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endoscopic procedures and sedation

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https://www.readbyqxmd.com/read/27876446/gastrostomy-tube-placement-is-safe-in-advanced-amyotrophic-lateral-sclerosis
#1
Manisha Kak, Naoum P Issa, Raymond P Roos, Bobbie Jean Sweitzer, Ori Gottlieb, Amy Guralnick, Steven R White, Carol E Semrad, Betty Soliven, Joumana Baroody, Kourosh Rezania
OBJECTIVES: To evaluate the safety and effect on survival of insertion of a gastrostomy tube (G-tube) in patients with amyotrophic lateral sclerosis (ALS) who have upright forced vital capacity (uFVC) ≤ 50% predicted. Current guidelines, which are based on higher rates of post-procedure complications in ALS patients with advanced respiratory dysfunction, have led to a recommendation to perform G-tube insertion before the FVC drops to <50% predicted, even when the patient has no significant dysphagia...
November 23, 2016: Neurological Research
https://www.readbyqxmd.com/read/27853681/sedative-and-analgesic-effects-of-propofol-fentanyl-versus-propofol-ketamine-during-endoscopic-retrograde-cholangiopancreatography-a-double-blind-randomized-clinical-trial
#2
Fakhroddin Bahrami Gorji, Parviz Amri, Javad Shokri, Hakimeh Alereza, Ali Bijani
BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) is a painful procedure that requires analgesia and sedation. OBJECTIVES: In this study, we compared the analgesic and sedative effects of propofol-ketamine versus propofol-fentanyl in patients undergoing ERCP. METHODS: In this clinical trial, 72 patients, aged 30 - 70 years old, who were candidates for ERCP were randomly divided into two groups. Before the start of ERCP, both groups received midazolam 0...
October 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/27821023/conscious-sedation-clues-for-diagnosing-obstructive-sleep-apnea-syndrome
#3
G K Unler, H S Gokturk, R Dogan, T Kivane, A Karakoca
BACKGROUND: The use of anesthetic agents for endoscopic sedation has recently increased. However, sedation introduces additional risks in patients with obstructive sleep apnea syndrome (OSAS). The presence of sleep apnea is not often enough questioned in clinical practice. The purpose of this study was to determine whether patients with sedation-induced snoring and decreased arterial oxygen saturation during gastroscopy are more likely to have OSAS. METHOD: This study considered 600 consecutive patients undergoing elective outpatient upper gastrointestinal endoscopy under conscious sedation for evaluation of dyspepsia...
July 2016: Acta Gastro-enterologica Belgica
https://www.readbyqxmd.com/read/27809769/retrospective-analysis-of-management-of-ingested-foreign-bodies-and-food-impactions-in-emergency-endoscopic-setting-in-adults
#4
Girolamo Geraci, Carmelo Sciume', Giovanni Di Carlo, Antonino Picciurro, Giuseppe Modica
BACKGROUND: Ingestion of foreign bodies and food impaction represent the second most common endoscopic emergency after bleeding. The aim of this paper is to report the management and the outcomes in 67 patients admitted for suspected ingestion of foreign body between December 2012 and December 2014. METHODS: This retrospective study was conducted at Palermo University Hospitals, Italy, over a 2-year period. We reviewed patients' database (age, sex, type of foreign body and its anatomical location, treatments, and outcomes as complications, success rates, and mortalities)...
November 4, 2016: BMC Emergency Medicine
https://www.readbyqxmd.com/read/27756140/in-response-to-the-editorial-sedation-in-endoscopy-in-2016-is-it-safe-sedation-with-propofol-led-by-the-endoscopist-in-complex-situations
#5
Manuel de la Matta
It is universally accepted that deep sedation involves more risks than light-to-moderate sedation. Deep sedation for endoscopic explorations is normally provided by anesthesiologists in Spain and in most countries of the European Unión. The present debate about deep sedation-anesthesia states goes beyond the topic of cardiovascular and respiratory adverse events, and targets the cognitive consequences and global increased mortality of uncontrolled sedation states, especially in specific fragile populations...
