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dexmedetomidine,fentanyl

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https://www.readbyqxmd.com/read/27869287/dexmedetomidine-for-attenuating-haemodynamic-response-to-intubation-stimuli-in-morbidly-obese-patients-anaesthetised-using-low-opioid-technique-comparison-with-fentanyl-based-general-anaesthesia
#1
Tomasz Gaszyński, Klaudia Czarnik, Łukasz Łaziński, Wojciech Gaszyński
BACKGROUND: Anaesthesiologists are facing the problem of an increasing population of morbidly obese patients. In order to minimize the risk of opioid-induced postoperative respiratory failure, the intraoperative administration of opioids should be reduced or replaced with other drugs. The purpose of this study was to compare haemodynamic response elicited by intubation in morbidly obese patients between two variants of anaesthesia induction: fentanyl-based or low-opioid using dexmedetomidine...
November 21, 2016: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/27857689/the-safety-and-efficacy-of-dexmedetomidine-vs-sufentanil-in-monitored-anesthesia-care-during-burr-hole-surgery-for-chronic-subdural-hematoma-a-retrospective-clinical-trial
#2
Wenming Wang, Lei Feng, Fenfen Bai, Zongwang Zhang, Yong Zhao, Chunguang Ren
Background: Chronic subdural hematoma (CSDH) is a very common clinical emergency encountered in neurosurgery. While both general anesthesia (GA) and monitored anesthesia care (MAC) can be used during CSDH surgery, MAC is the preferred choice among surgeons. Further, while dexmedetomidine (DEX) is reportedly a safe and effective agent for many diagnostic and therapeutic procedures, there have been no trials to evaluate the safety and efficacy of DEX vs. sufentanil in CSDH surgery. Objective: To evaluate the safety and efficacy of DEX vs...
2016: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/27847704/treatment-of-postoperative-pain-in-pediatric-operations-comparing-the-efficiency-of-bupivacaine-bupivacaine-dexmedetomidine-and-bupivacaine-fentanyl-for-caudal-block
#3
Hashem Jarineshin, Fereydoon Fekrat, Aida Kargar Kermanshah
BACKGROUND: Caudal analgesia is a common method for postoperative pain management in pediatric patients. Additive agents such as opioids and α2 agonists have been used to enhance the analgesic effects of local anesthetics for caudal block. OBJECTIVES: The aim of this study was to compare the additive effects of dexmedetomidine and fentanyl on bupivacaine-induced caudal analgesia in pediatric patients who had undergone elective inguinal hernia repair. METHODS: This randomized, double-blind clinical trial included children aged 1 - 5 years who were divided into three groups: the bupivacaine group (Group B) received 0...
October 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/27833559/the-opioid-sparing-effect-of-perioperative-dexmedetomidine-plus-sufentanil-infusion-during-neurosurgery-a-retrospective-study
#4
Shiyu Su, Chunguang Ren, Hongquan Zhang, Zhong Liu, Zongwang Zhang
Background: Approximately 60% of patients experience moderate-to-severe pain after neurosurgery, which primarily occurs in the first 24-72 h. Despite this, improved postoperative analgesia solutions after neurosurgery have not yet been devised. This retrospective study was conducted to evaluate the effect of intra- and post-operative infusions of dexmedetomidine (DEX) plus sufentanil on the quality of postoperative analgesia in patients undergoing neurosurgery. Methods: One hundred and sixty-three post-neurosurgery patients were divided into two groups: Group D (DEX infusion at 0...
2016: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/27833486/a-comparative-study-of-dexmedetomidine-and-fentanyl-as-adjuvants-to-levobupivacaine-for-caudal-analgesia-in-children-undergoing-lower-limb-orthopedic-surgery
#5
S M Elfawal, W A Abdelaal, M R Hosny
BACKGROUND: Levobupivacaine is an effective local anesthetic agent with less systemic toxicity than racemic bupivacaine, but it has short postoperative analgesic duration. Dexmedetomidine and fentanyl are promising adjuncts to provide excellent and prolonged postoperative caudal analgesia. This study compared the effects of caudal levobupivacaine plus dexmedetomidine and levobupivacaine plus fentanyl for postoperative analgesia and sedation in children undergoing lower limb orthopedic surgery...
