BACKGROUND Intraoperative dexmedetomidine may decrease postoperative emergence agitation in elderly patients due to its sedative effect. In this study, we evaluated the effect of adjuvant dexmedetomidine on smooth emergence from anaesthesia after orthopaedic surgery in elderly patients. METHODS A total 115 patients (ASA I-II, aged over 65 years) were randomly allocated into four groups. Anaes...

OBJECTIVE To evaluate the implementation of a neonatal pain and sedation protocol at 2 ICUs. METHODS The intervention started with the evaluation of local practice, problems, and staff satisfaction. We then developed and implemented the Vienna Protocol for Neonatal Pain and Sedation. The protocol included well-defined strategies for both nonpharmacologic and pharmacologic interventions based ...

TOPIC: Critical Care TYPE: Medical Student/Resident Case Reports INTRODUCTION: Endotracheal (ET) tube biting is a common problem with oropharyngeal intubation, though usually treatable patient redirection or sedation. Here we present rare case of cardiac arrest from ET biting. CASE PRESENTATION: A 27-year-old man hyper IgE syndrome and cervical syringomyelia was admitted to the intensive care u...

Over the past decade, most Canadian intensive care units (ICUs) have adopted locally developed standardized protocols for delivery of analgesics and sedatives to patients who are undergoing mechanical ventilation to alleviate pain, anxiety, and agitation. Although I do acknowledge the benefits of protocol-ized care, not all patients have the same needs with respect to sedation and analgesia, so...

Patients with schizophrenia often suffer from sleep disturbances such as excessive sleeping and insomnia. Common medications for schizophrenia can have a sedative effect on patients. Not all antipsychotic medications have the same sedative effect, which is related to dosage and affinity for histamine H1 receptors. Studies have shown that, compared with conventional antipsychotics, atypical anti...

PURPOSE Dexmedetomidine, a potent selective α2-adrenergic agonist, produces sedation and analgesia. This study was conducted to assess the effect of dexmedetomidine infusion on sevoflurane requirements, recovery profiles, and emergence agitation in children undergoing ambulatory surgery. MATERIALS AND METHODS Forty children undergoing ambulatory hernioplasty or orchiopexy were randomized into...

INTRODUCTION We report the effective use of dexmedetomidine in the treatment of a patient with a history of chronic alcohol abuse and an acute traumatic brain injury who developed agitation that was unresolved if from traumatic brain injury, or alcohol withdrawal or the combination of both. Treatment with benzodiazepines failed; lorazepam therapy obscured our ability to do reliable neurological...

INTRODUCTION Physical restraint (PR) use in the intensive care unit (ICU) has been associated with higher rates of self-extubation and prolonged ICU length of stay. Our objectives were to describe patterns and predictors of PR use. METHODS We conducted a secondary analysis of a prospective observational study of analgosedation, antipsychotic, neuromuscular blocker, and PR practices in 51 Cana...