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dexmedetomidine AND peripheral nerve blocks

Elham Memari, Mohammad-Ali Hosseinian, Ali Mirkheshti, Ali Arhami-Dolatabadi, Mojtaba Mirabotalebi, Mohsen Khandaghy, Yahya Daneshbod, Leila Alizadeh, Sadegh Shirian
Injection of a variety of drugs such as local anesthetics (LAs) for peripheral nerve block has been shown to cause damage to peripheral nerves. Bupivacaine is a local anesthetic widely used in surgical procedures. The aim of this study was to evaluate the neurotoxicity of LAs including Bupivacaine and dexmedetomidine (DEX)-Bupivacaine on sciatic nerve tissue at histopathological level. In addition, we investigated whether perineural administration of DEX can attenuate Bupivacaine-induced neurotoxicity. Twenty adult Sprague Dawley rats received unilateral sciatic nerve blocks with either 0...
September 17, 2016: Experimental and Toxicologic Pathology: Official Journal of the Gesellschaft Für Toxikologische Pathologie
S Khandaitkar, V Kolte, S R Shenoi, N Budhraja
Dexmedetomidine is a selective alpha-2-adrenoceptor agonist used as an adjuvant for regional anaesthesia. We studied its efficacy as an adjuvant to lidocaine in infraorbital nerve block in 90 patients divided equally into three groups. The first group (control) was given 2% lidocaine 2ml only, the second, 2% lidocaine 2ml with dexmedetomidine 14μg peripherally (peripheral group), and the third, 2% lidocaine 2ml peripherally with dexmedetomidine 14μg systemically (systemic group). Onset of anaesthesia, duration of action, blood pressure, oxygen saturation, and heart rate were evaluated...
August 10, 2016: British Journal of Oral & Maxillofacial Surgery
Nurgül Dolu, Levent Şahin, Davut Sinan Kaplan, Tuncer Demir, Hasan Şimşek, Mehrican Şahin, Beyhan Cengiz
BACKGROUND/AIM: The objective of this experimental study was to examine the effects of epinephrine, dexmedetomidine, and clonidine added as adjuvants to bupivacaine on block onset and effect times, as well as the effects on the Na+ and Ca+2 channel gene expressions, which may indicate cell damage in the sciatic nerve cell membrane. MATERIALS AND METHODS: Rats were divided into five groups: Group S (sham), saline solution; Group B, bupivacaine; Group BD, bupivacaine + dexmedetomidine; Group BC, bupivacaine + clonidine; and Group BE, bupivacaine + epinephrine...
April 19, 2016: Turkish Journal of Medical Sciences
Sung Hye Byun, Jonghoon Lee, Jong Hae Kim
BACKGROUND: Patients on antiplatelet therapy following percutaneous coronary intervention can become coagulopathic due to infection. Performing regional anesthesia for bilateral surgery in such cases is challenging. We report a case of successful combined inguinal femoral and subgluteal sciatic nerve blocks (CFSNBs) for simultaneous bilateral below-knee amputations in a coagulopathic patient on antiplatelet therapy. METHODS: A 70-year-old male patient presented with pain in both feet due to diabetic foot syndrome...
July 2016: Medicine (Baltimore)
Thomas A Trein, Beatriz P Floriano, Juliana T Wagatsuma, Joana Z Ferreira, Guilherme L da Silva, Paulo Sp Dos Santos, Sílvia Hv Perri, Valéria Nls Oliva
OBJECTIVE: To evaluate motor and sensory blockade of combining dexmedetomidine with ropivacaine, administered perineurally or systemically, for femoral and sciatic nerve blocks in conscious dogs. STUDY DESIGN: Randomized, controlled, experimental study. ANIMALS: Seven healthy Beagle dogs, aged 3.3 ± 0.1 years and weighing 11.0 ± 2.4 kg. METHODS: Dogs were anesthetized with isoflurane on three separate occasions for unilateral femoral and sciatic nerve blocks and were administered the following treatments in random order: perineural ropivacaine 0...
June 28, 2016: Veterinary Anaesthesia and Analgesia
Yuechun Lu, Jian Sun, Xinqi Zhuang, Guoyi Lv, Yize Li, Haiyun Wang, Guolin Wang
UNLABELLED: Research suggests that the addition of dexmedetomidine to local anesthetics can prolong peripheral nerve blocks; however, it is not known whether dexmedetomidine can reduce the quantity of local anesthetic needed. We hypothesized that adding dexmedetomidine as an adjuvant to an obturator nerve block could reduce the median effective concentration of lidocaine. In this double-blinded randomized trial, 60 patients scheduled for elective transurethral resection of bladder tumors on the lateral wall were randomly divided into two groups: the control group (C group, n = 30) and the dexmedetomidine group (D group, n = 30)...
