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procedural sedation and analgesia

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https://www.readbyqxmd.com/read/28926159/randomized-controlled-feasibility-trial-of-intranasal-ketamine-compared-to-intranasal-fentanyl-for-analgesia-in-children-with-suspected-extremity-fractures
#1
Stacy L Reynolds, Kathleen K Bryant, Jonathan R Studnek, Melanie Hogg, Connell Dunn, Megan A Templin, Charity G Moore, James R Young, Katherine Rivera Walker, Michael S Runyon
OBJECTIVE: We compared the tolerability and efficacy of intranasal sub-dissociative ketamine to intranasal fentanyl for analgesia of children with acute traumatic pain and investigated the feasibility of a larger non-inferiority trial that could investigate the potential opioid sparing effects of intranasal ketamine. METHODS: This randomized controlled trial compared intranasal ketamine 1 mg/kg to intranasal fentanyl 1.5 μg/kg in children 4-17 years old with acute pain from suspected, isolated extremity fractures presenting to an urban level II pediatric trauma center from December 2015 to November 2016...
September 19, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28913488/bilateral-thoracic-paravertebral-nerve-blocks-for-placement-of-percutaneous-radiologic-gastrostomy-in-patients-with-amyotrophic-lateral-sclerosis-a-case-series
#2
Arun Kalava, Steven Clendenen, J Mark McKinney, Elird Bojaxhi, Roy A Greengrass
BACKGROUND AND AIMS: To assess the efficacy of bilateral thoracic paravertebral nerve blocks (PVB) in providing procedural anesthesia and post-procedural analgesia for placement of percutaneous radiologic gastrostomy tubes (PRG) in patients with amyotrophic lateral sclerosis (ALS). METHODS: We prospectively observed 10 patients with ALS scheduled for PRG placement that had bilateral thoracic PVBs at thoracic 7, 8, and 9 levels with administration of a mixture of 3 mL of 1% ropivacaine, 0...
October 2016: Rom J Anaesth Intensive Care
https://www.readbyqxmd.com/read/28904501/patient-experience-with-conscious-sedation-as-a-method-of-pain-relief-for-transvaginal-oocyte-retrieval-a-cross-sectional-study
#3
Himanshu Singhal, Prasanna S Premkumar, Achamma Chandy, Aleyamma T Kunjummen, Mohan S Kamath
AIM: The aim of the study was to measure patient's satisfaction level and acceptance of conscious sedation as a method of pain relief following transvaginal oocyte retrieval (TVOR) during assisted reproduction technology treatment. We also evaluated the factors that may influence the efficacy of conscious sedation method. SETTING AND DESIGN: A prospective cross-sectional study. MATERIALS AND METHODS: Prospective study was conducted from October 2015 to January 2016 at a university-level hospital and 100 women were recruited...
April 2017: Journal of Human Reproductive Sciences
https://www.readbyqxmd.com/read/28877145/european-society-of-anaesthesiology-and-european-board-of-anaesthesiology-guidelines-for-procedural-sedation-and-analgesia-in-adults
#4
Jochen Hinkelbein, Massimo Lamperti, Jonas Akeson, Joao Santos, Joao Costa, Edoardo De Robertis, Dan Longrois, Vesna Novak-Jankovic, Flavia Petrini, Michel M R F Struys, Francis Veyckemans, Thomas Fuchs-Buder, Robert Fitzgerald
: Procedural sedation and analgesia (PSA) has become a widespread practice given the increasing demand to relieve anxiety, discomfort and pain during invasive diagnostic and therapeutic procedures. The role of, and credentialing required by, anaesthesiologists and practitioners performing PSA has been debated for years in different guidelines. For this reason, the European Society of Anaesthesiology (ESA) and the European Board of Anaesthesiology have created a taskforce of experts that has been assigned to create an evidence-based guideline and, whenever the evidence was weak, a consensus amongst experts on: the evaluation of adult patients undergoing PSA, the role and competences required for the clinicians to safely perform PSA, the commonly used drugs for PSA, the adverse events that PSA can lead to, the minimum monitoring requirements and post-procedure discharge criteria...
