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https://www.readbyqxmd.com/read/28419616/the-provision-of-pediatric-cardiac-anesthesia-services-in-germany-current-status-of-structural-and-personnel-organization
#1
Torsten Baehner, Oliver Dewald, Ingo Heinze, Matthias Mueller, Ehrenfried Schindler, Uwe Schirmer, Georg Baumgarten, Andreas Hoeft, Richard K Ellerkmann
BACKGROUND: Anesthesia for pediatric cardiac surgery requires a high level of expert knowledge. There are currently no recommendations and standards for anesthetic management for congenital cardiac surgery in Germany. AIM: The aim of the present study was to assess the current status of structural and personnel anesthetic standards at pediatric cardiac surgery centers in Germany. METHOD: All cardiac surgical centers in Germany were reviewed for an active program for congenital heart surgery...
April 17, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28416162/pharmacokinetics-of-buprenorphine-following-constant-rate-infusion-for-postoperative-analgesia-in-dogs-undergoing-ovariectomy
#2
Andrea Barbarossa, Julie Rambaldi, Massimo Giunti, Anna Zaghini, Marco Cunto, Daniele Zambelli, Simond Valgimigli, Francesco Santoro, Noemi Romagnoli
OBJECTIVE: To investigate the pharmacokinetics of buprenorphine and its main active metabolite, norbuprenorphine, after administration of an intravenous loading dose followed by constant rate infusion (CRI) in dogs. STUDY DESIGN: Prospective, clinical study. ANIMALS: A total of seven healthy dogs undergoing elective ovariectomy. METHODS: Buprenorphine was administered as a loading dose (intravenous bolus of 15 μg kg(-1)) followed by CRI (2...
January 11, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28391258/dexmedetomidine-combined-with-therapeutic-hypothermia-is-associated-with-cardiovascular-instability-and-neurotoxicity-in-a-piglet-model-of-perinatal-asphyxia
#3
Mojgan Ezzati, Go Kawano, Eridan Rocha-Ferreira, Daniel Alonso-Alconada, Jane K Hassell, Kevin D Broad, Igor Fierens, Bobbi Fleiss, Alan Bainbridge, David L Price, Pardis Kaynezhad, Brian Anderson, Mariya Hristova, Ilias Tachtsidis, Xavier Golay, Pierre Gressens, Robert D Sanders, Nicola J Robertson
The selective α2-adrenoreceptor agonist dexmedetomidine has shown neuroprotective, analgesic, anti-inflammatory, and sympatholytic properties that may be beneficial in neonatal encephalopathy (NE). As therapeutic hypothermia is only partially effective, adjunct therapies are needed to optimize outcomes. The aim was to assess whether hypothermia + dexmedetomidine treatment augments neuroprotection compared to routine treatment (hypothermia + fentanyl sedation) in a piglet model of NE using magnetic resonance spectroscopy (MRS) biomarkers, which predict outcomes in babies with NE, and immunohistochemistry...
April 8, 2017: Developmental Neuroscience
https://www.readbyqxmd.com/read/28387014/weak-by-the-machines-muscle-motor-protein-dysfunction-ndash-a-side-effect-of-intensive-care-unit-treatment
#4
REVIEW
O Friedrich, S Diermeier, L Larsson
Intensive care interventions involve periods of mechanical ventilation, sedation and complete mechanical silencing of patients. Critical illness myopathy (CIM) is an ICU-acquired myopathy that is associated with limb muscle weakness, muscle atrophy, electrical silencing of muscle and motor-proteinopathy. The hallmark of CIM is a preferential muscle myosin loss due to increased catabolic and reduced anabolic activity. The ubiquitin-proteasome pathway plays an important role, apart from recently identified novel mechanisms affecting nonlysosomal protein degradation or autophagy...
April 7, 2017: Acta Physiologica
https://www.readbyqxmd.com/read/28384962/comparison-of-intravenous-dexmedetomidine-with-midazolam-in-prolonging-spinal-anaesthesia-with-ropivacaine
#5
Balwinder Kaur Rekhi, Tejinderpal Kaur, Divya Arora, Pankaj Dugg
INTRODUCTION: Midazolam and dexmedetomidine both being sedatives, but the latter with additional analgesic properties is expected to prolong the duration of sensory and motor block obtained with spinal anaesthesia. AIM: To compare intravenous dexmedetomidine with midazolam and placebo with respect to sensory and motor block duration, analgesia, and sedation in patients undergoing lower limb and lower abdominal surgeries with intrathecal ropivacaine anaesthesia. MATERIALS AND METHODS: In this single blind placebo controlled trial, 60 patients, classified as American Society of Anaesthesiologists' (ASA) physical status I-II, were randomized into three groups (n=20 per group)...
