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procedural sedation and analgesia

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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
#1
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
#2
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...
July 19, 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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
https://www.readbyqxmd.com/read/28663619/comparison-of-the-effects-of-four-subdoses-of-dextroketamine-to-reduce-pain-during-posterior-brachial-plexus-block-a-randomized-double-blind-study
#9
Luiz Eduardo Imbellon, Marildo A Gouveia, Geraldo Borges de Morais Filho
BACKGROUND: The needle puncture produces discomfort during regional anesthesia. Sedation and local anesthesia are used to promote analgesia and amnesia. The main objective of this study was to compare the efficacy of four subanesthetic doses of dextroketamine for pain relief during brachial plexus block via the posterior approach. MATERIALS AND METHODS: Patients American Society of Anesthesiology I and II programed for elective surgery under brachial plexus block were distributed at randomized into four groups of twenty patients...
April 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28653359/ultrasound-assessment-of-gastric-content-in-the-immediate-postpartum-period-a-prospective-observational-descriptive-study
#10
F Vial, N Hime, J Feugeas, N Thilly, P Guerci, H Bouaziz
INTRODUCTION: Pulmonary aspiration of gastric contents in pregnant women undergoing general anesthesia or sedation/analgesia in the peripartum period is a feared complication in obstetric anesthesia. We assessed the changes in antral cross-sectional area (CSA) with ultrasonography in laboring women and in the immediate postpartum period. PATIENTS AND METHODS: In an observational study in a university-affiliated maternity, gastric ultrasonography examinations were performed in non-consecutive laboring women, after epidural analgesia insertion and after childbirth...
June 26, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28642966/procedural-sedation-and-analgesia-for-pediatric-shock-wave-lithotripsy-a-10-year-experience-of-single-institution
#11
Banu Cevik, Murat Tuncer, Kutlu Hakan Erkal, Bilal Eryildirim, Kemal Sarica
The aim of this study was to evaluate anesthesia practice for pediatric extracorporeal shock wave lithotripsy (ESWL) according to the age groups and discuss the anesthetic management of these patients. Pediatric patients treated with ESWL because of urolithiasis under anesthesia in our department between December 2007 and January 2017 were evaluated retrospectively. A total of 251 patients were divided into two groups as Group PS: preschool children (<6 years) and Group S: school children (≥6 years)...
June 22, 2017: Urolithiasis
https://www.readbyqxmd.com/read/28629738/nitrous-oxide-versus-oral-sedation-for-pain-management-of-first-trimester-surgical-abortion-a-randomized-study
#12
Rameet H Singh, Maria Montoya, Eve Espey, Lawrence Leeman
OBJECTIVE: The objective of the study was to compare nitrous oxide with oxygen (N2O/O2) to oral hydrocodone/acetaminophen and lorazepam for analgesia during first-trimester surgical abortion. STUDY DESIGN: This double-blind randomized trial assigned women undergoing first-trimester surgical abortion at<11 weeks' gestation to inhaled N2O/O2 vs. oral sedation for pain management. The N2O/O2 group received up to 70:30 ratio during the procedure and placebo pills preprocedure; the oral group received inhaled oxygen during the procedure and oral hydrocodone/acetaminophen 5 mg/325 mg and lorazepam 1 mg preprocedure...
June 16, 2017: Contraception
https://www.readbyqxmd.com/read/28592279/the-effect-of-post-traumatic-stress-disorder-on-intra-operative-analgesia-in-a-veteran-population-during-cataract-procedures-carried-out-using-retrobulbar-or-topical-anesthesia-a-retrospective-study
#13
Yuna Rapoport, Laura L Wayman, Amy S Chomsky
BACKGROUND: A growing proportion of veterans treated at the Veterans Health Administration (VA) have a history of post-traumatic-stress-disorder (PTSD), and there exists a higher rate of PTSD amongst veterans than the general population. The purpose of this study is to determine the correlation between PTSD and intra-operative analgesia, intra-operative time, and anesthesia type for cataract surgery in a veteran population. Secondary objectives are to determine if patient age, and first or second eye surgery affect intra-operative pain control or are correlated with type of anesthesia modality...
June 7, 2017: BMC Ophthalmology
https://www.readbyqxmd.com/read/28570293/mother-s-lived-experience-during-repair-of-long-gap-esophageal-atresia-a-phenomenological-inquiry
#14
Patricia Fleck, Carole Kenner, Rhonda Board, Sandra Mott
BACKGROUND: Infants born with long-gap esophageal atresia (LGEA) pose unique physiologic risks in the newborn period. Anatomic and physiologic anomalies require an extended hospitalization with procedural analgesia and sedation that impact the mother's experience of birth, maternal response, and nurturing of her infant. PURPOSE: The aim of this study was to understand the meaning of experiences that mothers of infants born with LGEA encounter in the neonatal intensive care unit while their infant undergoes esophageal repair...
