Efficacy and Safety of Dexmedetomidine Premedication in Balanced Anesthesia: A Systematic Review and Meta-Analysis in Dogs

Pan, Shiyue; Liu, Gang; Lin, J. H.; Yipeng, Jin

doi:10.3390/ani11113254

Cited by 18 publications

(19 citation statements)

References 43 publications

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“…This was consistent with research results of Jiang et al (2017) [30]. Pan et al (2021) [31] presented that Dex had satisfactory sedative and analgesic effects and the incidence of adverse reactions was 0.47%.…”

Section: Resultssupporting

confidence: 91%

Adoption of Dexmedetomidine in Different Doses at Different Timing in Perioperative Patients

Xie

Feng

2022

BioMed Research International

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Dexmedetomidine (Dex) is an alpha-2 agonist used for sedation during various procedures. Dex activates 2-adrenoceptors, and causes the decrease of sympathetic tone, with attenuation of the neuroendocrine and hemodynamic responses to anesthesia and surgery; it reduces anesthetic and opioid requirements; and causes sedation and analgesia. Objective: it was to compare the perioperative effects of different doses of Dex at different timing in patients using Dex during the perioperative period adopting a medical data classification algorithm based on optimized semi-supervised collaborative training (Tri-training). Methods: 495 patients requiring surgical treatment in Xingtai People’s Hospital were randomly selected as the study subjects. The patients were divided into group A (used before induction), group B (used during induction), and group C (used after induction) according to different induction timing, with 165 cases in each group. Then, groups A, B, and C were divided into groups A1, B1, and C1 (0.4 μg/(kg·h) rate), groups A2, B2, and C2 (0.6 μg/(kg·h) rate), and groups A3, B3, and C3 (0.8 μg/(kg·h) rate) according to the dose used, with 55 cases in each group. Intraoperative anesthesia and postoperative adverse reactions were compared among the 9 groups. Results: the similarity between the Tri-training algorithm optimized by Naive Bayes (NB) classification algorithm and the actual classification (93.49%) was clearly higher than that by decision tree (DT) and K-nearest neighbor (kNN) classification algorithm (76.21%, 74.31%); heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) values decreased obviously after Dex used in groups B1, C1, B2, C2, B3, and C3 (P <0.05), but did not change significantly in groups A1, A2, and A3 (P >0.05); the proportion of patients with satisfactory Ramsay score in group A3 was distinctly superior than that in groups A1, A2, B1, B2, B3, C1, C2, and C3 (P <0.05); the incidence of adverse reactions in group A3 was significantly inferior than that in groups A1, A2, B1, B2, B3, C1, C2, and C3 (P <0.05). Conclusion: the optimization effect of NB classification algorithm was the best, and the injection of Dex at the injection rate of 0.8 μg/(kg·h) before induction of anesthesia could apparently improve the fluctuation of HR, SBP, and DBP during perioperative period, and effectively reduce the occurrence of adverse reactions in patients, with better sedative effect on patients.

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Section: Resultssupporting

confidence: 91%

Adoption of Dexmedetomidine in Different Doses at Different Timing in Perioperative Patients

Xie

Feng

2022

BioMed Research International

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“…The combination of alpha-2 agonists and ketamine leads to a more reliable, steady, and profound sedation than alpha-2 agonists alone [14][15][16][17]. Ketamine is a dissociative agent able to provoke a dosedependent loss of consciousness while maintaining re exes, such as the swallowing re ex [18].…”

Section: Introductionmentioning

confidence: 99%

Determination of a safe sedative combination of dexmedetomidine, ketamine and butorphanol for minor procedures in dogs by use of a stepwise optimization method

Pownall

Imboden²,

Rubin

et al. 2023

Preprint

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Background: In veterinary practice, most minor procedures such as radiographs, skin biopsies and wound treatments require sedation. The combination of butorphanol, ketamine and dexmedetomidine is commonly used, but the ideal dosages for this combination have not been reported. This randomized prospective clinical trial initially tested 8 clinically relevant combinations in a blinded procedure in 50 dogs. The quality of each combination was rated using a purposefully developed negative score (NS; 0-21.5, the lower the NS the better the quality of sedation), to judge the quality of sedation, the occurrence of side effects, and need for additional anaesthetics. Then the combinations were divided into "promising" and "unsatisfactory" subgroups and their centroids Pc and Uc were determined before a new combination (N) was calculated using the formula N=Pc+α*(Pc-Uc). The combination N was tested in 6 dogs and then it replaced the worst of the previous 8 combinations. The same procedure was repeated after each new combination until the NS did not improve any further. As a last step, the best combination was tested in 100 adult dogs undergoing diagnostic or therapeutic procedures. Results: The optimal combination found was dexmedetomidine 0.005 mg/kg, ketamine 1 mg kg-1, and butorphanol 0.3 mg kg-1 with a median NS of 1.5 (interquartile range 1.5-2.4). In all 112 dogs receiving this combination, the quality of sedation was satisfactory and no severe side effects were detected. Conclusions: The application of this optimization method allowed the calculation of an optimal drug combination for sedation in healthy dogs. This combination revealed safe after being tested in 100 animals. This combination can now be used in daily clinical practice for healthy adult dogs undergoing minor procedures.

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“…Dexmedetomidine, an α2 adrenergic agonist, has been used widely in domestic and exotic animals including wildlife, dogs [ 5 , 6 ], cats [ 7 ], rodents [ 8 , 9 ], dairy and dromedary calves [ 10 , 11 ], horses [ 12 ], miniature donkeys [ 13 ], and captive tigers [ 14 ]. Like other α2 adrenergic agonists, it provides sedation, muscle relaxation, and analgesia [ 15 ]; there- fore, it has gained popularity over the last 10 years.…”

Section: Introductionmentioning

confidence: 99%

Dexmedetomidine Effectively Sedates Asian Elephants (Elephas maximus)

Buranapim

Kulnanan²,

Chingpathomkul³

et al. 2022

Animals

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This study investigated the sedative effects of dexmedetomidine in Asian elephants. We hypothesized that 2 µg/kg dexmedetomidine would provide sufficient standing sedation. A crossover design study was performed in three Asian elephants. Each elephant was assigned to 1 of 3 treatment groups—1 (D1), 1.5 (D1.5) or 2 (D2) µg/kg dexmedetomidine (intramuscular injection, IM) with a two-week ‘washout period’ between doses. Elephants were monitored for 120 min. At 120 min (Ta), atipamezole was administered IM. Sedation and responsiveness scores were evaluated. Physiological parameters (pulse rate, respiratory rate, and %SpO2) and clinical observations were monitored during the study and for 3 days post drug administration. D2 provided the longest sedation (approximately 70 min), compared to D1 and D1.5. After Ta, each elephant’s sedative stage lessened within 10–15 min without complications. No significant abnormal clinical observations were noted throughout and during the 3-days post study period. These data suggest that a single 2 µg/kg IM dexmedetomidine injection provides sufficient standing sedation for approximately 70 min in Asian elephants.

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Efficacy and Safety of Dexmedetomidine Premedication in Balanced Anesthesia: A Systematic Review and Meta-Analysis in Dogs

Cited by 18 publications

References 43 publications

Adoption of Dexmedetomidine in Different Doses at Different Timing in Perioperative Patients

Adoption of Dexmedetomidine in Different Doses at Different Timing in Perioperative Patients

Determination of a safe sedative combination of dexmedetomidine, ketamine and butorphanol for minor procedures in dogs by use of a stepwise optimization method

Dexmedetomidine Effectively Sedates Asian Elephants (Elephas maximus)

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