October 2016: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/27830713/efficacy-and-acceptability-of-different-auxiliary-drugs-in-pediatric-sevoflurane-anesthesia-a-network-meta-analysis-of-mixed-treatment-comparisons
#6
Wuchao Wang, Panchuan Huang, Weiwei Gao, Fangli Cao, Mingling Yi, Liyong Chen, Xiaoli Guo
Emergence agitation preventive medicine should be combined with pediatric anesthesia because of the high frequency of emergence agitation. However, it is challenging to determine the most appropriate medication that can be introduced into pediatric anesthesia for the sake of emergence agitation prevention. We reviewed and retrieved the data from PubMed and Embase. Various medications were assessed based on several endpoints including Emergence agitation outcomes (EA), postoperative nausea and vomiting (PONV), the number of patients who required analgesic (RA), pediatric anesthesia emergence delirium (PAED), the extubation time, the emergency time and the duration of post-anesthesia care unit (PACU) stay...
November 10, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27815834/preventing-emergence-agitation-using-ancillary-drugs-with-sevoflurane-for-pediatric-anesthesia-a-network-meta-analysis
#7
Xin Wang, Qi Deng, Bin Liu, Xiangdi Yu
Using sevoflurane for pediatric anesthesia plays a pivotal role in surgeries. Emergence agitation (EA) is a major adverse event accompanied with pediatric anesthesia. Other anesthetic adjuvants can be combined with sevoflurane in clinical practices for different purposes. However, it is uncertain that such a practice may have substantial influence on the risk of EA. We conducted a literature search in online databases, including PubMed, Embase, Cochrane Library, and Clinical Trials. Key data were extracted from eligible randomized control trials (RCTs)...
November 4, 2016: Molecular Neurobiology
https://www.readbyqxmd.com/read/27811495/use-of-methohexital-and-dexmedetomidine-for-maintenance-of-anesthesia-in-a-patient-with-mitochondrial-myopathy
#8
Elliott L Woodward, Zhiling Xiong
Provision of anesthesia for patients with mitochondrial disorders is associated with a unique set of challenges. These disorders are rare, which complicates efforts to develop high quality, evidence-based guidelines to inform the perioperative management of those who suffer from them. Accordingly, case reports remain an important source of information regarding their care. Here we present the case of a 27-year-old female patient with mitochondrial myopathy and a history suggestive of malignant hyperthermia susceptibility who received general anesthesia for 2 consecutive surgeries...
November 2, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/27798810/emergence-delirium-in-pediatric-anesthesia
#9
REVIEW
Arthura D Moore, Doralina L Anghelescu
Emergence delirium (ED) is a complex of perceptual disturbances and psychomotor agitation that occurs most commonly in preschool-aged children in the early postanesthetic period. The incidence of ED varies between 10 and 80% in children and is perceived as a troublesome clinical situation by 42% of pediatric anesthesiologists. Although these events are often short lived, they increase the risk of self-injury and delayed discharge, require additional nursing staff and can increase medical care costs, all of which are causes for concern...
October 31, 2016: Paediatric Drugs
https://www.readbyqxmd.com/read/27746558/rapid-and-reliable-smooth-extubation-comparison-of-fentanyl-with-dexmedetomidine-a-randomized-double-blind-clinical-trial
#10
P Rani, V R Hemanth Kumar, M Ravishankar, T Sivashanmugam, R Sripriya, M Trilogasundary
BACKGROUND: Fentanyl and dexmedetomidine have been tried to attenuate airway and circulatory reflexes during emergence and extubation individually but have not been compared with respect to the level of sedation to evolve a reliable technique for rapid and smooth extubation. AIM: To compare the effects of fentanyl and dexmedetomidine in attenuating airway and circulatory reflexes during emergence and extubation of the endotracheal tube. SETTING AND DESIGN: This double-blind, randomized, controlled study was done in patients undergoing surgery under general anesthesia belonging to the American Society of Anesthesiologists physical status 1 or 2...
