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Drugs in anesthesia

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68 papers 25 to 100 followers Anesthetic drug-related articles of interest
https://www.readbyqxmd.com/read/23329341/carbetocin-in-comparison-with-oxytocin-in-several-dosing-regimens-for-the-prevention-of-uterine-atony-after-elective-caesarean-section-in-the-netherlands
#1
COMPARATIVE STUDY
C A G Holleboom, J van Eyck, S V Koenen, I A M Kreuwel, F Bergwerff, E C Creutzberg, H W Bruinse
PURPOSE: The aim of the study was to compare the prophylactic effects of carbetocin with those of oxytocin for the prevention of uterine atony in patients undergoing elective caesarean section (CS) in the Netherlands. The primary endpoint was the need for additional uterotonic medication. METHODS: Each of the five participating Dutch hospitals treated 50-100 term patients with 100 μg of intravenous carbetocin on prescription. Each centre retrieved charts of 250 patients treated with oxytocin according to the hospital's policy for the prevention of uterine atony (oxytocin bolus 5 IU, bolus 10 IU or bolus 5 IU followed by 10 IU in 2 h)...
June 2013: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/12100762/effects-of-norepinephrine-epinephrine-and-norepinephrine-dobutamine-on-systemic-and-gastric-mucosal-oxygenation-in-septic-shock
#2
RANDOMIZED CONTROLLED TRIAL
Shao-Xia Zhou, Hai-Bo Qiu, Ying-Zi Huang, Yi Yang, Rui-Qiang Zheng
AIM: To compare the effects of dopamine, norepinephrine, epinephrine, and the combination of norepinephrine and dobutamine on systemic and gastric mucosal oxygen metabolism in patients with septic shock. METHODS: Sixteen patients with septic shock were enrolled in the present study. Each patient received dopamine firstly, then in a random succession epinephrine, norepinephrine, or norepinephrine-dobutamine, a mean systemic arterial pressure adjusted to >9.31 kPa...
July 2002: Acta Pharmacologica Sinica
https://www.readbyqxmd.com/read/25851818/impact-of-early-haemodynamic-goal-directed-therapy-in-patients-undergoing-emergency-surgery-an-open-prospective-randomised-trial
#3
RANDOMIZED CONTROLLED TRIAL
Gordana Pavlovic, John Diaper, Christoph Ellenberger, Angela Frei, Karim Bendjelid, Fanny Bonhomme, Marc Licker
Haemodynamic goal-directed therapies (GDT) may improve outcome following elective major surgery. So far, few data exist regarding haemodynamic optimization during emergency surgery. In this randomized, controlled trial, 50 surgical patients with hypovolemic or septic conditions were enrolled and we compared two algorithms of GDTs based either on conventional parameters and pressure pulse variation (control group) or on cardiac index, global end-diastolic volume index and stroke volume variation as derived from the PiCCO monitoring system (optimized group)...
February 2016: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/27542303/dexmedetomidine-for-prevention-of-delirium-in-elderly-patients-after-non-cardiac-surgery-a-randomised-double-blind-placebo-controlled-trial
#4
RANDOMIZED CONTROLLED TRIAL
Xian Su, Zhao-Ting Meng, Xin-Hai Wu, Fan Cui, Hong-Liang Li, Dong-Xin Wang, Xi Zhu, Sai-Nan Zhu, Mervyn Maze, Daqing Ma
BACKGROUND: Delirium is a postoperative complication that occurs frequently in patients older than 65 years, and presages adverse outcomes. We investigated whether prophylactic low-dose dexmedetomidine, a highly selective α2 adrenoceptor agonist, could safely decrease the incidence of delirium in elderly patients after non-cardiac surgery. METHODS: We did this randomised, double-blind, placebo-controlled trial in two tertiary-care hospitals in Beijing, China. We enrolled patients aged 65 years or older, who were admitted to intensive care units after non-cardiac surgery, with informed consent...
