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intranasal dexmedetomidine

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https://www.readbyqxmd.com/read/28716686/sedative-and-cardiovascular-effects-of-intranasal-or-intramuscular-dexmedetomidine-in-healthy-dogs
#1
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
#2
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
#3
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...
July 3, 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
#4
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...
June 21, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28609332/the-use-of-intranasal-dexmedetomidine-and-midazolam-for-sedated-magnetic-resonance-imaging-in-children-a-report-from-the-pediatric-sedation-research-consortium
#5
Carmen Sulton, Pradip Kamat, Michael Mallory, Jason Reynolds
OBJECTIVE: The objective of this study was to describe the use of intranasal dexmedetomidine (IN DEX) for sedated magnetic resonance imaging (MRI) examinations in children. The use of IN DEX for MRI in children has not been well described in the literature. MATERIALS AND METHODS: The Pediatric Sedation Research Consortium (PSRC) is a collaborative and multidisciplinary group of sedation practitioners dedicated to understanding and improving the process of pediatric sedation...
June 12, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28551041/emergency-departments-increasingly-administering-medications-through-the-nose
#6
REVIEW
Deborah L McBride
Administering medications through the nose as an alternative to intramuscular or intravenous injections is increasingly popular in emergency departments and out-of hospital settings because it is simple, fast, and can be used in situations where obtaining intravenous access is difficult or time intensive. This article examines the literature and indications for the out-of-hospital and emergency department administration of five commonly used intranasal medications: midazolam (used to sedate children and treat seizures), fentanyl (for pain relief), naloxone (for opioid overdoses), ketamine (to induce anesthesia) and dexmedetomidine (to sedate and relieve pain in children)...
May 24, 2017: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/28459726/dexmedetomidine-as-a-supplement-to-spinal-anesthesia-block-a-case-report-of-three-infants
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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...
August 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
#19
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
#20
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
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