signed rank test was used to compare the mean glucose levels before with those after the injection. Paired t test was used to compare the mean fructosamine values after the injection with those before the injection. Eighteen patients completed the study. Fifteen had adhesive capsulitis. The mean glucose levels before injection were 165.5, 195.5, 184.6, 199.4, 182.8, and 200.7 mg% before and 2 h after breakfast, lunch, and supper, respectively. There was no significant change between the mean glucose values before and after meals after the injection compared to those before the injection, respectively, except on a few occasions only throughout the study period. Mean fructosamine level before injection was 279 micromol/l+/-49.8 compared to 275 micromol/l+/-50.9 after the injection (P=0.125). Intraarticular injection of MPA at the shoulder joint in diabetic patients with shoulder pain has no significant effect on blood glucose levels.

Adrenal Cortex Hormones↗
PubMed2005

Intravitreal versus retrobulbar injections of triamcinolone for macular edema associated with branch retinal vein occlusion.

PURPOSE: To compare the short-term effect of intravitreal versus retrobulbar injection of triamcinolone acetonide for the treatment of macular edema caused by branch retinal vein occlusion. DESIGN: Randomized clinical trial. METHODS: Sixty eyes of 60 patients who had macular edema associated with branch retinal vein occlusion were randomly assigned to receive a single intravitreal injection (4 mg) or repeated retrobulbar injections (40 mg, three times) of triamcinolone. These injections (first injection in the retrobulbar group) were given approximately 1 week after focal laser photocoagulation. Using optical coherence tomography, the central retinal (foveal) thickness and total macular volume were measured before and at 1 and 3 months after injection. Visual acuity, intraocular pressure, and the incidence of reinjection were also examined. Fifty-two patients (86.7%) completed the 3-month follow-up. RESULTS: The mean foveal thickness and total macular volume decreased significantly after either intravitreal or repeated retrobulbar triamcinolone injections. Foveal thickness and macular volume were significantly less after intravitreal injection than after repeated retrobulbar injections, although there had been no significant differences at baseline. The percent reductions in foveal thickness and macular volume were also greater after intravitreal injection than after retrobulbar injections. Improvement in visual acuity was significantly better after intravitreal injection than after the retrobulbar injections. The incidence of intraocular pressure rise (to > or =20 mm Hg) was greater in the intravitreal group than in the retrobulbar group, but this was readily controlled by the use of antiglaucoma medications. After completion of the 3-month follow-up, 24 patients (46.2%) underwent reinjection. The need for reinjections was significantly greater in the retrobulbar group than in the intravitreal group (P = .0001). CONCLUSIONS: A single intravitreal injection of triamcinolone is significantly more effective than are repeated retrobulbar injections in reducing macular edema associated with branch retinal vein occlusion, and leads to greater improvement in visual acuity.

Adult↗
PubMed2005

Self-injection of monthly combined hormonal contraceptive.

OBJECTIVES: The monthly injectable contraceptive is usually administered in the office. We aimed to compare home self-injection with office administration with respect to satisfaction, compliance, and time and money spent on contraceptive behavior. METHODS: We enrolled 16 subjects and taught them self-injection for a prospective cohort trial with crossover. Subjects performed three self-injections at home and then had three office injections by the nurse. RESULTS: Ten subjects completed the protocol. They reported similarly low pain and anxiety with nurse injections and self-injections. Women reported spending less money and similar time for home injections. Most subjects strongly preferred giving themselves injections at home to office injections and would recommend self-injection to other women. CONCLUSIONS: Self-injection of the monthly contraceptive at home is a preferable alternative to office administration for these subjects. This study demonstrates the feasibility of teaching women self-injection. Future studies should look at how best to teach women self-injection and to select women who will be successful with self-injection of contraceptives.

Adolescent↗
PubMed2005

Intralesional triamcinolone acetonide injection for primary and recurrent chalazia: is it really effective?

