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dexmedetomidine and ketamine

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...
September 24, 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...
August 18, 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
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
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
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
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
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
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
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