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Faramarz Mosaffa, Seyed Amir Mohajerani, Reza Aminnejad, Ali Solhpour, Shideh Dabir, Gholam Reza Mohseni
BACKGROUND: Preemptive analgesia is the blocking of pain perception afferent pathways before noxious painful stimuli. Clonidine is an alpha agonist drug that is partially selective for α-2 adrenoreceptors. Clonidine is used as anti-anxiety medication and an, analgesic, and it prolongs the duration of the block in the brachial plexus block. OBJECTIVES: To compare the effect of preemptive clonidine with midazolam on intraoperative sedation, duration of block, and postoperative pain scores...
June 2016: Anesthesiology and Pain Medicine
Ryan C Dillon, Jose-Alberto Palma, Christy L Spalink, Diana Altshuler, Lucy Norcliffe-Kaufmann, David Fridman, John Papadopoulos, Horacio Kaufmann
OBJECTIVE: Adrenergic crises are a cardinal feature of familial dysautonomia (FD). Traditionally, adrenergic crises have been treated with the sympatholytic agent clonidine or with benzodiazepines, which can cause excessive sedation and respiratory depression. Dexmedetomidine is a centrally-acting α 2-adrenergic agonist with greater selectivity and shorter half-life than clonidine. We evaluated the preliminary effectiveness and safety of intravenous dexmedetomidine in the treatment of refractory adrenergic crisis in patients with FD...
October 17, 2016: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
Lei-Fang Cao, Xiao-Yan Peng, Ya Huang, Bing Wang, Feng-Ming Zhou, Ruo-Xiao Cheng, Li-Hua Chen, Wei-Feng Luo, Tong Liu
In the present study, we investigated whether restoring descending noradrenergic inhibitory tone can attenuate pain in a PD rat model, which was established by stereotaxic infusion of 6-hydroxydopamine (6-OHDA) into the bilateral striatum (CPu). PD rats developed thermal and mechanical hypersensitivity at the 4th week after surgery. HPLC analysis showed that NE content, but not dopamine or 5-HT, significantly decreased in lumbar spinal cord in PD rats. Additional noradrenergic depletion by injection of N-(2-chloroethyl)-N-ethyl-2-bromobenzylamine (DSP-4) aggravated pain hypersensitivity in PD rats...
2016: Neural Plasticity
Umesh K Dash, S Kiran, Urvashi Tandon, Kavitha Jinjil
BACKGROUND: The synergism between local anesthetic agents such as bupivacaine with intrathecal adjuvants such as opioids and clonidine is well established. AIMS: This study evaluates the clinical efficacy of clonidine75 μg versus fentanyl 25 μg as adjuvants to bupivacaine for spinal anesthesia. SETTINGS AND DESIGN: A prospective, randomized, parallel arm study was conducted over a period of 12 months in a tertiary care hospital. MATERIALS AND METHODS: Sixty patients were divided randomly into two groups, Group C and Group F...
September 2016: Anesthesia, Essays and Researches
Chandni Sinha, Bindey Kumar, Umesh Kumar Bhadani, Ajeet Kumar, Amarjeet Kumar, Alok Ranjan
BACKGROUND: Caudal block is a reliable regional analgesic technique for pediatric urogenital surgeries. Various adjuvants have been tried to enhance the duration of action of bupivicaine. Though clonidine is extensively used as an adjuvant in caudal anaesthesia, it can have troublesome adverse effects like bradycardia, hypotension and sedation. Lately dexamethasone has become popular as an adjuvant in paediatric caudals due to its safety profile. AIM: The aim of this study was to compare dexamethasone and clonidine coadministered with bupivicaine caudally in paediatric patients undergoing urogenital surgeries in terms of analgesia and adverse effects...
September 2016: Anesthesia, Essays and Researches
Radhe Sharan, Rajan Verma, Akshay Dhawan, Jugal Kumar
BACKGROUND: Ropivacaine, a newer local anesthetic, is gaining increased acceptance due to its improved safety profile over bupivacaine and lignocaine. Analgesic adjuvants have proved to be valuable in improving the quality of anesthesia and duration of analgesia. AIM: To compare the efficacy of clonidine and fentanyl as adjuvants to ropivacaine in spinal anesthesia in lower abdominal surgeries. MATERIALS AND METHODS: A randomized, double-blind control study was carried out in 100 patients who were randomly divided into two groups...