October 15, 2016: Lancet
https://www.readbyqxmd.com/read/24237879/intranasal-dexmedetomidine-vs-midazolam-for-premedication-in-children-undergoing-complete-dental-rehabilitation-a-double-blinded-randomized-controlled-trial
#5
RANDOMIZED CONTROLLED TRIAL
Saad A Sheta, Maha A Al-Sarheed, Ashraf A Abdelhalim
BACKGROUND: This prospective, randomized, double-blind study was designed to evaluate the use of intranasally administered dexmedetomidine vs intranasal midazolam as a premedication in children undergoing complete dental rehabilitation. METHODS: Seventy-two children of American Society of Anesthesiology classification (ASA) physical status (I & II), aged 3-6 years, were randomly assigned to one of two equal groups. Group M received intranasal midazolam (0.2 mg·kg(-1)), and group D received intranasal dexmedetomidine (1 μg·kg(-1))...
February 2014: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/25830866/remifentanil-acute-opioid-tolerance-and-opioid-induced-hyperalgesia-a-systematic-review
#6
REVIEW
Sang Hun Kim, Nicoleta Stoicea, Suren Soghomonyan, Sergio D Bergese
The use of opioids may seem to be a double-edged sword; they provide straight analgesic and antihyperalgesic effects initially, but subsequently are associated with the expression of acute opioid tolerance (AOT) and opioid-induced hyperalgesia (OIH) that have been reported in experimental studies and clinical observations. It has been suggested that opioids can induce an acute tolerance and hyperalgesia in dose- and/or time-dependent manners even when used within the clinically accepted doses. Recently, remifentanil has been used for pain management in clinical anesthesia and in the intensive care units because of its rapid onset and offset...
May 2015: American Journal of Therapeutics
https://www.readbyqxmd.com/read/15621365/ketamine-and-postoperative-pain-a-quantitative-systematic-review-of-randomised-trials
#7
REVIEW
Nadia Elia, Martin R Tramèr
Ketamine, an N-methyl-D-aspartate receptor antagonist, is known to be analgesic and to induce psychomimetic effects. Benefits and risks of ketamine for the control of postoperative pain are not well understood. We systematically searched for randomised comparisons of ketamine with inactive controls in surgical patients, reporting on pain outcomes, opioid sparing, and adverse effects. Data were combined using a fixed effect model. Fifty-three trials (2839 patients) from 25 countries reported on a large variety of different ketamine regimens and surgical settings...
January 2005: Pain
https://www.readbyqxmd.com/read/23730153/how-acidic-is-the-lidocaine-we-are-injecting-and-how-much-bicarbonate-should-we-add
#8
Simon G Frank, Donald H Lalonde
BACKGROUND: The infiltration of local anesthetics can be painful, which is likely due, in part, to their acidity. In spite of a Cochrane study that recommended neutralizing lidocaine with bicarbonate to decrease the pain of injection, not many surgeons have adopted the practice, and there are many 'recipes' for how much bicarbonate one should add. OBJECTIVE: To determine the acidity of lidocaine and the correct ratio of bicarbonate that should be added to neutralize lidocaine to achieve body pH...
2012: Canadian Journal of Plastic Surgery, Journal Canadien de Chirurgie Plastique
https://www.readbyqxmd.com/read/15920219/transient-neurologic-symptoms-after-spinal-anesthesia-with-lidocaine-versus-other-local-anesthetics-a-systematic-review-of-randomized-controlled-trials
#9
REVIEW
Dusanka Zaric, Christian Christiansen, Nathan L Pace, Yodying Punjasawadwong
Lidocaine has been used for spinal anesthesia since 1948, seemingly without causing concern. However, during the last 10 years, a number of reports have appeared implicating lidocaine as a possible cause of neurologic complications after spinal anesthesia. Follow-up of patients who received uncomplicated spinal anesthesia revealed that some of them developed pain in the lower extremities--transient neurologic symptoms (TNS). In this study, we sought to compare the frequency of 1) TNS and 2) neurologic complications after spinal anesthesia with lidocaine with that after other local anesthetics...
June 2005: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/17238883/ropivacaine-spinal-anesthesia-in-neonates-a-dose-range-finding-study
#10
Geoff Frawley, Adam Skinner, Jason Thomas, Sarah Smith
BACKGROUND: Our primary aim was to determine the minimum local anaesthetic dose (MLAD) defined as the median effective local anesthetic dose for spinal anesthesia in neonates. Secondary aims were to determine the dose-response curve for spinal anesthesia including the clinically relevant ED95 dose and to describe the duration of motor block following ropivacaine spinal anesthesia. METHODS: Fifty neonates less than 55 weeks postmenstrual age (PMA) having inguinal hernia repair were enrolled...
