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https://www.readbyqxmd.com/read/28731876/neuraxial-drug-delivery-for-the-management-of-cancer-pain-cost-updates-and-society-guidelines
#1
Collin F M Clarke
PURPOSE OF REVIEW: The present study discusses the utilization of neuraxial drug delivery (NDD) for the management of cancer pain, based on recent trials, reviews, and guidelines with a focus on cost analysis. RECENT FINDINGS: Almost all recent publications suggest that more stringent research is needed to improve evidence on NDD, particularly as conflicting reports exist regarding cost effectiveness of drug delivery systems. The combination of local anesthetics and opioids, with or without clonidine, continues to be reported as beneficial with the utilization of patient controlled systems providing an advantage over continuous ones...
July 20, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28728322/perioperative-hypertension-management-during-facelift-under-local-anesthesia-with-intravenous-hypnotics
#2
Ki Ho Chung, Myeong Soo Cho, Hoon Jin
Perioperative hypertension is a phenomenon in which a surgical patient's blood pressure temporarily increases throughout the preoperative and postoperative periods and remains high until the patient's condition stabilizes. This phenomenon requires immediate treatment not only because it is observed in a majority of patients who are not diagnosed with high blood pressure, but also because occurs in patients with underlying essential hypertension who show a sharp increase in their blood pressure. The most common complication following facelift surgery is hematoma, and the most critical risk factor that causes hematoma is elevated systolic blood pressure...
July 2017: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/28726169/comparison-of-the-systemic-and-local-pharmacokinetics-of-clonidine-mucoadhesive-buccal-tablets-with-reference-clonidine-oral-tablets-in-healthy-volunteers-an-open-label-randomised-cross-over-trial
#3
Bérangère Vasseur, Alain Dufour, Laetitia Houdas, Helen Goodwin, Kathryn Harries, Neslihan Yesiltas Emul, Simon Hutchings
INTRODUCTION: The clonidine mucoadhesive buccal tablet (MBT) is a novel delivery system resulting in high and sustained concentrations of clonidine in the oral cavity. In a phase II clinical trial, clonidine MBT reduced the incidence of severe oral mucositis (OM) compared to placebo in head and neck cancer patients undergoing chemoradiation. This study compared the pharmacokinetics (PK), safety and tolerability of clonidine MBT with a reference oral tablet (OT). METHODS: This was a randomised, three-period, single-dose crossover study in 36 healthy subjects aged 18-50 years...
July 19, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28715875/acute-orexigenic-effect-of-agmatine-involves-interaction-between-central-%C3%AE-2-adrenergic-and-gabaergic-receptors
#4
Brijesh Gulabrao Taksande, Omi Sharma, Manish Manohar Aglawe, Mayur Bhimrao Kale, Dinesh Yugraj Gawande, Milind Janraoji Umekar, Nandkishor Ramdas Kotagale
Agmatine and GABA have been abundantly expressed in brain nuclei involved in regulation of energy homeostasis and promoting stimulation of food intake in rodents. However, their mutual interaction, if any, in the elicitation of feeding behavior is largely remains unclear. The current study provides experimental evidence for the possible interaction of agmatine, adrenergic and GABAergic systems in stimulation of feeding in satiated rats. Satiated rats fitted with intracerebroventricular (i.c.v.) cannulae and were administered agmatine, alone or jointly with (a) GABAA receptor agonist, muscimol, diazepam or antagonist bicuculline and flumazenil, GABAA positive modulator, allopregnanolone or negative modulator of GABAA receptor, dehydroepiandrosterone (b) In view of the high affinity of agmatine for α2-adrenoceptors and the close association between α2-adrenoceptors and GABAergic system, the effect of their modulators on feeding elicited by agmatine/GABAergic agonists were also examined...
July 13, 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/28708771/effect-of-clonidine-on-hemodynamic-responses-during-laparoscopic-cholecystectomy-a-systematic-review-and-meta-analysis
#5
Yi Zhang, Xi Zhang, Yu Wang, Jiefeng Zhang
BACKGROUND: Clonidine might be beneficial to the patients undergoing laparoscopic cholecystectomy. This meta-analysis focused on the influence of clonidine on hemodynamic responses in patients undergoing laparoscopic cholecystectomy. METHODS: We searched several databases including PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases. This meta-analysis included randomized controlled trials regarding the influence of clonidine versus placebo on laparoscopic cholecystectomy...
