Journal of the Formosan Medical Association,
Journal Year:
2024,
Volume and Issue:
123(9), P. 961 - 967
Published: Feb. 2, 2024
Non-intubated
video-assisted
thoracoscopic
surgery
combines
a
minimally
invasive
technique
with
multimodal
locoregional
analgesia
to
enhance
recovery.
The
mainstay
sedation
protocol
involves
propofol
and
fentanyl.
Dexmedetomidine,
given
its
opioid-sparing
effect
minimal
respiratory
depression,
facilitates
in
non-intubated
patients.
This
study
aimed
evaluate
the
efficacy
of
dexmedetomidine
during
surgery.
Anaesthesia,
Journal Year:
2022,
Volume and Issue:
78(3), P. 371 - 380
Published: Dec. 19, 2022
The
effects
of
dexmedetomidine
in
adults
undergoing
cardiac
surgery
are
inconsistent.
We
conducted
a
systematic
review
and
meta-analysis
to
analyse
the
peri-operative
surgery.
searched
MEDLINE
via
Pubmed,
EMBASE,
Scopus
Cochrane
for
relevant
randomised
controlled
trials
between
1
January
1990
March
2022.
used
Joanna
Briggs
Institute
methodology
checklist
assess
study
quality
GRADE
approach
certainty
evidence.
assessed
sensitivity
results
false
data.
random-effects
meta-analyses
primary
outcomes:
durations
intensive
care
tracheal
intubation.
included
48
6273
participants.
Dexmedetomidine
reduced
mean
(95%CI)
duration
by
5.0
(2.2-7.7)
h,
p
=
0.001,
intubation
1.6
(0.6-2.7)
0.003.
relative
risk
postoperative
delirium
was
0.58
(0.43-0.78),
0.001;
0.76
(0.61-0.95)
atrial
fibrillation,
0.015;
0.49
(0.25-0.97)
short-term
mortality,
0.041.
Bradycardia
hypotension
were
not
significantly
affected.
Trial
sequential
analysis
consistent
with
meta-analysis.
Adjustments
possible
data
reduction
3.6
(1.8-5.4)
h
0.8
(0.2-1.4)
respectively.
Binary
adjustment
methodological
at
score
threshold
10
did
alter
significantly.
In
summary,
incidence
mortality
after
adult
reductions
stay
may
or
be
considered
clinically
useful,
particularly
International Journal of Molecular Sciences,
Journal Year:
2022,
Volume and Issue:
23(10), P. 5452 - 5452
Published: May 13, 2022
There
are
limited
neuroprotective
strategies
for
various
central
nervous
system
conditions
in
which
fast
and
sustained
management
is
essential.
Neuroprotection-based
therapeutics
have
become
an
intensively
researched
topic
the
neuroscience
field,
with
multiple
novel
promising
agents,
from
natural
products
to
mesenchymal
stem
cells,
homing
peptides,
nanoparticles-mediated
all
aiming
significantly
provide
neuroprotection
experimental
clinical
studies.
Dexmedetomidine
(DEX),
α2
agonist
commonly
used
as
anesthetic
adjuvant
sedation
opioid-sparing
medication,
stands
out
this
context
due
its
well-established
effects.
Emerging
evidence
preclinical
studies
suggested
that
DEX
could
be
protect
against
cerebral
ischemia,
traumatic
brain
injury
(TBI),
spinal
cord
injury,
neurodegenerative
diseases,
postoperative
cognitive
disorders.
MicroRNAs
(miRNAs)
regulate
gene
expression
at
a
post-transcriptional
level,
inhibiting
translation
of
mRNA
into
functional
proteins.
In
vivo
vitro
deciphered
brain-related
miRNAs
dysregulated
miRNA
profiles
after
several
disorders,
including
TBI,
ischemic
stroke,
Alzheimer's
disease,
sclerosis,
providing
emerging
new
perspectives
therapy
by
modulating
these
miRNAs.
Experimental
revealed
some
effects
mediated
miRNAs,
counteracting
mechanisms
disease
models,
such
lipopolysaccharides
induced
neuroinflammation,
β-amyloid
dysfunction,
ischemic-reperfusion
anesthesia-induced
neurotoxicity
models.
This
review
aims
outline
disorders
We
address
targeting
ameliorating
anesthetics,
reducing
improving
diseases.
Addiction,
Journal Year:
2022,
Volume and Issue:
117(10), P. 2591 - 2601
Published: Feb. 23, 2022
There
have
been
few
head-to-head
clinical
trials
of
pharmacotherapies
for
alcohol
withdrawal
(AW).
We,
therefore,
aimed
to
evaluate
the
comparative
performance
AW.Six
databases
were
searched
randomized
through
November
2021.
Trials
included
after
a
blinded
review
by
two
independent
reviewers.
Outcomes
incident
seizures,
delirium
tremens,
AW
severity
scores,
adverse
events,
dropouts,
dropouts
from
length
hospital
stay,
use
additional
medications,
total
benzodiazepine
requirements,
and
death.
Effect
sizes
pooled
using
frequentist
random-effects
network
meta-analysis
models
generate
summary
ORs
Cohen's
d
standardized
mean
differences
(SMDs).Across
149
trials,
there
10
692
participants
(76%
male,
median
43.5
years
old).
spanned
mild
(n
=
32),
moderate
51),
severe
66).
Fixed-schedule
chlormethiazole
(OR,
0.16;
95%
CI,
0.04-0.65),
fixed-schedule
diazepam
0.04-0.59),
lorazepam
(OR
0.19;
0.08-0.45),
chlordiazepoxide
0.21;
0.08-0.53),
divalproex
0.22;
0.05-0.86)
superior
placebo
at
reducing
seizures.
However,
only
0.05-0.76)
reduced
tremens.
Oxcarbazepine
(d
-3.69;
-6.21
-1.17),
carbamazepine
-2.76;
-4.13
-1.40),
oxazepam
-2.55;
-4.26
-0.83),
γ-hydroxybutyrate
-1.80;
-3.35
-0.26)
improved
endpoint
Clinical
Institute
Withdrawal
Assessment
Alcohol-Revised
scores
over
placebo.
Promazine
agents
significantly
associated
with
greater
because
events.
The
quality
evidence
was
downgraded
substantial
risk
bias,
heterogeneity,
inconsistency,
imprecision.Although
some
pharmacotherapeutic
modalities,
particularly
benzodiazepines,
appear
be
safe
efficacious
measures
withdrawal,
methodological
issues
high
bias
prevent
consistent
estimate
their
performance.
Journal of the Formosan Medical Association,
Journal Year:
2024,
Volume and Issue:
123(9), P. 961 - 967
Published: Feb. 2, 2024
Non-intubated
video-assisted
thoracoscopic
surgery
combines
a
minimally
invasive
technique
with
multimodal
locoregional
analgesia
to
enhance
recovery.
The
mainstay
sedation
protocol
involves
propofol
and
fentanyl.
Dexmedetomidine,
given
its
opioid-sparing
effect
minimal
respiratory
depression,
facilitates
in
non-intubated
patients.
This
study
aimed
evaluate
the
efficacy
of
dexmedetomidine
during
surgery.
