Anesthesia for a patient with morbid obesity using dexmedetomidine without narcotics.
Identifieur interne : 003D91 ( PubMed/Curation ); précédent : 003D90; suivant : 003D92Anesthesia for a patient with morbid obesity using dexmedetomidine without narcotics.
Auteurs : Roger E. Hofer [États-Unis] ; Juraj Sprung ; Michael G. Sarr ; Denise J. WedelSource :
- Canadian journal of anaesthesia = Journal canadien d'anesthesie [ 0832-610X ] ; 2005.
Descripteurs français
- KwdFr :
- Adulte, Analgésie autocontrôlée, Anastomose de Roux-en-Y, Anesthésie, Dexmédétomidine, Douleur postopératoire (traitement médicamenteux), Dérivation gastrique, Humains, Hypnotiques et sédatifs, Lymphoedème (), Mâle, Obésité morbide (), Position déclive, Stupéfiants, Surveillance peropératoire, Syndrome d'apnées obstructives du sommeil (), Ventilation artificielle.
- MESH :
- traitement médicamenteux : Douleur postopératoire.
- Adulte, Analgésie autocontrôlée, Anastomose de Roux-en-Y, Anesthésie, Dexmédétomidine, Dérivation gastrique, Humains, Hypnotiques et sédatifs, Lymphoedème, Mâle, Obésité morbide, Position déclive, Stupéfiants, Surveillance peropératoire, Syndrome d'apnées obstructives du sommeil, Ventilation artificielle.
English descriptors
- KwdEn :
- Adult, Analgesia, Patient-Controlled, Anastomosis, Roux-en-Y, Anesthesia, Dexmedetomidine, Gastric Bypass, Head-Down Tilt, Humans, Hypnotics and Sedatives, Lymphedema (complications), Male, Monitoring, Intraoperative, Narcotics, Obesity, Morbid (complications), Pain, Postoperative (drug therapy), Respiration, Artificial, Sleep Apnea, Obstructive (complications).
- MESH :
- chemical : Dexmedetomidine, Hypnotics and Sedatives, Narcotics.
- complications : Lymphedema, Obesity, Morbid, Sleep Apnea, Obstructive.
- drug therapy : Pain, Postoperative.
- Adult, Analgesia, Patient-Controlled, Anastomosis, Roux-en-Y, Anesthesia, Gastric Bypass, Head-Down Tilt, Humans, Male, Monitoring, Intraoperative, Respiration, Artificial.
Abstract
To describe the anesthetic management of a patient with extreme obesity undergoing bariatric surgery whose intraoperative narcotic management was entirely substituted with dexmedetomidine.
DOI: 10.1007/BF03027725
PubMed: 15684259
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Sarr</name></author><author><name sortKey="Wedel, Denise J" sort="Wedel, Denise J" uniqKey="Wedel D" first="Denise J" last="Wedel">Denise J. Wedel</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2005">2005</date><idno type="RBID">pubmed:15684259</idno><idno type="pmid">15684259</idno><idno type="doi">10.1007/BF03027725</idno><idno type="wicri:Area/PubMed/Corpus">003D91</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">003D91</idno><idno type="wicri:Area/PubMed/Curation">003D91</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">003D91</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Anesthesia for a patient with morbid obesity using dexmedetomidine without narcotics.</title><author><name sortKey="Hofer, Roger E" sort="Hofer, Roger E" uniqKey="Hofer R" first="Roger E" last="Hofer">Roger E. Hofer</name><affiliation wicri:level="1"><nlm:affiliation>Department of Anesthesiology, Mayo Clinic College of Medicine, 200 First Street S.W., Rochester, MN 55905, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Anesthesiology, Mayo Clinic College of Medicine, 200 First Street S.W., Rochester, MN 55905</wicri:regionArea></affiliation></author><author><name sortKey="Sprung, Juraj" sort="Sprung, Juraj" uniqKey="Sprung J" first="Juraj" last="Sprung">Juraj Sprung</name></author><author><name sortKey="Sarr, Michael G" sort="Sarr, Michael G" uniqKey="Sarr M" first="Michael G" last="Sarr">Michael G. Sarr</name></author><author><name sortKey="Wedel, Denise J" sort="Wedel, Denise J" uniqKey="Wedel D" first="Denise J" last="Wedel">Denise J. Wedel</name></author></analytic><series><title level="j">Canadian journal of anaesthesia = Journal canadien d'anesthesie</title><idno type="ISSN">0832-610X</idno><imprint><date when="2005" type="published">2005</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Analgesia, Patient-Controlled</term><term>Anastomosis, Roux-en-Y</term><term>Anesthesia</term><term>Dexmedetomidine</term><term>Gastric