October 19, 2016: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/27743126/patient-satisfaction-after-endoscopic-submucosal-dissection-under-propofol-based-sedation-a-small-premedication-makes-all-the-difference
#6
Seokyung Shin, Chan Hyuk Park, Hyun Ju Kim, Sang Hun Park, Sang Kil Lee, Young Chul Yoo
BACKGROUND: Ideal sedation for endoscopic submucosal dissection (ESD) aims to satisfy both the endoscopist and patient. However, previous studies show that a satisfactory procedure for the endoscopist does not equal higher patient satisfaction. This study attempted to find a sedation protocol that is able to increase patient satisfaction during propofol-based sedation by adding low-dose midazolam as premedication. METHODS: Seventy-two adult patients were randomly allocated to receive either 0...
October 14, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27738652/sedation-for-percutaneous-endoscopic-lumbar-discectomy
#7
Menekse Oksar
Although anesthetic requirements for minimally invasive neurosurgical techniques have been described in detail and applied successfully since the early 2000s, most of the literature on this subject has dealt with cranial cases that were operated on in the supine or sitting positions. However, spinal surgery has also used minimally invasive techniques that were performed in prone position for more than 30 years to date. Although procedures in both these neurosurgical techniques require the patient to be awake for a certain period of time, the main surgical difference with minimally invasive spinal surgery is that the patients are in the prone position, which may result in increased requirement of airway management because of deep sedation...
2016: TheScientificWorldJournal
https://www.readbyqxmd.com/read/27716069/should-every-region-use-the-same-gastric-cancer-scanning-and-treatment-approaches-let-s-reconsider-a-northeastern-turkey-example
#8
Albayrak Fatih, Ozturk Yasin, Dursun Hakan, Albayrak Yavuz
BACKGROUND: The rate for upper gastrointestinal (UGI) cancers, and especially the rate for gastric cancer, varies from country to country and from region to region within country. In Turkey, the incidence of gastric cancer varies widely among regions due to the diverse cultures and accompanying food habits of the population. This study aimed to determine the endoscopic frequency of esophageal and gastric cancers and the usefulness of alarm symptoms in diagnosing gastric cancer in subjects undergoing endoscopy in northeastern Turkey...
October 4, 2016: BMC Gastroenterology
https://www.readbyqxmd.com/read/27705012/how-patient-controlled-sedation-is-adopted-in-clinical-practice-of-sedation-for-endoscopic-retrograde-cholangiopancreatography-a-prospective-study-of-1196-cases
#9
Jarno Jokelainen, Marianne Udd, Leena Kylänpää, Harri Mustonen, Jorma Halttunen, Outi Lindström, Reino Pöyhiä
OBJECTIVE: Patient controlled sedation (PCS) has been shown to be a valid choice for sedation during endoscopic retrograde cholangiopancreatography (ERCP) in randomized studies. However, large scale studies are lacking. MATERIAL AND METHODS: A single center, prospective observational study to determine how sedation for ERCP is administered in clinical setting. All 956 patients undergoing 1196 ERCPs in the endoscopy unit of Helsinki University Central Hospital 2012-2013, methods of sedation and adverse events associated with different sedations were recorded...
October 5, 2016: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/27700181/laparoscopic-assisted-percutaneous-endoscopic-gastrostomy-combined-with-ct-gc
#10
Kazuya Kato, Yoshiaki Iwasaki, Kazuhiko Onodera, Minoru Matsuda, Mineko Higuchi, Kimitaka Kato, Yurina Kato, Masahiko Taniguchi, Hiroyuki Furukawa
PURPOSE: Despite the widespread use of percutaneous endoscopic gastrostomy (PEG) tubes, their placement may be associated with a variety of complications, including gastrocolic fistula. MATERIALS AND METHODS: In total, seven high-risk individuals diagnosed using computed tomography (CT)-gastrocolonography (GC) underwent laparoscopic-assisted PEG (LAPEG) placement. Study endpoints included the success of LAPEG under local anesthetic and intravenous sedation, inability to thread the PEG tube, the eventual tube location, the number of tube adjustments needed, adverse events, the operating time, and PEG tube-related infection...
