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https://www.readbyqxmd.com/read/28974331/major-publications-in-the-critical-care-pharmacotherapy-literature-january-december-2016
#1
REVIEW
Deanna Horner, Diana Altshuler, Chris Droege, Joel Feih, Kevin Ferguson, Mallory Fiorenza, Kasey Greathouse, Leslie Hamilton, Caitlin Pfaff, Lauren Roller, Joanna Stollings, Adrian Wong
PURPOSE: To summarize select critical care pharmacotherapy guidelines and studies published in 2016. SUMMARY: The Critical Care Pharmacotherapy Literature Update (CCPLU) Group screened 31 journals monthly for relevant pharmacotherapy articles and selected 107 articles for review over the course of 2016. Of those included in the monthly CCPLU, three guidelines and seven primary literature studies are reviewed here. The guideline updates included are as follows: hospital-acquired pneumonia and ventilator-associated pneumonia management, sustained neuromuscular blocking agent use, and reversal of antithrombotics in intracranial hemorrhage (ICH)...
September 22, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28969013/low-dose-of-dexmedetomidine-as-an-adjuvant-to-bupivacaine-in-cesarean-surgery-provides-better-intraoperative-somato-visceral-sensory-block-characteristics-and-postoperative-analgesia
#2
Yong-Hong Bi, Xiao-Guang Cui, Rui-Qin Zhang, Chun-Yu Song, Yan-Zhuo Zhang
OBJECT: In this study, we aimed to investigate the beneficial effects of dexmedetomidine on somato-visceral sensory block characteristcs, postoperative analgesia and stress response of intrathecal bupivacaine administration in women undergoing cesarean section, and to find out which dose is better. METHODS: Sixty parturients with the American Society of Anesthesiologists (ASA) physical status I or II were anesthetized with intrathecal bupivacaine(10mg) alone or in combination with dexmedetomidine (3 μg and 5 μg) to undergo cesarean section...
September 8, 2017: Oncotarget
https://www.readbyqxmd.com/read/28967478/partial-neuromuscular-block-impairs-arytenoid-abduction-during-hypercarbic-challenge-in-anesthetized-dogs
#3
Chia T Tseng, Daniel M Sakai, Madeline Libin, Monika Mostowy, Jonathan Cheetham, Luis Campoy, Robin D Gleed, Manuel Martin-Flores
OBJECTIVE: To evaluate the effect of two levels of partial neuromuscular block (NMB) on arytenoid abduction, tidal volume (VT) and peak inspiratory flow (PIF) in response to a hypercarbic challenge in anesthetized dogs. STUDY DESIGN: Prospective laboratory study. ANIMALS: Eleven healthy male Beagle dogs aged 3-5 years. METHODS: Dogs were anesthetized with propofol and dexmedetomidine infusions. The rima glottidis was observed via an endoscope placed through a laryngeal mask airway...
June 7, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28932733/pectoral-nerve-block-pecs-block-with-sedation-for-breast-conserving-surgery-without-general-anesthesia
#4
Eun-Jin Moon, Seung-Beom Kim, Jun-Young Chung, Jeong-Yoon Song, Jae-Woo Yi
Most regional anesthesia in breast surgeries is performed as postoperative pain management under general anesthesia, and not as the primary anesthesia. Regional anesthesia has very few cardiovascular or pulmonary side-effects, as compared with general anesthesia. Pectoral nerve block is a relatively new technique, with fewer complications than other regional anesthesia. We performed Pecs I and Pec II block simultaneously as primary anesthesia under moderate sedation with dexmedetomidine for breast conserving surgery in a 49-year-old female patient with invasive ductal carcinoma...
