Uso de dexmedetomidina em anestesiologia

Villela, Nivaldo Ribeiro; Júnior, Paulo do Nascimento

doi:10.1590/s0034-70942003000100013

Cited by 35 publications

(33 citation statements)

References 36 publications

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“…The dose equivalence of these drugs had not been studied before, but the observations of various studies have stated that the dose of clonidine is 1.5-2 times higher than that of dexmedetomidine when used in epidural route. [121314151617] The anesthetic and the analgesic requirement get reduced by the use of these two adjuvants because of their analgesic properties and augmentation of local anesthetic effects as they cause hyperpolarization of nerve tissues by altering transmembrane potential and ion conductance at locus coeruleus in the brainstem. [1819202122] The stable hemodynamics and the decreased oxygen demand due to enhanced sympatho-adrenal stability make them very useful pharmacologic agents.…”

Section: Introductionmentioning

confidence: 99%

Intraoperative conditions and quality of postoperative analgesia after adding dexmedetomidine to epidural bupivacaine and fentanyl in elective cesarean section using combined spinal-epidural anesthesia

2013

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This study was designed to evaluate the effect of adding dexmedetomidine to regular mixture of epidural drugs for pregnant women undergoing elective cesarean section with special emphasis on their sedative properties, ability to improve quality of intraoperative, postoperative analgesia, and neonatal outcome.Materials and Methods:Fifty women of ASA physical status I or II at term pregnancy were enrolled randomly to receive plain bupivacaine plus fentanyl (BF Group) or plain bupivacaine plus mixture of fentanyl and dexmedetomidine (DBF Group). Incidence of hypotension, bradycardia, Apgar scores, intraoperative pain assessment, onset of postoperative pain, sedation scores, and side effects were recorded.Results:No difference in the times taken for block to reach T4 sensory level, to reach the highest level of sensory block, and interval between first neuraxial injection and onset of surgery between the groups was noted. Onset of postoperative pain was significantly delayed in the DBF group (P = 0.001), the need for supplementary fentanyl was significantly less in DBF group (P = 0.03), no significant difference was noted between both groups regarding neonatal Apgar scores as well as the incidence of hypotension, bradycardia, nausea, vomiting, and duration of motor blockade. DBF group had significantly less incidence of shivering (P = 0.03).Conclusion:Adding dexmedetomidine to regular mixture of epidural anesthetics in women undergoing elective cesarean section improved intraoperative conditions and quality of postoperative analgesia without maternal or neonatal significant side effects.

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Section: Introductionmentioning

confidence: 99%

Intraoperative conditions and quality of postoperative analgesia after adding dexmedetomidine to epidural bupivacaine and fentanyl in elective cesarean section using combined spinal-epidural anesthesia

2013

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“…Different drugs such as opioids, ketamine, benzodiazepines, and α 2 -agonists, have been used in the prevention and treatment of agitation, but with varying success, which contributes to the development of studies to improve perioperative care delivered to children. Dexmedetomidine is a highly selective α 2 -adrenergic, with α 2 :α 1 receptor ratio of 1,600:1, and has important sedative and analgesic effects [13]. Its sedative effect occurs through inter-action with postsynaptic α 2 -receptors in the locus coeruleus, reduces noradrenalin release, and facilitates the action of inhibitory neurons, particularly gamma-aminobutyric acid system.…”

Section: Comparative Study and Safe Dose Analysis Of Dexmedetomidine mentioning

confidence: 99%

Comparative Study and Safe Dose Analysis of Dexmedetomidine in the Prevention of Emergence Agitation and Emergency Delirium in Children Undergoing General Anesthesia

