Alpha‐2 adrenoceptor agonists as adjuncts to Peripheral Nerve Blocks in Children – is there a mechanism of action and should we use them?

Lönnqvist, Per‐Arne

doi:10.1111/j.1460-9592.2012.03821.x

Cited by 24 publications

(14 citation statements)

References 45 publications

(47 reference statements)

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“…The Ih current plays an important role in returning the peripheral nerves to the resting potential, and blocking of the Ih current extends the hyperpolarization of the nerves. As this effect is especially evident in unmyelinated C fibers (pain) compared to A α fibers (motor), the Ih current block is reported to be more effective in blocking pain nerves than in blocking motor nerves [22]. …”

Section: Discussionmentioning

confidence: 99%

Comparison of dexmedetomidine and epinephrine as an adjuvant to 1% mepivacaine in brachial plexus block

Song

Shim

Lee

et al. 2014

Korean J Anesthesiol

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BackgroundDexmedetomidine extends the duration of nerve block when administered perineurally together with local anesthetics by central and/or peripheral action. In this study, we compared the duration of nerve block between dexmedetomidine and epinephrine as an adjuvant to 1% mepivacaine in infraclavicular brachial plexus block.Methods Thirty patients, scheduled for upper limb surgery were assigned randomly to 3 groups of 10 patients each. We performed brachial plexus block using a nerve stimulator. In the control group (group C), patients received 40 ml of 1% mepivacaine. In group E, patients received 40 ml of 1% mepivacaine containing 200 µg of epinephrine as an adjuvant. In group D, patients received 40 ml of 1% mepivacaine containing 1 µg/kg of dexmedetomidine as an adjuvant. Sensory block duration, motor block duration, time to sense pain, and onset time were assessed. We also monitored blood pressure, heart rate, oxygen saturation and bispectral index.ResultsIn group D and group E, sensory block duration, motor block duration and time to sense first pain were prolonged significantly compared to group C. However, there was no significant difference between group D and group E.ConclusionsPerineural 1 µg/kg of dexmedetomidine similarly prolonged nerve block duration compared to 200 µg of epinephrine, but slowed heart rate. Thus, dexmedetomidine is expected to be a good alternative as an adjuvant to local anesthesia in patients who are cautioned against epinephrine.

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Section: Discussionmentioning

confidence: 99%

Comparison of dexmedetomidine and epinephrine as an adjuvant to 1% mepivacaine in brachial plexus block

Song

Shim

Lee

et al. 2014

Korean J Anesthesiol

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“…It's α 2 -agonists reducing the release of norepinephine. It stimulates central presynaptic α2 receptor resulting in decreased noradrenaline release which in turn causes hypotension and bradycardia [11][12][13][14].…”

Section: Discussionmentioning

confidence: 99%

Effect of Multiple Doses of Dexmedetomidine for Moderate Sedation Facilitating Intubation during Nasotracheal Fiberoptic Laryngoscope in Awake Patients-A Randomized Prospective Study

Arafa¹,

ElSayed²

2017

J Anesth Clin Res

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Background: Nasal fiberoptic intubation in fully conscious patients is the gold standard technique of choice in known difficult airway as cervical instability, limited mouth opening and any facial defects. The usage of an ideal sedation agent with a perfect dose or regimen securing stability of hemodynamic conditions and optimizing the intubating condition at the same time is an indispensable demand for awake fiberoptic intubation.

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“…Peripherally, α2-agonists produce analgesia by reducing the release of norepinephine and causing inhibitory effect on nerve fiber action potential resulting in analgesia. Centrally, α2-agonists activate α2-adrenoreceptor and inhibit substance P release in the nociceptive pathway at the level of the dorsal root neuron resulting in sedation and analgesia [11][12][13][14].…”

Section: Discussionmentioning

confidence: 99%

Dexmedetomidine vs. Fentanyl as Adjuvant to Local Anaesthetic Mixture in Peribulbar Block for Retinal Surgery: A Randomized Prospective Study

Khalil¹,

Marouf²

2017

J Anesth Clin Res

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Alpha‐2 adrenoceptor agonists as adjuncts to Peripheral Nerve Blocks in Children – is there a mechanism of action and should we use them?

Cited by 24 publications

References 45 publications

Comparison of dexmedetomidine and epinephrine as an adjuvant to 1% mepivacaine in brachial plexus block

Comparison of dexmedetomidine and epinephrine as an adjuvant to 1% mepivacaine in brachial plexus block

Effect of Multiple Doses of Dexmedetomidine for Moderate Sedation Facilitating Intubation during Nasotracheal Fiberoptic Laryngoscope in Awake Patients-A Randomized Prospective Study

Dexmedetomidine vs. Fentanyl as Adjuvant to Local Anaesthetic Mixture in Peribulbar Block for Retinal Surgery: A Randomized Prospective Study

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