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[PMID]:29269549
[Au] Autor:Dean R
[Ad] Endereço:Bree Merritt Centre for Evidencebased Veterinary Medicine and Shelter Medicine team, University of Nottingham.
[Ti] Título:Using dexmedetomidine to alleviate noise-induced fear and anxiety in dogs.
[So] Source:Vet Rec;181(25):688-689, 2017 12 23.
[Is] ISSN:2042-7670
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Ansiedade/tratamento farmacológico
Dexmedetomidina/administração & dosagem
Cães/psicologia
Medo/efeitos dos fármacos
Ruído/efeitos adversos
[Mh] Termos MeSH secundário: Animais
Ansiedade/etiologia
Géis
Ensaios Clínicos Controlados Aleatórios como Assunto
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Gels); 67VB76HONO (Dexmedetomidine)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171223
[St] Status:MEDLINE
[do] DOI:10.1136/vr.j5761


  2 / 2463 MEDLINE  
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[PMID]:29444390
[Au] Autor:Goode J; Veyckemans F; Tourtchaninoff M; Grosu I
[Ti] Título:The use of alpha 2 agonists during idiopathic scoliosis repair : a narrative review of the literature.
[So] Source:Acta Anaesthesiol Belg;67(2):53-62, 2016.
[Is] ISSN:0001-5164
[Cp] País de publicação:Belgium
[La] Idioma:eng
[Ab] Resumo:Alpha 2 agonists are appreciated drugs designed for the peri-operative period, because of their anxiolytic, sedative and analgesic properties. However, they are usually avoided during scoliosis surgery, a longlasting major procedure involving healthy patients, because of their potential effects on Somatosensory and Motorevoked potentials. The absence ofrecommendations suggests that their effects on evoked potentials are still unclear. Thus, we tried in this narrative review to identify the literature representative of the effects of clonidine and dexmedetomidine on evoked potentials, on human beings, published between 1988 and 2015 in English or French, using GOOGLE SCHOLAR and PUBMED. Paucity of literature prevented any conclusion about Clonidine's effects on evoked potentials, but no data suggested a noxious effect of Clonidine on evoked potentials, used in oral premedication (300 µg) or during the procedure (2 to 5 µg/kg). If literature was more extensive for dexmedetomidine, studies were still controversial. Although the majority of the studies did not find statistically significant differences concerning the effects of this drug on evoked potentials (loading dose of 0.3 to 1 µg/ kg followed by continuous infusion of 0.3 to 0.8 µg/kg/h), 2 case reports and 2 studies described substantial decreases. However, dexmedetomidine's shorter duration of action allowed a quick return to basal situation within an hour. In conclusion, more studies are needed in order to evaluate the effects of alpha 2 agonists on evoked potentials and to assess the safety of their use in this setting.
[Mh] Termos MeSH primário: Agonistas de Receptores Adrenérgicos alfa 2/farmacologia
Clonidina/farmacologia
Dexmedetomidina/farmacologia
Potencial Evocado Motor/efeitos dos fármacos
Potenciais Somatossensoriais Evocados/efeitos dos fármacos
Escoliose/cirurgia
[Mh] Termos MeSH secundário: Agonistas de Receptores Adrenérgicos alfa 2/efeitos adversos
Seres Humanos
Monitorização Fisiológica
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Adrenergic alpha-2 Receptor Agonists); 67VB76HONO (Dexmedetomidine); MN3L5RMN02 (Clonidine)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180215
[St] Status:MEDLINE


  3 / 2463 MEDLINE  
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[PMID]:29248769
[Au] Autor:Moosavi SM; Shekar K; Fraser JF; Smith MT; Ghassabian S
[Ad] Endereço:Centre for Integrated Preclinical Drug Development, University of Queensland, Brisbane, Queensland, Australia.
[Ti] Título:An improved liquid chromatography tandem mass spectrometry (LC-MS/MS) method for quantification of dexmedetomidine concentrations in samples of human plasma.
