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endoscopic procedures and sedation

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https://www.readbyqxmd.com/read/29689257/use-of-diphenhydramine-as-an-adjunctive-sedative-for-colonoscopy-in-patients-on-chronic-opioid-therapy-a-randomized-controlled-trial
#1
Salman Nusrat, Mohammed F Madhoun, William M Tierney
BACKGROUND AND AIMS: Chronic opioid use increases tolerance to sedatives. Diphenhydramine is recommended for difficult-to-sedate patients during endoscopic procedures. We hypothesized that the addition of diphenhydramine to midazolam and fentanyl would improve objective and subjective measures of procedural sedation. METHODS: This randomized, double-blind, placebo-controlled trial included patients on chronic opioids undergoing colonoscopy. Patients were randomized to receive intravenous 50 mg of diphenhydramine (N=61) or placebo (N=58), in addition to fentanyl and midazolam...
April 21, 2018: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29679692/impact-of-fellowship-training-level-on-colonoscopy-quality-and-efficiency-metrics
#2
Hussein Bitar, Hassaan Zia, Muhammad Bashir, Pratyusha Parava, Muhammad Hanafi, William Tierney, Mohammad Madhoun
BACKGROUND & AIMS: Previous studies have described variable effects of fellow involvement on the adenoma detection rate (ADR), but few have stratified this effect by level of training. We aimed to evaluate the "fellow effect" on multiple procedural metrics including a newly defined adenoma management efficiency index, which may have a role in documenting colonoscopy proficiency for trainees. We also describe the impact of level of training on moderate sedation use. METHODS: We performed a retrospective review of 2024 patients (mean age 60...
April 18, 2018: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29620412/me-the-intruder-revisited-and-rethought
#3
Sarbelio Rodríguez Muñoz, Maria Ataz Orihuela, Beatriz Arberas Díez
I have read Dr. Luzón's article (1) and have shared his opinions for a long time. As I indicated in my letter 13 years ago (2), all of our patients need to receive adequate sedation in endoscopic explorations, including ERCP. It is also our obligation as the person responsible for the procedure, to ensure that this is so. At present and without renouncing any of my beliefs, I think it is necessary to ask ourselves several questions:  .
April 2018: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/29620410/sedation-assisted-by-an-endoscopist-sae-for-complex-endoscopic-procedures-is-it-time-to-change-the-current-guidelines
#4
Pablo Hernán Ocaña
Currently, sedation in endoscopic procedures is considered a necessary condition and a criterion of quality in digestive endoscopy. The role of SAE in conventional endoscopic procedures is clearly established in clinical guidelines, but this is not so clear in complex endoscopic procedures, such as ERCP. In recent years, numerous studies have been published, with results similar to those noticed in this article, endorsing the safety, efficacy and efficiency of SAE, when performed by properly trained staff.
April 2018: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/29620407/enhancing-the-current-evidence-on-endoscopist-directed-propofol-based-sedation
#5
Enrique Pérez-Cuadrado-Robles, Alexandre Ferreira, Jesús García-Cano
During the last years, there is more and more scientific evidence about the safety and feasibility of non-anesthesiologist administration of propofol (NAAP) in gastrointestinal endoscopy, reducing sedation induction and recovery time as well as increasing patient and endoscopist satisfaction. Furthermore, a similar risk of adverse events compared with traditional agents or anesthesiologist administration of propofol (AAP) has been described. The present special issue of the Spanish Journal of Gastroenterology (Revista Española de Enfermedades Digestivas) focusses on NAAP in different settings, including complex endoscopic procedures...
April 2018: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/29611112/sedation-practices-in-gastrointestinal-endoscopy-a-survey-from-southern-india
#6
Prakash Zacharias, Shibi Mathew, John Mathews, Aby Somu, Maya Peethambaran, Menon Prashanth, Mathew Philip
Gastrointestinal endoscopies can cause an unpleasant experience for the patient. In India, most endoscopists follow a common institutional policy for sedation. The aim of this study was to analyze the sedation practices in various endoscopy centers across southern India. Data were collected with the help of a structured questionnaire given to a senior endoscopist of the center. Data from the completed questionnaire were later analyzed. Data were obtained from 19 centers across southern India. All endoscopy suites had central oxygen supply and emergency cart...
