keyword
https://read.qxmd.com/read/37637415/a-randomized-double-blinded-study-assessing-the-dose-response-of-ropivacaine-with-dexmedetomidine-for-maintenance-of-labor-with-epidural-analgesia-in-nulliparous-parturients
#21
JOURNAL ARTICLE
Yao-Hua Shen, Dan M Drzymalski, Bin-Xiang Zhu, Su-Feng Lin, Fang-Qin Tu, Bei Shen, Fei Xiao
Background: The combination of ropivacaine and dexmedetomidine has been used as an epidural analgesic for inducing labor. However, there is limited data regarding the administration of epidural analgesia for labor maintenance, hence, this study aimed to determine the optimum concentration through dose-response curves of ropivacaine plus dexmedetomidine, which could be used along with the Programmed Intermittent Epidural Bolus (PIEB) technique. Methods: One hundred parturients were randomized into 4 groups who were administered four different doses of ropivacaine (dexmedetomidine at 0...
2023: Frontiers in Pharmacology
https://read.qxmd.com/read/37580838/feasibility-of-the-pupillary-pain-index-as-a-guide-for-depth-of-analgesia-during-opioid-sparing-anesthesia-with-continuous-infusion-of-dexmedetomidine
#22
JOURNAL ARTICLE
Martino Stefanini, Elena Cagnazzi, Stefano Calza, Nicola Latronico, Francesco A Rasulo
BACKGROUND: The pupillary dilation reflex (PDR) is an objective indicator of analgesic levels in anesthetized patients. Through measurement of the PDR during increasing tetanic stimulation (10-60 mA), it is possible to obtain the pupillary pain index (PPI), a score that assesses the level of analgesia. OBJECTIVES: The depth of analgesia during opioid-sparing anesthesia (OSA) with continuous infusion of dexmedetomidine in addition to general anesthesia was assessed...
August 14, 2023: J Anesth Analg Crit Care
https://read.qxmd.com/read/37566902/the-influence-of-dexmedetomidine-as-an-adjuvant-in-intrathecal-labor-analgesia-a-multicenter-study-on-efficacy-and-maternal-satisfaction
#23
RANDOMIZED CONTROLLED TRIAL
Chengyi Lao, Maoling Zhu, Yu Yang, Xuejiang Lin, Ruiping Huang, Xiaofen Wei, Xiaoyu Wei
In this study, we examined the impact of dexmedetomidine (DEX) on the effectiveness of epidural analgesia and labor outcomes. We administered different doses of DEX combined with 0.1% ropivacaine for epidural analgesia to evaluate the clinical effects and safety. To assess the effects of different concentrations of DEX in parturient women receiving epidural analgesia, we conducted a randomized double-blind trial. We selected 400 parturient women and randomly assigned them to 4 groups, with 100 parturient women in each group: S0...
January 2024: Journal of Clinical Pharmacology
https://read.qxmd.com/read/37470532/high-thoracic-epidural-anesthesia-and-dexmedetomidine-for-awake-off-pump-coronary-artery-bypass-grafting-a-feasible-option-for-patients-with-severe-pulmonary-disease
#24
JOURNAL ARTICLE
Neeraj K Barnwal, Vinil S Bhaskar, Kamlesh L Jain
High thoracic epidural anesthesia in cardiac surgery as the sole anesthetic technique is used in a select groups of patients having severe pulmonary co morbidities. We describe a case series of three patients at high risk for post operative pulmonary complications where this technique was used along with dexmedetomidine infusion for conscious sedation in off pump coronary artery bypass grafting. Proper selection of patients, proper placement of the epidural catheter at the appropriate level and timing of catheter insertion and removal are of paramount importance...
