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endoscopic procedures and sedation

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https://www.readbyqxmd.com/read/29046107/determinants-of-endotracheal-intubation-in-critically-ill-patients-undergoing-gastrointestinal-endoscopy-under-conscious-sedation
#1
Nathan J Smischney, Mohamed O Seisa, Mukesh Kumar, Jillian Deangelis, Darrell R Schroeder, Daniel A Diedrich
OBJECTIVES: Our primary aim was to determine the factors leading to prophylactic endotracheal intubation in intensive care unit (ICU) patients undergoing gastrointestinal endoscopy. Secondary aims were to determine the rate of unplanned endotracheal intubations during endoscopy and to determine the rate of aspiration following endoscopy for patients admitted to the ICU. METHODS: Critically ill adult (≥18 years) patients who underwent upper and lower endoscopic procedures from January 2012 to July 2016 in a medical/surgical ICU were included...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29043476/drug-induced-sedation-endoscopy-dise-data-fusion-system-clinical-feasibility-study
#2
Esuabom Dijemeni, Bhik Kotecha
Drug-induced sleep endoscopy (DISE) is a diagnostic technique for 3D dynamic anatomical visualisation of upper airway obstruction during sedated sleep. There is a lack of standardised procedure and objective measurement associated with information capture, information management, evaluation of DISE findings, treatment planning, and treatment outcomes. The objective of this study is to present clinical feasibility results using a DISE DATA FUSION system for capturing, merging, displaying and storing anatomical data from an endoscopic imaging system and cardiorespiratory data from an anaesthesiological monitoring system simultaneously in real-time during DISE...
October 17, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/29020995/sedation-with-propofol-during-ercp-is-the-combination-with-esketamine-more-effective-and-safer-than-with-alfentanil-study-protocol-for-a-randomized-controlled-trial
#3
Susanne Eberl, Lena Koers, Jeanin E van Hooft, Edwin de Jong, Thomas Schneider, Markus W Hollmann, Benedikt Preckel
BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) is a gastrointestinal procedure that requires a relatively motionless patient during the intervention. Deep sedation by intravenous propofol combined with an opioid has recently become the preferred sedation technique. However, when high doses of propofol are used, side effects, namely respiratory depression, may occur. Esketamine has hypnotic, analgesic, and sympathomimetic effects. Our assumption is that a combination of propofol with esketamine reduces the dosage of individual drugs, thereby minimizing sedation side effects while keeping the same satisfaction level of patients and endoscopists...
October 11, 2017: Trials
https://www.readbyqxmd.com/read/28970289/modifiable-factors-associated-with-patient-reported-pain-during-and-after-screening-colonoscopy
#4
Marek Bugajski, Paulina Wieszczy, Geir Hoff, Maciej Rupinski, Jaroslaw Regula, Michal Filip Kaminski
OBJECTIVE: Pain associated with colonoscopy is a major burden for patients. We investigated modifiable factors associated with patient-reported pain during and after colonoscopy. DESIGN: This cross-sectional analysis included database records from 23 centres participating in a population-based colonoscopy screening programme in Poland. Colonoscopies were performed under three sedation modalities: none, benzodiazepine-opioid sedation or propofol sedation. We used Gastronet (a validated tool) to assess patients' pain during and after colonoscopy; pain was scored on a four-point scale (no, little, moderate or severe pain), with moderate to severe defined as painful...
September 28, 2017: Gut
https://www.readbyqxmd.com/read/28967732/endobronchial-ultrasound-guided-transbronchial-needle-aspiration-under-conscious-sedation-with-meperidine-and-midazolam
#5
Lorenzo Agostini, Nicola Facciolongo, Mirco Lusuardi, Eleonora Casalini, Carla Galeone, Luciano Lasagni, Luigi Zucchi
Endobronchial Ultrasound guided transbronchial needle aspiration (EBUS-TBNA) is usually performed under general anesthesia or deep sedation with drugs such as Propofol that, at least in Italy, can be administered only by an anesthesiologist. Aim of the study was to assess conscious sedation feasibility, safety and tolerability using Meperidine and Midazolam as administered by Pulmonologist and relevant impact on the efficiency of the sampling procedures.All patients undergoing EBUS-TBNA from February 2013 to July 2014 were examined retrospectively...