April 3, 2018: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/29607394/diagnostic-adequacy-and-safety-of-endoscopic-ultrasound-guided-fine-needle-aspiration-in-patients-with-lymphadenopathy-in-a-large-cohort
#7
Rinkesh K Bansal, Narendra S Choudhary, Saurabh K Patle, Mahesh K Gupta, Chitranshu Vashishtha, Gagandeep Kaur, Haimanti Sarin, Rajesh Puri
Background and study aims : The role of endoscopic-ultrasound (EUS) guided fine-needle aspiration (FNA) in patients with lymphadenopathy in terms of diagnostic adequacy and safety in large population is not well defined. The aim of this study was to evaluate diagnostic adequacy and safety of EUS-FNA in patients with lymphadenopathy. Patients and methods:  Retrospective study from October 2010 to September 2015 at tertiary care center in Delhi-NCR. We analyzed data from 1005 EUS- FNAs of lymph nodes...
April 2018: Endoscopy International Open
https://www.readbyqxmd.com/read/29598971/-gastrointestinal-endoscopy-in-patients-of-advanced-age
#8
Ana García García de Paredes, Beatriz Mateos Muñoz, Agustín Albillos
The dramatic increase in life expectancy is leading to a significant increase in the use of gastrointestinal endoscopy in the elderly. Taking into account these demographic changes, the use of gastrointestinal endoscopy in this age group is of great importance. Although these procedures are generally safe and well tolerated even in very elderly patients, the onset of physiological changes associated with aging and the increased prevalence of cardiovascular and pulmonary comorbidities raise the risk of sedation related complications in these patients...
March 26, 2018: Revista Española de Geriatría y Gerontología
https://www.readbyqxmd.com/read/29588837/nasal-unsedated-seated-percutaneous-endoscopic-gastrostomy-nupeg-a-safe-and-effective-technique-for-percutaneous-endoscopic-gastrostomy-placement-in-high-risk-candidates
#9
Adam McCulloch, Ovishek Roy, Dunecan Massey, Rachel Hedges, Serena Skerratt, Nicola Wilson, Jeremy Woodward
Objective: Percutaneous endoscopic gastrostomy (PEG) tube placement is associated with a high risk of cardiorespiratory complications in patients with significant respiratory compromise. This study reports a case series of high-risk patients undergoing PEG placement using a modified technique-nasal unsedated seated PEG (nuPEG) placement. Design: Retrospective review of 67 patients at high risk of complications undergoing PEG placement between September 2012 and December 2016...
April 2018: Frontline Gastroenterology
https://www.readbyqxmd.com/read/29578351/endoscopy-and-sedation-an-inseparable-binomial-for-the-gastroenterologist
#10
Javier Crespo, Álvaro Terán
The development of endoscopy and its increasing demand among the population have led to a growing need for propofol-based sedation techniques. Benefit is indisputable for both patients and endoscopists, but some aspects require considering the "who" and "how" of sedation as related to safety and health care costs. Propofol is first-choice in endoscopy for the European Society of Gastrointestinal Endoscopy because of its fast onset of action and short half-life, and many reports exist on its safety when used by gastroenterologists rather than anesthesiologists...
April 2018: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/29575232/the-impact-of-narcotrend%C3%A2-eeg-guided-propofol-administration-on-the-speed-of-recovery-from-pediatric-procedural-sedation-a-randomized-controlled-trial
#11
Frank Weber, Laurence C Walhout, Johanna C Escher
BACKGROUND: Propofol is often used for procedural sedation in children undergoing gastrointestinal endoscopy. Reliable assessment of the depth of hypnosis during the endoscopic procedure is challenging. Processed electroencephalography using the Narcotrend Index can help titrating propofol to a predefined sedation level. AIMS: The aim of this trial was to investigate the impact of Narcotrend Index-guided titration of propofol delivery on the speed of recovery. METHODS: Children, aged 12-17 years, undergoing gastrointestinal endoscopy under procedural sedation, had propofol delivered via target controlled infusion either based on Narcotrend Index guidance (group NI) or standard clinical parameters (group C)...