July 13, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28707454/interventions-for-postoperative-pain-in-children-an-overview-of-systematic-reviews
#6
REVIEW
Krste Boric, Svjetlana Dosenovic, Antonia Jelicic Kadic, Marijan Batinic, Marija Cavar, Marjan Urlic, Nikolina Markovina, Livia Puljak
The aim of this study was to conduct an overview of systematic reviews that summarizes the results about efficacy and safety from randomized controlled trials involving the various strategies used for postoperative pain management in children. We searched the Cochrane Database of Systematic Reviews, CINAHL, Database of Reviews of Effect, Embase, MEDLINE, and PsycINFO from the earliest date to January 24, 2016. This overview included 45 systematic reviews that evaluated interventions for postoperative pain in children...
July 14, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28700791/efficacy-of-tramadol-extended-release-for-opioid-withdrawal-a-randomized-clinical-trial
#7
Kelly E Dunn, D Andrew Tompkins, George E Bigelow, Eric C Strain
Importance: Opioid use disorder (OUD) is a significant public health problem. Supervised withdrawal (ie, detoxification) from opioids using clonidine or buprenorphine hydrochloride is a widely used treatment. Objective: To evaluate whether tramadol hydrochloride extended-release (ER), an approved analgesic with opioid and nonopioid mechanisms of action and low abuse potential, is effective for use in supervised withdrawal settings. Design, Setting, and Participants: A randomized clinical trial was conducted in a residential research setting with 103 participants with OUD...
July 12, 2017: JAMA Psychiatry
https://www.readbyqxmd.com/read/28700715/the-pharmacological-and-non-pharmacological-treatment-of-attention-deficit-hyperactivity-disorder-in-children-and-adolescents-a-systematic-review-with-network-meta-analyses-of-randomised-trials
#8
Ferrán Catalá-López, Brian Hutton, Amparo Núñez-Beltrán, Matthew J Page, Manuel Ridao, Diego Macías Saint-Gerons, Miguel A Catalá, Rafael Tabarés-Seisdedos, David Moher
BACKGROUND: Attention deficit hyperactivity disorder (ADHD) is one of the most commonly diagnosed psychiatric disorders in childhood. A wide variety of treatments have been used for the management of ADHD. We aimed to compare the efficacy and safety of pharmacological, psychological and complementary and alternative medicine interventions for the treatment of ADHD in children and adolescents. METHODS AND FINDINGS: We performed a systematic review with network meta-analyses...
2017: PloS One
https://www.readbyqxmd.com/read/28697832/-efficacy-of-clonidine-transdermal-patch-in-treatment-of-moderate-to-severe-tic-disorders-in-children
#9
Jing-Min Guo, Xiao-Xi Shi, Shi-Wei Yang, Qin-Fang Qian, Yan Huang, Yan-Qin Xie, Ping Ou
OBJECTIVE: To investigate the difference in the efficacy between clonidine transdermal patch and haloperidol tablets in the treatment of moderate to severe tic disorders in children. METHODS: A total of 134 children with moderate to severe tic disorders were randomly divided into clonidine group (n=70) and haloperidol group (n=64). The clonidine and haloperidol groups were treated with clonidine transdermal patch and haloperidol tablets respectively, and the treatment lasted for 8 weeks in both groups...
July 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/28691871/non-health-care-facility-medication-errors-resulting-in-serious-medical-outcomes
#10
Nichole L Hodges, Henry A Spiller, Marcel J Casavant, Thiphalak Chounthirath, Gary A Smith
OBJECTIVE: The objective of this study is to provide an epidemiologic analysis of medication errors occurring outside of health care facilities that result in serious medical outcomes (defined by the National Poison Database System as "moderate effect," "major effect," "death," or "death, indirect report"). METHODS: National Poison Database System data from 2000 through 2012 were used for this retrospective analysis of non-health care facility medication errors...
