scholarly journals Determination of the Median Effective Dose of Dexmedetomidine for the Prevention of Emergence Agitation in Geriatric Patients Undergoing Major Open Surgery With General Anesthesia: A Prospective, Double-Blinded, Dose-Response Trial

Dose-Response ◽  
2021 ◽  
Vol 19 (3) ◽  
pp. 155932582110371
Author(s):  
WeiBing Wang ◽  
Hui Zhou ◽  
AiJiao Sun ◽  
JinBo Xiao ◽  
JingChong Dong ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Effective Dose ◽  
Open Surgery ◽  
Geriatric Patients ◽  
Continuous Intravenous Infusion ◽  
Emergence Agitation ◽  
Double Blinded ◽  
Main Complication ◽  
Response Trial

Dexmedetomidine can effectively decrease the incidences of emergence agitation (EA) in adult patients, but there are major side effects related to increased dose of dexmedetomidine. The purpose of this study was to determine the median effective dose of dexmedetomidine in the prevention of EA among geriatric patients undergoing major open surgery with general anesthesia. A total of 50 geriatric patients were enrolled in this study. Dexmedetomidine 0.5 μg·kg−1·h−1 continuous intravenous infusion was administered to the first patient. The next dose was increased or decreased by .05 depending on the response of the previous patient, according to the Dixon up-and-down method. An “effective” or “ineffective” response was determined based on the Riker sedation-agitation score (RSAS), we defined “effective” as RSAS<5, and “ineffective” as RSAS≥5. The ED50 of dexmedetomidine in prevention of EA was .30 μg·kg−1·h−1 (95% CI, .27–.33) and the predicted ED95 was .42 μg·kg−1·h−1 (95% CI, .38–.51). The incidence of bradycardia was significantly increased in the group without EA compared to the group with EA (57.1% vs 13.6%, P = .002). The ED50 of dexmedetomidine in prevention of EA was .30 μg·kg−1·h−1 (95% CI, .27–.33) and the predicted ED95 was .42 μg·kg−1·h−1 (95% CI, .38–.51). Bradycardia was the main complication.

scholarly journals Determination of the median effective dose of dexmedetomidine for the prevention of emergence agitation in geriatric patients undergoing major open surgery with general anesthesia: A prospective, double-blinded, dose-response trial

2021 ◽  
Author(s):  
weibing wang ◽  
AiJiao Sun ◽  
JingBo Xiao ◽  
JingChun Dong ◽  
Huang Xu ◽  
...  
Keyword(s):  
Effective Dose ◽  
Open Surgery ◽  
Geriatric Patients ◽  
Trial Registry ◽  
Emergence Agitation ◽  
Clinical Trial Registry ◽  
Registration Number ◽  
Double Blinded ◽  
Response Trial

Abstract BackgroundDexmedetomidine can effectively decrease the incidences of emergence agitation (EA) in adult patients, but there are major side effects related to increased dose of dexmedetomidine. The purpose of this study was to determine of the median effective dose of dexmedetomidine in the prevention of EA among geriatric patients undergoing major open surgery with general anesthesia.MethodsA total of 50 geriatric patients were enrolled in this study. Dexmedetomidine 0.5µg·kg-1·h-1 continuous intravenous infusion was administered to the first patient. The next dose was increased or decreased by 0.05 depending on the response of the previous patient, according to the Dixon up-and-down method. An “effective” or “ineffective” response was determined based on the Riker sedation-agitation score(RSAS), we defined “effective” as RSAS < 5, and “ineffective” as RSAS ≥ 5.ResultsThe ED50 of dexmedetomidine in prevention of EA was 0.30µg·kg-1·h-1 (95% CI, 0.27–0.33) and the predicted ED95 was 0.42µg·kg-1·h-1(95% CI, 0.38–0.51). The incidence of bradycardia was significant increased in group without EA compared to the group with EA (57.1% vs 13.6%, P = 0.002).ConclusionsThe ED50 of dexmedetomidine in prevention of EA was 0.30µg·kg-1·h-1 (95% CI, 0.27–0.33) and the predicted ED95 was 0.42µg·kg-1·h-1 (95% CI, 0.38–0.51). Bradycardia was the main complication.Trial registrationThis study was registered in the Chinese Clinical Trial Registry (Registration number: ChiCTR1900023769) on June 11th, 2019.

