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Arthur Davy, Julien Fessler, Marc Fischler, Morgan LE Guen
INTRODUCTION: In Europe, dexmedetomidine has marketing approval only for sedation in intensive care units. However, its use during general anesthesia has been widely reported. The aim of this narrative review is to draw a picture of potential indications in anesthesia. EVIDENCE ACQUISITION: We searched in MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials using the keywords "Dexmedetomidine, Dexdor, Precedex and Dexdomitor." The research ended in December 2016...
December 2017: Minerva Anestesiologica
Hersh Patel, Jung Kim, Tessa Kate Huncke
Citrullinemia type I is a rare autosomal recessive genetic condition that causes reduced activity of the enzyme, argininosuccinate synthase, which is needed for proper urea metabolism. The end result is hyperammonemia which can cause life-threatening neurologic symptoms and global developmental delay. Previous case reports of the anesthetic management of patients with citrullinemia describe delayed recovery possibly related to elevated ammonia levels postoperatively or choice of intraoperative anesthetics which have included narcotics...
September 2016: Journal of Clinical Anesthesia
Atsushi Komemushi, Satoshi Suzuki, Akira Sano, Shuji Kariya, Miyuki Nakatani, Rie Yagi Yoshida, Yumiko Kono, Koshi Ikeda, Keita Utsunomiya, Yoko Harima, Noboru Tanigawa
BACKGROUND: Dexmedetomidine (Precedex®)is an agonist of a2-adrenergic receptors in certain parts of the brain. It was approved for "procedural sedation in the non-intubation in under local anesthesia" in June 2013 in Japan. However, because of metabolism delay, dexmedetomidine has to be administered carefully to patients with liver dysfunction. PURPOSE: To evaluate the feasibility and safety of sedation using dexmedetomidine in percutaneous arterial chemoembolization for hepatocellular carcinoma with liver dysfunction...
September 2015: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Z Cui, D S-L Chow, L Wu, D A Lazar, R Rodrigo, O O Olutoye, O A Olutoye
Dexmedetomidine (DEX; Precedex(®)), approved by the Food and Drug Administration (FDA) in 1999 as a sedative for use in the intensive care unit, is a potent and highly selective α2-adrenoceptor agonist with significant sedative, analgesic and anxiolytic effects. However, the research of DEX use during pregnancy is limited and the impact of DEX on the fetal development is unclear. This article describes a high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) assay suitable for various biomatrices of plasma, urine and amniotic fluid, as a prerequisite for pharmacokinetic characterization of DEX in the pregnant ewe model...
June 15, 2014: Journal of Chromatography. B, Analytical Technologies in the Biomedical and Life Sciences
Lawrence A Trissel, Christopher A Saenz, Delshalonda S Ingram, Kimberly Y Williams, Julie P Retzinger
The physical compatibility of Precedex with 95 other drugs during simulated Y-site injection was evaluated by visual observation, turbidity measurement, and electronic particle content assessment (when appropriate). Five-milliliter samples of Precedex 4 micrograms/mL in 0.9% sodium chloride injection were combined with 5 mL of each of 95 other drugs. The other test drugs included anti-infectives, analgesics, antihistamines, diuretics, steroids, and other supportive-care drugs undiluted or diluted in 0.9% sodium chloride injection or 5% dextrose injection (for amphotericin B)...
May 2002: International Journal of Pharmaceutical Compounding
Yoonsun Mo, Anthony E Zimmermann
OBJECTIVE: To review recent clinical studies regarding the role of dexmedetomidine for prevention and treatment of delirium in intensive care unit (ICU) patients. DATA SOURCES: MEDLINE and PubMed searches (1988-Feburary 2013) were conducted, using the key words delirium, dexmedetomidine, Precedex, agitation, α-2 agonists, critical care, and intensive care. References from relevant articles were reviewed for additional information. STUDY SELECTION AND DATA EXTRACTION: Clinical trials comparing dexmedetomidine with other sedatives/analgesics or with antipsychotics for delirium were selected...
