Xiao-Xiao Li, Yu-Mei Li, Xue-Li Lv, Xing-He Wang, Su Liu
BACKGROUND: The efficacy and safety of spinal anesthesia by intrathecal dexmedetomidine (DEX) for parturients undergoing cesarean section are still lack of evidence. This aim of our study was to evaluate the efficacy and safety of intrathecal DEX for parturients undergoing cesarean section to provide more data evidence for intrathecal applications. METHODS: Three hundred parturients undergoing cesarean section under spinal anesthesia were randomly assigned into three groups: group B: 9...
August 3, 2020: BMC Anesthesiology
Amir Reza Naemi, Vahid Kashanitabar, Alireza Kamali, Ashkan Shiva
Nausea is a mental sensation of unease and discomfort before vomiting. Vomiting refers to the return of the contents of the upper gastrointestinal tract to the mouth caused by contractions of chest and abdomen muscles. Postoperative nausea and vomiting is an unpleasant experience with high treatment costs. Therefore, this study aimed to compare the effects of haloperidol, metoclopramide, dexmedetomidine, and ginger on postoperative nausea and vomiting after laparoscopy. This double-blind clinical trial was performed on all laparoscopy candidates at Valiasr hospital, Arak, Iran...
April 2020: Journal of Medicine and Life
Annie Ting Wang, Promod Pillai, Elyse Guran, Harmony Carter, Tanya Minasian, John Lenart, Rashmi Vandse
BACKGROUND: Although the safety and feasibility of awake craniotomy is well-established for epilepsy and brain tumor surgery, its application for resection of vascular lesions, including arteriovenous malformations (AVMs) and cavernomas, is still limited. Apart from the usual challenges of awake craniotomy, vascular lesions pose several additional problems. Our goal is to determine the safety and practicality of awake craniotomy in patients with cerebral vascular malformations located near the eloquent areas, using a refined anesthetic protocol...
July 28, 2020: World Neurosurgery
Maziar Mahjoubifard, Mehdi Heidari, Maryam Dahmardeh, Seyed Bashir Mirtajani, Alireza Jahangirifard
Materials and Methods: This clinical trial was conducted on 90 patients, aged 30-70 years, who had heart surgery. The participants were categorized into three groups. Group D received 1  µ g/kg intravenous dexmedetomidine in 10 minutes, group L received 1.5 mg/kg lidocaine (1%) 90 seconds before intubation, and group F received 2  µ g/kg fentanyl. The vital signs (HR, SBP, DBP, and MAP) were measured before intubation and 1st, 3rd, 5th, and 10th minutes after intubation. Data were analyzed with SPSS 19 software (chi-square, one-way ANOVA, or Kruskal-Wallis)...
2020: Anesthesiology Research and Practice
Basia Hamata, Pouya Rezazadeh-Azar, Jessica Hann, Donald Griesdale
BACKGROUND: Buprenorphine/naloxone has been shown to be an effective treatment of opioid use disorder. According to the Canadian National clinical practice guideline on the management of opioid use disorders, given the superior safety profile of buprenorphine/naloxone and its potential for flexible take-home dosing in comparison to other opioid agonist medication it is strongly recommended to initiate opioid agonist treatment with buprenorphine/naloxone as the preferred first-line treatment when possible...
July 7, 2020: Journal of Addiction Medicine
Tien-Hua Chen, Cheng-Hsi Su, Chen-Yuan Hsiao, Shih-Yi Kao, Pei-Jiun Tsai
BACKGROUND: Patients undergoing pancreaticoduodenectomy (PD) for periampullary lesions are usually elderly with a high risk of postoperative morbidity and mortality. This retrospective cohort study investigated whether postoperative preemptive light sedation aids in recovery of elderly patients following PD. METHODS: Ninety-nine geriatric patients undergoing PD at one hospital were enrolled from 2009 to 2018. Patients in the sedation group received mechanical ventilation support and preemptively light sedation with fentanyl and propofol or dexmedetomidine in the first 5 days postoperatively in the intensive care unit (ICU)...
July 2020: Journal of the Chinese Medical Association: JCMA
Malik Jamil Ahmed, Abaid Ur Rehman, Rana Muhammad Arshad, Muhammad Wasim Ali Amjad, Zeeshan Khan, Aamir Furqan
Objective To observe the efficacy of dexmedetomidine vs morphine as an adjunct in a paravertebral block (PVB) with bupivacaine in postoperative analgesia following modified radical mastectomy. Study design This was a randomized controlled trial performed from June 2018 to August 2019 in the Department of Anesthesia, Bakhtawar Amin Medical and Dental College, Ch. Pervaiz Ellahi Institute of Cardiology, Multan, Gurki Hospital, Services Institute of Medical Sciences, and Sheikh Zayed Hospital, Lahore. Methodology Seventy-eight patients were equally divided into group M, which received morphine (3 mg) and group D, which received dexmedetomidine (1 µg/kg), along with 20 cc 0...