July 10, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28686702/what-is-the-level-of-evidence-for-the-amnestic-effects-of-sedatives-in-pediatric-patients-a-systematic-review-and-meta-analyses
#11
Karolline Alves Viana, Anelise Daher, Lucianne Cople Maia, Paulo Sucasas Costa, Carolina de Castro Martins, Saul Martins Paiva, Luciane Rezende Costa
BACKGROUND: Studies have suggested that benzodiazepines are amnestic drug par excellence, but when taken together, what level of evidence do they generate? Are other sedatives as amnestic as benzodiazepines? The aim of this study was to assess the level of scientific evidence for the amnestic effect of sedatives in pediatric patients who undergo health procedures. METHODS: The literature was searched to identify randomized controlled trials that evaluated anterograde and retrograde amnesia in 1-19-year-olds who received sedative drugs during health procedures...
2017: PloS One
https://www.readbyqxmd.com/read/28671407/perioperative-cardiovascular-medication-management-in-noncardiac-surgery-common-questions
#12
Michael A Mikhail, Arya B Mohabbat, Amit K Ghosh
Several medications have been used perioperatively in patients undergoing noncardiac surgery in an attempt to improve outcomes. Antiplatelet therapy for primary prevention of cardiovascular events should generally be discontinued seven to 10 days before surgery to avoid increasing the risk of bleeding, unless the risk of a major adverse cardiac event exceeds the risk of bleeding. Antiplatelet therapy for secondary prevention should be continued perioperatively, except before procedures with very high bleeding risk, such as intracranial procedures...
May 15, 2017: American Family Physician
https://www.readbyqxmd.com/read/28666582/clonidine-restores-vascular-endothelial-growth-factor-expression-and-improves-tissue-repair-following-severe-trauma
#13
Tyler J Loftus, Andrew J Thomson, Kolenkode B Kannan, Ines G Alamo, Jessica K Millar, Jessica M Plazas, Elizabeth E Whitley, Philip A Efron, Alicia M Mohr
BACKGROUND: We hypothesized that clonidine and propranolol would increase VEGF and VEGF-receptor expression and promote lung healing following severe trauma and chronic stress. METHODS: Sprague-Dawley rats were subjected to lung contusion (LC), lung contusion/hemorrhagic shock (LCHS), or lung contusion/hemorrhagic shock/daily restraint stress (LCHS/CS). Clonidine and propranolol were administered daily. On day seven, lung VEGF, VEGFR-1, VEGFR-2, and HMGB1 were assessed by PCR...
June 23, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28663652/clonidine-as-an-adjuvant-in-fluoroscopic-guided-transforaminal-epidural-steroid-injection-in-a-patient-of-chronic-lumbosacral-radiculopathy
#14
Nandita Mehta, Misbah Salaria, A Q Salaria
Transforaminal epidural steroid injection (TFESI) is a minimally invasive modality used to treat patients with lumbosacral radiculopathy secondary to prolapsed intervertebral disc or spinal canal stenosis. In this case report, we describe the management of a patient with chronic lumbosacral radiculopathy secondary to intervertebral disc herniation which was seen as a right paracentral disc protrusion at levels L4-L5, L5-S1 causing thecal sac indentation, effacement of the right lateral recess and right exiting nerve root impingement as was seen on the magnetic resonance image...
April 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28663650/comparison-of-epidural-clonidine-and-dexmedetomidine-for-perioperative-analgesia-in-combined-spinal-epidural-anesthesia-with-intrathecal-levobupivacaine-a-randomized-controlled-double-blind-study
#15
Safiya I Shaikh, Laksmi R Revur, Marutheesh Mallappa
BACKGROUND: Epidural administrations of α2 agonists are being used as adjuvants as they lead to anxiolysis, sedation, analgesia, and hypnosis. AIM: This study aims to evaluate the analgesic effects of epidural α2 agonists-dexmedetomidine and clonidine in conjunction with intrathecal levobupivacaine in combined spinal epidural anesthesia (CSEA). METHODS: A prospective, randomized controlled study was done to assess and compare the efficacy and clinical profile of two α2 adrenergic agonists, clonidine, and dexmedetomidine administered epidurally in combination with intrathecal levobupivacaine in CSEA...
