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https://www.readbyqxmd.com/read/29666901/subcutaneously-administered-dexmedetomidine-is-efficiently-absorbed-and-is-associated-with-attenuated-cardiovascular-effects-in-healthy-volunteers
#1
P Uusalo, D Al-Ramahi, I Tilli, R A Aantaa, M Scheinin, T I Saari
PURPOSE: Palliative care patients often need sedation to alleviate intractable anxiety, stress, and pain. Dexmedetomidine is used for sedation of intensive care patients, but there is no prior information on its subcutaneous (SC) administration, a route that would be favored in palliative care. We compared the pharmacokinetics and cardiovascular, sympatholytic, and sedative effects of SC and intravenously (IV) administered dexmedetomidine in healthy volunteers. METHODS: An open two-period, cross-over design with balanced randomization was used...
April 17, 2018: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29665357/second-trimester-surgical-abortion-practices-in-the-united-states
#2
Katharine O White, Heidi E Jones, Jade Shorter, Wendy V Norman, Edith Guilbert, E Steve Lichtenberg, Maureen Paul
OBJECTIVE: To assess whether second-trimester surgical abortion practices of U.S. providers agree with evidence-based policy guidelines. STUDY DESIGN: We conducted a cross-sectional survey of abortion facilities in the U.S. identified via publicly available resources and professional networks from June through December 2013. RESULTS: Of 703 identified facilities, 383 (54%) participated including 172 clinicians providing second-trimester surgical abortions (D&Es)...
April 14, 2018: Contraception
https://www.readbyqxmd.com/read/29652275/dexmedetomidine-versus-ketofol-sedation-for-outpatient-diagnostic-transesophageal-echocardiography-a-randomized-controlled-study
#3
S Sruthi, Banashree Mandal, Manoj K Rohit, Goverdhan Datt Puri
Background: Moderate sedation is required for out-patient transesophageal echocardiography (TEE). Our objective was to compare the effect of Ketofol and dexmedetomidine for outpatient procedural sedation in diagnostic TEE with a hypothesis that Ketofol would be as effective as dexmedetomidine. Patients and. Methods: Fifty adult patients of age group 18-60 years with atrial septal defect, rheumatic valvular heart disease undergoing diagnostic TEE in the outpatient echocardiography laboratory were randomized into two groups, group D and group KF...
April 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29630034/effective-dose-of-intravenous-dexmedetomidine-to-prolong-the-analgesic-duration-of-interscalene-brachial-plexus-block-a-single-center-prospective-double-blind-randomized-controlled-trial
#4
RyungA Kang, Ji Seon Jeong, Jae Chul Yoo, Ju Hyun Lee, Soo Joo Choi, Mi Sook Gwak, Tae Soo Hahm, Jin Huh, Justin Sangwook Ko
BACKGROUND AND OBJECTIVES: Intravenous (IV) dexmedetomidine (DEX) is reported to prolong the analgesic duration after single-shot interscalene brachial plexus block (ISBPB). However, the effective analgesic dose of IV DEX remains undetermined. Therefore, we aimed to elucidate the clinically relevant dose of IV DEX to prolong the analgesic duration of ISBPB. METHODS: Seventy-two patients scheduled for arthroscopic shoulder surgery received ISBPB with 15 mL of 0.5% ropivacaine with 1:200,000 epinephrine and were randomly assigned to 1 of 4 groups (n = 18, each): (1) IV normal saline (control), (2) IV DEX 0...
April 6, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29628580/comparison-of-intravenous-bolus-and-infusion-of-dexmedetomidine-on-characteristics-of-subarachnoid-block
#5
Tripti Vatsalya, Chandrakant Waikar, Madhurima Singh
Aims: Dexmedetomidine is very dynamic drug, used for analgesia, sedation, blunting the laryngoscopic responses and as adjuvants in regional anesthesia. Studies have shown that intravenous (iv) dexmedetomidine given during spinal anesthesia increases the quality of subarachnoid block (SAB). In this study, we compare the two iv regimen of dexmedetomidine on analgesic effect of spinal anesthesia. One is bolus dose of dexmedetomidine and other is infusion during the surgery, both given after induction of spinal anesthesia...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29627630/awake-intradural-spinal-tumour-resection
#6
Anan Shtaya, Chan Bao Luong, Erlick Pereira
BACKGROUND: Meningioma is a common slow growing spinal tumour with a predilection for intradural occurrence. Patients usually present with pain followed by ataxia and sensory and sphincter problems. The gold standard treatment in these cases is gross total microsurgical resection under general anaesthesia. However, there exist high anaesthetic risk patients unsuitable for general anaesthesia. Performing spinal surgeries under local anaesthesia and sedation has been reported albeit rarely for mostly minimally invasive procedures but not for open intradural pathologies...
