Comparing the Effects of Sesame Oil vs. Nitroglycerin Ointment on the Incidence of Chemotherapy-Induced Phlebitis: A Single Blind Clinical Trial.

BACKGROUND: Phlebitis is a severe inflammatory response in patients undergoing chemotherapy that can lead to complications and increased length of hospitalization. OBJECTIVE: This study was conducted to examine the effects of sesame oil and nitroglycerin ointment on the incidence of chemotherapy-induced phlebitis in patients with cancer.  Methods: This clinical trial study involved 138 cancer patients who were randomly assigned into three groups. The three groups received nitroglycerin ointment, sesame oil, or betadine alcoholic solution that were applied on the distal catheter area at a length of 1.5 centimeters and width of 2 × 4 cm using graded paper. The site was then dressed and fixed with anti-allergenic adhesives. The research samples were examined for 72 hours for the incidence of phlebitis. RESULTS: No statistically significant difference was observed between the incidence of phlebitis in the sesame oil, nitroglycerin ointment and alcohol-betadine groups in the first 24 hours (p=0.2), the second 24 hours (p=0.13) and the third 24 hours (p=0.13). CONCLUSION: External use of both sesame oil and nitroglycerin is effective in reducing chemotherapy-induced phlebitis. Due to its anti-inflammatory effect and low cost, however, using sesame oil is recommended.

Intravenous cannula induced phlebitis in a tertiary care referral hospital: A prospective observational study with implication from patient's feedback system.

BACKGROUND: Medicines delivered directly to systemic circulation have saved many lives from life-threatening conditions, but also can impart undesirable effects. MATERIALS AND METHODS: A prospective observational study was performed for 10 months in the tertiary care hospital to identify and evaluate cannula induced phlebitis in our study population. The data collection form retrieved demographic details, diseases and cannulation particulars of each patient. Moreover, a patient feedback questionnaire (Cronbach's alpha=0.70) retrieved their concerns toward cannulation. RESULTS: Phlebitis was identified in 96 patients out of 146 subjects enrolled in the study; 52% had the first sign of phlebitis. Female patients were more prone, and the complication occurred irrespective of age (p>0.05). On the other hand, those on IV cefoperazone-sulbactam (n=13, 13.5%) followed by amoxicillin clavulanic acid (n=6, 6%) had significant cannulation complication (p<0.01). The cannula indwells time (p=0.001) and vein assessment (p=0.001) were statistically associated with incidence of phlebitis. Half of our samples had pain lasting about five minutes (χ2=9.2, p<0.05). Nevertheless, limited patients (n = 35, 36.5%) were prescribed topical Heparin Benzyl Nitrate, and none preferred to self-medicate nor opted for other home remedies. CONCLUSIONS: The study depicted high prevalence of phlebitis factored in by poor vein assessment and increase in indwelling time. We recommend proper awareness with on-site skill improvement program for health professionals on administration techniques and monitoring principles in order to lower cannulation related complications.

Effect of Chahuang ointment on prevention of phlebitis from peripherally inserted central catheter: randomized clinical trial.

OBJECTIVE: To assess the effect of Chahuang ointment, a Chinese herbal ointment, on the prevention of phlebitis in patients with peripherally inserted central catheters. METHOD: This was a multicenter randomized controlled trial, with 171 eligible patients randomly assigned into one of three groups: the Chahuang ointment group, the Mucopolysaccharide Polysulfate cream group, and the control group. The degrees of vein injuries at 72 hours after peripherally inserted central catheter insertion were the primary outcome. Secondary outcomes were the vascular wall thickness, tissue edema and microthrombus evaluated by Color Doppler Flow Imaging, the vascular endothelial growth factor, and endothelin-1 (ET-1) expression in vivo. RESULTS: Compared with the control group, the Chahuang ointment group showed significantly lower incidence of postoperative phlebitis, tissue edema, and microthrombus at 72 hours after peripherally inserted central catheter insertion (all P<0.01). The VEGF and ET-1 expression were significantly inhibited in the Chahuang ointment group after 3 days of treatment (both P<0.01). There were no statistical differences in the degree of vein injuries, microthrombus, or tissue edema between the Chahuang ointment and mucopolysaccharide polysulfate groups (all P>0.05). CONCLUSION: Chahuang ointment was shown to provide effective prevention and protection against phlebitis after peripherally inserted central catheter insertion.

