viernes, 29 de marzo de 2013

Dexmedetomidina

Ventajas hemodinámicas y anestésicas de la dexmedetomidina


Haemodynamic and anaesthetic advantages of dexmedetomidine
Subramanian Hari Rao, B Sudhakar, P K Subrahmanyam
South Afr J Anaesth Analg 2012;18(6):326-331


Abstract
Objectives: The aim of this study was to describe the effect of dexmedetomidine on haemodynamic stability in the intraoperative period, as well as on the pressor response to intubation and extubation and the requirement of inhalation anaesthetics and recovery. Design: A simple descriptive study. Settings and subjects: The study was conducted in a tertiary hospital in India from June 2010-June 2011. The 81 American Society of Anesthesiologists classification I and II patients who were enrolled in the study were given a loading dose of dexmedetomidine 1 μg/kg, followed by a continuous infusion of 0.5 μg/kg/hour. Supplementation with end-tidal sevoflurane 1-2% was considered when heart rate (HR) and mean arterial pressure exceeded 20% of baseline values. On completion of surgery, the time taken to discontinue dexmedetomidine infusion and the extubation time were recorded. Outcome measures: Changes in haemodynamic variables from baseline and a comparison of means were analysed by paired t-test for each time interval. Results: There was significant reduction in HR and systolic blood pressure following the loading dose of dexmedetomidine (12.31% and 8.82% respectively), in the intraoperative period (17.71% and 16.5% respectively), and during intubation and extubation (p-value < 0.001). None of the patients required supplementary doses of analgesics in the intraoperative period. Only 13 patients required end-tidal sevoflurane of 1% during the study. Seventy per cent of patients could be extubated within five minutes of discontinuing the infusion. Conclusion: Dexmedetomidine provided a stable haemodynamic profile in the perioperative period and a blunted pressor response to intubation and extubation. With its use, there was a minimal requirement for analgesics and inhalational agents. It had an acceptable recovery profile.
http://www.sajaa.co.za/index.php/sajaa/article/view/930/1174

Dexmedetomidina modifica las contracciones uterinas en las ratas embarazadas

Dexmedetomidine modifies uterine contractions in pregnancy terms of rats.
Öcal I, Günes Y, Mert T, Özcengiz D, Günay I.
Indian J Pharmacol [serial online] 2013 [cited 2013 Mar 11];45:168-73.
Objectives: The present study was aimed at determining the effective doses of Dexmedetomidine (Dex) involved in amplitude of contraction-force and frequency of uterine rings in pregnancy terms of rats. All experiments involving animal subjects were carried out with the approval of animal care and use Ethical Committee of Cukurova University. Experiments were performed on female Albino-Wistar rats (200-260 g; n = 40). Materials and Methods: Uterine rings from pregnant rats were placed in organ bath with Krebs and calcium ion (Ca 2+ )-free solutions to record and exposed to serially increasing log10 concentrations of Dex. Results: In Krebs solution, while Dex caused an increase in the spontaneous contraction-forces in all pregnancy terms of rats in a significant dose-dependent manner, it led to a decrease in contraction-frequency in late-pregnancy term of rats. In Ca 2+ -free, the spontaneous contraction-force decreased in late-pregnancy term and increased in early and middle-pregnancy terms. In addition, while Dex increased the contraction-frequency in early and middle-pregnancy terms, it decreased in late-pregnancy term in a dose-dependent manner. Statistical Analysis Used: The data were subjected to one-way analysis of variance. Repeated measures were employed for comparison of several group means through the Tukey post-hoc test (SPSS 10.00 Inc., Chicago, Ill, USA). P < 0.05 was considered statistically significant. Conclusions: This study suggested that Dex might differently alter the spontaneous contraction-forces and contraction-frequencies of uterine rings in all pregnancy terms of rats in Krebs and Ca 2+ -free solutions.
Keywords: Contraction-force, contraction-frequency, Ca 2+ influx, Dexmedetomidine, uterine muscle, pregnancy terms of rats
http://ijp-online.com/article.asp?issn=0253-7613;year=2013;volume=45;issue=2;spage=168;epage=173;aulast=%D6cal




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Anestesiología y Medicina del Dolor
www.anestesia-dolor.org


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