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Nasal dexmedetomidine

Abby M Bailey, Regan A Baum, Karolyn Horn, Tameka Lewis, Kate Morizio, Amy Schultz, Kyle Weant, Stephanie N Justice
BACKGROUND: Intranasal (IN) medication delivery is a viable alternative to other routes of administration, including intravenous (IV) and intramuscular (IM) administration. The IN route bypasses the risk of needle-stick injuries and alleviates the emotional trauma that may arise from the insertion of an IV catheter. OBJECTIVE: This review aims to evaluate published literature on medications administered via the IN route that are applicable to practice in emergency medicine...
March 1, 2017: Journal of Emergency Medicine
Oliwia Szerkus, Wiktoria Struck-Lewicka, Marta Kordalewska, Ewa Bartosińska, Renata Bujak, Agnieszka Borsuk, Agnieszka Bienert, Alicja Bartkowska-Śniatkowska, Justyna Warzybok, Paweł Wiczling, Antoni Nasal, Roman Kaliszan, Michał Jan Markuszewski, Danuta Siluk
AIM: The purpose of this work was to develop and validate a rapid and robust LC-MS/MS method for the determination of dexmedetomidine (DEX) in plasma, suitable for analysis of a large number of samples. METHOD: Systematic approach, Design of Experiments, was applied to optimize ESI source parameters and to evaluate method robustness, therefore, a rapid, stable and cost-effective assay was developed. The method was validated according to US FDA guidelines. LLOQ was determined at 5 pg/ml...
February 2017: Bioanalysis
Safinaz Karabayirli, Kadriye Serife Ugur, Ruveyda Irem Demircioglu, Bunyamin Muslu, Burhanettin Usta, Huseyin Sert, Nebil Ark
To compare dexmedetomidine with remifentanil in functional endoscopic sinus surgery (FESS) in regards to intra-operative bleeding, anesthetic consumption and post-operative recovery. Randomized, double blind study. Tertiary care medical center. Fifty patients with nasal polyposis who had been scheduled for FESS were randomly divided into two groups. In group D (n = 25), dexmedetomidine 1 µg/kg infused intravenous (IV) over 10 min before anesthesia induction, followed by a continuous of 0.7 µg/kg/h infusion during operation...
January 2017: European Archives of Oto-rhino-laryngology
A Das, S Chhaule, S Bhattacharya, S R Basunia, T Mitra, P S Halder, S Chattopadhyay, S K Mandal
BACKGROUND: Functional endoscopic sinus surgery (FESS) is the cornerstone of therapeutic management for nasal pathologies. This study is to compare the ability of preoperative and intraoperative esmolol versus dexmedetomidine for producing induced hypotension during FESS in adults in a day care setting. MATERIALS AND METHODS: Sixty patients (20-45 years) posted for FESS under general anesthesia were randomly divided into Group E (n = 30) receiving esmolol, loading dose 1 mg/kg over 1 min followed by 0...
July 2016: Saudi Journal of Anaesthesia
Mark A Burbridge, Jessica Brodt, Richard A Jaffe
A 32-year-old man with severe pulmonary arterial hypertension and Eisenmenger syndrome secondary to congenital ventricular septal defects presented for ventriculoperitoneal shunt insertion. Consultation between surgical and anesthesia teams acknowledged the extreme risk of performing this case, but given ongoing symptoms related to increased intracranial pressure from a large third ventricle colloid cyst, the case was deemed urgent. After a full discussion with the patient, including an explanation of anesthetic expectations and perioperative risks, the case was performed under monitored anesthesia care...
July 15, 2016: A & A Case Reports
A Das, A Mukherje, S Chhaule, S Chattopadhyay, P S Halder, T Mitra, S R Basunia, S K Mandal
BACKGROUND: Functional endoscopic sinus surgery (FESS) is the mainstay of a therapeutic technique for nasal pathologies. This study is to compare the ability of preoperative dexmedetomidine versus clonidine for producing controlled hypotensive anesthesia during FESS in adults in an ambulatory care setting. MATERIALS AND METHODS: Sixty patients (25-50 years) posted for ambulatory FESS procedures under general anesthesia were randomly divided into Group C and D (n = 33 each) receiving dexmedetomidine 1 μg/kg and clonidine 1...
