Background: Few studies (in other countries than the US) have reported on the efficacy and safety of dexmedetomidine for sedation of patients undergoing surgical or medical procedures under local anesthesia without intubation outside the intensive care unit. We performed a randomized, double-blind study in Japan.
Methods: Adult patients were randomly allocated to receive placebo, dexmedetomidine 0.5 μg/kg (DEX 0.5 group), or dexmedetomidine 1.0 μg/kg (DEX 1.0 group) over 10 min. Then, both dexmedetomidine groups received dexmedetomidine 0.2-0.7 μg/kg/h for maintaining an Observer's Assessment of Alertness/Sedation Scale (OAA/S) score of ≤ 4; however, propofol was administered to rescue patients whose score exceeded this value. The primary endpoint was the percentage of patients who did not require rescue propofol to achieve and maintain an OAA/S score of ≤ 4.
Results: In total, 162 patients were included in the placebo ( = 53), DEX 0.5 ( = 53), and DEX 1.0 ( = 56) groups. Propofol was not required in significantly more patients in the dexmedetomidine 0.5 and 1.0 μg/kg groups (52.8% and 57.1%, respectively) compared with the placebo group (1.9%) ( < 0.001 for both). Common adverse events were protocol-defined hypotension, respiratory depression and bradycardia. The incidence of bradycardia was significantly higher in the DEX 0.5 (26.4%) and DEX 1.0 (30.4%) groups than in the placebo group (9.4%) ( = 0.041 and = 0.008, respectively).
Conclusion: We concluded that a loading dose of 0.5 or 1.0 μg/kg dexmedetomidine followed by infusion at a rate of 0.2-0.7 μg/kg/h provided effective and well-tolerated sedation in patients undergoing surgical or medical procedures under local anesthesia without intubation.
Unlabelled: Clinical trials.gov identifier: NCT01438931.
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http://dx.doi.org/10.33160/yam.2022.02.005 | DOI Listing |
Spec Care Dentist
December 2024
Faculty of Dentistry, University of Hong Kong SAR China, Hong Kong, China.
Background: Unmet caries treatment needs are prevalent among people with disability, partly due to difficulties of cooperation during conventional dental treatment. This cohort study compared atraumatic restorative treatment (ART), silver modified atraumatic restorative treatment (SMART), and conventional restorative treatment (CRT), in terms of feasibility and acceptability in patients referred for special care dentistry in a specialized university clinic.
Methods: Patients referred for dental restorative care were treated using either ART, SMART, or CRT approach.
Dig Liver Dis
December 2024
Hospital Universitario del Tajo, Critical Care, Department, Universidad Alfonso X el Sabio, Spain. Electronic address:
Background: Gastrointestinal endoscopy is increasingly performed under sedation in older patients. Aging has implications in increasing the morbidity and the risk of complications related to sedation. The aim of this study is to assess the difference in complications between patients aged 65 to 74 years and those aged over 75 years.
View Article and Find Full Text PDFBMC Med Educ
December 2024
Department of Anesthesiology and Pain Medicine, the Affiliated Hospital of Jiaxing University, No.1882, South of the Second Ring Road, Jiaxing City, Zhejiang Province, 314000, China.
Background: Radial artery cannulation can be challenging, particularly for inexperienced providers. This study aimed to compare the success rates of resident physicians performing radial artery cannulation with mild sedation and analgesia versus without.
Materials And Methods: This study was a prospective, single-center, double-blind randomized controlled trial.
BMC Oral Health
December 2024
Department of Oral and Maxillofacial Surgery, Xuchang Central Hospital, Henan, China.
Objectives: This study explored the suitability of local anaesthesia with conscious sedation for parotid gland tumour surgery.
Methods: Three hundred sixty-four medical records were reviewed to gather data on several key aspects for retrospective analysis. These included age, incision length, operation time, tumour size, NNIS score, ASA score, and pathology.
BMC Palliat Care
December 2024
Department of Oncology, Laboratory of Experimental Radiotherapy, Katholieke Universiteit Leuven, Herestraat 49, 3000, Louvain, Belgium.
Background: Palliative sedation refers to the proportional use of titrated medication which reduces consciousness with the aim of relieving refractory suffering related to physical and psychological symptoms and/or existential distress near the end of life. Palliative sedation is intended to be an end of life option that enables healthcare professionals to provide good patient care but there remains controversy on how it is used. Little is known about decision-making processes regarding this procedure.
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