Can thiopental serve as a safe sedative agent?

2021 ◽  
pp. emermed-2021-211467
Author(s):  
Fatemeh Rasooli ◽  
Maryam Bahreini
Keyword(s):  
Sedative Agent

Survey on sedation-analgesia regimens, in particular the use of dexmedetomidine, among Dutch implanters of spinal cord neurostimulators

2019 ◽  
Vol 19 (4) ◽  
pp. 823-827
Author(s):  
Feline F.J.A. ter Bruggen ◽  
Dirk L. Stronks ◽  
Frank J.P.M. Huygen
Keyword(s):  
Spinal Cord ◽  
Pain Management ◽  
The Netherlands ◽  
Pharmacological Profile ◽  
Sedative Agent ◽  
Management Quality ◽  
Lead Placement ◽  
Positive Property ◽  
Sedation And Analgesia

Abstract Background and aims During implantation of most spinal cord neurostimulators, patients need to be cooperative to give feedback during lead placement, and also be comfortable. Sedation and analgesia can support these conditions. This survey aimed to provide an overview of the sedation-analgesia regimens currently used among Dutch pain specialists. The survey focused on the sedative agent “dexmedetomidine” due to its attractive pharmacological profile and its promising results during awake procedures. Methods A 27-item survey was sent to the 65 pain specialists involved in neurostimulation in the Netherlands. The survey consisted of questions related to different aspects of sedation and analgesia during neurostimulation, e.g. the current regimen, the opinion on and experience with dexmedetomidine as a sedative agent, and preferences regarding different aspects of sedation (i.e. production of arousable sedation, pain management, quality of patient’s feedback and overall preference). Results Of 65 pain specialists, 45 (69%) completed the survey. Most commonly used sedative was propofol (91%) and most common used analgesic was remifentanil (78%). Of the 45 respondents, 21 (47%) considered the use of dexmedetomidine, whereas 13 (29%) had experience with dexmedetomidine during neurostimulation. The most frequently mentioned positive property of dexmedetomidine was the easy production of arousable sedation. Most respondents who used dexmedetomidine preferred dexmedetomidine sedation over propofol sedation regarding all aspects of sedation. Conclusions The most commonly used sedation-analgesia regimen is the combination of propofol-remifentanil during the implantation of a neurostimulator among Dutch pain specialists. Only a small percentage of respondents had experience with the use of dexmedetomidine, despite its reported advantages. Implications When implanting a spinal cord neurostimulator, dexmedetomidine could be considered as a sedative, given its allowance for and preservation of a state of easy arousable sedation.

Safety and Efficacy of Dexmedetomidine as a Sedative Agent for Performing Awake Intubation

2016 ◽  
Vol 23 (6) ◽  
pp. e1788-e1800 ◽  
Author(s):  
Luo-Jing Zhou ◽  
Xiang-Zhi Fang ◽  
Ju Gao ◽  
Yang Zhangm ◽  
Li-Jian Tao
Keyword(s):  
Awake Intubation ◽  
Safety And Efficacy ◽  
Sedative Agent

Neurologic Withdrawal Symptoms Following Abrupt Discontinuation of a Prolonged Dexmedetomidine Infusion in a Child

2010 ◽  
Vol 15 (1) ◽  
pp. 38-42
Author(s):  
Jamie L. Miller ◽  
Christine Allen ◽  
Peter N. Johnson
Keyword(s):  
Continuous Infusion ◽  
Withdrawal Symptoms ◽  
Adrenergic Agonist ◽  
Short Term ◽  
Mechanically Ventilated ◽  
Sedative Agent ◽  
Full Resolution ◽  
Abrupt Discontinuation ◽  
Neurologic Sequelae ◽  
Dexmedetomidine Infusion

Dexmedetomidine is a α2-adrenergic agonist which possesses sedative, analgesic, and anxiolytic properties. It is approved for short-term use in adults to provide sedation while mechanically ventilated and for noninvasive procedural sedation. An increased number of anecdotal reports describe the use dexmedetomidine in children. Cardiovascular withdrawal symptoms have been reported in the literature. However, there have been few published reports of neurologic withdrawal symptoms following discontinuation of prolonged infusions of dexmedetomidine. We describe a 2 year-old child who received a prolonged continuous infusion (263 hours) of dexmedetomidine as an adjunctive sedative agent. Following abrupt discontinuation of dexmedetomidine, the patient presented with symptoms suggestive of neurological withdrawal. The symptoms gradually resolved over two days without further intervention, and the patient had full resolution of symptoms and was discharged home with no further neurologic sequelae.

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