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dexmedetomidine and ketamine

Melissa D Smith, Michele Barletta, Kathryn A Diehl, Erik H Hofmeister, Samuel P Franklin
OBJECTIVE: To compare the effect of propofol and ketamine/diazepam for induction following premedication on intraocular pressure (IOP) in healthy dogs. STUDY DESIGN: Prospective, quasi-experimental, unmasked, longitudinal. ANIMALS: A total of 61 client-owned dogs. METHODS: Dogs were anesthetized twice with a 4 week washout period. Premedication with dexmedetomidine (5 μg kg-1 ) and hydromorphone (0.1 mg kg-1 ) intramuscularly was followed by either propofol (4 mg kg-1 ) or ketamine (5 mg kg-1 ) and diazepam (0...
October 11, 2018: Veterinary Anaesthesia and Analgesia
Madeline J Foertsch, Jessica B Winter, Abigail G Rhoades, Lukas T Martin, Christopher A Droege, Neil E Ernst
Alcohol withdrawal syndrome (AWS) is a complex neurologic disorder that develops after an acute reduction in or cessation of chronic alcohol consumption that alters neurotransmitter conduction. The incidence of AWS in the intensive care unit varies, but has been associated with poor outcomes. This is primarily driven by downregulation of gamma-aminobutyric acid (GABA) leading to autonomic excitability and psychomotor agitation. No clinical assessment tools have been validated to assess for AWS in the intensive care unit, particularly for patients requiring mechanical ventilation...
January 2019: Critical Care Nursing Quarterly
Fei Yang, Yang Liu, Qing Yu, Shangyingying Li, Jin Zhang, Mang Sun, Lu Liu, Yao Lei, Qing Tian, Hui Liu, Shengfen Tu
BACKGROUND: Intranasal procedural sedation using dexmedetomidine is well described in the literature. The combination of intranasal dexmedetomidine and ketamine is a novel approach for which there are little data on the rate of successful sedation or adverse events. OBJECTIVES: The aim of this study is to evaluate the rate of successful sedation and adverse events of intranasal procedural sedation using a combination of dexmedetomidine and ketamine for diagnostic examination in children...
November 28, 2018: Paediatric Anaesthesia
Jianxia Liu, Min Du, Lu Liu, Fei Cao, Ying Xu
BACKGROUND: Sedation is often required for young children during transthoracic echocardiography. Dexmedetomidine and ketamine are two sedatives that are commonly used in children for procedural sedation, but they have some disadvantages when they are used alone. AIMS: The aim of this retrospective study was to analyze the effects and safety of intranasal sedation with a combination of dexmedetomidine and ketamine during transthoracic echocardiography in young children and to analyze risk factors for sedation failure...
November 19, 2018: Paediatric Anaesthesia
Geoffrey R Browning, David Eshar, Hugues Beaufrere
Few studies evaluate anesthesia in black-tailed prairie dogs (Cynomys ludovicianus). Isoflurane inhalant anesthesia is usedin this species most commonly, but injectable protocols are poorly described. Here we compared the physiologic effects, including anesthetic depth, vital signs, and hematologic changes, of anesthetic protocols using isoflurane or a combination ofdexmedetomidine, ketamine, and midazolam in black-tailed prairie dogs. In a randomized, complete crossover study design, intact male black-tailed prairie dogs (n = 9; age, 6 mo) were anesthetized by using a combination of dexmedetomidine (0...
November 5, 2018: Journal of the American Association for Laboratory Animal Science: JAALAS
Nihar Ameta, Mathews Jacob, Shahbaz Hasnain, Gaurishankar Ramesh
Background and Aims: Shivering after spinal anesthesia is a common complication and can occur in as many as 40%-70% of patients after regional anesthesia. This shivering, apart from its physiological and hemodynamic effects, has been described as even worse than surgical pain. The aim of the study was to evaluate and compare the effectiveness of prophylactic use of intravenous (IV) ketamine, dexmedetomidine, and tramadol for prevention of shivering after spinal anesthesia. Material and Methods: Two hundred American Society of Anesthesiologists physical status I and II patients subjected to spinal anesthesia were included in the study...