Bypass</term><term>Head-Down Tilt</term><term>Humans</term><term>Hypnotics and Sedatives</term><term>Lymphedema (complications)</term><term>Male</term><term>Monitoring, Intraoperative</term><term>Narcotics</term><term>Obesity, Morbid (complications)</term><term>Pain, Postoperative (drug therapy)</term><term>Respiration, Artificial</term><term>Sleep Apnea, Obstructive (complications)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte</term><term>Analgésie autocontrôlée</term><term>Anastomose de Roux-en-Y</term><term>Anesthésie</term><term>Dexmédétomidine</term><term>Douleur postopératoire (traitement médicamenteux)</term><term>Dérivation gastrique</term><term>Humains</term><term>Hypnotiques et sédatifs</term><term>Lymphoedème ()</term><term>Mâle</term><term>Obésité morbide ()</term><term>Position déclive</term><term>Stupéfiants</term><term>Surveillance peropératoire</term><term>Syndrome d'apnées obstructives du sommeil ()</term><term>Ventilation artificielle</term></keywords><keywords scheme="MESH" type="chemical" xml:lang="en"><term>Dexmedetomidine</term><term>Hypnotics and Sedatives</term><term>Narcotics</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Lymphedema</term><term>Obesity, Morbid</term><term>Sleep Apnea, Obstructive</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Pain, Postoperative</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Douleur postopératoire</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Analgesia, Patient-Controlled</term><term>Anastomosis, Roux-en-Y</term><term>Anesthesia</term><term>Gastric Bypass</term><term>Head-Down Tilt</term><term>Humans</term><term>Male</term><term>Monitoring, Intraoperative</term><term>Respiration, Artificial</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Analgésie autocontrôlée</term><term>Anastomose de Roux-en-Y</term><term>Anesthésie</term><term>Dexmédétomidine</term><term>Dérivation gastrique</term><term>Humains</term><term>Hypnotiques et sédatifs</term><term>Lymphoedème</term><term>Mâle</term><term>Obésité morbide</term><term>Position déclive</term><term>Stupéfiants</term><term>Surveillance peropératoire</term><term>Syndrome d'apnées obstructives du sommeil</term><term>Ventilation artificielle</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">To describe the anesthetic management of a patient with extreme obesity undergoing bariatric surgery whose intraoperative narcotic management was entirely substituted with dexmedetomidine.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">15684259</PMID><DateCreated><Year>2005</Year><Month>02</Month><Day>01</Day></DateCreated><DateCompleted><Year>2005</Year><Month>06</Month><Day>24</Day></DateCompleted><DateRevised><Year>2013</Year><Month>11</Month><Day>21</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">0832-610X</ISSN><JournalIssue CitedMedium="Print"><Volume>52</Volume><Issue>2</Issue><PubDate><Year>2005</Year><Month>Feb</Month></PubDate></JournalIssue><Title>Canadian journal of anaesthesia = Journal canadien d'anesthesie</Title><ISOAbbreviation>Can J Anaesth</ISOAbbreviation></Journal><ArticleTitle>Anesthesia for a patient with morbid obesity using dexmedetomidine without narcotics.</ArticleTitle><Pagination><MedlinePgn>176-80</MedlinePgn></Pagination><Abstract><AbstractText Label="PURPOSE" NlmCategory="OBJECTIVE">To describe the anesthetic management of a patient with extreme obesity undergoing bariatric surgery whose intraoperative narcotic management was entirely substituted with dexmedetomidine.</AbstractText><AbstractText Label="CLINICAL FEATURES" NlmCategory="METHODS">We describe a 433-kg morbidly obese patient with obstructive sleep apnea and pulmonary hypertension who underwent Roux-en-Y gastric bypass. Because of the concern that the use of narcotics might cause postoperative respiratory depression, we substituted their intraoperative use with a continuous infusion of dexmedetomidine (0.7 microg.kg(-1).hr(-1)). The anesthesia course was uneventful, and the intraoperative use of dexmedetomidine was associated with low anesthetic requirements (0.5 minimum alveolar concentration). After completion of the operation and after tracheal extubation, the dexmedetomidine infusion was continued uninterrupted throughout the end of the first postoperative day. The analgesic effects of dexmedetomidine extended narcotic-sparing effects into the postoperative period; the patient had lower narcotic requirements during the first postoperative day [48 mg of morphine by patient-controlled analgesia (PCA)] while still receiving dexmedetomidine, compared to the second postoperative day (morphine 148 mg by PCA) with similar pain scores.