September 2017: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/28928579/to-evaluate-the-efficacy-of-fentanyl-and-dexmedetomidine-as-adjuvant-to-ropivacaine-in-brachial-plexus-block-a-double-blind-prospective-randomized-study
#5
Nyla Farooq, Raj Bahadur Singh, Arindam Sarkar, Mohd Asim Rasheed, Sanjay Choubey
CONTEXT: Anesthesia and analgesia for surgeries to the upper extremity are commonly provided using brachial plexus anesthesia. There are limited or almost no studies comparing the use of ropivacaine with fentanyl to ropivacaine with dexmedetomidine. AIMS: To compare the efficacy of fentanyl and dexmedetomidine as adjuvants to ropivacaine for brachial plexus block among patients undergoing upper limb orthopedic surgeries. SETTINGS AND DESIGN: This was a prospective, randomized, double-blinded study...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28928571/dexmedetomidine-as-adjuvant-to-lower-doses-of-intrathecal-bupivacaine-for-lower-limb-orthopedic-surgeries
#6
Taznim Mohamed, Indu Susheela, Beena P Balakrishnan, Suvarna Kaniyil
BACKGROUND: Dexmedetomidine, an α2 adrenergic agonist, has been found to be a useful adjuvant to local anesthetics. It has been found to produce satisfactory block with lower doses of spinal bupivacaine. AIM: The aim of this study is to compare the difference in spinal block characteristics and hemodynamic effects of 7, 8, and 9 mg hyperbaric bupivacaine combined with 5 μg dexmedetomidine and to find out the optimum dose that would provide satisfactory block and hemodynamic stability for lower limb orthopedic surgeries...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28928567/dexmedetomidine-as-an-adjuvant-for-intravenous-regional-anesthesia-in-upper-limb-surgeries
#7
Vani Subramanya, Shashikala Thuraganur Kapinigowda, Aruna Teggina Math, Vijayalakshmi Beladakere Chennaiah
BACKGROUND: Intravenous regional anaesthesia is a simple, safe and effective technique with good success rate for upper limb surgeries. The duration of postoperative analgesia is an important limitation of this technique. Various adjuvants have been used to overcome this drawback. In this study we evaluate the effect of dexmedetomidine 0.5 μgkg(-1) as an adjuvant for lignocaine intravenous regional anaesthesia. METHODS: Sixty patients scheduled to undergo upper limb surgery were randomised to receive intravenous regional anaesthesia with lignocaine alone (Group L) or lignocaine with dexmedetomidine 0...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28928559/a-comparative-study-between-intrathecal-isobaric-ropivacaine-0-75-plus-dexmedetomidine-and-isobaric-ropivacaine-0-75-plus-fentanyl-for-lower-limb-surgeries
#8
Prabhavathi Ravipati, G Anand Isaac, P Narasimha Reddy, Leela Krishna, T Supritha
BACKGROUND: Spinal anesthesia is used commonly intraoperatively. However, local anesthetics are associated with relatively short duration of action. A number of adjuvants have been used to prolong the postoperative analgesia. OBJECTIVES: To compare efficacy of dexmedetomidine and fentanyl when given intrathecally as an adjuvant to 2.5 ml of 0.75% isobaric ropivacaine. MATERIALS AND METHODS: Sixty selected patients were randomized to receive 2...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28928546/influence-of-addition-of-dexmedetomidine-or-fentanyl-to-bupivacaine-lumber-spinal-subarachnoid-anesthesia-for-inguinal-hernioplasty
#9
Ayman Eskander T Saadalla, Osama Yehia A Khalifa
BACKGROUND: No drug, used as adjuvant to spinal bupivacaine, has yet been identified that specifically inhibits nociception without its associated side effects. AIM OF THE WORK: The purpose of this study is to compare the efficacy of dexmedetomidine and fentanyl with spinal bupivacaine in inguinal hernioplasty. PATIENTS AND METHODS: Sixty patients of inguinal hernioplasty were randomly allocated to one of three groups, Group C (n = 20) - the patients received 15 mg hyperbaric bupivacaine + 0...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28928325/transversus-abdominis-plane-block-for-pain-relief-in-patients-undergoing-in-endoscopic-repair-of-abdominal-wall-hernia-a-comparative-randomised-double-blind-prospective-study
#10
Aparna Sinha, Lakshmi Jayaraman, Dinesh Punhani, Pradeep Chowbey
INTRODUCTION: Transversus abdominis plane (TAP) block is now a well-established technique in post-operative analgesia for lower abdominal surgeries. We evaluated the effect of ultrasound-guided TAP block on recovery parameters in patients undergoing endoscopic repair of abdominal wall hernia. METHODS: Thirty adults were randomised to receive either ropivacaine with dexmedetomidine (TR) or saline (TP) in TAP block, before emergence from anaesthesia. The patients were assessed for pain relief, sedation, time to ambulate (TA), discharge readiness (DR), postoperative opioid requirement and any adverse events...
