Solution containing 5 µg/mL of dexmedetomidine was continuously infused by 0.5 μg/kg in 10 min, followed with 0.1 ml/kg/hr continuous infusion until the closure of the abdominal.

The placebo group (n = 20) will pumped in the same volume of saline 0.9% as calculated by patients' weight in 10 min, then will receive an i.v. infusion of 0.1 mL/kg/h saline 0.9%, until the closure of the abdominal.

Cesarean Section, Affecting Fetus or Newborn

The dexmedetomidine groups (n = 20 ) will receive i.v. infusion of 0.5 μg/kg of solution containing 5 µg/mL of dexmedetomidine, at 10 min after the level of anesthesia completed. Followed with 0.1ml/kg/hr continuous infusion until the closure of the abdominal.The placebo and the dexmedetomidine solutions will be looked identical and their infusions will be continued until skin closure.

Dexmedetomidine

The placebo group (n = 20) will pumped in the same volume of saline 0.9% as calculated by patients' weight in 10 min, then will receive an i.v. infusion of 0.1 mL/kg/h saline 0.9%, until the closure of the abdominal. The placebo and the dexmedetomidine solutions will be looked identical and their infusions will be continued until skin closure.

Placebo

The First Affiliated Hospital of Nanjing Medical University

Dexmedetomidine for Cesarean Section

Effect and Placental Transfer of Dexmedetomidine During Caesarean Section Under Epidural Anaesthesia

identifying the effects of 0.5 µg/kg/h dexmedetomidine for systolic blood pressure changes.

identifying the effects of 0.5 µg/kg/h dexmedetomidine for diastolic blood pressure changes.

identifying the effects of 0.5 µg/kg/h dexmedetomidine for saturation of pulse oxygen changes.

identifying the effects of 0.5 µg/kg/h dexmedetomidine for heart rate changes.

Apgar score：The Apgar scores were evaluated at 1 and 5 minute after the delivery.

The difference of blood gas analysis from MV, UA , UV.

Major complications (respiratory, cardiovascular events, nausea, vomiting and other adverse reactions)

identifying the effects of 0.5 µg/kg/h dexmedetomidine for the plasma dexmedetomidine concentrations (CUV, CUA and CMV).

identifying the effects of 0.5 µg/kg/h dexmedetomidine for Ramsay sedation scales.(Ramsay standard for evaluation: 1 point: anxious or restless or both; 2 point: cooperative, orientated and tranquil; 3 point: responding to commands; 4 point: brisk response to stimulus; 5 point: sluggish response to stimulus; 6 point: no response to stimulus.)

identifying the effects of 0.5 µg/kg/h dexmedetomidine for the rate of placental transfer of dexmedetomidine(CUV/CMV).
Methods:
When the baby was born, we double clamped the umbilical cord,and extracted 3ml blood from the maternal vein(MV) on the no venous route hand, umbilical artery(UA) and umbilical vein(UV) from the isolated placenta. The blood blood from Dex group were injected heparin sodium anticoagulant tube, centrifuged 3500 revolutions per minute for 5 minutes and separated of plasma to -20℃ frozen preservation. High-performance liquid chromatography-mass spectrometry(HPLC-MS/MS) was then used for measuring the plasma dexmedetomidine concentrations (CUV, CUA and CMV). The rate of placental transfer of dexmedetomidine is CUV/CMV.

Cunming Liu

Chief officer

The First Affiliated Hospital with Nanjing Medical University

Dexamethasone will be administered as a peritendinous soft tissue injection of 1 mL of dexamethasone sodium phosphate (4mg/mL) and 0.5 mL (5mg) of 1% lidocaine.
Dexamethasone will be administered as a peritendinous soft tissue injection of 1 mL of dexamethasone sodium phosphate (4mg/mL) and 0.5 mL (5mg) of 1% lidocaine
Patients will be followed at the initial office visit, 4-weeks, 8-weeks, 12-weeks, and 6 months post injection to determine clinical response. A second injection can be given only once if the patient desires due to no clinical response at the 4 or 8-week follow-up.

Ketorolac will be administered as a peritendinous soft tissue injection of 1 mL of ketorolac (30mg/mL) and 0.5 mL (5mg) of 1% lidocaine.
Patients will be followed at the initial office visit, 4-weeks, 8-weeks, 12-weeks, and 6 months post injection to determine clinical response. A second injection can be given only once if the patient desires due to no clinical response at the 4 or 8-week follow-up.

DeQuervains Tenosynovitis

Lateral Epicondylitis

Tennis Elbow

Trigger Finger

Tenosynovitis

Inflammatory Disease

The proposed use of ketorolac in this study is outside of the FDA-approved indication and is the investigational agent in this study
Ketorolac is a non-steroidal anti-inflammatory drug (NSAID). The approved indication for Ketorolac is for the short-term (≤5 days) management of moderately severe, acute pain that requires analgesia at the opioid level, usually in a postoperative setting. It is highly protein bound (99%) and is largely metabolized by the liver. In it's approved indication it is contraindicated for those with renal impairment, active peptic ulcer disease, pregnant or nursing females, individuals with NSAID hypersensitivity, or individuals at high risk for bleeding/clotting disorders.