July 18, 2017: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/28966686/sevoflurane-may-be-more-beneficial-than-propofol-in-patients-receiving-endoscopic-variceal-ligation-and-endoscopic-variceal-sclerotherapy-a-randomized-double-blind-study
#6
Linghua Tang, Huimin Liu, Yang Wu, Mei Li, Wei Li, Meng Jiang, Jiabao Hou, Ying Jiang, Zhongyuan Xia, Qingtao Meng
The aim of the present study was to evaluate the safety and efficacy of various general anesthesia regimens during endoscopic variceal ligation (EVL) and endoscopic variceal sclerotherapy (EVS). A total of 123 patients with American Society of Anesthesiologists physical status III and IV, aged 40-70 years, undergoing general anesthesia for EVL and EVS were randomly divided into two groups: Sevoflurane anesthesia (group S; n=60) and propofol anesthesia (group P; n=60). Vital signs, particularly heart rate (HR) and mean arterial pressure (MAP), were monitored...
October 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28951662/safety-and-performance-characteristics-of-outpatient-medical-thoracoscopy-and-indwelling-pleural-catheter-insertion-for-evaluation-and-diagnosis-of-pleural-disease-at-a-tertiary-center-in-canada
#7
Robert Kyskan, Pen Li, Sunita Mulpuru, Carolina Souza, Kayvan Amjadi
BACKGROUND: Many centers performing medical thoracoscopy (MT) to diagnose pleural disease will insert a chest tube and admit patients to hospital after the procedure, which is inconvenient for patients and contributes to healthcare costs. We report the data on the safety, outcomes, and performance characteristics of outpatient MT with indwelling pleural catheter (IPC) insertion in a large Canadian cohort. METHODS: This retrospective cohort study reviewed patients who underwent outpatient MT and IPC insertion under conscious sedation...
2017: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
https://www.readbyqxmd.com/read/28938982/safe-driving-after-propofol-sedation
#8
Lee Summerlin-Grady, Paul N Austin, Dion A Gabaldon
PURPOSE: Propofol is a short-acting medication with fast cognitive and psychomotor recovery. However, patients are usually instructed not to drive a motor vehicle for 24 hours after receiving propofol. The purpose of this article was to review the evidence examining when it is safe to drive after receiving propofol for sedation for diagnostic and surgical procedures. DESIGN: This is a systematic review of the literature. METHODS: A search of the literature was conducted using Google Scholar, PubMed, and the Cochrane Library for the time period 1990 to 2015...
October 2017: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/28938299/nonoperating-room-anesthesia-for-endoscopic-procedures
#9
Stephan Knigge, Klaus Hahnenkamp
PURPOSE OF REVIEW: The purpose of this review is to take a look on some practical aspects of anesthetic care in the endoscopy suite, concerning the general approach, safety, and monitoring issues. RECENT FINDINGS: Concerning propofol popularity for sedation during endoscopic procedures new studies create doubt in the safety of higher doses of propofol used for sedation. Careful titration of propofol, addition of synergistic supplements like ketamine and dexmedetomidine, and monitoring of anesthetic depth may limit the dose of propofol given to the patients...
September 21, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28937025/the-efficacy-and-safety-of-the-left-lateral-position-for-endoscopic-retrograde-cholangiopancreatography
#10
Tae Young Park, Sang Hyeon Choi, Young Joo Yang, Suk Pyo Shin, Chang Seok Bang, Ki Tae Suk, Gwang Ho Baik, Dong Joon Kim
BACKGROUND/AIM: Endoscopic retrograde cholangiopancreatography (ERCP) is typically performed in prone position. In cases of difficulty in prone position, ERCP can be performed in left lateral position. We aimed to evaluate the efficacy and safety of left lateral position for ERCP compared with those of prone position. PATIENTS AND METHODS: Between August 2015 and March 2016, a total of 62 patients with native papilla who underwent ERCP were randomly assigned to undergo the procedure in left lateral position (n = 31) or prone position (n = 31)...