September 5, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28864688/effect-of-propofol-combined-with-opioids-on-cough-reflex-suppression-in-gastroscopy-study-protocol-for-a-double-blind-randomized-controlled-trial
#5
Ning Yin, Jiangyan Xia, Yi-Zhi Cao, Xinjian Lu, Jing Yuan, Jue Xie
INTRODUCTION: The best methods for inducing analgesia and sedation for gastroscopy are still debated but finding an adequate regimen of sedation/analgesia is important. Stimulation of the larynx under sedation can cause reflex responses. Propofol with opioids has been recommended for gastroscopy sedation but the effects on cough reflex suppression remain unclear. This trial will evaluate the effects of propofol combined with small doses of dezocine, oxycodone, sufentanil or fentanyl for gastroscopy...
September 1, 2017: BMJ Open
https://www.readbyqxmd.com/read/28856857/application-of-dexmedetomidine-remifentanil-in-high-intensity-ultrasound-ablation-of-uterine-fibroids-a-randomised-study
#6
X Fu, F Huang, Y Chen, Y Deng, Z Wang
OBJECTIVE: To compare the effects of dexmedetomidine-remifentanil with the traditional analgesia and sedation regimen midazolam-remifentanil during HIFU treatment of uterine fibroids. DESIGN: A randomised controlled trial. SETTING: Department of Anesthesia in a single hospital. POPULATION: Patients with uterine fibroids. METHODS: A total of 80 patients diagnosed with uterine fibroids and scheduled for selective HIFU treatment were randomly divided into the dexmedetomidine group (the D group) and midazolam group (the M group)...
August 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28856114/total-intravenous-anesthesia-for-neurosurgical-procedures-in-narcoleptic-patients-two-case-reports
#7
Sara Pedrosa, Nuno Lareiro, Pedro Amorim
INTRODUCTION: Narcoleptic patients may be at increased risk of prolonged emergence, postoperative hypersomnia, apneic episodes, and sleep paralysis after general anesthesia. Modafinil is the first-line treatment, however, the implication it has on general anesthesia is not clear. This report present 2 cases of narcoleptic patients medicated with modafinil that were submitted to total intravenous anesthesia for neurosurgical procedures. CASE PRESENTATION: Informed consent was obtained from both patients...
June 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/28852329/fascia-iliaca-block-for-reduction-of-anterior-native-hip-dislocation-a-case-report
#8
Christopher West, Yatish Ranganath, Michael Willey
Native hip dislocations require urgent reduction in a setting where adequate sedation and analgesia is essential. We have recently implemented the use of fascia iliaca blocks at our institution for preoperative pain management for patients with proximal femur fractures. In the setting of limited resources, alternate modalities for sedation and analgesia may need to be implemented to obtain a timely reduction for hip dislocations. We present a case report where of the use of a fascia iliaca block along with light sedation to obtain a successful, atraumatic reduction of an anterior dislocation of a native hip joint...
2017: Iowa Orthopaedic Journal
https://www.readbyqxmd.com/read/28829527/does-caffeine-improve-respiratory-rate-during-remifentanil-target-controlled-infusion-sedation-a-case-report-in-endoscopic-sedation
#9
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/28828950/evaluation-of-interobserver-agreement-for-postoperative-pain-and-sedation-assessment-in-cats
#10
Javier Benito, Beatriz P Monteiro, Guy Beauchamp, B Duncan X Lascelles, Paulo V Steagall
OBJECTIVE To evaluate agreement between observers with different training and experience for assessment of postoperative pain and sedation in cats by use of a dynamic and interactive visual analog scale (DIVAS) and for assessment of postoperative pain in the same cats with a multidimensional composite pain scale (MCPS). DESIGN Randomized, controlled, blinded study. ANIMALS 45 adult cats undergoing ovariohysterectomy. PROCEDURES Cats received 1 of 3 preoperative treatments: bupivacaine, IP; meloxicam, SC with saline (0...
