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Effect of glucose and sodium chloride mouth rinses on neuromuscular fatigue: a preliminary study

Khong TK, Selvanayagam V, Yusof A

Eur J Sport Sci, 2021 Feb;21(2):224-230.
PMID: 32056510 DOI: 10.1080/17461391.2020.1730980

Carbohydrate (CHO) mouth rinse has been shown to improve endurance performance and maintain the central drive of contracting muscles. Salt (NaCl) mouth rinse solution, often used in dentistry to desensitise the oral cavity to pain, could also activate cortical areas of the brain. Hence, the objective of this preliminary study was to investigate whether CHO (glucose) and NaCl mouth rinses could attenuate the reduction in maximum voluntary contraction (MVC) and sustained MVC (sMVC) following an endurance exercise (30-minute cycling at 70% VO2max). Ten subjects (male, age: 22 ± 1 years, weight: 65.3 ± 12.4 kg, height: 164.5 ± 7.5 cm, VO2max: 48.3 ± 6.1 mL kg-1 min-1) completed three trials of 30-minute cycling exercise. In a randomised cross-over study, in each trial, the participants rinsed using either water, 6% glucose, or 6% NaCl solution for 5 s immediately prior to and every 10 min during the cycling exercise. The MVC and sMVC were measured pre and post cycling. Analysis of variance showed significant interaction and time effects for MVC, while for sMVC there was a significant interaction with time and group effects. Both MVC and sMVC were higher post cycling in the glucose and NaCl groups compared to the water group, which suggests that activation of glucose and NaCl oral receptors could better preserve post-exercise force production. This is the first study to show that NaCl mouth rinse can produce a comparable effect on glucose. Hence, mouth rinses may be able to activate other distinct pathways that could attenuate fatigue.

Matched MeSH terms: Sodium Chloride/administration & dosage*
Colonic irrigation-induced hyponatremia

Norlela S, Izham C, Khalid BA

Malays J Pathol, 2004 Dec;26(2):117-8.
PMID: 16329564

A 42-year-old Chinese woman presented with transient confusional state and memory loss due to acute water intoxicational hyponatremia complicating colonic irrigation (enemas) used as an alternative medicine to promote health. Although there is no evidence that such "antiautointoxication" technique conveys true benefit in any condition, this form of "quackery" may actually cause harm, such as water intoxication as in this case.

Matched MeSH terms: Sodium Chloride/administration & dosage
A comparison of sputum induction methods: ultrasonic vs compressed-air nebulizer and hypertonic vs isotonic saline inhalation

Loh LC, Eg KP, Puspanathan P, Tang SP, Yip KS, Vijayasingham P, et al.

Asian Pac J Allergy Immunol, 2004 Mar;22(1):11-7.
PMID: 15366653

Airway inflammation can be demonstrated by the modem method of sputum induction using ultrasonic nebulizer and hypertonic saline. We studied whether compressed-air nebulizer and isotonic saline which are commonly available and cost less, are as effective in inducing sputum in normal adult subjects as the above mentioned tools. Sixteen subjects underwent weekly sputum induction in the following manner: ultrasonic nebulizer (Medix Sonix 2000, Clement Clarke, UK) using hypertonic saline, ultrasonic nebulizer using isotonic saline, compressed-air nebulizer (BestNeb, Taiwan) using hypertonic saline, and compressed-air nebulizer using isotonic saline. Overall, the use of an ultrasonic nebulizer and hypertonic saline yielded significantly higher total sputum cell counts and a higher percentage of cell viability than compressed-air nebulizers and isotonic saline. With the latter, there was a trend towards squamous cell contaminations. The proportion of various sputum cell types was not significantly different between the groups, and the reproducibility in sputum macrophages and neutrophils was high (Intraclass correlation coefficient, r [95%CI]: 0.65 [0.30-0.91] and 0.58 [0.22-0.89], p < 0.001). Overall changes in median FEV, were small and comparable between all groups. Induction using ultrasonic nebulizers together with hypertonic saline was generally less well tolerated than compressed-air nebulizers and isotonic saline. We conclude that in normal subjects, although both nebulizers and saline types can induce sputum with reproducible cellular profile, ultrasonic nebulizers and hypertonic saline are more effective but less well tolerated.