March 25, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29539652/small-bowel-capsule-endoscopy-and-device-assisted-enteroscopy-for-diagnosis-and-treatment-of-small-bowel-disorders-european-society-of-gastrointestinal-endoscopy-esge-technical-review
#12
Emanuele Rondonotti, Cristiano Spada, Samuel Adler, Andrea May, Edward J Despott, Anastasios Koulaouzidis, Simon Panter, Dirk Domagk, Ignacio Fernandez-Urien, Gabriel Rahmi, Maria Elena Riccioni, Jeanin E van Hooft, Cesare Hassan, Marco Pennazio
SMALL-BOWEL CAPSULE ENDOSCOPY (SBCE): 1: ESGE recommends that prior to SBCE patients ingest a purgative (2 L of polyethylene glycol [PEG]) for better visualization.Strong recommendation, high quality evidence.However, the optimal timing for taking purgatives is yet to be established. 2: ESGE recommends that SBCE should be performed as an outpatient procedure if possible, since completion rates are higher in outpatients than in inpatients.Strong recommendation, moderate quality evidence...
March 14, 2018: Endoscopy
https://www.readbyqxmd.com/read/29526351/replacing-gastrostomy-tubes-with-collapsible-bumpers-in-pediatric-patients-is-it-safe-to-cut-the-tube-and-allow-the-bumper-to-pass-enterally
#13
Heather Thomas, Julia Yole, Michael H Livingston, Karen Bailey, Brian H Cameron, Lisa VanHouwelingen
PURPOSE: The "cut and push" technique for removal of percutaneous endoscopic gastrostomy (PEG) tubes with collapsible bumpers offers an alternative to the standard traction method of removal. This study compared the outcomes of these techniques. METHODS: We completed a research ethics board-approved retrospective cohort study, identifying all patients less than 18years of age who underwent PEG tube removal at a children's hospital between December 2013 and December 2016...
February 8, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29465200/-the-choice-of-tracheal-intubation-method-in-reconstructive-maxillo-facial-surgery-with-difficult-airways
#14
A Yu Zaytcev, K V Dubrovin, V A Svetlov
BACKGROUND: The development of modern video - and endoscopic equipment allows for revision and adjust to modern protocols for maintaining patency of the difficult airway, especially in maxillofacial or ENT -surgery. THE PURPOSE OF THE STUDY: Comparison the efficacy ofvarious methods of maintaining the airway patency in the practice of reconstructive maxillofacial surgery. MATERIALS AND METHODS: 89 patients, who were divided into 4 groups, were examined...
September 2017: Anesteziologiia i Reanimatologiia
https://www.readbyqxmd.com/read/29446162/endoscopic-ultrasonography-guided-transenteric-pancreatic-duct-drainage-without-cautery-for-obstructive-pancreatitis-as-a-result-of-ampullary-carcinoma
#15
Takeshi Miyata, Ken Kamata, Mamoru Takenaka
No abstract text is available yet for this article.
February 15, 2018: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/29426291/paediatric-pancreaticobiliary-endoscopy-a-21-year-experience-from-a-tertiary-hepatobiliary-centre-and-systematic-literature-review
#16
Margaret G Keane, Mayur Kumar, Natascha Cieplik, Douglas Thorburn, Gavin J Johnson, George J Webster, Michael H Chapman, Keith J Lindley, Stephen P Pereira
BACKGROUND: In adults ERCP and endoscopic ultrasound (EUS) are standard methods of evaluating and treating many hepatopancreaticobiliary (HPB) conditions. HPB disease is being diagnosed with increasing frequency in children but information about role of ERCP and EUS and their outcomes in this population remain limited. Therefore the aims of this study were to describe the paediatric ERCP and EUS experience from a large tertiary referral HPB centre, and to systematically compare outcomes with those of other published series...