September 2017: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
https://www.readbyqxmd.com/read/28895000/endoscopic-diode-laser-therapy-for-chronic-radiation-proctitis
#11
Lino Polese, Lucia Marini, Roberto Rizzato, Edgardo Picardi, Stefano Merigliano
The purpose of this study is to determine the effectiveness of endoscopic diode laser therapy in patients presenting rectal bleeding due to chronic radiation proctitis (CRP). A retrospective analysis of CRP patients who underwent diode laser therapy in a single institution between 2010 and 2016 was carried out. The patients were treated by non-contact fibers without sedation in an outpatient setting. Fourteen patients (median age 77, range 73-87 years) diagnosed with CRP who had undergone high-dose radiotherapy for prostatic cancer and who presented with rectal bleeding were included...
September 11, 2017: Lasers in Medical Science
https://www.readbyqxmd.com/read/28877087/percutaneous-endoscopic-gastrostomy-under-conscious-sedation-in-patients-with-amyotrophic-lateral-sclerosis-is-safe-an-observational-study
#12
Denise Strijbos, José Hofstede, Daniel Keszthelyi, Ad A M Masclee, Lennard P L Gilissen
OBJECTIVES: Amyotrophic lateral sclerosis (ALS) is a progressive neuromuscular disease that causes muscle weakness with respiratory and swallowing dysfunction, eventually leading to death. Permanent enteral feeding is indicated in almost all patients. A percutaneous endoscopic gastrostomy (PEG) tube is considered the first choice, usually performed under conscious sedation (intravenous midazolam). Guidelines are very cautious with respect to sedation in ALS because of the risk for respiratory complications...
November 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28873075/intraoperative-magnesium-sulphate-decreases-agitation-and-pain-in-patients-undergoing-functional-endoscopic-surgery-a-randomised-double-blind-study
#13
Hazem E Elsersy, Magdy Ch Metyas, Hana A Elfeky, Ahmed A Hassan
BACKGROUND: Postoperative agitation is harmful for the patient as it may be associated with removal of catheters, nasal packs, oxygen masks and self-injury, and pose a danger to operating theatre staff. OBJECTIVE: The current study investigated the potential role of magnesium sulphate in treatment of postoperative agitation following functional endoscopic sinus surgery. DESIGN: A randomised, double-blinded, placebo-controlled trial. SETTING: ENT operating room, Menofia University Hospitals, Egypt...
October 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28872700/optimal-procedural-sequence-for-same-day-bidirectional-endoscopy-with-moderate-sedation-a-prospective-randomized-study
#14
Shuo-Wei Chen, Chi-Liang Cheng, Nai-Jen Liu, Jui-Hsiang Tang, Yen-Lin Kuo, Cheng-Hui Lin, Yi-Ning Tsui, Bai-Ping Lee, Hsiang-Ling Hung
BACKGROUND AND AIM: Same-day bidirectional endoscopy (BDE) is a commonly performed procedure, but the optimal sequence for the procedure with moderate conscious sedation is not well-established. We investigated the optimal sequence for same-day BDE under moderate conscious sedation and carbon dioxide insufflation in terms of sedation doses, patient discomfort, and colonoscopy performance. METHODS: We performed a prospective randomized controlled study of 120 patients who were scheduled for BDE examination...
September 5, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28843955/predictors-of-use-of-monitored-anesthesia-care-for-outpatient-gastrointestinal-endoscopy-in-a-capitated-payment-system
#15
Megan A Adams, Katherine M Prenovost, Jason A Dominitz, Robert G Holleman, Eve A Kerr, Sarah L Krein, Sameer D Saini, Joel H Rubenstein
BACKGROUND & AIMS: Use of monitored anesthesia care (MAC) for gastrointestinal endoscopy has increased in the Veterans Health Administration (VHA), as in fee-for-service environments, despite the absence of financial incentives. We investigated factors associated with use of MAC in an integrated healthcare delivery system with a capitated payment model. METHODS: We performed a retrospective cohort study using multi-level logistic regression, with MAC use modeled as a function of procedure year, patient- and provider-level factors, and facility effects...
