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Gastrointestinal endoscopy AND sedation

Ertugrul Kılıc, Barış Demiriz, Nurgül Isıkay, Abdullah E Yıldırım, Selman Can, Cem Basmacı
OBJECTIVES: To observe the effects of both propofol/alfentanil and propofol/ketamine on sedation during upper gastrointestinal system endoscopy in morbidly obese patients (UGSEMOP). METHODS: In a prospective, double-blinded, randomized clinical study, 52 patients scheduled for UGSEMOP were assigned to either group A (n=26; 10 µg/kg intravenous [IV] alfentanil) or group K (n=26; 0.5 mg/kg IV ketamine). Each patient was administered 0.7 mg/kg propofol for induction...
November 2016: Saudi Medical Journal
Albayrak Fatih, Ozturk Yasin, Dursun Hakan, Albayrak Yavuz
BACKGROUND: The rate for upper gastrointestinal (UGI) cancers, and especially the rate for gastric cancer, varies from country to country and from region to region within country. In Turkey, the incidence of gastric cancer varies widely among regions due to the diverse cultures and accompanying food habits of the population. This study aimed to determine the endoscopic frequency of esophageal and gastric cancers and the usefulness of alarm symptoms in diagnosing gastric cancer in subjects undergoing endoscopy in northeastern Turkey...
October 4, 2016: BMC Gastroenterology
Ayman E Eskander, Nevine R El Baroudy, Amira S El Refay
BACKGROUND: Moderate sedation for gastrointestinal endoscopy has traditionally been provided by the endoscopist. Controversy has ensued over safe and efficient sedation practice as endoscopy has increased in numbers and complexity. AIM: To evaluate the safety of ketamine sedation given by non-anesthesiologist during gastrointestinal endoscopy in children. METHODS: A prospective study of 100 paediatric patients with gastrointestinal symptoms who were a candidate for upper or lower gastrointestinal endoscopy in paediatric endoscopy unit at Abo El-Reesh Paediatric Hospital, Cairo University...
September 15, 2016: Open Access Macedonian Journal of Medical Sciences
Brian T Hardy, Jessica Gentile-Solomon, Jeffrey A Solomon
CASE DESCRIPTION A 6-year-old spayed female Golden Retriever was evaluated for a 2-week history of progressive hyporexia, signs of abdominal pain, and weight loss. CLINICAL FINDINGS Physical examination findings included mild signs of pain on palpation of the cranial part of the abdomen and a body condition score of 4 (scale, 1 to 9). A CBC revealed mild microcytosis and hypochromasia; results of serum biochemical analysis were within the respective reference ranges, and abdominal ultrasonography revealed no abnormalities...
October 15, 2016: Journal of the American Veterinary Medical Association
Ulas E Akbulut, Sedat Saylan, Bilal Sengu, Gulgun E Akcali, Engin Erturk, Murat Cakir
PURPOSE: We aimed to compare the efficacy and safety of midazolam plus ketamine versus fentanyl plus propofol combination administered to children undergoing upper gastrointestinal endoscopy (UGE) and to determine the most appropriate sedation protocol. MATERIALS AND METHODS: This prospective, randomized, single-blind study included patients between the ages of 4 and 17 years who underwent UGE for diagnostic purposes. Patients were divided randomly into groups A (midazolam-ketamine combination, n=119) and B (fentanyl plus propofol combination, n=119)...
September 26, 2016: European Journal of Gastroenterology & Hepatology
Ryan J Kline, Ky Pham, Carmen L Labrie-Brown, Ken Mancuso, Paul LeLorier, James Riopelle, Alan David Kaye
BACKGROUND: Reflex hypotension and bradycardia have been reported to occur following administration of several drugs associated with administration of anesthesia and also following a variety of procedural stimuli. CASE REPORT: A 54-year-old postmenopausal female with a history of asystole associated with sedated upper gastrointestinal endoscopy and post-anesthetic-induction tracheal intubation received advanced cardiac resuscitation after insertion of a temporary transvenous pacemaker failed to prevent pulseless electrical activity...
2016: Ochsner Journal
Oliver Möschler
BACKGROUND: Documentation of findings and of the treatment implications resulting from them is one of the central tasks involved in medical work. The introduction of software tools for managing and providing technical support for this task is a logical development. METHODS: A literature search was conducted in September 2015 using PubMed and the search terms 'gastrointestinal endoscopy AND electronic documentation' and 'software tools AND gastrointestinal endoscopy AND documentation'...
February 2016: Visc Med
Thomas Lang
BACKGROUND: Gastrointestinal endoscopy is one of the most frequently performed diagnostic and therapeutic procedures in children nowadays. METHODS: Since the size of endoscopes has been adapted to pediatric patients, endoscopic procedures are performed almost routinely in pediatric gastrointestinal patients. However, this is an invasive procedure done under deep sedation, and procedure-related or sedation-related complications can occur more easily in pediatric patients...
February 2016: Visc Med
A Behrens, C Ell
INTRODUCTION: Administering sedation is an established standard in gastrointestinal endoscopy, particularly in situations in which sedation is used to make the examination more comfortable for the patient (e. g., during preventive check-up examinations). It is important to have precise information about the risk of sedation-associated complications. AIMS AND METHODS: The aim of this study was to record the incidence and type of sedation-associated complications in a low-risk group of patients (ASA 1 or 2) undergoing elective diagnostic esophagogastroduodenoscopy or colonoscopy...