September 20, 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/28886259/addition-of-dexmedetomidine-to-qx-314-enhances-the-onset-and-duration-of-sciatic-nerve-block-in-rats
#11
Wenling Zhao, Qinqin Yin, Jin Liu, Wensheng Zhang, Linghui Yang
An experimental set-up was designed to observe whether adding dexmedetomidine to QX-314 would enhance the onset and duration of sensory and motor function in a rat sciatic nerve block model. Fifty-six Sprague-Dawley rats received unilateral sciatic nerve blocks with 0.2 ml of 35 mM QX-314 alone, dexmedetomidine (5.3 μM [1 μg•kg-1], 26.4 μM [5 μg•kg-1], 52.8 μM [10 μg•kg-1]) alone, or a combination of the two. Thermal nociception and motor function were assessed by a blinded investigator, sciatic nerves and perineural tissues were harvested at 14 days after injection...
September 8, 2017: Canadian Journal of Physiology and Pharmacology
https://www.readbyqxmd.com/read/28868303/adjuvants-to-local-anesthetics-current-understanding-and-future-trends
#12
EDITORIAL
Amlan Swain, Deb Sanjay Nag, Seelora Sahu, Devi Prasad Samaddar
Although beneficial in acute and chronic pain management, the use of local anaesthetics is limited by its duration of action and the dose dependent adverse effects on the cardiac and central nervous system. Adjuvants or additives are often used with local anaesthetics for its synergistic effect by prolonging the duration of sensory-motor block and limiting the cumulative dose requirement of local anaesthetics. The armamentarium of local anesthetic adjuvants have evolved over time from classical opioids to a wide array of drugs spanning several groups and varying mechanisms of action...
August 16, 2017: World Journal of Clinical Cases
https://www.readbyqxmd.com/read/28865447/multicenter-assessment-of-sedation-and-delirium-practices-in-the-intensive-care-units-in-poland-is-this-common-practice-in-eastern-europe
#13
Katarzyna Kotfis, Małgorzata Zegan-Barańska, Maciej Żukowski, Krzysztof Kusza, Mariusz Kaczmarczyk, E Wesley Ely
BACKGROUND: The majority of critically ill patients experience distress during their stay in the Intensive Care Unit (ICU), resulting from systemic illness, multiple interventions and environmental factors. Providing humane care should address concomitant treatment of pain, agitation and delirium. The use of sedation and approaches to ICU delirium should be monitored according to structured guidelines. However, it is unknown to what extent these concepts are followed in Eastern European countries like Poland...
September 2, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28860845/dexmedetomidine-in-perioperative-acute-pain-management-a-non-opioid-adjuvant-analgesic
#14
REVIEW
Chaoliang Tang, Zhongyuan Xia
Many nociceptive, inflammatory, and neuropathic pathways contribute to perioperative pain. Although opioids have long been a mainstay for perioperative analgesia, other non-opioid therapies, and dexmedetomidine, in particular, have been increasingly used as part of a multimodal analgesic regimen to provide improved pain control while minimizing opioid-related side effects. This article reviews the evidence supporting the preoperative, intraoperative, and postoperative efficacy of dexmedetomidine as an adjuvant, and the efficacy of intravenous, spinal canal, and nerve block analgesia with dexmedetomidine for perioperative acute pain treatment...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28829798/dexmedetomidine-as-a-neuraxial-adjuvant-for-prevention-of-perioperative-shivering-meta-analysis-of-randomized-controlled-trials
#15
Jian Zhang, Xuena Zhang, Hui Wang, Haibin Zhou, Tian Tian, Anshi Wu
BACKGROUND: Dexmedetomidine, a highly selective α2-adrenoceptor agonist, has been investigated for anti-shivering effects in some trials. This current meta-analysis was conducted to evaluate the effectiveness of dexmedetomidine as a neuraxial adjuvant in preventing perioperative shivering. METHODS: This systematic review and meta-analysis was registered in PROSPERO [www.crd.york.ac.uk/PROSPERO] with the unique identification number CRD42017055991. The electronic databases PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL) were searched to select high-quality randomized controlled trials (RCTs) that evaluated the anti-shivering efficacy for neuraxial application dexmedetomidine as local anesthetic adjuvant...
