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European Journal of Clinical... Nov 2023Nausea is a common and unpleasant sensation for which current therapies such as serotonin (5-HT) antagonists are often ineffective, while also conferring a risk of... (Review)
Review Meta-Analysis
PURPOSE
Nausea is a common and unpleasant sensation for which current therapies such as serotonin (5-HT) antagonists are often ineffective, while also conferring a risk of potential adverse events. Isopropyl alcohol (IPA) has been proposed as a treatment for nausea. We aimed to compare IPA with 5-HT antagonists for the treatment of nausea across all clinical settings.
METHODS
MEDLINE, EMBASE, PubMed, CENTRAL and CINAHL were searched from inception to 17 July 2023 for randomised controlled trials (RCTs) comparing inhaled IPA and a 5-HT antagonist for treatment of nausea. Severity and duration of nausea, rescue antiemetic use, adverse events and patient satisfaction were the outcomes sought. Risk of bias (RoB) was assessed using Cochrane RoB 2. Random-effects model was used for meta-analysis. Combination of meta-analyses and narrative review was used to synthesise findings. The evidence was appraised using GRADE.
RESULTS
From 1242 records, 4 RCTs were included with 382 participants. Participants receiving IPA had a significantly lower mean time to 50% reduction in nausea (MD - 20.06; 95% CI - 26.26, - 13.85). Nausea score reduction at 30 min was significantly greater in the IPA group (MD 21.47; 95% CI 15.47, 27.47). IPA led to significantly reduced requirement for rescue antiemetics (OR 0.60; 95% CI 0.37, 0.95; p = 0.03). IPA led to no significant difference in patient satisfaction when compared with a 5-HT antagonist. The overall GRADE assessment of evidence quality ranged from very low to low.
CONCLUSION
IPA may provide rapid, effective relief of nausea when compared with 5-HT antagonists.
Topics: Humans; Serotonin; 2-Propanol; Nausea; Antiemetics; Serotonin 5-HT3 Receptor Antagonists
PubMed: 37704796
DOI: 10.1007/s00228-023-03560-x -
Journal of the American Dental... Sep 1946
Topics: 2-Propanol; Alcohols; Ethanol; Humans
PubMed: 21000173
DOI: 10.14219/jada.archive.1946.0163 -
Plastic Surgical Nursing : Official... 2004In my practice as a recovery room nurse, I had observed anesthesiologists and nurse anesthetists wave an opened alcohol preparation pad under a patient's nose when he or... (Review)
Review
In my practice as a recovery room nurse, I had observed anesthesiologists and nurse anesthetists wave an opened alcohol preparation pad under a patient's nose when he or she complained of nausea. When asked, "Why?'' the response often was, "Because it works.'' The following article describes the use of inhalation of isopropyl alcohol as a treatment for postoperative nausea and vomiting. Because alcohol swabs are so readily available, and certainly less expensive than some of the newer antiemetics on the market, this simple nursing intervention was worth investigating.
Topics: 2-Propanol; Administration, Inhalation; Adult; Antiemetics; Child; Clinical Nursing Research; Humans; Nursing Assessment; Nursing Evaluation Research; Postanesthesia Nursing; Postoperative Care; Postoperative Nausea and Vomiting; Treatment Outcome
PubMed: 15632723
DOI: 10.1097/00006527-200410000-00005 -
The American Journal of the Medical... Mar 2010In clinical practice, poisoning with ethylene glycol, methanol, and isopropyl alcohol is common. These alcohol-related intoxications can present with high anion gap... (Review)
Review
In clinical practice, poisoning with ethylene glycol, methanol, and isopropyl alcohol is common. These alcohol-related intoxications can present with high anion gap metabolic acidosis and increased osmolality. Toxicity and clinical symptoms are due to the accumulation of their metabolites, causing increased anion gap, rather than the parent compounds that are associated with an increase of serum osmolality. Clinical manifestations result from abnormalities of neurologic, cardiopulmonary, and renal function. Laboratory abnormalities when present are helpful for diagnosis but may be absent depending on the time of ingestion and time of presentation. Fomepizole and ethanol are potent inhibitors of alcohol dehydrogenase and reduce generation of toxic metabolites. Hemodialysis is an effective way of detoxification because it can remove unmetabolized alcohol in addition to the organic anions. High index of suspicion and early diagnosis can prevent the significant morbidity and mortality associated with these intoxications.
