The danger of chlorhexidine in lignocaine gel: A case report of anaphylaxis during urinary catheterisation

This article describes a case of anaphylaxis secondary to chlorhexidine during urethral catheterisation. Despite little evidence for the use of antiseptic lubricants in preventing catheter-associated urinary tract infections, the distribution and use of such products continues to be widespread. Chlorhexidine-free lubricating gel is widely available and should be used for urological procedures wherever possible.     

Chlorhexidine-induced degeneration of adrenergic nerves

Summary Possible toxic effects of chlorhexidine (CHX) on the sympathetic adrenergic ground plexus were studied in whole mounts of albino rat irides using Falck-Hillarp fluorescence histochemistry. CHX dissolved in an isotone, buffered sodium-acetate solution or in 70% alcohol was injected into the anterior chamber of eye. CHX caused a marked and dose-dependent degeneration of adrenergic nerves. Two days after the lowest dose, 0,25 g (5 l of a 0.05% CHX solution), approximately 30% of the nerves had disappeared. Almost complete degeneration was observed after the same time with higher doses (2.5 g, 5.0 g, and 7.5 g corresponding to 0.5, 1.0, and 1.5% CHX respectively). Two weeks after the lowest dose, the nerves had regenerated almost completely. With the highest dose used, only some 40% of the normal adrenergic nerve plexus had reformed after 51 days. Alcohol as a solvent did not have an additive effect on the neurotoxic action caused by CHX. The results demonstrate yet another aspect of chlorhexidine neurotoxicity, degeneration of peripheral adrenergic nerve terminals. This suggests that neurotoxic actions on thin unmyelinated fiber systems should be looked for also in the central nervous system (CNS).Supported by the Swedisch Council for Planning and Coordination of Research (Project: Chemical Hazards in the Environment), The Swedish Medical Research Council (14X-03185; 14P-5867; 04P-6889), Magnus Bergvalls Stiftelse, and Karolinska Institute Fonder     

复方替硝唑含漱液的制备与含量测定

目的:制备复方替硝唑含漱液,建立其含量测定方法并进行稳定性研究.方法:采用最大吸收波长法测定替硝唑的含量,用双波长等吸收点法测定醋酸氯己定的含量,恒温加速试验法考察稳定性.结果:替硝唑回归方程为C＝－0.039 68＋27.491 A,r＝0.999 9,醋酸氯己定回归方程为C＝0.062 47＋50.454 8△A,r＝0.999 99,精密度和回收率良好,置65℃(96 h),70℃(72 h),75℃(48 h)恒温水浴中加热,含量无明显下降.结论:复方替硝唑含嗽液制备方法简单,含量测定方法简便且稳定性好.     

HPLC法测定复方醋酸氯己定洗剂中醋酸氯己定和克霉唑含量

目的:建立复方醋酸氯己定洗剂的含量测定方法.方法:采用高效液相色谱法,μBndapak-C18柱(5μm,250 mm×3.9 mm);流动相为乙腈-甲醇-水(21:37:42),每1000ml内含磷酸5ml,三氟乙酸1 ml,三乙胺调pH3.9～4.0;流速为1 ml·min-1;检测波长为230 nm.结果:醋酸氯己定和克霉唑分别在10～125μg·m1和2～25 μg·ml-1范围内线性关系良好;平均回收率分别为95.6%及96.5%(RSD 1.2%,1.5%).结论:本法色谱分离效率高,专属性好,同时测定两种成份,方法简便.     

Evaluation of antimicrobial activity of association of chlorhexidine to photosensitizer used in photodynamic therapy in root canals infected by Enterococcus faecalis

IntroductionThe aim of the present study was to evaluate, in vitro, the influence of the addition of chlorhexidine to photosensitiser in the antimicrobial activity of photodynamic therapy in root canals infected by Enterococcus faecalis.MethodsThe root canals of 50 single-rooted human extracted teeth were enlarged up to a file F3 of Pro-Taper system, autoclaved, inoculated with Enterococcus faecalis and incubated for 14 days. The samples were divided into five groups (n = 10) according to the protocol of decontamination: G1 (control group) − no procedure was performed; G2–photosensitiser (0.01% methylene blue); G3–2% chlorhexidine gel; G4–photodynamic therapy; and G5–photodynamic therapy with photosensitiser modified by chlorhexidine. Microbiological test (CFU counting) was performed to evaluate the effectiveness of proposed treatments. Data were subjected to one-way ANOVA followed by post-hoc Tukey test (α=0.05).ResultsGroup 3 (CHX) showed the lowest mean contamination (2.03 log₁₀ CFU/mL), being statistically different from all other all groups (p < 0.05). There was no statistically significant difference between groups 4 (PDT) and 5 (PDT + CHX) (p < 0.05), being more effectives against E. faecalis when compared to groups 1 (NT) and 2 (MB), and less effective when compared to group 2 (CHX).ConclusionsThe addition of chlorhexidine to photosensitiser did not result in a better decontamination potential of photodynamic therapy alone over root canals infected by E. faecalis.     

Determination of ChloraPrep® drying time before neuraxial anesthesia in elective cesarean delivery. A prospective observational study

BackgroundChloraPrep® is a skin antiseptic commonly used before neuraxial anesthesia. It is believed that skin must be allowed to dry to prevent nerve damage by seeding ChloraPrep® solution into the neuraxis. We aimed to determine ChloraPrep® drying time in pregnant women before initiation of neuraxial anesthesia.MethodsIn 18 parturients undergoing elective cesarean delivery the skin ‘wetness’ after standardized ChloraPrep® application was prospectively assessed by blotting the skin with tissue paper and observing for residual orange tint. The isopropyl alcohol drying time was indirectly assessed by measuring the alcohol vapor concentration above the skin with a volatile organic compound analyzer. The primary outcome was the time measured from the end of skin preparation until tissue paper was no longer stained with orange tint. The secondary outcome was the time measured from the end of skin preparation until an abrupt reduction of isopropyl alcohol vapor concentration indicating that no further significant evaporation of alcohol was occurring.ResultsThe mean ChloraPrep® drying time assessed by blotting the skin with tissue paper was 123 s (SD 32 s, 95% CI 107 to 140 s, range 85–195 s). The estimated isopropyl alcohol drying time was 82 s (95% CI 77.4 to 86.3 s).ConclusionOur results suggest that ChloraPrep® drying time may be longer than the current manufacturer-recommended guideline of three minutes. The amount of ChloraPrep® used, application methods, patient characteristics, and environmental factors could influence the drying time.     

Clinical efficacy analysis of the mouth rinsing with pomegranate and chamomile plant extracts in the gingival bleeding reduction

Medicinal plants represent important therapeutic resources to health restoration, including the use of herbal products in the mouth conditions treatment. A randomized controlled clinical trial was performed in order to evaluate the effectiveness of mouth rinse with pomegranate and chamomile plant extracts, against chlorhexidine 0.12% in the gingiva bleeding condition. The mouth rinses with the herbal products were effective for this case, showing thus, antimicrobial and anti-inflammatory properties similar to that of chlorhexidine 0.12%.