February 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28336376/effect-of-anesthetics-on-microglial-activation-and-nanoparticle-uptake-implications-for-drug-delivery-in-traumatic-brain-injury
#6
Gokul Kannan, Siva P Kambhampati, Sapna R Kudchadkar
Traumatic brain injury (TBI) is a serious public health problem, often with devastating consequences for patients and their families. Affordable and timely therapies can have a substantial impact on outcomes in severe TBI. Despite the common use of sedatives and anesthetics in the acute phase of TBI management, their effect on glial cells is not well understood. We investigated the effect of a commonly used sedative, pentobarbital, on glial cells and their uptake of nanoparticles. First, we studied how pentobarbital affects BV2 mouse microglial cells in culture...
March 20, 2017: Journal of Controlled Release: Official Journal of the Controlled Release Society
https://www.readbyqxmd.com/read/28298785/the-effect-of-intravenous-dexmedetomidine-compared-to-propofol-on-patients-hemodynamics-as-a-sedative-in-brachial-plexus-block-a-comparative-study
#7
Amarjeet Kumar, Chandni Sinha, Ajeet Kumar, Poonam Kumari
BACKGROUND: The quest for an ideal sedative during regional anesthesia is on. Although propofol has been accepted as a sedative intraoperatively, it can be associated with troublesome hemodynamic changes. Dexmedetomidine is a new alpha 2 agonist used widely for sedation. AIMS: In this study, we tried to compare equivalent doses of dexmedetomidine infusion with propofol with emphasis on their effect on the hemodynamics. SETTINGS AND DESIGN: Prospective, single-blinded randomized controlled trial...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28298760/the-effectiveness-of-intravenous-dexmedetomidine-on-perioperative-hemodynamics-analgesic-requirement-and-side-effects-profile-in-patients-undergoing-laparoscopic-surgery-under-general-anesthesia
#8
Vinayak Panchgar, Akshaya N Shetti, H B Sunitha, Vithal K Dhulkhed, A V Nadkarni
BACKGROUND: There is an upward surge in the use of laparoscopic surgeries due to various advantages when compared to open surgeries. Major advantages are, due to small incisions which are cosmetically acceptable and most of them are now daycare procedures. Problem of economic burden and hospital bed occupancy has been overcome with laparoscopic surgeries. All these advantages are not free from disadvantages, as hemodynamic changes such as hypertension; tachycardia and other surgical-related complications are commonly observed intraoperatively...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28298753/a-prospective-randomized-trial-comparing-dexmedetomidine-and-midazolam-for-conscious-sedation-during-oocyte-retrieval-in-an-in-vitro-fertilization-program
#9
Ali Mohamed Ali Elnabtity, Mohamed Fouad Selim
BACKGROUND: Various sedative and analgesic techniques have been used for pain relief during oocyte retrieval which is the most painful part of in vitro fertilization (IVF) procedures. AIM: This study aimed at comparing dexmedetomidine and midazolam for conscious sedation in women undergoing transvaginal oocyte retrieval during an IVF program. SETTINGS AND DESIGN: Prospective randomized double-blinded comparative study. PATIENTS AND METHODS: Fifty-two patients undergoing oocyte retrieval in their first IVF cycle were randomly allocated into two equal groups...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28282236/comparison-of-morphine-morphine-lidocaine-and-morphine-lidocaine-ketamine-infusions-in-dogs-using-an-incision-induced-pain-model
#10
Ludovica Chiavaccini, Andrew K Claude, Robert E Meyer
We aimed to compare antinociceptive effects of IV infusions of morphine (M), morphine-lidocaine (ML), or morphine-lidocaine-ketamine (MLK) combined, in a mild-to-moderate pain model in dogs. Eighteen adult hounds were heavily sedated with IV morphine (0.2 mg/kg) and dexmedetomidine to undergo thoracic skin incisions. After reversal, dogs were randomly assigned to receive loading doses of lidocaine and ketamine (MLK), lidocaine and saline (ML), or equivalent volume of saline (M), followed by 18 hr constant infusions of morphine (0...
