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https://www.readbyqxmd.com/read/27909739/quantification-of-anticholinergic-and-sedative-drug-load-with-the-drug-burden-index-a-review-of-outcomes-and-methodological-quality-of-studies
#1
REVIEW
Hans Wouters, Helene van der Meer, Katja Taxis
PURPOSE: The Drug Burden Index (DBI) is a non-invasive method to quantify patients' anticholinergic and sedative drug burden from their prescriptions. This systematic review aimed to summarise the evidence on the associations between the DBI and clinical outcomes and methodological quality of studies. METHODS: A search in PubMed and Embase (search terms: 'drug', 'burden', and 'index') was performed and experts were contacted. We excluded publications that did not report empirical results or clinical outcomes...
December 1, 2016: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/27903341/-the-application-of-conscious-sedation-with-a-small-dose-of-dexmedetomidine-and-sufentanil-in-elderly-patients-undergoing-multiple-intestinal-polyps-resection
#2
C M Shi, Y D Zhou, M Xu, X D Wang, L M Meng, X J Liu, X Y Guo
Objective: To explore the effectiveness and feasibility of conscious sedation with a low dose of dexmedetomidine and sufentanil during multiple intestinal polyps resection in elderly patients. Methods: Sixty elderly patients who underwent multiple intestinal polyps resection in Peking University Third Hospital from Janurary to May 2016 were randomly divided into dexmedetomidine group (D group, n=30) and propofol group (P group, n=30). There were 28 males and 32 females with a mean age of (70.4±4.5) years old (range: 65-80 years old)...
November 22, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27871538/does-dexmedetomidine-cause-less-airway-collapse-than-propofol-when-used-for-deep-sedation
#3
Stacey Watt, Sassan Sabouri, Rafeek Hegazy, Puneet Gupta, Christopher Heard
STUDY OBJECTIVE: The risk of airway collapse in patients undergoing deep sedation is a major concern. In this study, we compared the airway patency of deep sedation provided by propofol with the airway patency of deep sedation provided by dexmedetomidine in magnetic resonance imaging (MRI) procedures. This comparison was done using MRI static and dynamic images and comparing these images to baseline after sevoflurane induction. DESIGN: After institutional review board approval, children who were scheduled for MRI procedures were given an inhalation induction, had intravenous access established, and were randomized to receive either dexmedetomidine 1-μg/kg load followed by 1-μg/(kg h) infusion or propofol infusion at 300 μg/(kg min) reduced to 250-μg/(kg min) infusion...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871510/anticholinergic-premedication-to-prevent-bradycardia-in-combined-spinal-anesthesia-and-dexmedetomidine-sedation-a-randomized-double-blind-placebo-controlled-study
#4
Eun Jin Ahn, Jun Ha Park, Hyo Jin Kim, Kyung Woo Kim, Hey Ran Choi, Si Ra Bang
OBJECTIVE: When dexmedetomidine is used in patients undergoing spinal anesthesia, high incidence of bradycardia in response to parasympathetic activation is reported. Therefore, we aimed to evaluate the effectiveness of atropine premedication for preventing the incidence of bradycardia and the hemodynamic effect on patients undergoing spinal anesthesia with sedation by dexmedetomidine. DESIGN: Randomized, double-blind, placebo-controlled study. SETTING: Operating room...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27853681/sedative-and-analgesic-effects-of-propofol-fentanyl-versus-propofol-ketamine-during-endoscopic-retrograde-cholangiopancreatography-a-double-blind-randomized-clinical-trial
#5
Fakhroddin Bahrami Gorji, Parviz Amri, Javad Shokri, Hakimeh Alereza, Ali Bijani
BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) is a painful procedure that requires analgesia and sedation. OBJECTIVES: In this study, we compared the analgesic and sedative effects of propofol-ketamine versus propofol-fentanyl in patients undergoing ERCP. METHODS: In this clinical trial, 72 patients, aged 30 - 70 years old, who were candidates for ERCP were randomly divided into two groups. Before the start of ERCP, both groups received midazolam 0...
