Efficacy Of Dexmedetomidine Research Articles

Respiratory and antinociceptive effects of dexmedetomidine and doxapram in ball pythons (Python regius).

To determine the effects of dexmedetomidine, doxapram, and dexmedetomidine plus doxapram on ventilation ([Formula: see text]e), breath frequency, and tidal volume (Vt) in ball pythons (Python regius) and of doxapram on the thermal antinociceptive efficacy of dexmedetomidine. 14 ball pythons. Respiratory effects of dexmedetomidine and doxapram were assessed with whole-body, closed-chamber plethysmography, which allowed for estimates of [Formula: see text]e and Vt. In the first experiment of this study with a complete crossover design, snakes were injected, SC, with saline (0.9% NaCl) solution, dexmedetomidine (0.1 mg/kg), doxapram (10 mg/kg), or dexmedetomidine and doxapram, and breath frequency, [Formula: see text]e, and Vt were measured before and every 30 minutes thereafter, through 240 minutes. In the second experiment, antinociceptive efficacy of saline solution, dexmedetomidine, and dexmedetomidine plus doxapram was assessed by measuring thermal withdrawal latencies before and 60 minutes after SC injection. Dexmedetomidine significantly decreased breath frequency and increased Vt but did not affect [Formula: see text]e at all time points, compared with baseline. Doxapram significantly increased [Formula: see text]e, breath frequency, and Vt at 60 minutes after injection, compared with saline solution. The combination of dexmedetomidine and doxapram, compared with dexmedetomidine alone, significantly increased [Formula: see text]e at 30 and 60 minutes after injection and did not affect breath frequency and Vt at all time points. Thermal withdrawal latencies significantly increased when snakes received dexmedetomidine or dexmedetomidine plus doxapram, versus saline solution. Concurrent administration of doxapram may mitigate the dexmedetomidine-induced reduction of breathing frequency without disrupting thermal antinociceptive efficacy in ball pythons.

Comparison Of Efficacy Of Intravenous Dexmedetomidine Vs Clonidine Vs Tramadol To Control Post Spinal Shivering In Parturiants Undergoing Elective Lscs

INTRODUCTION: - Post spinal shivering is very unpleasant, uncomfortable to the 55% population of parturient. Shivering is spontaneous, involuntary, rhythmic, tremor-like muscle hyperactivity that increases metabolic heat production up to 600% after general or regional anaesthesia. There are various methods available to control shivering during anaesthesia. We conducted this both drugs control post spinal shivering. In present study to compare the relative efficacy of Dexmedetomidine, Clonidine and Tramadol for control of intraoperative shivering under spinal anaesthesia Study design: Randomized double blind Observation study. AIMS AND OBJECTIVES: - The present study is undertaken to clinically compare the efficacy, haemodynamic effects, complications and side effects of Dexmedetomidine, Clonidine & Tramadol on control of post spinal shivering in parturient. METHODS: - After obtaining written informed consent, we conducted a randomised study in 90 parturient (30 in each group) and compared the efficacy of intravenous Dexmedetomidine Clonidine and Tramadol for controlling post spinal shivering. Patients were given inj. Dexmedetomidine (Group D) 0.5mcg/kg, Injection clonidine (Group C I.V. Clonidine 0.5mcg/kg), Tramadol (Group T- I.V. Tramadol 1mg/kg) when shivering of grade 2 to 4 was noted which lasted for minimum periof of 2 minutes after institution of subarachnoid block. CONCLUSION: Dexmedetomidine, Clonidine& Tramadol effectively treated patients with post spinal shivering, but time taken for complete cessation of shivering was earlier in Tramadol. From our study we conclude that, I.V Tramadol is a better alternative than I.VAlpha 2agonists (Dexmedetomidine & Clonidine) in treatment of post spinal anaesthesia shivering

Efficacy of dexmedetomidine and ketamine addition to bupivacaine 0.25% by epidural method in reducing postoperative pain in patients undergoing femur fracture surgery.

