جستجوی مقالات مرتبط با کلیدواژه « دکسمدتومدین » در نشریات گروه « پزشکی »

Postoperative shivering is a common complication in pregnant women undergoing cesarean section with spinal anesthesia, and since no ideal method has been proposed to prevent this complication, the present study was performed aimed to compare the effect of intravenous injection of pethidine and dexmedetomidine in prevention of shivering after cesarean section under spinal anesthesia.

This double-blind randomized clinical trial study was performed in 2019-2020 on 90 women candidates for cesarean section with spinal anesthesia in Alzahra and Shahid Beheshti hospitals of Isfahan. The subjects were randomly assigned to three groups (n=30 in each group). The first group received 0.25 mg pethidine, the second group 0.1 μg/kg dexmedetomidine and the third group received the same volume of normal saline. The drugs were injected intravenously immediately after fetal removal and umbilical cord clamp, and the incidence and severity of shivering in recovery were evaluated. Data were analyzed by SPSS statistical software (version 25) and One-way analysis of variance, analysis of variance with repeated observations, Chi-square and Wilcoxon tests. P< 0.05 was considered statistically significant.

There was a significant difference between the three groups in the incidence of shivering (P <0.001). In examining the frequency of shivering intensity in the three studied groups, the intensity of shivering in the pethidine group was less than that of dexmedetomidine, especially in grades 3 and 4, and the intensity of shivering in the two intervention groups was less than the control group (p=0.002).

The use of both pethidine and dexmedetomidine reduces the incidence of shivering after cesarean section. Since the side effects of dexmedetomidine are less than pethidine and also due to the limitation of pethidine consumption in some patients, it seems that the use of this drug is preferable to pethidine.

It remains a challenge to provide optimal sedation for patients on mechanical ventilation in ICU. Traditionally, Midazolam has been the most commonly administered sedative drug for ICU patients worldwide. Dexmedetomidine is a newer sedative used for ICU sedation having better hemodynamic stability and no respiratory depressant effect.

This was a parallel randomized, double-blind study. Study population was intensive care unit patients undergoing mechanical ventilation. All the 33 patients received 1 μg/kg IV dexmedetomidine over 10 minutes followed by a maintenance infusion of 0.5 μg/kg/h dexmedetomidine. After 24 hours patients received 0.05 mg/kg midazolam followed by a maintenance infusion of 0.1 mg/kg/h. The dosage of sedative was changed according to the outcome of maintaining a target sedation level of RASS 0 to -1. The cardiovascular and ABG parameters and quality of ventilation were measured at baseline, 12 and 24 hours after sedation.

28 patients (84.8%) were men and 5 (15.2) were women. The mean age of the patients was 36.12±69.74 years. Systolic blood pressure (P<0.005), diastolic blood pressure (P=0.003), mean arterial pressure (P=0.02) and heart rate (P=0.003) were significantly higher in Midazolam group at 24 hours. In addition, O2 saturation was significantly different between dexmedetomidine and midazolam at 12 hours (P=0.03) and 24 hours (P=0.001). ABG parameters were similar between two sedatives.

The results of this study showed that dexmedetomidine has better hemodynamic effects than midazolam. Also, the effects of dexmedetomidine and Midazolam on lung mechanics are the same.

In patients undergoing surgery, hemodynamic disorders are common. Therefore, we decided to compare the effects of fentanyl and dexmedetomidine on hemodynamic changes in patients undergoing Stereotactic surgery. 

In this double blinded clinical trial, 68 candidates for Stereotactic Surgery in Alzahra Hospital in 2017 enrolled in the study. Patients were randomly divided into two groups; the first group was given bolus of 2 μg / kg fentanyl, and in the second group a loading dose of 1 μgr / kg / 10 min, followed by maintenance dose of: 0.5 μg / kg / h of dexmedetomidine was admininstered intravenously. The Dexmedetomidine was infused immediately following anesthesia induction. The hemodynamic variables in the two groups were evaluated.

There was no significant difference between the two groups based on systolic and diastolic blood pressure and oxygen saturation at different times. The heart rate in the dexmedetomidine group at 30, 60 and 90 minutes was significantly lower than fentanyl. On the other hand, there was no significant difference between the two groups with regards to pH, Pco2 and HCO3 before and after operation and recovery time.

Both dexmedetomidine and fentanyl are two effective drugs for controlling hemodynamics parameters in patients undergoing stereotactic surgery, but dexmedetomidine drug reduces heart rate significantly compared with fentanyl.

Cataract is one of the most common eye diseases especially in elderly patients and most of these patients require surgery. In the process of sedation, different drugs are used, each with its advantages and disadvantages. Dexmedetomidine is one of the drugs that has recently received special attention for sedation. In this study, we compared the drug combination of dexmedetomidine-fentanyl with midazolam-fentanyl in cataract surgery.

In a case-control study, the patients who underwent cataract surgery by a surgeon with topical anesthesia and sedation techniques were included in the target group. Seventy patients were divided into two groups of 35 according to a random number table. One group received dexmedetomidine-fentanyl (dexmedetomidine group) and the other received midazolam-fentanyl (midazolam group). Age, sex, weight, systolic and diastolic blood pressure, heart rate, patient sedation, surgeon satisfaction, recovery nurse satisfaction, and postoperative nausea and vomiting were compared between the two groups. The study was performed in the Farabi Hospital, Tehran, Iran, from October to November 2019.

