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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
1

A Systematic Review on the use of Dexmedetomidine as a Sole Agent for Intravenous Moderate Sedation

Toong, Samuel Y. 20 December 2011 (has links)
Intravenous administration of benzodiazepines can be used for anxiety management in dentistry. The recent approval of Dexmedetomidine in Canada provides an alternative to benzodiazepines for moderate sedation. There is no review comparing Dexmedetomidine and Midazolam as a sole agent for intravenous moderate sedation. This paper determines to fill the void of knowledge. A total of 6 articles out of 117 were identified in Pubmed and Ovid Medline using the key terms “Dexmedetomidine” and “sedation”. The parameters that were evaluated were the need for rescue, patient and surgeon satisfaction, and adverse outcomes. Dexmedetomidine was found to be equal or better than Midazolam in the first three parameters. Hypotension and bradycardia were evident in moderate to high doses, but none needing intervention. Other side effects include headache and dry mouth. Dexmedetomidine is a reasonable and safe alternative to Midazolam, but more research is needed to evaluate Dexmedetomidine for general dentistry.
2

A Systematic Review on the use of Dexmedetomidine as a Sole Agent for Intravenous Moderate Sedation

Toong, Samuel Y. 20 December 2011 (has links)
Intravenous administration of benzodiazepines can be used for anxiety management in dentistry. The recent approval of Dexmedetomidine in Canada provides an alternative to benzodiazepines for moderate sedation. There is no review comparing Dexmedetomidine and Midazolam as a sole agent for intravenous moderate sedation. This paper determines to fill the void of knowledge. A total of 6 articles out of 117 were identified in Pubmed and Ovid Medline using the key terms “Dexmedetomidine” and “sedation”. The parameters that were evaluated were the need for rescue, patient and surgeon satisfaction, and adverse outcomes. Dexmedetomidine was found to be equal or better than Midazolam in the first three parameters. Hypotension and bradycardia were evident in moderate to high doses, but none needing intervention. Other side effects include headache and dry mouth. Dexmedetomidine is a reasonable and safe alternative to Midazolam, but more research is needed to evaluate Dexmedetomidine for general dentistry.
3

Dexmedetomidine as anesthetic adjuvant cardiovascular and anesthetic effects in animals and humans /

Lawrence, Christopher J. January 1998 (has links)
Proefschrift Universiteit Maastricht. / Met bibliogr., lit. opg. - Met samenvatting in het Nederlands.
4

Pharmacokinetics and pharmacodynamics of dexmedetomidine in horses

Shane, Sarah E. 30 April 2021 (has links) (PDF)
An ideal dexmedetomidine protocol has yet to be determined for standing sedation in horses. It was hypothesized that an intravenous (IV) bolus followed by continuous rate infusion (CRI) dexmedetomidine would have a quicker increase in plasma concentrations compared to repeated intramuscular (IM) injections. In a cross-over design, eight adult, female horses were randomly placed in two groups: the CRI group (IV bolus dexmedetomidine at 0.005 mg/kg followed by a CRI at 0.01 mg/kg/hr for 15 minutes then 0.005 mg/kg/hr for 60 minutes) and the IM group (dexmedetomidine at 0.01 mg/kg, followed by 0.005 mg/kg in 30-minute intervals for 60 minutes). Analgesia was evaluated using a mechanical pressure threshold device. Intravenous dexmedetomidine produced faster onset of sedation and increased pressure threshold compared to IM administration. Individual horses had a large variability in dexmedetomidine plasma concentrations between CRI and IM administration.
5

Efeitos da dexmedetomidina nas respostas cardiovascular e de oxigenação sistêmica ao pinçamento aórtico infra-renal em cães sob anestesia com sevoflurano