2016: PloS One
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
Ananda Bangera, Mukka Manasa, Prasad Krishna
BACKGROUND: Addition of dexmedetomidine to ropivacaine for peripheral nerve blocks has shown to improve the efficacy of ropivacaine by prolonging the duration of analgesia. This study was undertaken to evaluate the effects of ropivacaine alone and in combination with dexmedetomidine in the axillary block. MATERIALS AND METHODS: A total of 80 patients belonging to American Society of Anesthesiologists physical status I, II, and III, scheduled for elective forearm and/or hand surgeries were randomly allocated into one of the two groups to receive either 39 ml of 0...
January 2016: Saudi Journal of Anaesthesia
Shalini Pravin Sardesai, Kalyani Nilesh Patil, Adnanali Sarkar
BACKGROUND AND AIMS: Intravenous regional anaesthesia (IVRA) provides reliable and rapid analgesia with good muscular relaxation of the extremity distal to the tourniquet, but tourniquet pain and absence of post-operative analgesia are major drawbacks. α2 agonists, clonidine and dexmedetomidine are known to potentiate peripheral nerve blocks. The aim of this study was to compare clonidine and dexmedetomidine as adjuvants to IVRA with respect to block characteristics, tourniquet pain and post-operative analgesia...
November 2015: Indian Journal of Anaesthesia
Märit Lundblad, Mehdi Trifa, Olfa Kaabachi, Sonia Ben Khalifa, Amjed Fekih Hassen, Thomas Engelhardt, Staffan Eksborg, Per-Arne Lönnqvist
BACKGROUND: Adult meta-analyses have verified that adjunct use of alpha-2 adrenoceptor agonists (A2AA) together with local anesthetics (LA) will prolong the duration of peripheral nerve blocks. The standard use of A2AAs for peripheral nerve blockade has recently been recommended also in children, but the evidence base in support of this suggestion has to date been equivocal. The purpose of this meta-analysis was to produce evidence-based data regarding the effect in children. METHODS: Following a thorough literature search, five randomized controlled trials were included in a meta-analysis...
March 2016: Paediatric Anaesthesia
Faraj W Abdallah, Tim Dwyer, Vincent W S Chan, Ahtsham U Niazi, Darrell J Ogilvie-Harris, Stephanie Oldfield, Rajesh Patel, Justin Oh, Richard Brull
BACKGROUND: Perineural and IV dexmedetomidine have each been suggested to prolong the duration of analgesia when administered in conjunction with peripheral nerve blocks. In the first randomized, triple-masked, placebo-controlled trial to date, the authors aimed to define and compare the efficacy of perineural and IV dexmedetomidine in prolonging the analgesic duration of single-injection interscalene brachial plexus block (ISB) for outpatient shoulder surgery. METHODS: Ninety-nine patients were randomized to receive ISB using 15 ml ropivacaine, 0...
March 2016: Anesthesiology
Chun-Guang Wang, Yan-Ling Ding, Ai-Ping Han, Chang-Qing Hu, Shi Hao, Fang-Fang Zhang, Yong-Wang Li, Hu Liu, Zhe Han, De-Li Guo, Zhi-Qiang Zhang
The ischemia necrosis of limb frequently requires surgery of amputation. Lumbar plexus and sciatic nerve block is an ideal intra-operative anesthetic and post-operative antalgic technique for patients of amputation, especially for high-risk patients who have severe cardio-cerebrovascular diseases. However, the duration of analgesia of peripheral nerve block is hardly sufficient to avoid the postoperative pain and the usage of opioids. In this case, a 79-year-old man, with multiple cerebral infarcts, congestive heart failure, atrial flutter and syncope, was treated with an above knee amputation because of ischemia necrosis of his left lower limb...
2015: International Journal of Clinical and Experimental Medicine
Meghan A Kirksey, Stephen C Haskins, Jennifer Cheng, Spencer S Liu
BACKGROUND: The use of peripheral nerve blocks for anesthesia and postoperative analgesia has increased significantly in recent years. Adjuvants are frequently added to local anesthetics to prolong analgesia following peripheral nerve blockade. Numerous randomized controlled trials and meta-analyses have examined the pros and cons of the use of various individual adjuvants. OBJECTIVES: To systematically review adjuvant-related randomized controlled trials and meta-analyses and provide clinical recommendations for the use of adjuvants in peripheral nerve blocks...
