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intranasal dexmedetomidine, emergence agitation

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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
#1
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/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/28259526/review-of-intranasally-administered-medications-for-use-in-the-emergency-department
#3
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...
July 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27776827/intranasal-dexmedetomidine-sedation-as-adjuvant-therapy-in-acute-asthma-exacerbation-with-marked-anxiety-and-agitation
#4
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/27555179/efficacy-of-premedication-with-intranasal-dexmedetomidine-on-inhalational-induction-and-postoperative-emergence-agitation-in-pediatric-undergoing-cataract-surgery-with-sevoflurane
#5
RANDOMIZED CONTROLLED TRIAL
Yiquan Lin, Ying Chen, Jingxia Huang, Hongbin Chen, Weihua Shen, Wenjun Guo, Qianru Chen, Hongfeng Ling, Xiaoliang Gan
STUDY OBJECTIVES: This study aimed to test the hypothesis that premedication with a single dose of intranasal dexmedetomidine (DEX) could not only reduce preoperative anxiety but also minimize the emergence agitation in children undergoing cataract surgery with sevoflurane anesthesia. DESIGN: Single-blinded, randomized, placebo-controlled clinical comparison study. SETTING: Academic medical center. PATIENTS: Ninety American Society of Anesthesiologists physical status 1 and 2 children scheduled for cataract surgery...
September 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27212773/comparison-of-intranasal-dexmedetomidine-and-dexmedetomidine-ketamine-for-premedication-in-pediatrics-patients-a-randomized-double-blind-study
#6
Ravi Bhat, M C B Santhosh, Venkatesh M Annigeri, Raghavendra P Rao
BACKGROUND: Goal of premedication in pediatric anesthesia are relieving pre and postoperative anxiety, good parental separation, and smooth induction of anesthesia. Anxiety can produce aggressive reactions, increased distress, increased postoperative pain and postoperative agitation. The benzodiazepine, midazolam, is the most frequently used premedication in pediatric anesthesia. Midazolam has a number of beneficial effects when used as premedication in children: Sedation, fast onset, and limited duration of action...
May 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/25710047/emergence-agitation-prevention-in-paediatric-ambulatory-surgery-a-comparison-between-intranasal-dexmedetomidine-and-clonidine
#7
Anindya Mukherjee, Anjan Das, Sandip Roy Basunia, Surajit Chattopadhyay, Ratul Kundu, Raghunath Bhattacharyya
OBJECTIVE: Emergence agitation (EA), a short-lived, self-limiting phenomenon, arises frequently after the use of inhalational agents and hampers the implementation of pediatric ambulatory surgery in spite of using so many drugs with variable efficacy. METHODS: In this prospective, double-blinded, parallel group study (2008-2009), 80 children of both sex aged 3-7 years, with American Society of Anesthesiologists (ASA) physical status grade I-II, undergoing sevoflurane-based general anesthesia for elective day care surgery were randomly assigned into groups C or D...
January 2015: Journal of Research in Pharmacy Practice
https://www.readbyqxmd.com/read/22268591/dexmedetomidine-vs-midazolam-for-premedication-of-pediatric-patients-undergoing-anesthesia
#8
RANDOMIZED CONTROLLED TRIAL
Aynur Akin, Adnan Bayram, Aliye Esmaoglu, Zeynep Tosun, Recep Aksu, Resul Altuntas, Adem Boyaci
BACKGROUND: Dexmedetomidine, an α(2)-receptor agonist, provides sedation, analgesia, and anxiolytic effects, and these properties make it a potentially useful anesthetic premedication. In this study, we compared the effects of intranasal dexmedetomidine and midazolam on mask induction and preoperative sedation in pediatric patients. METHODS: Ninety children classified as ASA physical status I, aged between 2 and 9, who were scheduled to undergo an elective adenotonsillectomy, were enrolled for a prospective, randomized, and double-blind controlled trial...
September 2012: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/21575102/the-effect-of-dexmedetomidine-during-myringotomy-and-pressure-equalizing-tube-placement-in-children
#9
RANDOMIZED CONTROLLED TRIAL
Sophie R Pestieau, Zenaide M N Quezado, Yewande J Johnson, Jennifer L Anderson, Yao I Cheng, Robert J McCarter, Maria T Pena, Julia C Finkel
BACKGROUND: Bilateral myringotomy (BMT) is a commonly performed otolaryngologic procedure in children. OBJECTIVES: To examine the effects of intranasal dexmedetomidine, an α(2)-adrenoceptor agonist, on time-averaged pain scores, pain control, need for rescue analgesia, and agitation scores in children undergoing BMT. METHODS: We designed a trial to enroll 160 children randomized to one of four groups: two study groups, dexmedetomidine (1 or 2 μg·kg(-1)), or two control groups representing our institutional standards of practice (intranasal fentanyl-2 μg·kg(-1) or acetaminophen as needed postoperatively)...
November 2011: Paediatric Anaesthesia
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