Background and Aim:One of the most complex medical problems is pain, that due to inappropriate management of patients after surgery could cause various side effects on the psychological, physiological, and metabolic state of the patients. The natural duration of analgesia can be increased by adding new efficient adjuvant. The present study is mainly aimed to investigate the differences between the epidural dexmedetomidine and ketamine effectiveness when administered as an adjuvant to epidural 0.25% bupivacaine for improving the postoperative analgesia duration.Methods:In the present double-blind clinical study, 105 patients of the age range of 40–85 years were selected for elective femoral surgery and then was divided into three of ketamine, dexmedetomidine, and control randomly. The scores of postoperative pain were evaluated in accordance with the visual Analogue Scale (VAS) criteria and the duration of analgesia and the amount of analgesics consumption were recorded.Results:The mean pain VAS score during the first day after the surgery and recovery of patients in the dexmedetomidine group was significantly lower in comparison with two other groups (p = 0.01). However, no significant difference was found in the mean VAS score of Paine during 12 and 24 hours after the operation (P ≥ 0.05). Comparisons among these groups demonstrated that the mean on opioid administration during the operation and 24 hours after that was significantly higher in both groups of ketamine and control in comparison with the dexmedetomidine group (P = 0.001 and P = 0.01). Besides, analgesia duration among patients belonged to the dexmedetomidine group was notably lower in comparison with two other groups (P = 0.001).Conclusion:In epidural anesthesia cases adding ketamine and dexmedetomidine as adjuvants to the solution of bupivacaine 0.25%, could increase the duration of analgesia and reduce the consumption of analgesics, which is more in the dexmedetomidine group when compared with ketamine.

Analgesic efficacy of single- shot adductor canal block with levobupivacaine and dexmedetomidine in total knee arthroplasty: A randomized clinical trial

ABSTRACT Background The goal of this study was to compare the analgesic efficacy of dexmedetomidine and levobupivacaine in adductor canal block (ACB) in total knee arthroplasty (TKA) patients, as well as the ambulation ability and adverse effects. Methods Sixty patients, ranging in age from 18 to 60 years old and with an ASA status of I to II, had unilateral TKA under spinal anesthesia. They were randomized into two groups; Group L received 20 mL of 0.25% levobupivacaine and Group LD received 20 mL of 0.25% levobupivacaine plus 0.5 µg/kg dexmedetomidine for ACB. The time it took for the first analgesic to be requested, the amount of morphine used in a 24-hour period, the postoperative pain score, and the range of motion (ROM), a 100-foot walking test data, sedation, patient satisfaction, and adverse outcomes were measured. Results LD group had lower scores of VAS either at rest or on movement at nearly all-time intervals. The mean time to first analgesic request in group L (406.77 ± 10.64 min) and group LD (515.10 ± 27.98 min, P-value <0.001). The mean total dose of morphine consumed in first 24 h postoperative was significantly lower in LD group (6.47 ± 2.01 mg) when compared to L group (10.93 ± 2.35 mg, P value <0.001). There were significant differences in ROM test, 100 foot test, and patient satisfaction between groups but no major adverse effects in both groups. Conclusion The addition of 0.5 µg/kg dexmedetomidine to 20 mL of 0.25% levobupivacaine in single-shot ACB is better than 20 mL of 0.25% levobupivacaine alone regarding postoperative analgesia, patient satisfaction and ambulation ability following TKA but, with low rate of adverse events in both groups.

