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intranasal dexmedetomidine

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https://www.readbyqxmd.com/read/29661413/pharmacokinetic-and-pharmacodynamic-study-of-intranasal-and-intravenous-dexmedetomidine
#1
A Li, V M Yuen, S Goulay-Dufaÿ, Y Sheng, J F Standing, P C L Kwok, M K M Leung, A S Leung, I C K Wong, M G Irwin
BACKGROUND: Intranasal dexmedetomidine produces safe, effective sedation in children and adults. It may be administered by drops from a syringe or by nasal mucosal atomisation (MAD NasalTM ). METHODS: This prospective, three-period, crossover, double-blind study compared the pharmacokinetic (PK) and pharmacodynamic (PD) profile of i.v. administration with these two different modes of administration. In each session each subject received 1 μg kg-1 dexmedetomidine, either i...
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29661383/does-intranasal-dexmedetomidine-provide-adequate-plasma-concentrations-for-sedation-in-children-a-pharmacokinetic-study
#2
J W Miller, R Balyan, M Dong, M Mahmoud, J E Lam, J N Pratap, J R Paquin, B L Li, J P Spaeth, A Vinks, A W Loepke
BACKGROUND: Atomised intranasal dexmedetomidine administration is an attractive option when sedation is required for paediatric diagnostic procedures, as vascular access is not required. The risk of haemodynamic instability caused by dexmedetomidine necessitates better understanding of its pharmacokinetics in young children. To date, intranasal dexmedetomidine pharmacokinetics has only been studied in adults. METHODS: Eighteen paediatric patients received dexmedetomidine 1 or 2 μg kg-1 intranasally or 1 μg kg-1 i...
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29628576/comparison-of-intranasal-dexmedetomidine-compared-to-midazolam-as-a-premedication-in-pediatrics-with-congenital-heart-disease-undergoing-cardiac-catheterization
#3
Medhat M Messeha, Gamal Zakaria El-Morsy
Background: The intranasal route is a reliable way to administer preanesthetics and sedatives to children. The aim of this study was to compare the anxiolytic and sedative effect of intranasal dexmedetomidine and midazolam as a premedication in pediatrics with simple congenital heart disease undergoing cardiac catheterization. Patients and Methods: Sixty children 3-6 years old of either sex with simple congenital heart disease undergoing cardiac catheterization were randomly allocated into two groups: Dexmedetomidine group who received intranasal dexmedetomidine (0...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29382993/-c-omparative-evaluation-of-the-intranasal-spray-formulation-of-midazolam-and-dexmedetomidine-in-patients-undergoing-surgical-removal-of-impacted-mandibular-third-molars-a-split-mouth-prospective-study
#4
Shashank Hiwarkar, Rajesh Kshirsagar, Vikram Singh, Amod Patankar, Sanjay Chandan, Mukund Rathod, Ajay Mohite
Purpose: The purpose of this prospective randomized single blinded split mouth study was to conduct a comparative evaluation of the efficacy of intranasal atomised spray formulation of Dexmedetomidine with Midazolam in patients undergoing surgical removal of bilaterally impacted mandibular third molars. Methods: This prospective study was conducted in twenty volunteers. Each volunteer underwent the surgical removal of an impacted mandibular third molar at two separate appointments at an interval of two weeks...
March 2018: Journal of Maxillofacial and Oral Surgery
https://www.readbyqxmd.com/read/29369091/comparison-of-intranasal-dexmedetomidine-and-oral-pentobarbital-sedation-for-transthoracic-echocardiography-in-infants-and-toddlers-a-prospective-randomized-double-blind-trial
#5
Jeffrey W Miller, Lili Ding, Joel B Gunter, Jennifer E Lam, Erica P Lin, Joanna R Paquin, Bi Lian Li, James P Spaeth, Renee N Kreeger, Allison Divanovic, Mohamed Mahmoud, Andreas W Loepke
BACKGROUND: Acquisition of transthoracic echocardiographic (TTEcho) images in children often requires sedation. The optimal sedative for TTEcho has not been determined. Children with congenital heart disease are repeatedly exposed to sedatives and anesthetics that may affect brain development. Dexmedetomidine, which in animals alters brain structure to a lesser degree, may offer advantages in this vulnerable population. METHODS: A prospective, randomized, double-blind trial enrolled 280 children 3-24 months of age undergoing outpatient TTEcho, comparing 2...