August 2016: Zeitschrift Für Gastroenterologie
K Leslie, M L Allen, E Hessian, A Y-S Lee
We conducted a survey of Australian specialist anaesthetists about their practice of sedation for elective and emergency gastroscopy, endoscopic retrograde cholangiopancreatography (ERCP), and colonoscopy. A 24-item survey was emailed to 1,000 anaesthetists in August 2015. Responses were received from 409 anaesthetists (response rate=41%) with responses from 395 anaesthetists analysed. Pulse oximetry and oxygen administration were routine for all procedures for all respondents. Blood pressure was routinely measured by most respondents during gastroscopy (elective=88%; emergency=97%), ERCP (elective=99%; emergency=99%) and colonoscopy (elective=91%; emergency=98%)...
July 2016: Anaesthesia and Intensive Care
Anja Schaible, Katja Schwan, Thomas Bruckner, Konstanze Plaschke, Markus W Büchler, Markus Weigand, Peter Sauer, Christian Bopp, Phillip Knebel
BACKGROUND: Sedation prior to esophagogastroduodenoscopy is widespread and increases patient comfort. However, it demands additional trained personnel, accounts for up to 40 % of total endoscopy costs and impedes rapid hospital discharge. Most patients lose at least one day of work. 98 % of all serious adverse events occurring during esophagogastroduodenoscopy are ascribed to sedation. Acupuncture is reported to be effective as a supportive intervention for gastrointestinal endoscopy, similar to conventional premedication...
2016: Trials
Vaibhav Wadhwa, Danny Issa, Sushil Garg, Rocio Lopez, Madhusudhan R Sanaka, John J Vargo
BACKGROUND & AIMS: Even though propofol use for gastrointestinal endoscopic procedures has increased over the past decade, there is a perception that it causes a higher rate of cardiopulmonary adverse events. The aim of this study was to compare the sedation-related adverse events associated with use of propofol vs nonpropofol agents for endoscopic procedures. We also wanted to determine the influence of duration or complexity of the procedures and endoscopist-directed (gastroenterologist) vs non-gastroenterologist-directed sedation on the outcomes...
July 21, 2016: Clinical Gastroenterology and Hepatology
Juan Paredes Méndez, Luis Lazo Molina, Bruno Molina Martos
OBJECTIVE: Evaluate the diagnostic and therapeutic utility, safeness, efficacy and complications of double-balloon enteroscopy (DBE). MATERIAL AND METHODS: This prospective, descriptive study of DBE took place between July 2010 and June 2015 at the service of Gastroenterology of Hospital Nacional Guillermo Almenara Irigoyen- Lima Peru. 129 DBE were performed in 121 patients with the Fujinon EN-450T5 double balloon enteroscope, with conscious sedation and with previous bowel preparation...
April 2016: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
John J Vargo
No abstract text is available yet for this article.
July 2016: Gastrointestinal Endoscopy Clinics of North America
Charles J Lightdale
No abstract text is available yet for this article.
July 2016: Gastrointestinal Endoscopy Clinics of North America
Hyun Kee Chung, Jenifer R Lightdale
Sedation is a fundamental component of pediatric gastrointestinal procedures. The 2 main types of sedation for pediatric endoscopy remain general anesthesia and procedural sedation. Although anesthesiologist-administered sedation protocols are more common, there is no ideal regimen for endoscopy in children. This article discusses specific levels of sedation for endoscopy as well as various regimens that can be used to achieve each. Risks and considerations that may be specific to performing gastrointestinal procedures in children are reviewed...
July 2016: Gastrointestinal Endoscopy Clinics of North America
Nadim Mahmud, Tyler M Berzin
Gastrointestinal endoscopic sedation has improved procedural and patient outcomes but is associated with attendant risks of oversedation and hemodynamic compromise. Therefore, close monitoring during endoscopic procedures using sedation is critical. This monitoring begins with appropriate staff trained in visual assessment of patients and analysis of basic physiologic parameters. It also mandates an array of devices widely used in practice to evaluate hemodynamics, oxygenation, ventilation, and depth of sedation...
July 2016: Gastrointestinal Endoscopy Clinics of North America
Ben Da, James Buxbaum
The practice of endoscopic sedation requires a thorough understanding of preprocedural assessment, sedation pharmacology, intraprocedure monitoring, adverse event management, and postprocedural care. The training process has become increasingly standardized and entails knowledge and practice-based components. The use of propofol in particular requires a higher level of structured training owing to its narrow therapeutic window. Simulation has increased opportunities for practice-based training in a controlled environment...
July 2016: Gastrointestinal Endoscopy Clinics of North America
John E Tetzlaff, Walter G Maurer
The role of the anesthesia service in sedation for gastrointestinal endoscopy (GIE) has been steadily increasing. The goals of preprocedural assessment are determined by the specific details of the procedure, the issues related to the illness that requires the endoscopy, comorbidities, the goals for sedation, and the risk of complications from the sedation and the endoscopic procedure. Rather than consider these issues as separate entities, they should be considered as part of a continuum of preparation for GIE...
July 2016: Gastrointestinal Endoscopy Clinics of North America
Jing-Yang Liou, Chien-Kun Ting, Ming-Chih Hou, Mei-Yung Tsou
Classical midazolam-opioid combination for gastrointestinal endoscopy sedation has been adopted for decades. Dosing regimens have been studied but most require fixed dosing intervals. We intend to use a sophisticated pharmacodynamic tool, response surface model (RSM), to simulate sedation using different regimens. RSM can predict patient's response during different phases of the examination and predict patient's wake-up time with precision and without the need for fixed dosing intervals. We believe it will aid physicians in guiding their dosing strategy and timing...
June 2016: Medicine (Baltimore)
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