January 2016: Saudi Journal of Anaesthesia
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
R Polat, K Peker, I Baran, G Bumin Aydın, Ç Topçu Gülöksüz, A Dönmez
BACKGROUND: Postoperative emergency agitation (EA) is a common problem. Dexmedetomidine and remifentanil may be used to prevent this problem. Our primary aim was to compare dexmedetomidine, remifentanil, and placebo with respect to their effectiveness in preventing postoperative EA. MATERIAL AND METHODS: Ninety patients undergoing nasal surgery were randomized into three groups. The dexmedetomidine group (group D, n = 30) received dexmedetomidine infusion at a rate of 0...
October 2015: Der Anaesthesist
Martin Jöhr, Thomas M Berger
PURPOSE OF REVIEW: The aim of this review was to discuss recent developments in paediatric anaesthesia, which are particularly relevant to the practitioner involved in paediatric outpatient anaesthesia. RECENT FINDINGS: The use of a pharmacological premedication is still a matter of debate. Several publications are focussing on nasal dexmedetomidine; however, its exact place has not yet been defined. Both inhalational and intravenous anaesthesia techniques still have their advocates; for diagnostic imaging, however, propofol is emerging as the agent of choice...
December 2015: Current Opinion in Anaesthesiology
Ufuk Kuyrukluyıldız, Orhan Binici, Didem Onk, Serap Ayhan Celik, Mumtaz Taner Torun, Edhem Unver, Adalet Ozcicek, Aysin Alagol
UNLABELLED: Backround: Surgical operations are alternative treatments in persons with Obstructive Sleep Apnea Syndrome who cannot tolerate continuous positive airway pressure therapy. Drug-Induced Sleep Endoscopy is a method with which somnolence is pharmacologically induced and collapse is evaluated through nasal endoscopy in patients with Obstructive Sleep Apnea Syndrome. AIMS: We aimed to evaluate efficiency of dexmedetomidine or propofol used for sedation in patients undergoing drug-induced sleep endoscopy...
2015: International Journal of Clinical and Experimental Medicine
Nobuyasu Komasawa, Sayuri Matsunami, Kenta Nakao, Toshiaki Minami
Here we report a case of successful awake nasal intubation with the McGrath videolaryngscope (McGrath) in conjunction with a soft-tipped extra firm exchange catheter in a patient with a necrotic mandible developing a hole. An 81-year-old woman underwent partial tongue resection and cervical lymph node dissection. After additional radiation therapy, she developed a necrotic mandible with a hole from the oral cavity to the neck region. She was scheduled for resection of the necrotic mandible under general anesthesia...
March 2015: Masui. the Japanese Journal of Anesthesiology
Bruna Santangelo, Fabiana Micieli, Tiziana Mozzillo, Fabiana Reynaud, Francesco Marino, Luigi Auletta, Giancarlo Vesce
OBJECTIVE: To study the sedative and cardiorespiratory effects of transnasal (TN) administration of a combination of dexmedetomidine (DEX), midazolam (MID) and butorphanol (BUT) administered through a nasal catheter to rabbits undergoing diagnostic procedures. STUDY DESIGN: Descriptive cross-sectional experimental study. ANIMALS: Eight healthy New Zealand White rabbit does (12 ± 1 months old, 3.5 ± 0.3 kg). METHODS: DEX (0...
March 2016: Veterinary Anaesthesia and Analgesia
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
Peng Zhang, Jingying Ye, Chuxiong Pan, Nian Sun, Dan Kang
OBJECTIVE: To measure obstruction length and height using drug-induced sleep endoscopy (DISE) in obstructive sleep apnea (OSA) patients and to evaluate their association with outcomes of velopharyngeal surgery. STUDY DESIGN: Prospective cohort study. SETTING: University medical center. METHODS: Forty-three consecutive patients with OSA were evaluated by DISE using dexmedetomidine. The 2 new parameters, obstruction length (defined as the distance from the most superior point of the collapse to the most inferior point of the collapse) and obstruction height (the distance from the posterior border of the nasal septum to the most proximal point of the collapse), were measured by both DISE and a pressure transducer catheter method before surgery...