[So] Source:J Chromatogr B Analyt Technol Biomed Life Sci;1073:118-122, 2018 Jan 15.
[Is] ISSN:1873-376X
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:Dexmedetomidine (DMET) is a sedative, analgesic and anxiolytic with minimum adverse respiratory effects. An LC-MS/MS bioanalytical method has been developed and validated to accurately measure DMET concentrations in samples of human plasma. The method overcomes difficulties in the extraction and quantification of DMET due to the fact that it binds strongly to glass and plastic tubes, as well as solid phase extraction (SPE) cartridges. Human plasma (50 µL) was mixed with the internal standard (IS) (DMET-d4) solution (100 µL) and 0.1% formic acid (50 µL) and extracted using Oasis HLB 1 CC (30 mg) solid phase extraction (SPE) cartridges (Waters ). The glass tubes were coated with bovine serum albumin (BSA) 0.5% (20 µL) before eluting DMET and the IS. After evaporation under nitrogen at room temperature, the analytes were reconstituted in 20% acetonitrile in 0.1% formic acid in water and transferred to silanized glass vials. An electrospray ionisation (ESI) mass spectrometry method in positive mode was created and the precursor/product transitions (m/z) were 201.1 → 95.0 (DMET) and 204.9 → 99.0 (IS). The method was robust and fully validated based on the 2012 EMEA guideline for bioanalytical method validation in the concentration range of 0.5-20 ng/mL. Using this assay, we showed that DMET binds strongly to Extracorporeal Membrane Oxygenation (ECMO) circuits, consistent with expectations for small lipophilic compounds.
[Mh] Termos MeSH primário: Cromatografia Líquida/métodos
Dexmedetomidina/sangue
Espectrometria de Massas em Tandem/métodos
[Mh] Termos MeSH secundário: Dexmedetomidina/química
Dexmedetomidina/isolamento & purificação
Seres Humanos
Modelos Lineares
Reprodutibilidade dos Testes
Sensibilidade e Especificidade
Extração em Fase Sólida/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
67VB76HONO (Dexmedetomidine)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171218
[St] Status:MEDLINE


  4 / 2463 MEDLINE  
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[PMID]:29422100
[Au] Autor:Mikkelsen MLG; Ambrus R; Rasmussen R; Miles JE; Poulsen HH; Moltke FB; Eriksen T
[Ad] Endereço:Department of Veterinary Clinical Sciences, University of Copenhagen, 16 Dyrlægevej, 1870, Frederiksberg C, Denmark. mailo@sund.ku.dk.
[Ti] Título:The influence of norepinephrine and phenylephrine on cerebral perfusion and oxygenation during propofol-remifentanil and propofol-remifentanil-dexmedetomidine anaesthesia in piglets.
[So] Source:Acta Vet Scand;60(1):8, 2018 Feb 08.