October 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/27847102/influence-of-different-menstrual-phases-on-the-bispectral-index-during-dexmedetomidine-sedation
#6
Chao Han, Sheng-Jin Ge, Shao-Qiang Huang, Yao-Jun Lu, Ning Li
To investigate the influence of different menstrual phases on the Bispectral Index (BIS) during dexmedetomidine (Dex) sedation, 40 patients with regular menstrual cycle, American Society of Anesthesiologists I-II, aged 18-40 years, undergoing selective gynecologic laparoscopic surgery, were enrolled. According to different menstrual phases and the serum progesterone concentration, they were divided into two groups: the follicular phase group (Group F) and the luteal phase group (Group L), and each group had 20 patients...
November 2016: Kaohsiung Journal of Medical Sciences
https://www.readbyqxmd.com/read/27825666/loading-dose-of-dexdor-%C3%A2-and-optimal-sedation-during-oral-and-maxillofacial-ambulatory-surgery-procedures-an-observational-study
#7
A Martinez-Simon, E Cacho-Asenjo, B Hernando, C Honorato-Cia, L Naval, A Panadero, J M Nuñez-Cordoba
INTRODUCTION: Dexdor(®) do not include the possibility of loading dose, which could increase time to achieve adequate sedation for ambulatory procedures. The objective of this study was to evaluate the effect of several loading dose of dexmedetomidine in the time to achieve and maintain an optimal level of sedation and its clinical hemodynamic repercussion. MATERIAL AND METHODS: The IRB approved this observational study for patients that underwent oral and maxillofacial ambulatory surgery under dexmedetomidine at the University of Navarra Clinic from February 2013 to November 2014...
November 5, 2016: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/27815997/rapid-and-efficient-crossing-blood-brain-barrier-hydrophobic-drug-delivery-system-based-on-propionylated-amylose-helix-nanoclusters
#8
Wei Gao, Yongchun Liu, Guixia Jing, Ke Li, Yuan Zhao, Baoyong Sha, Qiang Wang, Daocheng Wu
A novel strategy of rapid transport across the blood-brain barrier (BBB) via phosphatidylethanolamine-triggered release is developed through both molecular dynamics (MD) simulation and experiments. Hydrophobic drugs, namely, propofol, iodine, and 1,1'-dioctadecyltetramethyl indotricarbocyanine iodide, were loaded with propionylated amylose helix (HLPAH) nanoclusters to form PLPAH, ILPAH, and DLPAH nanoclusters, respectively. These clusters were subjected to MD simulation, structure measurement, in vitro triggered study, in vivo DLPAH imaging, and analysis of PLPAH sedative effects on rabbits...
October 28, 2016: Biomaterials
https://www.readbyqxmd.com/read/27787391/cardiac-arrest-in-a-patient-with-anterior-fascicular-block-after-administration-of-dexmedetomidine-with-spinal-anesthesia-a-case-report
#9
Baek Jin Kim, Bong Il Kim, Sung Hye Byun, Eugene Kim, Shin Yeung Sung, Jin Yong Jung
BACKGROUND: Dexmedetomidine is a sedative and analgesic agent that is administered intravenously as an adjunct to spinal anesthesia. It does not suppress the respiratory system significantly, but has adverse effects on the cardiovascular system, for example, bradycardia and hypotension. We here report a patient who underwent cardiac arrest during spinal anesthesia after intravenous infusion of dexmedetomidine. METHODS: A 57-year-old woman with no significant medical history underwent spinal anesthesia for arthroscopic meniscus resection after rupturing the right knee meniscus...
October 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27779360/a-retrospective-comparison-of-propofol-alone-to-propofol-in-combination-with-dexmedetomidine-for-pediatric-3t-mri-sedation
#10
Juan P Boriosi, Jens C Eickhoff, Kristi B Klein, Gregory A Hollman
BACKGROUND AND AIM: Both propofol and dexmedetomidine have been found to be safe and effective sedation for magnetic resonance imaging (MRI). Our program experienced an increase in patients arousing and experiencing an adverse airway event during propofol sedation for MRI in the first months of using a new 3T (Tesla) MRI scanner that was found to have a longer reverberation time compared to the previous 1.5 T MRI. In an effort to decrease patient arousal and adverse airway events during MRI, we administered a dexmedetomidine load prior to our standard propofol protocol...
