Modern Sedation and Analgesia Strategies in Neurocritical Care

Current Neurology and Neuroscience Reports, Journal Year: 2023, Volume and Issue: 23(4), P. 149 - 158

Published: March 7, 2023

Language: Английский

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Dexmedetomidine ameliorates diabetic cardiomyopathy by inhibiting ferroptosis through the Nrf2/GPX4 pathway

Journal of Cardiothoracic Surgery, Journal Year: 2023, Volume and Issue: 18(1)

Published: July 10, 2023

Abstract Objective Dexmedetomidine (DEX) has been shown to have anti-apoptotic effects in diabetes mellitus, but its role mitigating diabetic cardiomyopathy (DCM) through ferroptosis regulation is unclear. Methods An vitro DCM model was established using H9C2 cells induced with high glucose (HG) and treated DEX at varying doses a nuclear factor erythroid 2-realated 2 (Nrf2) specific inhibitor ML385. Cell viability evaluated the MTT method after treatment or mannitol (MAN), dosage of used subsequent experimentation determined. The HG-induced osmotic pressure were assessed MAN as control. apoptosis flow cytometry. Protein levels Bcl2, Bax, Nrf2, glutathione peroxidase 4 (GPX4) measured Western blot. Superoxide dismutase (SOD) activity, malondialdehyde (MDA) levels, Fe 2+ concentration reactive oxygen species (ROS) corresponding kits dichlorodihydrofluorescein diacetate, respectively. Results Treatment had no effect on cell viability. HG induction reduced viability, increased apoptosis, upregulated , MDA, ROS, downregulated Bcl2 protein SOD Nrf2 GPX4. inhibited promoted translocation, activated Nrf2/GPX4 pathway. Inhibition partially reversed protective against HG-evoked injury. Conclusion Our findings demonstrate that attenuates cardiomyocyte injury by inhibiting pathway, providing potential therapeutic targets for treatment.

Language: Английский

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Dexmedetomidine Reduces Presynaptic γ-Aminobutyric Acid Release and Prolongs Postsynaptic Responses in Layer 5 Pyramidal Neurons in the Primary Somatosensory Cortex of Mice

International Journal of Molecular Sciences, Journal Year: 2025, Volume and Issue: 26(5), P. 1931 - 1931

Published: Feb. 24, 2025

Dexmedetomidine (DEX) exhibits notable sedative, analgesic, and anesthetic-sparing properties. While growing evidence suggests these effects are linked to the modulation of γ-aminobutyric acid (GABA) system, precise pre- postsynaptic mechanisms DEX action on cortical GABAergic signaling remain unclear. In this study, we applied whole-cell patch-clamp recording investigate impact transmission in layer 5 pyramidal neurons mouse primary somatosensory cortex. We recorded spontaneous inhibitory currents (sIPSCs), miniature IPSCs (mIPSCs), evoked potentials (eIPSPs) before during application. Our findings demonstrated that reduced activity-dependent transmission, as evidenced by a decrease sIPSC frequency, while mIPSC frequency was unaffected. eIPSPs were not significantly influenced either. Additionally, prolonged kinetics both sIPSCs mIPSCs, increasing rise decay times time mIPSCs. proposed modulated neuronal activity limiting GABA release altering GABAA receptor kinetics. Collectively, results indicated at presynaptic sites, which likely underlined its effects.

Language: Английский

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Identification of Acanthopanax trifoliatus (L.) Merr as a Novel Potential Therapeutic Agent Against COVID-19 and Pharyngitis

Molecules, Journal Year: 2025, Volume and Issue: 30(5), P. 1055 - 1055

Published: Feb. 25, 2025

Individuals infected with COVID-19 often experience the distressing discomfort of pharyngitis. Thus, it is crucial to develop novel drugs improve therapeutic options. In this study, we investigated interaction between bioactive compounds isolated from Acanthopanax trifoliatus (L.) Merr and proteins associated pharyngitis through in silico analysis. Several molecules demonstrated high affinities multiple targets, indicating significant potential for alleviating other COVID-19-related symptoms. Among them, rutin isochlorogenic acid C, two major components ethanol extracts, were further experimentally exhibit strong inhibitory effects against SARS-CoV-2 possess anti-inflammatory activities. Inhibition over 50% several key genes was observed, demonstrating efficacy methods identifying high-affinity target binders. Our findings provide a theoretical foundation development as multi-target agent both

Language: Английский

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INTRAVENOUS VERSUS INTRANASAL DEXMEDETOMIDINE: A COMPARATIVE ANALYSIS OF HEMODYNAMIC RESPONSES DURING LARYNGOSCOPY AND ENDOTRACHEAL INTUBATION

Asian Journal of Pharmaceutical and Clinical Research, Journal Year: 2025, Volume and Issue: unknown, P. 30 - 35

