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dexmedetomidine block

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https://www.readbyqxmd.com/read/28210917/adjuvant-agents-in-regional-anesthesia-in-the-ambulatory-setting
#1
REVIEW
Veerandra Koyyalamudi, Sudipta Sen, Shilpadevi Patil, Justin B Creel, Elyse M Cornett, Charles J Fox, Alan D Kaye
PURPOSE OF REVIEW: A majority of surgical practice has involved ambulatory centers with the number of outpatient operations in the USA doubling to 26.8 million per year. Local anesthesia delivery provides numerous benefits, including increased satisfaction, earlier discharge, and reduction in unplanned hospital admission. Further, with the epidemic of opioid mediated overdoses, local anesthesia can be a key tool in providing an opportunity to reduce the need for other analgesics postoperatively...
January 2017: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/28178091/investigating-the-efficacy-of-dexmedetomidine-as-an-adjuvant-to-local-anesthesia-in-brachial-plexus-block-a-systematic-review-and-meta-analysis-of-18-randomized-controlled-trials
#2
Nasir Hussain, Vincent Paul Grzywacz, Charles Andrew Ferreri, Amit Atrey, Laura Banfield, Naum Shaparin, Amaresh Vydyanathan
BACKGROUND AND OBJECTIVES: Dexmedetomidine has been thought to be an effective adjuvant to local anesthetics in brachial plexus blockade. We sought to clarify the uncertainty that still exists as to its true efficacy. METHODS: A meta-analysis of randomized controlled trials was conducted to assess the ability of dexmedetomidine to prolong the duration and hasten the onset of motor and sensory blockade when used as an adjuvant to local anesthesia for brachial plexus blockade versus using local anesthesia alone (control)...
March 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28153763/multiply-repeatable-and-adjustable-on-demand-phototriggered-local-anesthesia
#3
Alina Y Rwei, Changyou Zhan, Bruce Wang, Daniel S Kohane
A phototriggerable system whereby patients could repeatedly and non-invasively control the timing and dosage of local anesthesia according to their needs would be beneficial for perioperative pain and perhaps obviate the need for oral narcotics. However, clinical application of phototriggerable systems have been limited by concerns over phototoxicity of lasers and limited tissue penetration of light. To address these limitations, we increased the devices' effective sensitivity to light by co-delivering a second compound, dexmedetomidine, that potentiates the effect of delivered local anesthetics...
January 31, 2017: Journal of Controlled Release: Official Journal of the Controlled Release Society
https://www.readbyqxmd.com/read/28121930/dexmedetomidine-as-an-adjuvant-to-local-anesthetics-in-brachial-plexus-blocks-a-meta-analysis-of-randomized-controlled-trials
#4
Yongmei Ping, Qigang Ye, Wenwei Wang, Pingke Ye, Zhibin You
BACKGROUND: Brachial plexus block (BPB) for upper extremity surgery provides superior analgesia, but this advantage is limited by the pharmacological duration of local anesthetics. Dexmedetomidine (DEX) as a local anesthetics adjuvant for BPB has been utilized to prolong the duration of the nerve block in some randomized controlled trials (RCTs) but is far from unanimous in the efficacy and safety of the perineural route. Hence, an updated meta-analysis was conducted to assess the efficacy and safety of DEX as local anesthetic adjuvants on BPB...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28106354/adding-dexmedetomidine-to-ropivacaine-for-femoral-nerve-block-inhibit-local-inflammatory-response
#5
Jing Li, Hanghui Wang, Buhuai Dong, Jianbing Ma, Xucai Wu
BACKGROUND: Peripheral nerve block has an anti-inflammatory effect that is confirmed in animal studies, while inconclusive in human studies. Dexmedetomidine (DEX), a highly selective α2-adenoceptor agonist, has a potent anti-inflammatory effect. The aim of this study was to evaluate the effect of DEX added to ropivacaine for femoral nerve block (FNB) on local inflammatory response after total knee arthroplasty (TKA). METHODS: Sixty patients scheduled for TKA were randomized into two equal groups in a prospective randomized study...
January 20, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28100520/evidence-basis-for-using-perineural-dexmedetomidine-to-enhance-the-quality-of-brachial-plexus-nerve-blocks-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#6
L Vorobeichik, R Brull, F W Abdallah
BACKGROUND: Dexmedetomidine has been proposed as a perineural local anaesthetic (LA) adjunct to prolong peripheral nerve block duration; however, results from our previous meta-analysis in the setting of brachial plexus block (BPB) did not support its use. Many additional randomized trials have since been published. We thus conducted an updated meta-analysis. METHODS: Randomized trials investigating the addition of dexmedetomidine to LA compared with LA alone (Control) in BPB for upper extremity surgery were sought...