September 2016: Anesthesia, Essays and Researches
Madhavi Unmesh Santpur, Govind Marutrao Kahalekar, Nowreen Saraf, Aparna Losari
BACKGROUND: Regional anesthesia is the preferred technique for most of lower abdominal and lower limb surgeries. For decades, lignocaine had been the local anesthetic of choice for spinal anesthesia. Recent studies show that intravenous clonidine and dexmedetomidine can prolong the duration of the spinal anesthesia. Dexmedetomidine is a more suitable adjuvant compared to clonidine due to its more selective α2A receptor agonist activity. AIM: The study was undertaken to evaluate the effects of intravenous administration of dexmedetomidine on spinal anesthesia with 0...
September 2016: Anesthesia, Essays and Researches
Keelara Shivalingaiah Savitha, Radhika Dhanpal, J Shilpa
BACKGROUND: Multimodal analgesia (MMA) by synergy with volatile anesthetics minimizes their use thus decreasing operation theater pollution and greenhouse gas emission. AIMS: To estimate minimum alveolar concentration (MAC) requirement of isoflurane (ISO) for skin incision with use of MMA in the study group versus conventional regime in the control group for a constant bispectral index (BIS). To observe the side effects of analgesic drugs administered in the study...
September 2016: Anesthesia, Essays and Researches
Major Vishal Arora, Mohammad Zafeer Khan, Major Sanjay Choubey, Mohammad Asim Rasheed, Arindam Sarkar
CONTEXT: Various adjuvants are being used with local anesthetics for prolongation of intraoperative and postoperative analgesia. The α2-adrenergic agonist clonidine and potent opioid buprenorphine have the ability to potentiate the effects of local anesthetics. AIMS: The purpose of this prospective, double-blind study was to compare onset, duration of sensory and motor block, effect on hemodynamics, level of sedation, duration of postoperative analgesia, and any adverse effects of clonidine and buprenorphine...
September 2016: Anesthesia, Essays and Researches
Srivishnu Vardhan Yallapragada, Nagendra Nath Vemuri, Mastan Saheb Shaik
CONTEXT: The purpose of adding an adjuvant to local anesthetic in a central neuraxial blockade is to augment the desirable pharmacological actions of the agent and/or to minimize its undesirable pharmacological effects. Clonidine is an alfa-2 receptor agonist which has gained popularity in recent times as an adjuvant in spinal anesthesia. AIMS: To evaluate the influence of clonidine on the hemodynamic stability and the duration of anesthesia when added to intrathecal hyperbaric bupivacaine...
September 2016: Anesthesia, Essays and Researches
Venkatesh Selvaraj
BACKGROUND: Clonidine is an effective adjuvant to local anesthetics in peripheral nerve blocks. We studied the effect of clonidine as an adjuvant in wound infiltration for postoperative analgesia. AIM: To evaluate the role of clonidine as an adjuvant to bupivacaine in wound infiltration in terms of quality and duration of postoperative analgesia in patients undergoing total abdominal hysterectomy. SETTINGS AND STUDY DESIGN: Prospective, randomized, double-blinded study...
September 2016: Anesthesia, Essays and Researches
Janet C Tait, Evan W Mercer, Lucie Gerber, George N Robertson, William S Marshall
In eurythermic vertebrates, acclimation to the cold may produce changes in physiological control systems. We hypothesize that relatively direct osmosensitive control will operate better than adrenergic receptor mediated control of ion transport in cold vs. warm conditions. Fish were acclimated to full strength seawater (SW) at 21°C and 5°C for four weeks, gill samples and blood were taken and opercular epithelia mounted in Ussing style chambers. Short-circuit current (Isc) at 21°C and 5°C (measured at acclimation temperature), was significantly inhibited by the α2-adrenergic agonist clonidine but the ED50 dose was significantly higher in cold conditions (93...
October 13, 2016: Comparative Biochemistry and Physiology. Part A, Molecular & Integrative Physiology
Ines G Alamo, Kolenkode B Kannan, Harry Ramos, Tyler J Loftus, Philip A Efron, Alicia M Mohr
BACKGROUND: Propranolol has been shown previously to restore bone marrow function and improve anemia after lung contusion/hemorrhagic shock. We hypothesized that daily clonidine administration would inhibit central sympathetic outflow and restore bone marrow function in our rodent model of lung contusion/hemorrhagic shock with chronic stress. METHODS: Male Sprague-Dawley rats underwent 6 days of restraint stress after lung contusion/hemorrhagic shock during which the animals received clonidine (75 μg/kg) after the restraint stress...
October 11, 2016: Surgery
Ying Li, Jie Gao, Shu He, Yan Zhang, Qiwei Wang
Attention deficit hyperactivity disorder (ADHD) is one of the most common neurobehavioral disorders. We carried out this comparison of multiple treatments based on sufficient data in attempt to evaluate the efficacy and safety of ADHD medication for children and adolescents. PubMed, Embase and the Cochrane Database were used to search for relevant articles. Changes in the ADHD Rating Scale (ADHD-RS) scores and the Conners' Parent Rating Scale-Revised (CPRS) scores were used as outcomes for efficacy. Withdrawals due to all-cause, adverse effects and lack of efficacy were defined as primary outcomes evaluating the safety of such medications...
