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Sedation awareness

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https://www.readbyqxmd.com/read/29349346/characteristics-of-electroencephalogram-signatures-in-sedated-patients-induced-by-various-anesthetic-agents
#1
REVIEW
Byung-Moon Choi
Devices that monitor the depth of hypnosis based on the electroencephalogram (EEG) have long been commercialized, and clinicians use these to titrate the dosage of hypnotic agents. However, these have not yet been accepted as standard monitoring devices for anesthesiology. The primary reason is that the use of these monitoring devices does not completely prevent awareness during surgery, and the development of these devices has not taken into account the neurophysiological mechanisms of hypnotic agents, thus making it possible to show different levels of unconsciousness in the same brain status...
December 2017: Journal of Dental Anesthesia and Pain Medicine
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
#2
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
https://www.readbyqxmd.com/read/29335823/-drugs-for-intravenous-induction-of-anesthesia-propofol
#3
D Bolkenius, C Dumps, E Halbeck
In a series of articles dealing with hypnotics for induction of anesthesia, this article describes the development and current value of propofol. Its significance far exceeds that of a pure induction hypnotic (sedation in diagnostic and therapeutic procedures and on the intensive care unit). Propofol is also used for sedation in diagnostic and therapeutic procedures and on the intensive care unit. In the field of induction of anesthesia, the alternatives are barely used. Some contraindications are still controversial whereas others are no longer sufficiently anchored in the users' awareness (widespread off-label use)...
January 15, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29247274/procedural-sedation-and-analgesia-practices-by-emergency-physicians-in-the-netherlands-a-nationwide-survey
#4
Maybritt I Kuypers, Gaël J P Smits, Suzanne C Valkenet, Wendy A M H Thijssen, Frans B Plötz
BACKGROUND: Several efforts have been made to assure and to improve the quality of procedural sedation and analgesia (PSA) performed by emergency physicians (EPs) in The Netherlands. This study investigated the current PSA practice and competences of EPs in both adult and paediatric patients. In particular, if residency and current training, awareness of guidelines is sufficient for registered EPs to adequately perform PSA and if the availability of both adult and paediatric PSA in the ED is adequate...
December 15, 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29218318/patient-comfort-scores-do-not-affect-endoscopist-behavior-during-colonoscopy-while-trainee-involvement-has-negative-effects-on-patient-comfort
#5
Brian P H Chan, Amanda Hussey, Natalie Rubinger, Lawrence C Hookey
Introduction : Patient comfort is an important part of endoscopy and reflects procedure quality and endoscopist technique. Using the validated, Nurse Assisted Patient Comfort Score (NAPCOMS), this study aimed to determine whether the introduction of NAPCOMS would affect sedation use by endoscopists. Patients and methods : The study was conducted over 3 phases. Phase One and Two consisted of 8 weeks of endoscopist blinded and aware data collection, respectively...
December 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/29174368/an-integrative-review-of-interventions-to-support-parents-when-managing-their-child-s-pain-at-home
#6
REVIEW
Roses Parker, Stephen McKeever, Theresa Wiseman, Alison Twycross
To identify interventions aimed at helping parents manage their child's pain at home and to establish which aspects of interventions were effective. Integrative narrative review. MEDLINE, CINAHL Plus, PsychINFO, PsychArticles, AMED, PubMed, Scopus and Web of Knowledge databases were searched in 2016. This narrative synthesis followed Centre for Reviews and Dissemination and Economic and Social Research Council guidance. Reasons attributed to intervention success were analyzed using content analysis. From 2,534 papers, 17 were included...
November 21, 2017: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/29121531/decreased-pain-tolerance-before-surgery-and-increased-postoperative-narcotic-requirements-in-abstinent-tobacco-smokers
#7
Ling Shen, Kai Wei, Qianbo Chen, Haibo Qiu, Yong Tao, Qiang Yao, Jinchao Song, Chengjian Li, Liang Zhao, Yantao Liu, Zhijie Lu
INTRODUCTION: The clinical influence of smoking cessation on pain tolerance before surgery and postoperative pain perception is not fully understood. This clinical study investigated the effect of smoking cessation on pain threshold during the perioperative period in patients undergoing hepatic resection. METHODS: We enrolled 148 male patients (68 non-smokers and 80 abstinent smokers) who underwent hepatic resection and received postoperative patient-controlled intravenous analgesia...
