Intra-articular Injection of Hyaluronic Acid combined with Sorbitol / Mannitol for Osteoarthritis TECHNOLOGY REVIEW (MINI-HTA) INTRAARTICULAR INJECTION OF HYALURONIC ACID COMBINED WITH SORBITOL / MANNITOL FOR OSTEOARTHRITIS Malaysian Health Technology Assessment Section (MaHTAS) Medical Development Division Ministry information, statement or content of this document or any of the source materials. Please contact htamalaysia@moh.gov.my if further information is required. SUGGESTED CITATION: Nur Farhana M, Ana Fizalinda AS and Izzuna MMG. Intra-articular Injection of Hyaluronic Acid combined with Sorbitol / Mannitol for Os-teoarthritis. Technology Review. Ministry of Health
Mannitol for bowel preparation: Efficacy and safety results from the SATISFACTION randomised clinical trial. Bowel preparation represents a significant issue to high-quality colonoscopy. Oral mannitol requires a single dose, is of low volume, and has a pleasant taste and rapid action. This SATISFACTION study compared single-dose (same day) oral mannitol 100 g/750 mL with standard split-dose PEG -ASC2 L (MoviPrep®). The primary endpoint was the proportion of patients with adequate bowel cleansing. Secondary endpoints included efficacy (adenoma detection rate, caecal intubation rate, time of evacuation), safety (intestinal gases concentration, haemato-chemical parameters, adverse events), and patient satisfaction. The study included 703 patients (352 treated with mannitol and 351 with PEG-ASC
Prospective study on the role of preoperative mannitol in capsulorhexis and reducing intraoperative complications in primary angle-closure disease surgery. To evaluate the effect of preoperative intravenous mannitol on the capsulorhexis process and intraoperative complications in patients with primary angle-closure glaucoma (PACG). In this prospective randomized controlled trial, 65 PACG eyes were randomized into the mannitol and control groups. The capsulorhexis duration, number of forceps grasps, need for viscoelastic re-injection, and intraoperative complications were recorded. The mannitol group had a significantly shorter capsulorhexis duration and fewer forceps grasps of the capsule. All intraoperative complications (18.2%) occurred in the control group. The patients
Clinical Outcomes of Hypertonic Saline vs Mannitol Treatment Among Children With Traumatic Brain Injury. The use of hypertonic saline (HTS) vs mannitol in the control of elevated intracranial pressure (ICP) secondary to neurotrauma is debated. To compare mortality and functional outcomes of treatment with 3% HTS vs 20% mannitol among children with moderate to severe traumatic brain injury (TBI ) with moderate to severe TBI (Glasgow Coma Scale [GCS] score ≤13). Treatment with 3% HTS compared with 20% mannitol. Multiple log-binomial regression analysis was performed for mortality, and multiple linear regression analysis was performed for discharge Pediatric Cerebral Performance Category (PCPC) scores and 3-month Glasgow Outcome Scale-Extended Pediatric Version (GOS-E-Peds) scores. Inverse probability
Mannitol provocation enhances laryngoscopic diagnosis of suspected inducible laryngeal obstruction. Inducible laryngeal obstruction (ILO) is confirmed by observing paradoxical vocal fold movement (PVFM) on laryngoscopy, but test sensitivity is reduced by its intermittent nature. Specificity of isolated expiratory PVFM is also unclear, possibly denoting a physiologic response to lower airway obstruction. To clarify laryngoscopic diagnosis in suspected ILO through mannitol provocation. In patients with suspected ILO, we assessed rates of laryngoscopic PVFM, both at baseline and following mannitol provocation, defined as; any inspiratory adduction, ≥50% expiratory adduction, or both. We also studied accentuation of laryngoscopic findings following mannitol provocation, defined as new
Efficacy of postoperative analgesia with intravenous paracetamol and mannitol injection, combined with thoracic paravertebral nerve block in post video-assisted thoracoscopic surgery pain: a prospective, randomized, double-blind controlled trial. Although video-assisted thoracoscopic surgery (VATS) has advantages of reduced injury and faster healing, patients still endure moderate and severe postoperative pain. Paracetamol and mannitol injection, the first acetaminophen injection in China, has the advantages of convenient administration, rapid onset of action, and no first-pass effect. This aim of this study was to investigate the efficacy of postoperative analgesia with paracetamol and mannitol injection, combined with thoracic paravertebral nerve block (TPVB) in post VATS pain. This study
