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dexmedetomidine and ketamine

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https://www.readbyqxmd.com/read/30078856/dexmedetomidine-propofol-vs-ketamine-propofol-anaesthesia-in-paediatric-and-young-adult-patients-undergoing-device-closure-procedures-in-cardiac-catheterisation-laboratory-an-open-label-randomised-trial
#1
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
https://www.readbyqxmd.com/read/30064006/preemptive-analgesia-in-migs
#2
REVIEW
Jaime B Long, Kristin Bevil, Dobie Giles
Preemptive analgesia is an intervention provided prior to initiating painful stimuli which 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 2/26/18. 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 and preemptive analgesia...
July 28, 2018: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/30062134/in-search-of-a-longitudinal-animal-model-of-evoked-swallow-function
#3
REVIEW
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
https://www.readbyqxmd.com/read/30032884/comparison-of-nebulised-dexmedetomidine-ketamine-or-midazolam-for-premedication-in-preschool-children-undergoing-bone-marrow-biopsy
#4
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
https://www.readbyqxmd.com/read/29994943/anesthesia-for-electroconvulsive-therapy
#5
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...
July 9, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29971125/intranasal-premedication-effect-of-dexmedetomidine-versus-midazolam-on-the-behavior-of-2-6-year-old-uncooperative-children-in-dental-clinic
#6
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
https://www.readbyqxmd.com/read/29945433/shivering-prevention-and-treatment-during-cesarean-delivery-under-neuraxial-anesthesia-a-systematic-review
#7
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
https://www.readbyqxmd.com/read/29935583/comparative-effects-of-dexmedetomidine-propofol-sevoflurane-and-s-ketamine-on-regional-cerebral-glucose-metabolism-in-humans-a-positron-emission-tomography-study
#8
L Laaksonen, M Kallioinen, J Långsjö, T Laitio, A Scheinin, J Scheinin, K Kaisti, A Maksimow, R E Kallionpää, V Rajala, J Johansson, O Kantonen, M Nyman, S Sirén, K Valli, A Revonsuo, O Solin, T Vahlberg, M Alkire, H Scheinin
INTRODUCTION: The highly selective α2 -agonist dexmedetomidine has become a popular sedative for neurointensive care patients. However, earlier studies have raised concern that dexmedetomidine might reduce cerebral blood flow without a concomitant decrease in metabolism. Here, we compared the effects of dexmedetomidine on the regional cerebral metabolic rate of glucose (CMRglu ) with three commonly used anaesthetic drugs at equi-sedative doses. METHODS: One hundred and sixty healthy male subjects were randomised to EC50 for verbal command of dexmedetomidine (1...
July 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29929189/dexmedetomidine-protects-neural-stem-cells-from-ketamine-induced-injury
#9
Pan Lu, Shan Lei, Weisong Li, Yang Lu, Juan Zheng, Ning Wang, Yongjun Xia, Haixia Lu, Xinlin Chen, Yong Liu, Peng-Bo Zhang
BACKGROUND/AIMS: Ketamine inhibits the proliferation of neural stem cells (NSCs) and disturbs normal neurogenesis. Dexmedetomidine provides neuroprotection against volatile anesthetic-induced neuroapoptosis and cognitive impairment in the developing brain. Whether it may protect NSCs from ketamine-induced injury remains unknown. In this study, we investigated the protective effects of dexmedetomidine on ketamine-exposed NSCs and explored the mechanisms potentially involved. METHODS: Primary NSC cultures were characterized using immunofluorescence...
2018: Cellular Physiology and Biochemistry
https://www.readbyqxmd.com/read/29916196/recent-trends-in-the-practice-of-procedural-sedation-under-local-anesthesia-for-catheter-ablation-gastrointestinal-endoscopy-and-endoscopic-surgery-in-japan-a-retrospective-database-study-in-clinical-practice-from-2012-to-2015
#10
Akiko Matsui, Michihiro Morimoto, Hiroshi Suzuki, Thomas Laurent, Yoko Fujimoto, Yoshimi Inagaki
OBJECTIVES: To investigate changes in sedation practice during 2012-2015, using a large health claims database, for catheter ablation (CA), gastrointestinal endoscopic examination (EE), and surgery (ES) after dexmedetomidine (DEX) was approved for procedural sedation in 2013. We assessed the trends of sedative utilization, sedative-analgesic combinations, and, additionally, incidence of complications from 2012 to 2015. METHODS: Using the database provided by Medical Data Vision Co...
