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Dexmedetomidine, epidural

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https://www.readbyqxmd.com/read/30009148/a-comparison-of-continuous-thoracic-epidural-analgesia-with-bupivacaine-versus-bupivacaine-and-dexmedetomidine-for-pain-control-in-patients-with-multiple-rib-fractures
#1
Dawood Agamohammdi, Majid Montazer, Maryam Hoseini, Mehdi Haghdoost, Haleh Farzin
Background: The control of pain in traumatic patients with chest injury leading to rib fracture is one of the primary goals in traumatic patients. The efficacy of the thoracic epidural approach in comparison with other approaches for relieving post-thoracotomy pain is unknown. The goal of the present study was to compare thoracic epidural analgesia with bupivacaine alone and in combination with dexmedetomidine in patients with multiple rib fractures. Methods: 64 traumatic patients with multiple rib fractures were selected and randomly assigned to two similar groups...
April 2018: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/29970978/general-anesthesia-with-dexmedetomidine-and-remifentanil-in-a-neonate-during-oracotomy-and-resection-of-a-congenital-cystic-adenomatoid-malformation
#2
Ellise Cappuccio, Arlyne K Thung, Joseph D Tobias
Based on animal data, concern has been expressed regarding the potential deleterious neurocognitive effects of general anesthesia during infancy and early life. Although there are no definitive data to prove this effect, the neonatal period has been suggested to be the most vulnerable period. While various inhaled and intravenous anesthetic agents have been implicated, dexmedetomidine and the opioids may be devoid of such effects. However, there are limited data regarding the combination of these agents during neonatal surgery and anesthesia...
May 2018: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/29962637/comparison-of-epidural-bupivacaine-and-dexmedetomidine-with-bupivacaine-and-fentanyl-for-postoperative-pain-relief-in-lower-limb-orthopedic-surgery
#3
Arindam Sarkar, Narendra Singh Bafila, Raj Bahadur Singh, Mohd Asim Rasheed, Sanjay Choubey, Vishal Arora
Context: Different trials have shown that multimodal analgesia through different techniques is associated with superior pain relief. Opioids as epidural adjunct to local anesthetics have been in use for long and α2 agonists are being increasingly used for same. The present study aims at comparing the hemodynamic, sedative, and analgesic effects of epidurally administered fentanyl and dexmedetomidine when combined with bupivacaine. Aims: The aim of this study was to compare the efficacy of epidural dexmedetomidine with bupivacaine versus epidural fentanyl with bupivacaine for postoperative pain relief...
April 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29924051/consort-epidural-dexmedetomidine-improves-gastrointestinal-motility-after-laparoscopic-colonic-resection-compared-with-morphine
#4
Qiuxia Wan, Wengang Ding, Xiaoguang Cui, Xianzhang Zeng
BACKGROUND: We have previously shown that epidural dexmedetomidine, when used as an adjunct to levobupivacaine for control of postoperative pain after open colonic resection, improves recovery of gastrointestinal motility compared with morphine. METHODS: Sixty patients undergoing laparoscopic colonic resection were enrolled and allocated randomly to treatment with dexmedetomidine (group D) or morphine (group M). Group D received an epidural loading dose of dexmedetomidine (5 mL, 0...
June 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29643621/evaluation-of-dexmedetomidine-and-fentanyl-as-additives-to-ropivacaine-for-epidural-anesthesia-and-postoperative-analgesia
#5
S Kiran, Kavita Jinjil, Urvashi Tandon, Soumita Kar
Background and Aims: The synergism between epidural local anesthetic agent and opioids is well established, but evidence for the combination of local anesthetic agent with dexmedetomidine in epidurals is limited. This study evaluates the clinical efficacy of dexmedetomidine versus fentanyl as an additive to ropivacaine for epidural anesthesia. Material and Methods: Patients undergoing infraumbilical surgeries were divided randomly into three groups - Group R (n = 25): received 18 ml of 0...
January 2018: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29628563/postoperative-analgesia-with-epidural-dexmedetomidine-compared-with-clonidine-following-total-abdominal-hysterectomies-a-prospective-double-blind-randomized-trial
#6
Sunil Chiruvella, Balaji Donthu, Srinivasa Rao Nallam, Dora Babu Salla
Background and Aims: Anesthesia for total abdominal hysterectomies is not only concerned with relieving pain during intraoperative period but also during the postoperative period. We compared clonidine and dexmedetomidine as an adjuvant to levobupivacaine for epidural analgesia with respect to onset and duration of sensory block, duration of analgesia, and adverse effects. Materials and Methods: A total of 80 individuals between the age of 45 and 65 years of American Society of Anesthesiologists (ASA) physical status Classes I and II who underwent total abdominal hysterectomies were randomly allocated into two groups, comprising 40 patients in each group...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29606730/effect-of-different-analgesic-techniques-on-hemodynamic-variables-recorded-with-an-esophageal-doppler-monitor-during-ovariohysterectomy-in-dogs
#7
Ignacio Sández, María Soto, Daniel Torralbo, Eva Rioja
This study compared the efficacy of intravenous (IV) fentanyl and ketamine with lumbosacral epidural lidocaine in dogs undergoing ovariohysterectomy. Dogs with esophageal Doppler monitoring ( n = 112) were included in this retrospective study. All dogs were premedicated with dexmedetomidine and methadone, induced with IV propofol or alfaxalone and maintained using isoflurane and IV fentanyl, IV ketamine, or epidural lidocaine. Heart rate (HR), mean arterial pressure (MAP), expired fraction of isoflurane (ETIso), stroke distance (SD), minute distance (MD), peak velocity (PV) and mean acceleration (MA) were recorded before and after ligation of the ovarian pedicle (OvP)...