Ketorolac

Dexamethasone is a synthetic corticosteroid and possesses glucocorticoid activity, and will be used within its labeled indication for this study: intra-articular or soft tissue injection for: synovitis of osteoarthritis, epicondylitis, acute nonspecific tenosynovitis. It is the active comparator in this study.
In its approved indication there use limitations for immunocompromised individuals, pregnant females, persons with allergy to steroids, individuals with systemic fungal infections, and individuals with cerebral malaria. It is contra-indicated in systemic fungal infections, and hypersensitivity to any component of this product, including sulfites.

Dexamethasone

New York University School of Medicine

Dexamethasone Versus Ketorolac Injection for the Treatment of Local Inflammatory Hand and Upper Extremity Disorders

A Double-blinded, Prospective, Randomized, Controlled Trial Comparing Dexamethasone Versus Ketorolac Injection for the Treatment of Local Inflammatory Hand and Upper Extremity Disorders

Quinnell Grading system is assessed by the treating clinician at each visit upon physical exam of the patient's affected hand: 0-normal movement of finger; 1-uneven movement; 2-active correctible locking of digit; 3-passively correctible locking; 4-fixed deformity (15). This is recorded on the followup data sheets every time.

The QuickDASH is an 11-question standardized survey used to assess a patient's overall functional status and is widely used in the practice of orthopaedic surgery as an analog measurement of a patient's functional ability. Scores range from 0-100, with 100 being the most poor functionality and 0 being the best. This will be assessed at every visit by having the patient fill out the survey and our team calculating the score at the end of the visit.

The EQ-5D is a 5 question survey with 3 potential responses per question, based on measuring a patient's overall quality of life. The responses are compiled into a numerical score ranging from 1 to -0.11, with 1 being the best and -0.11 being the worst in terms of quality of life. This survey will be administered to patients at each visit, along with the other surveys.

VAS pain score is a 0-10 numerical score assessing patient's subjective level of reported pain. This will be recorded from the patient's written response at every visit.

The clinician will examine the patient and determine objectively if there is pain or no pain upon palpation of the first dorsal extensor compartment. Pain is recorded as a 1, and no pain is recorded as a 0, for this categorical variable measured at each visit.

The clinician will perform the finkelstein exam maneuver by ulnarly deviating the affected wrist, flexing the patient's thumb, and palpating the first dorsal compartment to see if pain is elicited. Pain is a positive response, marked as 1. No pain is a negative response, marked as zero. This is assessed at every visit, including baseline, like all other assessments mentioned here.

Clinician will examine the patient and palpate over the lateral epicondyle. Presence of pain is a positive test, recorded as 1. Absence of pain is a negative test, recorded as 0. This is done at every visit.

The clinician examines the patient and asks patient to extend wrist against resistance by the clinician. Production of pain is a positive test, recorded as 1. Absence of pain is a negative test, recorded as 0. This is done at ever visit.

The QuickDASH is an 11-question standardized survey used to assess a patient's overall functional status and is widely used in the practice of orthopaedic surgery as an analog measurement of a patient's functional ability. Scores range from 0-100, with 100 being the most poor functionality and 0 being the best. This will be assessed at every visit by having the patient fill out the survey and our team calculating the score at the end of the visit

Any diabetic patients who monitor their blood sugar levels will be asked to keep a log of their blood sugar levels measured at least once in the 24 hours after a visit, and at least once in the 48 hours after the visit, for each protocol visit. This is done for ALL groups, and both treatment arms.

NYU Langone Health

The dexmedetomidine group will receive i.v. infusion of 0.1 mL/kg/h of solution containing 6 µg/mL of dexmedetomidine, at 20 min before induction of anesthesia

The dexmedetomidine group will receive i.v. infusion of 0.1 mL/kg/h of solution containing 4 µg/mL of dexmedetomidine, at 20 min before induction of anesthesia

The dexmedetomidine group will receive i.v. infusion of 0.1 mL/kg/h of solution containing 2 µg/mL of dexmedetomidine, at 20 min before induction of anesthesia.

The placebo group (n = 20) will receive an i.v. infusion of 0.1 mL/kg/h saline 0.9%, at 20 min before induction of anesthesia

Pregnant Women Undergoing Cesarean Delivery

The dexmedetomidine groups (n = 20 for each) will receive i.v. infusion of 0.1 mL/kg/h of solution containing 2, 4, and 6 µg/mL of dexmedetomidine, at 20 min before induction of anesthesia. The placebo and the dexmedetomidine solutions will be looked identical and their infusions will be continued until skin closure, when their infusion rate will be decreased by 50% until 20 min after extubation.

The placebo group (n = 20) will receive an i.v. infusion of 0.1 mL/kg/h saline 0.9%, at 30 min before induction of anesthesia. The placebo solution will be looked identical and their infusions will be continued until skin closure, when the infusion rate will be decreased by 50% until 20 min after extubation. The test solution will be prepared by one anesthesiologist before induction of anesthesia.

amide/atrofija

Dexmedetomidine for Cesarean Section

Dexamethasone Versus Ketorolac Injection for the Treatment of Local Inflammatory Hand and Upper Extremity Disorders

Dexmedetomidine for Cesarean Delivery

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