Patients in the two groups were similar in age, sex, weight, and preoperative hemodynamic variables. There was no significant difference in preoperative systolic and diastolic blood pressure between the two groups (P=0.150). However, those who received dexmedetomidine had significantly lower intraoperative heart rate (P<0.001). The difference in postoperative systolic and diastolic blood pressure as well as postoperative heart rate was significantly lower in the dexmedetomidine group (P<0.001). There was no statistically significant difference between the two groups in postoperative sedation (P=0.93). The surgeon’s satisfaction was no significant difference between the two groups (P=0.17). Also, the rate of recovery nurse satisfaction was not significantly different between the two groups (P=0.21). The incidence of nausea and vomiting was similar in both groups (P=1.00).

Sedation with dexmedetomidine decreases blood pressure and heart rate. Therefore, it is recommended to use dexmedetomidine more cautiously in patients with unstable hemodynamics and especially in short surgical procedures.

Premedication is an integral part of general anesthesia which has side effects. The aim of this study was to compare the hemodynamic effects of Dexmedetomidine and Midazolam as a premedication in patients undergoing elective upper limb surgery during induction of anesthesia and postoperative shivering.

60 candidates for elective upper limb surgery who referred to Shahid Rajaee hospital were studied with the double-blind clinical trial method. Patients were randomly divided into two groups, included: 1. Midazolam and 2.Dexmedetomidine. SPO2, MAP, Heart rate, Systolic, and Diastolic blood pressure and postoperative shivering were evaluated at; early entrance time, before induction, 1, 5, 10 minutes after intubation, Post-extubating and recovery in all patients as well as post-surgery shivering. The collected data were analyzed using Chi-square, ANOVA and GLM Repeated Measure by using SPSS 19 software. The P < 0. 05 was considered as the significance level.

At all times, the mean SPO2 was significantly higher in Dexmedetomidine than in the Midazolam group, which was significant at 10 minutes after intubation (P < 0.001). Mean MAP, Heart rate, Systolic and Diastolic blood pressure were significantly further in Midazolam group than Dexmedetomidine group at all times. Postoperative shivering in patients with Dexmedetomidine was significantly lower than the Midazolam group (P < 0.001).

The results showed that Dexmedetomidine has a better hemodynamic control during anesthesia. It also reduces the incidence of postoperative shivering.

One of the objectives of a smooth laryngoscopy is to minimize hemodynamic changes. The goal of this study was to assess the effects of dexmedetomidine and labetalol on heart rate and blood pressure changes after laryngoscopy compared to a control group.

This was a randomized, double-blind clinical trial conducted on 120 patients aged between 18 and 60 years, who were candidates for surgery under general anesthesia at Alzahra Hospital in Isfahan during 2017-2018. Patients were randomly allocated to three groups: dexmedetomidine group, labetalol group, and control group. The patient's age, weight, height, gender, and clinical data including mean blood pressure(BP), heart rate, systolic BP, diastolic BP, and oxygen saturation during 1, 3, 5 and 10 minutes after intubation were collected and analyzed using repeated measure analysis.

The average age of patients who were candidates for surgery was 42.62 +/- 1.40. Fifty-two percent (63 patients) of the subjects were male. The results showed no significant difference in mean BP, diastolic BP, systolic BP or oxygen saturation (p>0.05) in the three groups. But the difference in heart rate between the three groups was statistically significant. The heart rate in the dexmedetomidine group was significantly lower than the labetalol and control groups (p =0.00).

The results of the current study demonstrated that using labetalol provided more desirable hemodynamic stability compared to dexmedetomidine and caused less hemodynamic disturbances.

One of the common blocks used in upper extremity surgery is axillary block. The aim of this study was to make a comparision between the effects of dexmedtomedian and fentanyl as adjuvants to lidocain on axillary plexus block. Methods and Materials: This double-blinded clinical terial included 36 patients and was performed in Besat and Kosar Hospitals in Sanandaj in 2017. Patients were randomly divided into two equal groups. Patients in group 1 received 40 cc of lidocaine 1% and normal saline plus 50 μg fentanyl. Group 2 patients received 100 mg of dexmedetomidine plus 40 cc of lidocaine 1% (Matched with group 1). Using SPSS software version 21, data were analyzed by independent sample t-test. There was a significant difference between the two groups in regard to the beginning and quality of the sensory block (p≤0.01) and motor block (p≤0.05). Based on visual analog scale addition of fentanyl to lidocaine at all times had a greater effect on reducing the pain intensity compared to the addition of dexmedetomidine and there was a significant difference between the two groups (p≤0.01). There was no significant difference in the incidence of nausea, vomiting, dizziness and seizure between the two groups. But, the groups showed significant differences in the incidence rates of heart arrhythmias and hypotension (p≤0.01). Comparison between fentanyl and dexmedetomidine showed that addition of fentanyl to lidocaine led to a greater effect on the properties of the axillary plexus block.

Background and Transesophageal echocardiography (TEE) is established as a sensitive and accurate diagnostic method for the rapid assessment of cardiovascular diseases. It is believed that dexmedetomidine might be useful for sedating patients undergoing TEE. This study compared the use of dexmedetomidine and midazolam in patients undergoing TEE. In a clinical trial, 48 patients undergoing TEE were randomly divided to receive either dexmedetomidine 1µg kg/i.v. over 10 min, followed by 0.2µg kg/i.v infusion, or midazolam 2 mg/i.v. Patients’ sedation level was determined according to Ramsay Sedation Scale, degree of analgesia, patient's satisfaction, arterial pressure, heart rate (HR) and readiness for discharge from recovery room. Degree of analgesia, in the group receiving dexmedetomidine was found higher compared with that of the midazolam group (3.67±0.86 vs 0.83±0.56, P<0.001). The level of patients satisfaction with sedation was also higher in dexmedetomidine group (P=0.001). Readiness for discharge in the two groups were 7.08±1.17 and 3.71±1.57 min, respectively (P=0.001). Blood pressure and heart rate were similar in both groups. Our study suggests that compared to midazolam, dexmedetomidine is more suitable in sedation of patients undergoing TEE.