June 2013: Annals of Pharmacotherapy
Yoonsun Mo, Anthony E Zimmermann
OBJECTIVE:To review recent clinical studies regarding the role of dexmedetomidine for prevention and treatment of delirium in intensive care unit (ICU) patients.DATA SOURCES:MEDLINE and PubMed searches (1988-Feburary 2013) were conducted, using the key words delirium, dexmedetomidine, Precedex, agitation, α-2 agonists, critical care, and intensive care. References from relevant articles were reviewed for additional information.STUDY SELECTION AND DATA EXTRACTION:Clinical trials comparing dexmedetomidine with other sedatives/analgesics or with antipsychotics for delirium were selected...
May 21, 2013: Annals of Pharmacotherapy
Ahmad Mansour, Samar Taha
PURPOSE: To present a case series on the use of dexmedetomidine (Precedex) sedation in painful posterior segment surgery performed under topical anesthesia, similar to its use in cataract surgery. METHODS: A prospective review of cases that had posterior segment surgery under topical anesthesia and that needed sedation. Dexmedetomidine-loading infusion was 1 mcg/kg over 10 minutes, followed by a maintenance infusion (0.5 mcg/kg/h). RESULTS: NINE PATIENTS WERE OPERATED ON UNDER TOPICAL ANESTHESIA: two scleral buckle, five cryopexy, one scleral laceration, and one pars plana vitrectomy with very dense laser therapy in an albinotic fundus; six patients had retinal detachment...
2012: Clinical Ophthalmology
Marco Sassi, Edvin Zekaj, Alessandra Grotta, Alberto Pollini, Armando Pellanda, Massimo Borroni, Claudio Pacchetti, Claudia Menghetti, Mauro Porta, Domenico Servello
OBJECTIVE: Evaluation of safety and efficacy of dexmedetomidine in deep brain stimulation (DBS) surgery. MATERIALS AND METHODS: A cohort of 23 patients, candidates for DBS for Parkinson's disease, Tourette syndrome, or obsessive-compulsive disorder, was randomized in two groups: dexmedetomidine group and control group. Standard anesthesiologic parameters were recorded and analyzed, together with the need for other medications. A ten-degree scale (visual analog scale) assessing patient discomfort during DBS also was recorded at the end of surgery...
September 2013: Neuromodulation: Journal of the International Neuromodulation Society
Gillian M Keating, Sheridan M Hoy, Katherine A Lyseng-Williamson
Intravenous dexmedetomidine (Precedex(®)) provides both effective sedation in mechanically ventilated patients in an intensive care setting and effective procedural sedation. In these patient populations, it reduces the need for rescue sedation with intravenous propofol or intravenous midazolam and reduces opioid requirements. In addition, patients receiving dexmedetomidine are calm and easy to arouse and manage. Intravenous dexmedetomidine is generally well tolerated and is not associated with respiratory depression...
August 1, 2012: Clinical Drug Investigation
Sheridan M Hoy, Gillian M Keating
Dexmedetomidine (Precedex®), a pharmacologically active dextroisomer of medetomidine, is a selective α(2)-adrenergic receptor agonist. It is indicated in the US for the sedation of mechanically ventilated adult patients in an intensive care setting and in non-intubated adult patients prior to and/or during surgical and other procedures. This article reviews the pharmacological properties, therapeutic efficacy and tolerability of dexmedetomidine in randomized, double-blind, placebo-controlled, multicentre studies in these indications...
July 30, 2011: Drugs
(no author information available yet)
Opioids, benzodiazepines, propofol, antipsychotics and dexmedetomidine (Precedex) are frequently used in the intensive care unit (ICU) to manage pain, anxiety, agitation and delirium, and to facilitate procedures such as mechanical ventilation. The use of dexmedetomidine, a centrally-acting selective α(2)-receptor agonist approved by the FDA in 1999, has been increasing in recent years. Some new studies comparing it to other drugs for ICU sedation have been published.