Braz, Leandro Gobbo [UNESP] 20 December 2006 (has links) (PDF)
Made available in DSpace on 2014-06-11T19:35:12Z (GMT). No. of bitstreams: 0 Previous issue date: 2006-12-20Bitstream added on 2014-06-13T19:05:31Z : No. of bitstreams: 1 braz_lg_dr_botfm.pdf: 1708938 bytes, checksum: b318bc866ed01bbfc8f6868c4b5eed0f (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / A dexmedetomidina (Dex) tem efeito de simpatolise no sistema nervoso central e de inibicao da neurotransmissao nos nervos simpaticos. Assim, a Dex poderia suprimir o estado hiperdinamico do sistema cardiocirculatorio que ocorre durante a cirurgia da aorta. Em modelo de pincamento infra-renal da aorta (Aox) em caes sob anestesia com o sevoflurano, estudaram-se os efeitos cardiovasculares e de oxigenacao sistemica da Dex. Trinta caes foram submetidos a anestesia com sevoflurano, empregando-se 0,75 da concentracao alveolar minima (CAM) do halogenado, ventilados artificialmente e submetidos a Aox e despincamento aortico (DAox). Os animais foram distribuidos aleatoriamente e de modo encoberto em tres grupos: Placebo: (n=10) . infusao de solucao salina; Dex 1 (n=10) . infusao de Dex (1 Êg.kg-1), em 10 minutos, seguida por infusao continua de Dex (1 Êg.kg-1.h-1); e Dex 2 (n=10) - infusao de Dex (2 Êg.kg-1), em 10 minutos, seguida por infusao continua de Dex (2 Êg.kg-1.h-1). Os atributos hemodinamicos e de oxigenacao sistemica foram estudados nos momentos controle, apos a infusao das solucoes, apos 20 e 40 minutos do Aox e apos 20 e 40 minutos do DAox. A Dex diminuiu a frequencia cardiaca (FC) e o indice cardiaco. Na vigencia do Aox, o IC e a FC, nos grupos da Dex, foram menores do que no grupo Placebo (p < 0,05). Em Dex 1 e Dex 2, a pressao arterial media (PAM) apresentou valores mais elevados do que os do Placebo, enquanto a pressao de oclusao da arteria pulmonar (POAP) e o indice de resistencia vascular sistemica (IRVS) aumentaram de maneira INTRODUCAO E LITERATURA 9 dosedependente (p < 0,05). Nos grupos da Dex, o indice de transporte de oxigenio (ITO2) foi menor do que no grupo Placebo, enquanto a saturacao de oxigenio do sangue venoso misto foi menor em Dex 2 em relacao aos demais grupos (p < 0,05). / Dexmedetomidine (Dex) causes a centrally mediated sympatholysis and an inhibition of neurotransmission in sympathetic nerves. Thus, Dex could suppress the circulatory hyperdynamic state which accompanies aortic surgery. We studied the effects of Dex on hemodynamics and systemic oxygenation before, during and after infra-renal aortic cross-clamping (Aox). Thirty dogs were randomly assigned to three different general anesthetic regimens prior to Aox and unclamping (UAox). Group 1 (n=10), control, received 0.75 MAC sevoflurane plus saline infusion. Group 2 (n=10), Dex 1, received 0.75 MAC sevoflurane plus Dex (1 g.kg-1 load) followed by 1 g.kg-1.h-1 infusion. Group 3, Dex 2, received 0.75 MAC sevoflurane plus Dex (2 g.kg-1 load) followed by 2 g.kg-1.h-1 infusion. Hemodynamic and oxygenation variables were measured at baseline, after saline or Dex loading dose, and 20 and 40 min after Aox, and 20 and 40 min after UAox. Cardiac index and heart rate significantly decreased in Dex groups before Aox. Mean arterial pressure after Aox was higher in Dex groups than in Control (P<0.05) while pulmonary artery occlusion pressure and systemic vascular resistance were dose-dependently increased (P<0.05). Systemic oxygen delivery and mixed venous oxygen saturation was lower in Dex 2 compared to control (P<0.05). UAox had little effect on hemodynamics or oxygenation for control and Dex 1, however, Dex 2 was associated with a higher oxygen extraction ratio (P<0.05). In conclusion, Dex deleteriously altered hemodynamic and oxygenation effects of sevoflurane during Aox. INTRODUÇÃO E LITERATURA 11 These effects might limit the use of Dex in association with sevoflurane during aortic surgery.
6

