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[PMID]:28829798
[Au] Autor:Zhang J; Zhang X; Wang H; Zhou H; Tian T; Wu A
[Ad] Endereço:Department of Anesthesiology, Beijing Chaoyang Hospital of Capital Medical University, Beijing, China.
[Ti] Título:Dexmedetomidine as a neuraxial adjuvant for prevention of perioperative shivering: Meta-analysis of randomized controlled trials.
[So] Source:PLoS One;12(8):e0183154, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Dexmedetomidine, a highly selective α2-adrenoceptor agonist, has been investigated for anti-shivering effects in some trials. This current meta-analysis was conducted to evaluate the effectiveness of dexmedetomidine as a neuraxial adjuvant in preventing perioperative shivering. METHODS: This systematic review and meta-analysis was registered in PROSPERO [www.crd.york.ac.uk/PROSPERO] with the unique identification number CRD42017055991. The electronic databases PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL) were searched to select high-quality randomized controlled trials (RCTs) that evaluated the anti-shivering efficacy for neuraxial application dexmedetomidine as local anesthetic adjuvant. Effects were summarized using pooled risk ratios (RRs), weighed mean differences (MDs), or standardized mean differences (SMDs) and corresponding 95% confidence intervals (Cls) with random effect model. Heterogeneity assessment, sensitivity analysis, and publication bias were performed. The primary outcome was perioperative shivering. RESULTS: A total of 1760 patients from 24 studies were included in this meta-analysis. Compared with the placebo, dexmedetomidine reduced the incidence of perioperative shivering (RR: 0.34; 95% Cl: 0.21 to 0.55; P < 0.00001), with a maximum effective dose of 5µg via subarachnoid space injection (RR: 0.55; 95% CI: 0.32 to 0.92; P = 0.02), especially in cesarean section (RR: 0.20; 95% CI: 0.09 to 0.45; P = 0.0001). Dexmedetomidine also could improve the characteristics of the block, with an increase only in the incidence of bradycardia (RR: 2.11; 95% CI: 1.23 to 3.60; P = 0.006). No significant difference could be found compared dexmedetomidine with other adjuvants, except morphine. CONCLUSIONS: This meta-analysis shows that dexmedetomidine as a neuraxial adjuvant had statistically significant efficacy on prevention of perioperative shivering. Moreover, dexmedetomidine could improve the characteristics of the block. However, the potential induction of bradycardia should be taken seriously.
[Mh] Termos MeSH primário: Dexmedetomidina/farmacologia
Ensaios Clínicos Controlados Aleatórios como Assunto
Tremor por Sensação de Frio/efeitos dos fármacos
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS
[Nm] Nome de substância:
67VB76HONO (Dexmedetomidine)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171016
[Lr] Data última revisão:
171016
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170823
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0183154


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[PMID]:28771404
[Au] Autor:Collins M; Young M
[Ad] Endereço:Department of Pediatrics, Howard University College of Medicine and Hospital, Washington, District of Columbia m_collins@howard.edu.
[Ti] Título:Benign Neonatal Shudders, Shivers, Jitteriness, or Tremors: Early Signs of Vitamin D Deficiency.
[So] Source:Pediatrics;140(2), 2017 Aug.
[Is] ISSN:1098-4275
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Jitteriness and tremors in the newborn period typically precipitate an extensive, invasive, and expensive search for the etiology. Vitamin D deficiency has not been historically included in the differential of tremors. We report a shivering, jittery newborn who was subjected to a battery of testing, with the only biochemical abnormality being vitamin D deficiency. A second case had chin tremors and vitamin D deficiency. Review of our patients suggests that shudders, shivers, jitteriness, or tremors may be the earliest sign of vitamin D deficiency in the newborn. Neonates who present with these signs should be investigated for vitamin D deficiency.