[Is] ISSN:1751-0147
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Vasopressors are frequently used to increase blood pressure in order to ensure sufficient cerebral perfusion and oxygenation (CPO) during hypotensive periods in anaesthetized patients. Efficacy depends both on the vasopressor and anaesthetic protocol used. Propofol-remifentanil total intravenous anaesthesia (TIVA) is common in human anaesthesia, and dexmedetomidine is increasingly used as adjuvant to facilitate better haemodynamic stability and analgesia. Little is known of its interaction with vasopressors and subsequent effects on CPO. This study investigates the CPO response to infusions of norepinephrine and phenylephrine in piglets during propofol-remifentanil and propofol-remifentanil-dexmedetomidine anaesthesia. Sixteen healthy female piglets (25-34 kg) were randomly allocated into a two-arm parallel group design with either normal blood pressure (NBP) or induced low blood pressure (LBP). Anaesthesia was induced with propofol without premedication and maintained with propofol-remifentanil TIVA, and finally supplemented with continuous infusion of dexmedetomidine. Norepinephrine and phenylephrine were infused in consecutive intervention periods before and after addition of dexmedetomidine. Cerebral perfusion measured by laser speckle contrast imaging was related to cerebral oxygenation as measured by an intracerebral Licox probe (partial pressure of oxygen) and transcranial near infrared spectroscopy technology (NIRS) (cerebral oxygen saturation). RESULTS: During propofol-remifentanil anaesthesia, increases in blood pressure by norepinephrine and phenylephrine did not change cerebral perfusion significantly, but cerebral partial pressure of oxygen (Licox) increased following vasopressors in both groups and increases following norepinephrine were significant (NBP: P = 0.04, LBP: P = 0.02). In contrast, cerebral oxygen saturation (NIRS) fell significantly in NBP following phenylephrine (P = 0.003), and following both norepinephrine (P = 0.02) and phenylephrine (P = 0.002) in LBP. Blood pressure increase by both norepinephrine and phenylephrine during propofol-remifentanil-dexmedetomidine anaesthesia was not followed by significant changes in cerebral perfusion. Licox measures increased significantly following both vasopressors in both groups, whereas the decreases in NIRS measures were only significant in the NBP group. CONCLUSIONS: Cerebral partial pressure of oxygen measured by Licox increased significantly in concert with the vasopressor induced increases in blood pressure in healthy piglets with both normal and low blood pressure. Cerebral oxygenation assessed by intracerebral Licox and transcranial NIRS showed opposing results to vasopressor infusions.
[Mh] Termos MeSH primário: Anestesia/veterinária
Circulação Sanguínea/efeitos dos fármacos
Córtex Cerebral/efeitos dos fármacos
[Mh] Termos MeSH secundário: Anestésicos Intravenosos/administração & dosagem
Animais
Córtex Cerebral/irrigação sanguínea
Córtex Cerebral/metabolismo
Dexmedetomidina/administração & dosagem
Hipnóticos e Sedativos/administração & dosagem
Norepinefrina/farmacologia
Oxigênio/metabolismo
Fenilefrina/farmacologia
Piperidinas/administração & dosagem
Propofol/administração & dosagem
Suínos
Vasoconstritores/farmacologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anesthetics, Intravenous); 0 (Hypnotics and Sedatives); 0 (Piperidines); 0 (Vasoconstrictor Agents); 1WS297W6MV (Phenylephrine); 67VB76HONO (Dexmedetomidine); P10582JYYK (remifentanil); S88TT14065 (Oxygen); X4W3ENH1CV (Norepinephrine); YI7VU623SF (Propofol)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180227
[Lr] Data última revisão:
180227
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180210
[St] Status:MEDLINE
[do] DOI:10.1186/s13028-018-0362-z


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[PMID]:27770407
[Au] Autor:Li S; Fu S; Xiao Y; Xu G
[Ad] Endereço:Jiangxi Medical College, Nanchang University, Nanchang, People's Republic of China.
[Ti] Título:Recent Perioperative Pharmacological Prevention of Acute Kidney Injury after Cardiac Surgery: A Narrative Review.
[So] Source:Am J Cardiovasc Drugs;17(1):17-25, 2017 Feb.
[Is] ISSN:1179-187X
[Cp] País de publicação:New Zealand
[La] Idioma:eng
[Ab] Resumo:Acute kidney injury (AKI) is a common and severe complication of cardiac surgery, and related rates of both hospitalization and long-term mortality are increasing. A number of studies have explored the preventive effects of perioperative pharmacological therapy on AKI after cardiac surgery. However, the mechanisms of AKI are multifaceted, and no universal treatment has been confirmed as beneficial. We review and analyze several current perioperative pharmacological therapies for AKI after cardiac surgery to identify promising preventive strategies.
