Jiangling Wang, Xiaohong Yuan, Wenjing Guo, Xiaobin Xiang, Qicheng Wu, Man Fang, Wen Zhang, Zewu Ding, Kangjie Xie, Jun Fang, Huidan Zhou, Shuang Fu
Background : Sedation and analgesia use in percutaneous radiofrequency ablation (RFPA) for liver cancer is a necessary part of the procedure; however, the optimal medicine for sedation and analgesia for PRFA remains controversial. The aim of this study was to compare the perioperative pain management, haemodynamic stability and side effects between oxycodone (OXY) and fentanyl (FEN) use in patients under dexmedetomidine sedation. Methods: Two hundred and five adults with an American Society of Anaesthesiologists physical status score of I to II were included in this study...
2020: International Journal of Medical Sciences
Khaled Mohamed Fares, Sahar Abdel-Baky Mohamed, Ahmad Mohammad Abd El-Rahman, Rania Mohammed AbdeLemam, Amira Mahmoud Mohamed Osman
BACKGROUND: Intrathecal fentanyl in spinal anesthesia improves intra- and postoperative analgesia. Dexmedetomidine is a fascinating adjuvant with regards to neuraxial anesthesia in children experiencing surgery for abdominal malignancy. PATIENTS AND METHODS: After endorsement by the institutional reviewing board (IRB) and guardians' written informed consent, this research was carried out on 60 pediatric malignancy patients scheduled for major abdominal surgery. Children were randomly distributed into three groups (20 patients each): Group C: given 2 mL of bupivacaine 0...
September 11, 2020: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Pablo Nejamkin, Florencia Landivar, María Clausse, Matías Lorenzutti, Verónica Cavilla, Verónica Gutierrez, Paula Vivani, María Del Sole, Manuel Martin-Flores
OBJECTIVE: To compare, versus a control, the sensory, sympathetic and motor blockade of lidocaine 1% and 2% administered epidurally in bitches undergoing ovariohysterectomy. STUDY DESIGN: Randomized, blinded, controlled clinical trial. ANIMALS: A total of 24 mixed-breed intact female dogs. METHODS: All dogs were administered dexmedetomidine, tramadol and meloxicam prior to general anesthesia with midazolam-propofol and isoflurane...
August 7, 2020: Veterinary Anaesthesia and Analgesia
Michael C Grant, Tetsuro Isada, Pavel Ruzankin, Allan Gottschalk, Glenn Whitman, Jennifer S Lawton, Jeffrey Dodd-O, Viachaslau Barodka
BACKGROUND: Cardiac anesthetics rely heavily on opioids, with the standard patient receiving between 70 and 105 morphine sulfate equivalents (MSE; 10-15 µg/kg of fentanyl). A central tenet of Enhanced Recovery Programs (ERP) is the use of multimodal analgesia. This study was performed to assess the association between nonopioid interventions employed as part of an ERP for cardiac surgery and intraoperative opioid administration. METHODS: This study represents a post hoc secondary analysis of data obtained from an institutional ERP for cardiac surgery...
September 1, 2020: Anesthesia and Analgesia
Do Hyun Kim, Junuk Lee, Sung Won Kim, Se Hwan Hwang
Objectives: A systematic review of the literature was conducted to evaluate hypotensive agents in terms of their adverse effects and associations with perioperative morbidity in patients undergoing nasal surgery. Methods: Two authors independently searched databases (Medline, Scopus, and Cochrane databases) up to February 2020 for randomized controlled trials comparing the perioperative administration of a hypotensive agent with a placebo or other agent. The outcomes of interest for this analysis were intraoperative morbidity, operative time, intraoperative bleeding, hypotension, postoperative nausea/vomiting, and postoperative pain...
August 28, 2020: Clinical and Experimental Otorhinolaryngology
K Guru, S Adinarayanan, B Krishnan, Satyen Parida, B Hemavathi, Prasanna Udupi Bidkar, K Narmadhalakshmi
Purpose: Reconstructive surgeries following fractures in the maxillofacial region often involve considerable bone manipulation, and paracetamol is a commonly used analgesic medication in both intraoperative and postoperative periods. Dexmedetomidine, an alpha-2 adrenoceptor agonist, has both sedative and analgesic properties with minimal cardiorespiratory effects and has been used primarily for its sedative properties in oral and maxillofacial surgery. Aims and Objectives: To compare the intraoperative analgesic requirements among patients undergoing oral and maxillofacial surgery who receive IV paracetamol versus IV dexmedetomidine...
September 2020: Journal of Maxillofacial and Oral Surgery
Andrea Trombetta, Francesca Cossovel, Domenico Leonardo Grasso, Egidio Barbi
OBJECTIVES: We report a case series of one-time 4 mcg/kg dose of intranasal dexmedetomidine and 1 mcg/kg of intranasal fentanyl plus inhaled nitrous oxide for procedural sedation in children with otitis media with effusion (OME) for tympanostomy tube placement with a specific handheld device (Solo TTD, AventaMed ®). METHODS: A retrospective review was conducted in a tertiary paediatric teaching hospital on patients with OME referred from December 2018 to December 2019 in need of procedural sedation for myringotomy and ventilation tube insertion (VTI)...
September 2020: International Journal of Pediatric Otorhinolaryngology
Sweta V Salgaonkar, Nisha M Jain, Sachin P Pawar
Background and Aims: Patients with major burns posted for early tangential excision and skin grafting pose peculiar challenges for anaesthesiologists. The purpose of the study was to assess safety and efficacy of total intravenous anaesthesia (TIVA) with tumescent infiltration anaesthesia (TIA) for these burn procedures. Methods: This observational single-arm study was conducted on 48 cases of a tertiary centre burn unit, requiring early tangential excision and skin grafting between third and fifth days of burn injury...
July 2020: Indian Journal of Anaesthesia
Reeva C Mincer, Crystal J Lee, Evelyn M Chung, Brian Huang, Eric C Sung
AIM: To assess the efficacy of dexmedetomidine (DEX) on the intravenous moderate sedation (IVMS) regimen, while treating patients of the special patient care (SPC) population. This study aims to incorporate DEX into the typical IVMS drug regimen in order to reduce the amount of benzodiazepines (BZD) and opioids administered and as a result reduce the amount of unwanted side effects. METHOD AND RESULTS: A retrospective study was performed in the University of California Los Angeles (UCLA) SPC Clinic, where 42 patients were seen with and without DEX for dental treatment under IVMS...
August 10, 2020: Special Care in Dentistry
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
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