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https://www.readbyqxmd.com/read/28625245/-effects-of-different-sedation-regimens-on-sedation-and-inflammatory-response-in-critically-ill-children-with-multiple-trauma
#1
Wenjia Tong, Conglei Song, Danqun Jin, Jingmin Sun, Yating Wang, Daliang Xu
OBJECTIVE: To compare the sedation and anti-inflammatory effects of dexmedetomidine and midazolam on critical ill children with multiple trauma. METHODS: A prospective randomized controlled trial was conducted. Sixty-five critical ill children with multiple trauma admitted to pediatric intensive care unit (PICU) of Anhui Province Children's Hospital from January 2014 to September 2016 were enrolled, who were randomly divided into dexmedetomidine group (33 cases) and midazolam group (32 cases)...
June 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28620949/nonintravenous-rescue-medications-for-pediatric-status-epilepticus-a-cost-effectiveness-analysis
#2
Iván Sánchez Fernández, Marina Gaínza-Lein, Tobias Loddenkemper
OBJECTIVE: To quantify the cost-effectiveness of rescue medications for pediatric status epilepticus: rectal diazepam, nasal midazolam, buccal midazolam, intramuscular midazolam, and nasal lorazepam. METHODS: Decision analysis model populated with effectiveness data from the literature and cost data from publicly available market prices. The primary outcome was cost per seizure stopped ($/SS). One-way sensitivity analyses and second-order Monte Carlo simulations evaluated the robustness of the results across wide variations of the input parameters...
June 16, 2017: Epilepsia
https://www.readbyqxmd.com/read/28620924/childhood-preoperative-anxiolysis-is-sedation-and-distraction-better-than-either-alone-a-prospective-randomized-study
#3
Chrystelle Sola, Audrey Lefauconnier, Sophie Bringuier, Olivier Raux, Xavier Capdevila, Christophe Dadure
BACKGROUND: Preoperative anxiety management receives special attention in pediatric anesthesia. Different pharmacological and nonpharmacological techniques can be employed. This study was designed to assess three different strategies for childhood preoperative anxiolysis: midazolam premedication, midazolam in combination with portable Digital Video-Disk player, or video distraction strategy alone. METHODS: In this prospective randomized study, children aged 2-12 years were assigned to one of the three study groups...
June 16, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28615640/differential-depression-of-neuronal-network-activity-by-midazolam-and-its-main-metabolite-1-hydroxymidazolam-in-cultured-neocortical-slices
#4
Monika Balk, Harald Hentschke, Uwe Rudolph, Bernd Antkowiak, Berthold Drexler
The benzodiazepine midazolam is widely used in critical care medicine. Midazolam has a clinically active metabolite, 1-hydroxymidazolam. The contribution of 1-hydroxymidazolam to the effects of midazolam is controversial. The aim of the current study was to compare the actions of midazolam and 1-hydroxymidazolam on network activity of cortical neurons. Midazolam depressed neuronal activity at a low concentration of 5 nM. When midazolam concentration was increased, it depressed neuronal discharge rates in a biphasic manner...
June 14, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28609332/the-use-of-intranasal-dexmedetomidine-and-midazolam-for-sedated-magnetic-resonance-imaging-in-children-a-report-from-the-pediatric-sedation-research-consortium
#5
Carmen Sulton, Pradip Kamat, Michael Mallory, Jason Reynolds
OBJECTIVE: The objective of this study was to describe the use of intranasal dexmedetomidine (IN DEX) for sedated magnetic resonance imaging (MRI) examinations in children. The use of IN DEX for MRI in children has not been well described in the literature. MATERIALS AND METHODS: The Pediatric Sedation Research Consortium (PSRC) is a collaborative and multidisciplinary group of sedation practitioners dedicated to understanding and improving the process of pediatric sedation...
