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Intrathecal dexmedetomidine

Sahar Abd-Elbaky Mohamed, Ahmad Mohammad Abd El-Rahman, Khaled M Fares
BACKGROUND: Intrathecal ketamine has been studied extensively in animals, but rarely in humans. Intrathecal dexmedetomidine prolongs the duration of spinal anesthesia. OBJECTIVE: To investigate the efficacy and safety of intrathecal dexmedetomidine, ketamine, or both when added to bupivacaine for postoperative analgesia in major abdominal cancer surgery. DESIGN: Double-blinded, randomized, controlled trial. SETTING: Academic medical center...
July 2016: Pain Physician
Xiaofei Qi, Daili Chen, Gehui Li, Xiaolei Huang, Yuantao Li, Xiaoguang Wang, Yong Li
To compare the effects of intrathecal dexmedetomidine and intrathecal morphine as supplements to bupivacaine in cesarean sections under spinal anesthesia. Full-term parturients (n=120) undergoing elective cesarean sections under spinal anesthesia were randomly allocated into three groups: Group B received 10 mg bupivacaine, Group BD received 10 mg bupivacaine plus 5 µg dexmedetomidine, and Group BM received 10 mg bupivacaine plus 100 µg morphine. The onset and regression time of sensory and motor blockade, postoperative analgesia, and side effects were recorded...
September 1, 2016: Biological & Pharmaceutical Bulletin
Pranjali Kurhekar, S Madan Kumar, D Sampath
BACKGROUND AND AIMS: Inrathecal opioids like morphine added to local anaesthetic agents have been found to be effective in achieving prolonged post-operative analgesia. Intrathecal dexmedetomidine may be devoid of undesirable side effects related to morphine and hence, this study was designed to evaluate analgesic efficacy, haemodynamic stability and adverse effects of both these adjuvants in patients undergoing gynaecological surgeries. METHODS: This was a prospective, randomised, double blind study involving 25 patients in each group...
June 2016: Indian Journal of Anaesthesia
Usha Shukla, Tallamraju Prabhakar, Kiran Malhotra, Dheeraj Srivastava
BACKGROUND AND AIMS: Trials are being carried out to identify an adjuvant to intrathecal bupivacaine that preferably potentiates postoperative analgesia. This prospective, randomized, double-blind study was aimed to compare the onset and duration of sensory and motor block, postoperative analgesia and adverse effects of dexmedetomidine or midazolam given with 0.5% hyperbaric bupivacaine for spinal anesthesia. MATERIAL AND METHODS: A total of 80 patients, scheduled for vaginal hysterectomies, were randomly allocated to Group D (n = 40) to receive intrathecally 3...
April 2016: Journal of Anaesthesiology, Clinical Pharmacology
Jyotsna Kubre, Ashish Sethi, Mamta Mahobia, Deeksha Bindal, Neeraj Narang, Anudeep Saxena
BACKGROUND AND INTRODUCTION: Spinal block, a known technique to obtain anaesthesia for infraumblical surgeries. Now physician have advantage of using adjuvant to prolong the effect of intrathecal block, which can be given either intravenously or intrathecally, dexmedetomidine is one of them. We studied effect of intravenous dexmedetomidine for prolongation of duration of intrathecal block of 0.5% bupivacaine block. OBJECTIVE: To evaluate the effect of intravenous dexmedetomidine on sensory regression, hemodynamic profile, level of sedation and postoperative analgesia...
May 2016: Anesthesia, Essays and Researches
Shagufta Naaz, Jahanara Bandey, Erum Ozair, Adil Asghar
BACKGROUND: Dexmedetomidine, a selective alpha2 adrenoceptor agonist, has been used as adjuvant to spinal anaesthesia. AIM: To find out the optimum dose of dexmedetomidine to be used in lower abdomen surgery intrathecally. MATERIALS AND METHODS: This was a randomized, controlled, double blinded study which included adult ASA I and II patients. They were allocated into five groups (n=20). Patients allergic to drugs to be used in the study and those with co-existing neurological disorders, coagulopathies, cardiac diseases, obesity and hypertension were excluded...
April 2016: Journal of Clinical and Diagnostic Research: JCDR
Sisinti Sanjeeb Patro, Hemant Deshmukh, Yerramalli Roja Ramani, Gitanjali Das
INTRODUCTION: Various adjuvants like morphine, buprenorphine and fentanyl, clonidine, ketamine are being used in anaesthetic practice since long for improvement of peri-operative analgesia following spinal anaesthesia. Such adjuvants have been helpful in induction of early ambulation but at the cost of their associated adverse effects. Therefore search for an effective adjuvant is still going on. Currently Dexmedetomidine, a highly selective α2-adrenoreceptor agonist is being studied for its adjuvant action in spinal anaesthesia...