July 2015: Otolaryngology—Head and Neck Surgery
Nils Welchering, Sebastian Ochoa, Xin Tian, Richard Francis, Maliha Zahid, Ricardo Muñoz, Cecilia W Lo
BACKGROUND: Dexmedetomidine (dex) is commonly used in intensive care due to its effective sedation and analgesia with few adverse effects and minimal respiratory depression. However, we recently observed that exposing mouse epithelial respiratory cells to dex decreased ciliary beat frequency (CBF), suggesting dex may pose pulmonary risk. OBJECTIVE: The purpose of this study is to determine the effects of dex at clinically relevant doses on CBF in human respiratory epithelia...
2015: Frontiers in Pediatrics
Peihua Li, Peng Zhou, Ping Shen
OBJECTIVE: To explore the application of the Dexmedetomidine utend drug induced sleep endoscopy. METHOD: Forty-four OSAHS patients diagnosed by PSG randomly were divided into group A (Dexmedetomidine group) and group B (Propofol group), each group of 22 cases. Group A: pump the Dexmedetomidine (1 microg/kg) over 15 minutes. Once the patient reached a satisfactory level of sedation, the electronic nasopharyngoscope was introduced into the nasal cavity group B: the propofol (2 mg/kg) was intravenous injected, use the same exmination after the object patients falling asleep...
August 2014: Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery
Yingyi Xu, Xingrong Song, Guoqiang Zhang
OBJECTIVE: To explore the 50% effective dose (ED₅₀) of dexmedetomidine nasal drip in the induction of hypnosis in children during computed tomography (CT). METHODS: A total of 34 American Society of Anesthesiologists (ASA)I-IIautistic children scheduled for brain CT examination were studied. The induction was made by dexmedetomidine nasal drip and the ED₅₀ of dexmedetomidine determined by up-and down sequential experiment.When eyelash reflex became lost or Ramsay score was ≥ 4 in 1 hour after dosing, hypnosis was achieved...
June 24, 2014: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Kenta Nakao, Nobuyasu Komasawa, Tomohiro Kusunoki, Shinichi Tatsumi, Masako Soen, Rumiko Uda, Masafumi Akatsuka, Toshiaki Minami
We present a case of anticipated difficult airway with severe rheumatoid arthritis in which intubation with fiberoptic bronchoscope (FOB) assisted by Pentax-AWS Airwayscope with the thin Intlock (AWS T) was effective. A 69-year-old woman was scheduled to undergo laparoscopic cholecystectomy for acute cholecystitis in a previous hospital. Tracheal intubation with Glidescope or nasal intubation was unsuccessful and abandoned due to mucosal injury and bleeding. Ventilation via several supraglottic airway devices was unsatisfactory, while mask ventilation was easy after induction of anesthesia...
July 2014: Masui. the Japanese Journal of Anesthesiology
Junzheng Wu, Mohamed Mahmoud, Megan Schmitt, Md Hossain, Dean Kurth
BACKGROUND: Propofol (PRO) and dexmedetomidine (DEX) are commonly used to produce anesthesia and sedation for routine MRI procedures. Children with complex conditions often require much lengthy MRI for multi-body-part scans with frequent scanner coil changes and patient body reposition. This study compared PRO and DEX techniques on outcomes for the particular MRI setting with longer than 1 h duration. METHODS: 95 children, aged from 1 to 7 years, scheduled for MRI >75 min were randomly assigned to PRO or DEX group...
August 2014: Paediatric Anaesthesia
Recep Aksu, Aynur Akin, Cihangir Biçer, Aliye Esmaoğlu, Zeynep Tosun, Adem Boyaci
BACKGROUND: Stimulation of various sites, from the nasal mucosa to the diaphragm, can evoke laryngospasm. To reduce airway reflexes, tracheal extubation should be performed while the patient is deeply anesthetized or with drugs that do not depress ventilation. However, tracheal extubation during rhinoplasty may be difficult because of the aspiration of blood and the possibility of laryngospasm. Dexmedetomidine and fentanyl both have sedative and analgesic effects, but dexmedetomidine has been reported to induce sedation without affecting respiratory status...
June 2009: Current Therapeutic Research, Clinical and Experimental
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