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Sedation monitoring

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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/28918427/safety-of-monitored-anesthesia-care-using-propofol-based-sedation-for-pleuroscopy
#2
Erik Vakil, Mona Sarkiss, David Ost, Macarena R Vial, Roberto F Casal, Georgie A Eapen, Horiana B Grosu
BACKGROUND: The optimal approach to sedation for pleuroscopy remains undefined. Propofol is the favored sedative-hypnotic for many proceduralists but has a narrow therapeutic window and the risk for oversedation is high. Propofol-based sedation administered by anesthesiologists and the routine use of end-tidal capnography and bispectral index (BIS) monitoring may attenuate risks of complications. OBJECTIVES: The purpose of our study was to evaluate the safety and efficacy of monitored anesthesia care for pleuroscopy...
September 16, 2017: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/28916326/are-wireless-electronic-stethoscopes-useful-for-respiratory-rate-monitoring-during-intravenous-sedation
#3
Keiko Morimoto, Yukako Tsutsui, Shin Ogura, Katsuhisa Sunda
PURPOSE: Wireless stethoscopes can measure respiratory rate noninvasively and continuously, but there are no reports of their use during dental treatment. This study evaluated the usefulness of wireless stethoscopes during dental procedures requiring intravenous sedation (IVS). MATERIALS AND METHODS: This study was a prospective cohort study. The study sample consisted of dental patients who received IVS by propofol or midazolam administration at the Nippon Dental University Hospital (Tokyo, Japan)...
August 24, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28910188/sedative-and-analgesic-drugs-online-a-content-analysis-of-the-supply-and-demand-information-available-in-thailand
#4
Kanokporn Pinyopornpanish, Wichuda Jiraporncharoen, Kanittha Thaikla, Kulyapa Yoonut, Chaisiri Angkurawaranon
BACKGROUND: Evidence from other countries has suggested that many controlled drugs are also offered online, even though it is illegal to sell these drugs without a license. OBJECTIVES: To evaluate the current contents related to the supply and demand of sedatives and analgesic drugs available online in Thailand, with a particular focus on Facebook. METHODS: A team of reviewers manually searched for data by entering keywords related to analgesic drugs and sedatives...
September 14, 2017: Substance Use & Misuse
https://www.readbyqxmd.com/read/28904684/anaesthetic-management-for-awake-craniotomy-in-brain-glioma-resection-initial-experience-in-military-hospital-mohamed-v-of-rabat
#5
Mohammed Meziane, Abdelghafour Elkoundi, Redouane Ahtil, Miloudi Guazaz, Bensghir Mustapha, Charki Haimeur
The awake brain surgery is an innovative approach in the treatment of tumors in the functional areas of the brain. There are various anesthetic techniques for awake craniotomy (AC), including asleep-awake-asleep technique, monitored anesthesia care, and the recent introduced awake-awake-awake method. We describe our first experience with anesthetic management for awake craniotomy, which was a combination of these techniques with scalp nerve block, and propofol/rémifentanil target controlled infusion. A 28-year-oldmale underwent an awake craniotomy for brain glioma resection...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28898439/evaluation-of-the-use-of-midazolam-as-a-co-induction-agent-with-ketamine-for-anaesthesia-in-sedated-ponies-undergoing-field-castration
#6
A Allison, R Robinson, C Jolliffe, P M Taylor
BACKGROUND: There are limited investigations comparing ketamine to a ketamine-midazolam co-induction. OBJECTIVES: To compare quality and safety of general anaesthesia induced using ketamine alone with anaesthesia co-induced using ketamine and midazolam. STUDY DESIGN: Randomised, double blinded, placebo controlled trial. METHODS: After i.v. detomidine (20 μg kg(-1) ) thirty-eight ponies undergoing field castration received either 0...
September 12, 2017: Equine Veterinary Journal
https://www.readbyqxmd.com/read/28882371/comparison-of-subcutaneous-dexmedetomidine-midazolam-versus-alfaxalone-midazolam-sedation-in-leopard-geckos-eublepharis-macularius
#7
Grayson A Doss, Dustin M Fink, Kurt K Sladky, Christoph Mans
OBJECTIVE: To compare dexmedetomidine-midazolam with alfaxalone-midazolam for sedation in leopard geckos (Eublepharis macularius). STUDY DESIGN: Prospective, randomized, blinded, complete crossover study. ANIMALS: Nine healthy adult leopard geckos. METHODS: Geckos were administered a combination of dexmedetomidine (0.1 mg kg(-1)) and midazolam (1.0 mg kg(-1); treatment D-M) or alfaxalone (15 mg kg(-1)) and midazolam (1...
