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https://www.readbyqxmd.com/read/28526145/alpha-2-agonists
#1
REVIEW
Viet Nguyen, Dawn Tiemann, Edward Park, Ali Salehi
Alpha-2 adrenergic receptors are spread throughout the central and peripheral nervous system, specifically in the pontine locus coeruleus, medullospinal tracts, rostral ventrolateral medulla, and the dorsal horn of the spinal cord. Alpha-2 agonist agents cause neuromodulation in these centers, leading to sedation, analgesia, vasodilatation, and bradycardia with little effect on the respiratory drive, which accounts for their good safety profile. The 2 major drugs in this group are clonidine and dexmedetomidine...
June 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28494889/influence-of-the-perioperative-administration-of-magnesium-sulfate-on-the-total-dose-of-anesthetics-during-general-anesthesia-a-systematic-review-and-meta-analysis
#2
REVIEW
Laura Rodríguez-Rubio, Eduardo Nava, Julián Solís García Del Pozo, Joaquín Jordán
BACKGROUND: Magnesium sulfate displays numerous characteristics that make it a useful drug in anesthesiology (N-methyl-d-aspartate receptor antagonist, vasodilator, antiarrhythmic, inhibitor of catecholamine release and of acetylcholine in the terminal motor plate). The perioperative use of this drug as an adjuvant capable of decreasing the required dose of anesthetics, has been proposed. OBJECTIVES: To assess the influence of intravenous magnesium sulfate administration during general anesthesia on the overall dose of required anesthetics...
June 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28486739/-castleman-s-disease-a-case-series-of-a-rare-lymphoproliferative-disease
#3
Ricarda Riepl, Thomas Karl Hoffmann, Jens Greve
Castleman's disease is a very rare and potentially severe lymphoproliferative disorder. First sign may be cervical lymphadenitis, requiring sufficient support in diagnosis and therapy by an ENT specialist. Based on a case series the current manuscript gives an overview of the symptoms, the course of disease and the therapy options. Patients with the first diagnosis of a Castleman's disease at the ENT clinic of Ulm University during the years 2011-2015 were included. The duration of symptoms, the applied diagnostic and therapeutic algorithms were evaluated...
May 9, 2017: Laryngo- Rhino- Otologie
https://www.readbyqxmd.com/read/28445291/efficacy-of-sevoflurane-as-an-adjuvant-to-propofol-based-total-intravenous-anesthesia-for-attenuating-secretions-in-ocular-surgery
#4
Hou-Chuan Lai, Yun-Hsiang Chang, Ren-Chih Huang, Nan-Kai Hung, Chueng-He Lu, Jou-Hsiu Chen, Zhi-Fu Wu
BACKGROUND: The incidence of nasal secretions into the operative field is as high as 5% in ophthalmic surgery under general anesthesia. It may induce postoperative endophthalmitis. Secretions under propofol-based total intravanous anesthesia (TIVA) are greater than sevoflurane anesthesia during surgery. Postoperative nausea and vomiting (PONV) after inhalational anesthesia is higher than TIVA and may increase intraocluar pressure. We investigated the effect of sevoflurane combination with propofol-based TIVA on nasopharyngeal secretions and PONV in ocular surgery...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28298760/the-effectiveness-of-intravenous-dexmedetomidine-on-perioperative-hemodynamics-analgesic-requirement-and-side-effects-profile-in-patients-undergoing-laparoscopic-surgery-under-general-anesthesia
#5
Vinayak Panchgar, Akshaya N Shetti, H B Sunitha, Vithal K Dhulkhed, A V Nadkarni
BACKGROUND: There is an upward surge in the use of laparoscopic surgeries due to various advantages when compared to open surgeries. Major advantages are, due to small incisions which are cosmetically acceptable and most of them are now daycare procedures. Problem of economic burden and hospital bed occupancy has been overcome with laparoscopic surgeries. All these advantages are not free from disadvantages, as hemodynamic changes such as hypertension; tachycardia and other surgical-related complications are commonly observed intraoperatively...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28298758/comparison-of-analgesic-efficacy-of-dexmedetomidine-and-midazolam-as-adjuncts-to-lignocaine-for-intravenous-regional-anesthesia
#6
Bharti Gupta, Ravinder Kumar Verma, Sudershan Kumar, Geeta Chaudhary