March 2016: Journal of Clinical and Diagnostic Research: JCDR
Farhad Safari, Reza Aminnejad, Seyed Amir Mohajerani, Farshad Farivar, Kamran Mottaghi, Hasan Safdari
BACKGROUND: Addicted patients have innate tolerance to local anesthetics in both neuraxial and peripheral blocks. Dexmedetomidine (Dex) is a highly selective α2 adrenergic receptor agonist used as additive to increase quality and duration of peripheral nerve blocks. OBJECTIVES: The current study aimed to compare the effect of dexmedetomidine and fentanyl additives on bupivacaine to prolong the duration of block and minimizing side effects. PATIENTS AND METHODS: Patients were candidates for elective surgery less than three hours of lower abdomen or lower extremities surgeries...
February 2016: Anesthesiology and Pain Medicine
Mayank Gupta, Priyanka Gupta, Dhananjay Kumar Singh
BACKGROUND: The extended analgesic efficacy of intrathecal dexmedetomidine (ITD) has been investigated in a few clinical trials; however, there is a lack of conclusive evidence upon its ideal dosage. OBJECTIVES: To elucidate the dose-response relationship between ITD and subarachnoid block characteristics, particularly the duration of analgesia and differential analgesia (DA: defined as time difference from the offset of motor blockade to the first analgesic requirement on numerical rating scale = 4...
March 2016: Pain Physician
Hala Saad Abdel-Ghaffar, Sahar Abdel-Baky Mohamed, Khaled Mohamed Fares
OBJECTIVE: To compare the analgesic effect of combined intrathecal morphine and dexmedetomidine with either drug alone for postoperative analgesia in patients undergoing major abdominal cancer surgery. METHODS: Ninety patients were allocated to receive intrathecal 10 mg bupivacaine 0.5% (bupivacaine group, n = 30), 10 mg bupivacaine 0.5% and 0.5 mg morphine (Morphine Group, n = 30), or 10 mg bupivacaine 0.5%, 0.5 mg morphine and 5 µg dexmedetomidine (morphine-Dex group, n = 30)...
March 21, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Xiaofei Qi, Yuantao Li, Niels Rahe-Meyer, Xiaolei Huang, Yin Gu, Xiaoguang Wang, Yong Li, Yajie Wen
BACKGROUND: To compare the effects and side effects of intrathecal ropivacaine supplemented with dexmedetomidine and fentanyl in hysteroscopic surgery under spinal anesthesia. METHODS: Female patients (n = 108) undergoing operative hysteroscopic procedures under spinal anesthesia were randomly allocated to the following groups for subarachnoid drug delivery: R (n = 36) received 7.5 mg ropivacaine; RD (n = 36) received 7.5 mg ropivacaine plus 5 μg dexmedetomidine; RF (n = 36) received 7...
March 2016: International Journal of Clinical Pharmacology and Therapeutics
Hugh D de Pereira Cardoso, Natalie C Fim, Mariangela A Marques, Helio Mint, Vania M de Vasconcelos Machado, Daneshvari R Solanki, Rodrigo Moreira Lima, Ana L de Carvalho, Lais H Navarro, Eliana M Ganem
BACKGROUND: There is experimental evidence that dexmedetomidine has neuroprotective effects. So, it could be expected that its intrathecal or epidural administration presents no harm. However, whether dexmedetomidine is neurotoxic to the spinal cord remains to be fully elucidated. OBJECTIVE: To evaluate the effect of preservative-free dexmedetomidine administered as a subarachnoid single injection on the spinal cord and meninges of rabbits. STUDY DESIGN: Research article...
February 2016: Pain Physician
Atul Kumar Singh, Yashpal Singh, Gaurav Jain, Ravi Kumar Verma
BACKGROUND: To augment the subarachnoid block utility, the efficacy of newer molecules as an adjuvant is investigated constantly. Considering the favorable profile of dexmedetomidine, it could have a potential role as an adjuvant to ropivacaine. AIM: We evaluated the efficacy of two different doses of dexmedetomidine as an adjuvant to isobaric ropivacaine, intrathecally. METHODS: Ninety patients scheduled for lower abdominal surgery under spinal anesthesia were randomized into three groups to receive 2...