January 23, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29364490/intranasal-drug-administration-for-procedural-sedation-in-children-admitted-to-pediatric-emergency-room
#6
C Fantacci, G C Fabrizio, P Ferrara, F Franceschi, A Chiaretti
OBJECTIVE: Pain relief is a very important aspect in Pediatrician's clinical practice. It is often thought that young children, particularly infants, do not perceive as much pain as adults because of their immature nervous system and that untreated pain would not have adverse long-term consequences. Instead, it has been demonstrated that infants and children experience pain in a similar manner to adults. Many factors, particularly emotional factors, can increase the child's pain perception...
January 2018: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29363517/use-of-intranasal-dexmedetomidine-as-a-solo-sedative-for-mri-of-infants
#7
Gokhan Olgun, Mir Hyder Ali
BACKGROUND: Dexmedetomidine, a selective α-2 receptor agonist, can be delivered via the intranasal (IN) route and be used for procedural sedation. The drug's favorable hemodynamic profile and relative ease of application make it a promising agent for sedation during radiologic procedures, although there are few studies on its efficacy for MRI studies. METHODS: A retrospective chart review was performed between June 2014 and December 2016. Outpatients between 1 and 12 months of age who received 4 μg/kg of IN dexmedetomidine for MRI were included in the analysis...
January 23, 2018: Hospital Pediatrics
https://www.readbyqxmd.com/read/29363516/the-evolving-role-of-intranasal-dexmedetomidine-for-pediatric-procedural-sedation
#8
Jason Reynolds, Daniel J Sedillo
No abstract text is available yet for this article.
January 23, 2018: Hospital Pediatrics
https://www.readbyqxmd.com/read/29187151/pediatric-premedication-a-double-blind-randomized-trial-of-dexmedetomidine-or-ketamine-alone-versus-a-combination-of-dexmedetomidine-and-ketamine
#9
Hui Qiao, Zhi Xie, Jie Jia
BACKGROUND: Preoperative anxiety is common in pediatric patients. When dexmedetomidine is used alone for sedation as premedication, children tend to awaken when separated from their parents, and body movements occur during invasive procedures. We tested the hypothesis that the combination of dexmedetomidine and ketamine may be a useful premedication to alleviate preoperative anxiety and improve cooperation during intravenous cannulation in pediatric patients, while producing minimal adverse events...
November 29, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/29174282/intranasal-dexmedetomidine-in-termination-of-first-trimester-pregnancy-of-suction-evacuation
#10
Hang Shi, Duo Yang, Jie Liu
BACKGROUND AND AIM: Deep sedation without intubation for termination of first trimester pregnancy of suction evacuation entails use of sedatives such as propofol or a combination of propofol and sulfentanil, with unwanted complications. Dexmedetomidine is an α2 -adrenoreceptor agonist which provides sedation, anxiolysis and analgesia, without any of the complications associated with the popular sedatives. METHODS: A total number of 90 patients were randomized to three groups: 1...
September 24, 2017: Asian Journal of Anesthesiology
https://www.readbyqxmd.com/read/29099542/chloral-hydrate-as-a-sedating-agent-for-neurodiagnostic-procedures-in-children
#11
REVIEW
Choong Yi Fong, Chee Geap Tay, Lai Choo Ong, Nai Ming Lai
BACKGROUND: Paediatric neurodiagnostic investigations, including brain neuroimaging and electroencephalography (EEG), play an important role in the assessment of neurodevelopmental disorders. The use of an appropriate sedative agent is important to ensure the successful completion of the neurodiagnostic procedures, particularly in children, who are usually unable to remain still throughout the procedure. OBJECTIVES: To assess the effectiveness and adverse effects of chloral hydrate as a sedative agent for non-invasive neurodiagnostic procedures in children...