[Mh] Termos MeSH primário: Discinesias/etiologia
Doenças do Recém-Nascido/diagnóstico
Tremor por Sensação de Frio
Tremor/etiologia
Deficiência de Vitamina D/diagnóstico
Vitamina D/análogos & derivados
[Mh] Termos MeSH secundário: Diagnóstico Diferencial
Discinesias/sangue
Seres Humanos
Lactente
Recém-Nascido
Doenças do Recém-Nascido/sangue
Masculino
Tremor/sangue
Vitamina D/sangue
Deficiência de Vitamina D/sangue
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
1406-16-2 (Vitamin D); 64719-49-9 (25-hydroxyvitamin D)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170828
[Lr] Data última revisão:
170828
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170804
[St] Status:MEDLINE


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[PMID]:28652388
[Au] Autor:Bailey IR; Laughlin B; Moore LA; Bogren LK; Barati Z; Drew KL
[Ad] Endereço:Institute of Arctic Biology, University of Alaska Fairbanks, Fairbanks, Alaska (I.R.B., B.L., L.A.M., L.K.B., Z.B., K.L.D.); and Departments of Chemistry and Biochemisty, University of Alaska Fairbanks, Fairbanks, Alaska (I.R.B., B.L., K.L.D.).
[Ti] Título:Optimization of Thermolytic Response to A Adenosine Receptor Agonists in Rats.
[So] Source:J Pharmacol Exp Ther;362(3):424-430, 2017 Sep.
[Is] ISSN:1521-0103
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Cardiac arrest is a leading cause of death in the United States, and, currently, therapeutic hypothermia, now called targeted temperature management (TTM), is the only recent treatment modality proven to increase survival rates and reduce morbidity for this condition. Shivering and subsequent metabolic stress, however, limit application and benefit of TTM. Stimulating central nervous system A adenosine receptors (A AR) inhibits shivering and nonshivering thermogenesis in rats and induces a hibernation-like response in hibernating species. In this study, we investigated the pharmacodynamics of two A AR agonists in development as antishivering agents. To optimize body temperature (T ) control, we evaluated the influence of every-other-day feeding, dose, drug, and ambient temperature (T ) on the T -lowering effects of N -cyclohexyladenosine (CHA) and the partial A AR agonist capadenoson in rats. The highest dose of CHA (1.0 mg/kg, i.p.) caused all ad libitum-fed animals tested to reach our target T of 32°C, but responses varied and some rats overcooled to a T as low as 21°C at 17.0°C T Dietary restriction normalized the response to CHA. The partial agonist capadenoson (1.0 or 2.0 mg/kg, i.p.) produced a more consistent response, but the highest dose decreased T by only 1.6°C. To prevent overcooling after CHA, we studied continuous i.v. administration in combination with dynamic surface temperature control. Results show that after CHA administration control of surface temperature maintains desired target T better than dose or ambient temperature.
[Mh] Termos MeSH primário: Agonistas do Receptor A1 de Adenosina/farmacologia
Adenosina/análogos & derivados
Aminopiridinas/farmacologia
Hipotermia Induzida/efeitos adversos
Tremor por Sensação de Frio/efeitos dos fármacos
Termogênese/efeitos dos fármacos
Tiazóis/farmacologia
[Mh] Termos MeSH secundário: Adenosina/farmacologia
Animais
Relação Dose-Resposta a Droga
Comportamento Alimentar/efeitos dos fármacos
Hibernação
Masculino
Consumo de Oxigênio/efeitos dos fármacos
Ratos
Ratos Sprague-Dawley
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Adenosine A1 Receptor Agonists); 0 (Aminopyridines); 0 (Thiazoles); 0 (capadenoson); 36396-99-3 (N(6)-cyclohexyladenosine); K72T3FS567 (Adenosine)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170902
[Lr] Data última revisão:
170902
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170628
[St] Status:MEDLINE
[do] DOI:10.1124/jpet.117.241315


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[PMID]:28637495
[Au] Autor:Kakitsuba N; Mekjavic IB
[Ad] Endereço:Department of Environment and Technology, School of Science and Technology, Meijo University, 468-8502 Shiogamaguchi 1-501, Tenpaku-ku, Nagoya, Aichi Prefecture, Japan. naoshi@ccmfs.meijo-u.ac.jp.
[Ti] Título:Diurnal variation in the core interthreshold zone and its relation to cutaneous sensation threshold zone.
[So] Source:J Physiol Anthropol;36(1):27, 2017 Jun 21.
