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sedation analgesia

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https://www.readbyqxmd.com/read/29334501/practice-guidelines-for-moderate-procedural-sedation-and-analgesia-2018-a-report-by-the-american-society-of-anesthesiologists-task-force-on-moderate-procedural-sedation-and-analgesia-the-american-association-of-oral-and-maxillofacial-surgeons-american-college
#1
https://www.readbyqxmd.com/read/29327341/combined-thoracic-paravertebral-and-pectoral-nerve-blocks-for-breast-surgery-under-sedation-a-prospective-observational-case-series
#2
A Pawa, J Wight, D N Onwochei, R Vargulescu, I Reed, L Chrisman, E Pushpanathan, A Kothari, K El-Boghdadly
Avoidance of general anaesthesia for breast surgery may be because of clinical reasons or patient choice. There is emerging evidence that the use of regional anaesthesia and the avoidance of volatile anaesthetics and opioid analgesia may have beneficial effects on oncological outcomes. We conducted a prospective observational case series of 16 breast cancer surgeries performed under thoracic paravertebral plus pectoral nerve block with propofol sedation to demonstrate feasibility of technique, patient acceptability and surgeon satisfaction...
January 12, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29327215/treatment-outcomes-of-using-inhalation-sedation-for-comprehensive-dental-care
#3
M Madouh, A BaniHani, J F Tahmassebi
AIM: To assess the outcomes of dental treatment under inhalation sedation within a UK specialist hospital setting. METHODS: This was a retrospective cohort study of the case notes of patients under 17 years of age who received dental treatment using inhalation sedation at a UK specialist setting during the period 2006-2011. Treatment outcomes were categorised into five groups: (1) treatment completed as planned, (2) modified treatment completed, (3) treatment abandoned in sedation unit and patient referred for treatment under general analgesia (GA), (4) treatment abandoned in sedation unit and patient referred for treatment under local analgesia (LA), (5) child failed to return to complete treatment...
January 11, 2018: European Archives of Paediatric Dentistry: Official Journal of the European Academy of Paediatric Dentistry
https://www.readbyqxmd.com/read/29318929/the-pharmacogenetics-of-medications-used-in-general-anesthesia
#4
Shangchen Xie, Wenjuan Ma, Qulian Guo, Jie Liu, Wei Li, Howard L McLeod, Yijing He
General anesthesia is a state of unconsciousness, amnesia, analgesia and akinesia induced by drugs including opioids, hypnotic-sedative agents, muscle relaxants and antiemetics. Clinical and genetic factors are reported to influence the efficacy and side effects of these agents. Based on the evidence, clinical action is needed to improve clinical outcomes. This review summarizes the latest knowledge with regards to the pharmacogenetics of anesthetics and general anesthesia related complications.
January 10, 2018: Pharmacogenomics
https://www.readbyqxmd.com/read/29306262/considerations-for-physicians-using-ketamine-for-sedation-of-children-in-emergency-departments
#5
Woo Sung Kim, Ji Yeon Ku, Hanbyul Choi, Hyo Jeong Choi, Ho Jung Kim, Bora Lee
OBJECTIVE: Ketamine use in emergency departments (EDs) for procedural sedation and analgesia is becoming increasingly common. However, few studies have examined patient factors related to adverse events associated with ketamine. This study investigated factors for consideration when using ketamine to sedate pediatric ED patients. METHODS: The study included pediatric patients receiving ketamine for laceration repair in the ED. Before sedation, information was collected about upper respiratory tract infection symptoms, allergy history, and fasting time...
December 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29290034/pharmacokinetics-of-dexmedetomidine-during-analgosedation-in-icu-patients
#6
Piotr Smuszkiewicz, Paweł Wiczling, Justyna Ber, Justyna Warzybok, Tomasz Małkiewicz, Jan Matysiak, Agnieszka Klupczyńska, Iwona Trojanowska, Zenon Kokot, Edmund Grześkowiak, Wojciech Krzyzanski, Agnieszka Bienert
Dexmedetomidine (DEX) is a fairly new alfa2-agonist which has been increasingly used in recent years for analgosedation, mostly because it offers a unique ability of providing both moderate level of sedation and analgesia without respiratory depression. Despite of many papers published, there are still only a few concerning the PK of the drug given as long-term infusion in ICU patients. The aim of this work was to characterize the population pharmacokinetics of dexmedetomidine and to investigate the potential benefits of individualization of drug dosing based on patient characteristics in the heterogeneous group of medical and surgical patients staying in intensive care unit...