May 30, 2011: Medical Letter on Drugs and Therapeutics
Amanda L Silver, Phoebe Yager, Prashant Purohit, Natan Noviski, Christopher J Hartnick
OBJECTIVE: Assess the postoperative use of dexmedetomidine (Precedex) in pediatric patients following airway reconstruction. STUDY DESIGN: Historical cohort study. SETTING: Tertiary medical center. SUBJECTS AND METHODS: A retrospective review of 24 children undergoing laryngotracheal reconstruction (LTR) or laryngeal cleft repair (LCR) was conducted. Twelve children were treated with standard sedation protocols where dexmedetomidine was administered in lieu of propofol (Diprivan); 12 age-, gender-, and procedure-matched controls were selected...
February 2011: Otolaryngology—Head and Neck Surgery
Seth B Roberts, Colin P Wozencraft, Patrick J Coyne, Thomas J Smith
Abstract Dexmedetomidine (Precedex®) is an alpha-2 adrenergic agonist that can produce sedation and analgesia without causing respiratory depression. Its use has been described in patients undergoing mechanical ventilation, sedation for surgical and nonsurgical procedures, and prevention of withdrawal. We describe its use as an adjuvant analgesic in a patient with cancer pain refractory to multiple treatment modalities.
March 2011: Journal of Palliative Medicine
Patrick J Coyne, Colin P Wozencraft, Seth B Roberts, Barton Bobb, Thomas J Smith
Intractable pain continues to pose problems for patients with life-limiting disease. The authors review the potential role of dexmedetomidine (Precedex), an α(2)-adrenergic agonist, as a bridge to obtaining effective analgesia. The authors offer criteria to consider in utilizing this medication within the context of palliative care.
December 2010: Journal of Pain & Palliative Care Pharmacotherapy
Suzanne M Shepard, Shai Tejman-Yarden, Sandeep Khanna, Christopher K Davis, Anjan S Batra
OBJECTIVE: Dexmedetomidine (DEX; Precedex) is an alpha-2 adrenergic receptor agonist that produces anxiolysis and sleep-like sedation without narcosis or respiratory depression and has relatively few cardiovascular side effects. Given its favorable sedative properties combined with its limited effects on hemodynamic and respiratory function, it is widely used in pediatric intensive care and anesthesia settings. DESIGN: Case report. SETTING: Pediatric intensive care unit...
January 2011: Critical Care Medicine
Lebron Cooper, Keith Candiotti, Christopher Gallagher, Ernesto Grenier, Kristopher L Arheart, Michael E Barron
OBJECTIVE: Transesophageal echocardiography (TEE) has become established as a sensitive and accurate diagnostic method for the rapid assessment of myocardial function. It was theorized that dexmedetomidine (Precedex; Hospira, Inc, Lake Forest, IL) might prove to be useful for sedating patients while undergoing TEE. DESIGN: A prospective, randomized trial was designed comparing dexmedetomidine versus standard therapy (eg, midazolam and opioids) for sedation. SETTING: This trial was performed in a tertiary care, single-institution university hospital...
April 2011: Journal of Cardiothoracic and Vascular Anesthesia
Tim Brady
Dexmedetomidine (Precedex, Hospira, Lake Forest, Illinois), an alpha-2 agonist, mainly is used for sedating mechanically ventilated uncooperative patients in the intensive care setting. It also is being used by anesthesia providers for multiple purposes, including cardiothoracic surgeries, neurological surgeries, and awake-fiberoptic intubations and for patients with a high risk for airway obstruction. This article reports the investigation of the off-label use of dexmedetomidine as an anesthetic adjunct for a transsphenoidal pituitary tumor resection in an adult...
April 2010: AANA Journal
Kelda M Kemp, Larry Henderlight, Michael Neville
No abstract text is available yet for this article.
2008: Nursing
David J Anschel, Andrew Aherne, Roy G Soto, Wesley Carrion, Carl Hoegerl, Palgun Nori, Peggy A Seidman
Intraoperative neurophysiological monitoring (IONM) during corrective spinal surgery is widely used. Because of the possible interference with the recording of evoked potentials by inhalational anesthetics, total intravenous anesthetic (TIVA) regimens have been advocated. TIVA regimens may be difficult to use in pediatric populations due to metabolic factors. We report on the results of multimodality IONM during 18 cases in which a TIVA regimen incorporating dexmedetomidine (Precedex, Hespira, Lake Forest, IL) was used...
February 2008: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
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