2023: Annals of Cardiac Anaesthesia
https://read.qxmd.com/read/37434222/comparison-between-the-effects-of-epidural-lidocaine-tramadol-and-lidocaine-tramadol-on-postoperative-pain-in-cats-undergoing-elective-orchiectomy
#25
JOURNAL ARTICLE
Cecilia Vullo, Annastella Falcone, Gabriele Marino, Salvatore Monti, Adolfo Maria Tambella, Antonello Bufalari, Giuseppe Catone
BACKGROUND: In veterinary clinical practice, orchiectomy is one of the most common surgical procedures for cats and is performed mainly in young animals. The purpose of this study was to compare three different epidural (EP) analgesic protocols used in cats undergoing orchiectomy in order to determine which protocol resulted in superior outcomes in terms of perioperative analgesia. Twenty-one client-owned male cats were premedicated with a combination of dexmedetomidine (10 µg/kg) and midazolam (0...
July 11, 2023: Acta Veterinaria Scandinavica
https://read.qxmd.com/read/37404262/dexmedetomidine-or-fentanyl-which-one-is-better-as-an-adjunct-drug-in-epidural-anesthesia-and-causes-more-postoperative-pain-reduction-a-comparative-study-a-randomized-clinical-trial
#26
JOURNAL ARTICLE
Reza Akhondzadeh, Alireza Olapour, Fatemeh Javaherforooshzadeh, Mahboobeh Rashidi, Nima Bakhtiari, Fatemeh Hosseininejad
OBJECTIVES: This study compared dexmedetomidine to fentanyl as an adjunct to ropivacaine for epidural anesthesia in patients undergoing femoral neck fracture surgery. METHODS: A total of 56 patients in two different groups with dexmedetomidine and fentanyl underwent the epidural anesthesia method by ropivacaine. This study compared the onset and duration of sensory block, duration of motor block, visual analog scale (VAS) analgesia, and sedation score. The VAS and hemodynamics (e...
February 2023: Anesthesiology and Pain Medicine
https://read.qxmd.com/read/37404259/the-effect-of-epidural-infusion-of-dexmedetomidine-on-postoperative-analgesia-after-thoracotomy-a-randomized-clinical-trial
#27
JOURNAL ARTICLE
Saeid-Reza Entezary, Seyed Hamid Reza Faiz, Mahmood-Reza Alebouyeh, Anoushiravan Sharifian, Pooya Derakhshan
BACKGROUND: The unique analgesic properties of dexmedetomidine have led anesthesiologists to use it as an alternative to relieve pain after major surgeries. OBJECTIVES: We aimed to evaluate the effect of continuous injection of thoracic epidural dexmedetomidine on analgesia after thoracotomy. METHODS: In this randomized, double-blind clinical trial, 46 patients (18 to 70 years old) who were candidates for thoracotomy surgery were randomly assigned to receive ropivacaine alone or combined with dexmedetomidine after epidural anesthesia as postoperative epidural anesthesia...
February 2023: Anesthesiology and Pain Medicine
https://read.qxmd.com/read/37391982/dexmedetomidine-as-an-adjuvant-to-bupivacaine-in-caudal-analgesia-in-children-undergoing-infra-umbilical-surgery
#28
RANDOMIZED CONTROLLED TRIAL
M M Haque, D Banik, A K Akhtaruzzaman, D K Bhowmick, M A Kader, R Reza, M M Morshed, M Hasanuzzaman, A K Azad, M L Mariom, M S Hossain, M Masud, N Sultana
When performing infra-umbilical procedures, caudal epidural analgesia with bupivacaine is frequently used to provide both intra- and post-operative analgesia. Dexmedetomidine, an alpha 2 agonistsare extensively used in neuraxial blocks and peripheral nerve blocks to prolong the action of bupivacaine. To find out the effects of dexmedetomidine as an adjuvant to bupivacaine for caudal analgesia in children undergoing infra-umbilical surgery. This was a randomized, controlled double-blinded prospective observational study and was performed from July 2019 to December 2019...
