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https://www.readbyqxmd.com/read/28938299/nonoperating-room-anesthesia-for-endoscopic-procedures
#1
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/28937993/anaesthesia-not-number-of-sessions-influences-the-magnitude-and-duration-of-an-ahf-rtms-in-dogs
#2
Robrecht Dockx, Kathelijne Peremans, Lise Vlerick, Nick Van Laeken, Jimmy H Saunders, Ingeborgh Polis, Filip De Vos, Chris Baeken
BACKGROUND: Currently, the rat has been a useful animal model in brain stimulation research. Nevertheless, extrapolating results from rodent repetitive Transcranial Magnetic Stimulation (rTMS) research to humans contains several hurdles. This suggests the desperate need for a large animal model in translational rTMS research. The dog would be a valid choice, not only due to the fact that humans and dogs share a neurophysiological background, but a similar neuropathological background as well...
2017: PloS One
https://www.readbyqxmd.com/read/28937888/development-of-a-web-based-nationwide-korean-pediatric-dental-sedation-registry
#3
Sung Chul Choi, Yeonmi Yang, Seunghoon Yoo, Jiyeon Kim, Taesung Jeong, Teo Jeon Shin
OBJECTIVE: Finding a balance between sedation efficacy and safety remains an ongoing challenge. In children, the risk of sedation-related complications is relatively high. It is of utmost importance to determine the factors related to improved overall sedation outcomes. However, most previous reports have been based on small samples at single institutions. The Korean Academy of Pediatric Dentistry (KAPD) developed a Korean Pediatric Dental Sedation Registry using a web-based platform...
September 22, 2017: Journal of Clinical Pediatric Dentistry
https://www.readbyqxmd.com/read/28937531/median-effective-dose-of-intranasal-dexmedetomidine-sedation-for-transthoracic-echocardiography-examination-in-postcardiac-surgery-and-normal-children-an-up-and-down-sequential-allocation-trial
#4
Yang Liu, Qing Yu, Mang Sun, Shangyingying Li, Jing Zhang, Yao Lei, Chaofeng Li, Fei Yang, Shengfen Tu
BACKGROUND: Dexmedetomidine (DEX) has been used for sedation in young infants and children undergoing transthoracic echocardiography (TTE). The median effective dose of intranasal DEX has not been described for postcardiac surgery children. Postcardiac surgery children could require more DEX to achieve satisfactory sedation for TTE examination than children suspected of congenital heart disease. OBJECTIVES: To study whether postcardiac surgery children need a larger dose of DEX for TTE than normal children...
September 20, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28937508/status-dystonicus-in-childhood
#5
Daniel E Lumsden, Mary D King, Nicholas M Allen
PURPOSE OF REVIEW: Dystonia is a common paediatric neurological condition. At its most severe, dystonia may lead to life-threatening complications, a state termed status dystonicus. This review provides an update on the definition, causes, management and outcome of childhood status dystonicus. RECENT FINDINGS: High-quality studies in childhood status dystonicus are lacking, though an increasing number of case series have been published. Status dystonicus appears to occur more frequently in children compared with adults, with a clear precipitant identified in around two-thirds of cases...
September 20, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28937286/comparing-subjective-and-objective-image-quality-at-two-different-radiation-exposure-ranges-of-the-paranasal-sinus-ct-examinations-using-a-volumetric-320-row-detector-ct-system
#6
Berhan Pirimoglu, Recep Sade, Muhammed Sedat Sakat, Hayri Ogul, Suat Eren, Mecit Kantarci
OBJECTIVES: To evaluate image quality of protocol including 135 kVp, 5 mAs and 80 kVp, 5 mAs in the paranasal sinus CT examinations using single volumetric 320-row multidetector CT technique. METHODS: From September to December 2016, both of our control group including 135 kVp and 5 mAs and our study group including 80 kVp and 5 mAs paranasal CT protocols were simultaneously performed on 40 patients using single volumetric 320-row multidetector CT device. Image quality for bony structures, air-filled structures and soft tissues were independently assessed for each group by three blinded observers using a 3-point grading scale (0 = not diagnostic, 1 = partially diagnostic, 2 = diagnostic)...
September 21, 2017: Dento Maxillo Facial Radiology
https://www.readbyqxmd.com/read/28937025/the-efficacy-and-safety-of-the-left-lateral-position-for-endoscopic-retrograde-cholangiopancreatography
#7
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/28936968/-progress-of-pain-assessment-and-analgesia-strategy-for-mechanical-ventilation-patients
#8
Qingdong Li, Xianyao Wan
Standardized pain assessment is a precondition of appropriate analgesia for mechanical ventilation patients. However, routine pain assessment rates remain very low in intensive care unit (ICU). Behavioral pain scale (BPS) and critical-care pain observation tool (CPOT) can be used to assess pain in mechanical ventilation patients who are unable to report pain by themselves. No matter what strategy we taken, analgesia-first sedation should be used in priority. Meanwhile, patient-centered and goal-directed sedation strategy should be adopted based on the individual condition...