April 2018: Canadian Veterinary Journal. la Revue Vétérinaire Canadienne
https://www.readbyqxmd.com/read/29595529/ec50-of-epidural-ropivacaine-combined-with-dexmedetomidine-for-labor-analgesia
#8
Wp Zhang, Cuiling Li
BACKGROUND: It was reported that the optimal concentration of epidural dexmedetomidine for labor analgesia was 0.5▒ug/mL when combined with 0.1% ropivacaine. This study investigated the median effective concentration (EC50) of epidural ropivacaine for labor analgesia when combined with 0.5▒ug/mL dexmedetomidine. METHODS: Sixty full-term primiparas were enrolled and divided into two groups in this prospective study. Group D received 10▒mL solution (ropivacaine + 0...
March 27, 2018: Clinical Journal of Pain
https://www.readbyqxmd.com/read/29555523/evaluation-of-topical-dexmedetomidine-administration-in-postlaminectomy-epidural-fibrosis-rat-model
#9
M E Yaman, G Ergül, Y Güvenç, Y Öztürk, F K Erbay, T Tolunay, S Şentürk, C Kırçıl, G Bozkurt
Epidural fibrosis is a challenging topic in spinal surgery. Numerous clinical and experimental studies have been focused on this issue to clarify problems faced in spinal procedures for the patient as well as the surgeon and find out new methodologies. Dense cytokines and growth factors which are released from inflammatory cells have been suggested to play a major role in the inception and progression of fibrosis. One of the most investigated and important actor in epidural fibrosis is assumed to be the transforming growth factor-1β (TGF-1β) formation...
May 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29486879/clinical-comparison-of-the-effects-of-isoflurane-or-propofol-anaesthesia-on-mean-arterial-blood-pressure-and-ventilation-in-dogs-undergoing-orthopaedic-surgery-receiving-epidural-anaesthesia
#10
RANDOMIZED CONTROLLED TRIAL
R Bustamante, D Aguado, R Cediel, I A Gómez de Segura, S Canfrán
The aim of this study was to compare the effects on mean arterial pressure (MAP) and ventilation of propofol total IV anaesthesia (TIVA) and isoflurane as anaesthetic maintenance in healthy dogs undergoing orthopaedic surgery, with epidural anaesthesia. Dogs were premedicated IM with dexmedetomidine (4μg/kg) and methadone (0.3mg/kg), induced with IV propofol (0.65-5mg/kg) and randomly assigned to be maintained with isoflurane (group I) or propofol (group P). Isoflurane end-tidal concentration (EtISO) and propofol infusion rate were adjusted during the surgery to maintain a suitable anaesthetic depth...
March 2018: Veterinary Journal
https://www.readbyqxmd.com/read/29479931/dexmedetomidine-as-an-adjunct-for-caudal-anaesthesia-and-analgesia-in-children-a-review
#11
Mehdi Trifa, Dmitry Tumin, Joseph D Tobias
BACKGROUND: The aim of this review was to evaluate the current evidence regarding the use of dexmedetomidine as an adjuvant to local anaesthetic agents (LAA) for caudal blockade anaesthesia and analgesia in children. METHODS: A literature search was performed of the Medline, Embase, and CINAHL databases using the keywords "dexmedetomidine" and "caudal". We included all studies that used caudal dexmedetomidine as an adjuvant to a LAA in children, excluding case reports, reviews, expert opinions, and animal studies...
February 22, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29180895/postoperative-pain-management-in-the-postanesthesia-care-unit-an-update
#12
REVIEW
Jie Luo, Su Min
Acute postoperative pain remains a major problem, resulting in multiple undesirable outcomes if inadequately controlled. Most surgical patients spend their immediate postoperative period in the postanesthesia care unit (PACU), where pain management, being unsatisfactory and requiring improvements, affects further recovery. Recent studies on postoperative pain management in the PACU were reviewed for the advances in assessments and treatments. More objective assessments of pain being independent of patients' participation may be potentially appropriate in the PACU, including photoplethysmography-derived parameters, analgesia nociception index, skin conductance, and pupillometry, although further studies are needed to confirm their utilities...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28962122/effects-of-dexmedetomidine-in-reducing-post-cesarean-adverse-reactions
#13
Yanshuai Mo, Shuang Qiu
This study evaluated the analgesia effect and the effect on adverse reaction of using dexmedetomidine (Dex) in post-cesarean section. Eighty women who had been performed caesarean delivery with combined spinal and epidural anesthesia were selected. The experimental group (group D) included 40 random patients and the control group (group C) included the other 40 women. Patients in group D were given ropivacaine hydrochloride and Dex while patients in group C were given ropivacaine hydrochloride and morphine...
