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dexmedetomidine block

Arvinder Pal Singh, Malika Mahindra, Ruchi Gupta, Sukhminder Jit Singh Bajwa
AIMS AND OBJECTIVES: Supplementation of dexmedetomidine produces a dose-dependent sedation, anxiolysis and analgesia without respiratory depression. This study was conducted to evaluate the possible effect of dexmedetomidine as an adjuvant to levobupivacaine for supraclavicular brachial plexus block in upper limb surgery. SETTINGS AND DESIGN: Tertiary care institute, Department of Anaesthesiology and Intensive Care, a placebo-controlled study. MATERIALS AND METHODS: After obtaining Ethical Committee approval, a randomized, double-blind, placebo-controlled study was conducted on sixty American Society of Anesthesiologists physical status I and II patients in the age group of 18-60 years, divided randomly into two groups, Group I received 30 ml of 0...
September 2016: Anesthesia, Essays and Researches
Daiki Yamanaka, Takashi Kawano, Atsushi Nishigaki, Bun Aoyama, Hiroki Tateiwa, Marie Shigematsu-Locatelli, Fabricio M Locatelli, Masataka Yokoyama
PURPOSE: In the present study, we examined whether and by what mechanisms dexmedetomidine (DMED) prevents the development of systemic inflammation (SI)-induced cognitive dysfunction in aged rats. METHODS: Animals received a single intraperitoneal (i.p.) injection of either 5.0 mg/kg lipopolysaccharide (LPS) or vehicle. LPS-treated rats were further divided into three groups: early DMED, late DMED, or midazolam (MDZ) treatment (n = 12 each). Seven days after LPS injection, cognitive function was evaluated using a novel object recognition task, followed by measurement of hippocampal levels of proinflammatory cytokines and Toll-like receptor 4 (TLR-4) expression...
October 13, 2016: Journal of Anesthesia
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
Archana Tripathi, Khushboo Sharma, Mukesh Somvanshi, Rajib Lochan Samal
BACKGROUND AND AIMS: Various additives are mixed with local anesthetic agents to increase the quality of block in regional anesthesia. We compared clonidine and dexmedetomidine as an adjunct to bupivacaine in supraclavicular brachial plexus block with respect to the onset and duration of sensory and motor block and duration of analgesia. MATERIAL AND METHODS: Sixty American Society of Anesthesiologists Grades I and II patients scheduled for various orthopedic surgeries of the upper limb under supraclavicular brachial plexus block were divided into two equal groups in a randomized, double-blind manner...
July 2016: Journal of Anaesthesiology, Clinical Pharmacology
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
E Velázquez-Delgado, S P Gaspar-Carrillo, A A Peña-Riveron, G E Mejía-Terrazas
INTRODUCTION: Dexmedetomidine prolongs sensory block of ropivacaine. Our objective was to study whether this extension would produce better postoperative pain control compared to that produced by clonidine in patients undergoing arthroscopic shoulder. MATERIALS AND METHODS: Study comparative, longitudinal, controlled, randomized into 3 groups. Control group I: ropivacaine 0.75% clonidine group II: 0.75% ropivacaine plus clonidine 1mg/kg group iiidexmedetomidine: 0...
September 9, 2016: Revista Española de Anestesiología y Reanimación
M Abdulatif, M Fawzy, H Nassar, A Hasanin, M Ollaek, H Mohamed
This randomised, controlled, double-blind study investigated the effects of different doses of perineural dexmedetomidine on the pharmacodynamic profile of femoral nerve block in patients undergoing arthroscopic knee surgery. Ultrasound-guided femoral nerve block was performed before general anaesthesia using 25 ml of bupivacaine 0.5% combined with normal saline in the control group, and 25 μg, 50 μg or 75 μg of dexmedetomidine in three treatment groups (n = 15 for each group). All patients received a standard general anaesthetic and multimodal postoperative analgesic regimen...
October 2016: Anaesthesia
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
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
Lauren K Dunn, Bhiken I Naik, Edward C Nemergut, Marcel E Durieux
Craniotomy pain may be severe and is often undertreated. Pain management following craniotomy is a balancing act of achieving adequate analgesia but avoiding sedation, respiratory depression, hypercapnia, nausea and vomiting, and hypertension. Opioids are a first-line analgesic therapy; however, concern that opioid-related adverse effects (sedation, respiratory depression) may interfere with neurologic assessment and increase intracranial pressure has limited use of these drugs for intracranial surgery. Non-opioid analgesics avoid these effects and may be useful as part of a multimodal regimen for post-craniotomy pain...