October 25, 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27746551/comparison-of-oxycodone-and-sufentanil-for-patient-controlled-intravenous-analgesia-after-laparoscopic-radical-gastrectomy-a-randomized-double-blind-clinical-trial
#11
Na Wang, Honglan Zhou, Xuesong Song, Jinguo Wang
BACKGROUND: Sufentanil is widely used for patient-controlled intravenous analgesia (PCIA). Oxycodone has a powerful analgesic effect and mild side effects. We conducted this study to compare the efficacy of oxycodone and sufentanil for PCIA on postoperative pain after laparoscopic radical gastrectomy. METHODOLOGY: A total of fifty patients scheduled for laparoscopic radical gastrectomy were equally randomized to receive postoperative pain treatment with either oxycodone (Group O) or sufentanil (Group S) for 48 h postoperatively...
September 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/27746530/efficacy-of-dexmedetomidine-and-fentanyl-on-pressor-response-and-pneumoperitoneum-in-laparoscopic-cholecystectomy
#12
Amar Parkash Kataria, Joginder Pal Attri, Ramita Kashyap, Leena Mahajan
BACKGROUND: The advent of laparoscopic surgeries has proved to be beneficial for both patient and surgeon although increased morbidity may result from hemodynamic changes associated with laryngoscopy, intubation, and pneumoperitoneum (PNP). AIM: The present study was prospective, randomized, double-blind conducted to evaluate the efficacy of dexmdetomidine and fentanyl in attenuation of pressor responses to laryngoscopy, intubation, and PNP in laparoscopic cholecystectomy (LC)...
September 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/27708953/current-antiviral-practice-and-course-of-hepatitis-b-virus-infection-in-inflammatory-arthritis-a-multicentric-observational-study-a-hbv-study
#13
Umut Kalyoncu, Hakan Emmungil, Ahmet Mesut Onat, Sedat Yılmaz, Timuçin Kaşifoglu, Servet Akar, Nevsun İnanç, Fatih Yıldız, Orhan Küçükşahin, Ömer Karadağ, Rıdvan Mercan, Cemal Bes, Veli Yazısız, Barış Yılmazer, Mustafa Özmen, Şükran Erten, Soner Şenel, Ayten Yazıcı, Koray Taşçılar, Melike Kalfa, Sedat Kiraz, Bünyamin Kısacık, Yavuz Pehlivan, Levent Kılıç, İsmail Şimşek, Ayşe Çefle, Nurullah Akkoç, Haner Direskeneli, Eren Erken, Murat Turgay, Mehmet Akif Öztürk, Mehmet Soy, Kenan Aksu, Ayhan Dinç, İhsan Ertenli
OBJECTIVE: The reactivation of hepatitis B virus (HBV) infection is a well-known event in hepatitis B surface antigen (HbsAg)-positive patients receiving immunosuppressive therapy. The objective of this study was to assess the antiviral practice and course of HBV infection in inflammatory arthritis. MATERIAL AND METHODS: Nineteen rheumatology centers participated in this retrospective study. HbsAg-positive patients who were taking disease-modifying antirheumatic drugs and who were being tested for HBV viral load at a minimum of two different time points were included...
December 2015: Eur J Rheumatol
https://www.readbyqxmd.com/read/27703624/dexmedetomidine-combined-with-midazolam-vs-dexmedetomidine-alone-for-sedation-during-spinal-anesthesia
#14
Douk-Keun Yoon, Jong-Seouk Ban, Sang-Gon Lee, Ji-Hyang Lee, Eunju Kim, Jihyun An
BACKGROUND: Dexmedetomidine is a useful sedative agent for spinal anesthesia. However, it has been reported that dexmedetomidine decreases heart rate in a dose-dependent manner. In the current study, we compared the administration of a bolus dose of midazolam and bolus loading of dexmedetomidine over 10 min with the goal of identifying an additional method of sedation. METHODS: Ninety patients classified as American Society of Anesthesiologists physical status I-II who were undergoing spinal anesthesia were divided into two groups...
October 2016: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/27693808/intravenous-lacosamide-in-seizure-emergencies-observations-from-a-hospitalized-in-patient-adult-population
#15
Giuseppe d'Orsi, Maria Grazia Pascarella, Tommaso Martino, Elena Carapelle, Francesca Pacillo, Maria Teresa Di Claudio, Daniela Mancini, Marina Trivisano, Carlo Avolio, Luigi M Specchio
PURPOSE: to evaluate the efficacy and safety of intravenous (IV) lacosamide (LCM) in the treatment of seizure clusters (SC) and status epilepticus (SE) in hospitalized adult patients. METHODS: we prospectively analyzed treatment response, seizure outcome, and adverse effects of IV LCM in 38 patients with seizure emergencies (15 with SC, 23 with SE) during a hospital stay. The loading dose of IV LCM was 200-400mg and the maintenance dose was 200-400mg daily. Response to IV LCM was evaluated within 20min, 4h and 24h of LCM infusion...