September 1, 2017: Journal of the American Veterinary Medical Association
https://www.readbyqxmd.com/read/28754357/what-is-the-utility-of-end-tidal-capnography-for-procedural-sedation-and-analgesia-in-the-emergency-department
#11
EDITORIAL
Michael Gottlieb, Melissa Rice
No abstract text is available yet for this article.
July 26, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28750729/-preparation-of-sedation-analgesia-procedures-in-spanish-paediatric-emergency-departments-a-descriptive-study
#12
Concepción Míguez, Niki Oikonomopoulou, Jorge Lorente, Paula Vázquez
INTRODUCTION: The objective of this study was to describe the current practice regarding the preparation of the sedation-analgesia (SA) procedures performed in the paediatric emergency centres in Spain. MATERIAL AND METHODS: A multicentre, observational and prospective analytical study was carried out on the SA procedures that were performed on children under 18 years-old in 18 paediatric emergency departments between February 2015 and January 2016. RESULTS: A total of 658 SA procedures were registered in 18 hospitals of Spain, most of them to children older than 24 months...
July 24, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28734807/-a-survey-on-premedication-prior-to-intubation-in-very-preterm-infants-28-32wg-with-respiratory-distress-syndrome-in-french-neonatal-intensive-care-units
#13
E Boiron, E Merlot, G Loron, X Durrmeyer, E Guyot
INTRODUCTION/OBJECTIVES: Tracheal intubation is a painful procedure for which the routine use of analgesia is recommended. However, the use of premedication for intubation is not yet generalized and there is great diversity in the drugs used. The main objective of this study was to describe the frequency of premedication use in preterm neonates aged between 28 and 32weeks of gestation, intubated for respiratory distress syndrome. Secondary objectives were to describe the existence of a written protocol, its influence on the frequency of premedication and the drugs used...
July 19, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28734732/perinatal-and-neonatal-use-of-sedation-and-analgesia
#14
REVIEW
Christopher McPherson, Terrie Inder
Optimal obstetric and neonatal care requires the provision of adequate analgesia for painful procedures. However, anesthetic and analgesic agents have the potential to adversely impact the developing fetal/neonatal brain. In this setting, clinicians must assess the risks and benefits of pharmacologic anesthesia and analgesia for specific indications in this population. General anesthesia is required for non-obstetric surgery and cesarean section in the absence of neuraxial anesthesia for the health of the mother and fetus...
October 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28733841/analgosedation-of-adult-patients-with-elevated-intracranial-pressure-survey-of-current-clinical-practice-in-austria
#15
Guenther Herzer, Claudia Mirth, Udo M Illievich, Wolfgang G Voelckel, Helmut Trimmel
BACKGROUND: Analgesia and sedation are key items in intensive care. Recently published S3 guidelines specifically address treatment of patients with elevated intracranial pressure. METHODS: The Austrian Society of Anesthesiology, Resuscitation and Intensive Care Medicine carried out an online survey of neurointensive care units in Austria in order to evaluate the current state of practice in the areas of analgosedation and delirium management in this high-risk patient group...
July 21, 2017: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/28725244/optimal-perioperative-anesthesia-management-for-gynecologic-interstitial-brachytherapy
#16
Alison A Nielsen, Tehani A Liyanage, Gary S Leiserowitz, Jyoti Mayadev
PURPOSE: To propose an optimal perioperative pain management clinical care pathway for interstitial brachytherapy for gynecologic cancer based on our interdepartmental experience. MATERIAL AND METHODS: We conducted a retrospective review of 23 women who underwent 32 interstitial brachytherapy procedures for gynecological cancers, analyzing patient demographics, type of anesthetic, medications, postoperative pain scores, adverse events, and delays in discharge. We measured the association of postoperative nausea and/or vomiting (PONV) with hydromorphone use, and postoperative pain scores and total narcotic administration with type of anesthesia...
