Neuromuscular electrical stimulation as an adjunctive therapy to drotaverine hydrochloride for treating patients with diarrhea-predominant irritable bowel syndrome: A retrospective study.

This retrospective study investigated the effectiveness and safety of neuromuscular electrical stimulation (NMES) as an adjunctive therapy to drotaverine hydrochloride (DHC) in patients with diarrhea-predominant irritable bowel syndrome (BP-IBS).A total of 108 patient cases with BP-IBS were included in this study. Of these, 54 cases were assigned to a treatment group and received NMES and DHC, whereas the other 54 subjects were assigned to a control group and underwent DHC alone. All patients were treated for a total of 4 weeks. Primary outcomes were measured by the visual analog scale (VAS), and average weekly stool frequency. Secondary outcome was measured by the Bristol scale. In addition, adverse events were documented. All outcome measurements were analyzed before and after 4-week treatment.Patients in the treatment group did not show better effectiveness in VAS (P = .14), and average weekly stool frequency (P = .42), as well as the Bristol scale (P = .71), compared with the patients in the control group. Moreover, no significant differences in adverse events were found between 2 groups.The results of this study showed that NMES as an adjunctive therapy to DHC may be not efficacious for patients with BP-IBS after 4-week treatment.

Topical papaverine and facial nerve dysfunction in cerebellopontine angle surgery.

HYPOTHESIS: Topical application of 3% papaverine hydrochloride in the cerebellopontine angle (CPA) produces reversible conduction block of the facial nerve. BACKGROUND: A case of loss of spontaneous and evoked facial muscle activity, and transient postoperative facial paralysis, after topical application of papaverine in the CPA during surgery for an acoustic neuroma using intraoperative cranial nerve monitoring is reported. Other cases of transient neurologic dysfunction after use of this drug have been reported. METHODS: A rabbit model of CPA surgery via suboccipital craniectomy, with intraoperative monitoring of the facial nerve, was used in this experiment. RESULTS: No significant difference in facial muscle stimulation thresholds was identified after application of varying concentrations of papaverine to the facial nerve in the CPA. CONCLUSION: Although the intraoperative event described in the report is suggestive of an effect of papaverine on facial nerve function, this effect could not be reproduced in an established animal model of CPA surgery.

In vitro evaluation of papaverine hydrochloride incompatibilities: a simulation of intraarterial infusion for cerebral vasospasm.

PURPOSE: To elucidate, in light of reports of complications associated with intraarterial infusion of papaverine hydrochloride, the known propensity of papaverine hydrochloride to form precipitate in combination with other solutions or pharmaceuticals. METHODS: Initially simulating a situation experienced during an intraarterial papaverine infusion for cerebral vasospasm, we mixed various concentrations of papaverine with serum, nonheparinized and heparinized saline, and nonionic contrast material. RESULTS: Papaverine in concentrations of 0.3% (300 mg/100 mL of normal saline) or greater formed a precipitate when mixed with human serum (blood). The precipitate crystals were 50 to 100 microns in size and could be returned to solution simply by the addition of more serum. CONCLUSION: Crystal emboli are a possible transient cause of complications experienced during treatment of vasospasm with its attendant altered flow dynamics.

Incompatibility of Hexabrix and papaverine in peripheral arteriography.

A case is reported in which a previously patent artery became temporarily occluded during angiography. The authors believe it happened because of incompatibility of the contrast agent ioxaglate (Hexabrix) and papaverine. Extreme caution is recommended whenever a new low-osmolality contrast agent is used in conjunction with a pharmacoangiographic agent.