Neuraxial dexmedetomidine: wonder drug or simply harmful

Sohan Lal Solanki, Vipin Kumar Goyal, Sohan Lal Solanki, Vipin Kumar Goyal

No abstract available

Keywords: Analgesia; Anesthesia; Dexmedetomidine.

Figures

Figure 1.. Chemical Structure of Dexmedetomidine
Figure 1.. Chemical Structure of Dexmedetomidine

References

    1. Kalso EA, Poyhia R, Rosenberg PH. Spinal antinociception by dexmedetomidine, a highly selective alpha 2-adrenergic agonist. Pharmacol Toxicol. 1991;68(2):140–3.
    1. Bloor BC, Ward DS, Belleville JP, Maze M. Effects of intravenous dexmedetomidine in humans. II. Hemodynamic changes. Anesthesiology. 1992;77(6):1134–42.
    1. Ebert TJ, Hall JE, Barney JA, Uhrich TD, Colinco MD. The effects of increasing plasma concentrations of dexmedetomidine in humans. Anesthesiology. 2000;93(2):382–94.
    1. Bekker A, Sturaitis M, Bloom M, Moric M, Golfinos J, Parker E, et al. The effect of dexmedetomidine on perioperative hemodynamics in patients undergoing craniotomy. Anesth Analg. 2008;107(4):1340–7. doi: 10.1213/ane.0b013e3181804298.
    1. Turan G, Ozgultekin A, Turan C, Dincer E, Yuksel G. Advantageous effects of dexmedetomidine on haemodynamic and recovery responses during extubation for intracranial surgery. Eur J Anaesthesiol. 2008;25(10):816–20. doi: 10.1017/S0265021508004201.
    1. Aksu R, Akin A, Bicer C, Esmaoglu A, Tosun Z, Boyaci A. Comparison of the effects of dexmedetomidine versus fentanyl on airway reflexes and hemodynamic responses to tracheal extubation during rhinoplasty: A double-blind, randomized, controlled study. Curr Ther Res Clin Exp. 2009;70(3):209–20. doi: 10.1016/j.curtheres.2009.06.003.
    1. Elvan EG, Oc B, Uzun S, Karabulut E, Coskun F, Aypar U. Dexmedetomidine and postoperative shivering in patients undergoing elective abdominal hysterectomy. Eur J Anaesthesiol. 2008;25(5):357–64. doi: 10.1017/S0265021507003110.
    1. Tan JA, Ho KM. Use of dexmedetomidine as a sedative and analgesic agent in critically ill adult patients: a meta-analysis. Eur J Anaesthesiol. 2010;28:3–6.
    1. Jones GM, Murphy CV, Gerlach AT, Goodman EM, Pell LJ. High-dose dexmedetomidine for sedation in the intensive care unit: an evaluation of clinical efficacy and safety. Ann Pharmacother. 2011;45(6):740–7. doi: 10.1345/aph.1P726.
    1. Solanki SL, Bharti N, Batra YK, Jain A, Kumar P, Nikhar SA. The analgesic effect of intrathecal dexmedetomidine or clonidine, with bupivacaine, in trauma patients undergoing lower limb surgery: a randomised, double-blind study. Anaesth Intensive Care. 2013;41(1):51–6.
    1. Shukla D, Verma A, Agarwal A, Pandey HD, Tyagi C. Comparative study of intrathecal dexmedetomidine with intrathecal magnesium sulfate used as adjuvants to bupivacaine. J Anaesthesiol Clin Pharmacol. 2011;27(4):495–9. doi: 10.4103/0970-9185.86594.
    1. Gupta M, Shailaja S, Hegde KS. Comparison of intrathecal dexmedetomidine with buprenorphine as adjuvant to bupivacaine in spinal asnaesthesia. J Clin Diagn Res. 2014;8(2):114–7. doi: 10.7860/JCDR/2014/7883.4023.
    1. Mahendru V, Tewari A, Katyal S, Grewal A, Singh MR, Katyal R. A comparison of intrathecal dexmedetomidine, clonidine, and fentanyl as adjuvants to hyperbaric bupivacaine for lower limb surgery: A double blind controlled study. J Anaesthesiol Clin Pharmacol. 2013;29(4):496–502. doi: 10.4103/0970-9185.119151.