June 2017: Journal of Contemporary Brachytherapy
https://www.readbyqxmd.com/read/28724494/pharmacokinetics-of-a-novel-transdermal-fentanyl-solution-in-rhesus-macaques-macaca-mulatta
#17
Gregory W Salyards, Marie-Josee Lemoy, Heather K Knych, Ashley E Hill, Kari L Christe
Rhesus macaques (Macaca mulatta) are the most commonly used NHP biomedical model and experience both research and clinical procedures requiring analgesia. Opioids are a mainstay of analgesic therapy. A novel, transdermal fentanyl solution (TFS) has been developed as a long-acting, single-administration topical opioid and was reported to provide at least 4 d of effective plasma concentrations in beagles (Canis familiaris). To evaluate the pharmacokinetic profile of TFS in healthy adult rhesus macaques, we used a 2-period, 2-treatment crossover study of a single topical administration of 1...
July 1, 2017: Journal of the American Association for Laboratory Animal Science: JAALAS
https://www.readbyqxmd.com/read/28702841/comparison-of-ketamine-and-ketofol-for-deep-sedation-and-analgesia-in-children-undergoing-laser-procedure
#18
Marija Stevic, Nina Ristic, Ivana Budic, Nebojsa Ladjevic, Branislav Trifunovic, Ivan Rakic, Marko Majstorovic, Ivana Burazor, Dusica Simic
The aim of our study was to research and evaluate cardiovascular and respiratory stability, clinical efficacy, and safety of two different anesthetic agents in pediatric patients who underwent Pulse dye (wavelength 595 nm, pulse duration 0-40 ms, power 0-40 J) and CO2 (wavelength 10,600 nm, intensity-fraxel mod with SX index 4 to 8, power 0-30 W) laser procedure. This prospective non-blinded study included 203 pediatric patients ASA I-II, aged between 1 month and 12 years who underwent short-term procedural sedation and analgesia for the laser procedure...
July 12, 2017: Lasers in Medical Science
https://www.readbyqxmd.com/read/28667196/patient-safety-during-procedural-sedation-using-capnography-monitoring-a-systematic-review-and-meta-analysis
#19
Rhodri Saunders, Michel M R F Struys, Richard F Pollock, Michael Mestek, Jenifer R Lightdale
OBJECTIVE: To evaluate the effect of capnography monitoring on sedation-related adverse events during procedural sedation and analgesia (PSA) administered for ambulatory surgery relative to visual assessment and pulse oximetry alone. DESIGN AND SETTING: Systematic literature review and random effects meta-analysis of randomised controlled trials (RCTs) reporting sedation-related adverse event incidence when adding capnography to visual assessment and pulse oximetry in patients undergoing PSA during ambulatory surgery in the hospital setting...
June 30, 2017: BMJ Open
https://www.readbyqxmd.com/read/28663622/comparative-evaluation-of-continuous-thoracic-paravertebral-block-and-thoracic-epidural-analgesia-techniques-for-post-operative-pain-relief-in-patients-undergoing-open-nephrectomy-a-prospective-randomized-single-blind-study
#20
Sujeet Kumar Singh Gautam, Pravin Kumar Das, Anil Agarwal, Sanjay Kumar, Sanjay Dhiraaj, Abhishek Keshari, Abinash Patro
BACKGROUND: Open surgical procedures are associated with substantial postoperative pain; an alternative method providing adequate pain relief with minimal side effects is very much required. AIM: The aim of this study was a comparative evaluation of the efficacy of continuous thoracic paravertebral block (PVB) and thoracic epidural analgesia (EA) for postoperative pain relief in patients undergoing open nephrectomy. SETTINGS AND DESIGN: Prospective, randomized, and single-blind study...
April 2017: Anesthesia, Essays and Researches
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