[Is] ISSN:1880-6805
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The core interthreshold zone (CIZ) is defined as the range between temperatures at the onset of shivering and sweating. Its circadian or diurnal variation has not been extensively studied. The present study examined whether the CIZ is subject to a diurnal rhythm. In addition, according to the previous finding that the CIZ was proportionally correlated with peripheral interthreshold zone (PIZ), it was also examined whether cutaneous sensation threshold zone (CSZ), a determinant of the PIZ, is correlated with the CIZ. METHODS: The CIZ and the CSZ were measured in ten Japanese men who underwent three experiments in a single day on the morning, afternoon, and evening in the 2014 experiment (so-called single-day experiment) and six Japanese men underwent the same experiments on the morning of day 1, the afternoon of day 2, and the evening of day 3 in the 2015 experiment (so-called multiple-day experiment). Air temperature was controlled at 20-24 °C. Each subject wore a suit perfused with 25 °C water at a rate of 600 cm /min and exercised on an ergometer at 50% of their maximum work rate for 10-15 min until their rate of sweating increased. They then remained seated without exercising until their oxygen uptake increased. Rectal temperature, skin temperatures at seven sites, the sweating rate at the forehead, and oxygen uptake were continuously monitored throughout experiment. Cutaneous warm and cold sensation thresholds at three sites were measured using 1- and 2-cm probes. RESULTS: The results from the single-day experiment demonstrated a small change in the CIZ and core temperature prior to exercise (T ) whereas those from the multiple-day experiment demonstrated continuous increase in the CIZ and T . The CSZ measured with a 1-cm probe was inversely proportional to the average skin temperature at three sites prior to measurement (T ). CONCLUSION: The results suggested that the CIZ may be not dependent on time of a day but T per se and may not be associated with the CSZ.
[Mh] Termos MeSH primário: Regulação da Temperatura Corporal/fisiologia
Ritmo Circadiano/fisiologia
Temperatura Cutânea/fisiologia
[Mh] Termos MeSH secundário: Adulto
Seres Humanos
Masculino
Tremor por Sensação de Frio/fisiologia
Sudorese/fisiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170828
[Lr] Data última revisão:
170828
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170623
[St] Status:MEDLINE
[do] DOI:10.1186/s40101-017-0141-y


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[PMID]:28406814
[Au] Autor:Slack DF; Corwin DS; Shah NG; Shanholtz CB; Verceles AC; Netzer G; Jones KM; Brown CH; Terrin ML; Hasday JD
[Ad] Endereço:1Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD.2Program in Trauma, Department of Surgery, University of Maryland School of Medicine, Baltimore, MD.3Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, MD.4Medicine and Research Services, Baltimore Veterans Affairs Medical Care System, Baltimore, MD.
[Ti] Título:Pilot Feasibility Study of Therapeutic Hypothermia for Moderate to Severe Acute Respiratory Distress Syndrome.
[So] Source:Crit Care Med;45(7):1152-1159, 2017 Jul.
[Is] ISSN:1530-0293
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: Prior studies suggest hypothermia may be beneficial in acute respiratory distress syndrome, but cooling causes shivering and increases metabolism. The objective of this study was to assess the feasibility of performing a randomized clinical trial of hypothermia in patients with acute respiratory distress syndrome receiving treatment with neuromuscular blockade because they cannot shiver. DESIGN: Retrospective study and pilot, prospective, open-label, feasibility study. SETTING: Medical ICU. PATIENTS: Retrospective review of 58 patients with acute respiratory distress syndrome based on Berlin criteria and PaO2/FIO2 less than 150 who received neuromuscular blockade. Prospective hypothermia treatment in eight acute respiratory distress syndrome patients with PaO2/FIO2 less than 150 receiving neuromuscular blockade. INTERVENTION: Cooling to 34-36°C for 48 hours. MEASUREMENTS AND MAIN RESULTS: Core temperature, hemodynamics, serum glucose and electrolytes, and P/F were sequentially measured, and medians (interquartile ranges) presented, 28-day ventilator-free days, and hospital mortality were calculated in historical controls and eight cooled patients. Average patient core temperature was 36.7°C (36-37.3°C), and fever occurred during neuromuscular blockade in 30 of 58 retrospective patients. In the prospectively cooled patients, core temperature reached target range less than or equal to 4 hours of initiating cooling, remained less than 36°C for 92% of the 48 hours cooling period without adverse events, and was lower than the controls (34.35°C [34-34.8°C]; p < 0.0001). Compared with historical controls, the cooled patients tended to have lower hospital mortality (75% vs 53.4%; p = 0.26), more ventilator-free days (9 [0-21.5] vs 0 [0-12]; p = 0.16), and higher day 3 P/F (255 [160-270] vs 171 [120-214]; p = 0.024). CONCLUSIONS: Neuromuscular blockade alone does not cause hypothermia but allowed acute respiratory distress syndrome patients to be effectively cooled. Results support conducting a randomized clinical trial of hypothermia in acute respiratory distress syndrome and the feasibility of studying acute respiratory distress syndrome patients receiving neuromuscular blockade.
