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https://www.readbyqxmd.com/read/28532200/spinal-analgesia-improves-surgical-outcome-after-open-nephrectomy-for-renal-cell-carcinoma-a-randomized-controlled-study
#1
Mascha Thurm, Britt-Inger Kröger Dahlin, Ola Winsö, Börje Ljungberg
OBJECTIVE: This study evaluated whether more effective perioperative analgesia can be part of a multimodal approach to minimizing morbidity and improving postoperative management after the open surgical approaches frequently used in the treatment of renal cell carcinoma (RCC). The aim of the study was to determine whether spinal anesthesia with clonidine can enhance postoperative analgesia, speed up mobilization and reduce the length of hospital stay (LOS). MATERIALS AND METHODS: Between 2012 and 2015, 135 patients with RCC were randomized, in addition to general anesthesia, to receive either spinal analgesia with clonidine or epidural analgesia, stratified to surgical technique...
May 22, 2017: Scandinavian Journal of Urology
https://www.readbyqxmd.com/read/28527421/a-phase-iii-randomized-multi-center-double-blind-placebo-controlled-study-of-safety-and-efficacy-of-lofexidine-for-relief-of-symptoms-in-individuals-undergoing-inpatient-opioid-withdrawal
#2
Charles W Gorodetzky, Sharon L Walsh, Peter R Martin, Andrew J Saxon, Kristen L Gullo, Kousick Biswas
BACKGROUND: Lofexidine is an alpha-2-adrenergic receptor agonist approved in the United Kingdom (UK) for the treatment of opioid withdrawal symptoms. Lofexidine has demonstrated better efficacy than placebo for reducing opioid withdrawal symptoms in patients undergoing opioid withdrawal with less reported hypotension than clonidine. METHODS: Designed as an FDA registration trial, this 8-day, randomized, double-blind, placebo-controlled, parallel-group study in 264 patients dependent on short-acting opioids evaluated the efficacy of lofexidine hydrochloride in reducing withdrawal symptoms in patients undergoing opioid withdrawal...
May 10, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28526145/alpha-2-agonists
#3
REVIEW
Viet Nguyen, Dawn Tiemann, Edward Park, Ali Salehi
Alpha-2 adrenergic receptors are spread throughout the central and peripheral nervous system, specifically in the pontine locus coeruleus, medullospinal tracts, rostral ventrolateral medulla, and the dorsal horn of the spinal cord. Alpha-2 agonist agents cause neuromodulation in these centers, leading to sedation, analgesia, vasodilatation, and bradycardia with little effect on the respiratory drive, which accounts for their good safety profile. The 2 major drugs in this group are clonidine and dexmedetomidine...
June 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28525514/perineural-dexmedetomidine-is-more-effective-than-clonidine-when-added-to-local-anesthetic-for-supraclavicular-brachial-plexus-block-a-systematic-review-and-meta-analysis
#4
Kariem El-Boghdadly, Richard Brull, Herman Sehmbi, Faraj W Abdallah
BACKGROUND: Clonidine, an α-2 agonist, has long been used as a local anesthetic adjunct with proven efficacy to prolong peripheral nerve block duration. Dexmedetomidine, a newer α-2 agonist, has a more favorable pharmacodynamic and safety profile; however, data comparing its efficacy as an adjunct to that of clonidine are inconsistent. We sought to compare the clinical efficacy of these 2 α-2 agonists by examining their effects on peripheral nerve block characteristics for upper extremity surgery...
June 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28519244/neonatal-abstinence-syndrome-update-on-diagnostic-and-therapeutic-strategies
#5
Genny Raffaeli, Giacomo Cavallaro, K Karel Allegaert, Enno Diederik Wildschut, Monica Fumagalli, Massimo Agosti, Dick Tibboel, Fabio Mosca
Substance use among pregnant women is a major public health issue. Both prescription opioid use and illicit opioid abuse have increased dramatically in recent years. Prolonged in utero drug exposure may result in neonatal abstinence syndrome (NAS), an acute multisystemic clinical entity that occurs in the first days of life. This syndrome is caused by abrupt discontinuation of fetal exposure to licit or illicit drugs chronically consumed by the mother during pregnancy and transmitted to the fetus through the placenta...