Topics: 2-Propanol; Animals; Ethylene Glycol; Humans; Methanol
PubMed: 20090509
DOI: 10.1097/MAJ.0b013e3181c94601 -
Southern Medical Journal Jul 1948
Topics: 2-Propanol; Alcoholic Intoxication; Alcohols; Humans
PubMed: 18872279
DOI: 10.1097/00007611-194807000-00013 -
Journal of Emergency Nursing Jan 2010
Topics: 2-Propanol; Adult; Alcoholism; Emergency Nursing; Humans; Male
PubMed: 20109790
DOI: 10.1016/j.jen.2009.10.006 -
The American Journal of Emergency... Mar 2021Nausea and vomiting (N&V) are among the most common complaints in the emergency department (ED). However, low acuity is assigned to most of these patients at the triage,... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVES
Nausea and vomiting (N&V) are among the most common complaints in the emergency department (ED). However, low acuity is assigned to most of these patients at the triage, and waiting for long hours without medication decreases patient safety and satisfaction. We aimed to compare the inhalation of isopropyl alcohol (IPA) with placebo (P) to treat nausea at the triage area of an ED.
METHODS
In this prospective, randomized and placebo-controlled trial, we used a convenience sample of consecutive adult (ages 18-65) patients presented to the triage area of the ED with the complaint of N&V, and we randomized them to inhale IPA or P embedded gauzes. We used an 11-point (0-10) numeric rating scale (NRS) to evaluate the degree of N&V before the inhalation, at the baseline, and at 2, 4 and 10 min after the inhalation.
RESULTS
We randomized 118 patients (IPA, n = 62; P, n = 56, intent-to-treat), three patients left the ED without being seen, and 115 patients completed the study. IPA and P groups were similar according to age, sex, comorbidities, and vital signs. We found that patients in the IPA group had significantly lower mean NRS starting with the 2nd minute (robust two-way mixed ANOVA between-subjects, p = 0.008). We also observed a significant within-subjects effect in the IPA group. The mean NRS value was decreased at each consecutive time point in the IPA group (all pairwise comparisons, p < 0.001).
CONCLUSION
In this study, IPA was significantly more effective than P for N&V at the triage. Moreover, patients in the IPA group had less need for rescue treatment.
Topics: 2-Propanol; Administration, Inhalation; Adolescent; Adult; Aged; Double-Blind Method; Emergency Service, Hospital; Emergency Treatment; Female; Humans; Male; Middle Aged; Nausea; Prospective Studies; Triage; Young Adult
PubMed: 33373914
DOI: 10.1016/j.ajem.2020.12.052 -
The New England Journal of Medicine Feb 2024Studies evaluating surgical-site infection have had conflicting results with respect to the use of alcohol solutions containing iodine povacrylex or chlorhexidine... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Studies evaluating surgical-site infection have had conflicting results with respect to the use of alcohol solutions containing iodine povacrylex or chlorhexidine gluconate as skin antisepsis before surgery to repair a fractured limb (i.e., an extremity fracture).
METHODS
In a cluster-randomized, crossover trial at 25 hospitals in the United States and Canada, we randomly assigned hospitals to use a solution of 0.7% iodine povacrylex in 74% isopropyl alcohol (iodine group) or 2% chlorhexidine gluconate in 70% isopropyl alcohol (chlorhexidine group) as preoperative antisepsis for surgical procedures to repair extremity fractures. Every 2 months, the hospitals alternated interventions. Separate populations of patients with either open or closed fractures were enrolled and included in the analysis. The primary outcome was surgical-site infection, which included superficial incisional infection within 30 days or deep incisional or organ-space infection within 90 days. The secondary outcome was unplanned reoperation for fracture-healing complications.
