Addition of dexmedetomidine to lidocaine for intravenous regional anaesthesia 1

Esmaoğlu, Aliye; Mızrak, Ayşe; Akın, Aynur; Turk, Yildirim; Boyacı, Adem

doi:10.1017/s0265021505000761

Cited by 82 publications

(66 citation statements)

References 24 publications

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“…[1,2] Like clonidine, the α-2 receptor agonist dexmedetomidine (DEX) has been reported to have a rapid onset time, to prolong the duration of local anesthetics, and to increase the quality of analgesia in a regional block. [3,4,5] Dexmedetomidine is being used for intravenous regional anesthesia (Bier's block), [5,6] intravenous (iv) sedation and analgesia for intubated and mechanically ventilated patients in intensive care units (ICUs). [7,8,9] Its use as an adjuvant in central neuraxial blocks has also been mentioned.…”

Section: Introductionmentioning

confidence: 99%

Dexmedetomidine as an Adjuvant to Levobupivacaine in Ultrasound Guided Supraclavicular Brachial Plexus Block

Waindeskar

Bhatia²,

Garg

et al. 2016

International Journal of Medical and Dental Sciences

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Section: Introductionmentioning

confidence: 99%

Dexmedetomidine as an Adjuvant to Levobupivacaine in Ultrasound Guided Supraclavicular Brachial Plexus Block

Waindeskar

Bhatia²,

Garg

et al. 2016

International Journal of Medical and Dental Sciences

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“…Few studies have evaluated the effects of dexmedetomidine on peripheral nerve blocks. (6)(7)(8)(9) and dexmedetomidine was reported to be safe and effective in these studies. In a study of comparing the effect of addition of 100 µg of dexmedetomidine to levobupivacaine, dexmedetomidine resulted in shortening of the onset time of block, along with prolonged duration of the sensory and motor block with increased duration of postoperative analgesia.…”

mentioning

confidence: 74%

“…(6)(7)(8) In a study that compared the effects of adding either clonidine or dexmedetomidine to lidocaine during a bier block, it was found that adding dexmedetomidine improved the quality of anaesthesia and analgesia more than the addition of clonidine. (9) In a study by Esmaoglu et al (10) addition of 100 µg of dexmedetomidine led to side effects such as bradycardia and hypotension, along with its effects such as sedation and anxiolysis.…”

Section: Group I (N = 50) Mean (Sd)mentioning

confidence: 99%

Dexmedetomidine Prolongs the Effect of 0.5% Isobaric Levobupivacaine in Axillary Brachial Plexus Block

Anandh¹,

Bhupal²,

Grewal³

et al. 2015

jemds

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INTRODUCTION:Upper limb surgeries are mostly performed under peripheral blocks; the brachial plexus block. Peripheral nerve blocks not only provide intraoperative anaesthesia but also prolong analgesia in the post-operative period. Although studies have described the effects of dexmedetomidine on neuraxial and peripheral nerve blocks, till date, there are limited number of studies available on the effect of adding dexmedetomidine to levobupivacaine for an axillary brachial plexus block. OBJECTIVE: In this study, we aimed to investigate the effects of adding 1 µg/kg of dexmedetomidine to levobupivacaine for an axillary brachial plexus block to assess the onset and duration of sensory and motor block along with duration of analgesia in the postoperative period. METHODS: Hundred patients with American Society of Anesthesiologists (ASA) physical status I/II, scheduled to undergo forearm and hand surgeries, were enrolled for the prospective randomized, double blind placebo controlled study. Patients were divided into two equal groups. Group I [Control Group]: 39 ml of 0.5% isobaric levobupivacaine + 1 ml of isotonic saline. Group II [Study Group]: 39 ml of 0.5% isobaric levobupivacaine + 1 ml of dexmedetomidine (1 µg/kg) solution. RESULTS: The results showed that the onset of sensory and motor block are significantly shorter in group II (study group)(p<0.05) while the duration of blocks were significantly longer in group II (p<0.05) along with better postoperative analgesia. None of the patients had bradycardia, hypotension or any other side effects in either of the groups. CONCLUSION: Addition of dexmedetomidine (1µg/kg) to 0.5% isobaric levobupivacaine shortens the onset time of sensory and motor block significantly, increases the duration of sensory and motor block and prolong the duration of postoperative analgesia without any side effects.

