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Sedative load

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https://www.readbyqxmd.com/read/29772269/a-new-method-for-determining-levels-of-sedation-in-dogs-a-pilot-study-with-propofol-and-a-novel-neuroactive-steroid-anesthetic
#1
B L Youngblood, Y Ueyama, W W Muir, G M Belfort, R H Hammond, J Dai, F G Salituro, A J Robichaud, J J Doherty
BACKGROUND: Different levels of consciousness are required in order to perform different medical procedures. Sedation scales established to objectively define various levels of sedation in humans have not been thoroughly characterized in non-human species. Postural changes in rats or dogs are useful as gross measures of sedation but are inadequate for quantitative assessment since graded levels of sedation are difficult to delineate and obscured by movement abnormalities. NEW METHOD: A new canine sedation scoring (CSS) method was developed based on the modified observer's assessment of alertness and sedation score (MOAA/S) used in humans...
May 14, 2018: Journal of Neuroscience Methods
https://www.readbyqxmd.com/read/29727969/contamination-profiles-mass-loadings-and-sewage-epidemiology-of-neuropsychiatric-and-illicit-drugs-in-wastewater-and-river-waters-from-a-community-in-the-midwestern-united-states
#2
Allie J Skees, Katelyn S Foppe, Bommanna Loganathan, Bikram Subedi
In this study, residues of the neuropsychiatric and illicit drugs including stimulants, opioids, hallucinogens, antischizophrenics, sedatives, and antidepressants were determined in influent and effluent samples from a small wastewater treatment plant, a receiving creek, and river waters in the Four Rivers region of the Midwestern United States. Nineteen neuropsychiatric drugs, eight illicit drugs, and three metabolites of illicit drugs were detected and quantitated in the water samples using HPLC-MS/MS. Residual concentrations of the drugs varied from below the detection limit to sub-μg/L levels...
August 1, 2018: Science of the Total Environment
https://www.readbyqxmd.com/read/29707324/non-intubated-thoracoscopic-bullectomy-under-sedation-is-safe-and-comfortable-in-the-perioperative-period
#3
Jinwook Hwang, Jae Seung Shin, Joo Hyung Son, Too Jae Min
Background: Non-intubated thoracoscopic surgery can be performed under sedation using adjuvant regional anesthesia, however, the benefits of non-intubated thoracoscopic surgery under sedation have not yet been completely verified. In this study, we compare the perioperative safety and pain complaints of sedation without intubation in thoracoscopic bullectomy with that of conventional general anesthesia with double-lumen intubation and mechanical ventilation. Methods: Forty-one patients with primary spontaneous pneumothorax who were scheduled for thoracoscopic bullectomy were enrolled in this study...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29679228/recovery-time-after-oral-and-maxillofacial-ambulatory-surgery-with-dexmedetomidine-an-observational-study
#4
Belen Hernando, Antonio Martinez-Simon, Elena Cacho-Asenjo, Iñaki F Troconiz, Cristina Honorato-Cia, Alfredo Panadero, Luis L Naval, Jorge M Nuñez-Cordoba
OBJECTIVES: To evaluate the relationship between pharmacokinetic descriptors of dexmedetomidine (predicted area under the curve during the procedure, predicted plasma level at the end of the procedure, and duration of procedure) and sedation depth (proportion of time with bispectral index < 85 during the procedure) with recovery time after ambulatory procedures. MATERIALS AND METHODS: Clinical observational study of patients undergoing oral and maxillofacial ambulatory surgery with dexmedetomidine as sole sedative agent...
April 20, 2018: Clinical Oral Investigations
https://www.readbyqxmd.com/read/29661382/comparison-of-target-controlled-infusion-and-manual-infusion-for-propofol-anaesthesia-in-children
#5
J Mu, T Jiang, X B Xu, V M Yuen, M G Irwin
BACKGROUND: One major criticism of prolonged propofol-based total i.v. anaesthesia (TIVA) in children is the prolonged recovery time. As target-controlled infusion (TCI) obviates the need to manually calculate the infusion rate, the use of TCI may better match clinical requirements, reduce propofol dose, and shorten recovery time. METHODS: Children of ASA grade 1, aged 1-12 yr, were recruited and randomly assigned to TCI or manual infusion. Children in the TCI group had propofol delivered by TCI...