September 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28936967/-effect-of-sedation-on-respiratory-function-of-patients-undergoing-mechanical-ventilation
#9
Jie Yang, Yan Kang
Sedation and analgesia for ventilated patients is an important treatment in intensive care unit (ICU). Patients receiving mechanical ventilation therapy comfortably and safely can improve patient-ventilator synchrony, reduce ventilation-related lung injury (VILI), improve compliance, decrease oxygen consumption and stress, prevent accidents, and reduce the incidence of complications and mortality in critical patients. Although sedation may protect lung function, it also has a greater impact on respiratory function...
September 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28936700/prescription-of-sedative-drugs-during-hospital-stay-a-swiss-prospective-study
#10
Laurence Schumacher, Maria Dobrinas, Damien Tagan, Annelore Sautebin, Anne-Laure Blanc, Nicolas Widmer
BACKGROUND: In recent years, the number of prescriptions for sedative drugs has increased significantly, as has their long-term use. Moreover, sedative use is frequently initiated during hospital stays. OBJECTIVES: This study aimed to describe new prescriptions of sedative drugs during hospital stays and evaluate their maintenance as discharge medication. METHODS: This observational prospective study took place in an internal medicine ward of a Swiss hospital over a period of 3 months in 2014...
September 21, 2017: Drugs—Real World Outcomes
https://www.readbyqxmd.com/read/28936695/early-application-of-airway-pressure-release-ventilation-may-reduce-the-duration-of-mechanical-ventilation-in-acute-respiratory-distress-syndrome
#11
Yongfang Zhou, Xiaodong Jin, Yinxia Lv, Peng Wang, Yunqing Yang, Guopeng Liang, Bo Wang, Yan Kang
PURPOSE: Experimental animal models of acute respiratory distress syndrome (ARDS) have shown that the updated airway pressure release ventilation (APRV) methodologies may significantly improve oxygenation, maximize lung recruitment, and attenuate lung injury, without circulatory depression. This led us to hypothesize that early application of APRV in patients with ARDS would allow pulmonary function to recover faster and would reduce the duration of mechanical ventilation as compared with low tidal volume lung protective ventilation (LTV)...
September 22, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28936072/alleviating-stress-response-to-tracheal-extubation-in-neurosurgical-patients-a-comparative-study-of-two-infusion-doses-of-dexmedetomidine
#12
Ankur Luthra, Hemanshu Prabhakar, Girija Prasad Rath
BACKGROUND: Tracheal extubation is almost always associated with increase in sympathoadrenal activity may result in hypertension, tachycardia, and arrhythmias. Attempts have been made to oppose the pressor response by the use of various drugs. Dexmedetomidine decreases norepinephrine which reduces the blood pressure and the heart rate (HR). We hypothesize that the infusion of dexmedetomidine may produce more stable hemodynamics during extubation as compared to boluses. MATERIALS AND METHODS: Ninety adult patients aged 18-65 years, the American Society of Anesthesiologists Grade I-II undergoing intracranial surgeries for various neurologic problem at All India Institute of Medical Sciences were enrolled in this randomized controlled trial...
August 2017: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28935559/postoperative-interruption-of-sedation-on-arrival-in-the-surgical-icu-a-new-standard-of-care
#13
Matthias Eikermann, Todd W Sarge
No abstract text is available yet for this article.
September 18, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28935558/immediate-interruption-of-sedation-compared-with-usual-sedation-care-in-critically-ill-postoperative-patients-sos-ventilation-a-randomised-parallel-group-clinical-trial
#14
Gerald Chanques, Matthieu Conseil, Claire Roger, Jean-Michel Constantin, Albert Prades, Julie Carr, Laurent Muller, Boris Jung, Fouad Belafia, Moussa Cissé, Jean-Marc Delay, Audrey de Jong, Jean-Yves Lefrant, Emmanuel Futier, Grégoire Mercier, Nicolas Molinari, Samir Jaber
BACKGROUND: Avoidance of excessive sedation and subsequent prolonged mechanical ventilation in intensive care units (ICUs) is recommended, but no data are available for critically ill postoperative patients. We hypothesised that in such patients stopping sedation immediately after admission to the ICU could reduce unnecessary sedation and improve patient outcomes. METHODS: We did a randomised, parallel-group, clinical trial at three ICUs in France. Stratified randomisation with minimisation (1:1 via a restricted web platform) was used to assign eligible patients (aged ≥18 years, admitted to an ICU after abdominal surgery, and expected to require at least 12 h of mechanical ventilation because of a critical illness defined by a Sequential Organ Failure Assessment score >1 for any organ, but without severe acute respiratory distress syndrome or brain injury) to usual sedation care provided according to recommended practices (control group) or to immediate interruption of sedation (intervention group)...
