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Sedation awareness

Mustafa M Almuqbel, Gareth Leeper, Ross Keenan, David N Plamer, Tracy R Melzer
OBJECTIVES: To highlight specific instances when radial k-space acquisitions in magnetic resonance imaging result in image artifacts and how to ameliorate such artifacts. METHODS: We acquired axial T2  weighted MR images on (1) the American College of Radiology (ACR) phantom and (2) a sedated sheep with rectilinear and multi-blade radial k-space filling acquisitions. Images were acquired on four (2 × 1.5T and 2 × 3T) different MRI scanners. For the radial k-space acquisitions, we acquired images with and without motion correction...
March 14, 2018: British Journal of Radiology
Richard H Epstein, Joni M Maga, Michael E Mahla, Eric S Schwenk, Marc J Bloom
BACKGROUND: Processed electroencephalogram (EEG) monitors help assess the hypnotic state during general anesthesia or sedation. Maintaining the bispectral index (BIS) or state entropy (SE) between 40 and 60 has been recommended to mitigate anesthesia awareness. Nonetheless, SEs > 70 were frequently observed at end-tidal sevoflurane concentrations unlikely to allow awareness. We sought to determine the prevalence of elevated discordant measurements during BIS and SE monitoring. METHODS: Electronic data collected over 11 months at two academic hospitals were retrospectively reviewed...
March 9, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Courtney C Moreno, Thomas Jarrett, Brianna L Vey, Pardeep K Mittal, Elizabeth A Krupinski, David L Roberts
AIMS: To assess patient knowledge about colorectal cancer incidence and prognosis as well as willingness to undergo screening with various tests (eg, optical colonoscopy, stool-based tests, computed tomographic colonography (CTC)). MATERIALS AND METHODS: A survey was administered to consecutive patients of a general academic-based internal medicine clinic. RESULTS: Survey response rate was 86.3%. A majority of respondents (55%) reported being aware of general information about colorectal cancer, and 99% indicated a belief that colorectal cancer screening was a good idea...
January 6, 2018: Current Problems in Diagnostic Radiology
Jon E Grant, Katherine Lust, Gary A Christenson, Sarah A Redden, Samuel R Chamberlain
OBJECTIVE: This study sought to examine the prevalence of gambling disorder (GD) in a university sample and its associated physical and mental health correlates. METHODS: A 156-item anonymous online survey was distributed via random email generation to a sample of 9449 university students. Current use of alcohol and drugs, psychological and physical status and academic performance were assessed, along with questionnaire-based measures of impulsivity and compulsivity...
February 9, 2018: International Journal of Psychiatry in Clinical Practice
Anna K Jönsson, Johan Schill, Hans Olsson, Olav Spigset, Staffan Hägg
This article summarises the current evidence on the risk of venous thromboembolism (VTE) with the use of antipsychotics. An increasing number of observational studies indicate an elevated risk of VTE in antipsychotic drug users. Although the use of certain antipsychotics has been associated with VTE, current data can neither conclusively verify differences in occurrence rates of VTE between first- and second-generation antipsychotics or between individual compounds, nor identify which antipsychotic drugs have the lowest risk of VTE...
February 8, 2018: CNS Drugs
Rebecca H Allen, Rameet Singh
Satisfactory pain control for women undergoing surgical abortion is important for patient comfort and satisfaction. Clinicians ought to be aware of the safety and efficacy of different pain control regimens. This document will focus on nonpharmacologic modalities to reduce pain and pharmacologic interventions up to the level of minimal sedation. For surgical abortion without intravenous medications, a multimodal approach to pain control may combine a dedicated emotional-support person, visual or auditory distraction, administration of local anesthesia to the cervix with buffered lidocaine, and a preoperative nonsteroidal anti-inflammatory drug...
January 30, 2018: Contraception
John R Richards, Jessica B Gould, Erik G Laurin, Timothy E Albertson
Cardiovascular and central nervous system (CNS) toxicity, including tachydysrhythmia, agitation, and seizures, may arise from cocaine or bupropion use. We report acute toxicity from the concomitant use of cocaine and bupropion in a 25-year-old female. She arrived agitated and uncooperative, with a history of possible antecedent cocaine use. Her electrocardiogram demonstrated tachycardia at 130 beats/min, with a corrected QT interval of 579 ms. Two doses of 5 mg intravenous metoprolol were administered, which resolved the agitation, tachydysrhythmia, and corrected QT interval prolongation...
January 31, 2018: Clinical and Experimental Emergency Medicine
Tomonari Fujita, Yoshito Mizoguchi, Yutaka Kunitake, Hiroshi Tateishi, Takayoshi Inaba, Takahiro A Kato, Akira Monji
Complaints of hypoglycemia resemble the sedative effect of antipsychotics. As such, clinicians may overlook hypoglycemia in patients with psychiatric disorders. Here, a case of hypoglycemia associated with hyperinsulinemia induced by quetiapine in a female patient with bipolar disorder is reported. The case suggests that clinicians should be aware of the potential for hypoglycemia induced by second-generation antipsychotics.
January 25, 2018: Primary Care Companion to CNS Disorders
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
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
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)...
February 2018: Der Anaesthesist
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
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
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
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
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
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
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
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
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
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