scholarly journals Risk Factors of Emergence Agitation in Adults Undergoing General Anesthesia for Nasal Surgery

2015 ◽  
Vol 8 (1) ◽  
pp. 46 ◽  
Author(s):  
Hyo-Jin Kim ◽  
Duk-Kyung Kim ◽  
Hyo-Yeol Kim ◽  
Jin-Kyoung Kim ◽  
Seung-Won Choi
Keyword(s):  
Risk Factors ◽  
General Anesthesia ◽  
Emergence Agitation ◽  
Nasal Surgery

scholarly journals Determination of Effective Dose of Ultraviolet Irradiation to Influent Water for Prevention of Kudoa yasunagai Infection

2016 ◽  
Vol 51 (3) ◽  
pp. 128-131
Author(s):  
Sang Phil Shin ◽  
Tomoyo Nishimura ◽  
Kazuo Ogawa ◽  
Sho Shirakashi
Keyword(s):  
Effective Dose ◽  
Ultraviolet Irradiation ◽  
Influent Water ◽  
Kudoa Yasunagai

scholarly journals Preliminary Evaluation of the Efficacy and Safety of Brimonidine for General Anesthesia

2021 ◽  
Author(s):  
Bin Chen ◽  
Xiaohui Wang ◽  
Mengrou Shi ◽  
Xin Li ◽  
Ting Zhang ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Effective Dose ◽  
Intraperitoneal Injection ◽  
Chloral Hydrate ◽  
Lethal Dose ◽  
Preliminary Evaluation ◽  
Efficacy And Safety ◽  
Sleeping Time ◽  
Analgesic Effects ◽  
Hypnotic Effect

Abstract Background:To determine the hypnotic and analgesic effects of brimonidine, and evaluate its efficacy and safety for general anesthesia. Potentiation of pentobarbital sleeping time with brimonidine was observed in mice, as was analgesic activity of brimonidine.Methods:The median effective dose (ED50)and lethal dose (LD50) of intraperitoneally injected brimonidine were determined in hypnotized mice. In addition, LD50 of intravenously injected brimonidine, ED50 of intravenously , intramuscularly and intrarectally injected brimonidine in hypnotized rabbits were determined. The synergistic anesthetic effect of brimonidine and chloral hydrate on rabbits was evaluated. Results:Intraperitoneal injection of 10 mg/kg brimonidine enhanced the hypnotic effect of a threshold dose of pentobarbital. Intraperitoneal injection brimonidine produced dose-related analgesic effects in mice. ED50 of intraperitoneally administered brimonidine in hypnotized mice was 75.7 mg/kg, and LD50 was 379 mg/kg. The ED50 of intravenous, intramuscular and intrarectal brimonidine for hypnosis in rabbits were 5.2 mg/kg, 8.8 mg/kg and 8.7mg/kg, respectively, and LD50 of intravenous brimonidine was 146 mg/kg. Combined intravenous administration of 0.6 mg/kg brimonidine and 0.03 g/kg chloral hydrate had a synergistic anesthetic effects.Conclusions:Brimonidine elicited hypnotic and analgesic effects after systemic administration, and exhibited safety. Brimonidine enhanced the effects of other types of narcotics when combined.

scholarly journals Transcutaneous electrical acupoint stimulation for postoperative cognitive dysfunction in geriatric patients with gastrointestinal tumor: a randomized controlled trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Lijuan Xi ◽  
Fang Fang ◽  
Haijuan Yuan ◽  
Daorong Wang
Keyword(s):  
General Anesthesia ◽  
Cognitive Dysfunction ◽  
Geriatric Patients ◽  
Postoperative Cognitive Dysfunction ◽  
Radical Resection ◽  
Gastrointestinal Tumors ◽  
Gastrointestinal Tumor ◽  
The Third ◽  
Link Type ◽  
Acupoint Stimulation