September 22, 2016: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/27687378/comparing-the-efficacy-and-safety-between-propofol-and-dexmedetomidine-for-sedation-in-claustrophobic-adults-undergoing-magnetic-resonance-imaging-padam-trial
#16
Pui-San Loh, Mohd Azlan Ariffin, Vineya Rai, Lee-Lee Lai, Lucy Chan, Norlisah Ramli
STUDY OBJECTIVE: To determine the efficacy of sedation with dexmedetomidine compared to propofol for claustrophobic adults undergoing magnetic resonance imaging (MRI) in our institution. DESIGN: Randomized, prospective, double-blinded study. SETTING: University-based tertiary referral center. PATIENTS: Thirty claustrophobic adults with American Society of Anesthesiologists physical status I and II who were planned for MRI...
November 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27642574/comparison-of-the-effects-of-dexmedetomidine-and-remifentanil-on-cognition-state-after-cataract-surgery
#17
Mahtab Poorzamany Nejat Kermany, Mastaneh Dahi, Reyhaneh Yamini Sharif, Badiozaman Radpay
BACKGROUND: Dexmedetomidine is a potent and highly specific α2-adrenoreceptor agonist that induces sedative and analgesic effects over a short-term period. As a result of these benefits, dexmedetomidine may be a better alternative than other available drugs for keeping the patient's cognition state in an acceptable condition after outpatient ophthalmic surgeries. OBJECTIVES: This randomized study was conducted to compare the sedative effects of dexmedetomidine and remifentanil on the cognitive state of patients who have undergone cataract surgery...
June 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/27555140/influence-of-dexmedetomidine-on-cognitive-function-in-volunteers
#18
Tomoaki Yatabe, Takahiko Tamura, Koichi Yamashita, Masataka Yokoyama
STUDY OBJECTIVE: Some outpatient procedures are performed under sedation with dexmedetomidine, although the effect of dexmedetomidine on cognitive function remains unclear. This study investigated the effect of dexmedetomidine on cognitive function in healthy volunteers. DESIGN: Observation study in volunteers. SETTING: University-affiliated teaching hospital. PATIENTS: Six healthy volunteers. INTERVENTIONS: After infusion of a 6-μg/kg per hour loading dose of dexmedetomidine for 10 minutes, a maintenance infusion of 0...
September 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27540247/application-of-pharmaceutical-knowledge-to-the-unconventional-use-of-a-rarely-used-anaesthetic-agent
#19
Caroline Cole
CASE SUMMARY: A 6 yr old 45 kg child with severe Cushinoid features was admitted to PICU with probable hypertensive encephalopathy. She presented with increasing headaches, vomiting and seizures becoming unresponsive with a GCS of 3. She was profoundly hypertensive and her cortisol levels were significantly elevated (>2000 nmol/L). Rapid reduction in cortisol levels was required to stabilise her condition prior to surgery. Etomidate is the only readily available intravenous preparation which reliably suppresses adrenocortical function...
September 2016: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/27513688/pharmacodynamics-and-pharmacokinetics-of-morphine-after-cardiac-surgery-in-children-with-and-without-down-syndrome
#20
Abraham J Valkenburg, Elisa A M Calvier, Monique van Dijk, Elke H J Krekels, Brendan P O'Hare, William F Casey, Ron A A Mathôt, Catherijne A J Knibbe, Dick Tibboel, Cormac V Breatnach
OBJECTIVE: To compare the pharmacodynamics and pharmacokinetics of IV morphine after cardiac surgery in two groups of children-those with and without Down syndrome. DESIGN: Prospective, single-center observational trial. SETTING: PICU in a university-affiliated pediatric teaching hospital. PATIENTS: Twenty-one children with Down syndrome and 17 without, 3-36 months old, scheduled for cardiac surgery with cardiopulmonary bypass...
October 2016: Pediatric Critical Care Medicine
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