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dexmedetomidine and ketamine

James Mack Fudge, Bernie Page, Amy Mackrell, Inhyung Lee
OBJECTIVES: This study sought to determine if bupivacaine targeted at specific, potentially painful sites could enhance postoperative analgesia in routine feline ovariohysterectomies. A secondary objective was to assess the utility of multiple acute pain scales for cats in a high-volume surgery setting. METHODS: Two hundred and twelve cats were included in a prospective, randomized, double-blinded, placebo-controlled clinical trial. Anesthesia included buprenorphine, ketamine, dexmedetomidine and isoflurane...
February 5, 2019: Journal of Feline Medicine and Surgery
Susanne Dyal, Robert MacLaren
Background: Alcohol withdrawal occurs commonly but diagnosis and therapies have not been described. Objective: To characterize practices regarding the assessment and treatment of acute severe alcohol withdrawal and describe perceived barriers to therapies. Methods: A random sample of 500 US-based critical care pharmacists received the pretested, electronically distributed questionnaire. Results: 94 (20%) of 471 eligible recipients responded with diverse representation. Manifestations of alcohol withdrawal that were commonly rated as severe were seizures (91...
February 2019: Hospital Pharmacy
Michael P Schnetz, Harry S Hochheiser, David J Danks, Douglas P Landsittel, Keith M Vogt, James W Ibinson, Steven L Whitehurst, Sean P McDermott, Melissa Giraldo Duque, Ata M Kaynar
BACKGROUND: Mean arterial pressure (MAP), bispectral index (BIS), and minimum alveolar concentration (MAC) represent valuable, yet dynamic intraoperative monitoring variables. They provide information related to poor outcomes when considered together, however their collective behavior across time has not been characterized. METHODS: We have developed the Triple Variable Index (TVI), a composite variable representing the sum of z-scores from MAP, BIS, and MAC values that occur together during surgery...
January 14, 2019: BMC Medical Research Methodology
Min Hur, Sun-Kyung Park, Hyun-Kyu Yoon, Seokha Yoo, Hyung-Chul Lee, Won Ho Kim, Jin-Tae Kim, Ja Hyeon Ku, Jae-Hyon Bahk
BACKGROUND: Although many drugs or interventions have been studied to manage catheter-related bladder discomfort (CRBD), their comparative effectiveness is unknown. We attempted to assess the comparative effectiveness of the strategies to manage CRBD in patients undergoing urologic surgery including amikacin, solifenacin, darifenacin, butylscopolamine, dexmedetomidine, gabapentin, glycopyrrolate, ketamine, oxybutynin, resiniferatoxin, tolterodine, tramadol, caudal block, dorsal penile nerve block, lidocaine-prilocaine cream...
January 2, 2019: Journal of Anesthesia
Jessica M Jiron, Jorge L Mendieta Calle, Evelyn J Castillo, Abel M Abraham, Jonathan G Messer, Wendi L Malphurs, Carolyn Malinowski, Kristina Grove, Leah R Reznikov, Jasenka Zubcevic, J Ignacio Aguirre
Rice rats (Oryzomys palustris) are an unconventional laboratory species that has been used to study photoperiodicity,periodontitis, and osteonecrosis of the jaw. Interventional procedures that require anesthesia, including oral procedures, aresometimes necessary in preclinical settings. The use of anesthetics including isoflurane and ketamine combined with α2-adrenoreceptor agonists, such as dexmedetomidine and xylazine, is well-established for laboratory rodents. However, theireffects have been studied only modestly in rice rats...
December 20, 2018: Journal of the American Association for Laboratory Animal Science: JAALAS
Melissa D Smith, Michele Barletta, Kathryn A Diehl, Erik H Hofmeister, Samuel P Franklin
OBJECTIVE: To compare the effect of propofol and ketamine/diazepam for induction following premedication on intraocular pressure (IOP) in healthy dogs. STUDY DESIGN: Prospective, quasi-experimental, unmasked, longitudinal. ANIMALS: A total of 61 client-owned dogs. METHODS: Dogs were anesthetized twice with a 4 week washout period. Premedication with dexmedetomidine (5 μg kg-1 ) and hydromorphone (0.1 mg kg-1 ) intramuscularly was followed by either propofol (4 mg kg-1 ) or ketamine (5 mg kg-1 ) and diazepam (0...