May 22, 2020: Curēus
Xing Jin, Ying Wu
In recent years, with the continuous understanding of pain knowledge and the continuous improvement of quality of life requirements, patient-controlled analgesia (PCA) has been widely used in a variety of pain patients. In this study, text mining technology was used to analyze relevant literature, try to find out the main drugs of PCA, classify the drugs, and dig out the important drug combination rules. PCA studies were retrieved from PubMed database in recent 10 years, and the bibliographic information of the literatures was taken as mining sample...
2020: Pain Research & Management
Amaya De Basagoiti, Xabier Antón, Amaya Calleja, Monike De Miguel, Eneritz Guerra, Begoña Loureiro, Ainara Campino
OBJECTIVES: The aim of this study was to describe the use of standard concentrations for continuous infusion drugs in Spanish neonatal intensive care units (NICUs). METHODS: We conducted an observational multicentre study based on a survey sent by email to 9 Spanish NICUs during January and February 2018. We collected data on intravenous drugs frequently used in neonates, and their preparation. Continuous infusion drugs with a standard concentration implemented in ≥2 NICUs were selected...
June 17, 2020: European Journal of Hospital Pharmacy. Science and Practice
Patrick J Nolan, Jeffrey A Delgadillo, Joseph M Youssef, Katherine Freeman, Jennifer L Jones, Arian Chehrehsa
PURPOSE: Propofol and fentanyl can cause airway obstruction and respiratory depression when used together for intravenous sedation. This study investigated whether dexmedetomidine and midazolam would decrease respiratory events requiring intervention during deep sedation compared with propofol, fentanyl, and midazolam. PATIENTS AND METHODS: A prospective, randomized, double-blinded, controlled trial was designed to assess 2 intravenous treatment groups during third molar surgery...
May 18, 2020: Journal of Oral and Maxillofacial Surgery
Chang-Hoon Koo, Sooyoung Jeon, Jinhee Kim, Jung-Hee Ryu
OBJECTIVES: Skull-pin head-holder application during neurosurgery is a highly noxious stimulus that may lead to abrupt hemodynamic change, which is an unfavorable response to maintain hemodynamics stability. The aim of this meta-analysis was to evaluate the effects of intravenous dexmedetomidine on hemodynamic response (blood pressure and heart rate) resulting from the application of skull-pin head-holder in neurosurgery. PATIENTS AND METHODS: A systematic review and meta-analysis was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guidelines...
May 20, 2020: Clinical Neurology and Neurosurgery
Melanie Jaeger, Rebecca L Attridge, Luke A Neff, G Christina Gutierrez
BACKGROUND: Ketamine, an N -methyl-d-aspartate receptor antagonist with sedative and analgesic properties, is becoming more popular as an adjunctive sedative in the critically ill patients. METHODS: We conducted a single center, retrospective cohort study of patients admitted to the medical intensive care unit (MICU) between 2013 and 2018. Patients who received continuous infusion ketamine or nonketamine sedatives (NKS) including dexmedetomidine, fentanyl, midazolam, or propofol were identified...
May 27, 2020: Journal of Pharmacy Practice
Ki Hwa Lee, Soo Jee Lee, Jae Hong Park, Se Hun Kim, Hyunseong Lee, Dae Seok Oh, Yong Han Kim, Yei Heum Park, Hyojoong Kim, Sang Eun Lee
Elderly patients with femoral fractures are anticipated to endure the most pain caused by positional changes required for spinal anesthesia. To improve pain relief, we compared the analgesic effects of intravenous dexmedetomidine-ketamine and dexmedetomidine-fentanyl combinations to facilitate patient positioning for spinal anesthesia in elderly patients with proximal femoral fractures. Forty-six patients were randomly assigned to two groups and received either 1 mg/kg of intravenous ketamine (group K) or 1 μg/kg of intravenous fentanyl (group F) concomitant with a loading dose of dexmedetomidine 1 μg/kg over 10 minutes, then dexmedetomidine infusion only was continued at 0...
May 2020: Medicine (Baltimore)
Satyajeet Misra, Bikram Kishore Behera, Jayanta Kumar Mitra, Alok Kumar Sahoo, Sritam Swarup Jena, Anand Srinivasan
Background: Dexmedetomidine, an alpha-2 agonist, has been used for attenuation of hemodynamic response to laryngoscopy, but not through the nebulized route. The aims of this study were to evaluate the effect of preoperative dexmedetomidine nebulization on the hemodynamic response to laryngoscopy-intubation, intraoperative anesthetic-analgesic requirements and recovery outcomes. Methods: 120 ASA I & II adult patients, of either gender, undergoing elective surgeries requiring tracheal intubation were enrolled and randomized to receive nebulized dexmedetomidine (1 µg/kg in 3-4 ml of 0...