May 18, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28515558/a-rare-case-of-complicated-opioid-withdrawal-in-delirium-without-convulsions
#6
B Neeraj Raj, N Manamohan, Divya Hegde, Chandrashekar B Huded, Johnson Pradeep
Opioids are one of the commonly abused substances in India. Opioid withdrawal symptoms classically include severe muscle cramps, bone aches, autonomic symptoms, anxiety, restlessness, insomnia, and temperature dysregulation. However, reports of cases with delirium during withdrawal are few. A 25-year-old male with severe opioid withdrawal symptoms developed delirium. Investigations were normal. There were no comorbidities, no significant past history and family history. Patient treated for opioid dependence with tapering doses of lorazepam and clonidine...
March 2017: Indian Journal of Psychological Medicine
https://www.readbyqxmd.com/read/28497473/topical-analgesics-for-acute-and-chronic-pain-in-adults-an-overview-of-cochrane-reviews
#7
REVIEW
Sheena Derry, Philip J Wiffen, Eija A Kalso, Rae F Bell, Dominic Aldington, Tudor Phillips, Helen Gaskell, R Andrew Moore
BACKGROUND: Topical analgesic drugs are used for a variety of painful conditions. Some are acute, typically strains or sprains, tendinopathy, or muscle aches. Others are chronic, typically osteoarthritis of hand or knee, or neuropathic pain. OBJECTIVES: To provide an overview of the analgesic efficacy and associated adverse events of topical analgesics (primarily nonsteroidal anti-inflammatory drugs (NSAIDs), salicylate rubefacients, capsaicin, and lidocaine) applied to intact skin for the treatment of acute and chronic pain in adults...
May 12, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28495246/clonidine-adhesive-patch-for-the-treatment-of-tic-disorders-a-systematic-review-and-meta-analysis
#8
Shuai Wang, Yan-Zhao Wei, Jianhong Yang, Yuming Zhou, Yi Zheng
OBJECTIVE: The aim of this study was to evaluate the efficacy and safety of clonidine adhesive patch for tic disorders (TDs). METHODS: Medline, Embase, Cochrane central register of controlled trials and Chinese databases of CBM, CNKI were searched from inception to 08.2016 for randomized controlled studies (RCTs), open-label control studies of clonidine adhesive patch versus other medications or/and placebo for TDs. The cochrane Handbook for Systematic Reviews of Interventions was used to guide our study...
April 7, 2017: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/28491012/are-alpha-2d-adrenoceptor-subtypes-involved-in-rat-mydriasis-evoked-by-new-imidazoline-derivatives-marsanidine-and-7-methylmarsanidine
#9
Joanna Raczak-Gutknecht, Teresa Frąckowiak, Antoni Nasal, Anita Kornicka, Franciszek Sączewski, Roman Kaliszan
The imidazoline compounds may produce mydriasis after systemic administration to some species (rats, cats, and mice). In mydriatic activity of imidazolines, α2D-adrenoceptors subtype(s) seems to be involved. In this study, the pupil dilatory effect evoked by 2 newly synthesized imidazoline derivatives-α2-adrenoceptor agonists: marsanidine and 7-methylmarsanidine-was compared. The compounds were tested alone as well as in the presence of α2-adrenoceptor antagonists (nonselective, yohimbine, and selective toward the following α2-adrenoceptor subtypes-α2A-2-[(4,5-dihydro-1H-imidazol-2-yl)methyl]-2,3-dihydro-1-methyl-1H-isoindole maleate (BRL44408), α2B-2-[2-(4-(2-methoxyphenyl)piperazin-1-yl)ethyl]-4,4-dimethyl-1,3-(2H,4H)-isoquinolindione dihydrochloride (ARC239), α2C-JP1302, α2D-2-(2,3-dihydro-2-methoxy-1,4-benzodioxin-2-yl)-4,5-dihydro-1H-imidazole hydrochloride [RX821002])...