February 2007: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/17111469/dose-response-study-of-spinal-hyperbaric-ropivacaine-for-cesarean-section
#11
RANDOMIZED CONTROLLED TRIAL
Xin-zhong Chen, Hong Chen, Ai-fei Lou, Chang-cheng Lü
BACKGROUND: Spinal hyperbaric ropivacaine may produce more predictable and reliable anesthesia than plain ropivacaine for cesarean section. The dose-response relation for spinal hyperbaric ropivacaine is undetermined. This double-blind, randomized, dose-response study determined the ED50 (50% effective dose) and ED95 (95% effective dose) of spinal hyperbaric ropivacaine for cesarean section anesthesia. METHODS: Sixty parturients undergoing elective cesarean section delivery with use of combined spinal-epidural anesthesia were enrolled in this study...
December 2006: Journal of Zhejiang University. Science. B
https://www.readbyqxmd.com/read/25116762/adverse-effects-of-perioperative-paracetamol-nsaids-glucocorticoids-gabapentinoids-and-their-combinations-a-topical-review
#12
REVIEW
O Mathiesen, J Wetterslev, V K Kontinen, H-C Pommergaard, L Nikolajsen, J Rosenberg, M S Hansen, K Hamunen, J J Kjer, J B Dahl
Post-operative pain affects millions of patients worldwide and the post-operative period has high rates of morbidity and mortality. Some of this morbidity may be related to analgesics. The aim of this review was to provide an update of current knowledge of adverse events (AE) associated with the most common perioperative non-opioid analgesics: paracetamol, non-steroidal anti-inflammatory drugs (NSAIDs), glucocorticoids (GCCs), gabapentinoids and their combinations. The review is based on data from systematic reviews with meta-analyses of analgesic efficacy and/or adverse effects of perioperative non-opioid analgesics, and randomised trials and cohort/retrospective studies...
November 2014: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/24974371/intralipid-emulsion-treatment-as-an-antidote-in-lipophilic-drug-intoxications
#13
Sebnem Eren Cevik, Tanju Tasyurek, Ozlem Guneysel
Intravenous lipid emulsion (ILE) is a lifesaving treatment of lipophilic drug intoxications. Not only does ILE have demonstrable efficacy as an antidote to local anesthetic toxicity, it is also effective in lipophilic drug intoxications. Our case series involved 10 patients with ingestion of different types of lipophilic drugs. Intravenous lipid emulsion treatment improved Glasgow Coma Scale or blood pressure and pulse rate or both according to the drug type. Complications were observed in 2 patients (minimal change pancreatitis and probable ILE treatment-related fat infiltration in lungs)...
September 2014: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/26850063/medical-cannabis-considerations-for-the-anesthesiologist-and-pain-physician
#14
Pierre Beaulieu, Aline Boulanger, Julie Desroches, Alexander J Clark
PURPOSE: New regulations are in place at the federal and provincial levels in Canada regarding the way medical cannabis is to be controlled. We present them together with guidance for the safe use of medical cannabis and recent clinical trials on cannabis and pain. SOURCE: The new Canadian regulations on the use of medical cannabis, the provincial regulations, and the various cannabis products available from the Canadian Licensed Producers were reviewed from Health Canada, provincial licensing authorities, and the licensed producers website, respectively...
May 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/27140684/the-myth-of-rescue-reversal-in-can-t-intubate-can-t-ventilate-scenarios
#15
Mohamed Naguib, Lara Brewer, Cristen LaPierre, Aaron F Kopman, Ken B Johnson
BACKGROUND: An unanticipated difficult airway during induction of anesthesia can be a vexing problem. In the setting of can't intubate, can't ventilate (CICV), rapid recovery of spontaneous ventilation is a reasonable goal. The urgency of restoring ventilation is a function of how quickly a patient's hemoglobin oxygen saturation decreases versus how much time is required for the effects of induction drugs to dissipate, namely the duration of unresponsiveness, ventilatory depression, and neuromuscular blockade...
