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sedation endoscopy

Thorsten Brechmann, Christoph Maier, Miriam Kaisler, Jan Vollert, Wolff Schmiegel, Svetlana Pak, Norbert Scherbaum, Fred Rist, Andrea Riphaus
Background: Propofol is recommended for sedation in gastrointestinal endoscopy (GE), but preliminary data suggest addictive potentials. Objective: The objective of this article is to evaluate the frequency of predominantly euphoric reaction after GE and patients' subsequent reminiscences. Methods: Eighty-two patients undergoing elective GE under propofol sedation were enrolled in a prospective observational study. The grade of anxiety, expectation or relief about the examination's result and affective state in terms of cheerfulness, relaxation, activation, sedation and anxiety were surveyed using a numeric rating scale (1 to 10) immediately before (t1), after GE (t2) and seven days (t3) later...
May 2018: United European Gastroenterology Journal
C Górriz Gil, V Matallana Royo, Ó Álvarez Montero, A Rodríguez Valiente, C Fernández Manzano, B Conde García, J R García-Berrocal
Eosinophilic esophagitis (EoE) is a recently recognised pathologic entity whose prevalence has risen significantly since first being described in 1993. Defined as a chronic, local immune-mediated disease with predominant eosinophil infiltration, it is nowadays the leading cause of dysphagia and food bolus impaction in children and young adults. Genetic and environmental risk factors, and especially food antigens, trigger the disease and are in the focus of investigation as avoidance can cure three quarters of patients...
June 6, 2018: HNO
Julio Cesar Martins Aquino, Wanderley Marques Bernardo, Diogo Turiani Hourneaux de Moura, Flávio Hiroshi Ananias Morita, Rodrigo Silva de Paula Rocha, Maurício Kazuyoshi Minata, Martin Coronel, Gustavo Luís da Silva Rodela, Robson Kiyoshi Ishida, Rogério Kuga, Eduardo Guimarães Hourneaux de Moura
Objectives:  To compare the insufflation of CO 2 and ambient air in enteroscopy. Search sources:  The investigators researched the electronic databases MedLine, Cochrane Library, Central, LILACS, BVS, Scopus and Cinahl. The grey search was conducted in the base of theses of the University of São Paulo, books of digestive endoscopy and references of selected articles and in previous systematic revisions. Study eligibility criteria:  The evaluation of eligibility was performed independently, in a non-blind manner, by two reviewers, firstly by title and abstract, followed by complete text...
June 2018: Endoscopy International Open
Kate Leslie, James Sgroi
PURPOSE OF REVIEW: The purpose of this article is to review the practice of sedation for adults having gastrointestinal endoscopy in Australia and to compare it with practice in other countries. RECENT FINDINGS: The practice of sedation for endoscopy in Australia is dominated by anaesthesiologists, who have a preference for deep propofol-based sedation. The recent literature includes a number of guidelines for sedation developed by multidisciplinary groups, anaesthesiologists and gastroenterologists in Australia and other countries...
May 24, 2018: Current Opinion in Anaesthesiology
Julian F Daza, Carolyn M Tan, Ryan J Fielding, Allison Brown, Forough Farrokhyar, Ilun Yang
BACKGROUND: With a growing demand for endoscopic services, the role of anesthesiologists in endoscopy units must be reassessed. The aim of this study was to compare patient outcomes in non-anesthesiologist-administered propofol (NAAP) versus anesthesiologist-administered propofol (AAP) during routine endoscopy. METHODS: We systematically searched Medline, CINAHL, Embase, Web of Science, CENTRAL and the grey literature for studies comparing NAAP and AAP. Primary outcomes included endoscopy- and sedation-related complications...
June 1, 2018: Canadian Journal of Surgery. Journal Canadien de Chirurgie
Jing-Yang Liou, Mei-Yung Tsou, Shinju Obara, Lu Yu, Chien-Kun Ting
BACKGROUND: Sedation for esophagogastroduodenoscopy (EGD) and colonoscopy is characterized by rapid patient induction and emergence. The drugs midazolam and alfentanil have long been used for procedural sedation; however, the relationship between plasma or effect-site concentrations (Cp or Ce, respectively) and emergence remains unclear. The aim of this study is to develop patient wake-up prediction models for both Cp and Ce using response surface modeling, a pharmacodynamics tool for assessing patients' responses...