December 30, 2017: Journal of Pharmacokinetics and Pharmacodynamics
https://www.readbyqxmd.com/read/29288841/management-of-severe-traumatic-brain-injury-first-24-hours
#7
Thomas Geeraerts, Lionel Velly, Lamine Abdennour, Karim Asehnoune, Gérard Audibert, Pierre Bouzat, Nicolas Bruder, Romain Carrillon, Vincent Cottenceau, François Cotton, Sonia Courtil-Teyssedre, Claire Dahyot-Fizelier, Frédéric Dailler, Jean-Stéphane David, Nicolas Engrand, Dominique Fletcher, Gilles Francony, Laurent Gergelé, Carole Ichai, Etienne Javouhey, Pierre-Etienne Leblanc, Thomas Lieutaud, Philippe Meyer, Sébastien Mirek, Gilles Orliaguet, François Proust, Hervé Quintard, Catherine Ract, Mohamed Srairi, Karim Tazarourte, Bernard Vigué, Jean-François Payen
The latest French Guidelines for the management in the first 24hours of patients with severe traumatic brain injury (TBI) were published in 1998. Due to recent changes (intracerebral monitoring, cerebral perfusion pressure management, treatment of raised intracranial pressure), an update was required. Our objective has been to specify the significant developments since 1998. These guidelines were conducted by a group of experts for the French Society of Anesthesia and Intensive Care Medicine (Société Francaise d'Anesthésie Réanimation (SFAR)) in partnership with the Association de Neuro-Anesthésie-Réanimation de Langue Française (ANARLF), the Société Française de Neurochirurgie (SFN), the Groupe Francophone de Réanimation et d'Urgences Pédiatriques (GFRUP) and the Association des Anesthésistes-Réanimateurs Pédiatriques d'Expression Française (ADARPEF)...
December 27, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29287863/demonstration-of-analgesic-effect-of-intranasal-ketamine-and-intranasal-fentanyl-for-postoperative-pain-after-pediatric-tonsillectomy
#8
Alper Yenigun, Sinan Yilmaz, Remzi Dogan, Seda Sezen Goktas, Muhittin Calim, Orhan Ozturan
OBJECTIVE: Tonsillectomy is one of the oldest and most commonly performed surgical procedure in otolaryngology. Postoperative pain management is still an unsolved problem. In this study, our aim is to demonstrate the efficacy of intranasal ketamine and intranasal fentanyl for postoperative pain relief after tonsillectomy in children. MATERIAL AND METHOD: This randomized-controlled study was conducted to evaluate the effects of intranasal ketamine and intranasal fentanyl in children undergoing tonsillectomy...
January 2018: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29284877/intravenous-dexmedetomidine-infusion-compared-with-that-of-fentanyl-in-patients-undergoing-arthroscopic-shoulder-surgery-under-general-anesthesia
#9
Mona Hossam Eldin Abdel Hamid
Background: Anesthesia for arthroscopic shoulder surgery is challenging due to the need for oligaemic surgical field as well as a good postoperative recovery profile. Aim: The present study was prospective, randomized to evaluate the efficacy of dexmdetomidine infusion compared to that of fentanyl in patients undergoing arthroscopic shoulder surgery under general anesthesia. Patients and Methods: A total of 60 patients aged from thirty to fifty years, American Society of Anesthesiologists Class I/II of either sex for arthroscopic shoulder surgery, were included...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29284862/comparison-of-enhancement-of-analgesic-effect-of-intrathecal-neostigmine-by-intrathecal-clonidine-and-transdermal-nitroglycerin-patch-on-bupivacaine-spinal-anesthesia
#10
Mathew V Mammen, Manoj Tripathi, Harish C Chandola, Amit Tyagi, Prateek Singh Bais, Om Prakash Sanjeev
Background: Relief of pain is very important goal intraoperatively and postoperatively. Neostigmine has been used successfully intrathecally with other agents such as clonidine and opioids for pain relief. Aims: This study aims to compare and evaluate the efficacy and safety of combining intrathecal (IT) neostigmine with IT clonidine and transdermal nitroglycerin (tNTG) patch for the relief of pain in patients after surgery. Settings and Design: This was a randomized, prospective, and comparative study...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29284860/effect-of-locally-administered-dexmedetomidine-as-adjuvant-to-levobupivacaine-in-supraclavicular-brachial-plexus-block-double-blind-controlled-study
#11