Avaliação hemodinâmica e do índice bispectral (BIS) de cadela anestesiadas com midazolam e cetamina associados à medetomidina ou dexmedetomidina e submetidos a ovário-salpingo-histeectomia

Silva, Fernando do Carmo [UNESP] 02 November 2010 (has links) (PDF)
Made available in DSpace on 2014-06-11T19:35:13Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-11-02Bitstream added on 2014-06-13T18:46:37Z : No. of bitstreams: 1 silva_fc_dr_botfm.pdf: 476082 bytes, checksum: 10edb5d9695b1bd752e906e89c31c5c4 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Fármacos dissociativos administrados em dose única têm sido utilizados em Anestesiologia, porém, muitas vezes são incapazes de promover grau de hipnose e analgesia adequado para o ato cirúrgico. A técnica por infusão contínua diminui flutuações paramétricas e requerimento de anestésicos. Estudou-se o BIS e os atributos hemodinâmicos de cadelas anestesiadas com administração contínua de dexmedetomidina, fármaco α2 seletivo empregado apenas recentemente em Veterinária. Foram utilizadas 20 cadelas adultas (7 a 15 kg) que receberam prétratamento por via venosa (iv) de levomepromazina, 1 mg.kg-1, e buprenorfina, 3 μg.kg-1. Após 15 minutos, aplicou-se a cetamina, 5 mg.kg-1 iv, e o midazolam, 0,2 mg.kg-1 iv, para indução da anestesia. Iniciou-se, então, a administração contínua de midazolam, 0,4 mg.kg-1.h-1, e cetamina, 20 mg.kg-1.h-1, associados, conforme o grupo, à: DEX (n=10): dexmedetomidina 20 μg.kg-1.h-1 ou MED (n=10): medetomidina 30 μg.kg-1.h-1, mantidos até o final da cirurgia. A dose de dexmedetomidina foi obtida por meio de estudo farmacocinético com o programa “Stanpump®”, planejando-se concentração plasmática em torno de 2,0 ng.mL-1, no momento da tração das estruturas operadas. Os valores do BIS diminuíram progressivamente em ambos os grupos (p<0,05), mas foram menores no grupo DEX (p<0,05), em comparação com o grupo MED. Não houve diferença significativa nos atributos hemodinâmicos (freqüência cardíaca, pressão arterial sistólica, diastólica e média) entre os grupos, tampouco entre os diversos momentos do estudo (p>0,05). A freqüência respiratória diminuiu em ambos os grupos (p<0,05), mas foi menor no grupo DEX em relação ao grupo MED (p<0,05). Os valores do CO2 expirado aumentaram progressivamente em ambos os grupos (p<0,05). O tempo de recuperação... / Anesthesia has been performed with single bolus administration of dissociative drugs. Continuous infusion technique decreases the parametric fluctuations and anesthetic requirement. Hemodynamics and BIS were determined in anesthetized dogs using continuous administration of dexmedetomidine. Twenty dogs were pretreated with levomepromazine 1 mg.kg–1 and buprenorfine 3 μg.kg–1, and induced with ketamine 5 mg.kg–1 and midazolam 0.2 mg.kg–1. Midazolam 0.4 mg.kg–1.h–1, and ketamine 20 mg.kg–1.h–1 were continuously administered in association with one of the following drugs: DEX: dexmedetomidine 20 μg.kg–1.h–1; or MED: medetomidine 30 μg.kg–1.h–1. Dexmedetomidine dose was obtained by pharmacokinetic studies using Stanpump®. BIS values decreased for both groups (p<0.05) and were lower for DEX (p<0.05), when compared to MED group. There was no difference regarding hemodynamic parameters among groups and moments in the same group (p<0.05). Respiratory rate decrease in both groups (p<0.05), and were lower in DEX compared to MED (p<0.05). End tidal CO2 increased in both groups (p<0.05). Recovery length was similar between groups (p<0.05), and there were no adverse effects. In conclusion, dexmedetomidine produced a greater reduction on BIS than medetomidine, and both drugs resulted in good hemodynamic stability and a calm recovery.
7