Published: March 7, 2025

Objectives: Laryngoscopy and intubation causes a profound sympathetic response, causing significant increase in heart rate (HR) blood pressure, potentially leading to complications like laryngospasm bronchospasm, requiring close monitoring expert anesthesia care. This study evaluated intranasal intravenous effectiveness of dexmedetomidine mitigating adverse hemodynamic consequences laryngoscopy intubation, aiming discern the optimal route for stability. Methods: double-blinded, randomized involved 72 adults (18–60 years, American Society Anesthesiologists I/II) undergoing various surgeries general endotracheal intubation. Group DIV received Inj. Dexmedetomidine 1 μg/kg intravenously as an infusion 100 mL Normal Saline over 10 min, 40 min before induction anesthesia. DIN 2 (1 each nostril) intranasally through atomizer The study’s primary objective was optimize dexmedetomidine’s dosage minimizing laryngoscopy’s stress response. Secondary outcomes included assessing incidence any event. Results: Both groups showed similar demographics, duration, baseline hemodynamics. Hemodynamic parameters decreased significantly 30–40 post-administration drug after (p<0.05). increased HR mean arterial pressure (MAP) where (98.86±17.16 bpm), MAP (108.5±15.69 mmHg) more than (88.89±9.23 bpm) (102.36±9.06 mmHg). greater attenuation at 1, 3, 5 post-laryngoscopy Conclusion: Intravenous is effective attenuating response

Language: Английский

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Efficacy of adding dexmedetomidine as adjuvant with bupivacaine in ultrasound-guided intermediate cervical plexus block for thyroidectomy surgery: randomized controlled study

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

Published: March 25, 2025

Abstract Background One important aspect of a successful thyroidectomy recovery is the level pain postoperatively. This research aimed to determine effectiveness an ultrasound-guided intermediate cervical plexus block (CPB) for with dexmedetomidine added as adjuvant bupivacaine. The primary outcome was duration analgesia defined time till first request rescue analgesia. secondary outcomes were total amount fentanyl consumed intraoperatively, patient’s opioids requirements within 24 h postoperative, VAS, and complications. Methods randomized controlled double-blinded study included 60 patients aged 18 years, all whom underwent thyroid cancer. Patients randomly allocated into two equal groups, B Group ( n = 30) received bilateral CPB, 20 ml bupivacaine 0.25%, DB CPB 0.25% plus 1 µg/kg dexmedetomidine. Results showed significantly longer p < 0.001), less intraoperative consumption 0.005), postoperative morphine 0.001). Also, scores, heart rate, mean arterial pressure lower in group than sometimes points. Conclusions addition prolonged reduced opioid consumption.

Language: Английский

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Comparison of the effect of dexmedetomidine intrathecal injection and intravenous infusion on subarachnoid blockade during knee arthroscopy procedures: a randomized controlled trial

BMC Anesthesiology, Journal Year: 2024, Volume and Issue: 24(1)

Published: Jan. 5, 2024

Abstract Background Comparison of whether intrathecal dexmedetomidine prolongs spinal anesthesia-associated sensorimotor blockade more than intravenous infusion during knee arthroscopy procedures performed under subarachnoid blockade. Methods Ninety patients aged 18–75 years, ASA class I-II, who underwent between October 2022 and April 2023 were randomized into intrathecal、intravenous control groups.Subjects received three modes administration: an group (2 ml 1% ropivacaine + 1 5 μg dexmedetomidine, along with saline infusion), (intrathecal 2 0.9% saline, pumped intravenously at a dose 0.5 μg/kg/h), infusion). Total analgesic duration, duration sensory motor blockade, Ramsay sedation score, Visual Analogue Score (VAS) different postoperative time points, occurrence adverse effects recorded. Results The total analgesia was significantly longer in the groups (352.13 ± 51.70 min VS 273.47 62.57 241.41 59.22 min, P < 0.001).The onset block shorter (4 [3–4]min [4–5]min [4–5]min; 0.001);the (5 [5–6]min 6[5.5–7]min; 0.001).Sedation scores higher ( 0.001). At h postoperatively, VAS score lower that 24 In addition, incidence bradycardia (30%, 6.5%, 3.4%, respectively; = 0.018, 0.007). Conclusions Intrathecal administration did prolong as well accelerate sensory-motor compared infusion, not result any hemodynamic instability or other events doses studied. Trial registration This single-center, prospective, RCT has completed Chinese Clinical Center 26/09/2023 number ChiCTR2300076170.

Language: Английский

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An evaluation of dexmedetomidine in combination with midazolam in pediatric sedation: a systematic review and meta-analysis

BMC Anesthesiology, Journal Year: 2024, Volume and Issue: 24(1)

Published: June 21, 2024

Dexmedetomidine and midazolam are commonly used sedatives in children. We conducted a systematic review meta-analysis to compare the safety effectiveness of sedation provided by dexmedetomidine combined with versus other including chloral hydrate, pediatric sedation.

Language: Английский

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Combination of ion-pair strategy and chemical enhancers for design of dexmedetomidine long-acting patches: Dual action mechanism induced longer controlled release and better delivery efficiency

European Journal of Pharmaceutics and Biopharmaceutics, Journal Year: 2022, Volume and Issue: 183, P. 47 - 60

Published: Dec. 21, 2022

Language: Английский

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Molecular mechanisms of cholinergic neurotransmission in visceral smooth muscles with a focus on receptor-operated TRPC4 channel and impairment of gastrointestinal motility by general anaesthetics and anxiolytics

Neuropharmacology, Journal Year: 2023, Volume and Issue: 242, P. 109776 - 109776

Published: Oct. 31, 2023

Language: Английский

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