Efficacy Evaluation of a Hyaluronic Acid Dermal Filler Containing Mannitol: Clinical and Aesthetic Assessment Using High-Frequency Ultrasound. Mannitol may be a good excipient for hyaluronic acid (HA) filler. This study aimed to assess the tolerability and effectiveness of a mannitol-containing HA filler for the improvement of nasolabial folds (NLFs). Thirty Middle Eastern participants aged 18 to 65 years with moderate-to-severe NLFs on the Wrinkle Severity Rating Scale (WSRS) received 1 to 2 mL of a HA filler containing mannitol in both NLFs. Wrinkle Severity Rating Scale; volume, depth, and area of NLFs; and ultrasound parameters were measured at baseline, Weeks 2, 12, and 24 after the injection. Adverse events and participants' satisfaction were recorded in all follow-up visits. Eighty
Mannitol versus furosemide in patients with thoracic malignancies who received cisplatin-based chemotherapy using short hydration: A randomized phase II trial. Mannitol is exclusively recommended in the National Comprehensive Cancer Network guidelines for diuresis in cisplatin (CDDP)-based chemotherapy. The utility of furosemide, a widely used and convenient diuretic, thus requires clarification . This is a prospective, single-centered, open-label, noninferiority phase II study. Patients with thoracic malignancies who planned to receive CDDP-based chemotherapy were randomly assigned to receive either mannitol (arm A) or furosemide (arm B). The primary end point was set as the proportion of patients who experienced any grade of "creatinine (Cr) increased" based on the upper limit of the normal range (ULN
Hyperosmolar Therapy in Elderly Neurosurgical Patients: Comparison of the Effect of Mannitol (20%) and Hypertonic Saline (3%) on Advanced Cardiovascular Parameters Using Transesophageal Echocardiography: A Preliminary Randomized Controlled Trial. Osmotherapeutic agents increase the intravascular volume by withdrawing water from the brain followed by relative hypovolemia due to diuresis leading to significant changes in systemic hemodynamics which might have adverse consequences in the elderly. We studied the effect of mannitol (20%) and hypertonic saline (HTS) (3%) on left ventricular outflow tract velocity time integral (LVOT-VTI) and cardiac output (CO) in elderly patients undergoing supratentorial neurosurgical procedures using transesophageal echocardiography. We recruited 28 patients aged above
Mannitol Reduces Pain and Trismus After Impacted Mandibular Third Molar Surgery. The removal of the lower third molar is a routine procedure in oral surgery, yet it often leads to postoperative side effects, particularly inflammation. Despite various interventions explored in prior studies, there is still a need for effective strategies, such as anti-inflammatory substances, to address postoperative side effects. The purpose of this study is to answer the following clinical question: Does the local injection of 0.9 M mannitol reduce postoperative pain, trismus, and swelling in patients undergoing bilateral symmetrically impacted mandibular third molar extraction? This prospective, single-blind, split-mouth study at Hamadan Dental School involved 30 patients with bilateral symmetrically
Comparison of mannitol and hypertonic saline solution for the treatment of suspected brain herniation during prehospital management of traumatic brain injury patients. Occurrence of mydriasis during the prehospital management of traumatic brain injury (TBI) may suggest severe intracranial hypertension (ICH) subsequent to brain herniation. The initiation of hyperosmolar therapy to reduce ICH and brain herniation is recommended. Whether mannitol or hypertonic saline solution (HSS) should be preferred is unknown. The objective of this study is to assess whether HSS, compared with mannitol, is associated with improved survival in adult trauma patients with TBI and mydriasis. A retrospective observational cohort study using the French Traumabase national registry to compare the ICU mortality
Effect of mannitol on postoperative delirium in patients undergoing coronary artery bypass graft: a randomised controlled trial. Postoperative delirium (POD), especially after cardiac surgery with cardiopulmonary bypass (CPB), is a relatively common and severe complication increasing side effects, length of hospital stay, mortality and healthcare resource costs. This study aimed to determine the impact of using mannitol serum in the prime of CPB for preventing the occurrence of delirium in patients undergoing coronary artery bypass surgery. This study is a single-centre, double-blinded, randomised, controlled trial that was conducted from December 2022 to May 2023. Patients in the age range of 18-70 who underwent elective coronary artery bypass surgery were included in the study