October 11, 2018: Veterinary Anaesthesia and Analgesia
Madeline J Foertsch, Jessica B Winter, Abigail G Rhoades, Lukas T Martin, Christopher A Droege, Neil E Ernst
Alcohol withdrawal syndrome (AWS) is a complex neurologic disorder that develops after an acute reduction in or cessation of chronic alcohol consumption that alters neurotransmitter conduction. The incidence of AWS in the intensive care unit varies, but has been associated with poor outcomes. This is primarily driven by downregulation of gamma-aminobutyric acid (GABA) leading to autonomic excitability and psychomotor agitation. No clinical assessment tools have been validated to assess for AWS in the intensive care unit, particularly for patients requiring mechanical ventilation...
January 2019: Critical Care Nursing Quarterly
Fei Yang, Yang Liu, Qing Yu, Shangyingying Li, Jin Zhang, Mang Sun, Lu Liu, Yao Lei, Qing Tian, Hui Liu, Shengfen Tu
BACKGROUND: Intranasal procedural sedation using dexmedetomidine is well described in the literature. The combination of intranasal dexmedetomidine and ketamine is a novel approach for which there are little data on the rate of successful sedation or adverse events. OBJECTIVES: The aim of this study is to evaluate the rate of successful sedation and adverse events of intranasal procedural sedation using a combination of dexmedetomidine and ketamine for diagnostic examination in children...
November 28, 2018: Paediatric Anaesthesia
Jianxia Liu, Min Du, Lu Liu, Fei Cao, Ying Xu
BACKGROUND: Sedation is often required for young children during transthoracic echocardiography. Dexmedetomidine and ketamine are two sedatives that are commonly used in children for procedural sedation, but they have some disadvantages when they are used alone. AIMS: The aim of this retrospective study was to analyze the effects and safety of intranasal sedation with a combination of dexmedetomidine and ketamine during transthoracic echocardiography in young children and to analyze risk factors for sedation failure...
November 19, 2018: Paediatric Anaesthesia
Geoffrey R Browning, David Eshar, Hugues Beaufrere
Few studies evaluate anesthesia in black-tailed prairie dogs (Cynomys ludovicianus). Isoflurane inhalant anesthesia is usedin this species most commonly, but injectable protocols are poorly described. Here we compared the physiologic effects, including anesthetic depth, vital signs, and hematologic changes, of anesthetic protocols using isoflurane or a combination ofdexmedetomidine, ketamine, and midazolam in black-tailed prairie dogs. In a randomized, complete crossover study design, intact male black-tailed prairie dogs (n = 9; age, 6 mo) were anesthetized by using a combination of dexmedetomidine (0...
November 5, 2018: Journal of the American Association for Laboratory Animal Science: JAALAS
Nihar Ameta, Mathews Jacob, Shahbaz Hasnain, Gaurishankar Ramesh
Background and Aims: Shivering after spinal anesthesia is a common complication and can occur in as many as 40%-70% of patients after regional anesthesia. This shivering, apart from its physiological and hemodynamic effects, has been described as even worse than surgical pain. The aim of the study was to evaluate and compare the effectiveness of prophylactic use of intravenous (IV) ketamine, dexmedetomidine, and tramadol for prevention of shivering after spinal anesthesia. Material and Methods: Two hundred American Society of Anesthesiologists physical status I and II patients subjected to spinal anesthesia were included in the study...
July 2018: Journal of Anaesthesiology, Clinical Pharmacology
Dustin M Fink, Grayson A Doss, Kurt K Sladky, Christoph Mans
OBJECTIVE To evaluate whether the sedative effects of a combination of dexmedetomidine and ketamine differed when it was administered IM in a hind limb versus a forelimb of leopard geckos (Eublepharis macularius). DESIGN Randomized crossover study. ANIMALS 9 healthy adult leopard geckos. PROCEDURES Each gecko received a combination of dexmedetomidine (0.1 mg/kg [0.045 mg/lb]) and ketamine (10 mg/kg [4.5 mg/lb]; DK), IM, in a forelimb and hind limb in a randomized order and with a 7-day interval between treatments...
