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intranasal dexmedetomidine

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https://www.readbyqxmd.com/read/28459726/dexmedetomidine-as-a-supplement-to-spinal-anesthesia-block-a-case-report-of-three-infants
#1
Franklin Chiao, Karen Boretsky
We report a novel use for dexmedetomidine as a supplemental intravenous or intranasal sedative for spinal anesthesia in infants. The children were 1, 2, and 9 months old having either inguinal hernia repair or circumcision. None of them experienced clinically relevant hemodynamic changes or apnea. Pain scores were zero throughout the postoperative period.
April 28, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28442950/effect-of-intranasal-dexmedetomidine-on-emergence-agitation-after-sevoflurane-anesthesia-in-children-undergoing-tonsillectomy-and-or-adenoidectomy
#2
Ahmed Mostafa Abd El-Hamid, Hany Mahmoud Yassin
BACKGROUND: Emergence agitation (EA) after sevoflurane anesthesia is common in children during recovery from general anesthesia and may result in postoperative complications. This study investigated safety and effectiveness of intranasal dexmedetomidine in reducing the incidence and severity of EA. METHODS: This prospective, randomized double-blinded controlled trial included 86 patients scheduled for the tonsillectomy and/or adenoidectomy under general anesthesia with sevoflurane...
April 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28414899/comparison-of-sedation-by-intranasal-dexmedetomidine-and-oral-chloral-hydrate-for-pediatric-ophthalmic-examination
#3
Qianzhong Cao, Yiquan Lin, Zhubin Xie, Weihua Shen, Ying Chen, Xiaoliang Gan, Yizhi Liu
BACKGROUND AND AIM: Pediatric ophthalmic examinations can be conducted under sedation either by chloral hydrate or by dexmedetomidine. The objective was to compare the success rates and quality of ophthalmic examination of children sedated by intranasal dexmedetomidine vs oral chloral hydrate. METHODS: One hundred and forty-one children aged from 3 to 36 months (5-15 kg) scheduled to ophthalmic examinations were randomly sedated by either intranasal dexmedetomidine (2 μg·kg(-1) , n = 71) or oral chloral hydrate (80 mg·kg(-1) , n = 70)...
June 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28372674/the-sedative-effects-of-the-intranasal-administration-of-dexmedetomidine-in-children-undergoing-surgeries-compared-to-other-sedation-methods-a-systematic-review-and-meta-analysis
#4
Hyun Jung Kim, Woo Jong Shin, Suin Park, Hyeong Sik Ahn, Jae Hoon Oh
STUDY OBJECTIVE: Administration of intranasal dexmedetomidine for sedation is comfortable and effective in children who are afraid of needles, and it offers efficient sedation similar to that of intravenous administration. We performed a systematic review and meta-analysis to evaluate the clinical effects of the pre-procedural administration of intranasal dexmedetomidine. DESIGN: We identified randomized controlled trials (RCTs) that compared intranasal dexmedetomidine administration to other administration methods of various sedatives or placebo from MEDLINE, EMBASE, Cochrane, KoreaMed and hand searches of trial registries...
May 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28366351/when-to-pick-the-nose-out-of-hospital-and-emergency-department-intranasal-administration-of-medications
#5
REVIEW
Megan A Rech, Brian Barbas, Whitney Chaney, Elizabeth Greenhalgh, Charles Turck
The intranasal route for medication administration is increasingly popular in the emergency department and out-of-hospital setting because such administration is simple and fast, and can be used for patients without intravenous access and in situations in which obtaining an intravenous line is difficult or time intensive (eg, for patients who are seizing or combative). Several small studies (mostly pediatric) have shown midazolam to be effective for procedural sedation, anxiolysis, and seizures. Intranasal fentanyl demonstrates both safety and efficacy for the management of acute pain...
March 25, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28347608/sedation-effects-of-intranasal-dexmedetomidine-delivered-as-sprays-versus-drops-on-pediatric-response-to-venous-cannulation
#6
Zhubin Xie, Weihua Shen, Jingyi Lin, Liwen Xiao, Minyan Liao, Xiaoliang Gan
OBJECTIVES: Mucosal atomization device (MAD) was designed to increase the bioavailability of intranasal medications by facilitating absorption, the present study aimed to evaluate and compare the sedation effects of intranasal dexmedetomidine delivered as drops versus sprays on pediatric responses to intravenous cannulation. METHODS: One hundred and six pediatric patients (aged from 2 to 5years) scheduled for elective ophthalmic surgery were intranasally received a dose of 2μg/kg in 20μl/kg of dexmedetomidine for sedation to reduce response to venous cannulation...
March 18, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28337075/intranasal-dexmedetomidine-as-a-sedative-for-pediatric-procedural-sedation
#7
Natalie Behrle, Esma Birisci, Jordan Anderson, Sara Schroeder, Abdallah Dalabih
OBJECTIVE: This study seeks to evaluate the efficacy and safety of intranasal (IN) dexmedetomidine as a sedative medication for non-invasive procedural sedation. METHODS: Subjects 6 months to 18 years of age undergoing non-invasive elective procedures were included. Dexmedetomidine (3 mcg/kg) was administered IN 40 minutes before the scheduled procedure time. The IN dexmedetomidine cohort was matched and compared to a cohort of 690 subjects who underwent sedation for similar procedures without the use of dexmedetomidine to evaluate for observed events/interventions and procedural times...