[Mh] Termos MeSH primário: Lesão Renal Aguda/prevenção & controle
Procedimentos Cirúrgicos Cardíacos/efeitos adversos
Assistência Perioperatória/métodos
Complicações Pós-Operatórias/prevenção & controle
[Mh] Termos MeSH secundário: Lesão Renal Aguda/etiologia
Lesão Renal Aguda/metabolismo
Dexmedetomidina/uso terapêutico
Seres Humanos
Hidrazonas/uso terapêutico
Complicações Pós-Operatórias/etiologia
Complicações Pós-Operatórias/metabolismo
Piridazinas/uso terapêutico
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Hydrazones); 0 (Pyridazines); 349552KRHK (simendan); 67VB76HONO (Dexmedetomidine)
[Em] Mês de entrada:1701
[Cu] Atualização por classe:180227
[Lr] Data última revisão:
180227
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161023
[St] Status:MEDLINE
[do] DOI:10.1007/s40256-016-0194-z


  6 / 2463 MEDLINE  
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[PMID]:29269298
[Au] Autor:Li Y; Pan Y; Gao L; Lu G; Zhang J; Xie X; Tong Z; Li B; Li G; Li W
[Ad] Endereço:Surgical Intensive Care Unit, Department of General Surgery, Jinling Clinical Medical College of Nanjing Medical University, No. 305 Zhongshan East Road, Nanjing 210002, Jiangsu Province, China.
[Ti] Título:Dexmedetomidine attenuates pancreatic injury and inflammatory response in mice with pancreatitis by possible reduction of NLRP3 activation and up-regulation of NET expression.
[So] Source:Biochem Biophys Res Commun;495(4):2439-2447, 2018 01 22.
[Is] ISSN:1090-2104
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Previous studies have shown that acute inflammation is associated with increased sympathetic activity, which in turn increases the inflammatory response and leads to organ damage. The present study aimed to investigate whether dexmedetomidine administration during acute pancreatitis (AP) lessens pancreatic pathological and functional injury and the inflammatory response, and to explore the underlying mechanisms. METHODS: Mild pancreatitis was induced in mice with caerulein, and severe pancreatitis was induced with caerulein plus lipopolysaccharide (LPS). After pancreatitis induction, dexmedetomidine at 10 or 20 µg/kg was injected via the tail vein. Pancreatic pathological and functional injury was assessed by histology and serum levels of amylase and lipase, respectively. The inflammatory response was evaluated by determining serum levels of inflammatory factors. The expression of myeloperoxidase (MPO) was examined by immunohistochemistry. The expression of norepinephrine transporter (NET), NLRP3, pro-IL-1ß, and interleukin (IL)-1ß in pancreatic tissue was detected by Western blot and real-time PCR. RESULTS: Dexmedetomidine at 20 µg/kg significantly attenuated pancreatic pathological injury, reduced serum levels of amylase, lipase, IL-1ß, IL-6, and tumor necrosis factor (TNF)-α, and decreased the expression of MPO in pancreatic tissue in both mouse models of pancreatitis. In addition, dexmedetomidine at 20 µg/kg significantly down-regulated the expression of NLRP3, pro-IL-1ß, and IL-1ß in pancreatic tissue, but up-regulated the expression of NET in both mouse models. CONCLUSION: Dexmedetomidine attenuates pancreatic injury and inflammatory response in mice with pancreatitis possibly by reducing NLRP3 activation and up-regulating NET expression.