July 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/25917689/does-a-prophylactic-dose-of-propofol-reduce-emergence-agitation-in-children-receiving-anesthesia-a-systematic-review-and-meta-analysis
#16
REVIEW
Sophia L van Hoff, Elizabeth S O'Neill, Lianna C Cohen, Brian A Collins
INTRODUCTION: Emergence agitation (EA) is common after sevoflurane anesthesia in children, and can lead to distressing inconsolability, agitation, crying, and injury. Use of a single dose of the short-acting sedative-hypnotic agent propofol at the end of a procedure has shown promise for preventing EA, but evidence evaluating the efficacy and safety of this approach has not been formally summarized. OBJECTIVE: The objective of this review was to assess the effects of a prophylactic dose of propofol vs placebo on the incidence and severity of EA in children age 0-13 years receiving general inhalational anesthesia...
July 2015: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/24566243/comparison-of-the-effects-of-0-03-and-0-05-mg-kg-midazolam-with-placebo-on-prevention-of-emergence-agitation-in-children-having-strabismus-surgery
#17
RANDOMIZED CONTROLLED TRIAL
Eun Jung Cho, Seung Zhoo Yoon, Jang Eun Cho, Hye Won Lee
BACKGROUND: Midazolam has been widely studied for preventing emergence agitation. The authors previously reported that in children with sevoflurane anesthesia, intravenous administration of midazolam (0.05 mg/kg) before the end of surgery reduced the incidence of emergence agitation but prolonged the emergence time. This study was designed to test the hypothesis that a lower midazolam dose could suppress emergence agitation with minimal disturbance of the emergence time in children with sevoflurane anesthesia...
June 2014: Anesthesiology
https://www.readbyqxmd.com/read/26975647/effect-of-dexmedetomidine-added-to-standard-care-on-ventilator-free-time-in-patients-with-agitated-delirium-a-randomized-clinical-trial
#18
RANDOMIZED CONTROLLED TRIAL
Michael C Reade, Glenn M Eastwood, Rinaldo Bellomo, Michael Bailey, Andrew Bersten, Benjamin Cheung, Andrew Davies, Anthony Delaney, Angaj Ghosh, Frank van Haren, Nerina Harley, David Knight, Shay McGuiness, John Mulder, Steve O'Donoghue, Nicholas Simpson, Paul Young
IMPORTANCE: Effective therapy has not been established for patients with agitated delirium receiving mechanical ventilation. OBJECTIVE: To determine the effectiveness of dexmedetomidine when added to standard care in patients with agitated delirium receiving mechanical ventilation. DESIGN, SETTING, AND PARTICIPANTS: The Dexmedetomidine to Lessen ICU Agitation (DahLIA) study was a double-blind, placebo-controlled, parallel-group randomized clinical trial involving 74 adult patients in whom extubation was considered inappropriate because of the severity of agitation and delirium...
April 12, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/26928796/changes-in-first-postoperative-night-bispectral-index-after-daytime-sedation-induced-by-dexmedetomidine-or-midazolam-under-regional-anesthesia-a-randomized-controlled-trial
#19
Wen-fei Tan, Er-ya Miao, Feng Jin, Hong Ma, Huang-wei Lu
BACKGROUND AND OBJECTIVES: Supplementation of spinal anesthesia with various sedatives is a standard protocol to alleviate patient anxiety associated with the surgical procedure. We hypothesized that, compared with dexmedetomidine, midazolam might have a subtle influence on sleep quality after surgery following elective transurethral prostatic resection (TURP) in elderly male patients. METHODS: A randomized, double-blind, controlled trial was conducted at the First Hospital of China Medical University from July 2014 to January 2015...
May 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/26874258/optimum-dose-of-neostigmine-to-reverse-shallow-neuromuscular-blockade-with-rocuronium-and-cisatracurium
#20
RANDOMIZED CONTROLLED TRIAL
E S Choi, A Y Oh, K S Seo, J W Hwang, J H Ryu, B W Koo, B G Kim
We examined the use of neostigmine for reversing shallow (defined as train-of-four ratio of 0.5), cisatracurium- and rocuronium-induced neuromuscular block in 112 patients, by use of 0 μg.kg(-1) , 10 μg.kg(-1) , 20 μg.kg(-1) or 40 μg.kg(-1) dose of neostigmine for reversal. The times from neostigmine administration to train-of-four ratios of 0.7, 0.9 and 1.0 were evaluated. Analysis of variance showed that the duration of action was significantly longer after cisatracurium compared with rocuronium. The time to reach a train-of-four ratio of 1...
April 2016: Anaesthesia
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