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Dexmedetomidine, epidural

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https://www.readbyqxmd.com/read/27833479/efficacy-of-dexmedetomidine-as-an-adjuvant-to-ropivacaine-in-pediatric-caudal-epidural-block
#1
Manoj Kamal, Sadik Mohammed, Saroj Meena, Geeta Singariya, Rakesh Kumar, Dilip Singh Chauhan
CONTEXT: Caudal analgesia is a reliable and an easy method to provide intraoperative and postoperative analgesia for infraumbilical surgeries in pediatric population but with the disadvantage of short duration of action after single injection. Many additives were used in combination with local anesthetics in the caudal block to prolong the postoperative analgesia. AIM: We compared the analgesic effects and side effects of dexmedetomidine added to ropivacaine in pediatric patients undergoing lower abdominal surgeries...
October 2016: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/27812971/efficacy-and-safety-of-dexmedetomidine-as-an-adjuvant-in-epidural-analgesia-and-anesthesia-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#2
REVIEW
Xu Zhang, Dong Wang, Min Shi, YuanGuo Luo
BACKGROUND AND OBJECTIVE: Several clinical trials have examined and indicated the usefulness of epidural dexmedetomidine therapy. However, there has been no systematic analysis of the findings of these trials to date. We undertook this systematic review and meta-analysis to investigate the efficacy and safety of epidural dexmedetomidine adjunctive therapy in different surgical procedures. MATERIALS AND METHODS: We searched EMBASE, PubMed, the Cochrane Library, and the Clinical Trials...
November 4, 2016: Clinical Drug Investigation
https://www.readbyqxmd.com/read/27792212/postoperative-analgesia-for-elective-total-knee-arthroplasty-under-subarachnoid-anesthesia-with-opioids-comparison-between-epidural-femoral-block-and-adductor-canal-block-techniques-with-and-without-perineural-adjuvants-a-prospective-randomized-clinical-trial
#3
José R Ortiz-Gómez, Marta Perepérez-Candel, José M Vázquez-Torres, José M Rodriguez-Del Río, Berta Torrón-Abad, Inocencia Fornet-Ruiz, Francisco J Palacio-Abizanda
BACKGROUND: Optimal control of acute postoperative pain and prevention of chronic persistent pain in total knee arthroplasty (TKA) remain a challenge. The main hypothesis was that nerve blocks improve postoperative analgesia especially if perineural adjuvants are added. METHODS: Immediate postoperative pain (24 h) was evaluated every hour in 639 patients using a verbal rating 11-point scale for patient self-reporting of pain (VRS-11). All patients received subarachnoid anesthesia and were randomly allocated in 8 groups: control group, epidural (EA) and single shots femoral (FNB) or adductor canal blocks (ACB), both with and without adjuvants: dexamethasone (+Dexa) or dexmedetomidine (+Dexm)...
October 28, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27761042/quality-of-post-operative-analgesia-after-epidural-dexmedetomidine-and-ketamine-a-comparative-pilot-study
#4
Nilesh Balu Sonawane, J Balavenkatasubramanian, P Gurumoorthi, Poonam Ashok Jadhav
No abstract text is available yet for this article.
October 2016: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/27630712/the-effect-of-dexmedetomidine-on-lumbar-epidural-injection-for-failed-back-surgery-syndrome
#5
Ashraf Eskandr, Sadik Abdel Maseeh
Purpose. Failed back surgery syndrome is a chronic pain condition requiring rapid, effective, and efficient management. This study evaluates the effect of adding dexmedetomidine to lumbar epidural steroids in patients with failed back surgery syndrome. Methods. Fifty patients suffering from failed back surgery syndrome were randomly assigned to one of two groups, receiving an epidural injection of 20 mL of either a mixture of betamethasone (14 mg) and bupivacaine 0.5 mg (group C) or a mixture of betamethasone (14 mg), bupivacaine 0...