August 23, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28829527/does-caffeine-improve-respiratory-rate-during-remifentanil-target-controlled-infusion-sedation-a-case-report-in-endoscopic-sedation
#16
Fabio Sbaraglia, Mariella De Riso, Maria Elena Riccioni, Guido Costamagna, Maria Sammartino
Sedation for endoscopic procedures may be challenging when facing patients with high risk. Traditional techniques, as propofol or meperidine/midazolam administration, cannot ensure an adequate level of safety and efficacy for these patients. Remifentanil infusion is a common alternative, but the incidence of apneic events does not allow achieving safely a good level of analgesia. To overcome with this issue, the authors borrowed suggestions from other medical fields. The clinical practice has recognized a wide utility of methylxanthines (caffeine, theophylline, etc)...
March 2017: Journal of Opioid Management
https://www.readbyqxmd.com/read/28823144/factors-impacting-patient-cooperation-during-elective-gastroscopy
#17
Sang Pyo Lee, In-Kyung Sung, Jeong Hwan Kim, Sun-Young Lee, Hyung Seok Park, Chan Sup Shim
BACKGROUND/AIMS: Some people have difficulty tolerating upper endoscopy. The cause of and risk factors for this are not well known. The aim of this study was to investigate the factors involved in poor cooperation during screening upper endoscopy. METHODS: A total of 4,422 subjects who underwent a health inspection with upper endoscopy carried out by a single experienced endoscopist were included. We retrospectively investigated subjects' self-reporting questionnaires and medical records, including endoscopic and histologic findings...
September 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/28799428/full-spectrum-endoscopy-fuse-versus-standard-forward-viewing-endoscope-sfv-in-a-high-risk-population
#18
Søren Roepstorff, Sabah Anwar Hadi, Morten Rasmussen
OBJECTIVES: To investigate the diagnostic performance of Full Spectrum Endoscopy (FUSE) compared to a conventional standard forward-viewing endoscope (SFV). The primary outcome was adenoma detection rate (ADR) and mean adenoma detection. Secondary outcome was feasibility of FUSE opposed to SFV. MATERIALS AND METHODS: Consecutive patients participating in the Danish colorectal cancer (CRC) screening programme were prospectively included in the study (n = 205)...
August 11, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28769979/safety-and-effectiveness-of-endoscopist-directed-nurse-administered-sedation-during-gastric-endoscopic-submucosal-dissection
#19
Yong Suk Cho, Sang Youn Shin, Changhyeok Hwang, Jeonghun Seo, Jong Won Choi, Byung Kyu Park, Sun Young Won, Chun Kyon Lee, Yong Kang Lee, Han Ho Jeon
BACKGROUND AND AIMS: Endoscopic submucosal dissection (ESD) is routinely performed in treating gastric neoplasia and requires long-term higher levels of sedation. Endoscopist-directed nurse-administered sedation (EDNAS) has not been well studied in ESD. This study aimed to evaluate the safety and effectiveness of EDNAS for ESD. METHODS: Patients treated with ESD for gastric tumors between 2013 and 2015 were retrospectively collected. Patients were divided into a midazolam-treated group (M group) and a midazolam plus propofol-treated group (MP group)...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/28761693/effect-of-dexmedetomidine-in-the-prophylactic-endoscopic-injection-sclerotherapy-for-oesophageal-varices-a-study-protocol-for-prospective-interventional-study
#20
Hiroki Nishikawa, Yoshinori Iwata, Akio Ishii, Hirayuki Enomoto, Yukihisa Yuri, Noriko Ishii, Yuho Miyamoto, Kunihiro Hasegawa, Chikage Nakano, Ryo Takata, Takashi Nishimura, Kazunori Yoh, Nobuhiro Aizawa, Yoshiyuki Sakai, Naoto Ikeda, Tomoyuki Takashima, Hiroko Iijima, Shuhei Nishiguchi
BACKGROUND: Dexmedetomidine (DEX) is a novel, highly selective α2-adrenoceptor agonist that elicits sedative, amnestic, sympatholytic and analgesic effects in patients. Several Japanese investigators have reported the clinical usefulness of DEX for sedation in endoscopic therapies for gastrointestinal malignancies; however, there have been limited data regarding the usefulness and safety of DEX for sedation during endoscopic procedures for oesophageal varices (OVs), such as endoscopic injection sclerotherapy (EIS)...
2017: BMJ Open Gastroenterology
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