[Mh] Termos MeSH primário: Dexmedetomidina/administração & dosagem
Fatores Imunológicos/imunologia
Proteína 3 que Contém Domínio de Pirina da Família NLR/imunologia
Proteínas da Membrana Plasmática de Transporte de Norepinefrina/imunologia
Pancreatite/tratamento farmacológico
Pancreatite/imunologia
[Mh] Termos MeSH secundário: Animais
Anti-Inflamatórios/administração & dosagem
Citocinas/imunologia
Relação Dose-Resposta a Droga
Masculino
Camundongos
Camundongos Endogâmicos ICR
Pancreatite/diagnóstico
Resultado do Tratamento
Regulação para Cima/efeitos dos fármacos
Regulação para Cima/imunologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Anti-Inflammatory Agents); 0 (Cytokines); 0 (Immunologic Factors); 0 (NLR Family, Pyrin Domain-Containing 3 Protein); 0 (Nlrp3 protein, mouse); 0 (Norepinephrine Plasma Membrane Transport Proteins); 67VB76HONO (Dexmedetomidine)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171223
[St] Status:MEDLINE


  7 / 2463 MEDLINE  
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[PMID]:29351316
[Au] Autor:Yeh CH; Hsieh LP; Lin MC; Wei TS; Lin HC; Chang CC; Hsing CH
[Ad] Endereço:Department of Medicinal Botanicals and Health applications, Da-Yeh University, Changhua, Taiwan.
[Ti] Título:Dexmedetomidine reduces lipopolysaccharide induced neuroinflammation, sickness behavior, and anhedonia.
[So] Source:PLoS One;13(1):e0191070, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Peripheral innate immune response may induce sickness behavior through activating microglia, excessive cytokines production, and neuroinflammation. Dexmedetomidine (Dex) has anti-inflammatory effect. We investigated the effects of Dex on lipopolysaccharide (LPS)-induced neuroinflammation and sickness behavior in mice. MATERIALS AND METHODS: BALB/c mice were intraperitoneally (i.p.) injected with Dex (50 ug/kg) or vehicle. One hour later, the mice were injected (i.p.) with Escherichia coli LPS (0.33 mg/kg) or saline (n = 6 in each group). We analyzed the food and water intake, body weight loss, and sucrose preference of the mice for 24h. We also determined microglia activation and cytokines expression in the brains of the mice. In vitro, we determine cytokines expression in LPS-treated BV-2 microglial cells with or without Dex treatment. RESULTS: In the Dex-pretreated mice, LPS-induced sickness behavior (anorexia, weight loss, and social withdrawal) were attenuated and microglial activation was lower than vehicle control. The mRNA expression of TNF-α, MCP-1, indoleamine 2, 3 dioxygenase (IDO), caspase-3, and iNOS were increased in the brain of LPS-challenged mice, which were reduced by Dex but not vehicle. CONCLUSION: Dexmedetomidine diminished LPS-induced neuroinflammation in the mouse brain and modulated the cytokine-associated changes in sickness behavior.
[Mh] Termos MeSH primário: Anedonia/efeitos dos fármacos
Encéfalo/efeitos dos fármacos
Dexmedetomidina/farmacologia
Comportamento de Doença/efeitos dos fármacos
Inflamação/induzido quimicamente
Lipopolissacarídeos/toxicidade
[Mh] Termos MeSH secundário: Animais
Apoptose/efeitos dos fármacos
Encéfalo/patologia
Inflamação/patologia
Masculino
Camundongos
Camundongos Endogâmicos BALB C
Microglia/efeitos dos fármacos
Reação em Cadeia da Polimerase em Tempo Real
Reação em Cadeia da Polimerase Via Transcriptase Reversa
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Lipopolysaccharides); 67VB76HONO (Dexmedetomidine)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180221
[Lr] Data última revisão:
180221
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180120
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191070


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[PMID]:29216621
[Au] Autor:Marquis K; Hohlfelder B; Szumita PM
[Ad] Endereço:Department of Pharmacy Services, Brigham and Women's Hospital, Boston, Massachusetts.
[Ti] Título:Stability of Dexmedetomidine in 0.9% Sodium Chloride in Two Types of Intravenous Infusion Bags.
[So] Source:Int J Pharm Compd;21(5):436-439, 2017 Sep-Oct.