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“…Additionally, it has been reported that dexmedetomidine added to local anesthetics in intravenous regional anesthesia improved the quality of anaesthesia (5,20) and it could partially prevent neuronal damage in some models of ischemia-induced brain injury (8, 9, 15-17). On the other hand, Konakci et al reported that dexmedetomidine produced moderate or severe demyelinization of myelin sheats in the white matter of spinal cord in rabbit, when it was administered by the epidural route (14).…”

Section: Kose Ea Et Al: Effects Of Intracisternal Dexmedetomidine Onmentioning

confidence: 99%

“…It has been demonstrated that dexmedetomidine produces antinociception in systemic (23,28), intrathecal (2,29) or epidural administration (1). It has been reported that the addition of dexmedetomidine to local anesthetic solution in intravenous regional anesthesia improved the quality of anesthesia and decreased the analgesic requirements (5,20). There is evidence that systemic administration of dexmedetomidine may partially prevent neuronal damage in some models of brain ischemia and this neuroprotective effect is mediated by the activation of the α₂-adrenergic receptors (8,9,(15)(16)(17).…”

Section: Introductionmentioning

confidence: 99%

Effects of intracisternal dexmedetomidine on cerebral neuronal cells in rat: a preliminary study

Kose¹,

Bakar²,

Kasımcan³

et al. 2012

Turkish Neurosurgery

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AIm:The aim was to investigate whether dexmedetomidine had a toxic effect on cerebral neurons when it was administered centrally into the cerebrospinal fluid by the intracisternal route. mAterIAl and methOds: Eighteen rats were anesthetized and the right femoral artery was cannulated. Mean arterial pressures, heart rates, arterial carbon dioxide tension, arterial oxygen tension, and blood pH were recorded. When the free cerebrospinal fluid flow was seen, 0.1 ml normal saline (Group SIC, n=6) or 9 µg/kg diluted dexmedetomidine in 0.1 ml volume (Group DIC, n=6) was administered into the cisterna magna of rats. After 24 hours, the whole body blood was collected for measurement of plasma lipid peroxidation (LPO) levels. The hippocampal formations used for histopathological examination and measurement of tissue LPO levels.results: There was a statistically significant difference between the DIC/SIC groups and DIC/CONTROL groups regarding the brain LPO levels (p=0.002, p<0.001, respectively). Plasma LPO levels were statistically different between the CONTROL/DIC groups, CONTROL/SIC groups, DIC/ SIC groups (p=0.002, p=0.047, p=0.025, respectively), The picnotic neuron counts were different between the CONTROL/SIC groups, CONTROL/ DIC groups, DIC/SIC groups (p<0.001, p=0.001, p=0.024, respectively). COnClusIOn:In conclusion, dexmedetomidine had a toxic effect on cerebral neurons when it was administered centrally into the cerebrospinal fluid by the intracisternal route.KeywOrds: Dexmedetomidine, Intracisternal, Intrathecal, Hippocampus, Brain, Cerebral neuron ÖZ AmAÇ: İntrasisternal olarak serebrospinal sıvı içine santral yolla verilen deksmedetomidinin serebral nöronlar üzerinde toksik etkisinin olup olmadığını araştırmak amaçlandı. yÖntem ve GereÇler: On sekiz sıçana anestezi verildikten sonra sağ femoral arterleri kanülize edildi. Ortalama arter basınçları, kalp hızları, arteriyal karbon dioksit basınçları, arteriyal oksijen basınçları, kan pH değerleri kaydedildi. Serbest serebrospinal sıvı akışı görüldükten sonra ratların sisterna magnaları içine 0,1 ml serum fizyolojik (Grup SIC, n=6) veya 0,1 ml volüm içinde 9 µg/kg sulandırılmış deksmedetomidin (Grup DIC, n=6) verildi. Yirmi dört saat sonra lipid peroksidasyon (LPO) seviyesi ölçümleri için tüm vücut kanı toplandı. Histopatolojik inceleme ve doku LPO seviyesi ölçümleri için hipokampüs kullanıldı.BulGulAr: Beyin dokusu LPO seviyeleri yönünden DIC/SIC ve DIC/CONTROL grupları arasında istatistiksel belirgin farklılık vardı (sırasıyla, p=0.002, p<0.001). Plazma LPO seviyeleri CONTROL/DIC, CONTROL/SIC, DIC/SIC grupları arasında istatistiksel olarak farklıydı (sırasıyla, p=0,002, p=0,047, p=0,025). Piknotik nöron sayıları CONTROL/SIC, CONTROL/ DIC, DIC/SIC grupları arasında istatiksel olarak farklıydı (sırasıyla, p<0,001, p=0,001, p=0,024). sOnuÇ: Sonuç olarak, intrasisternal olarak serebrospinal sıvı içine santral yolla verilen deksmedetomidinin serebral nöronlar üzerine toksik etkisi olduğu görüldü.

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Addition of dexmedetomidine to lidocaine for intravenous regional anaesthesia 1

Abstract: Addition of dexmedetomidine to local anaesthetic solution in IVRA improved the quality of anaesthesia and decreased analgesic requirements, but had no effect on the sensory and motor blocks onset and regression times.

Cited by 82 publications

References 24 publications

Dexmedetomidine as an Adjuvant to Levobupivacaine in Ultrasound Guided Supraclavicular Brachial Plexus Block

Dexmedetomidine as an Adjuvant to Levobupivacaine in Ultrasound Guided Supraclavicular Brachial Plexus Block

Dexmedetomidine Prolongs the Effect of 0.5% Isobaric Levobupivacaine in Axillary Brachial Plexus Block

Effects of intracisternal dexmedetomidine on cerebral neuronal cells in rat: a preliminary study

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