February 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28096582/comparison-of-different-regimens-of-intravenous-dexmedetomidine-on-duration-of-subarachnoid-block
#7
Anil Thomas, M V S Satyaprakash, Lenin Babu Elakkumanan, Prasanna Udupi Bidkar, Sandeep Kumar Mishra
BACKGROUND AND AIMS: Many studies have studied the effect of intravenous dexmedetomidine on the prolongation of the duration of the subarachnoid block (SAB). These studies had administered dexmedetomidine using different regimens. This study was designed to find out the suitable regimen with maximum advantages and minimum disadvantages. MATERIAL AND METHODS: Ninety-three ASA 1 and 2 patients scheduled to undergo surgeries under SAB were randomly allocated into three groups namely B, M, and BM...
October 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28058845/ultrasensitive-phototriggered-local-anesthesia
#8
Changyou Zhan, Weiping Wang, Claudia Santamaria, Bruce Wang, Alina Rwei, Brian P Timko, Daniel S Kohane
An injectable local anesthetic producing repeatable on-demand nerve block would be desirable for pain management. Here we present a phototriggerable device to achieve repeatable and adjustable on-demand local anesthesia in superficial or deep tissues, consisting of gold nanorods attached to low temperature sensitive liposomes (LTSL). The particles were loaded with tetrodotoxin and dexmedetomidine. Near-infrared light (NIR, 808 nm, continuous wave) could heat gold nanorods at low fluence (short duration and low irradiance), leading to rapid release of payload...
January 6, 2017: Nano Letters
https://www.readbyqxmd.com/read/28018501/regional-anesthesia-with-dexmedetomidine-infusion-a-feasible-method-for-the-awake-test-during-carotid-endarterectomy
#9
Jonggeun Lee, Up Huh, Seunghwan Song, Sung Woon Chung, Sang Min Sung, Han Jin Cho
Background: Carotid endarterectomy (CEA) is the standard treatment modality for the prevention of stroke in patients with carotid stenosis. This study reports our experiences during CEA with routine awake tests under regional anesthesia (RA) combined with light sedation by dexmedetomidine infusion. Materials and Methods: We retrospectively reviewed 23 patients who had undergone CEA between April 2013 and June 2015. All patients underwent the awake test during CEA with cervical plexus block and light sedation by continuous dexmedetomidine infusion...
2016: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/28017171/perineural-dexmedetomidine-effects-on-sciatic-nerve-in-rat
#10
Abdulkadir Yektaş, Murat Çabalar, Mehmet Sar, Ayşin Alagöl, Duygu Sultan Çelik, Vildan Yayla, Deniz Tolga
The present study was designed to test the hypothesis that high dose dexmedetomidine would increase the duration of antinociception to a thermal stimulus in a rat model of sciatic nerve blockade without causing nerve damage. The rats were anesthetized with isoflurane. After electromyography (EMG) recordings, right sciatic nerves were explored and perineural injections were delivered: Group D (n=7), 40μgμgkg(-1) dexmedetomidine administration, Group II (n=6), (0.2mL) saline administration, Group III (n=2), only surgically exploration of the right sciatic nevre...
January 2017: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/27996204/postoperative-pain-control-following-craniotomy-a-systematic-review-of-recent-clinical-literature
#11
Georgia G Tsaousi, Simon W Logan, Federico Bilotta
BACKGROUND: Pain intensity after craniotomy is considered to be moderate to severe during the first 2 postoperative days. The ideal pain treatment to facilitate a rapid postoperative recovery and optimize outcome is unknown. OBJECTIVES: This systematic review aims to report current clinical evidence related to pharmacological and adjuvant analgesic modalities for postcraniotomy pain control. DESIGN: Systematic review of randomized controlled trials (RCTs)...
December 20, 2016: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/27955918/dexmedetomidine-added-to-local-anesthetic-mixture-of-lidocaine-and-ropivacaine-enhances-onset-and-prolongs-duration-of-a-popliteal-approach-to-sciatic-nerve-blockade
#12
Xiawei Hu, Jinlei Li, Riyong Zhou, Quanguang Wang, Fangfang Xia, Thomas Halaszynski, Xuzhong Xu
PURPOSE: A literature review of multiple clinical studies on mixing additives to improve pharmacologic limitation of local anesthetics during peripheral nerve blockade revealed inconsistency in success rates and various adverse effects. Animal research on dexmedetomidine as an adjuvant on the other hand has promising results, with evidence of minimum unwanted results. This randomized, double-blinded, contrastable observational study examined the efficacy of adding dexmedetomidine to a mixture of lidocaine plus ropivacaine during popliteal sciatic nerve blockade (PSNB)...
January 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/27891424/a-study-on-the-efficacy-of-the-addition-of-low-dose-dexmedetomidine-as-an-adjuvant-to-lignocaine-in-intravenous-regional-anaesthesia-ivra
#13
Esha Nilekani, Yvonne Menezes, Shirley Ann D'souza
INTRODUCTION: Intravenous Regional Anaesthesia (IVRA) is a simple, effective method of providing anaesthesia for short duration surgical procedures on the extremities, its chief drawbacks are tourniquet pain, short duration of block and absence of post-operative analgesia. Dexmedetomidine is known to reduce anaesthetic requirements and also provide analgesia to the patient. AIM: To evaluate the efficacy of dexmedetomidine as an adjuvant to lignocaine in IVRA with respect to the quality of the block, tourniquet pain and post-operative analgesia...