August 2017: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/28566870/temporomandibular-joint-dislocation-in-an-18-month-old-child
#15
Jaeson Mohanan Painatt, Ravi Veeraraghavan, Ushass Puthalath
Temporomandibular joint (TMJ) dislocation in children is extremely rare. In our case, an 18-month-old child presented with a history of inability to close her mouth. To confirm the clinical diagnosis, a computed tomogram was taken. Clinical examination and X-ray of the TMJ revealed bilateral TMJ dislocation. Bilateral TMJ reduction was achieved manually after giving analgesia and procedural sedation. This is one of the few case reports of an acute dislocation in a toddler.
January 2017: Contemporary Clinical Dentistry
https://www.readbyqxmd.com/read/28551063/-superior-gluteal-nerve-a-new-block-on-the-block
#16
Miguel Sá, Rita Graça, Hugo Reis, José Miguel Cardoso, José Sampaio, Célia Pinheiro, Duarte Machado
BACKGROUND AND OBJECTIVES: The superior gluteal nerve is responsible for innervating the gluteus medius, gluteus minimus and tensor fascia latae muscles, all of which can be injured during surgical procedures. We describe an ultrasound-guided approach to block the superior gluteal nerve which allowed us to provide efficient analgesia and anesthesia for two orthopedic procedures, in a patient who had significant risk factors for neuraxial techniques and deep peripheral nerve blocks. CLINICAL REPORT: An 84-year-old female whose regular use of clopidogrel contraindicated neuraxial techniques or deep peripheral nerve blocks presented for urgent bipolar hemiarthroplasty in our hospital...
May 24, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28536837/controlled-sedation-with-midazolam-and-analgesia-with-nalbuphine-to-alleviate-pain-in-patients-undergoing-subcutaneous-implantable-cardioverter-defibrillator-implantation
#17
Michaël Peyrol, Jérémie Barraud, Jennifer Cautela, Baptiste Maille, Marc Laine, Laurent Bonello, Franck Thuny, Franck Paganelli, Frédéric Franceschi, Linda Koutbi, Samuel Levy
PURPOSE: Subcutaneous implantable cardioverter defibrillator (S-ICD) is an alternative to transvenous ICD to prevent sudden cardiac death. Subcutaneous ICD implantation frequently requires general anesthesia because of procedure nociceptive steps during creation of a large device pocket and lead tunneling. This study aims to determine if a strategy of operator-guided controlled sedation with midazolam and analgesia with nalbuphine is effective in alleviating pain during S-ICD implantation...
May 23, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28526145/alpha-2-agonists
#18
REVIEW
Viet Nguyen, Dawn Tiemann, Edward Park, Ali Salehi
Alpha-2 adrenergic receptors are spread throughout the central and peripheral nervous system, specifically in the pontine locus coeruleus, medullospinal tracts, rostral ventrolateral medulla, and the dorsal horn of the spinal cord. Alpha-2 agonist agents cause neuromodulation in these centers, leading to sedation, analgesia, vasodilatation, and bradycardia with little effect on the respiratory drive, which accounts for their good safety profile. The 2 major drugs in this group are clonidine and dexmedetomidine...
June 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28508254/comparison-of-pain-within-24%C3%A2-h-after-uterine-artery-embolization-with-tris-acryl-gelatin-microspheres-versus-gelatin-sponge-particles-for-leiomyoma
#19
Tetsuya Katsumori, Hisatomi Arima, Shunsuke Asai, Natsuko Hayashi, Hiroshi Miura
PURPOSE: To compare acute pain after uterine artery embolization (UAE) with tris-acryl gelatin microspheres (TAGM) versus gelatin sponge particles (GS) for leiomyoma. MATERIALS AND METHODS: This was a single-institution, retrospective study. Between July 2008 and November 2016, 101 consecutive patients with symptomatic uterine leiomyoma underwent UAE with the same protocol for post-procedural pain. GS was employed with near-stasis endpoint for the first 49 patients, whereas TAGM was used with limited endpoint for the next 52 patients...
May 15, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28497160/spinal-osteoid-osteoma-efficacy-and-safety-of-radiofrequency-ablation
#20
Ugo Albisinni, Giancarlo Facchini, Paolo Spinnato, Alessandro Gasbarrini, Alberto Bazzocchi
OBJECTIVE: The aim of this study was to evaluate the efficacy and complications of CT-guided radiofrequency ablation (RFA) of spinal osteoid osteoma (OO). MATERIALS AND METHODS: Between 2002 and 2012, a total of 61 patients (46 male and 15 female, mean age 26.4 ± 12.7 years) were subjected to RFA for spinal OO. The diagnosis of OO was made after a period of pain and symptoms of 20.6 ± 14.4 months. RFA was performed under conscious sedation and local analgesia...
August 2017: Skeletal Radiology
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