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Sang-Taek Im, Youn Yi Jo, Gayoung Han, Hyun Jung Jo, Yong Ho Kim, Chul-Kyu Park
Dexmedetomidine, an α 2-adrenoceptor agonist, is widely used as a sedative and analgesic agent in a number of clinical applications. However, little is known about the mechanism by which it exerts its analgesic effects on the trigeminal system. Two types of voltage-gated sodium channels, Nav 1.7 and Nav 1.8, as well as α 2-adrenoceptors are expressed in primary sensory neurons of the trigeminal ganglion (TG). Using whole-cell patch-clamp recordings, we investigated the effects of dexmedetomidine on voltage-gated sodium channel currents ( I Na ) via α 2-adrenoceptors in dissociated, small-sized TG neurons...
2018: Mediators of Inflammation
Haiping Xu, Baisong Zhao, Yingjun She, Xingrong Song
Dexmedetomidine, a selective α2 adrenergic agonist, has been shown to have neuroprotective and anti-apoptotic effects. To further investigate the underlying mechanisms, we used a rat model of spinal neurotoxicity induced by intrathecal administration of lidocaine. Four days after intrathecal catheter implantation, rats received an intraperitoneal injection of various doses of dexmedetomidine before an intrathecal injection of 20 µL 10% lidocaine. Dexmedetomidine-pretreated rats were also exposed to a selective α2 -adrenergic antagonist (yohimbine) or a specific protein kinase C (PKC) inhibitor (Gö 6983) that selectively inhibits several PKC isoforms...
September 18, 2018: Neurotoxicology
Julian Flükiger, Alexa Hollinger, Benjamin Speich, Vera Meier, Janna Tontsch, Tatjana Zehnder, Martin Siegemund
BACKGROUND: To determine the preventive and therapeutic effect of dexmedetomidine on intensive care unit (ICU) delirium. METHODS: The literature search using PubMed and the Cochrane Central Register of Controlled Trials was performed (August 1, 2018) to detect all randomized controlled trials (RCTs) of adult ICU patients receiving dexmedetomidine. Articles were included if they assessed the influence of dexmedetomidine compared to a sedative agent on incidence of ICU delirium or treatment of this syndrome...
September 20, 2018: Annals of Intensive Care
Katarzyna Kotfis, Marta Strzelbicka, Małgorzata Zegan-Barańska, Krzysztof Safranow, Mirosław Brykczyński, Maciej Żukowski, Eugene Wesley Ely
Patients after cardiac surgery experience significant pain, but cannot communicate effectively due to opioid analgesia and sedation. Identification of pain with validated behavioral observation tool in patients with limited abilities to self-report pain improves quality of care and prevents suffering. Aim of this study was to validate Polish version of behavioral pain scale (BPS) in intubated, mechanically ventilated patients sedated with dexmedetomidine and morphine after cardiac surgery.Prospective observational cohort study included postoperative cardiac surgery patients, both sedated with dexmedetomidine and unsedated, observed at rest, during a nociceptive procedure (position change) and 10 minutes after intervention...
September 2018: Medicine (Baltimore)
Shu Tomita, Shinya Yamazaki, Kohei Togami, Hitoshi Tada, Hiroyoshi Kawaai
Dexmedetomidine (DEX) is a sedative and analgesic agent that acts via the alpha-2 adrenoreceptor and is associated with reduced anesthetic requirements, as well as attenuated blood pressure and heart rate in response to stressful events. A previous study reported that cat gingival blood flow was controlled via sympathetic alpha-adrenergic fibers involved in vasoconstriction. In the present study, experiment 1 focused on the relationship between the effects of DEX on alpha adrenoreceptors and vasoconstriction in the tissues of the oral cavity and compared the palatal mucosal blood flow (PMBF) in rabbits between general anesthesia with sevoflurane and sedation with DEX...
2018: Anesthesia Progress
Rambod Amirnovin, L Nelson Sanchez-Pinto, Carol Okuhara, Phuong Lieu, Joyce Y Koh, John W Rodgers, Lara P Nelson
OBJECTIVES: Opioids and benzodiazepines are commonly used to provide analgesia and sedation for critically ill children with cardiac disease. These medications have been associated with adverse effects including delirium, dependence, withdrawal, bowel dysfunction, and potential neurodevelopmental abnormalities. Our objective was to implement a risk-stratified opioid and benzodiazepine weaning protocol to reduce the exposure to opioids and benzodiazepines in pediatric patients with cardiac disease...