Bikash Bisui, Swastika Samanta, Sumanta Ghoshmaulik, Amit Banerjee, Tirtha R Ghosh, Suman Sarkar
Context: Brachial plexus block is effective with good postoperative analgesia in upper limb surgery has gained importance as it safe, low cost, and maintains stable hemodynamics intraoperatively. To decrease the onset time and prolong the duration of nerve block bicarbonate, opioids (morphine, fentanyl, etc.), sympathomimetic agents (epinephrine, phenylephrine, etc.), α-2 agonists (clonidine and dexmedetomidine), calcium channel blocker (verapamil), magnesium sulfate, etc., were studied with local anesthetics and their isomers...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29284845/comparison-of-efficacy-of-oral-versus-regional-clonidine-for-postoperative-analgesia-following-ilioinguinal-iliohypogastric-block-in-children-a-prospective-randomized-double-blinded-placebo-controlled-study
#12
Arijit Sardar, Ganga Prasad, Mahesh Kumar Arora, Lokesh Kashyap
Background: Clonidine improves quality and prolongs the duration of analgesia in ilioinguinal/iliohypogastric nerve block when given along with local anesthetic and as well as premedication. The objective of this study was to compare the efficacy of oral and regional clonidine for postoperative analgesia in pediatric population after ilioinguinal/iliohypogastric block. Materials and Methods: Sixty children aged between 1 and 8 years scheduled for elective hernia surgery were randomly allocated to three groups...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29284837/to-compare-the-effects-of-different-doses-of-dexmedetomidine-on-intrathecal-bupivacaine-in-infraumbilical-surgeries-a-prospective-randomized-double-blind-clinical-study
#13
Shashikala Thuraganur Kapinegowda, Tejesh Channasandra Anandswamy, Vijaya Hanumanthappa Narayanappa, Sachin Kumar, Prashant Hatti
Introduction: Spinal anesthesia is preferred technique of choice in infraumbalical surgeries. Limitation of this technique is shorter duration of analgesia, so various adjuvants have been used with intrathecal bupivacaine such as fentanyl, clonidine, and dexmedetomidine. Dexmedetomidine is a highly selective alpha 2 adrenergic agonist. The aim of our study was to know the effect of different doses of dexmedetomidine on intrathecal bupivacaine. Materials and Methods: The prospective, randomized, double-blind study was conducted in tertiary health care center, on ninety patients of the American Society of Anesthesiology Class I and II, of age group 18-60 years of either sex...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29284510/the-napressim-trial-the-use-of-low-dose-prophylactic-naloxone-infusion-to-prevent-respiratory-depression-with-intrathecally-administered-morphine-in-elective-hepatobiliary-surgery-a-study-protocol-and-statistical-analysis-plan-for-a-randomised-controlled-trial
#14
David Cosgrave, Marie Galligan, Era Soukhin, Victoria McMullan, Siobhan McGuinness, Anand Puttappa, Niamh Conlon, John Boylan, Rabia Hussain, Peter Doran, Alistair Nichol
BACKGROUND: Intrathecally administered morphine is effective as part of a postoperative analgesia regimen following major hepatopancreaticobiliary surgery. However, the potential for postoperative respiratory depression at the doses required for effective analgesia currently limits its clinical use. The use of a low-dose, prophylactic naloxone infusion following intrathecally administered morphine may significantly reduce postoperative respiratory depression. The NAPRESSIM trial aims to answer this question...
December 29, 2017: Trials
https://www.readbyqxmd.com/read/29276277/impact-of-developing-adult-ketamine-order-panels-for-the-emergency-department
#15
Haley Baird, Rachel Rumbarger
Background: Ketamine in adults has been identified as a safe and effective alternative for multiple indications, each with specific evidence-based dosing ranges. Emergency department (ED) providers are tasked with appropriate ordering of ketamine. A multi-institutional retrospective analysis within EDs at a large health system from November 2013 to October 2015 reviewed ED adult ketamine prescribing patterns for procedural sedation (PS), rapid sequence intubation (RSI), and analgesia. Retrospective cohort results revealed 56% (84 of 150) of PS, 64% (16 of 25) of RSI, and 81...