Efeitos da administração epidural de dexmedetomidina sobre a concentração alveolar mínima do isofluorano em cães /

Campagnol, Daniela. January 2007 (has links)
Orientador: Francisco José Teixeira Neto / Banca: Francisco José Teixeira Neto / Banca: Silvia Renata Gaido Cortopassi / Banca: Carlos Augusto Araújo Valadão / Resumo: A administracao intravenosa de dexmedetomidina reduz significativamente a concentracao alveolar minima (CAM) dos agentes halogenados. No entanto, esse beneficio e frequentemente acompanhado por efeitos colaterais tipicos dos agonistas 2, como hipertensao, bradicardia e reducao do debito cardiaco. Ha indicios de que a administracao epidural de doses reduzidas de dexmedetomidina pode potencializar e prolongar seu efeito analgesico. Hipotetizou-se que a administracao epidural de dexmedetomidina reduziria a CAM do isofluorano de forma dose e tempo-dependente, sem ocasionar depressao cardiovascular significativa. Objetivou-se tambem caracterizar as alteracoes do indice bispectral (BIS) induzidas pela estimulacao nociceptiva empregada na mensuracao da CAM, bem como o efeito da dexmedetomidina epidural sobre essas alteracoes. Seis caes higidos (18,8}4,0 kg) foram anestesiados com isofluorano em 4 ocasioes distintas, com intervalo de 7 dias. Em cada anestesia, os animais receberam aleatoriamente 1 de 4 tratamentos pela via epidural. No tratamento controle, administrou-se solucao salina, enquanto nos tratamentos DEX1.5, DEX3 e DEX6, administrou-se dexmedetomidina nas doses de 1,5 . 3,0 e 6,0 Êg/kg, respectivamente. A CAM do isofluorano foi mensurada as 2 e 4,5 horas apos os tratamentos epidurais, por meio de estimulacao nociceptiva supramaxima (50V, 50 Hz e 10 ms) no membro pelvico. O valor medio de CAM (} desvio padrao) no tratamento controle foi de 1,57}0,23% e 1,55}0,25% as 2 e 4,5 horas, respectivamente. Quando comparado ao tratamento controle, o valor de CAM observado no tratamento DEX1,5 foi reduzido em 13% as 2 horas (1,35}0,11%), enquanto que a reducao as 4,5 horas (7% de reducao, CAM: 1,43}0,23%) nao foi significativa. No tratamento DEX3, a CAM foi significativamente reduzida em 29% (1,12}0,18%) e 13% (1,33}0,16%) as 2 e 4,5 horas, respectivamente. Reducoes de maior magnitude foram observadas... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Intravenous administration of dexmedetomidine significantly reduces the minimum alveolar concentration (MAC) of inhalant anesthetics. However, this beneficial effect is often associated with side effects such as hypertension, bradycardia, and a decrease in cardiac output. There are evidences epidural administration of relatively low doses of dexmedetomidine may result in more prolonged analgesia than intravenous administration of higher doses. The hypothesis of the present study is that epidural administration of dexmedetomidine would reduce isoflurane MAC in a dose and time-related fashion, without causing marked cardiovascular changes. This study aimed also to characterize the changes in bispectral index (BIS) induced by nociceptive stimulation used for MAC determinations and the effects of epidural dexmedetomidine on these changes. Six healthy dogs (18.8 8l4,0 kg) were anesthetized with isoflurane at 4 different occasions with at least 1-week intervals. On each anesthetic procedure, animals received 1 of 4 epidural treatments. Physiologic saline solution was administered in the control treatment, while for the treatments DEX1.5, DEX3, and DEX6, dexmedetomidine was administered at the doses of 1.5, 3.0, and 6.0 ìg/kg, respectively. Isoflurane MAC was assessed at 2 and 4.5 hours after epidural injections by means of supramaximal nociceptive stimulation (50V, 50 Hz e 10 ms) administered to the pelvic limb. Mean (l SD) isoflurane MAC in the control treatment was 1.57l0.23% and 1.55l0.25% at 2 e 4,5 hours, respectively. When compared to controls, mean MAC values observed in the DEX1.5 treatment were significantly reduced by 13% at 2 hours (1.35l0.11%), while the reduction observed at 4.5 hours (7% reduction, MAC: 1.43l0.23%) was not statistically significant... (Complete abstract click electronic access below) / Mestre
8