April 5, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29623221/efficacy-of-dexmedetomidine-versus-ketofol-for-sedation-of-postoperative-mechanically-ventilated-patients-with-obstructive-sleep-apnea
#7
Hatem Elmoutaz Mahmoud, Doaa Abou Elkassim Rashwan
Patients with sleep apnea are prone to postoperative respiratory complications, requiring restriction of sedatives during perioperative care. We performed a prospective randomized study on 24 patients with obstructive sleep apnea (OSA) who underwent elective surgery under general anesthesia. The patients were equally divided into two groups: Group Dex : received dexmedetomidine loading dose 1 mcg/kg IV over 10 min followed by infusion of 0.2-0.7 mcg/kg/hr; Group KFL : received ketofol as an initial bolus dose 500 mcg/kg IV (ketamine/propofol 1 : 1) and maintenance dose of 5-10 mcg/kg/min...
2018: Critical Care Research and Practice
https://www.readbyqxmd.com/read/29602985/rendezvous-endoscopic-recanalization-for-complete-esophageal-obstruction
#8
Stefano Fusco, Thomas Kratt, Cihan Gani, Dietmar Stueker, Daniel Zips, Nisar P Malek, Martin Goetz
BACKGROUND AND STUDY AIM: Complete esophageal obstruction after (chemo)radiation for head and neck cancers is rare. However, inability to swallow one's own saliva strongly inflicts upon quality of life. Techniques for endoscopic recanalization in complete obstruction are not well established. We assessed the efficacy and safety of rendezvous recanalization. PATIENTS AND METHODS: We performed a retrospective review of all patients who underwent endoscopic recanalization of complete proximal esophageal obstruction after radiotherapy between January 2009 and June 2016...
March 30, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29587271/iterative-variance-stabilizing-transformation-denoising-of-spectral-domain-optical-coherence-tomography-images-applied-to-retinoblastoma
#9
Soumia Sid Ahmed, Zoubeida Messali, Florent Poyer, Livia Lumbroso-Le Rouic, Laurence Desjardins, Nathalie Cassoux, Carole D Thomas, Sergio Marco, Stéphanie Lemaitre
BACKGROUND: Due to the presence of speckle Poisson noise, the interpretation of spectral domain-optical coherence tomography (SD-OCT) images frequently requires the use of data averaging to improve the signal-to-noise ratio. This implies long acquisition times and requires patient sedation in some cases. Iterative variance stabilizing transformation (VST) is a possible approach by which to remove speckle Poisson noise on single images. METHODS: We used SD-OCT images of human and murine (LH Beta-Tag mouse model) retinas with and without retinoblastoma acquired with 2 different imaging devices (Bioptigen and Micron IV)...
March 26, 2018: Ophthalmic Research
https://www.readbyqxmd.com/read/29583040/effects-of-mk-467-hydrochloride-and-hyoscine-butylbromide-on-cardiorespiratory-and-gastrointestinal-changes-induced-by-detomidine-hydrochloride-in-horses
#10
Heidi A Tapio, Marja R Raekallio, Anna Mykkänen, Khursheed Mama, Jóse L Mendez-Angulo, Heidi Hautajärvi, Outi M Vainio
OBJECTIVE To compare the effects of MK-467 and hyoscine butylbromide on detomidine hydrochloride-induced cardiorespiratory and gastrointestinal changes in horses. ANIMALS 6 healthy adult horses. PROCEDURES Horses received detomidine hydrochloride (20 μg/kg, IV), followed 10 minutes later by MK-467 hydrochloride (150 μg/kg; DET-MK), hyoscine butylbromide (0.2 mg/kg; DET-HYO), or saline (0.9% NaCl) solution (DET-S), IV, in a Latin square design. Heart rate, respiratory rate, rectal temperature, arterial and venous blood pressures, and cardiac output were measured; blood gases and arterial plasma drug concentrations were analyzed; selected cardiopulmonary variables were calculated; and sedation and gastrointestinal borborygmi were scored at predetermined time points...