2017: PloS One
https://www.readbyqxmd.com/read/28757829/effect-of-dexmedetomidine-as-an-adjuvant-to-bupivacaine-in-femoral-nerve-block-for-perioperative-analgesia-in-patients-undergoing-total-knee-replacement-arthroplasty-a-dose-response-study
#16
Senthil K Packiasabapathy, Lokesh Kashyap, Mahesh K Arora, Ravinder Kumar Batra, V K Mohan, Ganga Prasad, C S Yadav
CONTEXT: Dexmedetomidine is being increasingly used in nerve blocks. However, there are only a few dose determination studies. AIMS: To compare two doses of dexmedetomidine, in femoral nerve block, for postoperative analgesia after total knee arthroplasty (TKA). SETTINGS AND DESIGN: A prospective, randomized, controlled trial was conducted in the Department of Anesthesia at AIIMS, a Tertiary Care Hospital. MATERIALS AND METHODS: Sixty American Society of Anesthesiologists I-II patients undergoing TKA under subarachnoid block were randomized to three Groups A, B, and C...
July 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28757391/systemic-dexmedetomidine-attenuates-mechanical-allodynia-through-extracellular-sign-db-type-2-diabetic-mice
#17
Hui Chen, Xiang Xu, Xiao-Yu Yang, Bing-Yu Ling, He-Ping Sun, Chao Liu, Yu Qiu Zhang, Hong Cao, Lan Xu
Painful diabetic neuropathy (PDN) is a common complication of diabetes mellitus. However, the treatment for PDN is limited in clinical practice. In the present study, we investigated the effect of systemic administration dexmedetomidine (DEX), a selective alpha 2 adrenergic receptor (α2AR) agonist, on mechanical allodynia and its underlying mechanism in db/db mice, an animal model of type 2 diabetes mellitus. Our data demonstrated that db/db mice develop mechanical allodynia at the early stage of diabetes...
July 28, 2017: Neuroscience Letters
https://www.readbyqxmd.com/read/28735156/adaptive-periodic-paralysis-allows-weaning-deep-sedation-overcoming-the-drowning-syndrome-in-ecmo-patients-bridged-for-lung-transplantation-a-case-series
#18
Irina Timofte, Michael Terrin, Erik Barr, June Kim, Joseph Rinaldi, Nicholas Ladikos, Jay Menaker, Ali Tabatabai, Zachary Kon, Bartley Griffith, Richard Pierson, Si Pham, Aldo Iacono, Daniel Herr
PURPOSE: Sedation in extracorporeal membrane oxygenation (ECMO) is challenging. Patients require deep sedation because of extremely high respiratory rates and increased work of breathing ("Drowning Syndrome") resulting in altered intra-thoracic pressure and reduced pump flow associated with hemodynamic compromise and decreased oxygenation. However, deep sedation impedes essential active rehabilitation with physical therapy. METHODS: We reviewed data on 3 ECMO patients for whom we used a novel approach to replace continuous drips with periodic sedation/paralysis...
July 17, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28733534/low-dose-of-dexmedetomidine-as-an-adjuvant-to-bupivacaine-in-cesarean-surgery-provides-better-intraoperative-somato-visceral-sensory-block-characteristcs-and-postoperative-analgesia
#19
Yong-Hong Bi, Xiao-Guang Cui, Rui-Qin Zhang, Chun-Yu Song, Yan-Zhuo Zhang
OBJECT: In this study, we aimed to investigate the beneficial effects of dexmedetomidine on somato-visceral sensory block characteristcs, postoperative analgesia and stress response of intrathecal bupivacaine administration in women undergoing cesarean section, and to find out which dose is better. METHODS: Sixty parturients with the American Society of Anesthesiologists (ASA) physical status I or II were anesthetized with intrathecal bupivacaine(10mg) alone or in combination with dexmedetomidine (3 μg and 5 μg) to undergo cesarean section...
June 29, 2017: Oncotarget
https://www.readbyqxmd.com/read/28707454/interventions-for-postoperative-pain-in-children-an-overview-of-systematic-reviews
#20
REVIEW
Krste Boric, Svjetlana Dosenovic, Antonia Jelicic Kadic, Marijan Batinic, Marija Cavar, Marjan Urlic, Nikolina Markovina, Livia Puljak
The aim of this study was to conduct an overview of systematic reviews that summarizes the results about efficacy and safety from randomized controlled trials involving the various strategies used for postoperative pain management in children. We searched the Cochrane Database of Systematic Reviews, CINAHL, Database of Reviews of Effect, Embase, MEDLINE, and PsycINFO from the earliest date to January 24, 2016. This overview included 45 systematic reviews that evaluated interventions for postoperative pain in children...
September 2017: Paediatric Anaesthesia
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