September 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28924366/effects-of-dexmedetomidine-in-combination-with-fentanyl-based-intravenous-patient-controlled-analgesia-on-pain-attenuation-after-open-gastrectomy-in-comparison-with-conventional-thoracic-epidural-and-fentanyl-based-intravenous-patient-controlled-analgesia
#14
RANDOMIZED CONTROLLED TRIAL
Na Young Kim, Tae Dong Kwon, Sun Joon Bai, Sung Hoon Noh, Jung Hwa Hong, Haeyeon Lee, Ki-Young Lee
Background: This study was investigated the effects of dexmedetomidine in combination with fentanyl-based intravenous patient-controlled analgesia (IV-PCA) on pain attenuation in patients undergoing open gastrectomy in comparison with conventional thoracic epidural patient-controlled analgesia (E-PCA) and IV-PCA. Methods : One hundred seventy-one patients who planned open gastrectomy were randomly distributed into one of the 3 groups: conventional thoracic E-PCA (E-PCA group, n = 57), dexmedetomidine in combination with fentanyl-based IV-PCA (dIV-PCA group, n = 57), or fentanyl-based IV-PCA only (IV-PCA group, n = 57)...
2017: International Journal of Medical Sciences
https://www.readbyqxmd.com/read/28888583/food-and-drug-administration-warning-on-anesthesia-and-brain-development-implications-for-obstetric-and-fetal-surgery
#15
Olutoyin A Olutoye, Byron Wycke Baker, Michael A Belfort, Oluyinka O Olutoye
There has been growing concern about the detrimental effects of certain anesthetic agents on the developing brain. Preclinical studies in small animal models as well as nonhuman primates suggested loss or death of brain cells and consequent impaired neurocognitive function following anesthetic exposure in neonates and late gestation fetuses. Human studies in this area are limited and currently inconclusive. On Dec. 14, 2016, the US Food and Drug Administration issued a warning regarding impaired brain development in children following exposure to certain anesthetic agents used for general anesthesia, namely the inhalational anesthetics isoflurane, sevoflurane, and desflurane, and the intravenous agents propofol and midazolam, in the third trimester of pregnancy...
January 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28833190/cardiorespiratory-effects-of-epidural-anesthesia-using-lidocaine-with-morphine-or-dexmedetomidine-in-capuchin-monkeys-sapajus-sp-undergoing-bilateral-tubal-ligation-surgery-anesthetized-with-isoflurane
#16
Débora Passos Hinojosa Schäffer, Nayone Lima Lantyer Cordeiro de Araujo, Ana Rosa Otero, Francisco de Assis Dórea Neto, Vivian Fernanda Barbosa, Emanoel Ferreira Martins Filho, Arianne Pontes Oriá
BACKGROUND: Epidural anesthesia is indicated to decrease other anesthetic requirements, prolong analgesia, and reduce side effects. In primates, its use has been scarcely described. The aim was to evaluate the cardiorespiratory effects of epidural anesthesia with lidocaine and dexmedetomidine (DEX) or morphine (MOR). METHODS: Ten female capuchin monkeys (Sapajus sp.) received epidural anesthesia with lidocaine and DEX or MOR under general anesthesia. RESULTS: There was a significant decrease in heart rate with DEX and in blood pressure in all groups, with no changes in SpO2 ...
December 2017: Journal of Medical Primatology
https://www.readbyqxmd.com/read/28707454/interventions-for-postoperative-pain-in-children-an-overview-of-systematic-reviews
#17
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...
September 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28687146/intravenous-dexmedetomidine-for-cesarean-delivery-and-its-concentration-in-colostrum
#18
M Yoshimura, T Kunisawa, M Suno, A Sugawara, A Kurosawa, R Nakanishi, K Aoki, T Toriumi
BACKGROUND: Dexmedetomidine is a sedative agent with high α2 -adrenoreceptor selectivity. We investigated intravenous dexmedetomidine administration during scheduled cesarean delivery under neuraxial anesthesia; and its concentration in the colostrum. METHODS: Twenty-seven participants having elective cesarean delivery under combined spinal-epidural anesthesia were enrolled. After delivery and cord clamping, 6μg/kg/h of intravenous dexmedetomidine was administered for 10minutes, followed by a dose of 0...
November 2017: International Journal of Obstetric Anesthesia
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
#19
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/28656055/optimal-dose-of-epidural-dexmedetomidine-added-to-ropivacaine-for-epidural-labor-analgesia-a-pilot-study
#20
Zhang Wangping, Ren Ming
BACKGROUND: Dexmedetomidine combined with local anesthetics can decrease the concentration of epidural ropivacaine. However, the optimal dose of epidural dexmedetomidine combined with ropivacaine for labor analgesia is still uncertain. This study investigated the effect of adding different dose of epidural dexmedetomidine to ropivacaine during epidural labor analgesia. METHODS: One hundred women were randomly assigned to one of the four groups (Groups A, B, C, and D received 0...
2017: Evidence-based Complementary and Alternative Medicine: ECAM
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