October 28, 2017: Addictive Behaviors
https://www.readbyqxmd.com/read/29118675/selecting-optimal-second-generation-antihistamines-for-allergic-rhinitis-and-urticaria-in-asia
#8
Marysia Tiongco Recto, Ma Teresita Gabriel, Kanokvalai Kulthanan, Pongsakorn Tantilipikorn, Derrick Chen-Wee Aw, Tak Hong Lee, Ch'ng Chin Chwen, Somasundran Mutusamy, Nguyen Trong Hao, Vo Thanh Quang, Giorgio Walter Canonica
Background: Allergic diseases are on the rise in many parts of the world, including the Asia-Pacific (APAC) region. Second-generation antihistamines are the first-line treatment option in the management of allergic rhinitis and urticaria. International guidelines describe the management of these conditions; however, clinicians perceive the additional need to tailor treatment according to patient profiles. This study serves as a consensus of experts from several countries in APAC (Hong Kong, Malaysia, the Philippines, Singapore, Thailand, Vietnam), which aims to describe the unmet needs, practical considerations, challenges, and key decision factors when determining optimal second-generation antihistamines for patients with allergic rhinitis and/or urticaria...
2017: Clinical and Molecular Allergy: CMA
https://www.readbyqxmd.com/read/29115646/a-new-perspective-on-life-saving-procedures-in-a-battlefield-setting-emergency-cricothyroidotomy-needle-thoracostomy-and-chest-tube-thoracostomy-with-night-vision-goggles
#9
Sedat Bilge, Attila Aydın, Meltem Bilge, Cemile Aydın, Erdem Çevik, Mehmet Eryılmaz
BACKGROUND: In the patients with multiple and serious trauma, early applications of life-saving procedures are related to improved survival. We tried to experimentally determine the feasibility of life-saving interventions that are performed with the aid of night vision goggles (NVG) in nighttime combat scenario. METHODS: Chest tube thoracostomy (CTT), emergency cricothyroidotomy (EC), and needle thoracostomy (NT) interventions were performed by 10 combatant medical staff...
November 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29108303/anesthetic-dreaming-anesthesia-awareness-and-patient-satisfaction-after-deep-sedation-with-propofol-target-controlled-infusion-a-prospective-cohort-study-of-patients-undergoing-day-case-breast-surgery
#10
Marco Cascella, Roberta Fusco, Domenico Caliendo, Vincenza Granata, Domenico Carbone, Maria Rosaria Muzio, Giuseppe Laurelli, Stefano Greggi, Francesca Falcone, Cira Antonietta Forte, Arturo Cuomo
Background: Anesthetic dreaming and anesthesia awareness are well distinct phenomena. Although the incidence of intraoperative awareness is more common among patients who reported a dream after surgery, the exact correlation between the two phenomena remains an unsolved rebus. The main purpose of this study was to investigate anesthetic dreaming, anesthesia awareness and psychological consequences eventually occurred under deep sedation. Intraoperative dreaming experiences were correlated with dream features in natural sleep...
October 3, 2017: Oncotarget
https://www.readbyqxmd.com/read/29099371/abuse-potential-of-gabapentin-in-dentistry
#11
Mea A Weinberg, Stuart L Segelnick, Joseph S Insler
Gabapentin is an anticonvulsant drug widely prescribed for various ailments, including orofacial pain. It was once thought to have no potential for abuse; however, the last decade has seen a dramatic rise in the nonmedical use of gabapentin, particularly among opioid-dependent patients. Gabapentin is sedating and interacts with other sedating medications such as opioids, which can lead to impairment and accidents and may raise the risk of overdose. Dentists must be aware of the potential for abuse of gabapentin and weigh its benefits against its risks when prescribing the drug...
November 2017: General Dentistry
https://www.readbyqxmd.com/read/29052286/high-risk-respiratory-patients-experiences-of-bronchoscopy-with-conscious-sedation-and-analgesia-a-qualitative-study
#12
Catherine Saxon, Paul Fulbrook, Kwun Fong, Chantal F Ski
AIM: To understand the experiences of high-risk respiratory patients undergoing bronchoscopy with conscious sedation. BACKGROUND: Due to possible complications, high-risk respiratory patients are usually given smaller, cautious doses of sedation and analgesia for bronchoscopy. Described as 'conscious sedation', this facilitates depression of the patient's consciousness without causing respiratory compromise. Previously, studies have investigated patient experience using quantitative methods...
October 20, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29036939/female-genital-mutilation-reconstruction-a-preliminary-report
#13
Catherine S Chang, David W Low, Ivona Percec
Background: Female genital mutilation (FGM) is internationally recognized as a violation of human rights. Though rarely discussed, FGM is prevalent, affecting hundreds of millions of females worldwide. Objectives: We believe that is important for plastic surgeons to be informed and prepared to address the surgical and emotional needs of these women. We present our experience on treatment of women subjected to FGM. Methods: Three consecutive patients were treated by our clitoral restoration procedure...