[Mh] Termos MeSH primário: Hipotermia Induzida/métodos
Bloqueio Neuromuscular/métodos
Síndrome do Desconforto Respiratório do Adulto/terapia
Tremor por Sensação de Frio/fisiologia
[Mh] Termos MeSH secundário: APACHE
Adulto
Glicemia
Temperatura Corporal/fisiologia
Eletrólitos/sangue
Estudos de Viabilidade
Feminino
Hemodinâmica/fisiologia
Seres Humanos
Masculino
Meia-Idade
Estudos Prospectivos
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Blood Glucose); 0 (Electrolytes)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170809
[Lr] Data última revisão:
170809
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170414
[St] Status:MEDLINE
[do] DOI:10.1097/CCM.0000000000002338


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[PMID]:28372656
[Au] Autor:Sanchez Munoz MC; De Kock M; Forget P
[Ad] Endereço:Anesthesiology Department, Cliniques Universitaires Saint-Luc, Institute of Neuroscience (Pole CEMO), Université Catholique de Louvain, Brussels, Belgium.
[Ti] Título:What is the place of clonidine in anesthesia? Systematic review and meta-analyses of randomized controlled trials.
[So] Source:J Clin Anesth;38:140-153, 2017 May.
[Is] ISSN:1873-4529
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:STUDY OBJECTIVE: A place for clonidine has been suggested for many indications in perioperative medicine. The aim of this systematic review and these meta-analyses is to systematically, and quantitatively, evaluate these potential indications of clonidine. DESIGN, SETTING, PATIENTS AND INTERVENTIONS: We selected and analyzed (qualitatively and, when possible, quantitatively) the available literature published on PubMed/Medline and on the Cochrane database. Inclusion criteria included: human randomized controlled trials involving adults who received perioperative systemic (oral, intramuscular, transdermal and intravenous) clonidine for every type of surgery. MEASUREMENTS AND MAIN RESULTS: We identified 775 trials and thereafter excluded 718 and analyzed 57 trials concerning, in total, 14,790 patients of whom 7408 received clonidine and 6836 received placebo. Most important results shows that, in qualitative and quantitative analyses, clonidine vs placebo reduces analgesics consumption in, respectively, (159 vs 154 patients: 24%, 95%CI[16%-32%]; p<0.001), reduces nausea and vomiting (risk ratio, in 180 vs 181 patients: 0.35, 95%CI[0.25-0.51]; p<0.001), improves hemodynamic stability (reduction of HR: 14.9bpm, 95%CI[10.4-19.5]; p<0.001; reduction of the MAP: 12.5mmHg, 95%CI[7.14-17.86]; p<0.001); 1min after tracheal intubation, in 67 vs 68 patients), prevents postoperative shivering (risk ratio, in 140 vs 140 patients: 0.17, 95%CI[0.10-0.29]; p<0.001). On the other hand, clonidine does not have any influence on renal and cardiac outcomes (adverse events rates, in 5873 vs 5533 patients: 0.00, 95%CI[-0.10-0.11]; p=0.96) and does not prolong awakening time. CONCLUSIONS: In conclusion, these systematic review and meta-analyses of 57 trials confirm that clonidine improves pain control, reduces PONV, improves hemodynamic and sympathetic stability, with no adverse consequences on renal function or awakening time, but does not influence cardiac outcome in the general population, after non-cardiac surgery. Nevertheless, given the high heterogeneity between the studies, this does not exclude different results in patient subgroups or specific procedures.