March 2017: Journal of the American Animal Hospital Association
https://www.readbyqxmd.com/read/28282070/-rational-use-of-psychotropic-medications-and-sedative-load-in-older-adults-with-and-without-dementia
#11
María L Rattagan, Darío Lisei, Galeno J Rojas, Gabriel G Persi, Virginia L Parisi, Martín López Vicchi, Gustavo Da Prat de Magalhaes, María Bres Bullrich, Emilia M Gatto
Sedative drugs use has been associated with more cognitive impairment and increased mortality. Sedative load refers to cumulative exposure to multiple drugs with sedative properties. OBJECTIVE: Describe the use of psychotropic drugs and sedative load in older adults with and without dementia. MATERIAL AND METHODS: We conducted a cross-sectional study from 2014-2015 (Sanatorio Trinidad Mitre), in hospitalized patients older than 65 years old. Drugs were classified according to the WHO ATC system...
September 2016: Vertex: Revista Argentina de Psiquiatriá
https://www.readbyqxmd.com/read/28253863/combined-use-of-dexmedetomidine-and-propofol-in-monitored-anesthesia-care-a-randomized-controlled-study
#12
Kyu Nam Kim, Hee Jong Lee, Soo Yeon Kim, Ji Yoon Kim
BACKGROUD: Although propofol and dexmedetomidine have been widely used for monitored anesthesia care, their adverse effects necessitate the search for better methods. Therefore, we performed this randomized controlled trial to evaluate the combined use of propofol and dexmedetomidine. METHODS: Eighty-seven adult patients undergoing hand surgery under brachial plexus block were randomly allocated to receive 1.6 μg/ml of the target effect site concentration of propofol (P group) and infusion of 0...
March 1, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28228653/drug-prescription-appropriateness-in-the-elderly-an-italian-study
#13
Nicola Allegri, Federica Rossi, Federica Del Signore, Paolo Bertazzoni, Roberto Bellazzi, Giorgio Sandrini, Tomaso Vecchi, Davide Liccione, Alessia Pascale, Stefano Govoni
PURPOSE: Correct drug prescription in the elderly is a difficult task that requires careful survey of the current pharmacological therapies. In this article, we reviewed the drug prescriptions provided to 860 persons aged 65 years or over, residing in a small city of Lombardy, Italy. METHODS: Subjects were recruited from a local nursing home, the Pavia and Vigevano Neuropsychological Center for Alzheimer's Disease, general practitioners' offices, and the local University of the Third Age...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28207529/comparison-of-the-pro-postoperative-analgesia-of-intraoperative-dexmedetomidine-with-and-without-loading-dose-following-general-anesthesia-a-prospective-randomized-controlled-clinical-trial
#14
RANDOMIZED CONTROLLED TRIAL
Wei Fan, Haikou Yang, Yong Sun, Jun Zhang, Guangming Li, Ying Zheng, Yi Liu
Intraoperative dexemdetomidine (DEX) with or without loading dose is well-established to improve postoperative pain control in patient-controlled analgesia (PCA). This study was designed to compare the pro-analgesia effect between the 2 in patients received general anesthesia.Seventy patients shceduced abdominal surgery under general anesthesia were randomly assigned into 3 groups which were maintained using propofol/remifentanil/Ringer solution (PRR), propofol/remifentanil/dexmedetomidine with (PRDw) or without (PRDo) a loading dose of dexmedetomidine before induction...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27940505/a-previously-healthy-adolescent-with-acute-encephalopathy-and-decorticate-posturing
#15
Yu Kawai, Andrea G DeMonbrun, Rebecca S Chambers, Danielle A Nolan, Bram A Dolcourt, Nasuh M Malas, Michael W Quasney
A 14-year-old previously healthy female was transferred from a local emergency department after being found unresponsive at home. Parental questioning revealed she had fever and pharyngitis 2 weeks before presentation. Past mental health history was negative, including concern for past or present suicidal ideation/attempts, suspected substance use, or toxic ingestion. In the emergency department, she was orotracheally intubated due to a Glasgow Coma Scale of 3. She was hemodynamically stable and euglycemic...
January 2017: Pediatrics
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
#16
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...
March 2017: 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
#17
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
#18
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
#19
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
#20
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
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