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29653188/ketamine-reduces-deleterious-consequences-of-spreading-depolarizations
#6
Katelyn M Reinhart, C William Shuttleworth
Recent work has implicated spreading depolarization (SD) as a key contributor the progression of acute brain injuries, however development of interventions selectively targeting SDs has lagged behind. Initial clinical intervention efforts have focused on observations that relatively high doses of the sedative agent ketamine can completely suppress SD. However blocking propagation of SD could theoretically prevent beneficial effects of SD in surrounding brain regions. Selective targeting of deleterious consequences of SD (rather than abolition) could be a useful adjunct approach, and be achieved with lower ketamine concentrations...
April 10, 2018: Experimental Neurology
https://www.readbyqxmd.com/read/29652275/dexmedetomidine-versus-ketofol-sedation-for-outpatient-diagnostic-transesophageal-echocardiography-a-randomized-controlled-study
#7
S Sruthi, Banashree Mandal, Manoj K Rohit, Goverdhan Datt Puri
Background: Moderate sedation is required for out-patient transesophageal echocardiography (TEE). Our objective was to compare the effect of Ketofol and dexmedetomidine for outpatient procedural sedation in diagnostic TEE with a hypothesis that Ketofol would be as effective as dexmedetomidine. Patients and. Methods: Fifty adult patients of age group 18-60 years with atrial septal defect, rheumatic valvular heart disease undergoing diagnostic TEE in the outpatient echocardiography laboratory were randomized into two groups, group D and group KF...
April 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29624535/comparison-of-intraoperative-sedation-with-dexmedetomidine-versus-propofol-on-acute-postoperative-pain-in-total-knee-arthroplasty-under-spinal-anesthesia-a-randomized-trial
#8
Hyun-Jung Shin, Sang-Hwan Do, Jae-Sung Lee, Tae-Kyun Kim, Hyo-Seok Na
BACKGROUND: In patients undergoing total knee arthroplasty under spinal anesthesia, we compared the postoperative analgesic effect of intraoperative sedation with dexmedetomidine versus propofol. We hypothesized that sedation with dexmedetomidine would result in lower postoperative opioid analgesic consumption than with propofol. METHODS: Forty-eight patients were enrolled and randomly assigned to either a dexmedetomidine group (n = 24), which received a loading dose of 1 μg/kg dexmedetomidine over 10 minutes, followed by a continuous infusion of 0...
April 5, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29623221/efficacy-of-dexmedetomidine-versus-ketofol-for-sedation-of-postoperative-mechanically-ventilated-patients-with-obstructive-sleep-apnea
#9
Hatem Elmoutaz Mahmoud, Doaa Abou Elkassim Rashwan
Patients with sleep apnea are prone to postoperative respiratory complications, requiring restriction of sedatives during perioperative care. We performed a prospective randomized study on 24 patients with obstructive sleep apnea (OSA) who underwent elective surgery under general anesthesia. The patients were equally divided into two groups: Group Dex : received dexmedetomidine loading dose 1 mcg/kg IV over 10 min followed by infusion of 0.2-0.7 mcg/kg/hr; Group KFL : received ketofol as an initial bolus dose 500 mcg/kg IV (ketamine/propofol 1 : 1) and maintenance dose of 5-10 mcg/kg/min...
2018: Critical Care Research and Practice
https://www.readbyqxmd.com/read/29607519/long-term-effects-of-tibial-plateau-leveling-osteotomy-and-tibial-tuberosity-advancement-on-tibial-plateau-subchondral-bone-density-in-dogs
#10
Elizabeth S Leach, Ursula Krotscheck, Kelsey J Goode, Galina M Hayes, Peter Böttcher
OBJECTIVE: To evaluate long-term loading patterns using subchondral bone density (SBD) distribution of the tibial plateau after tibial plateau leveling osteotomy (TPLO) and tibial tuberosity advancement (TTA). STUDY DESIGN: Cross-sectional study. ANIMALS: Adult (> 2 years), medium to large breed dogs (>20 kg) that had been treated with TPLO or TTA at least 1 year prior to the study were recruited. A normal cohort of similar age and weight dogs with normal physical and orthopedic examinations served as control...