2015: PloS One
Joshua B Knight, Nicholas J Schott, Michael L Kentor, Brian A Williams
PURPOSE OF REVIEW: This review outlines the analgesic role of perineural adjuvants for local anesthetic nerve block injections, and evaluates current knowledge regarding whether adjuvants modulate the neurocytologic properties of local anesthetics. RECENT FINDINGS: Perineural adjuvant medications such as dexmedetomidine, clonidine, buprenorphine, dexamethasone, and midazolam play unique analgesic roles. The dosing of these medications to prevent neurotoxicity is characterized in various cellular and in-vivo models...
October 2015: Current Opinion in Anaesthesiology
Märit Lundblad, Daniela Marhofer, Staffan Eksborg, Per-Arne Lönnqvist
BACKGROUND: Adult meta-analysis has identified dexmedetomidine as a potentially useful adjunct to prolong the duration of peripheral nerve blocks. However, no data exist regarding the adjuvant use of dexmedetomidine in the setting of pediatric peripheral nerve blocks. METHODS: Using a prospective, randomized, double-blind design, children (1½-8 years, ASA 1-2) scheduled for outpatient inguinal hernia repair were randomized to receive either an ultrasound-guided ilioinguinal/iliohypogastric nerve block (IINB) with plain ropivacaine 0...
September 2015: Paediatric Anaesthesia
Oriana Ng, Sze Ying Thong, Claramae Shulyn Chia, Melissa Ching Ching Teo
Patients presenting for emergency abdominal procedures often have medical issues that cause both general anaesthesia and central neuraxial blockade to pose significant risks. Regional anaesthetic techniques are often used adjunctively for abdominal procedures under general anaesthesia, but there is limited published data on procedures done under peripheral nerve or plexus blocks. We herein report the case of a patient with recent pulmonary embolism and supraventricular tachycardia who required colostomy refashioning...
May 2015: Singapore Medical Journal
Suneet Kathuria, Shikha Gupta, Ira Dhawan
CONTEXT: Dexmedetomidine as an adjuvant to local anesthetics in peripheral nerve blocks has been used in only a few studies. AIMS: We aimed at assessing the effect of dexmedetomidine as an adjuvant to ropivacaine in supraclavicular brachial plexus block. SETTINGS AND DESIGN: Random, controlled, and triple blind. MATERIALS AND METHODS: Sixty American Society of Anesthesiologist grade I and II patients of either sex scheduled for elective upper limb surgery under supraclavicular brachial plexus block were divided into three equal groups in a prospective randomized double-blind controlled manner...
April 2015: Saudi Journal of Anaesthesia
Maya Keplinger, Peter Marhofer, Stephan C Kettner, Daniela Marhofer, Oliver Kimberger, Markus Zeitlinger
BACKGROUND: Previous data have indicated the efficacy of dexmedetomidine as an additive to peripheral regional anaesthesia. There are no pharmacodynamic data regarding the addition of dexmedetomidine to local anaesthetics for perineural administration. OBJECTIVE: The objective of this study is to assess the dose-dependency of dexmedetomidine when injected with ropivacaine for peripheral nerve blockade. DESIGN: A randomised, triple-blind, controlled study in volunteers...
November 2015: European Journal of Anaesthesiology
Atsushi Fujiwara, Nobuyasu Komasawa, Toshiaki Minami
A 71-year-old man was scheduled to undergo cardiac resynchronization therapy device (CRTD) implantation. He was combined with severe chronic heart failure due to ischemic heart disease. NYHA class was 3 to 4 and electrocardiogram showed non-sustained ventricular. Ejection fraction was about 20% revealed by transthoracic echocardiogram. He was also on several anticoagulation medications. We planned to implant the device under the greater pectoral muscle. As general anesthesia was considered risky, monitored anesthesia care utilizing peripheral nerve block and slight sedation was scheduled...
2014: SpringerPlus
Jang-Ho Song, Hee Yong Shim, Tong Joo Lee, Jong-Kwon Jung, Young-Deog Cha, Doo Ik Lee, Gun Woo Kim, Jeong Uk Han
BACKGROUND: Dexmedetomidine extends the duration of nerve block when administered perineurally together with local anesthetics by central and/or peripheral action. In this study, we compared the duration of nerve block between dexmedetomidine and epinephrine as an adjuvant to 1% mepivacaine in infraclavicular brachial plexus block. METHODS: Thirty patients, scheduled for upper limb surgery were assigned randomly to 3 groups of 10 patients each. We performed brachial plexus block using a nerve stimulator...
April 2014: Korean Journal of Anesthesiology
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