April 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28663645/prophylactic-use-of-intravenous-clonidine-compared-to-tramadol-in-prevention-of-intraoperative-shivering-under-regional-anesthesia
#16
Sarmila Guha Banerjee, Pallab Kumar Nath, Rita Halder, Ujjwal Bandyopadhyay
OBJECTIVES: This study aimed to evaluate the relative efficacy of prophylactic intravenous (IV) clonidine and tramadol for control of intraoperative shivering following spinal anesthesia. MATERIALS AND METHODS: After institutional ethical clearance, 142 patients were chosen from either gender, aged 20-60 years, physical status American Society of Anesthesiology Class I and II scheduled for elective infraumbilical surgery under spinal anesthesia. Patients were randomized into two groups: Group C (n = 71) received injection clonidine 50 μg) IV in 100 ml normal saline (NS) over 10 min and Group T (n = 71) received injection tramadol 50 mg IV...
April 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28663630/a-comparative-study-of-clonidine-and-lignocaine-for-attenuating-pressor-responses-to-laryngoscopy-and-endotracheal-intubation-in-neurosurgical-cases
#17
Vinay Marulasiddappa, H N Nethra
BACKGROUND AND AIMS: Laryngoscopy and endotracheal intubation are associated with reflex sympathetic stimulation, known as pressor response and can cause major complications. We compared the attenuating effect of time-tested lignocaine versus clonidine on the hemodynamic response to laryngoscopy and intubation in neurosurgical cases. DESIGN: A prospective, randomized, comparative, double-blind study with a sample size of sixty patients. METHODS: Sixty patients undergoing elective neurosurgery were randomly allocated into one of the two groups: Group L (n = 30) received lignocaine 1...
April 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28663629/the-effect-of-multimodal-analgesia-on-intraoperative-morphine-requirement-in-lumbar-spine-surgeries
#18
Keelara Shivalingaiah Savitha, Radhika Dhanpal, Apoorwa N Kothari
BACKGROUND: Lumbar spine surgery demands intense analgesia. Preemptive multimodal analgesia (MMA) is a novel approach to attenuate the stress response to surgical stimulus. AIMS: The aim of the study was to assess the intraoperative morphine consumption in patients undergoing lumbar spine surgery. PATIENTS AND METHODS: A randomized, prospective, double-blind study involving 42 patients belonging to the American Society of Anesthesiologists Class I and II scheduled to undergo elective lumbar spine surgery were allocated into two groups of 21 each...
April 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28663621/effect-of-premedication-with-oral-clonidine-on-hemodynamic-response-during-electroconvulsive-therapy
#19
Mangi Lal Deganwa, Rajesh Sharma, Avneesh Khare, Divya Sharma
BACKGROUND: Electroconvulsive therapy (ECT) is the most effective treatment available for the acute treatment of depression in patients who do not respond to medications. It is generally used as a second line treatment for many psychological disorders, mainly major depression and schizophrenia where medication is not effective. ECT is often associated with some complications such as hypertension, tachycardia arrhythmia and even myocardial infarction. Various methods have been used for prevention or control of these cardiovascular side effects...
April 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28663618/postoperative-analgesia-after-panhysterectomy-addition-of-clonidine-to-bupivacaine-boon-for-the-patients
#20
Keshav Govind Rao, Aparna Shukla, Shilpi Misra
INTRODUCTION: Postoperative period after panhysterectomy is very painful as there is too much tissue handling. In the practice of regional anesthesia neuraxial, opioids have been used extensively as an adjuvant to bupivacaine to enhance the potency and duration of sensory and motor block produced by bupivacaine with satisfactory results. However, delayed respiratory depression by opioids has prompted further research to develop nonopioid analgesics. This study was undertaken to assess the degree of sensory and motor block and postoperative analgesia provided by low dose 50 μg intrathecal clonidine admixed with 0...
April 2017: Anesthesia, Essays and Researches
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