Luo¹

2018

JHS

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Abstract:The purpose of this paper is to explore the safe and effective dose of dexmedetomidin for the prevention of agitation and delirium during the awakening period for children undergoing general anesthesia. Samples of 989 cases are collected from children with comprehensive treatment of dental caries, and were randomly divided into four groups. Group A, group B and group C were intravenously at constant speed (60 mL/h), 0.5 and 0.25 infusion with 1 μg/kg dexmedetomidine. Group D (control group) was intravenously saline at the same speed. The score of 5-point scale and the incidence of ED (emergency delirium) and EA (emergence agitation) in four groups were compared. Comparison of four groups of CHIPPS (children and infants postoperative pain) score, the amount of operation time and record seven halothane (TO), time to stop cover drug withdrawal of laryngeal anesthesia (TM), eye opening time (TE), independent records of children at the time of ICU stay after anesthesia (TP). Results show that there was no significant difference between the four groups (p > 0.05), among which the TM in B, C groups was significantly higher than that in A, D groups (p < 0.05). Group C was significantly higher than group B (p < 0.05). There was no significant difference in TE and TP between the A, B, D groups (p > 0. 05). TE in group C was significantly higher than that in groups A, D (p > 0. 05). The TP of group C was significantly higher than that of groups A, D (p < 0.05), but there was no significant difference between the B, C groups (p > 0.05). The incidence rates of EA and ED in groups A and B were significantly lower than those in group D (p < 0.05). Group C was significantly lower than group A (p < 0.05). There was no significant difference between group C and group C (p > 0.05). The CHIPPS score and sevoflurane dosage in groups A and B were significantly lower than those in group D (p < 0.05). Group C was significantly lower than group A (p < 0.05). There was no significant difference between group C (p > 0.05). Conclusion: the dose of dexmetomidine 0.5 μg/kg in children with general anesthesia can prevent restlessness and delirium after operation.

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“…[6] Dexmedetomidine is a highly selective α-2 adrenergic agonist with an affinity eight times greater than that of clonidine. [7], [8], [9], [10], [11], [12] The present double-blind prospective randomized study aims at comparing the hemodynamic, sedative, and analgesia potentiating effects of epidurally administered clonidine and dexmedetomidine when combined with bupivacaine.…”

Section: Introductionmentioning

confidence: 99%

Epidural Dexmedetomidine and Clonidine as a adjunct with Bupivacaine in patients undergoing lower limb orthopedic Surgeries. A Clinical Study.

Rai¹,

Malik²

2016

Int. J. Adv. Res. Biol. Sci.

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Background and Aims: Alpha (α-2) adrenergic agonists have both analgesic and sedative properties when used as an adjuvant in regional anesthesia. A prospective randomized double-blind study was carried out to evaluate the efficacy of epidural route and to compare the efficacy and clinical profile of dexmedetomidine and clonidine as an adjuvant to bupivacaine with special emphasis on their quality of analgesia, sedation and the ability to provide the smooth intra-operative and postoperative course. Material and Methods: The study was conducted in prospective, randomized and double-blind manner. It included 60 American Society of Anesthesiologists Class I and II patients undergoing lower limb surgery under epidural anesthesia. Patients were randomly divided into Group A receiving 0.5% isobaric bupivacaine 15 ml with dexmedetomidine 1 μg/kg and Group B receiving 0.5% isobaric bupivacaine 15 ml with clonidine 2 μg/kg epidurally. Onset and duration of sensory and motor blocks, duration of analgesia, sedation, and adverse effects were assessed. Results: Demographic data, surgical characteristics cardio-respiratory parameters, side-effect profile were comparable and statistically not significant in both the groups. However, sedation scores with dexmedetomidine were better than clonidine and turned out to be statistically significant. The onset times for sensory and motor blocks were significantly shorter in Group A as compared to Group B. The duration of analgesia and motor block was significantly longer in A Group as compared to Group B. Conclusion: Dexmedetomidine is a superior neuraxial adjuvant to bupivacaine when compared to clonidine for early onset of analgesia, superior intra-operative analgesia, stable cardio-respiratory parameters, prolonged postoperative analgesia and providing patient comfort.

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Uso de dexmedetomidina em anestesiologia

Cited by 35 publications

References 36 publications

Intraoperative conditions and quality of postoperative analgesia after adding dexmedetomidine to epidural bupivacaine and fentanyl in elective cesarean section using combined spinal-epidural anesthesia

Intraoperative conditions and quality of postoperative analgesia after adding dexmedetomidine to epidural bupivacaine and fentanyl in elective cesarean section using combined spinal-epidural anesthesia

Comparative Study and Safe Dose Analysis of Dexmedetomidine in the Prevention of Emergence Agitation and Emergency Delirium in Children Undergoing General Anesthesia

Epidural Dexmedetomidine and Clonidine as a adjunct with Bupivacaine in patients undergoing lower limb orthopedic Surgeries. A Clinical Study.

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