Abstract Background This study aimed to evaluate the effect of perioperative transcutaneous electrical acupoint stimulation (TEAS) on postoperative cognitive dysfunction (POCD) in older patients who were diagnosed with gastrointestinal tumor and received radical resection of gastrointestinal tumors under general anesthesia. Methods A total of 68 patients who received radical resection of gastrointestinal tumors under general anesthesia were randomly divided into two groups. TEAS group patients received TEAS treatment. The treatment time was 30 min before the induction of anesthesia until the end of the surgery, 1 day before operation and from the first day to the third day after the operation. Except on the day of surgery, we treated the patients for 30 min once a day. In the sham TEAS group, the electronic stimulation was not applied and the treatment was the same as the TEAS group. The primary outcome was perioperative cognition evaluated by the Mini-Mental State Examination (MMSE) and secondary outcomes were the perioperative level of interleukin-6 (IL-6), S100 calcium-binding protein β (S100β), and C-reactive protein (CRP). Results The postoperative score of MMSE, orientation, memory, and short-term recall in the sham TEAS group was significantly lower than the preoperative and TEAS group (P < 0.05). The incidence of POCD in the TEAS group (21.88%) was lower than those in the sham TEAS group (40.63%). S100β, IL-6, and CRP in the TEAS group were significantly lower than those in the sham TEAS group on the third day after the operation (P< 0.05). Postoperative S100β, IL-6, and CRP in two groups were significantly higher than those before operation except for S100β on the third day after the operation in the TEAS group (P < 0.05). Conclusions Perioperative TEAS treatment reduced the postoperative inflammatory response and increased the postoperative cognitive function score and decrease the incidence of POCD in geriatric patients with gastrointestinal tumor. Trial registration ClinicalTrials.gov NCT04606888. Registered on 27 October 2020. https://register.clinicaltrials.gov.

scholarly journals The Effect of Subtenons Lidocaine on Emergence Agitation after General Anesthesia in Pediatric Strabismus Surgery

2016 ◽  
Vol 12 (6) ◽  
pp. 48
Author(s):  
Agolli. L ◽  
Shuteriqi. B
Keyword(s):  
General Anesthesia ◽  
Normal Saline ◽  
Recovery Room ◽  
Eye Contact ◽  
Saline Group ◽  
Strabismus Surgery ◽  
Emergence Agitation ◽  
Surrounding Environment ◽  
Lidocaine Injection ◽  
In The Beginning

Objectives: To study the effect of subtenon lidocaine injection at the end of intervention on the post-operative emergence agitation in pediatric strabismus surgery under general anesthesia with sevofluran. Material: We studied 191 children patients undergoing muscle surgery for strabismus from 2-6 years old. Children were (prospectively) randomized to one of the four groups. These groups include: A –Group Sevofluran fentanyl; B –Group sevoflurane fentanyl, Subtenon lidocaine injection; C – Group Propofol, fentanyl, sevofluran; and D – Group Propofol, fentanyl, Sevoflurane, Subtenon lidocaine injection. In the beginning of the induction of anesthesia, children received dexametasone and metoclopropamide. At the end of the surgery, children received either lidocaine (2%) or normal saline (1ml) into the subtenons space. This was conducted on the recovery room using five scoring scale. These scale include: 1- the child makes eye contact, 2- Purposeful response after repeated stimuli, 3 – the child is aware of the surrounding environment, 4- severe restlessness, and 5 – The child is inconsolable. The degree of emergence agitation was observed. Furthermore, the score 4 and 5 was considered as an emergence agitation. Results: There are no differences regarding age and weight. The incidence of emergence agitation was significantly lower in the groups which were receiving subtenon lidocaine compared with saline group injections (p< 0.05). Conclusions: A lidocaine injection into subtenon space reduces the emergence agitation after general anesthesia in pediatric strabismus surgery.

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