October 2016: Current Neurology and Neuroscience Reports
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...
2016: Turkish Journal of Medical Sciences
(no author information available yet)
[This corrects the article on p. 403 in vol. 60, PMID: 27330202.].
July 2016: Indian Journal of Anaesthesia
Sudarshan Kumar Chaudhary, Ravinder Kumar Verma, Shelly Rana, Jai Singh, Bhanu Gupta, Yuvraj Singh
BACKGROUND AND AIMS: The advent of ultrasonographic-guided techniques has led to increased interest in femoro-sciatic nerve block (FSNB) for lower limb surgeries. α2-agonists have been used recently as adjuvants to local anaesthetics in nerve blocks. We aimed to compare equal doses of clonidine or dexmedetomidine as an adjuvant to levobupivacaine in FSNB for post-operative analgesia. METHODS: Ninety patients scheduled to undergo below knee orthopaedic surgeries under subarachnoid block were divided into three groups: Group LL (n = 30) patients received 38 mL of 0...
July 2016: Indian Journal of Anaesthesia
Khalid R Alzaben, Omar Q Samarah, Salameh S Obeidat, Oday Halhouli, Murad Al Kharabsheh
Charcot-Marie-Tooth disease comprises a group of disorders characterized by progressive muscle weakness and wasting. Reviewing the anaesthetic literature produced conflicting reports about the best anaesthetic options for patients with CMTD; as they are at increased risk of prolonged response to muscle relaxants, malignant hyperthermia and risks of regional anaesthesia. We present a case of the successful use of total intravenous anaesthesia with dexmedetomidine and propofol combined with caudal block using bupivacaine mixed with dexmedetomidine without any complications, for a 17 year old male patient with Charcot Marie-Tooth disease who underwent a lower limb orthopedic surgery...
June 2016: Middle East Journal of Anesthesiology
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)
Hao Cheng, Zhongmin Li, Nilas Young, Douglas Boyd, Zane Atkins, Fuhai Ji, Hong Liu
OBJECTIVE: The goal of this retrospective study was to investigate the effects of perioperative use of dexmedetomidine (Dex) on outcomes for older patients undergoing cardiac surgery. DESIGN: Retrospective investigation. SETTING: Patients from a single tertiary medical center. PARTICIPANTS: A total of 505 patients (≥65 years old) who underwent coronary artery bypass graft (CABG) or valve surgery. CABG and/or valve surgery plus other procedures were divided into 2 groups: 283 received intravenous Dex infusion (Dex group) and 222 did not (Non-Dex group)...
March 3, 2016: Journal of Cardiothoracic and Vascular Anesthesia
Märit Lundblad, Per-Arne Lönnqvist
PURPOSE OF REVIEW: This article reviews various adjunct drugs used in the context of neuroaxial blocks in children and to provide a literature and evidence-based suggestion for the rational use of such adjuncts. RECENT FINDINGS: Contrary to plain local anaesthetics, preservative-free morphine and clonidine, ketamine in neonatal rodents has been found to enhance apoptosis in the spinal cord. Dexmedetomidine has been shown to be equally effective as clonidine as an adjunct to caudal blocks...
October 2016: Current Opinion in Anaesthesiology
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
Mervyn Maze
Dexmedetomidine Diminishes Halothane Anesthetic Requirements in Rats Through a Postsynaptic Alpha 2 Adrenergic Receptor. By Segal IS, Vickery RG, Walton JK, Doze VA, and Maze M. ANESTHESIOLOGY 1988; 125:590-4. Abstract reprinted with permission.The effect of 4(5)-[1-(2,3-dimethylphenyl)ethyl]imidazole (medetomidine), the α2 adrenergic agonist, on anesthetic requirements was investigated in rats anesthetized with halothane. Halothane MAC was determined before and after either dexmedetomidine (D-enantiomer) or levomedetomidine (L-enantiomer) 10, 30, and 100 μg/kg, or vehicle intraperitoneally...
September 2016: Anesthesiology
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