September 1, 2017: Aesthetic Surgery Journal
https://www.readbyqxmd.com/read/28989831/intraoperative-awareness-and-recall-a-comparative-study-of-dexmedetomidine-and-propofol-in-cardiac-surgery
#14
Tufail Ahmad, Nadeem A Sheikh, Nihida Akhter, Bashir A Dar, Riyaz Ahmad
Background Awareness during general anesthesia is undesired and unanticipated patient wakefulness during surgery or recall of intraoperative events. Incidence of awareness in patients undergoing cardiac surgery is significantly higher than the overall incidence of 1% during general surgery. Awareness during cardiac surgery can be prevented by a number of methods. One such method is the supplemental, intraoperative use of sedative agents. Propofol, a bisubstituted phenol, is an intravenous general anesthetic that has been shown to reduce the incidence of awareness...
August 5, 2017: Curēus
https://www.readbyqxmd.com/read/28944481/efficacy-of-dexmedetomidine-on-perioperative-morbidity-during-nasal-surgery-a-meta-analysis
#15
Se Hwan Hwang, Ho Seok Lee, Young Hoon Joo, Jae Hyun Seo, Jun Myung Kang
OBJECTIVES: The goal of this meta-analysis was to perform a systematic review of the literature on the effect of dexmedetomidine on perioperative morbidity following nasal surgery and on the adverse effects of dexmedetomidine. DATA SOURCES: MEDLINE, Scopus, and Cochrane Database of Systematic Reviews. REVIEW METHODS: Two authors independently searched scientific and medical databases from their inception of article collection to March 2017...
September 25, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28939570/perceptions-of-parents-and-paediatricians-on-pain-induced-by-bone-marrow-aspiration-and-lumbar-puncture-among-children-with-acute-leukaemia-a-qualitative-study-in-china
#16
Yu Wang, Qiang Liu, Jia-Ning Yu, Hai-Xia Wang, Lu-Lu Gao, Ya-Liang Dai, Xin Jin, Feng Zuo, Juan Liu, Cai-Feng Bai, Guo-Xia Mu, Xiao-Min Chai, Yin-Juan Zhang, Yu-Xiang Li, Jian-Qiang Yu
OBJECTIVE: To obtain in-depth insight into the perceptions of parents and paediatricians in China regarding current procedural pain management on bone marrow aspirations and lumbar punctures in paediatric haemato-oncology department. DESIGN, SETTING AND PARTICIPANTS: This qualitative study was conducted in a 4500-bed university hospital in northwest China. To collect data, in-depth semistructured interviews were conducted with parents of children with acute leukaemia (n=12) and haemato-oncology paediatricians (n=11) using purposive sampling...
September 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28936072/alleviating-stress-response-to-tracheal-extubation-in-neurosurgical-patients-a-comparative-study-of-two-infusion-doses-of-dexmedetomidine
#17
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/28913911/older-adults-awareness-of-deprescribing-a-population-based-survey
#18
Justin P Turner, Cara Tannenbaum
OBJECTIVES: To determine older adults' awareness of the concept of medication-induced harm and their familiarity with the term "deprescribing." Secondary objectives were to ascertain determinants of self-initiated deprescribing conversations and to identify how older adults seek information on medication harms. DESIGN: Cross-sectional population-based household telephone survey using random-digit dialling. SETTING: Canada. PARTICIPANTS: Community-dwelling adults aged 65 and older (N = 2,665; n = 898 men, n = 1,767 women, mean age 74...
September 15, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28879336/the-use-of-general-anesthesia-to-facilitate-dental-treatment-in-adult-patients-with-special-needs
#19
REVIEW
Mathew Albert Wei Ting Lim, Gelsomina Lucia Borromeo
General anesthesia is commonly used to facilitate dental treatment in patients with anxiety or challenging behavior, many of whom are children or patients with special needs. When performing procedures under general anesthesia, dental surgeons must perform a thorough pre-operative assessment, as well as ensure that the patients are aware of the potential risks and that informed consent has been obtained. Such precautions ensure optimal patient management and reduce the frequency of morbidities associated with this form of sedation...
June 2017: Journal of Dental Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28852812/pediatric-providers-and-radiology-examinations-knowledge-and-comfort-levels-regarding-ionizing-radiation-and-potential-complications-of-imaging
#20
Benjamin Wildman-Tobriner, Victoria M Parente, Charles M Maxfield
BACKGROUND: Pediatric providers should understand the basic risks of the diagnostic imaging tests they order and comfortably discuss those risks with parents. Appreciating providers' level of understanding is important to guide discussions and enhance relationships between radiologists and pediatric referrers. OBJECTIVE: To assess pediatric provider knowledge of diagnostic imaging modalities that use ionizing radiation and to understand provider concerns about risks of imaging...
December 2017: Pediatric Radiology
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