Postoperative evaluation of analgesia promoted by the use of dexmedetomidine alone and associated with morphine as an intramuscular pre-anesthetic medication in bitches submitted for ovariohysterectomy

Abstract This study aimed to evaluate the postoperative analgesic efficacy of dexmedetomidine alone and when associated with morphine in patients under general inhalational anesthesia with isoflurane and undergoing elective ovariohysterectomy (OH). Twenty healthy bitches were selected via physical and laboratory examinations. Prior to the study, they underwent a 24-h period of adaptation to the environment and observers. They were then randomly divided into two groups: the dexmedetomidine group receiving a dose of 10 μg/kg, and dexmedetomidine group (10 μg/kg) associated with morphine receiving a dose of 0.3 mg/kg, administered via the intramuscular route. Thereafter, patients were induced with propofol and maintained with isoflurane diluted in 100% oxygen administered through a calibrated vaporizer. To verify postoperative analgesia, pain assessments were performed using the modified Glasgow (EGM) and Melbourne (EM) scales. For sedation assessment, the Dobbins scale was used at different times: before the administration of pre-anesthetic medication (T0) and at another six times in the postoperative period, 1 (T1), 2 (T2), 4 (T3), 8 (T4), 12 (T5), and 24 (T6) h after orotracheal extubation. No statistical differences were observed between groups in the scales according to Dunn’s Kruskal-Wallis post hoc test, and between the times a statistical difference was noticed by the Friedman test (p&lt;0.05) for the EGM and EM scale scores, but there was no need for analgesic rescue. Therefore, we found that isolated dexmedetomidine and morphine produced adequate analgesic effects in the postoperative period of bitches submitted for OH.

Study of efficacy of dexmedetomidine and fentanyl for suppression of pressor response to pneumoperitoneum during laparoscopic surgeries

Study of efficacy of dexmedetomidine and fentanyl for suppression of pressor response to pneumoperitoneum during laparoscopic surgeries

A comparative study to assess the efficacy of dexmedetomidine as an adjuvant to bupivacaine in the ultrasound-guided pectoral and serratus plane nerve block for patients undergoing modified radical mastectomy

Background and aims Dexmedetomidine has been noticed to be safe and efficient in prolonging the duration of peripheral nerve blocks. This study was designed to compare the length, quality of postoperative analgesia, hemodynamic stability, and patient’s satisfaction and number of patients requiring analgesia with the addition of dexmedetomidine to bupivacaine versus plain bupivacaine in pectoral nerve block (pecs) for modified radical mastectomy (MRM).Patients and methods These patients were randomly allocated using a computerized random number generator into two groups: group I (control group) (30 patients) received 25 ml of 0.25% of plain bupivacaine that was used for modified pecs block. Group II (study group) (30 patients) received 25 ml of 0.25% of plain bupivacaine plus dexmedetomidine (Precedex) 1 μg/kg that were used for pecs block.Results The results showed a longer duration of analgesia in group II (21±3 h) in comparison with group I (16±4 h). Statistical analysis showed a statistically highly significant (P=0.006). Also, consumption of morphine was lower in group II (5±3 mg/24 h) in comparison with group I (9±4 mg/24 h). Statistical analysis showed a statistically significant (P=0.01).Conclusion Dexmedetomidine as an adjunct to bupivacaine helps increase the duration and improves the quality of postoperative analgesia in pecs block without serious side effects.

Dexmedetomidine and esmolol for induced hypotension for functional endoscopic sinus surgery-a comparative study

Background: Functional endoscopic sinus surgery is a minimally invasive surgical procedure performed under controlled hypotensive anesthesia. This technique has the advantage of minimal blood loss and visualizes surgical field distinctly. Aim and Objectives: To compare the efficacy of Dexmedetomidine and Esmolol for the induction of controlled hypotension in functional endoscopic sinus surgeries. Materials and Methods: A total of 80 cases with paranasal sinus pathologies posted for functional endoscopic sinus surgeries between 21 and 60 years were recruited. Study participants were randomly divided into two study groups, i.e. Group 1 administered with dexmedetomidine and Group 2 administered with Esmolol. Parameters such as hemodynamics, total intraoperative fentanyl consumption, duration of surgery, and total blood loss were noted. Results: The mean difference of systolic blood pressure, diastolic blood pressure and mean arterial pressure was not statistically significant (P > 0.05). The mean difference of heart rate between two study groups was statistically significant (P < 0.05). The mean duration surgery in Group 1 was 87.9 min and in Group 2 was 89.5 min. The estimated blood loss was 132.2 ml in Group 1 and 134.2 ml in Group 2. No desaturation was observed in the study participants during recovery and the postoperative period. Conclusion: Both dexmedetomidine and esmolol infusion are efficacious and are safe drugs for maintaining controlled hypotension and improve the quality of surgical field. Dexmedetomidine was associated with good postoperative sedation while esmolol associated with early recovery time. Surgeon satisfaction score was similar was similar in both groups.