</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">Dexmedetomidine may be a useful anesthetic adjunct for patients who are susceptible to narcotic-induced respiratory depression. In this morbidly obese patient the narcotic-sparing effects of dexmedetomidine were evident both intraoperatively and postoperatively.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Hofer</LastName><ForeName>Roger E</ForeName><Initials>RE</Initials><AffiliationInfo><Affiliation>Department of Anesthesiology, Mayo Clinic College of Medicine, 200 First Street S.W., Rochester, MN 55905, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sprung</LastName><ForeName>Juraj</ForeName><Initials>J</Initials></Author><Author ValidYN="Y"><LastName>Sarr</LastName><ForeName>Michael G</ForeName><Initials>MG</Initials></Author><Author ValidYN="Y"><LastName>Wedel</LastName><ForeName>Denise J</ForeName><Initials>DJ</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D002363">Case Reports</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Can J Anaesth</MedlineTA><NlmUniqueID>8701709</NlmUniqueID><ISSNLinking>0832-610X</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D006993">Hypnotics and Sedatives</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D009294">Narcotics</NameOfSubstance></Chemical><Chemical><RegistryNumber>67VB76HONO</RegistryNumber><NameOfSubstance UI="D020927">Dexmedetomidine</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016058" MajorTopicYN="N">Analgesia, Patient-Controlled</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000713" MajorTopicYN="N">Anastomosis, Roux-en-Y</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000758" MajorTopicYN="Y">Anesthesia</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D020927" MajorTopicYN="Y">Dexmedetomidine</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015390" MajorTopicYN="N">Gastric Bypass</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D018475" MajorTopicYN="N">Head-Down Tilt</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006993" MajorTopicYN="Y">Hypnotics and Sedatives</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008209" MajorTopicYN="N">Lymphedema</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="N">complications</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016343" MajorTopicYN="N">Monitoring, Intraoperative</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D009294" MajorTopicYN="Y">Narcotics</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D009767" MajorTopicYN="N">Obesity, Morbid</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="Y">complications</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D010149" MajorTopicYN="N">Pain, Postoperative</DescriptorName><QualifierName UI="Q000188" MajorTopicYN="N">drug therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012121" MajorTopicYN="N">Respiration, Artificial</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D020181" MajorTopicYN="N">Sleep Apnea, Obstructive</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="N">complications</QualifierName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>2005</Year><Month>2</Month><Day>3</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2005</Year><Month>6</Month><Day>25</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2005</Year><Month>2</Month><Day>3</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">15684259</ArticleId><ArticleId IdType="pii">52/2/176</ArticleId><ArticleId IdType="doi">10.1007/BF03027725</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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