[Mh] Termos MeSH primário: Agonistas de Receptores Adrenérgicos alfa 2/uso terapêutico
Analgésicos/uso terapêutico
Anestesia/métodos
Clonidina/uso terapêutico
Manejo da Dor/métodos
Dor Pós-Operatória/tratamento farmacológico
Náusea e Vômito Pós-Operatório/prevenção & controle
[Mh] Termos MeSH secundário: Agonistas de Receptores Adrenérgicos alfa 2/administração & dosagem
Agonistas de Receptores Adrenérgicos alfa 2/efeitos adversos
Analgésicos/administração & dosagem
Analgésicos/efeitos adversos
Clonidina/administração & dosagem
Clonidina/efeitos adversos
Coração/efeitos dos fármacos
Hemodinâmica/efeitos dos fármacos
Seres Humanos
Rim/efeitos dos fármacos
Consumo de Oxigênio/efeitos dos fármacos
Assistência Perioperatória/métodos
Ensaios Clínicos Controlados Aleatórios como Assunto
Tremor por Sensação de Frio/efeitos dos fármacos
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Nm] Nome de substância:
0 (Adrenergic alpha-2 Receptor Agonists); 0 (Analgesics); MN3L5RMN02 (Clonidine)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170914
[Lr] Data última revisão:
170914
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170405
[St] Status:MEDLINE


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[PMID]:28361417
[Au] Autor:Kozyreva TV; Meyta ES; Kozaruk VP
[Ad] Endereço:Laboratory of Thermophysiology, Research Institute of Physiology and Fundamental Medicine, Novosibirsk, Russia. kozyreva@physiol.ru.
[Ti] Título:Participation of Purinergic P X Receptors in the Thermoregulatory Response to Cooling.
[So] Source:Bull Exp Biol Med;162(5):606-610, 2017 Mar.
[Is] ISSN:1573-8221
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:We studied the role of purinergic P X receptors in the body response to cooling. In experiments on rats, P X receptor antagonist PPADS was administered in different modes, which resulted in changes of different characteristics of the thermoregulatory response to cold. Iontophoresis of P X antagonist into the skin decreased the thermal thresholds of all thermoregulatory responses to cooling, which can attest to a modulating effect of P X receptors on peripheral thermosensitive afferents. Intraperitoneal administration of P X antagonist suppressed thermoregulatory activity of skeletal muscles (shivering) developing during cooling without changing the thresholds of thermoregulatory responses. The findings suggest that ATP and P X receptors play an important role in the formation of the response to cooling.
[Mh] Termos MeSH primário: Regulação da Temperatura Corporal
Receptores Purinérgicos P2X/fisiologia
[Mh] Termos MeSH secundário: Trifosfato de Adenosina/farmacologia
Animais
Temperatura Baixa
Resposta ao Choque Frio
Masculino
Consumo de Oxigênio
Agonistas do Receptor Purinérgico P2X/farmacologia
Antagonistas do Receptor Purinérgico P2X/farmacologia
Fosfato de Piridoxal/análogos & derivados
Fosfato de Piridoxal/farmacologia
Ratos Wistar
Tremor por Sensação de Frio/efeitos dos fármacos
Pele/irrigação sanguínea
Temperatura Cutânea
Vasoconstrição/efeitos dos fármacos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Purinergic P2X Receptor Agonists); 0 (Purinergic P2X Receptor Antagonists); 0 (Receptors, Purinergic P2X); 149017-66-3 (pyridoxal phosphate-6-azophenyl-2',4'-disulfonic acid); 5V5IOJ8338 (Pyridoxal Phosphate); 8L70Q75FXE (Adenosine Triphosphate)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170718
[Lr] Data última revisão:
170718
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170401
[St] Status:MEDLINE
[do] DOI:10.1007/s10517-017-3668-3


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[PMID]:28154256
[Au] Autor:He L; Xu JM; Liu SM; Chen ZJ; Li X; Zhu R
[Ad] Endereço:Department of Anesthesiology, The Affiliated Hospital of Guilin Medical University.