2016: Anesthesiology Research and Practice
https://www.readbyqxmd.com/read/27513640/effect-of-epidural-dexmedetomidine-combined-with-ropivacaine-in-labor-analgesia-a-randomized-double-blinded-controlled-study
#6
Yang Zhao, Yan Xin, Yongbo Liu, Xuanlong Yi, Yingzhi Liu
BACKGROUD: The purpose of our study is to evaluate the effect of adding dexmedetomidine to epidural ropivacaine in patients undergoing labor epidural analgesia. METHODS: Eighty healthy women were randomly assigned to two groups: control group(R; n=40) received epidural 0.125% ropivacaine for labor analgesia, whereas the study group (D; n=40) received epidural 0.125% ropivacaine with dexmedetomidine in addition. The blood pressure, heart rate, and the severity of pain of the parturient was assessed, the duration of the first stage and the second stage of labor time, the rate of instrumental delivery and the rate of cesarean section were recorded...
August 10, 2016: Clinical Journal of Pain
https://www.readbyqxmd.com/read/27383499/clinical-research-on-the-dexmedetomidine-applied-for-patient-controlled-sedation-during-the-lower-limbs-operation-under-combined-spinal-epidural-anesthesia
#7
Lei Fan, Ji Zhang, Zhifeng Lv, Huafeng Guo, Yan Zhao
To investigate the effect and safety of dexmedetomidine applied for patient-controlled sedation under combined spinal anesthesia. 150 cases who would be implemented lower limbs operations were randomly divided into patient-controlled sedation group (Group PCS) and control group (Group C) and 75 cases for each group. The ages of patients were between 18 and 65 years old and patients were with American Society of Anesthesiologists (ASA) or level. After being implemented combined spinal anesthesia, patients of Group PCS were undergone patient-controlled sedation by using dexmedetomidine (4μg/mL) with 2mL of load quantity, 1...
May 2016: Pakistan Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/27275050/the-efficacy-and-safety-of-epidural-dexmedetomidine-and-clonidine-with-bupivacaine-in-patients-undergoing-lower-limb-orthopedic-surgeries
#8
Safiya I Shaikh, Sarala B Mahesh
BACKGROUND AND AIMS: Alpha (α-2) adrenergic agonists have both analgesic and sedative properties when used as an adjuvant in regional anesthesia. A prospective randomized double-blind study was carried out to evaluate the efficacy of epidural route and to compare the efficacy and clinical profile of dexmedetomidine and clonidine as an adjuvant to bupivacaine with special emphasis on their quality of analgesia, sedation and the ability to provide the smooth intra-operative and postoperative course...
April 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/27275047/evaluation-of-low-dose-dexmedetomidine-and-neostigmine-with-bupivacaine-for-postoperative-analgesia-in-orthopedic-surgeries-a-prospective-randomized-double-blind-study
#9
Ashima Sharma, Naresh J Kumar, Mohammad Azharuddin, Lalith C Mohan, Gopinath Ramachandran
BACKGROUND AND AIMS: Neuraxial adjuants to local anesthetics is an effective technique of improving the quality and duration of postoperative analgesia. The safety and efficacy of drugs like dexmedetomidine and neostigmine as epidural medications have been sparsely investigated. MATERIAL AND METHODS: Combined spinal-epidural anesthesia was performed in 60 American Society of Anesthesiologists I and II patients who required lower limb surgeries of ≤3 h duration...
April 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/27212752/dexmedetomidine-as-an-adjuvant-to-bupivacaine-in-caudal-analgesia-in-children
#10
Vigya Goyal, Jyotsna Kubre, Krishnaprabha Radhakrishnan
CONTEXT: Postoperative pain management is becoming an integral part of anesthesia care. Various techniques of pediatric pain relief have been designed among which the most commonly practiced is caudal epidural block. Several adjuvants have been used to prolong the duration of caudal analgesia such as clonidine, neostigmine, ketamine, opioids, and ephedrine. We have designed the study using dexmedetomidine as an adjuvant to assess analgesic efficacy, duration of postoperative analgesia, hemodynamic stability, postoperative sedation, and any adverse effects in children...