Efeitos da dexmedetomidina administrada em infusão intravenosa contínua, associada ou não ao butorfanol, em equinos

Medeiros, Luiza Quintão [UNESP] 23 July 2010 (has links) (PDF)
Made available in DSpace on 2014-06-11T19:29:17Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-07-23Bitstream added on 2014-06-13T20:19:21Z : No. of bitstreams: 1 medeiros_lq_me_botfm.pdf: 815806 bytes, checksum: 50049ac5398d57eb867aaf50452b77c2 (MD5) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / A dexmedetomidina e o butorfanol, administrados por infusão intravenosa contínua, podem ser úteis para sedação contínua em equinos mantidos na posição quadrupedal. Os efeitos hemodinâmicos, respiratórios e sedativos da infusão intravenosa contínua da dexmedetomidina, associada ou não ao butorfanol, foram avaliados em seis equinos adultos (432±25 kg). Os animais foram submetidos a dois tratamentos aleatoriamente: dexmedetomidina (DEX) e dexmedetomidina e butorfanol (DEX+BUT), com intervalo mínimo de sete dias entre eles. Após preparação, os equinos ainda conscientes receberam o tratamento DEX: dexmedetomidina (bolus 3,5 mcg.kg-1 IV e taxa de infusão 5 mcg.kg-1.h-1) ou DEX+BUT: dexmedetomidina (bolus 3,5 mcg.kg-1 IV e taxa de infusão 3,5 mcg.kg-1.h-1) e butorfanol (bolus 0,02 mg.kg-1 IV e taxa de infusão 0,024 mg.kg-1.h-1). Os escores de sedação e as variáveis hemodinâmicas (método de termodiluição) e respiratórias foram registradas antes da sedação (momento basal), durante as infusões (5, 15, 30, 60 e 90 minutos) e após a interrupção das mesmas (15, 30 e 60 minutos). O teste T-pareado e ANOVA seguida do teste Tukey-Kramer foram utilizados para comparação dos valores cardiorrespiratórios (média±DP). Friedman seguido do teste de Dunn foram utilizados para análise de sedação (p < 0,05). A redução significativa do índice cardíaco (DEX (-37%; 60±9 para 38±4 mL.min-1.kg-1) e DEX+BUT (-41%; 63±6 para 37±4 mL.min-1.kg-1)), frequência cardíaca (DEX (-34%; 44±3 para 29±4 bpm) e DEX+BUT (-30%; 43±5 para 30±4 bpm)), índice de transporte de oxigênio (DEX (-47%; 1166±339 para 613±136 dL.min-1.kg-1) e DEX+BUT (-48%; 1075±204 para 555±73 dL.min-1.kg-1)) e frequência respiratória (DEX (-63%; 16±3 para 10±2 mpm) e DEX+BUT (-63%; 16±1 para 10±2 mpm)) foram acompanhados pelo aumento significativo do índice de resistência vascular... / Dexmedetomidine and butorphanol, administered by constant rate infusion (CRI) might be useful for continuous sedation in standing horses. The hemodynamic, respiratory and sedative effects of the CRI dexmedetomidine associated with butorphanol and CRI dexmedetomidine were evaluated in six adults horses (432±25 kg). The animals underwent 2 treatments in random order: dexmedetomidine (DEX) and dexmedetomidine and butorphanol (DEX+BUT) in a minimum 7-day interval. After instrumentation while unsedated all horses received treatment DEX: dexmedetomidine (3.5 mcg/kg bwt bolus IV, followed by 5 mcg/kg/hour bwt CRI) or treatment DEX+BUT: dexmedetomidine (3.5 mcg/kg bwt bolus IV, and 3.5 mcg/kg/hour bwt CRI) and butorphanol (0.02 mg/kg bwt bolus IV, and 0.024 mg/kg/hour bwt CRI). Sedative scores and hemodynamic (thermodilution method) and respiratory variables were recorded before sedation (baseline), during infusions (5, 15, 30, 60 and 90 minutes) and after infusions (15, 30 and 60 minutes). T-test and ANOVA followed by Tukey-Kramer´s test were used to compare cardiorespiratory values (mean±SD), and Friedman followed by Dunn´s test were used for sedation analysis (p < 0.05). The decreased from baseline in cardiac index (DEX (-37%; 60±9 to 38±4 mL/minute/kg) and DEX+BUT (-41%; 63±6 to 37±4 mL/minute/kg)), heart rate (DEX (-34%; 44±3 to 29±4 bpm) and DEX+BUT (-30%; 43±5 to 30±4 bpm)), delivery oxygen index (DEX (-47%; 1166±339 to 613±136 dL/minute/kg) and DEX+BUT (-48%; 1075±204 to 555±73 dL/minute/kg)) and respiratory rate (DEX (-63%; 16±3 to 10±2 mpm) and DEX+BUT (-63%; 16±1 to 10±2 mpm)), were accompanied by an increase from baseline in systemic vascular resistance index (DEX (+61%; 129±15 to 210±14 dynas/s/cm-5/kg) and DEX+BUT (+61%; 132±19 to 218±25 dynas/s/cm-5/kg)). The infusions induced head drop (DEX 51% and DEX+BUT 55%), decreased from baseline in sedation ... (Complete abstract click electronic access below)
9