April 2018: American Journal of Veterinary Research
https://www.readbyqxmd.com/read/29568958/dexmedetomidine-attenuates-h2o2-induced-neonatal-rat-cardiomyocytes-apoptosis-through-mitochondria-and-er-medicated-oxidative-stress-pathways
#11
Xue-Ru Liu, Tao Li, Lu Cao, Yi-Yan Yu, Lin-Lin Chen, Xue-Hui Fan, Bin-Bin Yang, Xiao-Qiu Tan
Dexmedetomidine (DEX), an α2 adrenoceptor agonist, has sedative and analgesic properties and myocardial protective effects. However, the mechanism underlying the protective effects of DEX on the myocardium remain unclear. The present study aimed to determine whether DEX serves an important role on cardioprotection through the endoplasmic reticulum (ER)‑ and mitochondria‑mediated apoptosis signaling pathways. Neonatal rat cardiomyocytes (NRCMs) were cultured and divided four groups: i) Normal culture medium with 10% fetal bovine serum (control group); ii) H2O2 at 500 µM (H2O2 group); iii) DEX at 5 µM (DEX group); and iv) H2O2 plus DEX (H2O2 + DEX group)...
March 15, 2018: Molecular Medicine Reports
https://www.readbyqxmd.com/read/29560077/higher-mallampati-scores-are-not-associated-with-more-adverse-events-during-pediatric-procedural-sedation-and-analgesia
#12
Maya S Iyer, Raymond D Pitetti, Melissa Vitale
Introduction: Procedural sedation and analgesia (PSA) is used by non-anesthesiologists (NAs) outside of the operating room for several types of procedures. Adverse events during pediatric PSA that pose the most risk to patient safety involve airway compromise. Higher Mallampati scores may indirectly indicate children at risk for airway compromise. Medical governing bodies have proposed guidelines for PSA performed by NAs, but these recommendations rarely suggest using Mallampati scores in pre-PSA evaluations...
March 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29559326/canadian-trends-in-carpal-tunnel-surgery
#13
Blair Peters, Jennifer L Giuffre
PURPOSE: Treatment patterns of carpal tunnel surgery by members of the American Society of Surgery of the Hand (ASSH) have recently been published. The majority of cases in this study were performed in the general operating room with intravenous (IV) sedation or a Bier block. Patients were most commonly prescribed hydrocodone for postoperative pain. The majority of carpal tunnel releases at our center are performed under local anesthesia alone, with plain acetaminophen (Tylenol) or codeine prescribed for postoperative pain...
March 17, 2018: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29557840/an-exploratory-study-of-sevoflurane-as-an-alternative-for-difficult-sedation-in-critically-ill-children
#14
Santiago Mencía, Alba Palacios, Miriam García, Ana M Llorente, Olga Ordóñez, Blanca Toledo, Jesús López-Herce
OBJECTIVES: To analyze the effectiveness of inhaled sevoflurane in critically ill children with challenging sedation. DESIGN: Prospective case series. SETTING: Two PICUs of university hospitals in Spain. INTERVENTIONS: Prospective observational study and exploratory investigation conducted in two PICUs in Madrid, Spain, over a 6-year period. Children treated with inhaled sevoflurane due to difficult sedation were included...
March 19, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29556559/administration-order-of-midazolam-fentanyl-for-moderate-dental-sedation
#15
Douglas Lobb, Alix Clarke, Hollis Lai
Background: The purpose of this study is to investigate the effects of administration order when a sedative drug (midazolam) and an opioid analgesic drug (fentanyl) is applied for moderate intravenous (IV) sedation in dentistry. Methods: A retrospective chart review was conducted in one dental clinic during its transition from a midazolam-first to a fentanyl-first protocol for dental procedures requiring moderate IV sedation. Physiological parameters, drug administration times, patient recovery times, drug dosages, and patient recall and satisfaction were investigated for differences...