April 24, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28879332/anesthetic-management-for-simultaneous-drug-induced-sleep-endoscopy-and-maxillomandibular-advancement-in-a-patient-with-obstructive-sleep-apnea
#8
Tae Seong Kuk, Eunsun So, Myong-Hwan Karm, Jimin Kim, Seong In Chi, Hyun Jeong Kim, Kwang-Suk Seo, Sung Woon On, Jin-Young Choi
Drug-induced sleep endoscopy (DISE) is used to identify areas of upper airway obstruction, which occurs when patients with obstructive sleep apnea (OSA) snore. DISE enables effective diagnosis and appropriate treatment of the obstruction site. Among surgical treatment methods for OSA, maxillomandibular advancement surgery (MMA) is performed to move a jaw forward; the surgery has a high success rate for OSA treatment. In DISE, anesthetics such as propofol and midazolam must be administered to induce snoring while the patient is deeply sedated for an accurate diagnosis to be made...
March 2017: J Dent Anesth Pain Med
https://www.readbyqxmd.com/read/28877145/european-society-of-anaesthesiology-and-european-board-of-anaesthesiology-guidelines-for-procedural-sedation-and-analgesia-in-adults
#9
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/28875616/prescription-pattern-of-antidepressants-for-children-and-adolescents-in-korea-based-on-nationwide-data
#10
Myong Wuk Chon, Jungsun Lee, Seockhoon Chung, Yangsik Kim, Hyo Won Kim
Antidepressant prescription for youths has recently been on the increase. There is a growing concern over the increasing off-label usage of antidepressants. Current data on off-label antidepressant usage vary across countries and healthcare systems. Therefore, we examined the extent and pattern of antidepressant prescription for Korean children and adolescents using population-based data. Our data was retrieved from the Korean National Health Insurance Service National Sample Cohort of the year 2013. Among 0...
October 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/28875137/risk-factor-analysis-of-additional-administration-of-sedative-agent-and-patient-dissatisfaction-in-intravenous-conscious-sedation-using-midazolam-for-third-molar-extraction
#11
Dong-Whan Shin, Jin-Yong Cho, Yoon-Sic Han, Hye-Young Sim, Hee-Sun Kim, Da-Un Jung, Ho Lee
OBJECTIVES: The primary purpose of this study was to investigate the factors related with additional administration of sedative agent during intravenous conscious sedation (IVS) using midazolam (MDZ). The secondary purpose was to analyze the factors affecting patient satisfaction. MATERIALS AND METHODS: Clinical data for 124 patients who had undergone surgical extraction of mandibular third molar under IVS using MDZ were retrospectively investigated in this case-control study...
August 2017: Journal of the Korean Association of Oral and Maxillofacial Surgeons
https://www.readbyqxmd.com/read/28873076/women-awaken-faster-than-men-after-electroencephalogram-monitored-propofol-sedation-for-colonoscopy-a-prospective-observational-study
#12
Andrea Riphaus, Mark Slottje, Jan Bulla, Carolin Keil, Christian Mentzel, Vera Limbach, Barbara Schultz, Christian Unzicker
BACKGROUND: Sedation for colonoscopy using intravenous propofol has become standard in many Western countries. OBJECTIVE: Gender-specific differences have been shown for general anaesthesia in dentistry, but no such data existed for gastrointestinal endoscopy. DESIGN: A prospective observational study. SETTING: An academic teaching hospital of Hannover Medical School. PATIENTS: A total of 219 patients (108 women and 111 men) scheduled for colonoscopy...
October 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28869145/the-early-diagnosis-and-management-of-mixed-delirium-in-a-patient-placed-on-ecmo-and-with-difficult-sedation-a-case-report
#13
María Acevedo-Nuevo, Maria Teresa González-Gil, Miguel Ángel Romera-Ortega, Ignacio Latorre-Marco, Maria Dolores Rodríguez-Huerta
Delirium represents a serious problem that impacts the physical and cognitive prognosis of patients admitted to intensive care units and requires prompt diagnosis and management. This article describes the case and progress of a patient placed on Extracorporeal Membrane Oxygenation with difficult sedation criteria and an early diagnosis of mixed delirium. During the case report, we reflect on the pharmacological and non-pharmacological strategies employed to cope with delirium paying special attention to the non-use of physical restraint measures in order to preserve vital support devices (endotracheal tube or Extracorporeal Membrane Oxygenation cannula)...
August 28, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28867906/open-carpal-tunnel-release-outcomes-performed-wide-awake-versus-with-sedation
#14
Jacob E Tulipan, Nayoung Kim, Jack Abboudi, Christopher Jones, Frederic Liss, William Kirkpatrick, Michael Rivlin, Mark L Wang, Jonas Matzon, Asif M Ilyas
Background  Carpal tunnel release (CTR) is the most common surgery of the hand, and interest is growing in performing it under local anesthesia without tourniquet. To better understand differences, we hypothesized that patients undergoing CTR under wide-awake local anesthesia with no tourniquet (WALANT) versus sedation (monitored anesthesia care [MAC]) would not result in a difference in outcome. Methods  Consecutive cases of electrodiagnostically confirmed open CTR across multiple surgeons at a single center were prospectively enrolled...