October 4, 2016: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/27676687/proposed-medicare-physician-payment-schedule-for-2017-impact-on-interventional-pain-management-practices
#11
Laxmaiah Manchikanti, Alan D Kaye, Joshua A Hirsch
The Centers for Medicare and Medicaid Services (CMS) released the proposed 2017 Medicare physician fee schedule on July 7, 2016, addressing Medicare payments for physicians providing services either in an office or facility setting, which also includes payments for office expenses and quality provisions for physicians. This proposed rule occurs in the context of numerous policy changes, most notably related to the Medicare Access & CHIP Reauthorization Act of 2015 (MACRA) and its Merit-Based Incentive Payment System (MIPS)...
September 2016: Pain Physician
https://www.readbyqxmd.com/read/27676093/a-comparison-of-sedation-with-midazolam-ketamine-versus-propofol-fentanyl-during-endoscopy-in-children-a-randomized-trial
#12
Ulas E Akbulut, Sedat Saylan, Bilal Sengu, Gulgun E Akcali, Engin Erturk, Murat Cakir
PURPOSE: We aimed to compare the efficacy and safety of midazolam plus ketamine versus fentanyl plus propofol combination administered to children undergoing upper gastrointestinal endoscopy (UGE) and to determine the most appropriate sedation protocol. MATERIALS AND METHODS: This prospective, randomized, single-blind study included patients between the ages of 4 and 17 years who underwent UGE for diagnostic purposes. Patients were divided randomly into groups A (midazolam-ketamine combination, n=119) and B (fentanyl plus propofol combination, n=119)...
January 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27631316/impact-of-responsive-insertion-technology-rit-on-reducing-discomfort-during-colonoscopy-randomized-clinical-trial
#13
Artur Pasternak, Miroslaw Szura, Rafal Solecki, Maciej Matyja, Antoni Szczepanik, Andrzej Matyja
BACKGROUND: In many countries, colonoscopies for colorectal cancer screening are performed without sedation due to the cost. Changes in the structure of the endoscopes are designed to facilitate the colonoscopic examination, reduce the duration of the procedure, and improve the imaging of the intestinal lumen. The variable stiffness of the endoscope and the recently introduced responsive insertion technology (RIT) are features aimed at easing colonoscope insertion and reducing the discomfort and pain during the examination...
September 8, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27588290/interfaces-in-pediatric-gastrointestinal-endoscopy-who-should-do-it
#14
REVIEW
Thomas Lang
BACKGROUND: Gastrointestinal endoscopy is one of the most frequently performed diagnostic and therapeutic procedures in children nowadays. METHODS: Since the size of endoscopes has been adapted to pediatric patients, endoscopic procedures are performed almost routinely in pediatric gastrointestinal patients. However, this is an invasive procedure done under deep sedation, and procedure-related or sedation-related complications can occur more easily in pediatric patients...
February 2016: Visceral Medicine
https://www.readbyqxmd.com/read/27569734/sedation-and-use-of-analgesics-in-endoscopic-retrograde-cholangiopancreatography-a-double-blind-comparison-study-of-meperidine-midazolam-remifentanil-midazolam-and-remifentanil-alone
#15
Jinhua Zhang, Yong Huang, Zhao Li, Jian Li, Kunpeng Liu, Chenghui Li
PURPOSE: To compare the efficacy and remifentanil with midazolam for conscious sedation during endoscopic retrograde cholangiopancreatography (ERCP). METHODS: 99 patients scheduled for ERCP were randomly allocated to be treated with either meperidine/midazolam (group C, n = 33), remifentanil (group R, n = 33), or the remifentanil plus midazolam (group RM, n = 33). In group C, intermittent intravenous meperidine and midazolam were administrated during the procedure; in group R, remifentanil was infused continuously at a rate of 0...