October 2016: Journal of Clinical and Diagnostic Research: JCDR
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
#14
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/27833486/a-comparative-study-of-dexmedetomidine-and-fentanyl-as-adjuvants-to-levobupivacaine-for-caudal-analgesia-in-children-undergoing-lower-limb-orthopedic-surgery
#15
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/27833479/efficacy-of-dexmedetomidine-as-an-adjuvant-to-ropivacaine-in-pediatric-caudal-epidural-block
#16
Manoj Kamal, Sadik Mohammed, Saroj Meena, Geeta Singariya, Rakesh Kumar, Dilip Singh Chauhan
CONTEXT: Caudal analgesia is a reliable and an easy method to provide intraoperative and postoperative analgesia for infraumbilical surgeries in pediatric population but with the disadvantage of short duration of action after single injection. Many additives were used in combination with local anesthetics in the caudal block to prolong the postoperative analgesia. AIM: We compared the analgesic effects and side effects of dexmedetomidine added to ropivacaine in pediatric patients undergoing lower abdominal surgeries...
October 2016: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/27816166/-perineural-dexmedetomidine-effects-on-sciatic-nerve-in-rat
#17
Abdulkadir Yektaş, Murat Çabalar, Mehmet Sar, Ayşin Alagöl, Duygu Sultan Çelik, Vildan Yayla, Deniz Tolga
The present study was designed to test the hypothesis that high dose dexmedetomidine would increase the duration of antinociception to a thermal stimulus in a rat model of sciatic nerve blockade without causing nerve damage. The rats were anesthetized with isoflurane. After electromyography (EMG) recordings, right sciatic nerves were explored and perineural injections were delivered: Group D (n=7), 40μgμgkg(-1) dexmedetomidine administration, Group II (n=6), (0.2mL) saline administration, Group III (n=2), only surgically exploration of the right sciatic nevre...
January 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/27812971/efficacy-and-safety-of-dexmedetomidine-as-an-adjuvant-in-epidural-analgesia-and-anesthesia-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#18
REVIEW
Xu Zhang, Dong Wang, Min Shi, YuanGuo Luo
BACKGROUND AND OBJECTIVE: Several clinical trials have examined and indicated the usefulness of epidural dexmedetomidine therapy. However, there has been no systematic analysis of the findings of these trials to date. We undertook this systematic review and meta-analysis to investigate the efficacy and safety of epidural dexmedetomidine adjunctive therapy in different surgical procedures. MATERIALS AND METHODS: We searched EMBASE, PubMed, the Cochrane Library, and the Clinical Trials...
November 4, 2016: Clinical Drug Investigation
https://www.readbyqxmd.com/read/27792212/postoperative-analgesia-for-elective-total-knee-arthroplasty-under-subarachnoid-anesthesia-with-opioids-comparison-between-epidural-femoral-block-and-adductor-canal-block-techniques-with-and-without-perineural-adjuvants-a-prospective-randomized-clinical-trial
#19
José R Ortiz-Gómez, Marta Perepérez-Candel, José M Vázquez-Torres, José M Rodriguez-Del Río, Berta Torrón-Abad, Inocencia Fornet-Ruiz, Francisco J Palacio-Abizanda
BACKGROUND: Optimal control of acute postoperative pain and prevention of chronic persistent pain in total knee arthroplasty (TKA) remain a challenge. The main hypothesis was that nerve blocks improve postoperative analgesia especially if perineural adjuvants are added. METHODS: Immediate postoperative pain (24 hours) was evaluated every hour in 639 patients using a verbal rating 11-point scale for patient self-reporting of pain (VRS-11). All patients received subarachnoid anesthesia and were randomly allocated in 8 groups: control group, epidural (EA) and single shots femoral (FNB) or adductor canal blocks (ACB), both with and without adjuvants: dexamethasone (+Dexa) or dexmedetomidine (+Dexm)...
January 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27792047/does-dexmedetomidine-have-a-perineural-mechanism-of-action-when-used-as-an-adjuvant-to-ropivacaine-a-paired-blinded-randomized-trial-in-healthy-volunteers
#20
Jakob H Andersen, Ulrik Grevstad, Hanna Siegel, Jørgen B Dahl, Ole Mathiesen, Pia Jæger
BACKGROUND: Dexmedetomidine used as an adjuvant to local anesthetics may prolong the duration of peripheral nerve blocks. Whether this is mediated by a perineural or systemic mechanism remains unknown. The authors hypothesized that dexmedetomidine has a peripheral mechanism of action. METHODS: The authors conducted a randomized, paired, triple-blind trial in healthy volunteers. All received bilateral saphenous nerve blocks with 20 ml ropivacaine, 0.5%, plus 1 ml dexmedetomidine, 100 µg/ml, in one thigh and 20 ml ropivacaine 0...
January 2017: Anesthesiology
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