July 2023: Mymensingh Medical Journal: MMJ
https://read.qxmd.com/read/37254106/low-dose-intranasal-dexmedetomidine-premedication-improves-epidural-labor-analgesia-onset-and-reduces-procedural-pain-on-epidural-puncture-a-prospective-randomized-double-blind-clinical-study
#29
RANDOMIZED CONTROLLED TRIAL
Hao Sun, Xiang Ma, Shengyou Wang, Zhenzhen Li, Yao Lu, Haijuan Zhu
BACKGROUND: Epidural labor analgesia is a safe and effective method of pain management during labor with the drawbacks of delayed onset and maternal distress during epidural puncture. This study aimed to determine whether pretreatment with intranasal low-dose dexmedetomidine effectively shortens the onset of analgesia and reduces procedural pain. METHODS: In this prospective, randomized double-blind trial, nulliparous patients were randomly assigned to either the intranasal dexmedetomidine group or the control group...
May 30, 2023: BMC Anesthesiology
https://read.qxmd.com/read/37127531/comparison-of-dexmedetomidine-vs-opioids-as-local-anesthetic-adjuvants-in-patient-controlled-epidural-analgesia-a-meta-analysis
#30
JOURNAL ARTICLE
Yafen Gao, Zhixian Chen, Yu Huang, Shujun Sun, Dong Yang
BACKGROUND: The efficacy and adverse effects of dexmedetomidine (DEX) as a local anaesthetics adjuvant for patient controlled epidural analgesia (PCEA) is inconclusive, and this meta-analysis assesses the efficacy and risks of DEX for PCEA using opioids as a reference. METHODS: Two researchers independently searched the Pubmed, Embase, Cochrane library, and China Biology Medicine (CBM) for randomized controlled trials comparing DEX and opioids as local anesthetic adjuvants in PCEA...
May 2, 2023: Korean Journal of Anesthesiology
https://read.qxmd.com/read/37092309/patient-controlled-intravenous-administration-of-dexmedetomidine-with-nalbuphine-versus-sufentanil-for-post-cesarean-delivery-analgesia-a-retrospective-observational-study
#31
JOURNAL ARTICLE
Wei-Wei Li, Bei Zheng, Rong Shi, Yue-Ming Jiang, Yan-Nan Liu, Zhi-Wei Wang
This retrospective observational study aims to investigate the patient-controlled intravenous analgesia (PCIA) of dexmedetomidine (DEX) with nalbuphine (NAL) versus sufentanil (SUF) for post-cesarean delivery management. A total of 300 women were evaluated who underwent cesarean section surgery with combined spinal-epidural anesthesia. After surgery, all patients were connected to a patient-controlled analgesia pump. The PCIA protocol was programmed with 0.11 μg/kg/h DEX in combination with 0.03 μg/kg/h SUF in Group I (n = 150) or 0...
April 24, 2023: Kaohsiung Journal of Medical Sciences
https://read.qxmd.com/read/37063658/analgesic-effect-of-ropivacaine-combined-with-dexmedetomidine-in-the-postoperative-period-in-children-undergoing-ultrasound-guided-single-shot-sacral-epidural-block-a-systematic-review-and-meta-analysis
#32
REVIEW
Shoubo Quan, Yuexia Lu, Yujie Huang
OBJECTIVE: This study aims to evaluate the efficacy of dexmedetomidine as an adjuvant to ropivacaine in prolonging postoperative analgesia and reducing pain scores in children undergoing surgery. METHODS: Five online databases were searched for RCTs on postoperative analgesia of pediatric patients undergoing ultrasound-guided single-shot sacral epidural block with dexmedetomidine as an adjuvant to ropivacaine up to January 2, 2023. Pain score and sedation score at 2, 4, 8, 12, and 24 h after the operation, the time of first receiving additional analgesic drugs, and the number of postoperative adverse effects were selected to compare the efficacy and safety of combined treatment with ropivacaine alone for pediatrics...