PURPOSE: To evaluate the safety and efficacy of intralesional triamcinolone acetonide (TA) injection in primary and recurrent chalazia. DESIGN: Retrospective, interventional, consecutive case series. PARTICIPANTS: One hundred forty-seven patients with primary or recurrent chalazia (155 cases) treated at the oculoplastic clinic at the Jules Stein Eye Institute between January 1, 2000, and December 31, 2003. METHODS: Patients received an intralesional injection of 0.1 to 0.2 ml TA (40 mg/ml). Data regarding lesion size, including digital color photography, lesion regression or recurrence, and complete ophthalmic examination, were recorded at the time of injection and at different intervals until resolution or surgical excision. Success was defined as at least an 80% decrease in size with no recurrence. If the lesion recurred or regression was minimal (<50%), further injections were given as needed. Patients who declined injection or who did not respond to 2 to 3 injections were referred for surgical excision and drainage. MAIN OUTCOME MEASURES: Lesion size, clinical resolution, time to resolution, recurrence, and complications. RESULTS: Most of the patients received 1 injection (93 patients; 60%) or 2 injections (31 patients; 20%) with resolution of the lesion (more than 80% decrease in size), with an average time to resolution of 2.5 weeks. Patients who did not respond to 2 injections were more likely to fail treatment (minimal or no regression), to respond to further injections, or to undergo surgical excision and drainage (P = 0.0001, chi-square test). Patients with blepharitis required more injections to resolution (2+/-1.3 vs. 1.4+/-1; P = 0.05, independent samples t test). Intraocular pressure and visual acuity remained stable after treatment. No complications, such as visual loss, subcutaneous fat atrophy, or skin depigmentation changes, were noted with steroids injections; assuming a complication rate of 2%, our power was adequate to rule out these complications. CONCLUSIONS: Intralesional TA injection in primary and recurrent chalazia is effective in achieving lesion regression. Most cases resolve with an average of 1 to 2 injections. Chalazia that fail to respond to 2 or 3 injections are more likely to benefit from surgical excision. It may be considered as a first treatment in cases where diagnosis is straightforward.

Adolescent↗
PubMed2006

Population beliefs about the efficacy of injections in Pakistan's Sindh province.

OBJECTIVE: Reused syringes have been identified as a major risk factor for hepatitis B and C in Pakistan, a country facing a growing epidemic of these infections. We conducted this study to identify factors associated with receiving at least one injection during the past 3 months in an urban and a rural area in the Sindh province of Pakistan. METHODS: A population-based cross-sectional study of individuals aged 3 months was conducted in 34 clusters in an urban and a rural setting. Information was obtained on the number of contacts with healthcare providers and the number of injections received during the past 3 months. Beliefs about the efficacy of injections were also tested. Multivariable logistic regression analysis was performed to identify factors associated with receiving at least one injection during the past 3 months. RESULTS: Of 1150 subjects who participated in the study, 848 (74%) reported having received at least one injection during the past 3 months. Seventy-one percent (815/1150) believed that injections act faster than oral drugs and relieve symptoms quickly. There was a lack of risk perception among the participants: 19% (222/1150) believed that injections involve less risk than do oral drugs. Multivariable logistic regression analysis revealed that individuals who had visited unqualified practitioners (adjusted OR=6.1; 95% CI: 2.6-14.1) or general practitioners (adjusted OR=3.4; 95% CI: 1.9-6.0) were more likely to have received an injection. Belief that 'injections act faster and relieve symptoms quickly' had a multiplicative interaction with the area of dwelling: people in rural areas who held this belief were more likely to receive injections than people who did not hold this belief and were living in urban areas. CONCLUSIONS: In Pakistan, people's lack of awareness of risks associated with injections and their strong belief in the fast action of injections are driving injection overuse. These factors are supplemented by general practitioners' and unqualified providers' inclinations to prescribe more injections. Efforts must be made to include the unqualified practitioners in any interventions aimed to reduce injection overuse in Pakistan.

Adolescent↗
PubMed1996

Does technique or material used affect bladder tissue reactions when injecting teflon or silicone paste?