February 9, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29422678/clinical-translation-of-tethered-confocal-microscopy-capsule-for-unsedated-diagnosis-of-eosinophilic-esophagitis
#17
Nima Tabatabaei, DongKyun Kang, Minkyu Kim, Tao Wu, Catriona N Grant, Mireille Rosenberg, Norman S Nishioka, Paul E Hesterberg, John Garber, Qian Yuan, Aubrey J Katz, Guillermo J Tearney
Esophagogastroduodenoscopy (EGD) is a widely used procedure, posing significant financial burden on both healthcare systems and patients. Moreover, EGD is time consuming, sometimes difficult to tolerate, and suffers from an imperfect diagnostic yield as the limited number of collected biopsies does not represent the whole organ. In this paper, we report on technological and clinical feasibility of a swallowable tethered endomicroscopy capsule, which is administered without sedation, to image large regions of esophageal and gastric mucosa at the cellular level...
February 8, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29421914/the-safety-of-deep-sedation-with-propofol-controlled-by-the-endoscopist-in-endoscopic-retrograde-cholangiopancreatography-ercp-a-prospective-study-in-a-tertiary-hospital
#18
Lara Luzón Solanas, Leticia Ollero Domenche, Eva María Sierra Moros, José Val Pérez, María Teresa Soria San Teodoro, Teresa Giménez Júlvez, Rafael Uribarrena Amezaga
INTRODUCTION: propofol administered by an endoscopist with a trained nurse has evolved as an alternative to anesthesia monitoring and is increasingly common in the routine clinical practice, even in advanced endoscopy. OBJECTIVE: to evaluate the safety of deep sedation with endoscopist-controlled propofol in patients undergoing endoscopic retrograde cholangiopancreatography (ERCP). MATERIAL AND METHODS: this was a prospective study in patients undergoing ERCP under deep sedation with propofol...
February 9, 2018: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/29397050/bronchoalveolar-lavage-for-diagnosis-of-tuberculosis-infection-in-elephants
#19
R Hermes, J Saragusty, I Moser, S Holtze, J Nieter, K Sachse, T Voracek, A Bernhard, T Bouts, F Göritz, T B Hildebrandt
Tuberculosis (TB) has been known to affect elephants for thousands of years. It was put into spotlight when few circus elephants were diagnosed carrying Mycobacterium (M.) tuberculosis. Because of the zoonotic risk and high susceptibility to M. tuberculosis, periodic testing was enacted since, in captive breeding programmes. Presently, trunk wash is the recommended diagnostic procedure for TB. Trunk wash, however, puts the operator at risk, has low sensitivity, and is prone to contamination. Here, bronchoalveolar lavage is described for the first time for TB diagnosis in elephants...
February 5, 2018: Epidemiology and Infection
https://www.readbyqxmd.com/read/29340298/efficacy-and-safety-of-sedation-during-endoscopic-submucosal-dissection-of-gastric-cancers-using-a-comparative-trial-of-propofol-versus-midazolam
#20
Hitomi Kikuchi, Takuto Hikichi, Ko Watanabe, Jun Nakamura, Tadayuki Takagi, Rei Suzuki, Mitsuru Sugimoto, Yuichi Waragai, Naoki Konno, Hiroyuki Asama, Mika Takasumi, Yuki Sato, Katsutoshi Obara, Hiromasa Ohira
Background and study aims : Proper sedation is necessary for the safe and satisfactory completion of endoscopic submucosal dissection (ESD) for early gastric cancer. This study was conducted as a comparative trial of efficacy and safety, comparing propofol-based sedation and midazolam-based sedation during ESD of early gastric cancer patients. Patients and methods : This study examined 64 lesions in 58 patients treated using ESD with midazolam plus pentazocine between July 2013 and January 2014 (group M) and 237 lesions in 216 patients treated by ESD using propofol plus pentazocine between February 2014 and December 2015 (group P)...
January 2018: Endoscopy International Open
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