Role of dexmedetomidine in postoperative cognitive dysfunction and sleep improvement in aged rats by regulating the PI3K/Akt signaling pathway and its mechanism

Brain Research, Journal Year: 2025, Volume and Issue: unknown, P. 149482 - 149482

Published: Jan. 1, 2025

Language: Английский

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Effects of dexmedetomidine on postoperative sleep quality: a systematic review and meta-analysis of randomized controlled trials

BMC Anesthesiology, Journal Year: 2023, Volume and Issue: 23(1)

Published: March 21, 2023

Abstract Study objectives To assess the effect of dexmedetomidine (DEX) on postoperative sleep quality using polysomnography (PSG) to identify possible interventions for disturbances. Methods An electronic search PubMed/MEDLINE, EMBASE, Cochrane Library and Web Science was conducted from database inception November 20, 2022. Randomized controlled trials (RCTs) DEX administration PSG or its derivatives were included. No language restrictions applied. The efficiency index (SEI), arousal (AI), percentages stage N1, N2 N3 non-rapid eye movement (NREM) sleep, rapid (REM) measured in our meta-analysis. Results Five studies, involving 381 participants Administration significantly improved SEI, lowered AI, decreased duration N1 increased compared placebo groups. There no significant differences REM sleep. Visual Analogue Scale (VAS) score Ramsay sedation with adverse delirium (POD). However, high heterogeneity observed most primary secondary outcomes. Conclusions Our study provides support perioperative improve quality. optimal dosage overall require further investigation large-scale randomized trials.

Language: Английский

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Intravenous infusion of dexmedetomidine during the surgery to prevent postoperative delirium and postoperative cognitive dysfunction undergoing non-cardiac surgery: a meta-analysis of randomized controlled trials

European journal of medical research, Journal Year: 2024, Volume and Issue: 29(1)

Published: April 18, 2024

Dexmedetomidine plays a pivotal role in mitigating postoperative delirium and cognitive dysfunction while enhancing the overall quality of life among surgical patients. Nevertheless, influence dexmedetomidine on such complications various anaesthesia techniques remains inadequately explored. As such, present study, meta-analysis was conducted to comprehensively evaluate its effects dysfunction.

Language: Английский

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Impact of perioperative dexmedetomidine on long-term outcomes in older patients following cardiac surgery: follow-up of a randomized trial

BMC Anesthesiology, Journal Year: 2025, Volume and Issue: 25(1)

Published: March 17, 2025

Perioperative dexmedetomidine is reported to reduce complications and even in-hospital mortality after cardiac surgery. We therefore tested the hypothesis that perioperative may improve long-term outcomes This was follow-up of a randomized trial. enrolled 285 patients aged 60 years or older who were scheduled for elective Patients receive either placebo (normal saline) during early Follow-up conducted up 6 post-surgery. The primary endpoint overall survival. Secondary included major adverse cardiovascular events (MACE)-free hospital-free survivals, as well cognitive function quality life in 6-year survivors. All final analysis. Median duration 80 months (interquartile range 30 80). Overall survival did not differ between two groups: there 18 deaths (12.6%) with versus 22 (15.5%) dexmedetomidine; hazard ratio (HR) 1.22, 95% CI 0.65 2.27, p = 0.418. MACE-free 23 (16.1%) 24 (16.9%) HR 1.03, 0.58 1.83, P 0.911. Hospital-free 39 (27.3%) 42 (29.6%) 1.04, 0.67 1.61, 0.853. Among survivors, scores similar groups. found that, undergoing surgery, administered surgery alter life. However, considering underpowered sample size non-negligible loss rate, our results need further confirmation. ClinicalTrials.gov: NCT03289325 (September 20, 2017).

Language: Английский

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Clinical Use of Adrenergic Receptor Ligands in Acute Care Settings

Handbook of experimental pharmacology, Journal Year: 2024, Volume and Issue: unknown

Published: Jan. 1, 2024

Language: Английский

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Study on the preventive effect of dexmedetomidine on anesthetic associated sleep disturbance in young to middle-aged female patients undergoing hysteroscopy: a study protocol for a crossover randomized controlled trial

Trials, Journal Year: 2024, Volume and Issue: 25(1)

Published: July 15, 2024

Abstract Background Postoperative sleep disturbance has a potentially detrimental effect on postoperative recovery. Perioperative patients are affected by several factors. General anesthesia induces non-physiological state that does not resemble natural sleep. Exposure to propofol/sevoflurane can lead desynchronization of the circadian rhythm, which may result in characterized mid-cycle advancement and daytime sleepiness. Dexmedetomidine is highly selective α2-adrenoceptor agonist with unique sedative facilitates transition from wakefulness. Basic research shown dexmedetomidine deep sedation, similar physical sleep, helps maintain forebrain connectivity, likely reduce delirium after surgery. The aim this study evaluate influence exposure mono-anesthetic propofol development young middle-aged female undergoing hysteroscopy whether prophylactic administration influences reducing disturbance. Methods This prospective randomized controlled trial (RCT) will include 150 at First Affiliated Hospital Xiamen University. Participants be randomly assigned three groups 1:1:1 ratio. group have two subgroups receive nasal spray 0.2 µg/kg or 0.5 25 min before surgery, while control saline spray. Three undergo propofol-based TIVA according same scheme. Sleep quality measured using wearable device double-blind assessments performed surgery 1, 3, 7 days SPSS 2.0 used for statistical analysis. A χ 2 test compare groups, t -test determine significance continuous variables. Discussion purpose investigate incidence propofol-associated disorders combination regimen prevention disorders. help improve patients’ satisfaction provide new strategy comfortable perioperative medical treatment. Trial registration ClinicalTrials.gov NCT06281561. Registered February 24, 2024.