November 2016: International Journal of Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/27456180/survey-of-anaesthetists-practice-of-sedation-for-gastrointestinal-endoscopy
#16
K Leslie, M L Allen, E Hessian, A Y-S Lee
We conducted a survey of Australian specialist anaesthetists about their practice of sedation for elective and emergency gastroscopy, endoscopic retrograde cholangiopancreatography (ERCP), and colonoscopy. A 24-item survey was emailed to 1,000 anaesthetists in August 2015. Responses were received from 409 anaesthetists (response rate=41%) with responses from 395 anaesthetists analysed. Pulse oximetry and oxygen administration were routine for all procedures for all respondents. Blood pressure was routinely measured by most respondents during gastroscopy (elective=88%; emergency=97%), ERCP (elective=99%; emergency=99%) and colonoscopy (elective=91%; emergency=98%)...
July 2016: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/27451091/similar-risk-of-cardiopulmonary-adverse-events-between-propofol-and-traditional-anesthesia-for-gastrointestinal-endoscopy-a-systematic-review-and-meta-analysis
#17
Vaibhav Wadhwa, Danny Issa, Sushil Garg, Rocio Lopez, Madhusudhan R Sanaka, John J Vargo
BACKGROUND & AIMS: Even though propofol use for gastrointestinal endoscopic procedures has increased over the past decade, there is a perception that it causes a higher rate of cardiopulmonary adverse events. The aim of this study was to compare the sedation-related adverse events associated with use of propofol vs nonpropofol agents for endoscopic procedures. We also wanted to determine the influence of duration or complexity of the procedures and endoscopist-directed (gastroenterologist) vs non-gastroenterologist-directed sedation on the outcomes...
July 21, 2016: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/27441684/magnetic-endoscope-imaging-for-routine-colonoscopy-impact-on-propofol-dosage-and-patient-safety-a-randomized-trial
#18
Peter Klare, Bonnie Hartrampf, Bernhard Haller, Christoph Schlag, Fabian Geisler, Mohamed Abdelhafez, Henrik Einwächter, Monther Bajbouj, Roland M Schmid, Stefan von Delius
BACKGROUND AND STUDY AIM: The use of magnetic endoscope imaging (MEI) has been previously shown to facilitate colonoscopy procedures. We aimed to evaluate the benefits of MEI in terms of reduction in propofol dosage in patients undergoing routine colonoscopy. METHODS: We conducted a randomized prospective trial in a university hospital in Germany. Endoscopists were randomly assigned 1:1 to use MEI during colonoscopy (MEI arm) or to conduct colonoscopy without the use of MEI (standard arm)...
October 2016: Endoscopy
https://www.readbyqxmd.com/read/27439348/use-of-a-laparoscopic-specimen-retrieval-pouch-to-facilitate-removal-of-intact-or-fragmented-cystic-calculi-from-standing-sedated-horses-8-cases-2012-2015
#19
Scott A Katzman, Betsy Vaughan, Jorge E Nieto, Larry D Galuppo
OBJECTIVE To evaluate the use of a laparoscopic specimen retrieval pouch for removal of intact or fragmented cystic calculi from standing horses. DESIGN Retrospective case series. ANIMALS 8 horses (5 geldings and 3 mares) with cystic calculi. PROCEDURES Physical examination and cystoscopic, ultrasonographic, and hematologic evaluations of urinary tract function were performed for each horse. A diagnosis of cystic calculus was made on the basis of results of cystoscopy and ultrasonography. Concurrent urolithiasis or other urinary tract abnormalities identified during preoperative evaluation were recorded...
August 1, 2016: Journal of the American Veterinary Medical Association
https://www.readbyqxmd.com/read/27416044/emerging-biomarkers-for-the-diagnosis-and-monitoring-of-inflammatory-bowel-diseases
#20
Anet A Soubières, Andrew Poullis
There is currently no single test available to confidently diagnose cases of inflammatory bowel disease (IBD). Physicians rely on a number of diagnostic tools, including clinical evaluation, serum testing, and imaging, which are used on conjunction with endoscopic evaluation. It is often difficult to determine whether patients with abdominal pain and change in bowel habit have functional bowel symptoms or whether they have a true diagnosis of IBD. Even once a diagnosis of IBD has been made, a significant proportion of patients are labeled with the term "indeterminate colitis" where histological sampling cannot confidently subclassify patients as either Crohn's or ulcerative colitis...
August 2016: Inflammatory Bowel Diseases
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