The Role of Dexmedetomidine and Pethidine in Controlling Intraoperative Shivering During Spinal Anesthesia

Spinal anesthesia is a safe and widely used anesthetic procedure, practiced for both elective and emergency surgeries. The present study compares the efficacy of Dexmedetomidine and Pethidine to control intraoperative shivering during spinal anesthesia. The study was conducted from January 2020 - July 2020 in a tertiary care centre including 60 patients aged between 20-60 years, belonging to ASA grade I/II, who developed grade 2-3 shivering following spinal anesthesia. These patients were randomized into two groups: Group I received a single intravenous bolus dose of 0.5 mcg/kg of Dexmedetomidine over 5 minutes and Group II received a single intravenous bolus dose of 0.5 mg/kg Pethidine over 5 minutes. Patients were monitored for drug failure, recurrence of shivering, and side effects. Preoperative temperature in Group I and Group II was 37.1 degrees Celsius and 37.2 degrees Celsius, respectively. The temperature in both groups during shivering was 36.2 and 36.4 degrees Celsius in Group I and Group II, respectively. Preoperative heart rate in Group I and Group II was 84.2 beats/minute and 75.4 beats/minute, respectively. Heart rate in both groups during shivering was 83.6 and 73.5 beats/minute in Group I and Group II, respectively. Grade 3 shivering was observed in 14 patients of Group I and in 19 patients of Group II (p&lt; 0.05). Sixteen and eleven patients in Group I and Group II, respectively were found to have Grade 4 shivering (p&lt; 0.05). Five patients of Group I and four patients of Group II experience recurrent shivering (P&lt; 0.05). Nausea was reported by 2 patients in Group I and 1 patient in Group II (P&lt; 0.05). Dexmedetomidine has better intraoperative shivering control during spinal anesthesia.

English

English

865: Safety and Efficacy of Dexmedetomidine in a Single-Center Pediatric Intensive Care Unit

1Medical University of South Carolina, Charleston, SC 2Kapiolani Medical Center for Women and Children, Honolulu, HI 3Kapiolani Medical Center For Women & Children, Honolulu, HI

779: Safety and Efficacy of Dexmedetomidine in Nonintubated Patients for Delirium and Alcohol Withdrawal

779: Safety and Efficacy of Dexmedetomidine in Nonintubated Patients for Delirium and Alcohol Withdrawal

Safety and Efficacy of Dexmedetomidine in Breast Surgeries: A Systematic Review and Meta-Analysis

PurposePain control during and after breast surgery is still a challenging task. Dexmedetomidine (DEX) is considered as a sedative agent that is widely used perineurally or intravenously as an adjuvant in general anesthesia and critical care medicine practice. The aim of this study is to evaluate the efficacy of perineural DEX and intravenous (IV) DEX and their effects on postoperative complications in breast surgeries. DesignSystematic review and meta-analysis. MethodsThe present study systematically reviewed all identified randomized controlled trials for efficacy and safety of IV and perineural use of DEX in breast surgeries. Databases were searched for articles published before October 2019. FindingsTwelve trials were identified including 803 patients undergoing breast surgery. Although administration of IV DEX and its use with pectoral nerve (Pecs) block significantly postponed time for first analgesic request and decreased pain score at 1 and 12 hours after surgery, paravertebral use of DEX had no statistically significant effect. Pooled data about perineural DEX showed no significant effect on postoperative nausea and vomiting (PONV), whereas IV DEX significantly reduced PONV. Pooled analysis also showed that DEX administration did not significantly affect postoperative complications, such as postoperative itching, bradycardia, and pneumothorax in patients undergoing breast surgery. ConclusionsThe results showed that unlike paravertebral DEX, both DEX use with Pecs blocks and IV DEX were effective in control of postoperative pain in patients undergoing breast surgeries. Unlike perineural DEX, IV DEX significantly reduced PONV.

