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Drugs in anesthesia

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73 papers 25 to 100 followers Anesthetic drug-related articles of interest
https://www.readbyqxmd.com/read/26332857/dexmedetomidine-as-a-rapid-bolus-for-treatment-and-prophylactic-prevention-of-emergence-agitation-in-anesthetized-children
#1
RANDOMIZED CONTROLLED TRIAL
John A Hauber, Peter J Davis, Laima P Bendel, Slava V Martyn, Denise L McCarthy, Minh-Chau Evans, Franklyn P Cladis, Sarah Cunningham, Robert Scott Lang, Neal F Campbell, Jay B Tuchman, Michael C Young
BACKGROUND: Administration of dexmedetomidine (DEX) in the pediatric population for its sedative, analgesic, and anxiolytic properties has been widely reported, despite there being no label indication approved by the U.S. Food and Drug Administration for pediatric patients. Infusions of DEX, rather than bolus administration, are recommended to attenuate the hemodynamic response caused by the α2-adrenoreceptor agonist. In this prospective, double-blind, randomized study, we examined the effect of rapid IV bolus injection of DEX on emergence agitation and the hemodynamic response in a large sample of children undergoing tonsillectomy with or without adenoidectomy, with or without myringotomy, and/or tympanostomy tube insertion...
November 2015: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27918778/efficacy-of-oral-risperidone-haloperidol-or-placebo-for-symptoms-of-delirium-among-patients-in-palliative-care-a-randomized-clinical-trial
#2
RANDOMIZED CONTROLLED TRIAL
Meera R Agar, Peter G Lawlor, Stephen Quinn, Brian Draper, Gideon A Caplan, Debra Rowett, Christine Sanderson, Janet Hardy, Brian Le, Simon Eckermann, Nicola McCaffrey, Linda Devilee, Belinda Fazekas, Mark Hill, David C Currow
Importance: Antipsychotics are widely used for distressing symptoms of delirium, but efficacy has not been established in placebo-controlled trials in palliative care. Objective: To determine efficacy of risperidone or haloperidol relative to placebo in relieving target symptoms of delirium associated with distress among patients receiving palliative care. Design, Setting, and Participants: A double-blind, parallel-arm, dose-titrated randomized clinical trial was conducted at 11 Australian inpatient hospice or hospital palliative care services between August 13, 2008, and April 2, 2014, among participants with life-limiting illness, delirium, and a delirium symptoms score (sum of Nursing Delirium Screening Scale behavioral, communication, and perceptual items) of 1 or more...
January 1, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/26936022/a-comparison-of-intranasal-dexmedetomidine-for-sedation-in-children-administered-either-by-atomiser-or-by-drops
#3
COMPARATIVE STUDY
B L Li, N Zhang, J X Huang, Q Q Qiu, H Tian, J Ni, X R Song, V M Yuen, M G Irwin
Intranasal dexmedetomidine has been used successfully for sedation in children. A mucosal atomisation device delivers an atomised solution to the nasal mucosa which facilitates rapid and effective delivery of medication to the systemic circulation. We compared intranasal delivery of dexmedetomidine in a dose of 3 μg.kg(-1) by either atomiser or drops from a syringe in children < 3 years old undergoing transthoracic echocardiography. Two hundred and seventy-nine children were randomly assigned to one or other group...
May 2016: Anaesthesia
https://www.readbyqxmd.com/read/27780181/benefit-and-harm-of-adding-ketamine-to-an-opioid-in-a-patient-controlled-analgesia-device-for-the-control-of-postoperative-pain-systematic-review-and-meta-analyses-of-randomized-controlled-trials-with-trial-sequential-analyses
#4
Benjamin Assouline, Martin R Tramèr, Lukas Kreienbühl, Nadia Elia
Ketamine is often added to opioids in patient-controlled analgesia devices. We tested whether in surgical patients, ketamine added to an opioid patient-controlled analgesia decreased pain intensity by ≥25%, cumulative opioid consumption by ≥30%, the risk of postoperative nausea and vomiting by ≥30%, the risk of respiratory adverse effects by ≥50%, and increased the risk of hallucination not more than 2-fold. In addition, we searched for evidence of dose-responsiveness. Nineteen randomized trials (1349 adults, 104 children) testing different ketamine regimens added to various opioids were identified through searches in databases and bibliographies (to 04...
December 2016: Pain
https://www.readbyqxmd.com/read/23506796/strategies-for-prevention-of-postoperative-delirium-a-systematic-review-and-meta-analysis-of-randomized-trials
#5
REVIEW
Hao Zhang, Yan Lu, Meng Liu, Zui Zou, Long Wang, Feng-Ying Xu, Xue-Yin Shi
INTRODUCTION: The ideal measures to prevent postoperative delirium remain unestablished. We conducted this systematic review and meta-analysis to clarify the significance of potential interventions. METHODS: The PRISMA statement guidelines were followed. Two researchers searched MEDLINE, EMBASE, CINAHL and the Cochrane Library for articles published in English before August 2012. Additional sources included reference lists from reviews and related articles from 'Google Scholar'...
March 18, 2013: Critical Care: the Official Journal of the Critical Care Forum
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
REVIEW
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
#20
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
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