September 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/27746530/efficacy-of-dexmedetomidine-and-fentanyl-on-pressor-response-and-pneumoperitoneum-in-laparoscopic-cholecystectomy
#11
Amar Parkash Kataria, Joginder Pal Attri, Ramita Kashyap, Leena Mahajan
BACKGROUND: The advent of laparoscopic surgeries has proved to be beneficial for both patient and surgeon although increased morbidity may result from hemodynamic changes associated with laryngoscopy, intubation, and pneumoperitoneum (PNP). AIM: The present study was prospective, randomized, double-blind conducted to evaluate the efficacy of dexmdetomidine and fentanyl in attenuation of pressor responses to laryngoscopy, intubation, and PNP in laparoscopic cholecystectomy (LC)...
September 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/27729502/a-retrospective-study-of-sedation-and-analgesic-requirements-of-pediatric-patients-on-extracorporeal-membrane-oxygenation-ecmo-from-a-single-center-experience
#12
Pilar Anton-Martin, Vinai Modem, Donna Taylor, Donald Potter, Cindy Darnell-Bowens
INTRODUCTION: The purpose of this study is to describe the sedative and analgesic requirements identifying factors associated with medication escalation in neonates and children supported on ECMO. METHOD: Observational retrospective cohort study in a tertiary pediatric intensive care unit from June 2009 to June 2013. RESULTS: One hundred and sixty patients were included in the study. Fentanyl and midazolam were the first line agents used while on ECMO...
October 10, 2016: Perfusion
https://www.readbyqxmd.com/read/27693975/valproate-for-agitation-in-critically-ill-patients-a-retrospective-study
#13
David J Gagnon, Gabriel V Fontaine, Kathryn E Smith, Richard R Riker, Russell R Miller, Patricia A Lerwick, F L Lucas, John T Dziodzio, Kristen C Sihler, Gilles L Fraser
PURPOSE: The purpose was to describe the use of valproate therapy for agitation in critically ill patients, examine its safety, and describe its relationship with agitation and delirium. MATERIALS AND METHODS: This retrospective cohort study evaluated critically ill adults treated with valproate for agitation from December 2012 through February 2015. Information on valproate prescribing practices and safety was collected. Incidence of agitation, delirium, and concomitant psychoactive medication use was compared between valproate day 1 and valproate day 3...
September 11, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27687431/different-interventions-in-preventing-opioid-induced-cough-a-meta-analysis
#14
REVIEW
Li Shuying, Li Ping, Ni Juan, Luo Dong
BACKGROUND: Cough is one of the most common complications of opioids. Many studies have evaluated the effect of various drugs in preventing opioid-induced cough (OIC). However, there is existing controversy about those reports. The present study was performed to assess the efficacy of different interventions on OIC. METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, and Embase to identify randomized controlled trials on the efficacy of different drugs in the prevention of OIC...
November 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27625482/comparison-of-block-characteristics-of-spinal-anesthesia-following-intravenous-dexmedetomidine-and-clonidine
#15
Akansha Agrawal, Sanjay Agrawal, Yashwant S Payal
BACKGROUND AND AIMS: Different routes of administration of α2 adrenergic receptor agonists have been found to prolong the duration of spinal block. MATERIAL AND METHODS: One hundred and twenty patients, aged 18-60 years, of ASA physical status I or II posted for elective fixation of fractures of lower limb under spinal anesthesia were selected. Spinal anesthesia was administered with 2.5 ml of 0.5% bupivacaine mixed with 10 μg fentanyl. The patients were randomized to receive intravenous (IV) dexmedetomidine 1 μg/kg/h for 15 min followed by infusion of 0...
July 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/27610584/evaluation-of-sedatives-analgesics-and-neuromuscular-blocking-agents-in-adults-receiving-extracorporeal-membrane-oxygenation
#16
Jeremy R DeGrado, Benjamin Hohlfelder, Brianne M Ritchie, Kevin E Anger, David P Reardon, Gerald L Weinhouse
PURPOSE: The objective of this study was to evaluate the use of sedative, analgesic, and neuromuscular blocking agents (NMBAs) in patients undergoing extracorporeal membrane oxygenation (ECMO) support. MATERIALS AND METHODS: This was a 2-year, prospective, observational study of adult intensive care unit patients on ECMO support for more than 48hours. RESULTS: We analyzed 32 patients, including 15 receiving VA (venoarterial) ECMO and 17 VV (venovenous) ECMO...
