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Dexmedetomidine AND child

Parul Uppal Malhotra, Seema Thakur, Parul Singhal, Deepak Chauhan, Cheranjeevi Jayam, Ritu Sood, Yagyeshwar Malhotra
BACKGROUND: Pharmacological methods have been used as an adjunct to enhance child cooperativeness and facilitate dental treatment. OBJECTIVE: Purpose of this study was to evaluate and compare the effect of sedation by intranasal dexmedetomidine and oral combination drug midazolam-ketamine in a group of children with uncooperative behavior requiring dental treatment. MATERIALS AND METHODS: This was a prospective, randomized, double-blind study that included patients 3-9 years old with American Society of Anesthesiologists-I status...
April 2016: Contemporary Clinical Dentistry
Veena Sheshadri, B A Chandramouli
Resection of lesions near the eloquent cortex of brain necessitates awake craniotomy to reduce the risk of permanent neurologic deficits during surgery. There are limited reports of anesthetic management of awake craniotomy in pediatric patients. This report is on use of dexmedetomidine sedation for awake craniotomy in a 11-year-old child, without any airway adjuncts throughout the procedure. Dexmedetomidine infusion administered at a dosage of 0.2 to 0.7μg kg(-1) h(-1) provided adequate sedation for the entire procedure...
August 2016: Journal of Clinical Anesthesia
Mohamed R El-Tahan, D John Doyle, Laila Telmesani, Abdulmohsen Al'Ghamdi, Alaa M Khidr, Mohamed Maher Abdeen
We report on the successful use of dexmedetomidine to treat persistent intractable hiccup in a child who underwent cochlear implantation under sevoflurane-fentanyl anesthesia.
June 2016: Journal of Clinical Anesthesia
B L Li, N Zhang, J X Huang, Q Q Qiu, H Tian, J Ni, X R Song, V M Yuen, M G Irwin
Intranasal dexmedetomidine has been used successfully for sedation in children. A mucosal atomisation device delivers an atomised solution to the nasal mucosa which facilitates rapid and effective delivery of medication to the systemic circulation. We compared intranasal delivery of dexmedetomidine in a dose of 3 μ by either atomiser or drops from a syringe in children < 3 years old undergoing transthoracic echocardiography. Two hundred and seventy-nine children were randomly assigned to one or other group...
May 2016: Anaesthesia
Amber Thomas, Jamie L Miller, Kevin Couloures, Peter N Johnson
OBJECTIVES: The purpose of this study was to describe the method of delivery, dosage regimens, and outcomes of sedatives administered by extravascular route for imaging procedures in children. METHODS: Medline, Embase, International Pharmaceutical Abstracts, and Cochrane Database of Systematic Reviews were searched using keywords "child", "midazolam", "ketamine", dexmedetomidine", "fentanyl", "nitrous oxide", and "imaging." Articles evaluating the use of extravascular sedation in children for imaging procedures published in English between 1946 and March 2015 were included...
November 2015: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
Ravi Bhat, Milon V Mitragotri
No abstract text is available yet for this article.
October 2015: Indian Journal of Anaesthesia
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
Chris O'Hara, Robert F Tamburro, Gary D Ceneviva
Agents used to control end-of-life suffering are associated with troublesome side effects. The use of dexmedetomidine for sedation during withdrawal of support in pediatrics is not yet described. An adolescent female with progressive and irreversible pulmonary deterioration was admitted. Despite weeks of therapy, she did not tolerate weaning of supplemental oxygen or continuous bilevel positive airway pressure. Given her condition and the perception that she was suffering, the family requested withdrawal of support...