June 12, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28604098/nitrous-oxide-and-midazolam-sedation-a-systematic-review-and-meta-analysis
#6
Gowri Sivaramakrishnan, Kannan Sridharan
Nitrous oxide and midazolam have been used as sedative agents to decrease fear and anxiety associated with dental procedures. Although these agents have been widely used individually, the combination of the two is also commonly used. Four clinical trials were identified that compared the combination technique with the individual use of the drugs. The standardized mean difference (SMD) for each outcome measure was considered for final analysis. Three studies with 534 participants were included in the final meta-analysis, and the SMD [95% CI] was obtained as -0...
2017: Anesthesia Progress
https://www.readbyqxmd.com/read/28604093/safety-and-efficacy-of-3-pediatric-midazolam-moderate-sedation-regimens
#7
Rachel Gentz, Paul Casamassimo, Homa Amini, Dan Claman, Megann Smiley
Our aim was to characterize effectiveness and complications in children receiving oral midazolam alone, nasal midazolam alone, or oral midazolam with other sedatives. Children received oral midazolam alone, nasal midazolam, or oral midazolam in combination with other sedative medications. All subjects received a presedation history and physical examination and were sedated per protocol by any of 28 resident providers under attending supervision. Sedations were rated for success and complications by clinicians...
2017: Anesthesia Progress
https://www.readbyqxmd.com/read/28604090/anesthetic-management-of-a-patient-with-multiple-sclerosis
#8
Naohiro Ohshita, Shoko Gamoh, Masahiko Kanazumi, Masahiro Nakajima, Yoshihiro Momota, Yasuo M Tsutsumi
A 54-year-old woman diagnosed with multiple sclerosis (MS) at the age of 19 years was scheduled to undergo temporomandibular joint mobilization. She was currently in a remission phase from her MS but with persistent sequelae, including impaired eyesight and muscle weakness of the limbs. In addition, the blood vessels in her upper limbs were compromised by the formation of internal shunts secondary to vascular prosthesis replacements for plasma exchange therapy in MS. After a previous joint mobilization surgery, her temporomandibular joint developed adhesions with resultant trismus...
2017: Anesthesia Progress
https://www.readbyqxmd.com/read/28597354/pharmacologic-considerations-for-pediatric-sedation-and-anesthesia-outside-the-operating-room-a-review-for-anesthesia-and-non-anesthesia-providers
#9
REVIEW
Narjeet Khurmi, Perene Patel, Molly Kraus, Terrence Trentman
Understanding the pharmacologic options for pediatric sedation outside the operating room will allow practitioners to formulate an ideal anesthetic plan, allaying anxiety and achieving optimal immobilization while ensuring rapid and efficient recovery. The authors identified relevant medical literature by searching PubMed, MEDLINE, Embase, Scopus, Web of Science, and Google Scholar databases for English language publications covering a period from 1984 to 2017. Search terms included pediatric anesthesia, pediatric sedation, non-operating room sedation, sedation safety, and pharmacology...
June 8, 2017: Paediatric Drugs
https://www.readbyqxmd.com/read/28584346/analgesic-efficacy-of-ultrasound-guided-paravertebral-block-versus-serratus-plane-block-for-modified-radical-mastectomy-a-randomised-controlled-trial
#10
Kapil Gupta, Kadapa Srikanth, Kiran Kumar Girdhar, Vincent Chan
BACKGROUND AND AIMS: Modified radical mastectomy (MRM) may be associated with severe post-operative pain, leading to chronic pain syndrome. We compared the post-operative analgesic profile of two ultrasound-guided nerve blocks: Paravertebral block (PVB) and serratus plane block (SPB). METHODS: This double-blind, randomised study was conducted on fifty adult females, scheduled for MRM with axillary dissection. After inducing general anaesthesia with intravenous midazolam 1 mg, fentanyl 1...
May 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28579345/efficacy-and-safety-of-midazolam-and-ketamine-in-paediatric-upper-endoscopy
#11
Ahmet Basturk, Reha Artan, Aygen Yılmaz
BACKGROUND AND STUDY AIM: Upper endoscopy can be successfully carried out in children under deep sedation and anaesthesia. However, the best method of upper endoscopy for children who require gastrointestinal intervention has yet to be defined. The aim of this study is to investigate the efficacy and safety of the sedation induced by intravenous midazolam and ketamine during upper endoscopy in children. PATIENTS AND METHODS: This study included patients ages 3-18years who had undergone upper endoscopy...