Therapeutic efficacy of dexmedetomidine on chronic obstructive pulmonary disease via downregulating lncRNA PACER.

The aim of the study was to clarify the therapeutic mechanism of Dexmedetomidine (DEX) on the chronic obstructive pulmonary disease (COPD) and its regulatory effect on long non-coding RNA (lncRNA) PACER. Serum level of PACER in COPD patients was detected by quantitative real-time polymerase chain reaction (qRT-PCR). The diagnostic potential of PACER in COPD was assessed by plotting ROC curves. The in vivo COPD model was generated in rats by cigarette smoking exposure. Primary rat alveolar epithelial cells were isolated, purified and cultured. After overexpression of PACER in primary rat alveolar epithelial cells, proliferative and migratory abilities were assessed by cell counting kit-8 (CCK-8) and transwell assay, respectively. Subsequently, we detected changes in PACER expression, viability and migratory potentials in primary rat alveolar epithelial cells harvested from control rats, and those harvested from COPD rats and induced with either DEX or not. Rescue experiments were conducted to uncover the involvement of PP2A in PACER-regulated cell phenotypes. PACER was upregulated in serum of COPD patients, which was a potential biomarker for diagnosing COPD. Overexpression of PACER in primary rat alveolar epithelial cells enhanced proliferative and migratory abilities. Compared with primary rat alveolar epithelial cells harvested from control rats, proliferative and migratory abilities were stronger in those harvested from COPD rats and induced with either DEX or not. Notably, DEX induction decreased PACER expression, and proliferative and migratory abilities in primary rat alveolar epithelial cells harvested from COPD rats. Overexpression of PP2A could partially abolish the promotive effects of PACER on proliferative and migratory abilities in DEX-induced primary rat alveolar epithelial cells harvested from COPD rats. PACER drives the proliferative and migratory abilities of alveolar epithelial cells through activating PP2A. Dexmedetomidine is conducive to COPD treatment by downregulating PACER.

Efficacy and safety of dexmedetomidine in patients receiving mechanical ventilation: Evidence from randomized controlled trials.

At present, the efficacy and safety of dexmedetomidine in patients receiving mechanical ventilation (MV) is still controversial. Therefore, the purpose of this research was to assess the efficacy and safety of dexmedetomidine in MV patients by reviewing the results of randomized controlled trials (RCT). RCTs evaluating the efficacy of dexmedetomidine in the treatment of MV patients were obtained by searching relevant online databases, including PubMed, EMbase, Web of Science, the Cochrane Library, Medline, OVID, and ClinicalTrials.gov. Literature meeting the inclusion criteria were selected and evaluated by two researchers independently. Risk ratio (RR)/standardized mean difference (SMD) and 95% confidence interval (CI) were used to express the differences between groups. Seven RCTs were included in our study, with 986 participants in the dexmedetomidine group and 862 participants in the control group. Summary analysis results displayed no reduction in 30‐day mortality (RR = 0.77, 95% CI: 0.59 to 1.02), delirium (RR = 0.77, 95% CI: 0.57 to 1.03), and adverse events (RR = 1.06, 95% CI: 0.22 to 5.08) in the dexmedetomidine group compared with the control group. As the length of stay in the intensive care unit (ICU) were presented as median and interquartile range (IQR)/standard deviation (SD), descriptive analysis of the results were performed. Generally, for 99.65% (953/986) of patients, dexmedetomidine was not better than the control group in reducing ICU length of stay. Our results demonstrate that for patients requiring MV, dexmedetomidine was not superior to the control group. However, analysis of more RCTs is required to confirm this conclusion.

