A dexmedetomidina para sedação, por via venosa, não interfere com a duração dos bloqueios sensitivo e motor da raquianestesia

Magalhães, Edno; Ladeira, Luís Cláudio de Araújo; Govêia, Cátia Sousa; Espíndola, Beatriz Vieira

doi:10.1590/s0034-70942006000100001

Cited by 7 publications

(3 citation statements)

References 3 publications

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“…Atualmente não existe uma clara explicação para este fenômeno, mas possíveis causas podem ser relacionadas, com rápido retorno à consciência em ambiente não familiar, dor causada por ferida cirúrgica ou distensão vesical, sequela de estresse na indução, hipoxemia (obstrução da via aérea), ambiente ruidoso, duração da anestesia, temperamento da criança e medicação pré-anestésica (Silva et al, 2008;Akkaya et al, 2014;Kayyal et al, 2014). Além disso, estudos mostram que alguns fatores, como idade, anestesia com sevoflurano, crianças em idade pré-escolar e com ansiedade, presença ou ausência dos pais na indução e despertar, têm sido relacionados com a agitação pós-anestésica (Magalhães et al, 2006;Cavalcante et al, 2015).…”

Section: Introductionunclassified

O uso dexmedetomidina na agitação em crianças: uma revisão da literatura

Oliveira

Oliveira²

2022

RSD

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Introdução: A incidência de agitação pós-operatória em crianças sob anestesia geral é alta, e pode ser manifestada por diversos comportamentos, como choro, irritabilidade, intensa agitação e desorientação, que em muitos casos, necessita de contenção mecânica. O uso de dexmedetomidina nessa situação é bem descrito por vários autores. Este sedativo fornece uma “sedação consciente” ao paciente, onde parecem adormecidos, mas podem ser facilmente despertáveis sem depressão respiratória. Objetivos: Realizar uma revisão da literatura sobre o uso da dexmedetomidina no controle de agitação em crianças submetidas a anestesia operatória, além de comparar o uso de outros sedativos, como cetamina, com a dexmedetomidina. Metodologia: Revisão bibliográfica narrativa, por meio do levantamento de dados, utilizando as plataformas de base de dados Scielo, MedLine e PubMed, com os descritores: “dexmedetomidine” AND “psychomotor agitation” AND “child” OR “clonidine” AND “ketamine”. Resultados e Conclusão: A maior parte dos estudos mostrou que a dexmedetomidina é bem aplicada na agitação em crianças, promovendo alívio de dor pós-operatória, com baixa incidência de eventos adversos, podendo, assim, ser utilizada com segurança. Além disso, outros fármacos, como a cetamina, também apresentaram resultados satisfatórios para a prevenção de agitação pós-operatória em crianças.

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Section: Introductionunclassified

O uso dexmedetomidina na agitação em crianças: uma revisão da literatura

Oliveira

Oliveira²

2022

RSD

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“…[3] It provides sedation, analgesia, sympatholysis, and anxiolysis. [4] It is used as a preemptive medication to attenuate the sympathetic responses to surgery. Dexmedetomidine potentiates anesthetic effects of other intraoperative anesthetics.…”

Section: Introductionmentioning

confidence: 99%

“…Some previous studies were done with the administration of the bolus dose alone[6] and some were done with the maintenance dose alone. [4] However, the majority of previous studies were done with the administration of both bolus and maintenance dose. [57] The current study was designed to know which regimen of administration of intravenous dexmedetomidine in a patient who is under SAB, gives maximum advantages and minimum disadvantages.…”

Section: Introductionmentioning

confidence: 99%

Comparison of different regimens of intravenous dexmedetomidine on duration of subarachnoid block

Thomas

Satyaprakash

Elakkumanan

et al. 2016

J Anaesthesiol Clin Pharmacol

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Background and Aims:Many studies have studied the effect of intravenous dexmedetomidine on the prolongation of the duration of the subarachnoid block (SAB). These studies had administered dexmedetomidine using different regimens. This study was designed to find out the suitable regimen with maximum advantages and minimum disadvantages.Material and Methods:Ninety-three ASA 1 and 2 patients scheduled to undergo surgeries under SAB were randomly allocated into three groups namely B, M, and BM. After SAB, Group B received 0.5 μg/kg of dexmedetomidine bolus over 15 min, Group M received 0.5 μg/kg/h of dexmedetomidine infusion until the end of surgery, Group BM received both bolus and infusion.Results:The time to achieve T10 sensory level (SL) was significantly faster in the Groups B and BM than in the Group M. Maximum block height achieved was T4 and was same in all the groups. The Time to achieve maximum SL and Bromage 3 was comparable in all groups. The two-segment regression time and time to reach Bromage 0 was significantly higher in Groups M and BM than Group B. The time for a first request of analgesia was similar in Groups M and BM. The maximum sedation attained in all groups was Ramsay Sedation Score of 3. Side effects such as bradycardia, hypotension, and desaturation were comparable between the groups.Conclusion:We conclude that the continuous infusion of dexmedetomidine results in more advantages than just a bolus dose. Therefore, we suggest using only the maintenance dose of intravenous dexmedetomidine after subarachnoid blockade for prolonging the duration and achieving sedation.

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Influence of different menstrual phases on the Bispectral Index during dexmedetomidine sedation

Han

Huang

et al. 2016

The Kaohsiung J of Med Scie

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To investigate the influence of different menstrual phases on the Bispectral Index (BIS) during dexmedetomidine (Dex) sedation, 40 patients with regular menstrual cycle, American Society of Anesthesiologists I-II, aged 18-40 years, undergoing selective gynecologic laparoscopic surgery, were enrolled. According to different menstrual phases and the serum progesterone concentration, they were divided into two groups: the follicular phase group (Group F) and the luteal phase group (Group L), and each group had 20 patients. Before anesthesia induction, patients were infused with an initial loading dose of Dex (1 μg/kg) for 10 minutes and then 0.5 μg/kg/h for 20 minutes. BIS and the changes in hemodynamic and respiratory parameters were recorded within those 30 minutes. Time to lower BIS to 70 and 60 in Group L was shorter than that in Group F (9.4 ± 1.3 minutes vs. 11.3 ± 2.1 minutes, p = 0.005; 11.3 ± 2.4 minutes vs. 14.0 ± 3.6 minutes, p = 0.021). The number of patients whose BIS reached 50 in Group L was greater than that in Group F (15 vs. 8, p < 0.05). The lowest BIS value in the Group L was lower than that in Group F (46.8 ± 6.3 vs. 55.3 ± 5.5, p = 0.006), and the heart rate of patients in both groups showed a decrease (p < 0.05). The sedative effect of Dex was more significant in patients during the luteal phase than during the follicular phase.

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A dexmedetomidina para sedação, por via venosa, não interfere com a duração dos bloqueios sensitivo e motor da raquianestesia

Abstract: RESUMO

Cited by 7 publications

References 3 publications

O uso dexmedetomidina na agitação em crianças: uma revisão da literatura

O uso dexmedetomidina na agitação em crianças: uma revisão da literatura

Comparison of different regimens of intravenous dexmedetomidine on duration of subarachnoid block

Influence of different menstrual phases on the Bispectral Index during dexmedetomidine sedation

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