October 13, 2016: Molecular Neurobiology
Daniel Ayanga, Daryl Shorter, Thomas R Kosten
Opioid Use Disorder (OUD) is a significant public health concern, negatively impacting the medical, psychological, and social domains of an individual's life as well as creating substantial burdens for society. Effective treatment interventions are necessary for reduction of OUD and its consequences. Pharmacotherapy represents a central component of management. Areas Covered: This review focuses on pharmacologic strategies for OUD treatment, discussing both primary as well as adjunctive therapy modalities. We will discuss both medications used during detoxification to treat withdrawal, as well as those used as maintenance therapy...
October 13, 2016: Expert Opinion on Pharmacotherapy
Amy O'Donnell, Catherine McParlin, Stephen C Robson, Fiona Beyer, Eoin Moloney, Andrew Bryant, Jennifer Bradley, Colin Muirhead, Catherine Nelson-Piercy, Dorothy Newbury-Birch, Justine Norman, Emma Simpson, Brian Swallow, Laura Yates, Luke Vale
BACKGROUND: Nausea and vomiting in pregnancy (NVP) affects up to 85% of all women during pregnancy, but for the majority self-management suffices. For the remainder, symptoms are more severe and the most severe form of NVP - hyperemesis gravidarum (HG) - affects 0.3-1.0% of pregnant women. There is no widely accepted point at which NVP becomes HG. OBJECTIVES: This study aimed to determine the relative clinical effectiveness and cost-effectiveness of treatments for NVP and HG...
October 2016: Health Technology Assessment: HTA
William J Warrender, Usman Ali M Syed, Sommer Hammoud, William Emper, Michael G Ciccotti, Joseph A Abboud, Kevin B Freedman
BACKGROUND: Effective postoperative pain management after shoulder arthroscopy is a critical component to recovery, rehabilitation, and patient satisfaction. PURPOSE: This systematic review provides a comprehensive overview of level 1 and level 2 evidence regarding postoperative pain management for outpatient arthroscopic shoulder surgery. STUDY DESIGN: Systematic review. METHODS: We performed a systematic review of the various modalities reported in the literature for postoperative pain control after outpatient shoulder arthroscopy and analyzed their outcomes...
October 11, 2016: American Journal of Sports Medicine
Patrick Lauscher, Harry Kertscho, Malte Krömker, Barbara Haberichter, Kai Zacharowski, Peter Rosenberger, Jens Meier
BACKGROUND: Clonidine effectively decreases perioperative mortality by reducing sympathetic tone. However, application of clonidine might also restrict anaemia tolerance due to impairment of compensatory mechanisms. Therefore, the influence of clonidine induced, short-term sympathicolysis on anaemia tolerance was assessed in anaesthetized pigs. We measured the effect of clonidine on anaemia tolerance and of the potential for macrohemodynamic alterations to constrain the acute anaemia compensatory mechanisms...
October 12, 2016: BMC Anesthesiology
Selahattin Tugrul, Remzi Dogan, Erol Senturk, Ilker Kocak, Seda Sezen, Mefkur Bakan, Orhan Ozturan
: OBJECTıVE: The objective of this randomized double blind study was to evaluate effect of the premedication with oral clonidine on blood pressure, cleaning of surgical site and bleeding in the ESS performed due to advanced NP. METHODS: A total of 52 patients who underwent functional endoscopic sinus surgery (FESS) due to Kennedy grade 4 nasal polyposis (NP) were included. Patients were randomized into two groups. Group 1 (n=26) received 0.2mg oral clonodine one hour before the operation in addition to standard anesthesia procedure...
August 30, 2016: American Journal of Otolaryngology
R Dandriyal, S Pachauri, K Y Giri, S Rastogi, N I B Prasad, S Agarwal, H P Singh
Our aim was to evaluate the efficacy of clonidine with lidocaine as a local anaesthetic agent for inferior alveolar mandibular nerve blocks for dental extraction. We studied 200 patients who required extraction of mandibular teeth and divided them into two groups of 100 each, the first of which was given lidocaine and adrenaline (12.5μg/ml) and the second lidocaine and clonidine (15μg/ml). Cardiovascular vascular variables (blood pressure, heart rate, and mean arterial pressure) were assessed before, during, and after extraction, and postoperative pain was measured on a visual analogue scale...
October 3, 2016: British Journal of Oral & Maxillofacial Surgery
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