May 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/27212750/comparative-study-for-better-adjuvant-with-ropivacaine-in-epidural-anesthesia
#11
Pramila Soni
BACKGROUND: Better adjuvants for epidural analgesia are still evolving. Dexmedetomidine that is alpha-2 agonist can be used as an adjuvant in epidural analgesia and anesthesia. AIMS: The aim of this study was to compare the effect of dexmedetomidine versus clonidine in combination with ropivacaine in epidural anesthesia on intraoperative and postoperative analgesia, to find out the better adjuvant for regional anesthesia. SETTINGS AND DESIGN: Randomized control trial...
May 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/27139887/the-future-of-intensive-care-unit-sedation-a-report-of-continuous-infusion-ketamine-as-an-alternative-sedative-agent
#12
Scott T Benken, Alexandra Goncharenko
This report describes a patient case utilizing a nontraditional sedative, continuous infusion ketamine, as an alternative agent for intensive care unit (ICU) sedation. A 27-year-old female presented for neurosurgical management of a coup contrecoup injury, left temporal fracture, epidural hemorrhage (EDH), and temporal contusion leading to sustained mechanical ventilation. The patient experienced profound agitation during mechanical ventilation and developed adverse effects with all traditional sedatives: benzodiazepines, dexmedetomidine, opioids, and propofol...
May 2, 2016: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/26991622/dexmedetomidine-combined-with-general-anesthesia-provides-similar-intraoperative-stress-response-reduction-when-compared-with-a-combined-general-and-epidural-anesthetic-technique
#13
RANDOMIZED CONTROLLED TRIAL
Yun Li, Bin Wang, Li-Li Zhang, Shu-Fang He, Xian-Wen Hu, Gordon T C Wong, Ye Zhang
BACKGROUND: Epidural anesthesia may attenuate the sympathetic hyperactivity and stress response from surgery. In this study, we compared the stress response, hemodynamic variables, and recovery profiles of patients undergoing total IV anesthesia (TIVA) and intraoperative dexmedetomidine with those receiving epidural anesthesia and TIVA. METHODS: Ninety patients undergoing elective open gastrectomy under TIVA were recruited. The dexmedetomidine group (group D, n = 30) received IV dexmedetomidine 0...
April 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/26957695/comparative-evaluation-of-dexmedetomidine-and-clonidine-with-low-dose-ropivacaine-in-cervical-epidural-anesthesia-for-modified-radical-mastectomy-a-prospective-randomized-double-blind-study
#14
Shivakumar M Channabasappa, Gopinath H Venkatarao, Shobha Girish, Nandakishore K Lahoti
CONTEXT: Alpha-2 adrenergic agonists clonidine and dexmedetomidine, are well known to produce analgesia through an opioid independent mechanism. Alpha-2 agonists are used as an adjuvant to local anesthetic agents to extend the duration of spinal, epidural and brachial plexus blocks. AIMS: We compared clonidine and dexmedetomidine as an adjuvant to Ropivacaine in cervical epidural anesthesia (CEA) with respect to onset and duration of sensory block, duration of analgesia and adverse effects...
January 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/26957689/epidural-ropivacaine-with-dexmedetomidine-reduces-propofol-requirement-based-on-bispectral-index-in-patients-undergoing-lower-extremity-and-abdominal-surgeries
#15
Renu Joy, Vinayak Seenappa Pujari, Mohan V R Chadalawada, Ajish Varghese Cheruvathoor, Yatish Bevinguddaiah, Nirmal Sheshagiri
BACKGROUND AND AIM: To assess the amount of propofol required for induction based on bispectral index (BIS) after administering epidural anesthesia with ropivacaine alone and ropivacaine with dexmedetomidine in patients undergoing lower extremities and abdominal surgeries. SUBJECTS AND METHODS: A double-blinded randomized clinical trial was carried out in 60 patients over a period of 2 years in a tertiary care hospital. American Society of Anaesthesiologists I or II in age group 18-65 years were included in the study...