August 10, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27610299/successful-management-of-dexmedetomidine-for-postoperative-intensive-care-sedation-in-a-patient-with-anti-nmda-receptor-encephalitis-a-case-report-and-animal-experiment
#17
Daiki Yamanaka, Takashi Kawano, Hiroki Tateiwa, Hideki Iwata, Fabricio M Locatelli, Masataka Yokoyama
BACKGROUND: Anti-N-methyl-d-aspartate receptor (NMDA-R) encephalitis is a recently identified but increasingly recognized autoimmune paraneoplastic disease. Because these patients present complex neuropsychiatric symptoms due to NMDA-R dysfunction, the optimal methods of sedation/anesthesia remain controversial. Here, we present animal experiment data, along with a related case report, implying the safe and effective use of dexmedetomidine in patients with anti-NMDA-R encephalitis. FINDINGS: (1) Animal experiment: in order to investigate whether dexmedetomidine may interfere with NMDA-R activity, an NMDA antagonist (MK-801) model in rats was used to simulate anti-NMDA-R encephalitis...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27606116/combination-of-continuous-dexmedetomidine-infusion-with-titrated-ultra-low-dose-propofol-fentanyl-for-an-awake-craniotomy
#18
Samaresh Das, Ali Al-Mashani, Neelam Suri, Neeraj Salhotra, Nilay Chatterjee
An awake craniotomy is a continuously evolving technique used for the resection of brain tumours from the eloquent cortex. We report a 29-year-old male patient who presented to the Khoula Hospital, Muscat, Oman, in 2016 with a two month history of headaches and convulsions due to a space-occupying brain lesion in close proximity with the left motor cortex. An awake craniotomy was conducted using a scalp block, continuous dexmedetomidine infusion and a titrated ultra-low-dose of propofolfentanyl. The patient remained comfortable throughout the procedure and the intraoperative neuropsychological tests, brain mapping and tumour resection were successful...
August 2016: Sultan Qaboos University Medical Journal
https://www.readbyqxmd.com/read/27554227/effect-of-continuous-paravertebral-dexmedetomidine-administration-on-intraoperative-anesthetic-drug-requirement-and-post-thoracotomy-pain-syndrome-after-thoracotomy-a-randomized-controlled-trial
#19
Vikas Dutta, Bhupesh Kumar, Aveek Jayant, Anand K Mishra
OBJECTIVES: To assess the effect of paravertebral administration of dexmedetomidine as an adjuvant to local anesthetic on the intraoperative anesthetic drug requirement and incidence of post-thoracotomy pain syndrome. DESIGN: Prospective, randomized, controlled, double-blind trial. SETTING: Single university hospital. PARTICIPANTS: The study comprised 30 patients who underwent elective thoracotomy and were assigned randomly to either the Ropin or Dexem group (n = 15 each)...
May 31, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27510395/comparison-of-an-intraoperative-infusion-of-dexmedetomidine-fentanyl-and-remifentanil-on-perioperative-hemodynamics-sedation-quality-and-postoperative-pain-control
#20
Jin Woo Choi, Jin Deok Joo, Dae Woo Kim, Jang Hyeok In, So Young Kwon, Kwonhui Seo, Donggyu Han, Ga Young Cheon, Hong Soo Jung
We aimed to compare fentanyl, remifentanil and dexmedetomidine with respect to hemodynamic stability, postoperative pain control and achievement of sedation at the postanesthetic care unit (PACU). In this randomized double-blind study, 90 consecutive total laparoscopic hysterectomy patients scheduled for elective surgery were randomly assigned to receive fentanyl (1.0 μg/kg) over 1 minute followed by a 0.4 μg/kg/hr infusion (FK group, n = 30), or remifentanil (1.0 μg/kg) over 1 minute followed by a 0.08 μg/kg/min infusion (RK group, n = 30), or dexmedetomidine (1 μg/kg) over 10 minutes followed by a 0...
September 2016: Journal of Korean Medical Science
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