May 20, 2020: Korean Journal of Anesthesiology
Abhyuday Kumar, Amarjeet Kumar, Neeraj Kumar, Ajeet Kumar
Background: Status Epilepticus, when continued despite the administration of two antiepileptic drugs, is called refractory status epilepticus (RSE). The seizure-like phenomenon due to propofol is widely reported in the literature. However, refractory status epilepticus (RSE) caused by propofol is rare and is a diagnostic dilemma. Case: A 44-year-old male patient presented with RSE during the intraoperative period and was under general anesthesia on propofol infusion...
May 11, 2020: Korean Journal of Anesthesiology
Dandan Feng, Rui Jia, Zhengliang Ma, Xiaoping Gu
OBJECTIVE: To explore risk factors for postoperative nausea and vomiting (PONV) that requires intervention with medications during adolescent idiopathic scoliosis (AIS) surgery. METHODS: We analyzed the data of 986 patients with AIS (including 156 male and 830 female patients) undergoing scoliosis surgery through a posterior approach between December, 2012 and January, 2016 in Nanjing Drum Tower Hospital. The data were collected from the patients including ASA grade, body mass index (BMI), Cobb angle, preoperative respiratory and cardiovascular diseases, operation time, type of anesthesia, quantity of intraoperative liquid infusion, blood loss, urine volume, the lowest MAP and CVP, intraoperative fentanyl consumption, and intraoperative administration of dexmedetomidine, dexamethasone, ondansetran and droperidol...
March 30, 2020: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
Unnikrishnan Prathapadas, Ajay Prasad Hrishi, Arulvelan Appavoo, Smita Vimala, Manikandan Sethuraman
Background  Dexmedetomidine could be a suitable adjuvant in neuroanesthesia due to its analgesic and anesthetic-sparing properties with the added advantage of facilitating intraoperative neuromonitoring. However, its recovery profile is still debated upon, as in neuroanesthesia, a prompt recovery is essential for postoperative neurologic assessment. We designed this study to evaluate the effect of dexmedetomidine on the anesthetic and recovery profile of patients presenting for supratentorial neurosurgeries...
April 2020: Journal of Neurosciences in Rural Practice
Sheng Hua Wu, David Vi Lu, Chun Dan Hsu, I Cheng Lu
Background and objectives: Flexible bronchoscopy has been widely used for diagnosis and intervention, while various drugs are used for sedation during bronchoscopy. We examined two regular standardized sedation options (with or without dexmedetomidine) regularly used in our regional hospital. The aim was to assess the efficacy and safety of dexmedetomidine on conscious sedation under bronchoscopy. Materials and Methods: A retrospective chart review was conducted from April 2017 to March 2018. All patients undergoing flexible bronchoscopy with moderate sedation were enrolled...
April 23, 2020: Medicina
Loredana Cristiano, Francesco Coppolino, Valerio Donatiello, Antonella Paladini, Pasquale Sansone, Maria Beatrice Passavanti, Vincenzo Pota, Luca Gregorio Giaccari, Caterina Aurilio, Giuseppe Sepolvere, Maria Caterina Pace
INTRODUCTION: Dexmedetomidine is a highly selective alpha-2 adrenoreceptor agonist without any effect on the GABA receptor. Its sedative, anxiolytic, analgesic, and sympatholytic activities together with opioid-sparing effects make it suitable for short- and long-term sedation in the intensive care setting. We report our experience with dexmedetomidine use during transfemoral transcatheter aortic valve implantation (TAVI) procedure as an alternative to general anesthesia. METHODS: This is a retrospective analysis of high-risk patients undergoing dexmedetomidine infusion for the transfemoral TAVI procedure between July 2017 and October 2019...
May 2020: Advances in Therapy
Jing Peng, Fujuan He, Chenguang Qin, Yuanyuan Que, Rui Fan, Bin Qin
Background: The intra- and postoperative effects of dexmedetomidine are not completely consistent and midazolam/fentanyl is most widely used in peripheral surgeries. The objectives of the study were to evaluate the sedative, analgesic, hemodynamic, anti-inflammatory, and antioxidant effects of dexmedetomidine against midazolam in patients undergoing peripheral surgeries with mild traumatic brain injuries. Methods: Medical records of patients who underwent peripheral surgeries with mild traumatic brain injury were included in the analysis...
April 2020: Dose-response: a Publication of International Hormesis Society
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