April 1, 2018: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/29594976/efficacy-of-a-dexmedetomidine-remifentanil-combination-compared-with-a-midazolam-remifentanil-combination-for-conscious-sedation-during-therapeutic-endoscopic-retrograde-cholangio-pancreatography-a-prospective-randomized-single-blinded-preliminary-trial
#11
Zhiqiang Lu, Wenyuan Li, Huiyu Chen, Yanning Qian
BACKGROUND: Dexmedetomidine as a conscious sedative exhibits both analgesia and respiratory sparing effects. AIMS: We evaluated and compared the sedative effect and the safety of a dexmedetomidine-remifentanil (DR) regimen with a midazolam-remifentanil (MR) combination during the endoscopic retrograde cholangio-pancreatography (ERCP) requiring conscious sedation. METHODS: One-hundred and ninety-eight patients were randomized and divided into two groups...
March 29, 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29551918/clinical-evaluation-of-combination-of-dexmedetomidine-and-midazolam-vs-dexmedetomidine-alone-for-sedation-during-spinal-anesthesia
#12
Ze-Yu Zhao, Jian-Hui Gan, Jian-Bo Liu, Qing Cheng
Background: Dexmedetomidine is a useful sedative agent for spinal anesthesia. However, it has been reported to decreases heart rate in a dose-dependent manner. In the present study, we compared the bolus dose of midazolam and bolus loaded dexmedetomidine over 10 min to determine additional sedation methods. Methods: A total of 100 patients who were classified as American Society of Anesthesiologists physical status I-II undergoing spinal anesthesia were randomly divided into two groups...
December 2017: Saudi Journal of Biological Sciences
https://www.readbyqxmd.com/read/29534384/-study-of-comparing-dexmedetomidine-and-remifentanil-for-conscious-sedation-during-radiofrequency-ablation-of-hepatocellular-carcinoma
#13
H T Sun, M Xu, G L Chen, J He
Objective: This study aimed to compare dexmedetomidine with remifentanil for conscious sedation in patients undergoing radiofrequency ablation of hepatocellular carcinoma. Methods: Sixty patients, who were aged 41 to 73 years with American Society of Anesthesiologists (ASA) physical status Ⅰ-Ⅱ, and scheduled for elective radiofrequency ablation of hepatocellular carcinoma under conscious sedation in National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, from January 2014 to June 2016, were allocated randomly to receive dexmedetomidine maintenance regimen(group D, n =30)or remifentanil maintenance regimen(group R, n =30)by random digital table...
February 27, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29509711/electrodermal-activity-during-blood-pooling-for-arterial-blood-gases-analysis-in-sedated-adult-intensive-care-unit-patients
#14
Theodoros Aslanidis, Vasilios Grosomanidis, Konstantinos Karakoulas, Athanasios Chatzisotiriou
Electrodermal activity (EDA) is considered a measure of autonomous nervous system activity. This study performed an exploratory analysis of the EDA changes during blood pooling for arterial blood gas analysis in sedated adult critical care patients and correlated the variations to other monitored parameters. EDA, along with other parameters, were monitored during 4 h routine daytime intensive care nursing and treatment in an adult ICU. 4 h measurements were divided into two groups based upon the sedation level...
March 6, 2018: Medical Sciences: Open Access Journal
https://www.readbyqxmd.com/read/29458319/proportional-assist-ventilation-versus-pressure-support-ventilation-in-weaning-ventilation-a-pilot-randomised-controlled-trial
#15
John Botha, Cameron Green, Ian Carney, Kavi Haji, Sachin Gupta, Ravindranath Tiruvoipati
OBJECTIVE: Proportional assist ventilation with load-adjustable gain factors (PAV+) is a mode of ventilation that provides assistance in proportion to patient effort. This may have physiological and clinical advantages when compared with pressure support ventilation (PSV). Our objective was to compare these two modes in patients being weaned from mechanical ventilation. DESIGN: Prospective randomised controlled trial comparing PSV with PAV+. SETTING: University-affiliated, tertiary referral intensive care unit (ICU)...