November 1, 2018: Journal of the American Veterinary Medical Association
Astha Jaikaria, Seema Thakur, Parul Singhal, Deepak Chauhan, Cheranjeevi Jayam, Kartik Syal
Introduction: It is common to encounter a patient who is anxious to the magnitude that precludes the possibility of provision of dental treatment. This study aims to evaluate and compare the sedative effect of oral combinations of midazolam-ketamine (MK), dexmedetomidine-fentanyl (DF), and dexmedetomidine-ketamine (DK) in a group of uncooperative children requiring dental treatment. Methodology: This was a prospective, randomized, triple-blind study where 36 children who were 3-9 year old with American Society of Anesthesiologists -I status and presenting early childhood caries were randomly assigned to: Group A - 0...
September 2018: Contemporary Clinical Dentistry
Greta Vladinov, Lilibeth Fermin, Renee Longini, Yanett Ramos, Edward Maratea
This study provides a review of the contemporary literature for the effects of most commonly used anesthetic drugs for sedation and anesthesia during adult electrophysiologic (EP) studies where supraventricular tachycardias (SVT) need to be induced for diagnostic purposes and/or catheter ablation. Some medications may affect cardiac electrophysiology and conduction, altering the ability to induce the arrhythmia, and may have negative impact on mapping and ablation treatment. The objective of the study is to determine the best sedative choice during SVT ablations...
November 2018: Pacing and Clinical Electrophysiology: PACE
Pyoyoon Kang, Sun-Kyung Park, Seokha Yoo, Min Hur, Won H Kim, Jin-Tae Kim, Jae-Hyon Bahk
INTRODUCTION: Although many drugs have been studied to prevent postoperative shivering, their comparative effectiveness is unknown. We attempted to assess the comparative effectiveness of the pharmacologic strategies to prevent shivering after surgery including intravenous (IV) and intrathecal (IT) meperidine, IV and IT dexmedetomidine, IV and IT clonidine, nefopam, tramadol, ketamine, and serotonin receptor antagonists. EVIDENCE ACQUISITION: We implemented a frequentist network meta-analysis of randomised trials...
September 18, 2018: Minerva Anestesiologica
Ki Jinn Chin, Stephen Lewis
STUDY DESIGN: A case report. OBJECTIVE: The aim of this study was to report the use of erector spinae plane (ESP) blocks as part of an opioid-free multimodal anesthetic regimen and its impact on postoperative pain and opioid requirements following spine surgery. SUMMARY OF BACKGROUND DATA: Posterior spinal fusion surgery is highly painful and usually requires significant amounts of opioids for adequate perioperative analgesia; this is commonly associated with adverse effects, including opioid-induced hyperalgesia, nausea, and ileus...
August 31, 2018: Spine
Daniel C Turner, Christopher A Girkin, J Crawford Downs
No abstract text is available yet for this article.
January 2019: Ophthalmology
Clemens R M Barends, Anthony R Absalom, Michel M R F Struys
PURPOSE OF REVIEW: Ambulatory procedural sedation is used to relieve anxiety, pain and discomfort in a broad spectrum of patients during many types of diagnostic or therapeutic procedures. This review focuses on recent comparative studies of commonly used and new drugs for adult ambulatory sedation. RECENT FINDINGS: Midazolam and propofol are commonly used for ambulatory sedation. Their pharmacological properties offer many advantages and there is much experience with their use...
December 2018: Current Opinion in Anaesthesiology
Kunal Tewari, Vishal V Tewari, Subroto K Datta
Background and Aims: Several drug combinations have been tried in patients with acyanotic congenital heart disease (ACHD) undergoing transcatheter device closure in the cardiac catheterisation laboratory (CCL). Adequate sedation, analgesia, akinesia, cardiorespiratory stability, and prompt recovery are key requirements. Ketamine with propofol is used for this purpose. Dexmedetomidine carries a shorter recovery time. This study compared dexmedetomidine-propofol (DP) with ketamine-propofol (KP) in patients in the CCL...
July 2018: Indian Journal of Anaesthesia
Jaime B Long, Kristin Bevil, Dobie L Giles
Preemptive analgesia is an intervention provided before initiating painful stimuli that may reduce or prevent subsequent pain. This systematic review examines the evidence supporting the practice of preemptive analgesia in minimally invasive gynecologic surgery (MIGS). We searched PubMed, Cochrane Register for Controlled Trials, and Embase from inception through February 26, 2018. The search was limited to human and English language studies. A total of 324 studies were identified. The abstracts were screened for relevance for minimally invasive gynecologic surgery (MIGS) and preemptive analgesia...
July 29, 2018: Journal of Minimally Invasive Gynecology
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