[Ti] Título:Intrathecal Dexmedetomidine Alleviates Shivering during Cesarean Delivery under Spinal Anesthesia.
[So] Source:Biol Pharm Bull;40(2):169-173, 2017.
[Is] ISSN:1347-5215
[Cp] País de publicação:Japan
[La] Idioma:eng
[Ab] Resumo:Shivering associated with spinal anesthesia during Cesarean delivery is an uncomfortable experience for the parturient, which may also cause adverse effects. In this prospective, randomized, double-blind, placebo-controlled study, we sought to evaluate the effect of intrathecal dexmedetomidine, administered as an adjunct to hyperbaric bupivacaine for Cesarean delivery, on the incidence and severity of shivering associated with spinal anesthesia. Patients undergoing Cesarean delivery were randomly allocated to three groups of 30 patients each. Experimental treatments were added to hyperbaric bupivacaine as follows: Patients in group I (control) were administered isotonic saline. Patients in groups II and III received dexmedetomidine (2.5, 5 µg, respectively), mixed with isotonic saline. Shivering was observed in 11, 10 and 2 patients in groups I, II and III, respectively. The incidence of shivering in group III was significantly lower than that in groups I (p=0.005) and II (p=0.01). The severity of shivering was significantly different between the three groups (p=0.01). There were no significant inter-group differences with respect to mean arterial pressure and heart rate at any time point after administration of intrathecal local anesthesia (p>0.05). Intrathecal dexmedetomidine (5 µg) administered as an adjunct to hyperbaric bupivacaine during Cesarean delivery significantly reduced the incidence and intensity of shivering associated with spinal anesthesia.
[Mh] Termos MeSH primário: Analgésicos não Entorpecentes/administração & dosagem
Raquianestesia/métodos
Cesárea/efeitos adversos
Cesárea/métodos
Dexmedetomidina/administração & dosagem
Tremor por Sensação de Frio/efeitos dos fármacos
[Mh] Termos MeSH secundário: Adulto
Anestésicos Locais/administração & dosagem
Bupivacaína/administração & dosagem
Método Duplo-Cego
Quimioterapia Combinada
Feminino
Seres Humanos
Injeções Espinhais
Gravidez
Estudos Prospectivos
Tremor por Sensação de Frio/fisiologia
[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:1702
[Cu] Atualização por classe:170208
[Lr] Data última revisão:
170208
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170204
[St] Status:MEDLINE
[do] DOI:10.1248/bpb.b16-00651


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[PMID]:28125971
[Au] Autor:Nakagawa T; Hashimoto M; Hashimoto Y; Shirozu K; Hoka S
[Ad] Endereço:Department of Anesthesiology, Hachinohe city Hospital, Aomori, Japan.
[Ti] Título:The effects of tramadol on postoperative shivering after sevoflurane and remifentanil anesthesia.
[So] Source:BMC Anesthesiol;17(1):1, 2017 Jan 03.
[Is] ISSN:1471-2253
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUNDS: Remifentanil has been reported to cause post-anesthetic shivering (PAS). Higher doses of remifentanil reportedly induce more intense PAS. Tramadol, a synthetic opioid that acts at multiple sites, is considered to be an effective treatment for PAS, but the evidence for its therapeutic benefit after remifentanil anesthesia is limited. We investigated the effect of tramadol on the incidence of PAS after remifentanil anesthesia. METHODS: Sixty-three patients who had undergone upper abdominal surgery under general anesthesia were studied retrospectively. Tramadol was administered at induction of anesthesia. The patients were divided into four groups: HT(+), high dose remifentanil (1-1.5 µg/kg/min) with tramadol; HT(-), high dose remifentanil without tramadol; LT(+), low dose remifentanil (0.15-0.25 µg/kg/min) with tramadol; and LT(-), low dose remifentanil without tramadol. We recorded perioperative changes in nasopharyngeal temperature and episodes of PAS on emergence from anesthesia. RESULTS: The incidences of PAS in both tramadol treatment groups were significantly lower than the groups that did not receive tramadol. Nasopharyngeal temperature after surgery fell significantly more from baseline in the tramadol treatment groups compared with the non-treatment groups. CONCLUSION: Tramadol administered at induction of anesthesia appears to suppress PAS following remifentanil anesthesia.