February 2018: Journal of Dental Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29531569/a-comparison-of-pain-control-and-complications-using-three-different-ways-of-anesthesia-in-patients-undergoing-transrectal-ultrasound-guided-prostate-biopsy
#16
Hamid Mazdak, Amir Mohamad Abtahi, Fatemeh Momeni, Mohammad Hossein Izadpanahi
Background: We aim to compare the degree of pain control and complications in three types of anesthesia using periprostatic nerve block (PPNB) plus intrarectal local anesthesia (IRLA), low-dose spinal anesthesia, and intravenous (IV) sedation in patients undergoing transrectal ultrasound (TRUS)-guided prostate biopsy. Materials and Methods: In this clinical trial study, 106 patients were participated from December 2015 to December 2016 at Alzahra Hospital, Isfahan, Iran...
2018: Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences
https://www.readbyqxmd.com/read/29530747/use-of-intravenous-acetaminophen-in-postoperative-pain-management-after-partial-and-full-bony-impacted-third-molar-extractions-a-randomized-double-blind-controlled-trial
#17
Isabel Atencio, Max Beushausen, John J Kowalczyk, Andres Flores-Hidalgo, Nora F Fino, Dale A Baur
PURPOSE: Currently, there is a concern at the national level of the overuse of both prescription and nonprescription opioid use. The purpose of this study was to identify whether the use of the intravenous (IV) formulation of acetaminophen (Ofirmev; Mallinckrodt Pharmaceuticals, Staines-upon-Thames, United Kingdom) is an effective tool in the reduction of postoperative pain, with a secondary goal of reduction of postoperative narcotic use. MATERIALS AND METHODS: A total of 72 patients with previously diagnosed either partial bony or complete bony impacted third molars were selected with care to avoid long-acting local anesthetics or dissociative anesthetic agents...
February 20, 2018: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29521816/incidence-and-causes-of-adverse-events-in-diagnostic-radiological-studies-requiring-anesthesia-in-the-wake-up-safe-registry
#18
Asad A Khawaja, Dmitry Tumin, Ralph J Beltran, Joseph D Tobias, Joshua C Uffman
OBJECTIVES: General anesthesia or sedation can facilitate the completion of diagnostic radiological studies in children. We evaluated the incidence, predictors, and causes of adverse events (AEs) when general anesthesia is provided for diagnostic radiological imaging. METHODS: Deidentified data from 24 pediatric tertiary care hospitals participating in the Wake-Up Safe registry during 2010-2015 were obtained for analysis. Children 18 years or younger receiving general anesthesia for radiological procedures were identified using Current Procedural Terminology codes, and reported AEs were analyzed if they were associated with anesthetic care at magnetic resonance imaging or computed tomography locations...
March 8, 2018: Journal of Patient Safety
https://www.readbyqxmd.com/read/29521421/the-pharmacokinetics-and-analgesic-effects-of-extended-release-buprenorphine-administered-subcutaneously-in-healthy-dogs
#19
M Barletta, S M Ostenkamp, A C Taylor, J Quandt, B D X Lascelles, K M Messenger
Buprenorphine is a partial μ agonist opioid used for analgesia in dogs. An extended-release formulation (ER-buprenorphine) has been shown to provide effective analgesia for 72 hr in rats and mice. Six healthy mongrel dogs were enrolled in a randomized, blinded crossover design to describe and compare the pharmacokinetics and pharmacodynamics of ER-buprenorphine administered subcutaneous at 0.2 mg/kg (ER-B) and commercially available buprenorphine for injection intravenously at 0.02 mg/kg (IV-B). After drug administration, serial blood samples were collected to measure plasma buprenorphine concentrations using liquid chromatography/mass spectrometry detection...
March 9, 2018: Journal of Veterinary Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29517431/cardiovascular-effects-of-alfaxalone-and-propofol-in-the-bullfrog-lithobates-catesbeianus
#20
Catherine J A Williams, Aage K O Alstrup, Mads F Bertelsen, Heidi M Jensen, Cleo A C Leite, Tobias Wang
Alfaxalone is becoming a popular anesthetic for nonmammalian vertebrates, but the physiological effects of its administration remain largely unknown in these taxa. Therefore, the cardiovascular responses to a clinically relevant dose of alfaxalone (10 mg/kg) are reported in the bullfrog ( Lithobates catesbeianus), following intramuscular (IM) and intravascular (IV) administration (via a femoral artery catheter) and compared with an IV dose of propofol, another parenteral GABA (γ-aminobutyric acid) agonist in common veterinary use as an induction agent...
March 2018: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
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