OBJECTIVES: Submucosal injections of polytetrafluoroethylene (PTFE) and polydimethylsiloxane (PDMS) paste continue to be used for the correction of vesicoureteral reflux and urinary incontinence. Potential distant particle migration and foreign body tissue reactions are thought to be significantly affected by the technique of injection and the paste material used. A study to determine if injection technique, paste material, or pretreatment of the injection site significantly affects local tissue reaction was performed on 44 New Zealand white rabbits. METHODS: Animals were randomly assigned to undergo four distinct injection treatments into the submucosa or bladder muscularis. Prior to injecting 0.1 cc of the PTFE or PDMS paste, some sites were pretreated with 0.1 cc saline to separate tissue planes, epinephrine to cause vasoconstriction, or doxycycline to provide sclerosis. Pretreatment controls were also performed without injecting PTFE or PDMS paste. Animals were killed, and quadrant bladder biopsies were performed at 1 hour (9), 1 day (9), 7 days (10), 1 month (8), and 6 months (8). A single pathologist, blinded to the injection treatments, performed a histologic evaluation to determine bleb location and the degree of inflammation, fibrosis, and epithelial necrosis. RESULTS: Seven of the 12 submucosal PTFE injection treatments were found on biopsy to be primarily within the muscularis, compared to 1 of 9 with PDMS paste. Three of the 24 PTFE injections could not be found at autopsy. Of these, two were injected into the muscularis, and all were discovered at least 1 month following injection. Particles were present in all 22 PDMS injection sites that were retrieved. Pretreatments, especially with doxycycline, resulted in significant epithelial necrosis at 1 and 7 days. At 1 and 6 months there were no differences in inflammation or fibrosis between PTFE and PDMS or any pretreatment combinations with saline or epinephrine. CONCLUSIONS: Correctly injected, silicone (PDMS) paste appears most likely to remain in the submucosal space. Pretreatment injections may cause early epithelial necrosis. PTFE and PDMS elicit similar foreign body reactions over time.

Animals↗
PubMed1999

Fertilization and in vitro development of porcine oocytes following intracytoplasmic injection of round spermatid or round spermatid nuclei.

The objective of this study was to determine fertilization rates and developmental ability of porcine oocytes following injection of round spermatid and round spermatid nucleus with artificial activation either 2 h before or immediately after injection. Electrical stimulation at 2 h before spermatid injection significantly increased the incidence of normal fertilization compared with that following injection without stimulation or with stimulation immediately after injection. Incidences of formation of 2 pronuclei and of apposition were not different in oocytes following intracytoplasmic spermatid and spermatid nucleus injection. Chromosome analysis revealed that most oocytes were diploid either following round spermatid or round spermatid nucleus injection. There was no diploid set of chromatin in oocytes at 20 h following sham injection. At 6 d following injection blastocoele formation was seen in the oocytes following round spermatid (25%) and round spermatid nucleus injection (27%). However, none of the oocytes developed to the blastocyst stage 6 d following sham injection. The average cell numbers of blastocysts 8 d after injection of spermatid and spermatid nucleus were 99 and 87, respectively. These results suggest that electrical stimulation before injection enhances the incidence of fertilization following round spermatid injection in the pig. Our study also indicates that either the round spermatid or it's nucleus can be used to produce viable embryos by injection into unfertilized porcine oocytes.

Animals↗
PubMed2002

Efficacy of percutaneous intramyocardial injections using a nonfluoroscopic 3-D mapping based catheter system.

BACKGROUND: Percutaneous transendomyocardial injection with an injection catheter is a new drug delivery method for e.g. therapeutic angiogenesis. Little is known about the efficacy of this drug delivery technique. We studied efficiency and retention of transendomyocardial injections with a NOGA guided injection catheter system by using scintigraphy with radio-labeled model drugs. METHODS: Ten non-ischemic landrace pigs were used. In each animal 2-3 transendomyocardial injections were performed using a 3-D mapping based catheter system called NOGA. As a model for proteins like angiogenic growth factors we used (99m)Tc labeled albumin and as a model for small particles like microspheres or adenovirus we used (99m)Tc labeled colloid albumin. Efficiency of the injections and retention of the transendomyocardial deposited substance were evaluated by a gamma camera during and after injection of 0.1 or 0.2 ml. RESULTS: All 29 injections showed scintigraphic proof of intramyocardial deposition. The average injection efficiency of all 29 injections was 26 +/- 23%. The average injection efficiency of 0.1 and 0.2 ml injections were 33 +/- 30% (n = 8) and 24 +/- 20% (n = 21), respectively (p = 0.33). Intramyocardial retention curves of albumin showed a rapid wash-out within the first 2 hours of the injection, whereas the retention of colloid albumin showed no decrease. In conclusion, transendomyocardial delivery of proteins or particles with an injection catheter show favorable efficiency rates, however the retention time of intramyocardial deposited small proteins like albumin is short. This may indicate the need for sustained release systems of angiogenic growth factors for intramyocardal injection in therapeutic angiogenesis.