[Mh] Termos MeSH primário: Piperidinas/efeitos adversos
Piperidinas/antagonistas & inibidores
Tremor por Sensação de Frio/efeitos dos fármacos
Tramadol/uso terapêutico
[Mh] Termos MeSH secundário: Administração Intravenosa
Adulto
Idoso
Idoso de 80 Anos ou mais
Analgésicos Opioides/administração & dosagem
Analgésicos Opioides/uso terapêutico
Período de Recuperação da Anestesia
Temperatura Corporal/efeitos dos fármacos
Relação Dose-Resposta a Droga
Feminino
Seres Humanos
Masculino
Éteres Metílicos/administração & dosagem
Meia-Idade
Estudos Retrospectivos
Tramadol/administração & dosagem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Analgesics, Opioid); 0 (Methyl Ethers); 0 (Piperidines); 38LVP0K73A (sevoflurane); 39J1LGJ30J (Tramadol); P10582JYYK (remifentanil)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171013
[Lr] Data última revisão:
171013
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170128
[St] Status:MEDLINE
[do] DOI:10.1186/s12871-016-0295-x


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[PMID]:28089568
[Au] Autor:Blondin DP; Frisch F; Phoenix S; Guérin B; Turcotte ÉE; Haman F; Richard D; Carpentier AC
[Ad] Endereço:Department of Medicine, Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Université de Sherbrooke, Sherbrooke, QC J1K 2R1, Canada.
[Ti] Título:Inhibition of Intracellular Triglyceride Lipolysis Suppresses Cold-Induced Brown Adipose Tissue Metabolism and Increases Shivering in Humans.
[So] Source:Cell Metab;25(2):438-447, 2017 Feb 07.
[Is] ISSN:1932-7420
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Indirect evidence from human studies suggests that brown adipose tissue (BAT) thermogenesis is fueled predominantly by fatty acids hydrolyzed from intracellular triglycerides (TGs). However, no direct experimental evidence to support this assumption currently exists in humans. The aim of this study was to determine the role of intracellular TG in BAT thermogenesis, in cold-exposed men. Using positron emission tomography with C-acetate and F-fluorodeoxyglucose, we showed that oral nicotinic acid (NiAc) administration, an inhibitor of intracellular TG lipolysis, suppressed the cold-induced increase in BAT oxidative metabolism and glucose uptake, despite no difference in BAT blood flow. There was a commensurate increase in shivering intensity and shift toward a greater reliance on glycolytic muscle fibers without modifying total heat production. Together, these findings show that intracellular TG lipolysis is critical for BAT thermogenesis and provides experimental evidence for a reciprocal role of BAT thermogenesis and shivering in cold-induced thermogenesis in humans.
[Mh] Termos MeSH primário: Tecido Adiposo Marrom/metabolismo
Temperatura Baixa
Espaço Intracelular/metabolismo
Lipólise
Tremor por Sensação de Frio/fisiologia
Triglicerídeos/metabolismo
[Mh] Termos MeSH secundário: Acetatos/metabolismo
Tecido Adiposo Marrom/irrigação sanguínea
Tecido Adiposo Marrom/efeitos dos fármacos
Adulto
Radioisótopos de Carbono
Glucose/metabolismo
Seres Humanos
Cinética
Lipólise/efeitos dos fármacos
Masculino
Niacina/farmacologia
Especificidade de Órgãos/efeitos dos fármacos
Oxirredução/efeitos dos fármacos
Fluxo Sanguíneo Regional/efeitos dos fármacos
Tremor por Sensação de Frio/efeitos dos fármacos
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Acetates); 0 (Carbon Radioisotopes); 0 (Triglycerides); 2679MF687A (Niacin); IY9XDZ35W2 (Glucose)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170713
[Lr] Data última revisão:
170713
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170117
[St] Status:MEDLINE



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