Efficacy of dexmedetomidine on postoperative analgesia &amp;amp; sedation in children undergoing adenotonsillectomy

Background: Adenotonsillectomy is a common surgical procedure in pediatric population, but post-operative pain management is a challenging concern for anaesthetist. The present study was designed to assess the efficacy of dexmedetomidine on post-operative sedation and analgesia in paediatric cases undergoing adenotonsillectomy. Materials and methods: A total 80 pediatric cases undergoing adenotonsillectomy between age group 4-9 years belong to ASA grade I and II were recruited. Study consists of two groups i.e. group 1 with 1mcg/kg Dexmeditomidine and group 2 with 2 mcg/kg fentanyl. Parameters like heart rate, systolic blood pressure (SBP), diastolic blood pressure (DBP), requirement of post-operative analgesia and sedation assessed by Ramsay sedation score & CHEOPS score and emergence agitation were assessed. Results: The mean heart rate was significant between two study groups at the beginning, 5 min, 15 min, 20 min and at 25 min (p<0.005). The mean SBP in group 1 was high at the beginning, later the values were decreased when compared group 2. However, the mean DBP in group 1 was low when compared to the group 2 at all-time intervals. The mean Ramsay sedation score difference was statistically significant among two study groups at the beginning, 5 min, 10 min, 15 min and 45 min (p<0.005). The requirement of additional rescue doses were noticed more in group 2. Conclusion: Dexmedetomidine was effective in maintaining intraoperative heart rate, systolic blood pressure and diastolic blood pressure. Dexmedetomidine is an effective and safe analgesic substitute to fentanyl intra-operatively and reduces the requirement of postoperative rescue opioid. Dexmedetomidine was more effective in preventing emergence agitation, avoiding severe pain and reducing incidence of postoperative nausea and vomiting.

Efficacy of Dexmedetomidine as an Adjuvant to Bupivacaine in Ultrasound-Guided Transverse Abdominis plane Block for Laparoscopic appendicectomy: A Randomised Controlled Study.

ObjectiveDexmedetomidine is an alpha 2-adrenergic agonist that prolongs analgesia as an adjuvant when added in neuraxial and peripheral nerve blocks. The aim of the present study was to evaluate the efficacy of dexmedetomidine as an adjuvant to bupivacaine in ultrasound (USG)-guided transverse abdominis plane (TAP) block for postoperative analgesia in laparoscopic appendicectomy.MethodsA total of 60 American Society of Anesthesiologists I and II adult patients aged between 16 and 60 years planned for laparoscopic appendicectomy were randomised into two groups (A and B). Group A patients received 20 mL of 0.125% bupivacaine+1 μg kg−1 dexmedetomidine, whereas group B patients received 20 mL of 0.125% bupivacaine alone on both sides at the time of USG-guided TAP block. Haemodynamic variables, pain scores, sedation scores, time to first dose of rescue analgesic and side effects, if any, were assessed and compared between the groups.ResultsDemographic and operative characteristics were comparable in both groups. The mean duration of analgesia was more in group A (7.33 h) than in group B (4.8 h). The requirement of rescue analgesics was more in group B (80%) than in group A (56.7%). The sedation and pain scores at 2, 4 and 6 h were better in group A than in group B (p<0.05). The heart rate, systolic blood pressure and diastolic blood pressure were lower in group A during the postoperative period than in group B.ConclusionThe addition of dexmedetomidine as an adjuvant to bupivacaine in TAP block provides prolonged postoperative analgesia and better pain control with reduced need for rescue analgesics than bupivacaine alone in patients undergoing laparoscopic appendicectomy.