[Is] ISSN:1092-4221
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Dexmedetomidine is a frequently used sedative in the critical care setting. It is commercially available as a 4-mg/mL premixed compound or as 200-mcg/2-mL vials that must be further diluted prior to administration. However, limited data exist regarding the stability of dexmedetomidine admixtures compounded from the 200-mcg/2-mL vials, particularly for durations greater than 48 hours. Therefore, we performed stability testing on compounded dexmedetomidine prepared in two types of intravenous infusion bags for 14 days. Dexmedetomidine is available as 200-mcg/2-mL vials for dilution, 80-mcg/20-mL single-dose vials, and as 200-mcg/50-mL and 400-mcg/100-mL glass bottles. The stability of dexmedetomidine admixtures has previously been tested for 48 hours. The purpose of this analysis was to test the stability of dexmedetomidine admixtures for 14 days. Six dexmedetomidine admixtures of 200 mcg/50 mL were compounded in polyvinyl chloride and non-polyvinyl chloride bags, three of which were stored under refrigeration and three of which were kept at room temperature. High-performance liquid chromatography testing was performed to determine the concentration at Days 1 through 14. Stability was determined by taking the mean concentration of samples taken from each bag. All samples were tested in duplicate. A sample was considered stable if the concentration was greater than 90% of the original concentration. All samples retained over 90% of the drug under their respective storage conditions for the duration of the study. At time 0, the concentration of dexmedetomidine was between 3.99 mcg/mL and 4.01 mcg/mL. On Day 14, the mean concentration was between 95.8% and 98.9%, depending on the bag type and storage condition. The pH remained between 4.7 and 5.8 during the study period as has previously been reported in the literature. Dexmedetomidine admixtures of 200 mcg/50 mL were stable in both polyvinyl chloride bags and non-polyvinyl chloride bags for 14 days under refrigeration and 48 hours at room temperature. This represents the longest time allowable under United States Pharmacopeia Chapter <797> without the need for sterility testing.
[Mh] Termos MeSH primário: Dexmedetomidina/química
[Mh] Termos MeSH secundário: Cromatografia Líquida de Alta Pressão
Dexmedetomidina/administração & dosagem
Embalagem de Medicamentos
Estabilidade de Medicamentos
Concentração de Íons de Hidrogênio
Infusões Intravenosas
Cloreto de Sódio
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
451W47IQ8X (Sodium Chloride); 67VB76HONO (Dexmedetomidine)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171208
[St] Status:MEDLINE


  9 / 2463 MEDLINE  
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[PMID]:29390531
[Au] Autor:Tu Y; Gao F
[Ad] Endereço:Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China.
[Ti] Título:Dexmedetomidine-based monitored conscious sedation combined local anesthesia for levator resection in a 10-year-old child with Marcus Gunn jaw-winking synkinesis: A case report.
[So] Source:Medicine (Baltimore);96(51):e9369, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Levator resection has become a routine procedure for patients with severe Marcus Gunn jaw-winking synkinesis (MGJWS). To optimize the surgical outcome, adult patients need to be kept awake, or easily aroused and responsive to verbal commands during the operation. However, levator resection is commonly performed under general anesthesia in pediatric patients. In the present case, we described a successful anesthetic protocol of conscious sedation with local anesthesia for levator resection in a child. PATIENT CONCERNS: A 10-year-old boy with MGJWS was admitted to our hospital and scheduled for levator resection. The patient was born through a normal delivery and had no previous history of allergy, no comorbidity, and no history of receiving anesthesia or operation. The laboratory tests of the patient were unremarkable. DIAGNOSES: The diagnosis of MGJWS was made by two experienced ophthalmologists. INTERVENTIONS: A 10-year-old boy with MGJWS was admitted to our hospital and scheduled for levator resection. The levator resection was performed under monitored conscious sedation with dexmedetomidine and local anesthesia. OUTCOMES: Patient with spontaneous breathing responded normally to verbal commands throughout the operation, and no adverse events occurred. The patient and ophthalmologist reported high satisfaction with anesthesia management. LESSONS: Dexmedetomidine-based monitored conscious sedation with local anesthesia is a feasible alternative to general anesthesia for levator resection in collaborative patients.