June 1, 2017: Arab Journal of Gastroenterology: the Official Publication of the Pan-Arab Association of Gastroenterology
https://www.readbyqxmd.com/read/28577272/a-two-way-randomized-cross-over-pharmacokinetic-and-pharmacodynamic-study-of-an-innovative-oral-solution-of-midazolam-adv6209
#12
Catherine Guittet, Maria Manso, Ingrid Burton, Luc-André Granier, Frédéric Marçon
PURPOSE: The objective of this study was to assess the bioavailability and the sedative effect of a single-dose administration of an innovative oral solution of midazolam containing γ-cyclodextrins (ADV6209). METHODS: A bioavailability study with a standard two-sequences, two-periods, and crossover design was conducted. Subjects randomly received 15 mg of ADV6209 by oral route followed by 5 mg of the reference drug (midazolam hydrochloride intravenous solution (Hypnovel®, Roche) by intravenous route or vice versa...
June 2, 2017: Pharmaceutical Research
https://www.readbyqxmd.com/read/28574956/identifying-high-alert-medications-in-a-university-hospital-by-applying-data-from-the-medication-error-reporting-system
#13
Lotta Tyynismaa, Anni Honkala, Marja Airaksinen, Kenneth Shermock, Lasse Lehtonen
OBJECTIVES: To facilitate safe use of high-alert medications, lists of medications posing higher risks for medication errors (MEs) and harmful effects have been compiled. These lists can be general or reflect clinical practices in specific settings. Less common has been to compile a hospital-specific list applying data from the organization's ME reporting system. Our objective was to demonstrate a method for compiling such a high-alert medication list in a university hospital. METHODS: Of the eighteen 136 MEs reported during 2007 to 2013, ME reports with medications coded as a contributing factor to the incident were included (n = 249)...
June 1, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28573171/topical-lidocaine-inhibits-spasm-during-colonoscopy-a-double-blind-randomized-controlled-trial-with-video
#14
Daiki Nemoto, Kenichi Utano, Noriyuki Isohata, Shungo Endo, Kensuke Kumamoto, Taka-Aki Koshimizu, Alan Lefor, Kazutomo Togashi
BACKGROUND AND STUDY AIMS:  Topical peppermint oil prevents intestinal spasm, but can cause rebound spasm. Lidocaine hydrochloride, a local anesthetic, may work as an antispasmodic by blocking Na + channels. The aim of this study was to investigate the effect of topical lidocaine on the inhibition of colonic spasm during colonoscopy, compared with peppermint oil. PATIENTS AND METHODS:  A randomized, controlled double-blind trial was conducted in an academic endoscopy unit...
June 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28571040/videolaryngoscopy-during-conscious-sedation-in-patients-not-suitable-for-phonosurgery-by-microlaryngoscopy-a-pilot-study
#15
Vincenzo Saita, Eugenia Allegra, Nicolò Marino, Serena Trapasso, Maria Concetta Monea
BACKGROUND: Microlaryngoscopy is the preferred and most widely used technique in phonosurgery for the treatment of benign and early malignant glottic lesions. However, the procedure may be technically difficult or impossible due to alterations of the cervical spine that may not allow hyperextension of the head or may present general anesthesia contraindications. The aim of this study is to evaluate the efficacy and safety of our surgical approach for lesions of the vocal folds in patients who are not suitable for phonosurgery by microlaryngoscopy...
June 2, 2017: ORL; Journal for Oto-rhino-laryngology and its related Specialties
https://www.readbyqxmd.com/read/28556259/phenobarbital-and-midazolam-increase-neonatal-seizure-associated-neuronal-injury
#16
Daniel Torolira, Lucie Suchomelova, Claude G Wasterlain, Jerome Niquet
Status Epilepticus is common in neonates and infants, and is associated with neuronal injury and adverse developmental outcomes. GABAergic drugs, the standard treatment for neonatal seizures, can have excitatory effects in the neonatal brain, which may worsen the seizures and their effects. Using a recently developed model of status epilepticus in P7 rat pups that results in widespread neuronal injury, we found that the GABAA agonists phenobarbital and midazolam significantly increased Status Epilepticus-associated neuronal injury in various brain regions...