Effect of Dexmedetomidine on Delirium in Elderly Surgical Patients: A Meta-analysis of Randomized Controlled Trials

The purpose of this meta-analysis is to assess the effect of dexmedetomidine on delirium in elderly surgical patients. The Cochrane Library, Web of Science, PubMed, EMBASE, and Google Scholar were searched (January 1, 2000, to February 4, 2020) for randomized controlled trials (RCTs). RCTs without language restrictions were included if delirium incidence was assessed in elderly surgical patients receiving dexmedetomidine. Intervention and basic information were extracted. 21 studies were included. Dexmedetomidine reduced delirium occurrence (risk ratio [RR] = 0.55; 95% CI = 0.45 to 0.67) in elderly surgical patients with sufficient evidence from trial sequential analysis. Dexmedetomidine did not prevent delirium incidence for cardiac surgery (RR = 0.71; 95% CI = 0.44 to 1.15) with insufficient evidence. Dexmedetomidine decreased mortality incidence (RR = 0.47; 95% CI = 0.25 to 0.89), shortened the length of intensive care unit (ICU; standard mean difference [SMD] = -0.46) and hospital stays (SMD = -0.41), and increased bradycardia incidence (RR = 1.60). This review revealed that dexmedetomidine could reduce delirium incidence for elderly noncardiac surgical patients, and the effect of dexmedetomidine on delirium for elderly cardiac surgical patients needs further studies to guide clinicians. Dexmedetomidine reduced delirium incidence in elderly surgical patients. The efficacy of dexmedetomidine on delirium for elderly cardiac surgical patients warrants further studies. Furthermore, dexmedetomidine was associated with an increased bradycardia incidence, shorter length of ICU/hospital stays, and a lower incidence of mortality.

Dexmedetomidine reduces the amount of benzodiazepines and opioids administered during moderate conscious sedation for dental treatment

To assess the efficacy of dexmedetomidine (DEX) on the intravenous moderate sedation (IVMS) regimen, while treating patients of the special patient care (SPC) population. This study aims to incorporate DEX into the typical IVMS drug regimen in order to reduce the amount of benzodiazepines (BZD) and opioids administered and as a result reduce the amount of unwanted side effects. A retrospective study was performed in the University of California Los Angeles (UCLA) SPC Clinic, where 42 patients were seen with and without DEX for dental treatment under IVMS. Medications administered, vital signs, and complications were recorded at 5 minute intervals over the first hour. All BZDs and opioids were converted to their IV midazolam and IV fentanyl equivalents, respectively. An opioid conversion equation was developed to summate the total amount of anesthetic agents administered. Data were analyzed by t-test. The amount of BZDs administered was reduced, however the decrease was not statistically significant (P=.066). There was a significant reduction in opioids (P<.05) and total anesthetic agents (P<.05) administered. The addition of DEX to the anesthetic regimen results in a reduction of overall medications administered.

Dexmedetomidine versus magnesium sulfate as an adjuvant to local anesthetics in spinal anesthesia: a meta-analysis of randomized controlled trials.

ObjectiveTo compare the efficacy of dexmedetomidine and magnesium sulfate as an adjuvant to local anesthetics in spinal anesthesia.MethodsA search of PubMed, Medline, Embase, the Cochrane Library, and Google Scholar was performed. Randomized controlled trials comparing the efficacy of dexmedetomidine and magnesium sulfate as a local anesthetic adjuvant in spinal anesthesia were identified. The primary outcome was sensory block duration. The mean difference (MD) or odds ratio along with the 95% confidence interval (CI) was used to analyze the outcomes.ResultsSix studies involving 360 patients were included. Intrathecal dexmedetomidine was associated with a significantly longer sensory block duration (MD = −73.62; 95% CI = −101.09 to −46.15), faster onsets of sensory blockade and motor blockade, and a longer motor block duration than intrathecal magnesium sulfate. There was no significant difference between the regarding the rates of hypotension, bradycardia, shivering, and postoperative nausea and vomiting between the groups.ConclusionsDexmedetomidine is superior to magnesium sulfate as an adjuvant to local anesthetics in spinal anesthesia because of its more rapid onset and longer duration of spinal block without significant adverse effects.