2023: Frontiers in Pediatrics
https://read.qxmd.com/read/37057296/comparison-of-efficacy-and-safety-of-different-doses-of-dexmedetomidine-for-epidural-labor-analgesia
#33
JOURNAL ARTICLE
Liang Ge, Peng Zhang, Lingguo Kong, Wei Wang, Qian Tong, Quanlong Fan, Xudong Han
OBJECTIVE: To explore the efficacy and safety of different doses of dexmedetomidine (DEX) for epidural labor analgesia (ELA). METHODS: From June 2021 to June 2022, 147 parturients who underwent ELA in our hospital were selected and divided into low- (0.5  μ g/kg DEX), medium- (0.75  μ g/kg DEX), and high-dose (1.0  μ g/kg DEX) groups ( n  = 49 for each) according to the random number table method. The analgesic effect was assessed using the Ramsay sedation score and Visual Analogue Scale (VAS), and the labor duration, mean arterial pressure (MAP), and heart rate (HR) before and after analgesia, vaginal bleeding within 2 h postpartum, and delivery outcomes (the cesarean section conversion rate and the neonatal Apgar score) were statistically analyzed...
2023: Emergency Medicine International
https://read.qxmd.com/read/36990180/dexmedetomidine-alone-or-combined-with-morphine-for-epidural-anesthesia-in-bitches-undergoing-elective-ovariohysterectomy
#34
JOURNAL ARTICLE
Andressa R Souza, Isadora G Franco, Isabela M Costa, Gustavo H Julião, Beatriz B Oliveira, Talita F Moreira, Marcos C Sant'Anna, Caio J X Abimussi, Beatriz P Floriano
The purpose of this study was to assess perioperative analgesia provided by the combination of epidural dexmedetomidine and morphine in bitches undergoing elective ovariohysterectomy. Twenty-four bitches were included in the study and allocated into 3 groups: GM, morphine 0.1 mg/kg; GD, dexmedetomidine 2 µg/kg; and GDM, dexmedetomidine and morphine at the same doses. All solutions were diluted in saline to a total of 0.36 mL/kg. Heart rate (HR), respiratory rate (FR) and systolic blood pressure (SAP) were recorded prior to epidural analgesia (TB), immediately following epidural analgesia (TEA), at surgical incision (TSI), at the first ovarian pedicle clamping (TOP1), at the second pedicle clamping (TOP2), at uterine stump clamping (TUC), at the start of abdominal cavity closure (TSC) and at the end of skin closure (TEC)...
2023: Topics in Companion Animal Medicine
https://read.qxmd.com/read/36948497/opioid-free-mastectomy-under-thoracic-epidural-anesthesia-analgesia-in-a-patient-with-critical-tracheal-stenosis-a-case-report
#35
R De Oliveira, P R C Ferreira, C Neves, C Barreto
Mastectomy is traditionally performed under general anaesthesia and invasive ventilation, and is often complemented with regional techniques. In this setting, tracheal stenosis can pose a challenge to airway management. The aim of this report is to describe the successful management of a 68-year-old woman with severe subglottic tracheal stenosis undergoing mastectomy due to breast cancer. Surgery was performed without airway instrumentation under an opioid-free regimen consisting of thoracic epidural, propofol and dexmedetomidine perfusion, and non-opioid analgesics...
May 2023: Revista española de anestesiología y reanimación
https://read.qxmd.com/read/36939497/impact-of-pharmacological-interventions-on-intrapulmonary-shunt-during-one-lung-ventilation-in-adult-thoracic-surgery-a-systematic-review-and-component-network-meta-analysis
#36
JOURNAL ARTICLE
Raoul Schorer, Anna-Luna Dombret, Andres Hagerman, Benoît Bédat, Alessandro Putzu
BACKGROUND: Intrapulmonary shunt is a major determinant of oxygenation in thoracic surgery under one-lung ventilation. We reviewed the effects of available treatments on shunt, Pao2 /FiO2 and haemodynamics through systematic review and network meta-analysis. METHODS: Online databases were searched for RCTs comparing pharmacological interventions and intrapulmonary shunt in thoracic surgery under one-lung ventilation up to March 30, 2022. Random-effects (component) network meta-analysis compared 24 treatments and 19 treatment components...