September 17, 2018: Pediatric Critical Care Medicine
Haidi Qiu, Zhe Sun, Fathima Shadhiya, Renuka Arulthas, Gita Vishnu Priya, Pariyatha Christopher, Zulaihat Muhammad, Yonghao Yu
In the clinical settings, patients often develop opioid-induced hyperalgesia (OIH) after utilization of high dose intra-operative remifentanil. Systemic α2 agonists, including dexmedetomidine, are believed to reduce pain and opioid requirements after surgery, thus decreasing the incidence of hyperalgesia. The present study aimed to investigate the effect of dexmedetomidine on remifentanil-induced hyperalgesia and explored the sex differences. A total of 48 patients (24 male, 24 female) with an American Society of Anesthesiologists physical status of I-II that were undergoing thyroidectomy were randomly assigned to one of the following six groups: Male controlled group (MC) and female controlled group (FC) (group MC, n=8 and group FC, n=8), which received a preoperative placebo of 0...
October 2018: Experimental and Therapeutic Medicine
Bin Zheng, Shuncai Zhang, Yanlu Ying, Xinying Guo, Hengchang Li, Lixin Xu, Xiangcai Ruan
The abnormally high nucleotide-binding oligomerization domain (NOD)-like receptor family pyrin domain containing 3 (NLRP3) inflammasome activity is a typical characteristic of traumatic brain injury (TBI). Dexmedetomidine (Dex) is a highly selective alpha-2 adrenergic receptor agonist that inhibits the activation of NLRP3. Thus, it was hypothesized that Dex could attenuate TBI by inhibiting NLRP3 inflammasome activity in hippocampus. Rats were subjected to controlled cortical impact method to induce TBI and treated with Dex...
September 19, 2018: Bioscience Reports
Guobin Wang, Jianhua Niu, Zhitao Li, Haifeng Lv, Hongliu Cai
This study aimed to evaluate the efficacy and safety of dexmedetomidine versus any other treatment without dexmedetomidine in patients who have undergone cardiac surgery. Electronic databases including PubMed, Embase, and Cochrane Library were systematically searched without limitations of language and publication time. Randomized controlled trials (RCTs) aiming to evaluate the efficacy and safety of dexmedetomidine versus any other treatment without dexmedetomidine in patients that have undergone cardiac surgery were selected...
2018: PloS One
G Wang, J-Y Li, Y-Q Weng, M Ding, H-L Yu, Q Wang, H-C Ren, R-B Xu, W-L Yu
OBJECTIVE: We investigated the protective effect of ulinastatin combined with dexmedetomidine on lung injury after hepatic ischemia-reperfusion in rats. MATERIALS AND METHODS: A total of 60 healthy and clean male Sprague Dawley (SD) rats were divided into the blank control group (group O), the model control group (group K), the ulinastatin and dexmedetomidine group (group F) according to random number table with 20 rats in each group. RESULTS: The plasma concentrations of tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), interleukin-8 (IL-8) and malondialdehyde (MDA) at T1, T2 and T3 time points in rats of the three groups were significantly higher than those of the T0 time point (p<0...
September 2018: European Review for Medical and Pharmacological Sciences
Myoung H Kim, Ki Y Lee, Sun J Bae, Minju Jo, Jin S Cho
BACKGROUND: Surgical stress induces stress hormone release and sympathetic hyperactivation, resulting in hemodynamic instability. Dexmedetomidine has sympatholytic and hemodynamic stabilizing effects. We investigated whether dexmedetomidine could attenuate stress responses in major spine surgery. METHODS: In this prospective randomized study, 52 patients undergoing spine fusion surgery were randomized to placebo (n=26) or to dexmedetomidine (n=26) groups. Dexmedetomidine at a rate of 0...
September 18, 2018: Minerva Anestesiologica
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
Yong Xiao, Lifang Zhou, Youbing Tu, Yuantao Li, Yubing Liang, Xu Zhang, Jing Lv, Yu Zhong, Yubo Xie
Background: Propofol induces short- and long-term neurotoxicity. Our previous study showed that dexmedetomidine (Dex) can attenuate the propofol-induced acute neurotoxicity in rodents by enhancing the PI3K/Akt signaling. However, whether treatment of young rats with Dex could protect them from long-term neurotoxicity induced by propofol is unclear. Materials and methods: Seven-day-old male Sprague Dawley rats were randomized and injected intraperitoneally with saline (100 μL, NS), propofol (100 mg/kg), Dex (75 μg/kg), propofol (100 mg/kg) plus Dex (25, 50 or 75 μg/kg), 10% dimethyl sulfoxide (DMSO, 100 μL) or TDZD-8 (a GSK3β inhibitor, 1 mg/kg), or intracerebroventricularly with DMSO (5 μL) or LY294002 (a PI3K inhibitor, 25 μg/5 μL DMSO)...