Language: Английский

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Pharmacological Management of Sleep–Wake Disturbances in Delirium

The Journal of Clinical Pharmacology, Journal Year: 2024, Volume and Issue: unknown

Published: Oct. 16, 2024

Abstract Delirium is a heterogeneous syndrome primarily characterized by fluctuations in attention and awareness. Sleep–wake disturbances are common significant feature of delirium can manifest as circadian rhythm inversion, sleep fragmentation, reduced rapid eye movement (REM) slow‐wave sleep. Some literature suggests that the relationship between disruption reciprocal wherein two reinforce one another may share an underlying etiology. As there no FDA‐approved medications for or delirium‐related disturbances, management focused on addressing medical concerns promoting physiologic patterns with non‐pharmacological behavioral interventions. In practice, however, often used, albeit limited evidence to support their use. This review explores pharmacology pharmacokinetics several investigating use delirium: melatonin, ramelteon, dual orexin receptor antagonists (DORAs), dexmedetomidine. Current possible benefit ramelteon dexmedetomidine patients ICU setting, DORAs therapeutic options re‐regulation sleep–wake cycle delirium. We discuss pertinent pharmacokinetic pharmacodynamic factors influence clinical decision‐making regarding these

Language: Английский

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Clinical observation of dexmedetomidine nasal spray in the treatment of sleep disorders on the first night after undergoing maxillofacial surgery: a single-center double-blind randomized controlled study

Journal of Pharmacy & Pharmaceutical Sciences, Journal Year: 2023, Volume and Issue: 26

Published: Oct. 3, 2023

Purpose: Dexmedetomidine exerts a sedative effect by promoting the sleep pathway endogenously and producing state similar to N2 sleep. This study aimed efficacy safety of dexmedetomidine nasal spray in treatment postoperative disturbance. Methods: enrolled 120 participants [men women; age, 18-40 years; American Society Anesthesiologists grade, I or II] who underwent maxillofacial surgery under general anesthesia through nasotracheal intubation. The were randomly divided into three groups: blank control group (BC group), 1.0 μg/kg (1.0 Dex 1.5 (1.5 with 40 patients allocated each group. At 21:30 on night after operation, intervention groups administered their corresponding doses spray. Pittsburgh Sleep Quality Index (PSQI) scale was used evaluate baseline status 1 month preoperatively operation. Polysomnography (PSG) record We recorded rescue times analgesic drugs first surgery, adverse reactions, total hospital stay duration, costs. Results: Compared BC group, those had longer awake for shorter time dose administration, woke up less often, significantly improved efficiency (p < 0.05). PSQI scores lower proportion > 5 prolonged N3 sleep, reduced frequency requiring sufentanil rescue, incidence sore throat average length (all, p Conclusion: quality having undergone safely effectively 1.0-1.5 atomized sprays. Notably, only latter could prolong Level Evidence II: obtained from at least one properly designed randomized controlled trial.

Language: Английский

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Dexmedetomidine for Preventing Sleep Disturbance after Ambulatory Anesthesia: A Case Report

A&A Practice, Journal Year: 2024, Volume and Issue: 18(4), P. e01776 - e01776

Published: April 1, 2024

Propofol anesthesia may impact a patient's sleep quality in the immediate postprocedure timeframe. We describe 24-year-old man presenting for gastrostomy-jejunostomy tube replacement who reported debilitating sleep-onset disturbances after 3 previous anesthetic exposures same procedure. Review of records revealed recurring use propofol infusion. proposed using dexmedetomidine infusion to potentially avoid another extended disturbance. Following dexmedetomidine-centered plan, patient experiencing his usual pattern without side-effects 5 consecutive days postprocedure. This case highlights potential propofol-induced disturbance ambulatory setting, which be avoided with administration.

Language: Английский

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Advances in the use of dexmedetomidine during the perioperative period to improve postoperative sleep quality in patients undergoing surgery

Journal of International Medical Research, Journal Year: 2024, Volume and Issue: 52(11)

Published: Nov. 1, 2024

There is a high incidence of postoperative sleep and architecture disorders in patients undergoing surgery, dexmedetomidine (DEX) commonly used to improve quality ameliorate the adverse effects poor on various organ systems. The continuous intraoperative intravenous infusion DEX, addition DEX analgesia pumps, after admission intensive care unit are often clinically at doses 0.1 0.7 μg/kg/hour, but structure identified these studies have been inconsistent. Thus, it unclear whether improves quality. methods administering differing effects, route modifies effect structure, intrinsic mechanism whereby remains be fully investigated. In present review, we describe new directions for future research into mechanisms involved, which should help guide design further studies. This narrative review was completed according Scale Assessment Narrative Review Articles (SANRA).

Language: Английский

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