June 18, 2018: Drugs—Real World Outcomes
https://www.readbyqxmd.com/read/29900768/hyperkalemia-in-two-jaguars-panthera-onca-anesthetized-with-dexmedetomidine-ketamine-and-isoflurane
#11
Marta Romano, Jordyn M Boesch, Santiago Peralta, Christine Parker, George Kollias
  Two jaguars were anesthetized with dexmedetomidine, ketamine, and isoflurane. Arterial blood samples analyzed shortly after darting revealed no abnormalities. Samples analyzed 2 and 1.5 hr after darting revealed moderate hyperkalemia in both animals (6.8 and 6.2 mEq/L, respectively). Shortly after hyperkalemia was recognized, one jaguar developed electrocardiographic abnormalities (sinoventricular rhythm and widened QRS complexes), and a few minutes later, suffered cardiopulmonary arrest. Resuscitation with chest compressions, intermittent positive-pressure ventilation, and epinephrine was successful, and autonomous breathing and circulation resumed within a few minutes...
June 2018: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
https://www.readbyqxmd.com/read/29900763/hematology-and-serum-biochemistry-values-of-the-red-panda-subspecies-ailurus-fulgens-styani
#12
Caitlin Burrell, Li Luo, Marieke Kester Jones, Andrea Lee, Elizabeth Freeman, Copper Aitken-Palmer
  Health evaluations were conducted on individuals ( n = 62, age < 1 to 11 yr) from a captive red panda ( Ailurus fulgens styani) population at the Chengdu Research Base for Giant Panda Breeding in Sichuan Province, People's Republic of China. Individuals were anesthetized using combinations of ketamine, dexmedetomidine, diazepam, isoflurane, and tiletamine/zolazepam. Whereas physical exams revealed no abnormalities for 40% of red pandas, 24% had dental abnormalities and 18% had orthopedic abnormalities...
June 2018: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
https://www.readbyqxmd.com/read/29870425/ect-a-new-look-at-an-old-friend
#13
Pavan Kumar Kadiyala, Lakshmi Deepthi Kadiyala
PURPOSE OF REVIEW: Electroconvulsive therapy (ECT) as a treatment option in psychiatry is advancing day by day. This review discusses new advancements in ECT with regards to anesthetic variables, stimulus, and response variables along with their impact on clinical outcomes. RECENT FINDINGS: Anesthetic variables influence clinical efficacy and patient tolerance of ECT. Although etomidate or a ketamine-propofol combination may be the first choice for many clinicians, the search for ideal induction agent continues...
August 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29800375/a-non-comparative-prospective-pilot-study-of-ketamine-for-sedation-in-adult-septic-shock
#14
Jason M Reese, Victoria Fernandes Sullivan, Nathan L Boyer, Cristin A Mount
Introduction: Sedation and analgesia in the intensive care unit (ICU) for patients with sepsis can be challenging. Opioids and benzodiazepines can lower blood pressure and decrease respiratory drive. Ketamine is an N-methyl-D-aspartate (NMDA) receptor antagonist that provides both amnesia and analgesia without depressing respiratory drive or blood pressure. The purpose of this pilot study was to assess the effect of ketamine on the vasopressor requirement in adult patients with septic shock requiring mechanical ventilation...
May 24, 2018: Military Medicine
https://www.readbyqxmd.com/read/29784078/corticoadrenal-and-cardiorespiratory-responses-to-administration-of-propofol-combined-with-dexmedetomidine-or-ketamine-in-rabbits
#15
Alfredo González-Gil, Rosa Ana Picazo, Paul de Bruyn, Juan Carlos Illera
Anesthetic protocols may influence adrenal function. Effective methods for modulating stress are desirable to minimize secondary effects during the perioperative period. The aim of this study was to evaluate the effects of the administration of propofol with dexmedetomidine or ketamine on corticoadrenal function and heart and respiratory rates. A random treatment-order design was used: each rabbit received all treatments, with at least 14 d between experiments. Rabbits were assigned to 3 treatment groups (10 per group): group 1, 1 mL normal saline solution intravenously; group 2, propofol (3 mg/kg IV) and dexmedetomidine (0...