May 23, 2018: Journal of the Formosan Medical Association, Taiwan Yi Zhi
J-Y Liou, C-K Ting, W-N Teng, M S Mandell, M-Y Tsou
BACKGROUND: The non-linear mixed amount with zero amounts response surface model can be used to describe drug interactions and predict loss of response to noxious stimuli and respiratory depression. We aimed to determine whether this response surface model could be used to model sedation with the triple drug combination of midazolam, alfentanil and propofol. METHODS: Sedation was monitored in 56 patients undergoing gastrointestinal endoscopy (modelling group) using modified alertness/sedation scores...
June 2018: British Journal of Anaesthesia
Otto S Lin, Wade Weigel
PURPOSE OF REVIEW: To assess the trends in nonoperating room anesthesia (NORA) for gastrointestinal endoscopy over the past few years, and to describe alternative methods of delivering propofol sedation in selected low-risk patients. RECENT FINDINGS: The use of NORA for routine gastrointestinal endoscopic procedures has been rising steadily over the past decade in the United States, considerably increasing healthcare costs. Because of this, there have been attempts to develop nonanesthesiologist-administered propofol sedation methods in low-risk patients...
May 16, 2018: Current Opinion in Anaesthesiology
Christopher M Kollmann, Wolff Schmiegel, Thorsten Brechmann
Background and aims: Apparent aspiration is a notable adverse event during gastrointestinal endoscopy under sedation (GIES), but data about inapparent aspiration are scarce. Generally, particularly older patients are at higher risk of suffering from adverse events. Objective: The objective of this article is to determine the risk of pneumonia, lower respiratory tract infection (LRI) and systemic inflammatory activation after GIES, especially in patients of at least 65 years...
April 2018: United European Gastroenterology Journal
Hana M Wiemer, Michael B Butler, Patrick C Froese, Allan Lapierre, Chris Carriere, Glen R Etsell, Dana Farina, Jennifer Jones, Jock Murray, Samuel G Campbell
CLINICIAN'S CAPSULE What is known about the topic? Advanced care paramedics (ACPs) in our emergency department (ED) successfully perform procedural sedation and analgesia (PSA) for several procedures, including orthopedic manipulations. What did this study ask? How does the novel practice of ACP-led ED PSA for upper gastrointestinal (UGI) endoscopy compare to that for orthopedic procedures? What did this study find? Adverse events occurred more frequently during UGI endoscopy sedations than orthopedic sedations (41...
May 15, 2018: CJEM
Rongzan Zhang, Quan Lu, Younong Wu
INTRODUCTION: Midazolam and propofol are both used for sedation in gastrointestinal endoscopy. We conducted a systematic review and meta-analysis to compare the efficacy and safety of midazolam and propofol in gastrointestinal endoscopy. MATERIALS AND METHODS: PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases were systematically searched. Randomized controlled trials assessing the effect of midazolam versus propofol on sedation in gastrointestinal endoscopy are included...
May 5, 2018: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Xiaotian Sun, Yang Xu, Xueting Zhang, Aitong Li, Hanqing Zhang, Teng Yang, Yan Liu
Propofol sedation has been applied during esophagogastroduodenoscopy procedures, but whether topical pharyngeal anesthesia should be administered at the same time has rarely been reported. Our study examined the role of topical pharyngeal anesthesia in sedated endoscopies in a randomized controlled double-blinded clinical trial. A total of 626 patients who underwent sedated esophagogastroduodenoscopy were randomized into the experimental group (n = 313) or the control group (n = 313). The discomfort score, immediately and one day after the procedure, was not statistically significant [7...
April 27, 2018: Scientific Reports
Angelika Behrens, Christian Ell
No abstract text is available yet for this article.