2015: Palliative Care
Neda Taghizadeh, Andrew Davidson, Katrina Williams, David Story
Autism spectrum disorder (ASD) is now diagnosed in more than 1 in 100 children, so it is not surprising that anesthetists are increasingly providing care for children with this diagnosis. The diagnostic classification for ASD has recently changed and our understanding of the causes and management of ASD are also changing rapidly. This review provides a timely update to increase understanding and awareness of the problems that children with ASD experience, and to minimize perioperative problems. Current literature on premedication and the increasing use of alpha-2 agonists such as clonidine and dexmedetomidine as well as the use of old favorites midazolam and ketamine is reviewed...
November 2015: Paediatric Anaesthesia
Seyedeh Zahra Faritus, Mehrdad Khazaee-Koohpar, Mohsen Ziyaeifard, Mohammad Javad Mehrabanian
BACKGROUND: Premedication is required for reducing anxiety and child's struggling against mask acceptance on anesthesia in pediatric surgery for congenital heart disease. Midazolam has been widely used for this purpose, but because of its side effects, finding an effective replacement with less complication is necessary. OBJECTIVES: In the present study, we compared the efficacy of oral midazolam versus dexmedetomidine in terms of anxiolysis and mask acceptance behavior...
June 2015: Anesthesiology and Pain Medicine
Flora Cipriani, Aldo Mancino, Silvia Maria Pulitanò, Marco Piastra, Giorgio Conti
INTRODUCTION: In the last 20 years, the rate of exposure to marijuana has increased dramatically, even in the pediatric population. Effects of intoxication are variable, more severe neurological symptoms can be observed following ingestion, thus hospital or intensive care unit admission is often required. Usually cannabinoids intoxicated patients are treated with administration of benzodiazepines or opioids, accepting the related risk of intubation and mechanical ventilation. Dexmedetomidine is a highly selective α2-adrenergic receptor agonist, with no effect on the respiratory drive and pattern and produces a good level of sedation, allowing to avoid the administration of other sedatives...
2015: Journal of Medical Case Reports
Mohamed Ibrahim
BACKGROUND: For optimum magnetic resonance imaging (MRI) image quality and to ensure precise diagnosis, patients have to remain motionless. We studied the effects of intranasal dexmedetomidine and ketamine with intravenous midazolam for pre-procedural and procedural sedation in school aged children. PATIENTS AND METHODS: Children were randomly allocated to one of two groups: (Group D) received intranasal dexmedetomidine 3 μg kg(-1) and (Group K) received intranasal ketamine 7 mg kg(-1)...
May 2014: Anesthesia, Essays and Researches
Ola M Zanaty, Shahira Ahmed El Metainy
BACKGROUND: This study was designed to evaluate and compare the efficacy and safety of nebulized dexmedetomidine, nebulized ketamine, and the combination of these drugs for premedication in pediatric outpatient dental surgeries. METHODS: A prospective, randomized, double-blinded study was conducted in the Alexandria Main University Hospital after approval of the Medical Ethics Committee. Informed written consent was obtained from the patient's parents. Sixty children classified as ASA physical status I and II and aged 3 to 6 years were enrolled in the study...
July 2015: Anesthesia and Analgesia
Jyothi R Savla, Babita Ghai, Dipika Bansal, Jyotsna Wig
INTRODUCTION: This study was conducted to determine the effect of oral midazolam (OM) or intranasal dexmedetomidine (IND) on the EC50 of sevoflurane for successful laryngeal mask airway placement in children. We hypothesize that premedication with either agent might reduce the sevoflurane EC50 for laryngeal mask airway placement in children to a similar extent. METHODS: Fifty-two American Society of Anesthesiologists (ASA) I children (aged 1-6 years) scheduled for general anesthesia with laryngeal mask airway were randomized to one of the three groups: group M received 0...