    1. El-Hennawy AM, Abd-Elwahab AM, Abd-Elmaksoud AM, El-Ozairy HS, Boulis SR. Addition of clonidine or dexmedetomidine to bupivacaine prolongs caudal analgesia in children. Br J Anaesth. 2009;103(2):268–74. doi: 10.1093/bja/aep159.
    1. Saadawy I, Boker A, Elshahawy MA, Almazrooa A, Melibary S, Abdellatif AA, et al. Effect of dexmedetomidine on the characteristics of bupivacaine in a caudal block in pediatrics. Acta Anaesthesiol Scand. 2009;53(2):251–6. doi: 10.1111/j.1399-6576.2008.01818.x.
    1. Campagnol D, Teixeira Neto FJ, Giordano T, Ferreira TH, Monteiro ER. Effects of epidural administration of dexmedetomidine on the minimum alveolar concentration of isoflurane in dogs. Am J Vet Res. 2007;68(12):1308–18. doi: 10.2460/ajvr.68.12.1308.
    1. Elhakim M, Abdelhamid D, Abdelfattach H, Magdy H, Elsayed A, Elshafei M. Effect of epidural dexmedetomidine on intraoperative awareness and post-operative pain after one-lung ventilation. Acta Anaesthesiol Scand. 2010;54(6):703–9. doi: 10.1111/j.1399-6576.2009.02199.x.
    1. Selim MF, Elnabtity AM, Hasan AM. Comparative evaluation of epidural bupivacaine - dexmedetomidine and bupivacaine -fentanyl on Doppler velocimetry of uterine and umbilical arteries during labor. J Prenat Med. 2012;6(3):47–54.
    1. Abdallah FW, Brull R. Facilitatory effects of perineural dexmedetomidine on neuraxial and peripheral nerve block: a systematic review and meta-analysis. Br J Anaesth. 2013;110(6):915–25. doi: 10.1093/bja/aet066.
    1. Mirkheshti A, Saadatniaki A, Salimi A, Manafi Rasi A, Memary E, Yahyaei H. Effects of dexmedetomidine versus ketorolac as local anesthetic adjuvants on the onset and duration of infraclavicular brachial plexus block. Anesth Pain Med. 2014;4(3):e22651. doi: 10.5812/aapm.17620.
    1. Nagasaka Y, Machino A, Fujikake K, Kawamoto E, Wakamatsu M. [Cardiac arrest induced by dexmedetomidine]. Masui. 2009;58(8):987–9.
    1. Bharati S, Pal A, Biswas C, Biswas R. Incidence of cardiac arrest increases with the indiscriminate use of dexmedetomidine: a case series and review of published case reports. Acta Anaesthesiol Taiwan. 2011;49(4):165–7. doi: 10.1016/j.aat.2011.11.010.
    1. Klinger RY, White WD, Hale B, Habib AS, Bennett-Guerrero E. Hemodynamic impact of dexmedetomidine administration in 15,656 noncardiac surgical cases. J Clin Anesth. 2012;24(3):212–20. doi: 10.1016/j.jclinane.2011.07.016.
    1. Konakci S, Adanir T, Yilmaz G, Rezanko T. The efficacy and neurotoxicity of dexmedetomidine administered via the epidural route. Eur J Anaesthesiol. 2008;25(5):403–9. doi: 10.1017/S0265021507003079.
    1. Sanders RD, Sun P, Patel S, Li M, Maze M, Ma D. Dexmedetomidine provides cortical neuroprotection: impact on anaesthetic-induced neuroapoptosis in the rat developing brain. Acta Anaesthesiol Scand. 2010;54(6):710–6. doi: 10.1111/j.1399-6576.2009.02177.x.
    1. Celik F, Gocmez C, Kamasak K, Tufek A, Guzel A, Tokgoz O, et al. The comparison of neuroprotective effects of intrathecal dexmedetomidine and metilprednisolone in spinal cord injury. Int J Surg. 2013;11(5):414–8. doi: 10.1016/j.ijsu.2013.03.008.

Source: PubMed

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