January 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/26894155/dexmedetomidine-as-an-adjuvant-to-pre-emptive-caudal-epidural-ropivacaine-for-lumbosacral-spine-surgeries
#16
Sandhya Kalappa, Raghavendra Biligiri Sridhara, Saraswathi Kumaraswamy
INTRODUCTION: Pre-emptive caudal epidural is a proven technique for providing analgesia for spinal surgeries. Prolonged pain relief with no motor blockade is desired for early mobilisation. AIM: Present study aimed to evaluate the effect of addition of Inj dexmedetomidine to caudal ropivacaine on the duration of analgesia, haemodynamic profile and the associated side effects. MATERIALS AND METHODS: In this prospective double-blind study a total of 60 patients undergoing lumbosacral spine surgery were randomised to receive 20 cc of pre-emptive caudal epidural injection of either inj ropivacaine 0...
January 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/26894153/comparison-of-epidural-bupivacaine-levobupivacaine-and-dexmedetomidine-in-patients-undergoing-vascular-surgery
#17
Lakshmi Adalagere Sathyanarayana, Vijayakumar M Heggeri, Parimala Prasanna Simha, Satish Narasimaiah, Manjunath Narasimaiah, Bharathi Katheraguppa Subbarao
INTRODUCTION: Levobupivacaine is the s-isomer of racemic Bupivacaine. It is less cardio, neurotoxic and equally potent local anaesthetic compared to its racemate. It is known to cause less Depression of myocardial contractility. Dexmeditomidine when used via epidural route has synergistic effect with local anaesthetics. Majority of patients presenting for vascular surgery are elderly and have associated co-morbidities like diabetes, hypertension, and coronary artery disease. We intend to study safety and efficacy of epidural Levoupivacaine and Dexmedetomidine in this group of patients...
January 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/26815259/clinical-and-histological-effects-of-the-intrathecal-administration-of-a-single-dose-of-dexmedetomidine-in-rabbits
#18
Hugh D de Pereira Cardoso, Natalie C Fim, Mariangela A Marques, Helio Mint, Vania M de Vasconcelos Machado, Daneshvari R Solanki, Rodrigo Moreira Lima, Ana L de Carvalho, Lais H Navarro, Eliana M Ganem
BACKGROUND: There is experimental evidence that dexmedetomidine has neuroprotective effects. So, it could be expected that its intrathecal or epidural administration presents no harm. However, whether dexmedetomidine is neurotoxic to the spinal cord remains to be fully elucidated. OBJECTIVE: To evaluate the effect of preservative-free dexmedetomidine administered as a subarachnoid single injection on the spinal cord and meninges of rabbits. STUDY DESIGN: Research article...
February 2016: Pain Physician
https://www.readbyqxmd.com/read/26758074/anesthetic-management-of-nonintubated-video-assisted-thoracoscopic-surgery-using-epidural-anesthesia-and-dexmedetomidine-in-three-patients-with-severe-respiratory-dysfunction
#19
Yoshika Iwata, Yusuke Hamai, Tomohiro Koyama
Nonintubated video-assisted thoracoscopic surgery (VATS) has been reported to be safe and feasible for patients with various thoracic diseases, including those who have respiratory dysfunction. In nonintubated VATS, it is important to maintain spontaneous respiration and to obtain a satisfactory operating field through adequate collapse of the lung by surgical pneumothorax. Therefore, we need to minimize the patient's physical and psychological discomfort by using regional anesthesia and sedation. If analgesia and sedation are inadequate, conversion to intubated general anesthesia may be required...
April 2016: Journal of Anesthesia
https://www.readbyqxmd.com/read/26712965/comparative-analysis-of-epidural-bupivacaine-versus-bupivacaine-with-dexmedetomidine-for-vaginal-hysterectomy
#20
Seema Shreepad Karhade, Shilpa Amol Acharya, Kalpana Harnagale
BACKGROUND: Dexmedetomidine a new drug, which is alpha-two agonist, is recommended by manufacturers as an adjuvant in epidural analgesia and anesthesia. AIMS: To study the effects of dexmedetomidine on quality and efficacy of the epidural bupivacaine 0.5% for vaginal hysterectomies, by studying the onset of action, duration of action, highest dermatomal level achieved, degree of motor blockade, intraoperative and postoperative anesthesia and analgesia achieved. SETTING AND DESIGN: Prospective randomized study...
September 2015: Anesthesia, Essays and Researches
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