May 26, 2017: Annals of Neurology
https://www.readbyqxmd.com/read/28551062/-alternative-approach-to-autonomic-instability-of-very-severe-tetanus-stellate-ganglion
#17
Başak Altıparmak, Ali İhsan Uysal, Eylem Yaşar, Semra Demirbilek
Tetanus is an acute and deadly disease caused by Clostridium tetani. A 60-year-old male came to hospital after he injured his thumb with a knife. Ten days later, he returned to hospital with abdominal spasms. He was vaccinated against tetanus and referred to intensive care unit. As he had sudden difficulty in respiration, he was entubated. Midazolam, magnesium and esmolol infusion were started. Next day, muscle spasms progressed all over his body. Midazolam infusion was replaced with propofol and vecuronium...
May 24, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28544992/pharmacokinetics-pharmacodynamics-and-tolerability-of-usl261-midazolam-nasal-spray-randomized-study-in-healthy-geriatric-and-non-geriatric-adults
#18
Alexander K Berg, Michael J Myrvik, Peter J Van Ess
AIM: Characterize pharmacokinetics, pharmacodynamics, and safety/tolerability of USL261 in geriatric adults to inform its potential for treating bouts of increased seizure activity. METHODS: Phase 1, randomized, double-blind, 2-way crossover study in healthy geriatric (≥65years; n=18) and non-geriatric (18-40years; n=12) adults evaluated single USL261 doses (2.5 and 5.0mg) administered intranasally. Pharmacokinetic parameters were estimated for midazolam and 1-hydroxymidazolam (active metabolite), including area under the plasma concentration-time curve (AUC), maximum plasma concentration (Cmax), time to Cmax (Tmax), and half-life (t1/2)...
June 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28543780/intranasal-midazolam-versus-rectal-diazepam-for-the-management-of-canine-status-epilepticus-a-multicenter-randomized-parallel-group-clinical-trial
#19
M Charalambous, S F M Bhatti, L Van Ham, S Platt, N D Jeffery, A Tipold, J Siedenburg, H A Volk, D Hasegawa, A Gallucci, G Gandini, M Musteata, E Ives, A E Vanhaesebrouck
BACKGROUND: Intranasal administration of benzodiazepines has shown superiority over rectal administration for terminating emergency epileptic seizures in human trials. No such clinical trials have been performed in dogs. OBJECTIVE: To evaluate the clinical efficacy of intranasal midazolam (IN-MDZ), via a mucosal atomization device, as a first-line management option for canine status epilepticus and compare it to rectal administration of diazepam (R-DZP) for controlling status epilepticus before intravenous access is available...
May 24, 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/28540436/premedication-with-melatonin-vs-midazolam-efficacy-on-anxiety-and-compliance-in-paediatric-surgical-patients
#20
Pietro Impellizzeri, Enrica Vinci, Maria Cristina Gugliandolo, Francesca Cuzzocrea, Rosalba Larcan, Tiziana Russo, Maria Rosaria Gravina, Salvatore Arena, Gabriella D'Angelo, Eloisa Gitto, Angela Simona Montalto, Angela Alibrandi, Lucia Marseglia, Carmelo Romeo
Preoperative anxiety is a major problem in paediatric surgical patients. Melatonin has been used as a premedicant agent and data regarding effectiveness are controversial. The primary outcome of this randomized clinical trial was to evaluate the effectiveness of oral melatonin premedication, in comparison to midazolam, in reducing preoperative anxiety in children undergoing elective surgery. As secondary outcome, compliance to intravenous induction anaesthesia was assessed. There were 80 children undergoing surgery randomly assigned, 40 per group, to receive oral midazolam (0...
May 24, 2017: European Journal of Pediatrics
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