August 2017: Journal of Hand and Microsurgery
https://www.readbyqxmd.com/read/28865447/multicenter-assessment-of-sedation-and-delirium-practices-in-the-intensive-care-units-in-poland-is-this-common-practice-in-eastern-europe
#15
Katarzyna Kotfis, Małgorzata Zegan-Barańska, Maciej Żukowski, Krzysztof Kusza, Mariusz Kaczmarczyk, E Wesley Ely
BACKGROUND: The majority of critically ill patients experience distress during their stay in the Intensive Care Unit (ICU), resulting from systemic illness, multiple interventions and environmental factors. Providing humane care should address concomitant treatment of pain, agitation and delirium. The use of sedation and approaches to ICU delirium should be monitored according to structured guidelines. However, it is unknown to what extent these concepts are followed in Eastern European countries like Poland...
September 2, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28861941/early-follow-up-of-lung-disease-in-infants-with-cystic-fibrosis-using-the-raised-volume-rapid-thoracic-compression-technique-and-computed-tomography-during-quiet-breathing
#16
Rémi Gauthier, Yann Cabon, Marie Agnes Giroux-Metges, Cecile Du Boisbaudry, Phillipe Reix, Muriel Le Bourgeois, Raphael Chiron, Nicolas Molinari, Magali Saguintaah, Francis Amsallem, Stefan Matecki
BACKGROUND: Among the different techniques used to monitor lung disease progression in infants with CF diagnosed by Newborn screening (NBS), raised volume-rapid thoracic compression (RVRTC) remains a promising tool. However, the need of sedation and positive pressure ventilation considerably limits its clinical use. We recently described a semi-quantitative method to evaluate air trapping by chest tomography during quite breathing without sedation (CTqb score). This parameter is the radiological sign of airway obstruction and could be also used for lung disease follow-up in infants with CF...
September 1, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28858548/squamous-papilloma-causing-airway-obstruction-during-conscious-sedation
#17
Paul Brady, Christine McCreary, Ken D O'Halloran, Catherine Gallagher
Monitoring for respiratory depression is essential during conscious sedation. We report a case of a squamous papilloma as an unusual cause of intermittent partial airway obstruction in a 43-year-old man undergoing intravenous conscious sedation with midazolam. The Integrated Pulmonary Index (IPI) is an algorithm included in some commercially available monitors that constitutes a representation of 4 parameters: end-tidal carbon dioxide, respiratory rate, oxygen saturation, and pulse rate. We discuss the potential of the IPI as a monitoring tool during sedation...
2017: Anesthesia Progress
https://www.readbyqxmd.com/read/28856114/total-intravenous-anesthesia-for-neurosurgical-procedures-in-narcoleptic-patients-two-case-reports
#18
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/28854538/dexmedetomidine-pharmacokinetic-pharmacodynamic-modelling-in-healthy-volunteers-1-influence-of-arousal-on-bispectral-index-and-sedation
#19
P J Colin, L N Hannivoort, D J Eleveld, K M E M Reyntjens, A R Absalom, H E M Vereecke, M M R F Struys
Background: Dexmedetomidine, a selective α 2 -adrenoreceptor agonist, has unique characteristics, such as maintained respiratory drive and production of arousable sedation. We describe development of a pharmacokinetic-pharmacodynamic model of the sedative properties of dexmedetomidine, taking into account the effect of stimulation on its sedative properties. Methods: In a two-period, randomized study in 18 healthy volunteers, dexmedetomidine was delivered in a step-up fashion by means of target-controlled infusion using the Dyck model...
August 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28845902/persistence-of-delirium-after-cessation-of-sedatives-and-analgesics-and-impact-on-clinical-outcomes-in-critically-ill-patients
#20
Michael T Kenes, Joanna L Stollings, Li Wang, Timothy D Girard, E Wesley Ely, Pratik P Pandharipande
STUDY OBJECTIVE: As delirium is a common manifestation in critically ill patients and is associated with worse clinical outcomes, we sought to characterize the reversibility of delirium after discontinuation of sedation and to determine whether sedation-associated delirium that rapidly reverses impacts clinical outcomes. DESIGN: Post hoc subgroup analysis of prospectively collected data from a previously published study. PATIENTS: Seventy adults admitted to a medical intensive care unit (ICU) between March and July 2012 who required mechanical ventilation with continuous analgesia and/or sedation and underwent a spontaneous awakening trial (SAT)...
August 28, 2017: Pharmacotherapy
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