Efficacy of topical chamomile on the incidence of phlebitis due to an amiodarone infusion in coronary care patients: a double-blind, randomized controlled trial.

BACKGROUND: Amiodarone is a useful antiarrhythmic drug. Phlebitis, caused by intravenous amiodarone, is common in patients in coronary care units (CCUs). OBJECTIVE: The aim of this study was to evaluate the effect of topical chamomile on the incidence of phlebitis due to the administration of an amiodarone infusion into the peripheral vein. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS: This was a randomized, double-blind clinical trial, conducted on 40 patients (n = 20 per group) in two groups-an intervention group (chamomile ointment) and a control group (lanoline, as a placebo), hospitalized in the CCUs and undergoing an amiodarone infusion into the peripheral vein over 24 h. Following the cannulation and commencement of the infusion, placebo or chamomile ointment was rubbed in, up to 10 cm superior to the catheter and repeated every eight hours for three days. The cannula site was then assessed based on the phlebitis checklist. MAIN OUTCOME MEASURES: The incidence and time of occurrence of phlebitis, relative risk, severity of phlebitis were the main outcome measures. RESULTS: Nineteen patients (19/20) in the control group had phlebitis on the first day of the study and one patient (20/20) on the second day. In the intervention group, phlebitis occurred in 13 cases (13/20) on the first day and another two (2/7) was found on the second day. The incidence of phlebitis was significantly different between two groups (P = 0.023). The cumulative incidence of phlebitis in the intervention group (15/20) is significantly later and lower than that in the control group (20/20) during two days (P = 0.008). Two patients in the intervention group did not develop phlebitis at all during the 3-day study. Also, the relative risk of phlebitis in the two groups was 0.68 (P = 0.008 5). A significant difference was not observed with regard to phlebitis severity in both groups. CONCLUSION: It seems that phlebitis occurred to a lesser extent and at a later time frame in the intervention group compared to control group. Topical chamomile may be effective in decreasing the incidence of phlebitis due to an amiodarone infusion. TRIAL REGISTRATION: This protocol was registered in the Iranian Registry of Clinical Trials (IRCT2014042017361N1).

Adverse events with outpatient anesthesia in Massachusetts.

PURPOSE: This retrospective study documented the frequency of various complications associated with outpatient anesthesia. PATIENTS AND METHODS: A questionnaire was mailed to the 157 active members of the Massachusetts Society of Oral and Maxillofacial Surgeons (MSOMS) and all members responded. Morbidity data were obtained for the calendar year 1999. Mortality data included 1999 and the preceding 4 years. This continues our long-term survey of ambulatory oral surgical office deaths in Massachusetts since 1984. The data include anesthesia-related complications and all office deaths for the patients treated by these oral and maxillofacial surgeons. RESULTS: The most common complication in our survey continues to be syncope, which occurred in 1 in 160 patients receiving local anesthesia. The incidences of other specific anesthetic problems are given. Two treatment-related deaths occurred among approximately 1,706,100 patients treated during the 5-year period of 1995 through 1999, for a mortality rate of 1/853,050. CONCLUSIONS: The results of this retrospective practitioner survey documented the specific incidence of untoward anesthetic events with outpatient anesthesia and found a mortality rate consistent with the 6 similar mortality studies since 1980. These 7 retrospective reviews found 34/28,399,193 outpatient deaths for an overall dental anesthesia mortality rate of 1/835,000.