Efeitos da dexmedetomidina nas respostas cardiovascular e de oxigenação sistêmica ao pinçamento aórtico infra-renal em cães sob anestesia com sevoflurano /

Braz, Leandro Gobbo. January 2006 (has links)
Orientador: Paulo do Nascimento Júnior / Banca: Norma Sueli Pinheiro Modolo / Banca: Rosa Inês Costa Pereira / Banca: Irimar de Paula Presso / Banca: Luiz Vicente Garcia / Resumo: A dexmedetomidina (Dex) tem efeito de simpatolise no sistema nervoso central e de inibicao da neurotransmissao nos nervos simpaticos. Assim, a Dex poderia suprimir o estado hiperdinamico do sistema cardiocirculatorio que ocorre durante a cirurgia da aorta. Em modelo de pincamento infra-renal da aorta (Aox) em caes sob anestesia com o sevoflurano, estudaram-se os efeitos cardiovasculares e de oxigenacao sistemica da Dex. Trinta caes foram submetidos a anestesia com sevoflurano, empregando-se 0,75 da concentracao alveolar minima (CAM) do halogenado, ventilados artificialmente e submetidos a Aox e despincamento aortico (DAox). Os animais foram distribuidos aleatoriamente e de modo encoberto em tres grupos: Placebo: (n=10) . infusao de solucao salina; Dex 1 (n=10) . infusao de Dex (1 Êg.kg-1), em 10 minutos, seguida por infusao continua de Dex (1 Êg.kg-1.h-1); e Dex 2 (n=10) - infusao de Dex (2 Êg.kg-1), em 10 minutos, seguida por infusao continua de Dex (2 Êg.kg-1.h-1). Os atributos hemodinamicos e de oxigenacao sistemica foram estudados nos momentos controle, apos a infusao das solucoes, apos 20 e 40 minutos do Aox e apos 20 e 40 minutos do DAox. A Dex diminuiu a frequencia cardiaca (FC) e o indice cardiaco. Na vigencia do Aox, o IC e a FC, nos grupos da Dex, foram menores do que no grupo Placebo (p < 0,05). Em Dex 1 e Dex 2, a pressao arterial media (PAM) apresentou valores mais elevados do que os do Placebo, enquanto a pressao de oclusao da arteria pulmonar (POAP) e o indice de resistencia vascular sistemica (IRVS) aumentaram de maneira INTRODUCAO E LITERATURA 9 dosedependente (p < 0,05). Nos grupos da Dex, o indice de transporte de oxigenio (ITO2) foi menor do que no grupo Placebo, enquanto a saturacao de oxigenio do sangue venoso misto foi menor em Dex 2 em relacao aos demais grupos (p < 0,05). / Abstract: Dexmedetomidine (Dex) causes a centrally mediated sympatholysis and an inhibition of neurotransmission in sympathetic nerves. Thus, Dex could suppress the circulatory hyperdynamic state which accompanies aortic surgery. We studied the effects of Dex on hemodynamics and systemic oxygenation before, during and after infra-renal aortic cross-clamping (Aox). Thirty dogs were randomly assigned to three different general anesthetic regimens prior to Aox and unclamping (UAox). Group 1 (n=10), control, received 0.75 MAC sevoflurane plus saline infusion. Group 2 (n=10), Dex 1, received 0.75 MAC sevoflurane plus Dex (1 g.kg-1 load) followed by 1 g.kg-1.h-1 infusion. Group 3, Dex 2, received 0.75 MAC sevoflurane plus Dex (2 g.kg-1 load) followed by 2 g.kg-1.h-1 infusion. Hemodynamic and oxygenation variables were measured at baseline, after saline or Dex loading dose, and 20 and 40 min after Aox, and 20 and 40 min after UAox. Cardiac index and heart rate significantly decreased in Dex groups before Aox. Mean arterial pressure after Aox was higher in Dex groups than in Control (P<0.05) while pulmonary artery occlusion pressure and systemic vascular resistance were dose-dependently increased (P<0.05). Systemic oxygen delivery and mixed venous oxygen saturation was lower in Dex 2 compared to control (P<0.05). UAox had little effect on hemodynamics or oxygenation for control and Dex 1, however, Dex 2 was associated with a higher oxygen extraction ratio (P<0.05). In conclusion, Dex deleteriously altered hemodynamic and oxygenation effects of sevoflurane during Aox. INTRODUÇÃO E LITERATURA 11 These effects might limit the use of Dex in association with sevoflurane during aortic surgery. / Doutor
10

Efficacy of Dexmedetomidine Compared to Propofol in Pain Pump Placement Procedures

Haun,Cameron, Schwehr, Rebecca, Green-Boesen, Kelly, Boesen, Kevin January 2011 (has links)
Class of 2011 Abstract / OBJECTIVES: To compare the use of propofol to dexmedetomidine hydrochloride (Precedex®) in patients undergoing pain pump placements at University Physicians Hospital. METHODS: A retrospective chart review was performed evaluating anesthesia charts from December 2009 through February 2011. Heart rate (HR), blood pressure (BP), respiratory rate (RR), surgery time, and length of stay in the PACU were collected for both treatment groups. Demographic variables were also collected including age, sex, medical condition for which they are having a procedure performed, other co-morbid conditions and concurrent medications. RESULTS: Charts were reviewed for 8 dexmedetomidine patients and 16 propofol patients. There was no statistical difference among the groups with regard to demographics. The groups had similar procedural average systolic blood pressures, diastolic blood pressures, and heart rate (p = 0.93; p = 0.56, p = 0.37 respectively). The procedure time and recovery time in the PACU were similar between the dexmedetomidine group and propofol group (p = 0.52; p = 0.25, respectively). The endpoint respiratory rate was significantly lower in the propofol group (p = 0.05). There was no difference in additional sedative-analgesic medication use. CONCLUSION: Dexmedetomidine does not offer any clinical advantages to propofol when used as anesthesia for pain pump placement.

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