Dexmedetomidine: new insights

Mantz, Jean; Josserand, Julien; Hamada, Sophie

doi:10.1097/eja.0b013e32833e266d

Cited by 242 publications

(188 citation statements)

References 28 publications

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“…Dexmedetomidine has been used successfully in a variety of clinical settings to produce sedation, analgesia, and anaesthesia (Mantz et al 2011; 130.3 ± 9.7* 85.8 ± 6.6* 100.5 ± 7.7* 60 38.4 ± 0.4 17.5 ± 4.5 111.7 ± 10.2* 97.2 ± 1.2 127.8 ± 20.1* 82.8 ± 9.5* 97.5 ± 11.9* Values are mean ± SD; T = temperature; RR = respiratory rate; HR = heart rate; SpO 2 = blood oxygen saturation; SBP = systolic blood pressure; DBP = diastolic blood pressure; MAP = mean arterial pressure *P < 0.05 compared with 5 min within each group doi: 10.17221/8420-VETMED…”

Section: Discussionmentioning

confidence: 99%

Effects of the dexmedetomidine, midazolam, butorphanol, and atropine combination on plasma oxidative status and cardiorespiratory parameters in raccoon dogs (Nyctereutes procyonoides)

Feng¹,

Hu²,

Zhang³

et al. 2015

Vet. Med. - Czech

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ABSTRACT:Oxidative stress in the body occurs when the production of free radicals overwhelms the antioxidant defence systems. This study aimed to investigate the effects of a combination of dexmedetomidine, midazolam, butorphanol, and atropine (DMBA) as an anaesthetic on plasma oxidative status in twelve raccoon dogs. Baseline measures were recorded prior to anaesthesia, and then the animals were anaesthetised with the combination of dexmedetomidine (25 µg/kg), midazolam (0.45 mg/kg), butorphanol (0.25 mg/kg), and atropine (0.035 mg/kg). Temperature, respiratory rate, haemoglobin saturation by oxygen, pulse rate, systolic arterial pressure, diastolic arterial pressure, and mean arterial pressure were continually monitored. Blood pressure was significantly decreased at 30 to 60 min (P < 0.05). Pulse rate ranged from 96 to 123 bpm, without episodes of severe bradycardia or tachycardia. Blood samples were collected from saphenous venipuncture at 0, 0.5, 1, and 24 h before, during, and after anaesthesia. Plasma superoxide dismutase, glutathione peroxidase, and catalase activity, and malondialdehyde concentrations were measured by colorimetry, and plasma vitamin E level was determined by high-performance liquid chromatography. Superoxide dismutase and glutathione peroxidase activities increased significantly (P < 0.05) at 0.5 h, and then gradually decreased to baseline values after 1 h. Catalase activity increased significantly (P < 0.05) at 0.5 h, 1 h, and then gradually decreased to baseline values after 24 h. There was no significant change in vitamin E level (P < 0.05).The concentration of malondialdehyde decreased significantly at 0.5, 1, and 24 h after injection (P < 0.05). The results show that the administered dose of dexmedetomidine, midazolam, butorphanol, and atropine has antioxidant effects in raccoon dogs. Our study is the first to demonstrate that dexmedetomidine, midazolam, butorphanol, and atropine exert antioxidant effects, which may be exploited to alleviate the stress of examination and research at veterinary clinics.

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Section: Discussionmentioning

confidence: 99%

Effects of the dexmedetomidine, midazolam, butorphanol, and atropine combination on plasma oxidative status and cardiorespiratory parameters in raccoon dogs (Nyctereutes procyonoides)

Feng¹,

Hu²,

Zhang³

et al. 2015

Vet. Med. - Czech

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“…Por otro lado, una sedación excesiva también puede repercutir negativamente, dada la probabilidad de depresion respiratoria y requerimiento de ventilación mecánica, con la posible necesidad de hospitalización en unidad de cuidado intensivo (16,20,22).…”

Section: Discussionunclassified

“…A pesar de que se ha sugerido un efecto analgésico (inferior al de los opioides), mediado por receptores alfa-2 a nivel central, la analgesia inducida por la dexmedetomidina no es clara y puede estar explicada en relación con la disminución o alteracion en la percepción de la ansiedad (15,16,26).…”