BACKGROUND: Intravenous regional anesthesia (IVRA) is safe, technically simple, and cost-effective technique compared to general anesthesia with success rates of 94-98% for upper and lower limb surgeries. The main disadvantage of this procedure is its limited duration for surgery, lack of postoperative analgesia, and tourniquet pain. To overcome this disadvantage, various adjuvants to lignocaine have been studied from time to time. AIM: To compare the analgesic efficacy of dexmedetomidine and midazolam as adjuncts to lignocaine for IVRA for forearm and hand surgeries...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28237684/effects-of-dexmedetomidine-combined-with-ropivacaine-on-sciatic-and-femoral-nerve-blockade-in-dogs
#7
Thomas A Trein, Beatriz P Floriano, Juliana T Wagatsuma, Joana Z Ferreira, Guilherme L da Silva, Paulo S P Dos Santos, Sílvia H V Perri, Valéria Nls Oliva
OBJECTIVE: To evaluate motor and sensory blockade of combining dexmedetomidine with ropivacaine, administered perineurally or systemically, for femoral and sciatic nerve blocks in conscious dogs. STUDY DESIGN: Randomized, controlled, experimental study. ANIMALS: Seven healthy Beagle dogs, aged 3.3 ± 0.1 years and weighing 11.0 ± 2.4 kg. METHODS: Dogs were anesthetized with isoflurane on three separate occasions for unilateral femoral and sciatic nerve blocks and were administered the following treatments in random order: perineural ropivacaine 0...
February 22, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28144067/stenting-of-critical-tracheal-stenosis-with-adjuvant-cardio-pulmonary-bypass
#8
Himanshu Bhardwaj, Ahmed Awab, Houssein A Youness, Brent Brown
Severe and critical central airway obstruction causing impaired ventilation and/or oxygenation can impose tremendous challenges on the interventional pulmonologist. Near total airway obstruction can rapidly evolve into potentially fatal complete airway occlusion during bronchoscopic airway manipulation under moderate sedation; as well as during the induction of the general anesthesia. Although there are currently interventional pulmonary procedures available to tackle the critical airway obstruction in extreme situations, cardio-pulmonary bypass should be considered prior to the intervention to maintain the adequate gas exchange during the procedure...
January 2017: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/28046175/acute-effects-of-general-anesthesia-with-propofol-pentobarbital-or-isoflurane-plus-propofol-on-plasma-metabolites-and-hormones-in-adult-pigs
#9
G Daş, A Vernunft, S Görs, E Kanitz, J M Weitzel, K-P Brüssow, C C Metges
Experimental setups for physiological research, in which acute operative interventions need to be performed, can require inclusion of general anesthesia (GA), which may interfere or confound with the effects of the experimental factors of interest on measured variables. It was recently shown that the most commonly used sedatives/anesthetics in pigs (e.g., ketamine, xylazine, azaperone) affect physiological responses and thus the primary metabolic readouts have the potential to be confounded. To extend the search for a physiologically-friendly anesthesia regime for such studies, we investigated effects of GA induced by propofol (Prop) or pentobarbital (Pent) or propofol plus isoflurane (Prop + Isof) on plasma concentrations of commonly measured metabolites and hormones...
December 2016: Journal of Animal Science
https://www.readbyqxmd.com/read/27924197/dexmedetomidine-infusion-as-an-anesthetic-adjuvant-to-general-anesthesia-for-appropriate-surgical-field-visibility-during-modified-radical-mastectomy-with-i-gel%C3%A2-a-randomized-control-study
#10
Kumkum Gupta, Bhawana Rastogi, Prashant K Gupta, Ivesh Singh, Vijendra Pal Singh, Manish Jain
BACKGROUND: Modified radical mastectomy is associated with appreciable blood loss, while endotracheal intubation leads to elevated hemodynamic responses. The present study aimed to evaluate the clinical efficacy of dexmedetomidine infusion as an anesthetic adjuvant to general anesthesia during modified radical mastectomy with I-Gel. METHODS: Sixty adult consenting female patients, of American Society of Anesthesiologists physical status 1 to 2 and aged 4,065 years, were blindly randomized into two groups of 30 patients each...