Albumins↗
PubMed1999

Intracytoplasmic sperm injection: position of the polar body affects pregnancy rate.

A prospective study on intracytoplasmic sperm injection (ICSI) was performed to evaluate the effect of the position of the polar body relative to the opening of the injection needle during sperm injection, and of the person who performs the injections on fertilization, cleavage, and pregnancy rates. This study included 173 couples undergoing 313 ICSI cycles from September 1995 to December 1997. All injections were performed by two persons. For each injected oocyte the person who performed the injection was recorded as well as the position of the polar body during injection (6 o'clock: animal pole towards the opening of the needle; 12 o'clock: animal pole away from the opening of the needle). Of 2630 oocytes retrieved, 2232 were injected. Significantly more oocytes developed two pronuclei after injection with the polar body at 6 o'clock versus 12 o'clock (P = 0.01; 51 versus 45% respectively) and after injection by person 1 versus person 2 (P = 0.02; 50 and 45% respectively). Higher pregnancy rate (P = 0.046) was found after transfer of embryos from oocytes injected with the polar body at 6 o'clock (36%) versus 12 o'clock (18%). This was the result of a significant interaction (P = 0.03) between the position of the polar body and the person performing the injections. Given the higher fertilization rate in the 6 o'clock group, it is recommended that oocytes be injected with the polar body at 6 o'clock. The higher pregnancy rate as a result of polar body position and the interaction between polar body position and the operator suggest variations in injection technique.

Adult↗
PubMed2001

Optimum site for in ovo amino acid injection in broiler breeder eggs.

Three experiments were conducted to evaluate the effect of differences in in ovo amino acid (AA) injection sites in broiler breeder eggs on subsequent hatchability and BW of chicks. In Experiment 1, an AA solution was injected into eggs with 13-mm or 19-mm, 27-ga needles. Uninjected eggs served as controls. Hatchability was decreased (P < 0.05) in eggs receiving AA injections with the 19-mm needle in comparison to the control and 13-mm-injected groups. However, BW of chicks increased (P < 0.05) relative to pre-incubational egg weight by AA injection with the 13-mm needle. In order to evaluate the in ovo location of AA injections from Experiment 1, India ink was injected into eggs in Experiment 2 with a 13-or 19-mm needle. Immediately after injection, the air cell end of the egg was windowed in order to observe effects of injection site. Windowing of eggs was accomplished by removing a piece of the eggshell over the air cell and the underlying membrane at Day 7 of incubation. The amount of injected India ink was higher in the extra-embryonic coelom in eggs treated by both needles. However, the occurrence of India ink in the extra embryonic coelom was higher (P < 0.05) in the group injected with AA solution using a 13-mm needle as compared to that after injection using a 19-mm needle. The observation of India ink in the amniotic cavity was higher (P < 0.05) in the group injected with AA solution using a 19-mm needle rather than that using a 13-mm needle. In Experiment 3, treatments consisted of control (uninjected eggs) or windowed eggs. Windowed eggs received AA to the chorioallantoic membrane, the yolk, extra-embryonic coelom, or amniotic cavity at Day 7 of incubation. Hatchability was reduced, but chicks hatched when eggs were windowed and when AA were injected into the yolk sac or extra-embryonic coelom. However, chicks did not hatch when AA were administered to the chorioallantoic membrane or into the amniotic cavity. These results suggest that the best AA injection sites in ovo may be the yolk and extra-embryonic coelom.

Amino Acids↗
PubMed1998

The effect of needle gauge and lidocaine pH on pain during intradermal injection.

