keyword
https://read.qxmd.com/read/32480196/the-effects-of-intravenous-dexmedetomidine-on-hemodynamic-response-in-patients-undergoing-skull-pin-head-holder-application-during-neurosurgery-a-meta-analysis-of-randomized-controlled-trials
#21
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
https://read.qxmd.com/read/32458765/safety-and-effectiveness-of-sedation-with-adjunctive-ketamine-versus-nonketamine-sedation-in-the-medical-intensive-care-unit
#22
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
https://read.qxmd.com/read/32443302/analgesia-for-spinal-anesthesia-positioning-in-elderly-patients-with-proximal-femoral-fractures-dexmedetomidine-ketamine-versus-dexmedetomidine-fentanyl
#23
RANDOMIZED CONTROLLED TRIAL
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)
https://read.qxmd.com/read/32434291/the-effect-of-preoperative-dexmedetomidine-nebulization-on-the-hemodynamic-response-to-laryngoscopy-and-intubation-a-randomized-control-trial
#24
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
https://read.qxmd.com/read/32388939/intraoperative-refractory-status-epilepticus-caused-by-propofol
#25
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
https://read.qxmd.com/read/32376591/-risk-factors-for-nausea-and-vomiting-after-adolescent-idiopathic-scoliosis-surgery
#26
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
https://read.qxmd.com/read/32367982/effect-of-low-dose-dexmedetomidine-on-the-anesthetic-and-recovery-profile-of-sevoflurane-based-anesthesia-in-patients-presenting-for-supratentorial-neurosurgeries-a-randomized-double-blind-placebo-controlled-trial
#27
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
https://read.qxmd.com/read/32340204/the-effectiveness-of-low-dose-dexmedetomidine-infusion-in-sedative-flexible-bronchoscopy-a-retrospective-analysis
#28
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
https://read.qxmd.com/read/32297286/use-of-dexmedetomidine-in-transfemoral-transcatheter-aortic-valve-implantation-tf-tavi-procedures
#29
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
https://read.qxmd.com/read/32284701/intraoperative-dexmedetomidine-versus-midazolam-in-patients-undergoing-peripheral-surgery-with-mild-traumatic-brain-injuries-a-retrospective-cohort-analysis
#30
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
https://read.qxmd.com/read/32275025/cardioprotective-effects-of-propofol-dexmedetomidine-in-open-heart-surgery-a-prospective-double-blind-study
#31
Ahmed Said Elgebaly, Sameh Mohamad Fathy, Ayman Ahmed Sallam, Yaser Elbarbary
Background: Myocardial protection in cardiac surgeries is a must and requires multimodal approaches in perioperative period to decrease and prevent the increase of myocardial oxygen demand and consumption that lead to postoperative cardiac complications including myocardial ischemia, dysfunction, and heart failure. Study Design: Prospective, controlled, randomized, double-blinded study. Aims: This study aims to study the effect of propofol-dexmedetomidine continuous infusion cardioprotection during open-heart surgery in adult patients...
April 2020: Annals of Cardiac Anaesthesia
https://read.qxmd.com/read/32256348/efficacy-and-safety-of-midazolam-oral-solution-for-sedative-hypnosis-and-anti-anxiety-in-children-a-systematic-review-and-meta-analysis
#32
Xiao Cheng, Zhe Chen, Lingli Zhang, Peipei Xu, Fang Qin, Xuefeng Jiao, Yiyi Wang, Mao Lin, Linan Zeng, Liang Huang, Dan Yu
Background: Midazolam is recommended by health guidelines for sedation and hypnosis in children. Oral solution is a suitable dosage form for children. But there is no conclusive evidence for sedative-hypnosis and antianxiety effects by midazolam oral solution in children. Methods: Relevant studies were identified through searching PubMed, Embase, Cochrane Library, CINAHL, International Pharmaceuticals, four Chinese electronic databases, and relevant lists. Two reviewers independently selected trials, assessed trial quality, and extracted the data...
2020: Frontiers in Pharmacology
https://read.qxmd.com/read/32255203/comparative-efficacy-of-ancillary-drugs-in-sevoflurane-related-emergence-agitation-after-paediatric-adenotonsillectomy-a-bayesian-network-meta-analysis
#33
Hongmei Jiao, Hongwei Wang, Ziru Jiang, Jingli Hu
WHAT IS KNOWN AND OBJECTIVE: The comparative efficacy of ancillary drugs on sevoflurane-related emergence agitation (EA) in paediatric anaesthesia for adenotonsillectomy remains unclear. The purpose of this Bayesian network meta-analysis was to investigate the efficacy of ancillary drugs on sevoflurane-related EA in paediatric anaesthesia for adenotonsillectomy. METHODS: MEDLINE, Embase, the Cochrane Library and Web of Science databases were electronically searched to identify randomized controlled trials (RCTs) of different ancillary drugs used in adenotonsillectomy from inception to April 2019...
April 7, 2020: Journal of Clinical Pharmacy and Therapeutics
https://read.qxmd.com/read/32210319/glun2a-selective-positive-allosteric-modulator-nalmefene-flumazenil-reverses-ketamine-fentanyl-dexmedetomidine-induced-anesthesia-and-analgesia-in-rats
#34
Chunzhu Li, Jia Yan, Dewei Tang, Jidong Zhu, Chen Huang, Yu Sun, Rong Hu, Hao Wang, Chaoying Fu, Yelin Chen, Hong Jiang
Anesthetics are used to produce hypnosis and analgesic effects during surgery, but anesthesia for a long time after the operation is not conducive to the recovery of animals or patients. Therefore, finding appropriate treatments to counter the effects of anesthetics could enhance postoperative recovery. In the current study, we discovered the novel role of a GluN2A-selective positive allosteric modulator (PAM) in ketamine-induced anesthesia and investigated the effects of the PAM combined with nalmefene and flumazenil (PNF) in reversing the actions of an anesthetic combination (ketamine-fentanyl-dexmedetomidine, KFD)...
