Preventing Reactions to Snake Antivenom with Low-Dose Adrenaline
Author Information
Author(s): de Silva H. Asita, Pathmeswaran Arunasalam, Ranasinha Channa D., Jayamanne Shaluka, Samarakoon Senarath B., Hittharage Ariyasena, Kalupahana Ranjith, Ratnatilaka G. Asoka, Uluwatthage Wimalasiri, Aronson Jeffrey K., Armitage Jane M., Lalloo David G., de Silva H. Janaka
Primary Institution: Clinical Trials Unit, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
Hypothesis
Can low-dose adrenaline, promethazine, and hydrocortisone prevent acute adverse reactions to antivenom in snakebite victims?
Conclusion
Low-dose adrenaline is safe and significantly reduces the risk of severe reactions to snake antivenom.
Supporting Evidence
- Adrenaline reduced severe reactions to antivenom by 43% at 1 hour.
- 75% of patients experienced acute reactions to antivenom.
- Hydrocortisone and promethazine did not significantly reduce adverse reactions.
Takeaway
Giving a small dose of adrenaline before snake antivenom can help stop bad reactions from happening.
Methodology
A randomized, double-blind, placebo-controlled trial with a 2×2×2 factorial design involving 1,007 patients.
Potential Biases
Potential bias in patient selection and treatment administration.
Limitations
The study was conducted in specific hospitals in Sri Lanka, which may limit generalizability.
Participant Demographics
Patients over 12 years old admitted after snakebite, with a mean age of 36.5 years and 77.1% male.
Statistical Information
P-Value
p<0.001
Confidence Interval
95% CI 0.43–0.75
Statistical Significance
p<0.001
Digital Object Identifier (DOI)
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