Related Experiment Video
Updated: Jul 29, 2025
05:39
Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia
Published on: May 26, 2023
1.6K
Dexmedetomidine as an Adjuvant in Peripheral Nerve Block
Zheping Chen1, Zhenzhen Liu1, Chang Feng1
1Department of Anesthesiology, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250012, People's Republic of China.
Drug Design, Development and Therapy
|May 23, 2023
Summary
Dexmedetomidine as an adjuvant in peripheral nerve blocks can enhance anesthesia and prolong nerve block duration, potentially reducing opioid use. Its risk-benefit profile requires careful consideration for non-label use.
Area of Science:
- Anesthesiology
- Pharmacology
Background:
- Peripheral nerve blocks are crucial for balanced anesthesia, reducing opioid requirements and aiding rehabilitation.
- Ultrasound guidance enhances peripheral nerve block accuracy and efficacy.
- Dexmedetomidine, an alpha-2 adrenergic agonist, offers sedation, analgesia, and hemodynamic stability.
Purpose of the Study:
- To review the pharmacology and mechanism of dexmedetomidine.
- To evaluate dexmedetomidine's efficacy as an adjuvant in peripheral nerve blocks.
- To compare dexmedetomidine with other adjuvants and discuss its application progress.
Main Methods:
- Literature review of studies on dexmedetomidine in peripheral nerve blocks.
- Analysis of dexmedetomidine's effects on anesthesia onset and duration.
- Comparison of dexmedetomidine with other common nerve block adjuvants.
Main Results:
- Dexmedetomidine shortens anesthesia onset time.
- It prolongs sensory and motor nerve block duration.
- Its use as an adjuvant requires risk-benefit assessment due to non-label status in some regions.
Conclusions:
- Dexmedetomidine shows promise as an effective adjuvant in peripheral nerve blocks.
- Further research is needed to fully establish its role and optimize its use.
- Careful evaluation of risk-benefit is essential for its clinical application.
Related Concept Videos
01:19Depolarizing Blockers: Pharmocokinetics
353
Depolarizing blockers are administered through intravenous injection. Succinylcholine is the most common choice of depolarizing blockers in emergency clinical practices. Although they have a rapid onset, they readily diffuse away from the motor end plate into the extracellular fluid. They are metabolized by enzymes such as liver butyrylcholinesterase and plasma pseudocholinesterases. This produces a short duration of action, typically 5-10 minutes long, unlike nondepolarizing blockers, which...
353
01:24Parenteral Anesthetics: Overview
164
Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
164
01:27Nondepolarizing (Competitive) Neuromuscular Blockers: Pharmacological Actions
468
Nondepolarizing neuromuscular blockers prevent the membrane depolarization of muscle cells and inhibit muscle contraction. These are usually administered with anesthetics to achieve complete muscle relaxation. Upon administration, these drugs first block the small, rapidly contracting muscles of the face and hands, followed by the larger muscles of the trunk and the intercostal muscles. The diaphragm is the last muscle to be affected.
Although all competitive neuromuscular blockers are designed...
Although all competitive neuromuscular blockers are designed...
468
01:17Nondepolarizing (Competitive) Neuromuscular Blockers: Mechanism of Action
1.9K
Nondepolarizing neuromuscular blockers induce paralysis by competitively blocking nicotinic acetylcholine receptors at the muscle end plate. Examples include pancuronium, mivacurium, vecuronium, and rocuronium. These quaternary ammonium derivatives are administered intravenously, are poorly absorbed, and are excreted via the kidneys.
Competitive antagonists prevent acetylcholine from binding to its receptor, inhibiting membrane depolarization. Without conformational changes or intrinsic...
Competitive antagonists prevent acetylcholine from binding to its receptor, inhibiting membrane depolarization. Without conformational changes or intrinsic...
1.9K
01:28Depolarizing Blockers: Mechanism of Action
1.7K
Depolarizing blockers act on skeletal muscle fibers' membranes and induce their depolarization. Most depolarizing blockers have two quaternary N+ atoms that bind the nicotinic acetylcholine receptors and cause neuromuscular blockade within minutes.
Succinylcholine is the most commonly used depolarizing blocker. Chemically, it constitutes two molecules of acetylcholine joined together by an acetate methyl group. They act on the receptors in the same way as acetylcholine. Because...
Succinylcholine is the most commonly used depolarizing blocker. Chemically, it constitutes two molecules of acetylcholine joined together by an acetate methyl group. They act on the receptors in the same way as acetylcholine. Because...
1.7K
01:29Local Anesthetics: Clinical Application as Epidural Anesthesia
462
Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
462