Dexmedetomidine in anaesthesia

Paris, Andrea; Tonner, Peter H.

doi:10.1097/01.aco.0000174958.05383.d5

Cited by 191 publications

(134 citation statements)

References 85 publications

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“…Dexmedetomidine is a relatively new drug which has potent sympatholytic, analgesic, and sedative properties mediated through α 2-adrenoceptors in the central and peripheral nervous systems (Bekker and Sturaitis 2005;Paris and Tonner 2005). It has become increasingly popular among anesthesiologists and intensive care physicians as an adjuvant to the classical regimen of anesthesia techniques (Paris and Tonner 2005).…”

Section: Discussionmentioning

confidence: 99%

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Hemodynamic and Anesthetic Advantages of Dexmedetomidine, an .ALPHA.2-Agonist, for Surgery in Prone Position

Özköse

Demir

Pampal

et al. 2006

Tohoku J. Exp. Med.

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The α 2-agonist dexmedetomidine (Dex), a sedative and analgesic, reduces heart rate (HR) and blood pressure, and has been used in the practice of anesthesia. In this study, we aimed to evaluate the effects of Dex on hemodynamic variables, anesthetic sparing effects, and recovery profiles in patients who underwent surgery in prone position. The prone position itself can cause a decrease in the systemic blood pressure. Forty patients who undergo lumbar discectomy were randomly assigned to receive either Dex (a loading dose 1 μ g/ kg in 10 minutes followed by an infusion rate of 0.2 μ g/ kg/ hr) or saline. In both groups, the anesthesia was induced with fentanyl, thiopental and rocuronium, and maintained with desflurane in 50% N 2 O. Mean arterial blood pressure (MAP), HR, cardiac output (CO), and level of anesthesia were monitored. Recovery times and analgesic requirements were also recorded. As a response to endotracheal intubation, a significant increase in MAP and HR was observed in the control group compared to the Dex group, but no difference in CO. The recovery times were significantly shorter in the Dex group compared to the control group. Anesthetic and analgesic requirements of the Dex group were lower than controls. Thus, the use of Dex caused no detrimental effects on the hemodynamic variables in prone position. In addition, Dex decreased pressure response to intubation, and anesthetic and analgesic requirements, shortened recovery times, and decreased postoperative pain level. Dex may be an alternative to currently used adjunctive anesthetic agents in lumbar discectomy operations.anesthesia; dexmedetomidine; NICO; cardiac output; lumbar discectomy

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Section: Discussionmentioning

confidence: 99%

“…It has become increasingly popular among anesthesiologists and intensive care physicians as an adjuvant to the classical regimen of anesthesia techniques (Paris and Tonner 2005). Also, it has been shown to reduce the anesthetic and analgesic requirements in animals and humans (Khan et al 1999;Dutta et al 2001).…”

Section: Discussionmentioning

confidence: 99%

Hemodynamic and Anesthetic Advantages of Dexmedetomidine, an .ALPHA.2-Agonist, for Surgery in Prone Position

Özköse

Demir

Pampal

et al. 2006

Tohoku J. Exp. Med.

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“…Dexmedetomidine is one of the most frequently applied intravenous pharmacs used for sedation in ICUs. It is a non-benzodiazepine, highly selective alpha 2 -adrenergic agonist which links itself to the transmembrane g protein alpha 2a, alpha 2b and alpha 2c of the peripheral, cerebral and spinal adrenoreceptors [33]. Unlike other sedatives dexmedetomidine, by acting on the alpha 2 receptors of locus coeruleus [34], causes an-algesia [35] without the risk of breathing depression [36,37].…”

Section: Discussionmentioning

confidence: 99%

The importance of early recognition and timely treatment of delirium in intensive care units

Stašević-Karličić¹,

Stasevic²,

Djordjević³

et al. 2016

Praxis Med

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Delirium is connected to bad short-term (the increase in hospital mortality rate and hospital days) and long-term outcomes (disfunctionality, institutionalisation, cognitive damage and post hospital-release dementia). The objective of this study is to determine whether there are possible incompatibilities of treatment of delirium with the recommendations in the guides of good clinical practice from developed countries. The grounded method was used in the study. The so called principal sampling of 17 psychiatrists, anesthesiologists and registered nurses was conducted. Afterwards, the unstructured interviews with the selectees were conducted, transcribed and analyzed immediately through coding, category and concept detection. Having completed this, the theoretical sampling of new interview examinees was conducted. Their analysis enabled the concepts to be linked into a working theory and graphically displayed. The new sampling, the new interviews and their analysis were then continued interactively until the saturation of the working theory was achieved and the final version of the theory was formulated based on the findings reached through the interviews. Having completed the principal sampling and coding of the transcripts led the researches to the saturation of the theory through the separation of eight categories: A -Delirium as a sign of system infection, B -Therapy -Anaesthesiologists administer benzodiazepines, whereas psychiatrists administer antipsychotics, C -An inconspicuous onset of delirium is overlooked, D -Bleeding as the cause of delirium, E -Anticholinergics as a cause of delirium, F -Misunderstanding the nature of delirium by anaesthesiologists, G -Being aware that the patient is vitally endangered, and H -The nurses apply enhanced health care measures. Delirium is a syndrome which can be prevented in 30-40% of cases (50). An etiological treatment would help avoid complicating delirium's clinical picture and would very much prevent poor outcomes, such as institutionalisation, cognitive damage and delirious patients' high mortality rate.

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“…However, dexmedetomidine was approved for sedation in the Intensive care unit in the USA in 1999 and administration in anaesthesia practice remains an 'offlabel' use. Further studies are needed to establish the role of dexmedetomidine in the perioperative period [16].…”

Section: Discussionmentioning

confidence: 99%