@bilih.bsky.social @jeffgadsden.bsky.social @dr-amit-pawa.bsky.social Thanks for the Paravertebral series. Anyone have any experience of dexmeditomidine either in the LA solution or IV for awake breast surgery? A few studies suggest useful anxiolysis and analgesia without respiratory depression. - ThreadSky

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@bilih.bsky.social @jeffgadsden.bsky.social @dr-amit-pawa.bsky.social Thanks for the Paravertebral series. Anyone have any experience of dexmeditomidine either in the LA solution or IV for awake breast surgery? A few studies suggest useful anxiolysis and analgesia without respiratory depression.

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andrepro.bsky.social•16 days ago

I use it IV for long cases on regional anesthesia. It has some kind of respiratory depression, at least bradypnoe. But its pronounced on higher doses. My experience start with 0,7 and then mostly titrate down to 0.2-0.3.

blockdoc.bsky.social•14 days ago

Thanks 👍

dreammaker33.bsky.social•12 days ago

@dr-amit-pawa.bsky.social @jeffgadsden.bsky.social do you add dexmed to your block solutions? If so, how much does it prolong the block? I did a lit search and it suggested a few hours but anecdotally, I'm finding 0.5ug/kg significantly prolongs the block. Has this been your experience?

andrepro.bsky.social•10 days ago

I use it regularly. For average adults i use 1 mcg/kg, for older patients 0,5 mcg/kg, because sedative activity of dexmed is more prominent, much more than clonidine for example. It prolongs block in average 4-6h, but motor block as well.

dr-amit-pawa.bsky.social•10 days ago

Hi there! I don’t as we don’t routinely have it in our UK operating rooms so I have no experience of it in clinical practice.

I have heard folks say similar- but as you say, the evidence itself is not compelling

#BILIH #BlockItLikeItsHot

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