2018: Neuropsychiatric Disease and Treatment
Yue Zhao, Huaqiang Zhou, Wulin Tan, Yiyan Song, Zeting Qiu, Si Li, Shaowei Gao, Wenqi Huang
Background: There is no conclusive evidence for the effects of prolonged infusion of dexmedetomidine in critically ill patients. We aimed to investigate the safety of long-term dexmedetomidine infusion in a large critically ill patients cohort from the Multiparameter Intelligent Monitoring in Intensive Care III (MIMIC-III) database. Methods: We retrospectively extracted records from MIMIC-III database. Dexmedetomidine administration time was the basis for group...
August 2018: Annals of Translational Medicine
Lea Andjelković, Vesna Novak-Jankovič, Neva Požar-Lukanovič, Zoran Bosnić, Alenka Spindler-Vesel
Objective The consumption of opioid analgesics could be reduced by the use of analgesics with different mechanisms of action. We investigated whether additional treatment with dexmedetomidine or lidocaine could reduce opioid consumption. Methods We randomized 59 study participants into three groups and examined: (i) fentanyl consumption, (ii) consumption of piritramide, and (iii) cognitive function and neuropathic pain. The control group received continuous propofol infusion and fentanyl boluses. Continuous intravenous infusion of dexmedetomidine (0...
September 13, 2018: Journal of International Medical Research
Seung H Kim, Do-Hyeong Kim, Seokyung Shin, Seon J Kim, Tae L Kim, Yong S Choi
BACKGROUND: Tourniquet use during total knee arthroplasty (TKA) produces ischemia- reperfusion injury (IRI), with systemic release of inflammatory cytokines and reactive oxygen species upon tourniquet release. We conducted a randomized, placebo-controlled, double-blind trial to examine whether dexmedetomidine (DEX) as an adjunct during general anesthesia in patients undergoing unilateral TKA could attenuate the rise in inflammatory cytokines and oxidative stress. METHODS: Sixty-eight patients were randomized to either the control or DEX group...
September 10, 2018: Minerva Anestesiologica
Ju Eun Oh, Ji Hae Jun, Hye Jeong Hwang, Eun Jung Shin, Young Jun Oh, Yong Seon Choi
AIMS: Dexmedetomidine (DEX), a highly selective and potent α2-adrenergic receptor agonist, has anti-apoptotic, anti-inflammatory, and anti-oxidative stress effects in diabetes mellitus (DM) rats. The underlying molecular mechanisms and signaling pathways of diabetic cardiomyopathy remain poorly understood. This study aimed to elucidate the effect of DEX on cardiac function in DM rats. METHODS: Eight-week-old male Sprague Dawley rats were divided into three groups: control (n = 5), diabetes (DM, n = 7), and diabetes + DEX (DM + DEX, n = 10)...
September 11, 2018: Acta Diabetologica
Mihaela A Damian, Gregory B Hammer, Mohammed H Elkomy, Adam Frymoyer, David R Drover, Felice Su
BACKGROUND: Dexmedetomidine (DEX) is a sedative and analgesic medication that is frequently used postoperatively in children after liver transplantation. Hepatic dysfunction, including alterations in drug clearance, is common immediately after liver transplantation. However, the pharmacokinetics (PK) of DEX in this population is unknown. The objective of this study was to determine the PK profile of DEX in children after liver transplantation. METHODS: This was a single-center, open-label PK study of DEX administered as an intravenous loading dose of 0...
September 5, 2018: Anesthesia and Analgesia
Alonço Viana, Chen Zhao, Talita Rosa, Arnaldo Couto, Denise Duprat Neves, Maria Helena Araújo-Melo, Robson Capasso
OBJECTIVE: Drug-induced sleep endoscopy (DISE) has gained interest for upper airway evaluation in patients with snoring and obstructive sleep apnea (OSA), and different drugs have been used to induce sedation. Nevertheless, all drugs have presented specific advantages and disadvantages with differential effects on respiratory physiology. This study evaluated and compared the effects of midazolam, propofol and dexmedetomidine on DISE findings, O2 nadir, and bispectral index (BIS) in the same sample of patients...
September 7, 2018: Laryngoscope
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