April 20, 2018: Gut
Huasheng Lai, Junsheng Huang, Yangzhi Xu, Jie Zhang, Zhenyu Chen, Fengcheng Xi, Aimin Li, Side Liu
Background/Aim: Magnetically-controlled capsule endoscopy (MCE) is a potential option for the evaluation of gastric diseases in cases that are unsuited for conventional endoscopy, avoiding discomfort, sedation, and related complications. This retrospective study investigated associations between MCE findings and patient gender, age, and inpatient/outpatient status. Patients and Methods: The data of 580 consecutive patients who underwent MCE from 2015 to 2016 were analyzed...
May 2018: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
Maciej Matyja, Artur Pasternak, Mirosław Szura, Michał Pędziwiatr, Piotr Major, Kazimierz Rembiasz
Introduction: Colonoscopy plays a critical role in colorectal cancer (CRC) screening and has been widely regarded as the gold standard. Cecal intubation rate (CIR) is one of the well-defined quality indicators used to assess colonoscopy. Aim: To assess the impact of new technologies on the quality of colonoscopy by assessing completion rates. Material and methods: This was a dual-center study at the 2nd Department of Surgery at Jagiellonian University Medical College and at the Specialist Center "Medicina" in Krakow, Poland...
March 2018: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
Matt Lechner, Dominic Wilkins, Bhik Kotecha
Sleep disordered breathing (SDB) comprises a spectrum of disorders, ranging from simple snoring to severe obstructive sleep apnoea (OSA), with a significant burden to health care systems in high income countries. If left untreated, OSA has significant cumulative, long-term health consequences. In the 1990s drug induced sedation endoscopy (DISE) has been developed to become a primary tool in the diagnosis and management of OSA. It allows meticulous endoscopic evaluation of the airway and identifies areas of collapse, thereby informing both on the selection of surgical techniques, where efficacy depends entirely on success at relieving obstruction at a certain level and on the usefulness of conservative measures, such as mandibular advancement splints...
February 24, 2018: Sleep Medicine Reviews
Juan Ángel Ferrer Rosique, Héctor Julián Canaval Zuleta, Guillermo Cacho Acosta
Although sedation in endoscopy is increasingly used and contributes to the quality of procedures, its role in upper gastrointestinal endoscopy (UGE) is not as well defined as in other procedures. For this reason, we conducted a prospective pilot study where the patient, once informed of the different options, decided whether or not to undergo sedation for UGE. Remarkably, almost 60% preferred not to undergo sedation, with a high degree of satisfaction and no adverse effects in any of the groups (Ferrer Rosique JA, et al...
April 2018: Revista Española de Enfermedades Digestivas
Pablo Hernán Ocaña
Currently, sedation in endoscopic procedures is considered a necessary condition and a criterion of quality in digestive endoscopy. The role of SAE in conventional endoscopic procedures is clearly established in clinical guidelines, but this is not so clear in complex endoscopic procedures, such as ERCP. In recent years, numerous studies have been published, with results similar to those noticed in this article, endorsing the safety, efficacy and efficiency of SAE, when performed by properly trained staff.
April 2018: Revista Española de Enfermedades Digestivas
Francisco Pérez Roldán
It is a letter that aims to emphasize the type of sedation that is sometimes used by anesthetists to perform a standard endoscopy and the excessive use of the operating room, which increases the cost of endoscopy and reduces the resources of surgical time.
April 2018: Revista Española de Enfermedades Digestivas
Enrique Pérez-Cuadrado-Robles, Alexandre Ferreira, Jesús García-Cano
During the last years, there is more and more scientific evidence about the safety and feasibility of non-anesthesiologist administration of propofol (NAAP) in gastrointestinal endoscopy, reducing sedation induction and recovery time as well as increasing patient and endoscopist satisfaction. Furthermore, a similar risk of adverse events compared with traditional agents or anesthesiologist administration of propofol (AAP) has been described. The present special issue of the Spanish Journal of Gastroenterology (Revista Española de Enfermedades Digestivas) focusses on NAAP in different settings, including complex endoscopic procedures...
April 2018: Revista Española de Enfermedades Digestivas
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