September 2015: Anesthesia, Essays and Researches
Tarundeep Bhatia, Jaideep Bhatia, Joginder Pal Attri, Sukhpreet Singh, Ranjana Khetarpal
BACKGROUND: General anesthesia as a technique for laparoscopic cholecystectomies has disadvantage in terms of the stress response, lack of postoperative analgesia and emesis. Regional anesthesia offers advantages over general anesthesia in terms of cost, postoperative analgesia, intact respiratory control mechanism and early ambulation. Shoulder tip pain remains the main concerns that can be alleviated by adding various adjuvants to local anesthetics. AIMS AND OBJECTIVES: To study the effect of adding intrathecal dexmedetomidine to bupivacaine to decrease shoulder tip pain, onset and duration of sensory and motor block, hemodynamic changes and side effects if any...
September 2015: Anesthesia, Essays and Researches
R A Salem, E I Darweesh, M A Wanis, A A Mohamed
OBJECTIVE: To evaluate the efficacy of intrathecal dexmedetomidine at improving the quality of the operative field, and prolonging the duration of sensory block, motor block, and postoperative analgesia during spinal surgery PATIENTS AND METHODS: This prospective, double-blinded, randomized controlled study included 52 patients undergoing an instrumented one-level posterolateral lumbar spine fusion for lumbar spondylolisthesis under spinal anesthesia. The patients were randomized into two groups: group D (n = 26) received 15 mg of hyperbaric bupivacaine with 5 μg of dexmedetomidine, while group P (n = 26) received 15 mg of hyperbaric bupivacaine only...
December 2015: European Review for Medical and Pharmacological Sciences
K Sudheesh, Rs Raghavendra Rao, M Kavya, J Aarthi, D Devika Rani, S S Nethra
BACKGROUND AND AIMS: Dexmedetomidine (DMT), as intrathecal adjuvant has been shown to successfully prolong duration of analgesia but delay the motor recovery. Hence, this study was designed to find out the dose of DMT which can provide satisfactory analgesia without prolonging motor block. METHODS: A total of 50 patients scheduled for elective perianal surgeries were randomly allocated to Groups C or D (n = 25). Group D received hyperbaric bupivacaine 0.5% 4 mg + DMT 5 μg and Group C received hyperbaric bupivacaine 0...
October 2015: Indian Journal of Anaesthesia
Xiao Liang, Miao Zhou, Jiao-Jiao Feng, Liang Wu, Shang-Ping Fang, Xin-Yu Ge, Hai-Jing Sun, Peng-Cheng Ren, Xin Lv
PURPOSE: Postoperative nausea and vomiting (PONV) is a frequent complication in postoperative period. The aim of the current meta-analysis was to assess the efficacy of dexmedetomidine on PONV. METHODS: Two researchers independently searched PubMed, Embase and Cochrane Central Register of Controlled Trials for randomized controlled trials (RCTs). The meta-analysis was performed with Review Manager. RESULTS: Eighty-two trials with 6,480 patients were included in this meta-analysis...
2015: International Journal of Clinical and Experimental Medicine
Changsheng Zhang, Changtian Li, Massimiliano Pirrone, Li Sun, Weidong Mi
The authors performed a meta-analysis to compare the characteristics of clonidine and dexmedetomidine as adjuvants to local anesthetic in intravertebral anesthesia. Four investigators independently searched electronic databases for randomized trials comparing the characteristics of clonidine vs dexmedetomidine as adjuvants to local anesthetic on adults. The endpoints were onset of analgesia, sensory and motor block, and duration of analgesia. A random-effects model was used to perform quantitative analysis...
July 2016: Journal of Clinical Pharmacology
Jahnabee Sarma, P Shankara Narayana, P Ganapathi, M C Shivakumar
INTRODUCTION: Intrathecal clonidine or dexmedetomidine has improved the quality of spinal anesthesia, this clinical study was undertaken to assess the behavior of intrathecal clonidine as an adjuvant to bupivacaine in augmenting sensory block in patients undergoing lower limb surgeries. MATERIALS AND METHODS: We studied 150 patients, between 18 and 60 years of age, patients were randomly divided into three groups of 50 each Group B: 0.5% bupivacaine 15 mg + 0.5 ml normal saline Group C: 0...
May 2015: Anesthesia, Essays and Researches
Aamir Laique Khan, Raj Bahadur Singh, Rajni K Tripathi, Sanjay Choubey
CONTEXT: Spinal anesthesia is preferred choice of anesthesia in lower abdominal surgeries since long time. However problem with this is limited duration of action, so for long duration surgeries alternative are required. Dexmedetomidine is a highly selective alpha-2-adrenergic agonist has property to potentiate the action of local anesthetic used in spinal anesthesia. Fentanyl is an opioid and it has also the same property. AIMS: To compare the efficacy, analgesic effects, and side-effects of dexmedetomidine and fentanyl as adjuvant to bupivacaine for lower abdominal surgery...
May 2015: Anesthesia, Essays and Researches
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