December 2016: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/27842565/regional-anesthesia-for-painful-injuries-after-disasters-rapid-study-protocol-for-a-randomized-controlled-trial
#11
Adam C Levine, Carrie Teicher, Adam R Aluisio, Tess Wiskel, Pola Valles, Miguel Trelles, Justin Glavis-Bloom, Rebecca F Grais
BACKGROUND: Lower extremity trauma during earthquakes accounts for the largest burden of disaster-related injuries. Insufficient pain management is common in resource-limited disaster settings, and regional anesthesia (RA) may reduce pain in injured patients beyond current standards of care. To date, no controlled trials have been conducted to evaluate the use of RA for pain management in a disaster setting. METHODS/DESIGN: The Regional Anesthesia for Painful Injuries after Disasters (RAPID) study aims to evaluate whether regional anesthesia (RA), either with or without ultrasound (US) guidance, can reduce pain from earthquake-related lower limb injuries in a disaster setting...
November 14, 2016: Trials
https://www.readbyqxmd.com/read/27833486/a-comparative-study-of-dexmedetomidine-and-fentanyl-as-adjuvants-to-levobupivacaine-for-caudal-analgesia-in-children-undergoing-lower-limb-orthopedic-surgery
#12
S M Elfawal, W A Abdelaal, M R Hosny
BACKGROUND: Levobupivacaine is an effective local anesthetic agent with less systemic toxicity than racemic bupivacaine, but it has short postoperative analgesic duration. Dexmedetomidine and fentanyl are promising adjuncts to provide excellent and prolonged postoperative caudal analgesia. This study compared the effects of caudal levobupivacaine plus dexmedetomidine and levobupivacaine plus fentanyl for postoperative analgesia and sedation in children undergoing lower limb orthopedic surgery...
October 2016: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/27821836/effects-of-combined-general-epidural-anesthesia-on-hemodynamics-respiratory-function-and-stress-hormone-levels-in-patients-with-ovarian-neoplasm-undergoing-laparoscopy
#13
Qiang Xu, Hao Zhang, Yan-Mei Zhu, Nian-Jun Shi
BACKGROUND The aim of this study was to evaluate the influence of combined general/epidural anesthesia (GEA) on hemodynamics, respiratory function and stress hormone levels in patients with ovarian neoplasm undergoing laparoscopy. MATERIAL AND METHODS A total of 177 patients with ovarian neoplasm (screened by inclusion/exclusion criteria) receiving laparoscopy were divided into groups G (general anesthesia alone), L1.0 (GEA with 1.0% lidocaine), and L1.5 (GEA with 1.5% lidocaine). Hemodynamics, respiratory parameters and stress hormone levels in the 3 groups were recorded and analyzed...
November 8, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/27812971/efficacy-and-safety-of-dexmedetomidine-as-an-adjuvant-in-epidural-analgesia-and-anesthesia-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#14
REVIEW
Xu Zhang, Dong Wang, Min Shi, YuanGuo Luo
BACKGROUND AND OBJECTIVE: Several clinical trials have examined and indicated the usefulness of epidural dexmedetomidine therapy. However, there has been no systematic analysis of the findings of these trials to date. We undertook this systematic review and meta-analysis to investigate the efficacy and safety of epidural dexmedetomidine adjunctive therapy in different surgical procedures. MATERIALS AND METHODS: We searched EMBASE, PubMed, the Cochrane Library, and the Clinical Trials...
April 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/27778056/-unilateral-spinal-anesthesia-literature-review-and-recommendations
#15
REVIEW
B Büttner, A Mansur, M Bauer, J Hinz, I Bergmann
Unilateral spinal anesthesia is a cost-effective and rapidly performed anesthetic technique. An exclusively unilateral block only affects the sensory, motor and sympathetic functions on one side of the body and offers the advantages of a spinal block without the typical adverse side effects seen with a bilateral block. The lack of hypotension, in particular, makes unilateral spinal anesthesia suitable for patients with cardiovascular risk factors e. g. aortic valve stenosis or coronary artery disease. Increasing numbers of surgical procedures are now being performed on an outpatient basis...