July 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/29275138/does-a-history-of-psychoactive-substances-abuse-play-a-role-in-the-level-of-pain-of-the-patient-with-severe-trauma
#16
C López-López, A Arranz-Esteban, M V Martinez-Ureta, M C Sánchez-Rascón, C Morales-Sánchez, M Chico-Fernández
OBJECTIVE: To analyse the influence of psychotropic substance use on the level of pain in patients with severe trauma. DESIGN: Longitudinal analytical study. SCOPE: Intensive Care Unit (ICU) of Trauma and Emergencies. PATIENTS: severe trauma, non-communicative and mechanical ventilation >48hours. Two groups of patients were created: users and non-users of psychotropic substances according to medical records. INTERVENTIONS: Measurement of pain level at baseline and during mobilization, using the Pain Indicator Behaviour Scale...
December 20, 2017: Enfermería Intensiva
https://www.readbyqxmd.com/read/29274594/prospective-cohort-study-on-noise-levels-in-a-pediatric-cardiac-intensive-care-unit
#17
Gonzalo Garcia Guerra, Ari R Joffe, Cathy Sheppard, Jodie Pugh, Elham Khodayari Moez, Irina A Dinu, Hsing Jou, Lisa Hartling, Sunita Vohra
No abstract text is available yet for this article.
December 14, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29247274/procedural-sedation-and-analgesia-practices-by-emergency-physicians-in-the-netherlands-a-nationwide-survey
#18
Maybritt I Kuypers, Gaël J P Smits, Suzanne C Valkenet, Wendy A M H Thijssen, Frans B Plötz
BACKGROUND: Several efforts have been made to assure and to improve the quality of procedural sedation and analgesia (PSA) performed by emergency physicians (EPs) in The Netherlands. This study investigated the current PSA practice and competences of EPs in both adult and paediatric patients. In particular, if residency and current training, awareness of guidelines is sufficient for registered EPs to adequately perform PSA and if the availability of both adult and paediatric PSA in the ED is adequate...
December 15, 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29246707/reprint-of-efficacy-and-safety-of-different-doses-of-dezocine-for-preemptive-analgesia-in-gynecological-laparoscopic-surgeries-a-prospective-double-blind-and-randomized-controlled-clinical-trial
#19
Meiyan Zhou, Liwei Wang, Congyou Wu, Li Yan, Rongguo Wang, Bin Sun, Jianhua Wang
BACKGROUND: The incidence of reproductive system tumors in Chinese females is increasing year by year, with the trend of younger onset ages. Laparoscopic surgery has been recognized by the majority of medical staff and patients, but the postoperative pain still exists. Therefore, it has become the focus of attention of medical workers to take effective analgesia measures to alleviate postoperative pain as well as to improve the degree of comfort and satisfaction for the patients. OBJECTIVES: The research objective was to study the effect of different doses of dezocine preemptive analgesia on the safety and the pain post laparoscopic surgeries, in order to explore the best dose of dezocine for postoperative analgesia in gynecological laparoscopic surgeries...
December 12, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/29245985/effect-of-dexmedetomidine-infusion-for-intravenous-patient-controlled-analgesia-on-the-quality-of-recovery-after-laparotomy-surgery
#20
Juan Xin, Yabing Zhang, Leng Zhou, Fei Liu, Xiaoshuang Zhou, Bin Liu, Qian Li
Background: The Quality of Recovery-15 (QoR-15) is a patient-centered questionnaire to evaluate the recovery after surgery and anesthesia. Dexmedetomidine has sedative, analgesic, antiinflammatory and inhibitory sympathetic effects, which may contribute to early recovery. We hypothesized dexmedetomidine added to intravenous patient-controlled analgesia (PCA) could enhance the quality of recovery (QoR) in patients undergoing laparotomy surgery. Methods: In this randomized, double-blind, controlled study, 100 patients undergoing laparotomy surgery were randomly allocated into two groups: Dexmedetomidine (group D) and control (group S)...
November 21, 2017: Oncotarget
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