April 2017: Dose-response: a Publication of International Hormesis Society
https://www.readbyqxmd.com/read/28490900/complex-management-of-a-patient-with-refractory-primary-erythromelalgia-lacking-a-scn9a-mutation
#10
Sarah A Low, Wendye Robbins, Vivianne L Tawfik
A 41-year-old woman presented with burning and erythema in her extremities triggered by warmth and activity, which was relieved by applying ice. Extensive workup was consistent with adult-onset primary erythromelalgia (EM). Several pharmacological treatments were tried including local anesthetics, capsaicin, ziconotide, and dantrolene, all providing 24-48 hours of relief followed by symptom flare. Interventional therapies, including peripheral and sympathetic ganglion blocks, also failed. Thus far, clonidine and ketamine have been the only effective agents for our patient...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28488361/clonidine-for-sedation-and-analgesia-for-neonates-receiving-mechanical-ventilation
#11
REVIEW
Olga Romantsik, Maria Grazia Calevo, Elisabeth Norman, Matteo Bruschettini
BACKGROUND: Although routine administration of pharmacologic sedation or analgesia during mechanical ventilation in preterm neonates is not recommended, its use in clinical practice remains common. Alpha-2 agonists, mainly clonidine and dexmedetomidine, are used as adjunctive (or alternative) sedative agents alongside opioids and benzodiazepines. Clonidine has not been systematically assessed for use in neonatal sedation during ventilation. OBJECTIVES: To assess whether clonidine administered to term and preterm newborn infants receiving mechanical ventilation reduces morbidity and mortality rates...
May 10, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28482547/development-and-in-vitro-evaluation-of-potential-electromodulated-transdermal-drug-delivery-systems-based-on-carbon-nanotube-buckypapers
#12
Alex Schwengber, Héctor J Prado, Pablo R Bonelli, Ana L Cukierman
Buckypapers based on different types of carbon nanotubes with and without the addition of four model drugs, two of basic nature (clonidine hydrochloride, selegiline hydrochloride) and the others of acidic character (flurbiprofen, ketorolac tromethamine) were prepared and characterized. The influence of the conditions employed in the preparation of the buckypapers (dispersion time and solvents used in the preparation, as well as the type of carbon nanotubes used and the characteristics of the drug involved) on their conductivity was especially examined...
July 1, 2017: Materials Science & Engineering. C, Materials for Biological Applications
https://www.readbyqxmd.com/read/28455405/respiration-driven-excessive-sinus-tachycardia-treated-with-clonidine
#13
Matthew Emile Li Kam Wa, Patricia Taraborrelli, Sajad Hayat, Phang Boon Lim
A 26-year-old man presented to our syncope service with debilitating daily palpitations, shortness of breath, presyncope and syncope following a severe viral respiratory illness 4 years previously. Mobitz type II block had previously been identified, leading to a permanent pacemaker and no further episodes of frank syncope. Transthoracic echocardiography, electophysiological study and repeated urine metanepherines were normal. His palpitations and presyncope were reproducible on deep inspiration, coughing, isometric hand exercise and passive leg raises...
April 28, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28420580/comparative-pharmacodynamic-analysis-of-imidazoline-compounds-using-rat-model-of-ocular-mydriasis-with-a-test-of-quantitative-structure-activity-relationships
#14
Joanna Raczak-Gutknecht, Antoni Nasal, Teresa Frąckowiak, Anita Kornicka, Franciszek Sączewski, Renata Wawrzyniak, Łukasz Kubik, Roman Kaliszan
Imidazol(in)e derivatives, having the chemical structure similar to clonidine, exert diverse pharmacological activities connected with their interactions with alpha2-adrenergic receptors, e.g. hypotension, bradycardia, sedation as well as antinociceptive, anxiolytic, antiarrhythmic, muscle relaxant and mydriatic effects. The mechanism of pupillary dilation observed after systemic administration of imidazol(in)es to rats, mice and cats depends on the stimulation of postsynaptic alpha2-adrenoceptors within the brain...
April 6, 2017: Journal of Pharmaceutical and Biomedical Analysis
https://www.readbyqxmd.com/read/28419660/acute-masseter-dystonia-in-a-pediatric-patient-receiving-aripiprazole-and-methylphenidate-following-induction-of-general-anesthesia
#15
Michelle LeRiger, Jasper Williams, Greta Duncan-Wiebe, Mohanad Shukry
An 11-year-old male receiving aripiprazole, methylphenidate, and clonidine developed acute masseter dystonia inhibiting tracheal intubation after induction of general anesthesia with propofol and rocuronium. Following emergence, he had trismus and jaw discomfort. Psychiatry consultation suspected an acute dystonic reaction, so diphenhydramine was administered intravenously which resolved symptoms. We suspect chronic aripiprazole and methylphenidate usage combined with propofol administration in the short-term absence of methylphenidate made this patient susceptible to dystonic reactions...