January 2023: British Journal of Anaesthesia
https://read.qxmd.com/read/36934844/resistance-to-local-anesthetics-truth-or-myth
#37
A Brito, M Pinto, Z Moreira, N Lages
The report of anesthetic technique failure is crucial and the etiology of the problem should be determined. We describe a case of locoregional anesthesia failure, in which, after excluding its most common causes, the resistance to local anesthetics was considered as the most probable clinical hypothesis. For this reason, a genetic test was performed, as well as the efficacy of other local anesthetics was evaluated, constituting a different approach in the cases of locoregional anesthesia failure. True resistance to local anesthetics is difficult to diagnose so information about this is scarce in the literature...
May 2023: Revista española de anestesiología y reanimación
https://read.qxmd.com/read/36818484/effect-of-intravenous-dexmedetomidine-on-shivering-in-cesarean-section-under-intrathecal-anesthesia-randomized-clinical-trial
#38
JOURNAL ARTICLE
Sholeh Nesioonpour, Soraya Bayat, Ali Ghomeishi, Kaveh Behaeen, Mohsen Savaie, Azar Ahmadzadeh
BACKGROUND: Shivering is one of the most common side effects after cesarean section (C-section) under spinal or epidural anesthesia. However, it is often not treated. OBJECTIVES: The aim of this study was to evaluate the effectiveness of intravenous dexmedetomidine (DEX) in the prevention of shivering after intrathecal anesthesia in women undergoing C-sections. METHODS: This double-blind, placebo-controlled clinical trial was conducted on 80 women candidates for elective C-sections under intrathecal anesthesia who were referred to Imam Khomeini Governmental Hospital in Ahvaz, Iran, during 2020 - 2021...
June 2022: Anesthesiology and Pain Medicine
https://read.qxmd.com/read/36692824/effect-of-different-doses-of-epidural-dexmedetomidine-on-reducing-visceral-traction-reaction-for-cesarean-section-a-double-blind-randomized-controlled-trial
#39
RANDOMIZED CONTROLLED TRIAL
Minghao Liu, Bin Wang, Bizimana Prudence, Xuezi Chen
PURPOSE: This study aimed to evaluate the effect of different doses of epidural dexmedetomidine on reducing visceral traction reaction for cesarean section under epidural anesthesia. METHODS: Nulliparas were randomly allocated to receive epidural ropivacaine alone (group R) or in combination with dexmedetomidine 0.5 μg/kg (group RD0.5), 0.75 μg/kg (group RD0.75), and 1 μg/kg (group RD1) with 46 nulliparas in each group. The primary outcome was intraoperative visceral traction reaction (graded from 0 to 3, with 0 and 3, respectively, regarded as 'no discomfort in stomach or perineum; no nausea, vomiting or intestinal tympanites' and 'serious visceral pain, nausea and vomiting, intestinal tympanites')...
June 2023: Journal of Anesthesia
https://read.qxmd.com/read/36651373/nebulized-dexmedetomidine-versus-neostigmine-atropine-for-treating-post-dural-puncture-headache-after-cesarean-section-a-double-blind-randomized-controlled-trial
#40
RANDOMIZED CONTROLLED TRIAL
Omar M Soliman, Ahmed I Aboulfotouh, Ahmed M Abdelhafez, Abualauon Abedalmohsen
BACKGROUND: Post-dural puncture headache (PDPH) is one of the most common complications of neuraxial anesthesia after an accidental dural puncture. This study aimed to test non-interventional alternatives to treat PDPH. Our goals were to compare the effectiveness of nebulized dexmedetomidine (DEX) versus neostigmine/atropine in the conservative management of PDPH. METHODS: A randomized double-blind controlled study of ninety (90) women divided into three equal groups: group C (given nebulization of saline 0...
October 2023: Minerva Anestesiologica
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