November 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27746567/effect-of-dexmedetomidine-bolus-dose-on-isoflurane-consumption-in-surgical-patients-under-general-anesthesia
#16
Reshma B Muniyappa, Geetha C Rajappa, Suresh Govindswamy, Prathima P Thamanna
BACKGROUND AND OBJECTIVE: Various adjuvants have been introduced to decrease the dose of volatile agents and their side effects. Dexmedetomidine a potent alpha-2 adrenoreceptor agonist is one such agent. Our objective is to assess the effect of preanesthetic dexmedetomidine on isoflurane consumption and its effect on intraoperative hemodynamic stability and recovery profile. SETTING AND DESIGN: This prospective, randomized controlled, double-blind study was done in a tertiary care hospital...
September 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/27746524/evaluation-of-clonidine-as-an-adjuvant-to-bupivacaine-in-wound-infiltration-for-providing-postoperative-analgesia-after-abdominal-hysterectomy
#17
Venkatesh Selvaraj
BACKGROUND: Clonidine is an effective adjuvant to local anesthetics in peripheral nerve blocks. We studied the effect of clonidine as an adjuvant in wound infiltration for postoperative analgesia. AIM: To evaluate the role of clonidine as an adjuvant to bupivacaine in wound infiltration in terms of quality and duration of postoperative analgesia in patients undergoing total abdominal hysterectomy. SETTINGS AND STUDY DESIGN: Prospective, randomized, double-blinded study...
September 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/27708377/postoperative-hormonal-therapy-prevents-recovery-of-neurological-damage-after-surgery-in-patients-with-breast-cancer
#18
Atsushi Sekiguchi, Chiho Sato, Izumi Matsudaira, Yuka Kotozaki, Rui Nouchi, Hikaru Takeuchi, Masaaki Kawai, Hiroshi Tada, Takanori Ishida, Yasuyuki Taki, Noriaki Ohuchi, Ryuta Kawashima
Cancer survivors are exposed to several risk factors for cognitive dysfunction, such as general anesthesia, surgical trauma, and adjuvant therapies. In our recent study we showed that thalamic volume reduction and attentional dysfunction occurred shortly after surgery. Here, we examined the 6-month prognosis of the 20 patients with breast cancer who underwent surgery. Seven patients did not receive any adjuvant therapy after the surgery and 13 patients received a hormonal therapy after the surgery. We assessed their attentional functions, and thalamic volumes shortly after and 6 months after surgery...
October 6, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27591461/paravertebral-block-for-management-of-acute-postoperative-pain-and-intercostobrachial-neuralgia-in-major-breast-surgery
#19
Mercedes Fernández Gacio, Ana Maria Agrelo Lousame, Susana Pereira, Clara Castro, Juliana Santos
BACKGROUND: Several locoregional techniques have been described for the management of acute and chronic pain after breast surgery. The optimal technique should be easy to perform, reproducible, with little discomfort to the patient, little complications, allowing good control of acute pain and a decreased incidence of chronic pain, namely intercostobrachial neuralgia for being the most frequent entity. OBJECTIVES: The aim of this study was to evaluate the paravertebral block with preoperative single needle prick for major breast surgery and assess initially the control of postoperative nausea and vomiting (PONV) and acute pain in the first 24h and secondly the incidence of neuropathic pain in the intercostobrachial nerve region six months after surgery...
September 2016: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/27575449/hypnosis-and-anesthesia-back-to-the-future
#20
Enrico Facco
Hypnosis is a physiological mind activity characterized by focused attention, absorption, dissociation and plastic imagination. In the early 19th century, several hundred surgical interventions were described with hypnosis as the sole anesthetic, in an epoch when no anesthetic drugs were available; then hypnosis was prejudicially abandoned and forgotten after its introduction. In the past two decades, an increasing number of studies on hypnosis has shown its capacity to modify the activity of the prefrontal cortex, default mode network and pain neuromatrix (including the anterior cingulate cortex, amygdala, thalamus, insula and somatosensory cortex) and increase pain threshold up to the level of surgical anesthesia...
December 2016: Minerva Anestesiologica
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