May 1, 2018: Journal of the American Association for Laboratory Animal Science: JAALAS
https://www.readbyqxmd.com/read/29739543/special-indications-for-opioid-free-anaesthesia-and-analgesia-patient-and-procedure-related-including-obesity-sleep-apnoea-chronic-obstructive-pulmonary-disease-complex-regional-pain-syndromes-opioid-addiction-and-cancer-surgery
#16
REVIEW
Adrian Sultana, David Torres, Roman Schumann
Opioid-free anaesthesia (OFA) is a technique where no intraoperative systemic, neuraxial or intracavitary opioid is administered with the anaesthetic. Opioid-free analgesia similarly avoids opioids in the perioperative period. There are many compelling reasons to avoid opioids in the surgical population. A number of case reports and, increasingly, prospective studies from all over the world support its benefits, especially in the morbidly obese population with or without sleep apnoea. A derivative technique is opioid sparing, where the same techniques are used but some opioid use is allowed...
December 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/29720907/sedation-and-analgesia-using-medications-delivered-via-the-extravascular-route-in-children-undergoing-laceration-repair
#17
REVIEW
Jamie L Miller, Amanda C Capino, Amber Thomas, Kevin Couloures, Peter N Johnson
OBJECTIVES: To describe the method of delivery, dosage regimens, and outcomes of sedatives and analgesics administered via the extravascular route for laceration repair in children. METHODS: Medline, Embase, and International Pharmaceutical Abstracts were searched using the keywords "child," "midazolam," "ketamine," dexmedetomidine," "fentanyl," "nitrous oxide" (N2 O), and "laceration repair." Articles evaluating the use of extravascular sedation in children for laceration repair published in the English language between 1946 and June 2017 were included...
March 2018: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/29707324/non-intubated-thoracoscopic-bullectomy-under-sedation-is-safe-and-comfortable-in-the-perioperative-period
#18
Jinwook Hwang, Jae Seung Shin, Joo Hyung Son, Too Jae Min
Background: Non-intubated thoracoscopic surgery can be performed under sedation using adjuvant regional anesthesia, however, the benefits of non-intubated thoracoscopic surgery under sedation have not yet been completely verified. In this study, we compare the perioperative safety and pain complaints of sedation without intubation in thoracoscopic bullectomy with that of conventional general anesthesia with double-lumen intubation and mechanical ventilation. Methods: Forty-one patients with primary spontaneous pneumothorax who were scheduled for thoracoscopic bullectomy were enrolled in this study...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29688787/comparison-of-desflurane-and-propofol-at-equipotent-doses-in-combination-with-a-constant-rate-infusion-of-dexmedetomidine-on-global-and-peripheral-perfusion-and-oxygenation-in-horses
#19
Stephan Neudeck, Sabine B R Kästner, Liza Wittenberg-Voges, Karl Rohn, Klaus Hopster
OBJECTIVE To determine global and peripheral perfusion and oxygenation during anesthesia with equipotent doses of desflurane and propofol combined with a constant rate infusion of dexmedetomidine in horses. ANIMALS 6 warmblood horses. PROCEDURES Horses were premedicated with dexmedetomidine (3.5 μg•kg-1 , IV). Anesthesia was induced with propofol or ketamine and maintained with desflurane or propofol (complete crossover design) combined with a constant rate infusion of dexmedetomidine (7 μg•kg-1 •h-1 )...
May 2018: American Journal of Veterinary Research
https://www.readbyqxmd.com/read/29655977/dexmedetomidine-or-fentanyl-cardiovascular-stability-and-analgesia-during-propofol-ketamine-total-intravenous-anaesthesia-in-experimental-pigs
#20
Andreas Lervik, Joanna Raszplewicz, Birgit Ranheim, Susanna Solbak, Simen F Toverud, Henning A Haga
OBJECTIVE: To compare cardiovascular function and response to nociception during total intravenous anaesthesia in pigs with propofol, ketamine and either dexmedetomidine or fentanyl administered as a continuous infusion. STUDY DESIGN: Blinded, randomized, balanced, crossover study ANIMALS: Eight immunocastrated male, mixed breed pigs with a mean ± standard deviation body weight of 26.4 ± 1.9 kg for dexmedetomidine and 27.5 ± 3.8 kg for fentanyl treatment...
May 2018: Veterinary Anaesthesia and Analgesia
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