April 17, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28416983/local-conduction-during-acute-myocardial-infarction-in-rats-interplay-between-central-sympathetic-activation-and-endothelin
#16
Theofilos M Kolettis, Marianthi Kontonika, Vassilios La Rocca, Antonios P Vlahos, Giannis G Baltogiannis, Zenon S Kyriakides
We investigated the effects of autonomic dysfunction and endothelin on local conduction and arrhythmogenesis during myocardial infarction. We recorded ventricular tachyarrhythmias, monophasic action potentials, and activation sequences in wild-type and ETB-deficient rats displaying high endothelin levels. Central sympathetic inputs were examined after clonidine administration. Clonidine mitigated early and delayed arrhythmogenesis in ETB-deficient and wild-type rats, respectively. The right ventricular activation delay increased in clonidine-treated ETB-deficient rats and slightly decreased in wild-type rats...
April 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28413281/a-comparative-study-of-the-effect-of-clonidine-fentanyl-and-the-combination-of-both-as-adjuvant-to-intrathecal-bupivacaine-for-postoperative-analgesia-in-total-abdominal-hysterectomy
#17
Fareed Ahmed, Mamta Khandelwal, Anil Sharma
BACKGROUND AND AIMS: The aim of this study was to evaluate the level of sensory block, onset and duration of motor block, postoperative analgesia, and adverse effects of combination of clonidine and fentanyl given intrathecally with hyperbaric bupivacaine (HB). MATERIAL AND METHODS: Three hundred and twenty eight patients were randomized into four groups. Group bupivacaine (group B) received 15 mg of HB; group bupivacaine clonidine (group BC) received 15 mg of HB plus 25 μg clonidine; group bupivacaine fentanyl (group BF) received 15 mg of HB plus 25 μg fentanyl and group bupivacaine clonidine fentanyl (group BCF) received 15 mg of HB plus 25 μg clonidine and 25 μg fentanyl intrathecally...
January 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28405129/effect-of-addition-of-fentanyl-and-clonidine-to-local-anesthetic-solution-in-peribulbar-block
#18
Poonam Nehra, Vrinda Oza, Vandana Parmar, Pooja Fumakiya
OBJECTIVE: To compare the effect of addition of fentanyl and clonidine as adjuvants to bupivacaine and lignocaine in peribulbar block. METHODS: The study was conducted on 105 adult patients of either sex, of ASA grade I and II undergoing ophthalmic surgeries. Patients were randomly divided into 3 groups of 35 each. All the patients were given peribulbuar block with 5ml lignocaine 2% +3 ml bupivacaine 0.5% +1 ml hyaluronidase (250 IU). In addition to this 1 ml normal saline was added to Group S, 25 μg fentanyl to Group F and 25 μg clonidine to Group C...
January 2017: Journal of Pharmacology & Pharmacotherapeutics
https://www.readbyqxmd.com/read/28399049/evaluation-of-gabapentin-and-clonidine-use-in-children-following-spinal-fusion-surgery-for-idiopathic-scoliosis-a-retrospective-review
#19
Dinesh K Choudhry, B Randall Brenn, Karen Sacks, Suken Shah
BACKGROUND: Opioids are the mainstay of therapy for pain relief following posterior spinal fusion (PSF) surgery. Various adjunctive medications are being used to augment analgesia and to reduce opioid-related side effects. At our institution, we have sequentially added 2 adjuncts to a standard morphine patient-controlled analgesia (PCA) regimen. The goal of our study was to evaluate pain control and the benefit of gabapentin and the combination of gabapentin and clonidine, whereas morphine PCA was in use in children following PSF surgery...
April 10, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28394849/inhibition-of-voltage-gated-na-channels-by-bupivacaine-is-enhanced-by-the-adjuvants-buprenorphine-ketamine-and-clonidine
#20
Carsten Stoetzer, Christine Martell, Jeanne de la Roche, Andreas Leffler
BACKGROUND AND OBJECTIVES: Regional anesthesia includes application of local anesthetics (LAs) into the vicinity of peripheral nerves. Prolongation or improvement of nerve blocks with LAs can be accomplished by coapplication with adjuvants, including buprenorphine, ketamine, and clonidine. While the mechanisms mediating prolonged or improved LA-induced effects by adjuvants are poorly understood, we hypothesized that they are likely to increase LA-induced block of voltage-gated Na channels...
April 7, 2017: Regional Anesthesia and Pain Medicine
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