March 2018: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/29456702/application-of-pre-injection-of-dexmedetomidine-of-different-doses-in-pediatric-intravenous-general-anesthesia-without-tracheal-intubation
#16
Mi Zhou, Qiang Wang, Qiong Zhang, Yifei Liu, Leyun Zhan, Aihua Shu
This study observed the clinical efficacy of pre-injection of dexmedetomidine of different doses before surgery and the adverse reactions during the recovery period in pediatric intravenous general anesthesia without tracheal intubation. Pediatric patients who received general anesthesia without tracheal intubation before surgery from January 2016 to March 2017 were randomly divided into four groups (n=30), and were respectively treated with intravenous pump infusion of loaded dexmedetomidine of high-dose (2...
March 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29443767/effect-of-oxycodone-hydrochloride-combined-with-flurbiprofen-axetil-for-intravenous-patient-controlled-analgesia-in-lower-abdominal-patients-a-randomized-trial
#17
RANDOMIZED CONTROLLED TRIAL
Xiaobing Xiang, Xiaohong Yuan, Yanhong Lian, Jun Fang, Yingli Wu
BACKGROUND: Problems like postoperative pain are still common phenomena after general anesthesia. Oxycodone hydrochloride is a semisynthetic opioid with a safe and excellent therapeutic effect on visceral pain. Flurbiprofen axetil has the efficacy of targeted analgesia. We hypothesize that different doses of oxycodone hydrochloride combined with flurbiprofen axetil would generate great results on postoperative intravenous analgesia in lower abdominal patients. METHODS: In the clinical trial, 90 American Society of Anesthesiologists I or II patients scheduled for elective general anesthesia were randomly divided into 3 groups, 30 cases in each group...
February 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29336387/dexmedetomidine-for-prevention-of-skeletal-muscle-ischaemia-reperfusion-injury-in-patients-with-chronic-limb-ischaemia-undergoing-aortobifemoral-bypass-surgery-a-prospective-double-blind-randomized-controlled-study
#18
Tanveer Singh Kundra, Ashwini Thimmarayappa, Manasa Dhananjaya, N Manjunatha
BACKGROUND: Dexmedetomidine is a selective α-2 agonist used for sedation. It has also been shown to have myocardial protective effect and prevent ischemia-reperfusion injury in off-pump coronary artery bypass patients. The aim of our study was to assess the effect of dexmedetomidine for prevention of skeletal muscle ischemia-reperfusion injury in patients undergoing aortobifemoral bypass surgery. METHODOLOGY: Sixty adult patients (Group dexmedetomidine n = 30, Group normal saline n = 30) undergoing aortobifemoral bypass surgery were recruited over 3 months...
January 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29284877/intravenous-dexmedetomidine-infusion-compared-with-that-of-fentanyl-in-patients-undergoing-arthroscopic-shoulder-surgery-under-general-anesthesia
#19
Mona Hossam Eldin Abdel Hamid
Background: Anesthesia for arthroscopic shoulder surgery is challenging due to the need for oligaemic surgical field as well as a good postoperative recovery profile. Aim: The present study was prospective, randomized to evaluate the efficacy of dexmdetomidine infusion compared to that of fentanyl in patients undergoing arthroscopic shoulder surgery under general anesthesia. Patients and Methods: A total of 60 patients aged from thirty to fifty years, American Society of Anesthesiologists Class I/II of either sex for arthroscopic shoulder surgery, were included...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29219242/behavioural-assessment-unit-improves-outcomes-for-patients-with-complex-psychosocial-needs
#20
George Braitberg, Marie Gerdtz, Susan Harding, Steven Pincus, Michelle Thompson, Jonathan Knott
OBJECTIVE: We aimed to assess the impact of a new model of care for patients presenting to the ED with acute behavioural disturbance. METHODS: This pre-/post-intervention study involved creating a dedicated, highly resourced six bed unit, the behavioural assessment unit (BAU). Co-located with the ED at the Royal Melbourne Hospital, the unit was designed to fast-track the admission of patients affected by intoxication, mental illness or psychosocial crisis and provide front-loaded interventions...
December 8, 2017: Emergency Medicine Australasia: EMA
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