April 2014: Paediatric Anaesthesia
David Costi, Allan M Cyna, Samira Ahmed, Kate Stephens, Penny Strickland, James Ellwood, Jessica N Larsson, Cheryl Chooi, Laura L Burgoyne, Philippa Middleton
BACKGROUND: Sevoflurane is an inhaled volatile anaesthetic that is widely used in paediatric anaesthetic practice. Since its introduction, postoperative behavioural disturbance known as emergence agitation (EA) or emergence delirium (ED) has been recognized as a problem that may occur during recovery from sevoflurane anaesthesia. For the purpose of this systematic review, EA has been used to describe this clinical entity. A child with EA may be restless, may cause self-injury or may disrupt the dressing, surgical site or indwelling devices, leading to the potential for parents to be dissatisfied with their child's anaesthetic...
2014: Cochrane Database of Systematic Reviews
Atsushi Furuya, Sho Suzuki, Satoko Kondo, Riko Kiuchi, Satomi Suzuki, Akihiko Nonaka
We report anesthetic management of a 22-month-old child with Cornelia de Lange syndrome scheduled for palatoplasty because of cleft palate. Micrognathia and short neck of the patient suggested difficult airway management. For anesthetic induction, 1 microg x kg(-1) dexmedetomidine was loaded intravenously, followed by infusion at a rate of 0.7 microg x kg(-1) x hr(-1) with incremental inhalation of sevoflurane. During the induction, spontaneous breathing was maintained. By laryngoscopy with Machintosh blade after intravenous propofol for the purpose of laryngeal reflex inhibition, only the tip of epiglottis was seen...
July 2014: Masui. the Japanese Journal of Anesthesiology
Keira P Mason, Dana P Turner, Timothy T Houle, Paulette J Fontaine, Jerrold Lerman
OBJECTIVE: Dexmedetomidine is administered for pediatric sedation for MRI studies. It has the advantage of preserving respiratory function and producing a sedation state identical to that of natural sleep. It can, however, cause a dose-dependent decrease in systemic blood pressure in children. The purpose of this study was to investigate whether i.v. fluid loading with normal saline solution before the initiation of dexmedetomidine administration would affect the frequency of hypotension...
June 2014: AJR. American Journal of Roentgenology
Anuradha Ganigara, Madhavi Nishtala, Yabagodu Rama Vakoda Chandrika, Kunigal Ravishankar Chandrakala
Frontometaphyseal dysplasia (FMD), also called Gorlin-Cohen syndrome, is a rare hereditary X-linked dominant craniotubular bone disorder. The presentation describes the airway management of a 2-year-old child suffering from FMD with significant retrognathia, posted for major long bone corrective osteotomy. Induction with a combination of dexmedetomidine and ketamine preceded a successful endotracheal intubation under spontaneous ventilation.
April 2014: Journal of Anaesthesiology, Clinical Pharmacology
James M Hitt, Toby Corcoran, Kelly Michienzi, Paul Creighton, Christopher Heard
Conscious or moderate sedation is routinely used to facilitate the dental care of the pre- or un-cooperative child. Dexmedetomidine (DEX) has little respiratory depressant effect, possibly making it a safer option when used as an adjunct to either opioids or benzodiazepines. Unlike intranasal (IN) midazolam, IN application of DEX and sufentanil (SUF) does not appear to cause much discomfort. Further, although DEX lacks respiratory depressive effects, it is an α2-agonist that can cause hypotension and bradycardia when given in high doses or during prolonged periods of administration...
2014: Pharmaceutics
Hyo Sun Kim, Jung-Wook Kim, Ki-Taeg Jang, Sang-Hoon Lee, Chong-Chul Kim, Teo Jeon Shin
Sedation of uncooperative children for dental treatment is difficult since treatment is mainly carried out inside the oral cavity. Dexmedetomidine (DEX), recently introduced into clinical practice, has little influence on respiratory system even at high doses. We present cases of patients who underwent dental treatment under sedation using DEX infusion. DEX at a dose of 1 microg/kg was administered over 10 min after intravenous cannulation. DEX was infused to maintain sedation level within the range of the Observer's Assessment of Alertness and Sedation (OAA/S) scale 3- 4 throughout dental treatments...
2013: Journal of Clinical Pediatric Dentistry
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