Matched MeSH terms: Sodium Chloride/administration & dosage
Fulltext Faster onset time of supraclavicular brachial plexus block using local anesthetic diluted with dextrose

Lim HJ, Hasan MS, Chinna K

Braz J Anesthesiol, 2016 Jul-Aug;66(4):341-5.
PMID: 27343781 DOI: 10.1016/j.bjane.2014.11.012

BACKGROUND AND OBJECTIVES: A high sodium concentration is known to antagonize local anesthetics when infiltrated around neural tissue. Thus, we hypothesized that the onset time for sensory and motor blockade, in supraclavicular brachial plexus block using ropivacaine diluted with dextrose would be shorter than with saline.

METHODS: Patients scheduled for upper limb surgery were randomized to receive ultrasound guided supraclavicular brachial plexus block with 0.5% ropivacaine. Evaluation of sensory and motor blockade was performed every 5min for 60min. Patients were followed-up on postoperative day 1, and between days 7 and 10 for the presence of any complications. Twenty-five patients in each group were analyzed.

RESULTS: Mean time for onset of analgesia for the dextrose group was 37.6±12.9min while the mean time for the saline group was 45.2±13.9min with a p-value of 0.05. The effect size was 0.567, which was moderate to large. No major complications were observed.

CONCLUSION: We conclude that there was a decrease in onset time of analgesia when dextrose was used as a diluent instead of saline for ultrasound guided supraclavicular block.

Matched MeSH terms: Sodium Chloride/administration & dosage
Strategies to Reduce Acute Kidney Injury and Improve Clinical Outcomes Following Percutaneous Coronary Intervention: A Subgroup Analysis of the PRESERVE Trial

Garcia S, Bhatt DL, Gallagher M, Jneid H, Kaufman J, Palevsky PM, et al.

JACC Cardiovasc Interv, 2018 11 26;11(22):2254-2261.
PMID: 30466822 DOI: 10.1016/j.jcin.2018.07.044

OBJECTIVES: The aim of this study was to compare intravenous (IV) sodium bicarbonate with IV sodium chloride and oral acetylcysteine with placebo for the prevention of contrast-associated acute kidney injury (CAAKI) and intermediate-term adverse outcomes.
BACKGROUND: Data are conflicting on the optimal strategy to reduce CAAKI and related complications after percutaneous coronary intervention (PCI).
METHODS: The PRESERVE (Prevention of Serious Adverse Events Following Angiography) trial used a 2 × 2 factorial design to randomize 5,177 patients with stage III or IV chronic kidney disease undergoing angiography to IV 1.26% sodium bicarbonate or IV 0.9% sodium chloride and 5 days of oral acetylcysteine or placebo. A subgroup analysis was conducted of the efficacy of these interventions in patients who underwent PCI during the study angiographic examination. The primary endpoint was a composite of death, need for dialysis, or persistent kidney impairment at 90 days; CAAKI was a secondary endpoint.
RESULTS: A total of 1,161 PRESERVE patients (mean age 69 ± 8 years) underwent PCI. The median estimated glomerular filtration rate was 50.7 ml/min/1.73 m2 (interquartile range: 41.7 to 60.1 ml/min/1.73 m2), and 952 patients (82%) had diabetes mellitus. The primary endpoint occurred in 15 of 568 patients (2.6%) in the IV sodium bicarbonate group and 24 of 593 patients (4.0%) in the IV sodium chloride group (odds ratio: 0.64; 95% confidence interval: 0.33 to 1.24; p for interaction = 0.41) and in 23 of 598 patients (3.8%) in the acetylcysteine group and 16 of 563 patients (2.8%) in the placebo group (odds ratio: 1.37; 95% confidence interval: 0.71 to 2.62; p for interaction = 0.29). There were no significant between-group differences in the rates of CAAKI.
CONCLUSIONS: Among patients with CKD undergoing PCI, there was no benefit of IV sodium bicarbonate over IV sodium chloride or of acetylcysteine over placebo for the prevention of CAAKI or intermediate-term adverse outcomes.

Matched MeSH terms: Sodium Chloride/administration & dosage*