November 3, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29030006/dexmedetomidine-mitigate-acute-lung-injury-by-inhibiting-il-17-induced-inflammatory-reaction
#12
Yong Zhang, Shushan Jia, Tianqin Gao, Ruyi Zhang, Zhaoguo Liu, Yaoqi Wang
Interleukin-17 (IL-17) is considered to play an important role in the pathogenesis of a number of inflammatory conditions. Previous studies demonstrated that intranasal injections of IL-17 resulted in pulmonary inflammation and lung damage, we therefore hypothesize that dexmedetomidine, a potent α2 adrenergic receptor agonist that shows anti-inflammation effects in several animal models of inflammation, would attenuate IL-17 induced lung injury. We examined the lung damage using a histological approach, and assessed the number of lung-infiltrating neutrophils in the bronchoalveolar lavage fluid...
January 2018: Immunobiology
https://www.readbyqxmd.com/read/28940686/median-effective-dose-of-intranasal-dexmedetomidine-sedation-for-transthoracic-echocardiography-in-pediatric-patients-with-noncyanotic-congenital-heart-disease-an-up-and-down-sequential-allocation-trial
#13
Qing Yu, Yang Liu, Mang Sun, Jing Zhang, Yan Zhao, Fengzhi Liu, Shangyingying Li, Shengfen Tu
BACKGROUND: Intranasal dexmedetomidine can provide adequate sedation during short procedures. However, previous literature investigating the single-dose use of intranasal dexmedetomidine for sedation during transthoracic echocardiography in younger children is scarce, and the effects of age on sedation with intranasal dexmedetomidine remain controversial. OBJECTIVE: This study was to determine the 50% effective dose and estimate the 95% effective dose of single-dose intranasal dexmedetomidine to induce sedation in pediatric patients with noncyanotic congenital heart disease, and also determine the effect of age on the dose required for sedation...
November 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28937531/median-effective-dose-of-intranasal-dexmedetomidine-sedation-for-transthoracic-echocardiography-examination-in-postcardiac-surgery-and-normal-children-an-up-and-down-sequential-allocation-trial
#14
Yang Liu, Qing Yu, Mang Sun, Shangyingying Li, Jing Zhang, Yao Lei, Chaofeng Li, Fei Yang, Shengfen Tu
BACKGROUND: Dexmedetomidine (DEX) has been used for sedation in young infants and children undergoing transthoracic echocardiography (TTE). The median effective dose of intranasal DEX has not been described for postcardiac surgery children. Postcardiac surgery children could require more DEX to achieve satisfactory sedation for TTE examination than children suspected of congenital heart disease. OBJECTIVES: To study whether postcardiac surgery children need a larger dose of DEX for TTE than normal children...
September 20, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28802384/retrospective-study-of-intranasal-dexmedetomidine-as-a-prophylactic-against-emergence-delirium-in-pediatric-patients-undergoing-ear-tube-surgery
#15
Lisgelia Santana, Katherine Mills
OBJECTIVES: This study evaluated the effect of intranasal dexmedetomidine on emergence delirium (ED) in pediatric patients who underwent ear tube surgeries. Due to the brief nature of the surgery and low levels of pain experienced, an IV is rarely needed, limiting the medications available to anesthesiologists to manage postoperative delirium that may arise during recovery from inhalational anesthesia. Intravenous dexmedetomidine is an alpha-2 agonist anesthetic that is used in pediatric patients for the management of ED in various surgical procedures...
