Background: The purpose of this study was to investigate the degree of sedation and the incidence of adverse effects resulting from various methods of administering the initial dose followed by continuous infusion of dexmedetomidine (DEX) for sedation in elderly patients undergoing spinal anesthesia.

Methods: In total, 72 patients aged over 65 years who were to be administered spinal anesthesia were randomly allocated into three groups. The initial doses were injected to the groups as follows: group DD, DEX 0.5 μg/kg for 10 min; group MD, midazolam 0.02 mg/kg; and group D, no initial dose. This was followed immediately by infusing a maintenance dose of DEX 0.5 μg/kg/h to all groups.

Results: The Bispectral index (BIS) in the D group was significantly higher than in the other two groups. There were no significant differences in the Ramsay sedation scale (RSS) among the groups. The RSS 3 level was reached in 10 min from the start of sedation in MD and DD groups and in 20 min from the start of sedation in D group. Neither bradycardia nor hypotension was observed in any of the groups.

Conclusions: Patients in all three groups reached the RSS 3 sedating-effect level. However, the group that received continuous infusion only without the initial dose showed higher BIS than the other two groups and reached the RSS 3 later. No adverse events were observed in any of the groups.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7713845PMC
http://dx.doi.org/10.17085/apm.20007DOI Listing

Publication Analysis

Top Keywords

initial dose
12
effects methods
8
sedation elderly
8
elderly patients
8
patients undergoing
8
undergoing spinal
8
spinal anesthesia
8
continuous infusion
8
groups
8
three groups
8

Similar Publications

Background: Guidelines recognized dual combination in initial antihypertensive therapy. Studies found that low-dose quadruple combination were superior to monotherapy. However, whether low-dose quadruple therapy is better than dual combination is unknown.

View Article and Find Full Text PDF

Background And Objective: There is a significant medical need for improved long-acting local anesthetics to decrease postsurgical pain and reduce postoperative opioid use. While ropivacaine is considered a safer local anesthetic than bupivacaine, no long-acting ropivacaine formulation is currently marketed. Available formulations of bupivacaine show inconsistent pharmacokinetics (PK) among different surgical models, and inconsistency in PK may lead to a reluctance to use the medication owing to fear of local anesthetic systemic toxicity (LAST) or unreliable efficacy.

View Article and Find Full Text PDF

A 78-years-old man was treated for asthma and pansinusitis for >5 years, and mepolizumab was initiated two years previously. Two months after the cessation of mepolizumab treatment, the asthma symptoms worsened and acute progressive muscle weakness and sensory disturbance developed. On day 8 after the onset of weakness and hypoesthesia, the patient presented with complete flaccid tetraplegia and diffuse hypoesthesia of all extremities, without paresthesia or pain, and was admitted to our hospital.

View Article and Find Full Text PDF

This case highlights that refractory pancytopenia leading to death can occur with methimazole treatment even at a very low cumulative dose and after a very short duration of exposure. In addition, the standard treatments to correct the pancytopenia may not be effective and a bone marrow transplant may be required. Current American Thyroid Association guidelines do not recommend routine monitoring of the complete blood count in patients receiving thionamides because of the rapidity of the onset of agranulocytosis and the lack of positive evidence that such monitoring would be useful.

View Article and Find Full Text PDF

Aims: Multiple studies have addressed the association between detectable levels of C-peptide and glycemic control, as well as the development of chronic complications of type 1 diabetes mellitus (T1DM), including both macrovascular and microvascular diseases. We aimed to summarize the available evidence on the clinical significance of detectable levels of C-peptide in T1DM.

Method: A systematic search was performed on online databases using the following key terms: T1DM, C-peptide, diabetes mellitus complications, and glycemic parameters.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!