September 18, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28934894/factors-associated-with-unplanned-extubation-in-children-a-case-control-study
#15
Paulo Sérgio Lucas da Silva, Marcelo Cunio Machado Fonseca
PURPOSE: Although several studies assess unplanned extubation (UE) in children, few have addressed determinants of UE and factors associated with reintubation in a case-controlled manner. We aimed to identify the risk factors and outcomes associated with UE in a pediatric intensive care unit. METHODS: Cases of UE were randomly matched with control patients at a ratio of 1:4 for age, severity of illness, and admission diagnosis. For cases and controls, we also collected data associated with UE events, reintubation, and outcomes...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28934782/the-dose-dependent-effects-of-ketoprofen-on-dynamic-pain-after-open-heart-surgery
#16
Vedat Eljezi, Claire Biboulet, Henri Boby, Pierre Schoeffler, Bruno Pereira, Christian Duale
BACKGROUND: Non-steroidal anti-inflammatory drugs (NSAIDs) can reduce postoperative pain, in both static (i.e., at rest) and dynamic contexts (e.g., during coughing or mobilization), and reduced doses could improve their efficacy/tolerance balance. OBJECTIVES: To test this hypothesis of efficacy after open heart surgery, in which NSAIDs are poorly used, particularly for safety concerns. STUDY DESIGN: Randomized, double-blind trial. SETTING: Single-center, French university hospital...
September 2017: Pain Physician
https://www.readbyqxmd.com/read/28934019/cochlear-implantation-under-conscious-sedation-with-local-anesthesia-safety-efficacy-costs-and-satisfaction
#17
Samion Shabashev, Yasser Fouad, T Kate Huncke, J Thomas Roland
OBJECTIVE: To evaluate the safety, efficiency, cost effectiveness, and satisfaction of patients undergoing cochlear implantation under conscious sedation versus general anesthesia. STUDY DESIGN: Retrospective case review of 20 patients who underwent cochlear implantation under conscious sedation which was compared to 20 age-matched patients where surgery was performed under general anesthesia. METHODS: Perioperative times, length of stay, anesthesia drug costs, postoperative complications, and patient satisfaction were compared between the two groups...
September 21, 2017: Cochlear Implants International
https://www.readbyqxmd.com/read/28933806/pediatric-wound-care-and-management-in-the-emergency-department
#18
Jennifer E. Sanders
Traumatic wounds and lacerations are common pediatric presenting complaints to emergency departments. Although there is a large body of literature on wound care, many emergency clinicians base management of wounds on theories and techniques that have been passed down, so controversial, conflicting, and unfounded recommendations are prevalent. This issue reviews evidence-based recommendations for wound care and management, including wound cleansing and irrigation, anxiolysis/sedation techniques, closure methods, and post-repair wound care...
October 2017: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/28933333/-canine-elbow-humeroulnar-incongruity-measurements-using-computed-tomography
#19
R Snášil, P Proks, A Nečasová, K Michalčáková, A Nečas
PURPOSE OF THE STUDY The purpose of the study is to compare the repeatability and reproducibility of quantitative and subjective evaluation of elbow humeroulnar incongruity (HUI) using computed tomography (CT) on an in vivo canine model. MATERIAL AND METHODS HUI was evaluated on canine (n = 50) elbow joints (n = 100). The computed tomography of elbow joints was performed under intravenous sedation. Multiplanar reconstructions (MPR) were produced. HUI was evaluated on sagittal MPR images subjectively and by measuring the subluxation index (SI)...
2017: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/28933107/-research-progress-of-chemical-constituents-and-pharmacological-activities-of-essential-oil-of-ligusticum-chuanxiong
#20
REVIEW
Jing-Chang Du, Xiao-Fang Xie, Liang Xiong, Chen Sun, Cheng Peng
Essential oil is the low polar and volatile components distilled or extracted from Ligusticum chuanxiong, the dry root of perennial herb L. chuanxiong, which has proven to be one of the main biological active ingredients of L. chuanxiong. Studies suggested that essential oil of L. chuanxiong mainly contains phthalide, terpene alcohols and fatty acids compounds. Different regions or varied extraction technology had influences on the type and contents of compound in essential oil of L. chuanxiong and the total yield efficiency of essential oil, while the differences among the distribution of compounds leads to the variant pharmacological function of essential oil of L...
December 2016: Zhongguo Zhong Yao za Zhi, Zhongguo Zhongyao Zazhi, China Journal of Chinese Materia Medica
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