January 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28275979/intranasal-dexmedetomidine-for-procedural-sedation-in-children-a-suitable-alternative-to-chloral-hydrate
#8
REVIEW
Giorgio Cozzi, Stefania Norbedo, Egidio Barbi
Sedation is often required for children undergoing diagnostic procedures. Chloral hydrate has been one of the sedative drugs most used in children over the last 3 decades, with supporting evidence for its efficacy and safety. Recently, chloral hydrate was banned in Italy and France, in consideration of evidence of its carcinogenicity and genotoxicity. Dexmedetomidine is a sedative with unique properties that has been increasingly used for procedural sedation in children. Several studies demonstrated its efficacy and safety for sedation in non-painful diagnostic procedures...
April 2017: Paediatric Drugs
https://www.readbyqxmd.com/read/28259526/review-of-intranasally-administered-medications-for-use-in-the-emergency-department
#9
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
https://www.readbyqxmd.com/read/28250480/efficacy-of-intranasal-dexmedetomidine-versus-oral-midazolam-for-paediatric-premedication
#10
Lakshmi Kumar, Ajay Kumar, Ramkumar Panikkaveetil, Bindu K Vasu, Sunil Rajan, Suresh G Nair
BACKGROUND AND AIMS: Premedication is an integral component of paediatric anaesthesia which, when optimal, allows comfortable separation of the child from the parent for induction and conduct of anaesthesia. Midazolam has been accepted as a safe and effective oral premedicant. Dexmedetomidine is a selective alpha-2 agonist with sedative and analgesic effects, which is effective through the transmucosal route. We compared the efficacy and safety of standard premedication with oral midazolam versus intranasal dexmedetomidine as premedication in children undergoing elective lower abdominal surgery...
February 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28181351/sedation-methods-for-transthoracic-echocardiography-in-children-with-trisomy-21-a-retrospective-study
#11
Jeff Miller, Lili Ding, James Spaeth, Jennifer Lam, Joanna Paquin, Erica Lin, Allison Divanovic, Bi Lian Li, Shankar Baskar, Andreas W Loepke
BACKGROUND: Many children with Trisomy 21 have neurologic or behavioral problems that make it difficult for them to remain still during noninvasive imaging studies, such as transthoracic echocardiograms (TTEcho). Recently, intranasal dexmedetomidine sedation has been introduced for this purpose. However, dexmedetomidine has been associated with bradycardia. Children with Trisomy 21 have been reported to have a higher risk of bradycardia and airway obstruction with sedation or anesthesia compared to children without Trisomy 21...
February 8, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28105598/clinical-pharmacokinetics-and-pharmacodynamics-of-dexmedetomidine
#12
REVIEW
Maud A S Weerink, Michel M R F Struys, Laura N Hannivoort, Clemens R M Barends, Anthony R Absalom, Pieter Colin
Dexmedetomidine is an α2-adrenoceptor agonist with sedative, anxiolytic, sympatholytic, and analgesic-sparing effects, and minimal depression of respiratory function. It is potent and highly selective for α2-receptors with an α2:α1 ratio of 1620:1. Hemodynamic effects, which include transient hypertension, bradycardia, and hypotension, result from the drug's peripheral vasoconstrictive and sympatholytic properties. Dexmedetomidine exerts its hypnotic action through activation of central pre- and postsynaptic α2-receptors in the locus coeruleus, thereby inducting a state of unconsciousness similar to natural sleep, with the unique aspect that patients remain easily rousable and cooperative...
January 19, 2017: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/28065226/effects-of-two-intranasal-dexmedetomidine-doses-as-premedication-on-sevoflurane-ec50-for-successful-laryngeal-mask-airway-placement-in-children
#13
Jin Xu, Xiao-Ming Deng, Ling-Xin Wei, Dong Yang, Ju-Hui Liu, Juan Zhi, Ya-Nan Li
Objective To observe the effects of two different intranasal dexmedetomidine doses as premedication on the EC50 of sevoflurane for successful laryngeal mask airway placement in children. Methods Children aged 3-6 years, of American Society of Anesthesiologists physical status 1, and scheduled for plastic surgery were enrolled in this study. Children were assigned to receive either spray administration of intranasal dexmedetomidine 1 μg/kg (group D1, n=21) or 2 μg/kg (group D2, n=20) approximately 30 minutes before anesthesia...