RESULTS
A total of 6785 patients with a closed fracture and 1700 patients with an open fracture were included in the trial. In the closed-fracture population, surgical-site infection occurred in 77 patients (2.4%) in the iodine group and in 108 patients (3.3%) in the chlorhexidine group (odds ratio, 0.74; 95% confidence interval [CI], 0.55 to 1.00; P = 0.049). In the open-fracture population, surgical-site infection occurred in 54 patients (6.5%) in the iodine group and in 60 patients (7.3%) in the chlorhexidine group (odd ratio, 0.86; 95% CI, 0.58 to 1.27; P = 0.45). The frequencies of unplanned reoperation, 1-year outcomes, and serious adverse events were similar in the two groups.
CONCLUSIONS
Among patients with closed extremity fractures, skin antisepsis with iodine povacrylex in alcohol resulted in fewer surgical-site infections than antisepsis with chlorhexidine gluconate in alcohol. In patients with open fractures, the results were similar in the two groups. (Funded by the Patient-Centered Outcomes Research Institute and the Canadian Institutes of Health Research; PREPARE ClinicalTrials.gov number, NCT03523962.).
Topics: Humans; 2-Propanol; Anti-Infective Agents, Local; Antisepsis; Canada; Chlorhexidine; Ethanol; Extremities; Iodine; Preoperative Care; Skin; Surgical Wound Infection; Fractures, Bone; Fracture Fixation; Cross-Over Studies; United States
PubMed: 38294973
DOI: 10.1056/NEJMoa2307679 -
American Journal of Kidney Diseases :... Sep 2002Isopropyl alcohol (IPA) is an ingredient of commonly used household solutions. Accidental and suicidal ingestion of IPA sometimes can be fatal if it goes unrecognized... (Comparative Study)
Comparative Study Review
Isopropyl alcohol (IPA) is an ingredient of commonly used household solutions. Accidental and suicidal ingestion of IPA sometimes can be fatal if it goes unrecognized and untreated. There are few published reports on IPA intoxication. We describe a case of repeated IPA ingestion in a single individual, followed by a review of the literature on the subject. The differential diagnosis, diagnostic pitfalls, and therapeutic interventions in patients with IPA intoxications are discussed.
Topics: 2-Propanol; Acidosis; Acute Kidney Injury; Diagnosis, Differential; Humans; Ketosis; Male; Middle Aged; Recurrence
PubMed: 12200829
DOI: 10.1053/ajkd.2002.34938 -
Journal of Palliative Medicine Jan 2023The use of inhaled isopropyl alcohol (IPA) has been proposed as a therapeutic intervention for the relief of nausea in various settings. The objective of this...
The use of inhaled isopropyl alcohol (IPA) has been proposed as a therapeutic intervention for the relief of nausea in various settings. The objective of this systematic review was to evaluate the existing evidence for the use of inhaled IPA in the management of nausea and vomiting. We performed a literature search on Medline, EMBASE, Web of Science, Scopus, CINAHL, PsycInfo, and Cochrane Library databases before November 2021. The following concepts were searched using subject headings and keywords as needed "aromatherapy," "alcohol," "ethylic alcohol," "ethanol," "isopropyl alcohol," "emesis," "chemotherapy-induced," "pregnancy," "hyperemesis gravidarum," "motion sickness," "emetics," "antiemetics," "inhalation," and "inhale." Searches were not limited to a specific language. The bibliographies of identified articles were also manually searched. Two authors independently assessed the included studies for risk of bias. Thirteen randomized controlled trials out of 158 studies identified met the inclusion criteria, with a total of 1253 participants. Twelve studies were conducted in the postoperative anesthesia care unit and two studies were performed in the emergency department setting. Four studies were double blinded, one was single blind, and eight were open label. Three studies assessed the use of inhaled IPA for prevention, whereas 10 studies evaluated its use in the treatment of nausea and vomiting. Seven studies reported IPA to be more effective, four studies reported no difference, and two studies reported IPA to be ineffective. Participant satisfaction was high overall, regardless of intervention received. No adverse effects were reported. The overall quality of evidence was low. There is a lack of strong evidence to support the use of inhaled IPA in the management of nausea and vomiting. Additional trials are warranted to confirm this finding and to further explore the use of inhaled IPA in various populations and settings.
Topics: Pregnancy; Female; Humans; 2-Propanol; Single-Blind Method; Nausea; Antiemetics; Vomiting
PubMed: 36178929
DOI: 10.1089/jpm.2022.0332