July 2018: Journal of Anaesthesiology, Clinical Pharmacology
Dustin M Fink, Grayson A Doss, Kurt K Sladky, Christoph Mans
OBJECTIVE To evaluate whether the sedative effects of a combination of dexmedetomidine and ketamine differed when it was administered IM in a hind limb versus a forelimb of leopard geckos (Eublepharis macularius). DESIGN Randomized crossover study. ANIMALS 9 healthy adult leopard geckos. PROCEDURES Each gecko received a combination of dexmedetomidine (0.1 mg/kg [0.045 mg/lb]) and ketamine (10 mg/kg [4.5 mg/lb]; DK), IM, in a forelimb and hind limb in a randomized order and with a 7-day interval between treatments...
November 1, 2018: Journal of the American Veterinary Medical Association
Astha Jaikaria, Seema Thakur, Parul Singhal, Deepak Chauhan, Cheranjeevi Jayam, Kartik Syal
Introduction: It is common to encounter a patient who is anxious to the magnitude that precludes the possibility of provision of dental treatment. This study aims to evaluate and compare the sedative effect of oral combinations of midazolam-ketamine (MK), dexmedetomidine-fentanyl (DF), and dexmedetomidine-ketamine (DK) in a group of uncooperative children requiring dental treatment. Methodology: This was a prospective, randomized, triple-blind study where 36 children who were 3-9 year old with American Society of Anesthesiologists -I status and presenting early childhood caries were randomly assigned to: Group A - 0...
September 2018: Contemporary Clinical Dentistry
Greta Vladinov, Lilibeth Fermin, Renee Longini, Yanett Ramos, Edward Maratea
This study provides a review of the contemporary literature for the effects of most commonly used anesthetic drugs for sedation and anesthesia during adult electrophysiologic (EP) studies where supraventricular tachycardias (SVT) need to be induced for diagnostic purposes and/or catheter ablation. Some medications may affect cardiac electrophysiology and conduction, altering the ability to induce the arrhythmia, and may have negative impact on mapping and ablation treatment. The objective of the study is to determine the best sedative choice during SVT ablations...
November 2018: Pacing and Clinical Electrophysiology: PACE
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
Ki Jinn Chin, Stephen Lewis
STUDY DESIGN: A case report. OBJECTIVE: The aim of this study was to report the use of erector spinae plane (ESP) blocks as part of an opioid-free multimodal anesthetic regimen and its impact on postoperative pain and opioid requirements following spine surgery. SUMMARY OF BACKGROUND DATA: Posterior spinal fusion surgery is highly painful and usually requires significant amounts of opioids for adequate perioperative analgesia; this is commonly associated with adverse effects, including opioid-induced hyperalgesia, nausea, and ileus...
August 31, 2018: Spine
Daniel C Turner, Christopher A Girkin, J Crawford Downs
To determine the magnitude of IOP elevation associated with eye rubbing STUDY DESIGN: Experimental Study SUBJECTS: Three nonhuman primates (NHPs) METHODS: Three young adult male rhesus macaques were briefly anesthetized with ketamine and dexmedetomidine, and antibiotic ointment was placed in both eyes. The anesthetic was immediately reversed with atipamezole, and the animals quickly recovered. IOP was continuously recorded at 500 measurements per second during the experiment using a validated implantable wireless telemetry system; high-definition video was recorded while the NHP rubbed its eyes to remove the ointment, and rubbing events were marked in the IOP data...
August 25, 2018: Ophthalmology
Clemens R M Barends, Anthony R Absalom, Michel M R F Struys
PURPOSE OF REVIEW: Ambulatory procedural sedation is used to relieve anxiety, pain and discomfort in a broad spectrum of patients during many types of diagnostic or therapeutic procedures. This review focuses on recent comparative studies of commonly used and new drugs for adult ambulatory sedation. RECENT FINDINGS: Midazolam and propofol are commonly used for ambulatory sedation. Their pharmacological properties offer many advantages and there is much experience with their use...