December 20, 2016: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
https://www.readbyqxmd.com/read/27833345/efficacy-of-intranasal-dexmedetomidine-for-conscious-sedation-in-patients-undergoing-surgical-removal-of-impacted-third-molar-a-double-blind-split-mouth-study
#14
Sujeeth Kumar Shetty, Garima Aggarwal
BACKGROUND: This study was conducted to evaluate the utility and effectiveness of Intranasal Dexmedetomidine on Sedation status and pain experience of the patients undergoing surgical extraction of impacted third molar. MATERIALS AND METHODS: In this double-blind, split mouth study, in 15 patients, evaluations pertaining to classes of third molar impaction was done. Each patient was randomly assigned to receive either intranasal normal saline (placebo group) or intranasal 1...
December 2016: Journal of Maxillofacial and Oral Surgery
https://www.readbyqxmd.com/read/27825415/comparison-of-sedative-effects-of-two-spray-administration-of-intranasal-br-dexmedetomidine-doses-for-premedication-in-children
#15
Jin Xu, Xiao-Ming Deng, Dong Yang, Ling-Xin Wei, Juan Zhi, Wen-Li Xu, Ju-Hui Liu
Objective To compare two spray administration of intranasal dexmedetomidine (DEX) doses for premedication in children. Methods In this prospective,randomized,double-blind study,41 children aged 3-6 years were enrolled. Children were assigned to receive either spray administration of intranasal DEX 1 μg/kg (Group D1) or 2 μg/kg (Group D2). The Ramsay Sedation Scale scores were evaluated at 5 min intervals. Sedation status at separation from patient was also evaluated. Heart rate (HR) and saturation of peripheral oxygen (SpO2) were recorded before and every 15 min after drug administration...
October 10, 2016: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
https://www.readbyqxmd.com/read/27776827/intranasal-dexmedetomidine-sedation-as-adjuvant-therapy-in-acute-asthma-exacerbation-with-marked-anxiety-and-agitation
#16
Giorgio Cozzi, Sara Lega, Rita Giorgi, Egidio Barbi
We describe 2 patients with acute asthma exacerbation who were admitted to the emergency department (ED) with severe agitation and restlessness as a prominent finding, for which bedside asthma treatment sedation with intranasal dexmedetomidine was performed. In both cases, dexmedetomidine allowed the patients to rest and improved tolerance to treatment. Dexmedetomidine is a unique sedative with an excellent safety profile and minimal effect on respiratory function. These properties render it particularly promising for the management of severe agitation in children admitted to the ED with acute asthma exacerbation...
January 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27734549/comparison-of-oral-midazolam-with-intranasal-dexmedetomidine-premedication-for-children-undergoing-ct-imaging-a-randomized-double-blind-and-controlled-study
#17
Babita Ghai, Kajal Jain, Akshay Kumar Saxena, Nidhi Bhatia, Kushaljit Singh Sodhi
BACKGROUND: Children undergoing computerized tomography (CT) frequently require sedation to allay their anxiety, and prevent motion artifacts and stress of intravenous (IV) cannulation. AIMS: The aim of this trial was to compare the effectiveness of oral midazolam and intranasal dexmedetomidine as sole premedicants in children for carrying out both IV cannulation as well as CT scanning, without the need for additional IV sedatives. METHODS: Fifty-nine children, aged 1-6 years, scheduled to undergo CT imaging under sedation were randomized to receive either 0...
January 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27635747/effectiveness-of-preoperative-intranasal-dexmedetomidine-compared-with-oral-midazolam-for-the-prevention-of-emergence-delirium-in-pediatric-patients-undergoing-general-anesthesia-a-systematic-review-protocol
#18
Laura S Bonanno, Stephanie Pierce, Jennifer Badeaux, James J FitzSimons
This review aims to identify the effectiveness of preoperative intranasal dexmedetomidine compared with oral midazolam for the prevention of emergence delirium in pediatric patients undergoing general anesthesia.
August 2016: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/27627818/median-effective-dose-of-intranasal-dexmedetomidine-for-rescue-sedation-in-pediatric-patients-undergoing-magnetic-resonance-imaging
#19
Wenhua Zhang, Yanting Fan, Tianyun Zhao, Jinghui Chen, Gaolong Zhang, Xingrong Song
BACKGROUND: The median effective dose (ED50) of intranasal dexmedetomidine after failed chloral hydrate sedation has not been described for children. This study aims to determine the ED50 of intranasal dexmedetomidine for rescue sedation in children aged 1 to 36 months, who were inadequately sedated by chloral hydrate administration during magnetic resonance imaging (MRI). METHODS: This study was performed on 120 children, who were 1 to 36 months old and underwent MRI scanning...
December 2016: Anesthesiology
https://www.readbyqxmd.com/read/27570849/intranasal-sedatives-in-pediatric-dentistry
#20
Maha A AlSarheed
OBJECTIVES: To identify the intranasal (IN) sedatives used to achieve conscious sedation during dental procedures amongst children. METHODS: A literature review was conducted by identifying relevant studies through searches on Medline. Search included IN of midazolam, ketamine, sufentanil, dexmedetomidine, clonidine, haloperidol, and loranzepam. Studies included were conducted amongst individuals below 18 years, published in English, and were not restricted by year...
September 2016: Saudi Medical Journal
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