September 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28741653/a-randomised-controlled-trial-of-oral-chloral-hydrate-vs-intranasal-dexmedetomidine-before-computerised-tomography-in-children
#16
V M Yuen, B L Li, D K Cheuk, M K M Leung, T W C Hui, I C Wong, W W Lam, S W Choi, M G Irwin
Chloral hydrate is commonly used to sedate children for painless procedures. Children may recover more quickly after sedation with dexmedetomidine, which has a shorter half-life. We randomly allocated 196 children to chloral hydrate syrup 50 mg.kg-1 and intranasal saline spray, or placebo syrup and intranasal dexmedetomidine spray 3 μg.kg-1 , 30 min before computerised tomography studies. More children resisted or cried after drinking chloral hydrate syrup than placebo syrup, 72 of 107 (67%) vs. 42 of 87 (48%), p = 0...
October 2017: Anaesthesia
https://www.readbyqxmd.com/read/28716686/sedative-and-cardiovascular-effects-of-intranasal-or-intramuscular-dexmedetomidine-in-healthy-dogs
#17
Fabiana Micieli, Bruna Santangelo, Fabiana Reynaud, Alessandro Mirra, Giusy Napoleone, Giovanni Della Valle, Karine G Portier, Giancarlo Vesce
OBJECTIVE: To compare the clinical effects and sedation scores following either intranasal (IN) or intramuscular (IM) administration of dexmedetomidine in dogs. STUDY DESIGN: Prospective, blinded, randomized, clinical study. ANIMALS: A total of 20 client-owned dogs scheduled for noninvasive diagnostic procedures. METHODS: Dogs were allocated to be administered dexmedetomidine 0.02 mg kg(-1) IN (IN group) or IM (IM group)...
April 5, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28708753/effectiveness-of-preoperative-intranasal-dexmedetomidine-compared-with-oral-midazolam-for-the-prevention-of-emergence-delirium-in-the-pediatric-patient-undergoing-general-anesthesia-a-systematic-review
#18
James FitzSimons, Laura S Bonanno, Stephanie Pierce, Jennifer Badeaux
BACKGROUND: Emergence delirium is defined as a cognitive disturbance during emergence from general anesthesia resulting in hallucinations, delusions and confusion manifested by agitation, restlessness, involuntary physical movement and extreme flailing in bed. Postoperative emergence delirium develops in 12% to 18% of all children undergoing general anesthesia for surgery. This post-anesthetic phenomenon changes cognitive and psychomotor behavior, and puts pediatric patients and health care personnel at risk of injury...
July 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28674865/intranasal-dexmedetomidine-for-adrenergic-crisis-in-familial-dysautonomia
#19
Christy L Spalink, Erin Barnes, Jose-Alberto Palma, Lucy Norcliffe-Kaufmann, Horacio Kaufmann
PURPOSE: To report the use of intranasal dexmedetomidine, an α2-adrenergic agonist for the acute treatment of refractory adrenergic crisis in patients with familial dysautonomia. METHODS: Case series. RESULTS: Three patients with genetically confirmed familial dysautonomia (case 1: 20-year-old male; case 2: 43-year-old male; case 3: 26-year-old female) received intranasal dexmedetomidine 2 mcg/kg, half of the dose in each nostril, for the acute treatment of adrenergic crisis...
August 2017: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
https://www.readbyqxmd.com/read/28639236/the-effects-of-intranasal-dexmedetomidine-premedication-in-children-a-systematic-review-and-meta-analysis
#20
Jong Hun Jun, Kyu Nam Kim, Ji Yoon Kim, Shin Me Song
PURPOSE: Intranasal dexmedetomidine premedication is a newly introduced method for reducing stress and anxiety before general anesthesia in children. We performed a meta-analysis to identify the effects of intranasal dexmedetomidine premedication in children. SOURCE: We conducted a systematic review to find published randomized-controlled trials using intranasal dexmedetomidine as premedication. We searched databases in EMBASE™, MEDLINE®, and the Cochrane Controlled Trials Register using the Ovid platform...
September 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
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