Objectives The objective of the study was to evaluate the in vitro virucidal activity of commercial mouthwashes against SARS‐CoV‐2 and variants of concern. Materials and Methods Antiviral activity was assessed at different time intervals, based on common use of these products by titrating residual viral infectivity on Vero E6 cells. Results All the mouthwashes were effective to reduce the infectious titers of SARS‐CoV‐2 and its tested variants. Mouthwashes Listerine ® Cool Mint milder taste and Listerine ® Cavity Protection milder taste reduced the infectious viral titer by up to 3.9 log10 after 30 s, while mouthwash Cetilsan ® Sugar Free was able to reduce the viral titer by 2.2–2.9 log10 at all tested time intervals. Mouthwash Curasept ® ADS DNA Intensive treatment was less effective to decrease viral infectivity (0.7–2.2 log10 TCID50/ml at all tested time intervals). Interestingly, the Gamma variant appeared more resistant to treatment in vitro with the different mouthwashes. Conclusions In this study, we were able to assess the ability of different mouthwashes to in vitro decrease the infectivity of SARS‐CoV‐2 and its variants, and we observed that Gamma variant of concern was more resistant to treatment with mouthwashes.
This study evaluated a protocol of light conscious sedation for multimodal analgesia in patients with a clinical history of acute myocardial infarction requiring tooth extraction and to assess postoperative pain by using the quantity intake of acetaminophen as the indicator. Material and methods All 50 patients received preliminary anxiolysis via oral chlordemethyldiazepam administration. After 15 to 20 minutes, only patients reporting they were not fully relaxed received additional intravenous diazepam before tooth extraction. Acetaminophen 1000 mg was suggested as the preferred postoperative analgesic drug. Results The studied patients included 39 women and 11 men with a mean age of 69.4 ± 17.1 years. They were classified according to the American Society of Anesthesiologists Physical Status classification system as follows: 12 patients belonging to class II, 32 patient to class III, and the remaining six to class IV. Based on the Modified Dental Anxiety Scale, six patients were phobic and seven anxious. Nevertheless, intravenous conscious sedation was needed in 23 patients via diazepam. The first day after surgery, 76% of patients took acetaminophen, and 58% took acetaminophen the second day, with a mean two-day total intake of acetaminophen of 1020 ± 789 mg/day. Stratified statistical analysis was performed and revealed that 60.87% of patients receiving intravenous diazepam needed to take acetaminophen on the first day after dental extraction in contrast to the 88.89% of patients who did not receive intravenous diazepam (χ 2 test; P = .021).
Background: Patients undergoing surgery and general anesthesia often experience anxiety, fear and stress, with negative bodily responses. These may be managed by the pre-procedural application of anxiolytic, analgesic, and anesthetic drugs that have, however, potential risks or side effects. Music therapy (MT) can be used as a complementary no-drug intervention alongside standard surgical care before, during and after medical procedures. The aim of this study was to evaluate the effects of preoperative MT intervention compared to premedication with midazolam on levels of anxiety, sedation and stress during general anesthesia for elective stomatology surgery. Methods: A two-arm randomized and controlled single-center, parallel-group, pre–post event study was conducted. In total, 70 patients affected by stage I or II (both clinically and instrumentally N0) micro-invasive oral cancer and undergoing elective surgery under general anesthesia were assigned to the control group (CG) or to the music therapy group (MTG). MTG patients received preoperative music therapy intervention (MT) from a certified music therapist before surgery, while the CG patients did not receive MT but instead received premedication with intravenous midazolam, 0,02 mg/kg. Anesthesia was the same in both groups. The systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) were recorded at the entrance to the operating room, just before the induction of anesthesia and every 5 min until the end of surgery. An anxiety visual analogues scale (A-VAS) was used to evaluate the level of anxiety. The bispectral index (BIS) monitor was used to measure the depth of sedation just before and 10 min after both music intervention and midazolam administration. Stress response was assessed 5 min before and 20 min after surgery via the control of plasma prolactin (PRL), growth hormone (GH), and cortisol levels. The patient global impression of satisfaction (PGIS) was tested 1 h after surgery. Participants in the MTG were asked to answer 3 questions concerning their experience with MT. Results: No statistical differences among the PRL, GH and cortisol levels between the two groups were registered before and after the treatment, as well as for PAS, PAD and HR. Significant differences in the A-VAS scores between the MTG and CG (p < 0.01) was observed. Compared to the CG, MTG patients had a statistically significantly lower BIS score (p = 0.02) before induction. A PGIS score of 86.7% revealed that patients in the MTG were very satisfied, versus 80% in the CG (p < 0.05). Conclusion: Preoperative music therapy could be an alternative to intravenous midazolam when aiming to promote a preoperative and post-operative state of anxiolysis and sedation in stomatology surgery, even if no differences were found in terms of the surgery-related stress response according to physiological and hormonal determinations.
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