December 2018: Current Opinion in Anaesthesiology
Kunal Tewari, Vishal V Tewari, Subroto K Datta
Background and Aims: Several drug combinations have been tried in patients with acyanotic congenital heart disease (ACHD) undergoing transcatheter device closure in the cardiac catheterisation laboratory (CCL). Adequate sedation, analgesia, akinesia, cardiorespiratory stability, and prompt recovery are key requirements. Ketamine with propofol is used for this purpose. Dexmedetomidine carries a shorter recovery time. This study compared dexmedetomidine-propofol (DP) with ketamine-propofol (KP) in patients in the CCL...
July 2018: Indian Journal of Anaesthesia
Jaime B Long, Kristin Bevil, Dobie L Giles
Preemptive analgesia is an intervention provided before initiating painful stimuli that may reduce or prevent subsequent pain. This systematic review examines the evidence supporting the practice of preemptive analgesia in minimally invasive gynecologic surgery (MIGS). We searched PubMed, Cochrane Register for Controlled Trials, and Embase from inception through February 26, 2018. The search was limited to human and English language studies. A total of 324 studies were identified. The abstracts were screened for relevance for minimally invasive gynecologic surgery (MIGS) and preemptive analgesia...
July 29, 2018: Journal of Minimally Invasive Gynecology
Jared Langerman, Sotirios G Doukas, Hisashi Hasegawa, James Goodrich, Michael Lerner, Clarence Sasaki
Background: A malfunction or impairment of swallow function can potentiate aspiration events and interfere with both quality of life and survival. Establishing an animal model for swallow research would provide a better understanding of its pathophysiology and would also allow for the development and validation of physiologically based clinical interventions to improve swallow function. Two requirements define the ideal model for longitudinal exploration: 1) identification of species similar to human in form and function; and 2) provision for reliable and reproducible evoked swallow under general anesthesia and one that would also support a longitudinal study design...
June 2018: Laryngoscope Investigative Otolaryngology
H S Abdel-Ghaffar, S M Kamal, F A El Sherif, S A Mohamed
BACKGROUND: The aim of our study was to compare the efficacy of dexmedetomidine, ketamine, and midazolam for sedative premedication administered by nebuliser 30 min before general anaesthesia in preschool children undergoing bone marrow biopsy and aspiration. METHODS: Ninety children aged 3-7 yr were randomly allocated into three equal groups to be premedicated with either nebulised ketamine 2 mg kg-1 (Group K), dexmedetomidine 2 μg kg-1 (Group D), or midazolam 0...
August 2018: British Journal of Anaesthesia
Martin Soehle, Janina Bochem
PURPOSE OF REVIEW: Electroconvulsive therapy (ECT) is a well established and effective therapy in treatment-resistant depression. It is performed under general anesthesia, but no consensus exists regarding the optimal anesthetic drugs. A growing interest in optimizing adjunctive medication regimes in ECT anesthesia has emerged in recent years. Moreover different methods of seizure induction have been evaluated. RECENT FINDINGS: Pretreatment with dexmedetomidine eased the propofol injection pain and reduced the hyperdynamic response to ECT, but prolonged recovery...
October 2018: Current Opinion in Anaesthesiology
Alireza Mahdavi, Masoud Fallahinejad Ghajari, Ghassem Ansari, Leila Shafiei
Objectives: The aim of this study was to compare the intranasal premedication effect of newly introduced dexmedetomidine (DEX) versus midazolam on the behavior of uncooperative children in the dental clinic. Materials and Methods: This crossover double-blind clinical trial was conducted on 20 uncooperative children aged 2-6 years who required at least two similar dental treatment visits. The subjects were randomly given 1 μg/kg of DEX and 0.5 mg/kg of midazolam via the intranasal route...
March 2018: Journal of Dentistry of Tehran University of Medical Sciences
Jie Liu, Yong Wang, Wuhua Ma
INTRODUCTION: Perioperative shivering during cesarean sections (CSs) under neuraxial anesthesia (NA) is clinically common but often under-treated. It may prominently increase oxygen consumption, which can be catastrophic for parturients with ischemic cardiovascular disease. Thus, the prevention and treatment of shivering may be of great significance in parturients. The purpose of this systematic review was to investigate the effectiveness of several drugs on shivering prevention and treatment during CSs under NA...
June 26, 2018: Minerva Anestesiologica
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