[Mh] Termos MeSH primário: Blefaroptose/diagnóstico
Blefaroptose/terapia
Dexmedetomidina/administração & dosagem
Cardiopatias Congênitas/diagnóstico
Cardiopatias Congênitas/terapia
Anormalidades Maxilomandibulares/diagnóstico
Anormalidades Maxilomandibulares/terapia
Monitorização Fisiológica/métodos
Doenças do Sistema Nervoso/diagnóstico
Doenças do Sistema Nervoso/terapia
Músculos Oculomotores/cirurgia
[Mh] Termos MeSH secundário: Anestesia Local
Criança
Sedação Consciente/métodos
Seguimentos
Seres Humanos
Masculino
Doenças Raras
Reflexo Anormal
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
67VB76HONO (Dexmedetomidine)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180219
[Lr] Data última revisão:
180219
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009369


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[PMID]:28450772
[Au] Autor:Nazir N; Jain S
[Ad] Endereço:Department of Anesthesiology, School of Medical Sciences & Research, Sharda University, Greater Noida.
[Ti] Título:A Randomized Controlled Trial Study on the Effect of Adding Dexmedetomidine to Bupivacaine in Supraclavicular Block Using Ultrasound Guidance.
[So] Source:Ethiop J Health Sci;26(6):561-566, 2016 Nov.
[Is] ISSN:2413-7170
[Cp] País de publicação:Ethiopia
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The benefits of regional anesthetic techniques are well established. Use of additives to local anesthetics can prolong these benefits. The aim of this study was to find out the effect of adding dexmedetomidine to bupivacaine for supraclavicular block. METHODS: In this randomized, double-blind study, 70 ASA I & II patients of either sex undergoing elective surgeries on the upper limb were given supraclavicular block under ultrasound guidance. Group C (n=35) received 38 mL 0.25% bupivacaine + 2mL normal saline and group D received 38 mL 0.25% bupivacaine + 1 µg/kg dexmedetomidine (2mL). Patients were observed for, onset of motor and sensory block, duration of motor and sensory block, duration of analgesia, sedation score, hemodynamic changes and any adverse events. RESULTS: In group D, the onset was faster (P< 0.001), durations of sensory and motor block duration of and analgesia were prolonged as compared to group C (P < 0.0001).There was a significant drop in heart rate (HR) from the baseline in group D (P < 0.05) at 30, 60, 90 and 120 min. However, none of the patients dropped HR below 50/min. Mean Arterial Pressure (MAP) remained unaffected. The patients in group D were more effectively sedated than those in group C (P < 0.05). No adverse event was reported in either group. CONCLUSION: Dexmedetomidine as adjuvant to bupivacaine in supraclavicular block resulted in faster action, prolonged motor and sensory block, prolonged analgesia with hemodynamic stability and adequate sedation.
[Mh] Termos MeSH primário: Analgésicos não Entorpecentes/uso terapêutico
Anestésicos Locais/uso terapêutico
Bloqueio do Plexo Braquial/métodos
Bupivacaína/uso terapêutico
Dexmedetomidina/uso terapêutico
[Mh] Termos MeSH secundário: Adulto
Analgesia/métodos
Analgésicos não Entorpecentes/administração & dosagem
Anestésicos Locais/administração & dosagem
Bupivacaína/administração & dosagem
Dexmedetomidina/administração & dosagem
Método Duplo-Cego
Quimioterapia Combinada
Feminino
Hemodinâmica
Seres Humanos
Masculino
Meia-Idade
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Analgesics, Non-Narcotic); 0 (Anesthetics, Local); 67VB76HONO (Dexmedetomidine); Y8335394RO (Bupivacaine)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180205
[Lr] Data última revisão:
180205
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE



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