Section: Discussionunclassified

“…Medicamentos como la dexmedetomidina han demostrado una adecuada respuesta clínica y baja tasa de complicaciones respiratorias, así como menor incidencia de delirium (10)(11)(12)(13)(14) A pesar de los beneficios de dexmedetomidina para sedación, también se ha asociado a eventos adversos graves como bradicardia severa, hipotensión e incluso, paro cardiaco (15)(16)(17). Su uso en diferentes procedimientos, asociados a diferentes modalidades de anestesia tambien se ha visto relacionado con episodios de bradicardia, que requieren de manejo con atropina para la prevención de complicaciones hemodinámicas mas severas (18,19).…”

Section: Introductionunclassified

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Anestesia loco regional más sedación con dexmedetomidina para cirugía de Mohs con reconstrucción

et al. 2018

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Comparte ResumenIntroducción: la cirugía micrográfica de Mohs se emplea para la escisión de tumores cutáneos malignos y frecuentemente es seguida de reconstrucción, prolongando el procedimiento y causando ansiedad y molestia al paciente. Esta cirugía se realiza con anestesia local y sedación complementaria. Dentro de los anestésicos intravenosos la dexmedetomidina es una excelente opción; sin embargo, se han reportado casos de bradicardia severa asociado a inestabilidad hemodinámica y riesgo de complicaciones con su uso. Objetivo: describir la frecuencia de bradicardia con repercusión hemodinámica en pacientes llevados a cirugía micrográfica de Mohs más reconstrucción, bajo anestesia loco regional y sedación con dexmedetomidina. Métodos: estudio observacional descriptivo retrospectivo de 30 pacientes llevados a cirugía de Mohs entre el 1 de noviembre 2012 a 30 de noviembre de 2013. Resultados: el 53,3 % eran mujeres, la edad promedio fue de 68,4 años, 21,4 % fueron clasificados como ASA I, 53,5 % ASA II y 25 % ASA III. El tiempo quirúrgico promedio fue de 184 ± 61 minutos y de anestesia con dexmedetomidina fue 196 ± 65,2 minutos. Solo un paciente requirió atropina durante la cirugía y ningún paciente requirió conversión a anestesia general. Conclusión: la dexmetomidina es una buena alternativa para proporcionar sedación en los pacientes llevados a cirugía de Mohs bajo anestesia loco-regional, debido a su baja incidencia de bradicardia con repercusión hemodinámica y ausencia de la necesidad de soporte ventilatorio.Palabras clave: Cirugía de Mohs; Bradicardia; Anestesia local; Dexmedetomidina; Sedación. AbstractIntroduction: Mohs micrographic surgery is used for the excision of malignant skin tumors and often is followed by reconstruction, prolonging the procedure, causing anxiety and discomfort to the patient. Mohs surgery is performed with local anesthesia and complementary sedation. Among the intravenous anesthetics, Dexmedetomidine is an excellent option; however, there have been reports of severe bradycardia associated with hemodynamic instability and risk of complications with its use. Objective: to describe the frequency of bradycardia with hemodynamic repercussion in patients undergoing Mohs micrographic surgery plus reconstruction, under loco

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“…15,16 Currently, The PI3K/Akt/mTOR has been widely reported to be the classical signaling pathway of apoptosis and autophagy activation. 17 Based on the above-mentioned findings, We hypothesized that administration Dex may activate the PI3K/Akt/mTOR pathway to suppress neuronic autophagy in the hippocampus, exerting a powerful neuroprotective effects against TBI in rats.…”

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confidence: 99%

PI3K/Akt/mTOR pathway participates in neuroprotection by dexmedetomidine inhibits neuronic autophagy following traumatic brain injury in rats

et al. 2014

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Dexmedetomidine: new insights

Cited by 242 publications

References 28 publications

Effects of the dexmedetomidine, midazolam, butorphanol, and atropine combination on plasma oxidative status and cardiorespiratory parameters in raccoon dogs (Nyctereutes procyonoides)

Effects of the dexmedetomidine, midazolam, butorphanol, and atropine combination on plasma oxidative status and cardiorespiratory parameters in raccoon dogs (Nyctereutes procyonoides)

Anestesia loco regional más sedación con dexmedetomidina para cirugía de Mohs con reconstrucción

PI3K/Akt/mTOR pathway participates in neuroprotection by dexmedetomidine inhibits neuronic autophagy following traumatic brain injury in rats

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