UNLABELLED: Local anesthetics can produce pain during skin infiltration. We designed a randomized, prospective trial to determine whether needle gauge and/or solution pH affect pain during the intradermal infiltration of lidocaine. After approval by our institution's human studies review board, 40 healthy adult volunteers gave their consent to participate in this study. All of the volunteers randomly received four intradermal injections. Each volunteer was blinded as to the content of the intradermal injections and to which needle size was used for each injection. Each volunteer randomly received a 0.25-mL intradermal injection of the following four solutions: 1) lidocaine 2% administered through a 25-gauge needle (lido-25); 2) lidocaine 2% mixed with sodium bicarbonate (4 mL of 2% lidocaine plus 1 mL of sodium bicarbonate, pH 7.26) administered through a 25-gauge needle (lido-bicarb-25); 3) lidocaine 2% administered through a 30-gauge needle (lido-30); and 4) lidocaine 2% mixed with sodium bicarbonate (4 mL of 2% lidocaine plus 1 mL of sodium bicarbonate) administered through a 30-gauge needle (lido-bicarb-30). In each patient, the injection site was in the same region for each of the four injections. The skin wheal was tested for appropriate anesthesia using a 19-gauge needle on the skin wheal. A visual analog pain score was recorded after each intradermal injection. The pain scores were significantly higher in the lido-25 (3.2 +/- 0.2) group than in the lido-30 (2.5 +/- 0.3), lido-bicarb-25 (1.9 +/- 0.2), and lido-bicarb-30 (1.3 +/- 0.2) groups. The lido-bicarb-30 injection was also rated as less painful than the lido-30 injection. We found no differences between the lidobicarb-25 and the lido-bicarb-30 injections. Complete analgesia for the 19-gauge needle pain stimulus was achieved in all patients for each injection. We conclude that, overall, the pain intensity of an intradermal injection of 2% lidocaine is low. The addition of sodium bicarbonate to 2% lidocaine decreases the pain associated with an intradermal skin wheal, and although the use of a 30-gauge needle decreases the pain of injection, the addition of sodium bicarbonate seems to have a greater overall effect than needle size. IMPLICATIONS: Forty volunteers randomly received four intradermal injections consisting of 2% lidocaine with or without sodium bicarbonate via a 25- or 30-gauge needle. The addition of bicarbonate had a greater overall effect than needle size in decreasing the pain associated with the intradermal injection of lidocaine.

Adult↗
PubMed2005

Effects of epidural saline injection on cerebrospinal fluid volume and velocity waveform: a magnetic resonance imaging study.

BACKGROUND: The phenomenon of epidural "top-up" (increased spread of local anesthetic due to epidural fluid injection) is explained partly by an epidural volume effect. This study was designed to investigate the change in cerebrospinal fluid (CSF) volume and velocity waveform induced by epidural saline injection. METHODS: (1) Lumbar epidural catheters were placed in 28 patients. Magnetic resonance images were obtained for measurements of lumbosacral CSF volume and velocity waveform. Saline was injected into the epidural space through the catheter to three groups of randomly assigned patients: 5-ml saline (n = 10), 10-ml saline (n = 9), and 15-ml saline (n = 9) groups. A repeat image series was performed after epidural injection to compare CSF volume and velocity waveform before and after epidural injection. (2) We also examined the time course of dural sac compression after epidural saline injection in a separate series. Seven axial images at disk levels from T11-T12 to L5-S1 were obtained before injection and 1, 3, 5, 10, 15, 20, 25, and 30 min after 10-ml saline injection to compare each dural area before and after injection. RESULTS: (1) Saline injected through the epidural catheter compressed the dural sac with variability of the extent of compression, resulting in a significantly decreased CSF volume in all patients (P <== 0.001). The mean reductions in CSF volume were 2.0 +/- 1.0 ml in the 5-ml group, 4.4 +/- 1.4 in the 10-ml group, and 7.2 +/- 2.6 in the 15-ml group. There were significant differences among the three groups (P < 0.05 approximately 0.001). After the saline injection, the synchronization between the CSF velocity waveform and the cardiac cycle disappeared in significantly more patients in the 10-ml group (7 of 9 patients) than in the other groups (P < 0.05). However, there was no significant relation between measures of CSF velocity waveform and dural area in any patient. (2) The maximum reduction of the sum of the total of seven disk areas occurred 5 min after epidural saline injection; thereafter, dural compression was gradually restored but did not return to the value before injection for 30 min. CONCLUSIONS: These findings indicate that the reduction in CSF volume was injection-volume dependent, dural compression lasted at least 30 min after saline injection, and the changes of the CSF flow dynamics did not correlate with the degree of dural sac compression.

Adult↗