March 24, 2020: Scientific Reports
https://read.qxmd.com/read/32209963/effect-of-dexmedetomidine-on-dynamic-cerebral-autoregulation-and-carbon-dioxide-reactivity-during-sevoflurane-anesthesia-in-healthy-patients
#35
Sujoy Banik, Girija P Rath, Ritesh Lamsal, Parmod K Bithal
Background: Some early reports on dexmedetomidine suggest that it impairs cerebral autoregulation and may have deleterious effects; however, concrete evidence is lacking. This study was perfomed to assess its effect on dynamic cerebral autoregulation (dCA) using transcranial Doppler (TCD). Methods: Thirty American Society of Anesthesiologists physical status I and II patients between 18 and 60 years, undergoing lumbar spine surgery, received either an infusion of dexmedetomidine (Group D) or normal saline (Group C), followed by anesthesia induction with propofol, fentanyl and maintenance with oxygen, nitrous oxide and sevoflurane...
March 25, 2020: Korean Journal of Anesthesiology
https://read.qxmd.com/read/32166278/spectrum-of-current-management-of-pediatric-pulmonary-hypertensive-crisis
#36
Meghan L Bernier, Lewis H Romer, Melania M Bembea
Pulmonary hypertension is a growing pediatric problem and children may present with pulmonary hypertensive crisis-a life-threatening emergency requiring acute interventions. The aim of this study was to characterize the broad spectrum of care provided in North American PICUs for children who present with pulmonary hypertensive crisis. Design: Electronic cross-sectional survey. Survey questions covered the following: demographics of the respondents, institution, and patient population; pulmonary hypertension diagnostic modalities; pulmonary hypertension-specific pharmacotherapies; supportive therapies, including sedation, ventilation, and inotropic support; and components of multidisciplinary teams...
August 2019: Critical care explorations
https://read.qxmd.com/read/32139928/outcomes-of-intrathecal-analgesia-in-multiparous-women-undergoing-normal-vaginal-delivery-a-randomised-controlled-trial
#37
Gaballah M Khaled, Abdallah I Sabry
Background and Aims: Although intrathecal analgesia is an effective option during labour, there is a need to establish sustainable and assured analgesia during the entire labour process. We aimed to assess the effect of adding dexmedetomidine, fentanyl or morphine to low-dose bupivacaine-dexamethasone for intrathecal labour analgesia in multiparous women. Methods: This was a triple-blind, randomised controlled trial that included 140 multiparous women. Eligible women were randomly allocated to have intrathecal bupivacaine-dexamethasone with dexmedetomidine (group D), fentanyl (group F), morphine (group M) or saline (placebo) (group C)...
February 2020: Indian Journal of Anaesthesia
https://read.qxmd.com/read/32103353/anesthetic-management-of-a-child-with-catecholaminergic-polymorphic-ventricular-tachycardia-undergoing-insertion-of-implantable-cardioverter-defibrillator-a-case-report
#38
Keisuke Omiya, Kazuha Mitsui, Takashi Matsukawa
BACKGROUND: Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a fatal cardiac ion channelopathy that causes sudden unexpected death in the young. CASE PRESENTATION: The patient was a 3-year-old girl with CPVT. Insertion of an implantable cardioverter defibrillator (ICD) using epicardial pacing was scheduled. After premedication of rectal midazolam was given, general anesthesia was induced with midazolam, fentanyl, and rocuronium, and maintained with midazolam, fentanyl, remifentanil, and rocuronium...
February 26, 2020: JA clinical reports
https://read.qxmd.com/read/32098647/medications-to-reduce-emergence-coughing-after-general-anaesthesia-with-tracheal-intubation-a-systematic-review-and-network-meta-analysis
#39
REVIEW
Alan Tung, Nicholas A Fergusson, Nicole Ng, Vivien Hu, Colin Dormuth, Donald E G Griesdale
BACKGROUND: Emergence coughing can harm the patient following completion of surgery, but it is unclear which medication is most effective at reducing this event. We conducted a systematic review and network meta-analysis of RCTs to determine the medications' relative efficacies on decreasing moderate to severe emergence coughing after general anaesthesia. Medications studied were lidocaine (i.v., intracuff, topical, or tracheal application), dexmedetomidine, remifentanil, and fentanyl...
February 22, 2020: British Journal of Anaesthesia
https://read.qxmd.com/read/32009711/comparing-effects-of-intrathecal-adjuvants-fentanyl-and-dexmedetomidine-with-hyperbaric-ropivacaine-in-patients-undergoing-elective-infraumbilical-surgeries-a-prospective-double-blind-clinical-study
#40
T K Shashikala, Sachinkumar S Sagar, Puttaiah Ramaliswamy, Vinod V Hudgi
Background: Spinal anesthesia is most commonly used anesthesia technique for infraumbilical surgeries, and it is cost-effective with decreased hospital stay. Intrathecal isobaric ropivacaine has shorter duration of anesthesia than bupivacaine. By making, ropivacaine hyperbaric will help to achieve dense block with good postoperative analgesia. Materials and Methods: Ninety patients with American Society of Anesthesiologists physical status Classes I and II, aged between 18 and 60 years of either sex, undergoing for elective infraumbilical surgeries were randomly allocated into three groups 30 each ( n = 30)...
October 2019: Anesthesia, Essays and Researches
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