Incidence and risks of excessive distension absorption in hysteroscopic surgery using 5% mannitol solution: a retrospective descriptive study. To clarify the incidence of excessive distension absorption in hysteroscopic surgery using 5% mannitol solution, evaluate the associated risks, and help to establish a safe fluid deficit threshold for such complication. Retrospective descriptive study . Academic medical center. Ten thousand six hundred ninety-three patients underwent inpatient hysteroscopic surgery with 5% mannitol perfusion using a monopolar electrosurgical instrument from Jan. 2015 to Sep. 2020. None. This study has been approved by the Ethics Committee of Sun Yat-sen Memorial Hospital. A fluid deficit of more than 1000 mL was defined as the diagnostic criteria for excessive
Comparison of 4.54% hypertonic saline and 20% mannitol for brain relaxation during auditory brainstem implantation in pediatric patients: a single-center retrospective observational cohort study. Mannitol is frequently utilized to achieve intracranial brain relaxation during the retrosigmoid approach for auditory brainstem implantation (ABI). Hypertonic saline (HS) is an alternative for reducing intracranial pressure; however, its application during ABI surgery remains under-investigated. We aimed to compare the efficacy and safety between HS and mannitol for maintaining brain relaxation. This single-center retrospective cohort study included pediatric patients undergoing ABI surgery from September 2020 to January 2022 who received only 4.54% HS or 20% mannitol for brain relaxation. The analysis
Effects of dupilumab on mannitol airway hyperresponsiveness in uncontrolled severe asthma. Airway hyper-responsiveness (AHR) is a hallmark of persistent asthma. However, effects of IL-4/13 blockade with dupilumab (Dupi) on AHR are unknown. To investigate the effect of 12 weeks of Dupi on AHR, asthma control and quality of life. After a 4-week run-in on beclomethasone/formoterol(BDP/FM) MART (baseline), participants with uncontrolled type-2 high severe asthma received open-label Dupi 300mg 2-weekly, for 12 weeks. Mannitol challenges were done at baseline, 2, 4 and 12 weeks and following a 12-week washout. Study power was 90% to detect 1 doubling difference (dd) in mannitol PD FEV threshold at week 12. 23 out of 24 enrolled patients completed per protocol mannitol AHR at 12 weeks. Mean
Comparison of 20% mannitol and 3% hypertonic saline for intraoperative brain relaxation during supratentorial brain tumour craniotomy in patients with a midline shift. A prospective, randomized, double-blind study was designed to assess differences in brain relaxation between 20% mannitol and 3% hypertonic saline (HS) during elective supratentorial brain tumour surgery in patients with midline shift. Sixty patients undergoing supratentorial craniotomy for tumour resection were enrolled to receive either 5mL/kg of 20% mannitol (n=30) or 3% HS (n=30) administered at skin incision. P in arterial blood was maintained within 35-40mmHg and arterial blood pressure was controlled within baseline values ±20%. The primary outcome was the proportion of satisfactory brain relaxation. The surgeon
Which trial do we need? Mannitol therapy in hospitalized adult patients with tick-borne encephalitis and brain oedema: a double-blind placebo-controlled multicentre randomized trial.
Comparison of Equiosmolar Doses of 7.5% Hypertonic Saline and 20% Mannitol on Cerebral Oxygenation Status and Release of Brain Injury Markers During Supratentorial Craniotomy: A Randomized Controlled Trial. Hyperosmolar therapy is the mainstay of treatment to reduce brain bulk and optimize surgical exposure during craniotomy. This study investigated the effect of equiosmolar doses of 7.5 % hypertonic saline (HTS) and 20% mannitol on intraoperative cerebral oxygenation and metabolic status, systemic hemodynamics, brain relaxation, markers of cerebral injury, and perioperative craniotomy outcomes. A total of 51 patients undergoing elective supratentorial craniotomy were randomly assigned to receive 7.5% HTS (2 mL/kg) or 20% mannitol (4.6 mL/kg) at scalp incision. Intraoperative arterial