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Efficacy of dexamethasone or clonidine as adjuvants in interscalene brachial plexus block for preventing rebound pain after shoulder surgery: a randomized clinical trial.
Braz J Anesthesiol
November 2024
Universidade Federal do Maranhão (UFMA), Programa de Pós-Graduação em Saúde do Adulto, São Luis, MA, Brazil. Electronic address:
Background: Rebound pain is believed to involve both nociceptive pain due to insufficient analgesia and hyperalgesia induced by regional anesthesia. Adjuvant's addition could prevent rebound pain. This study aimed to determine if the addition of dexamethasone or clonidine to local anesthetic when performing interscalene block could prevent rebound pain.
View Article and Find Full Text PDFDyskinetic crisis in -related disorders: clinical perspectives and management strategies.
Front Neurol
June 2024
European Reference Network for Rare Neurological Diseases (ERN-RND), Tübingen, Germany.
Article Synopsis
- Dyskinetic disorders (-RD) are a set of neurodevelopmental and movement issues caused by gene variants, with dyskinetic crises characterized by sudden, intense abnormal movements that pose treatment challenges.
- The study utilized a Delphi consensus method with international experts to create a framework on dyskinetic crises, covering definitions, triggers, diagnostic criteria, complications, and management strategies.
- The consensus defined dyskinetic crises, noted potential triggers like stress and infections, suggested acute management options such as benzodiazepines, and stressed the need for better education for parents and caregivers to facilitate early recognition and intervention.
Opioid Intoxication to Withdrawal: A Case of Takotsubo Cardiomyopathy.
Cureus
May 2024
Internal Medicine/Pediatrics, AdventHealth Orlando, Orlando, USA.
Article Synopsis
- * An elderly woman with chronic opioid use experienced TTC symptoms during withdrawal, but her condition improved after treatment with clonidine.
- * This case highlights the need for healthcare providers to be aware of TTC as a serious risk when stopping opioids suddenly in patients dependent on them, especially amid the ongoing opioid crisis.
X is a 22-month-old White male infant with a complex medical history, including diagnoses of FBXO11 mutation, hypotonia, restrictive lung disease and mild intermittent asthma, laryngotracheomalacia, obstructive sleep apnea (OSA), feeding difficulties with a history of aspiration, gastroesophageal reflux disease (GERD), and developmental delays. X's medical presentation has resulted in multiple prior medical admissions for respiratory failure due to acute illnesses, procedures and treatments including gastrojejunostomy (GJ) tube dependence, supraglottoplasty to reshape tissues of the upper larynx, and the use of biphasic positive airway pressure (BiPAP) at night and room air during the day when he is at baseline. In addition, he has nocturnal events characterized by significant agitation, screaming, crying, body stiffening and limb movements with pauses in breathing, mouth breathing, restless sleep, and difficulty waking in the morning with concomitant daytime fatigue despite above treatments for OSA.
View Article and Find Full Text PDFClonidine use during dexmedetomidine weaning: A systematic review.
World J Crit Care Med
January 2023
Department of Anesthesiology & Perioperative Medicine, Mayo Clinic, Rochester, MN 55905, United States.
Article Synopsis
- Dexmedetomidine is a commonly used sedative in ICU settings, but stopping it suddenly can lead to withdrawal symptoms; enteral clonidine may help ease this transition, though dosing guidance is unclear.
- A systematic review aimed to assess how enteral clonidine is used for weaning off dexmedetomidine, focusing on practice patterns, dosing, and outcomes in critically ill adults.
- Three observational studies involving 88 patients were included, revealing varied weaning times and physician discretion on starting clonidine, but lacking specific dosing recommendations.
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