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analgesia anesthesia endoscopy

S Prakash, V K Pai, M Dhar, A A Kumar
Children with autistic spectrum disorders are often encountered in anesthesia practice mainly for outdoor procedural sedation or anesthesia in endoscopy and magnetic resonance imaging suites. We describe a case of a 7-year-old autistic boy who required management of dental caries. He had a phobia to intravenous cannulation, displayed increasing anxiety and became combative on the day of surgery. With parental involvement and distraction, we succeeded in giving oral midazolam by concealing it, with the intent of avoiding intramuscular injection or unnecessary restraint...
July 2016: Saudi Journal of Anaesthesia
Aparna Dalal
Intestinal transplantation is a complex and challenging surgery. It is very effective for treating intestinal failure, especially for those patients who cannot tolerate parenteral nutrition nor have extensive abdominal disease. Chronic parental nutrition can induce intestinal failure associated liver disease (IFALD). According to United Network for Organ Sharing (UNOS) data, children with intestinal failure affected by liver disease secondary to parenteral nutrition have the highest mortality on a waiting list when compared with all candidates for solid organ transplantation...
April 2016: Transplantation Reviews
Makoto Asakawa
Anesthesia for endoscopic surgery can be challenging depending on surgical manipulations and patient comorbidity. Anesthetists must understand the possible systemic changes and complications that are associated with endoscopic surgery. Pneumoperitoneum induces vasoconstriction, reduces cardiac output, and decreases functional residual capacity in the cardiopulmonary system. Both hypoventilation caused by the thoracoscopic procedure and CO2 insufflation increase Paco2. To prevent the problems associated with high Paco2, monitoring of end-tidal CO2 (ETco2) and capability of positive pressure ventilation are crucial...
January 2016: Veterinary Clinics of North America. Small Animal Practice
Tomonori Sugawara, Toshihiro Takeda, Gotaro Shirakami
Sedation and/or analgesia are required during respiratory endoscopy procedure to reduce the patient's anxiety, unpleasantness and pain. At present most of diagnostic respiratory endoscopy cases are carried out outside the operating room without the involvement of anesthesiologists in Japan. Inadequate anesthesia/sedation may cause patient's discomfort and/or serious injury. Anesthesiologists are expected to play a part in the sedation and analgesia education/training for nonanesthesiologists to ameliorate patient satisfaction and safety...
March 2015: Masui. the Japanese Journal of Anesthesiology
Mamoru Kadosaki
There is an increasing demand for anesthesiologists to work outside the operating room in order to provide general anesthesia or monitored sedation for a variety of medical investigations or procedures in infants and children. The concept that treatment should be a pain- and stress-free experience is now well accepted, and this has placed additional responsibilities on anesthesiologists. We describe pediatric anesthesia and monitored sedation for diagnostic medical procedures. Children requiring a painful procedure and prolonged examination should be provided with optimal sedation and analgesia...
August 2014: Rinsho Byori. the Japanese Journal of Clinical Pathology
Xiao-lin Wang, Jun-le Liu, Wei-dong Mi, Hong Zhang
OBJECTIVE: To evaluate anesthetic techniques for elderly patients during percutaneous endoscopic gastrostomy (PEG). METHODS: Clinical data about 5 cases aged 80 years or more undergoing PEG from June 2012 to May 2013 in Chinese People's Liberation Army General Hospital were retrospectively analyzed and literature review. RESULTS: Analgesia/minimal sedation combined with local anesthesia (LA including throat spray and operative site infiltrated ) is employed in the one of patients with Tracheoesophageal Fistula (TEF), for the remaining patients, analgesia/deep sedation and LA combination were used, during induction, temporary respiratory depression, blood pressure and heart rate decreased occurred respectively in the different patient, assisted ventilation and ephedrine IV was effective, the anesthesia strategy was to maintain a desired sedation with propofol or etomidate intravenously in small increments or by adjusted infusion , and to keep SpO2 at 95% or more with a supplemental oxygen through face mask under spontaneous ventilation...
December 3, 2013: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Min-Hsien Chiang, Shao-Chun Wu, Chia-Hsun You, Keng-Liang Wu, Yi-Chun Chiu, Chao-Wei Ma, Chin-Wei Kao, Kun-Chen Lin, Kuan-Hung Chen, Peng-Chih Wang, An-Kuo Chou
BACKGROUND AND STUDY AIMS: The best anesthesia methods for analgesia and sedation during gastrointestinal endoscopy are still debated. The aim of this study was to compare the recovery time, clinical presentations, and satisfaction between target-controlled infusion (TCI) and manually controlled infusion (MCI) in same-day bidirectional endoscopy (esophagogastroduodenoscopy followed by colonoscopy). PATIENTS AND METHODS: A total of 220 patients with American Society of Anesthesiology physical status 1 or 2 were enrolled and randomized into the TCI or MCI groups...
November 2013: Endoscopy
Umberto Melia, Montserrat Vallverdú, Mathieu Jospin, Erik W Jensen, Jose Fernando Valencia, Francesc Clariá, Pedro L Gambus, Pere Caminal
The level of sedation in patients undergoing medical procedures evolves continuously, such as the effect of the anesthetic and analgesic agents is counteracted by pain stimuli. The monitors of depth of anesthesia, based on the analysis of the electroencephalogram (EEG), have been progressively introduced into the daily practice to provide additional information about the state of the patient. However, the quantification of analgesia still remains an open problem. The purpose of this work is to analyze the capability of prediction of nociceptive responses based on the time-frequency representation (TFR) of EEG signal...
2013: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Dan Carter, Adi Lahat, Neofytos P Papageorgiou, Shulamit Goldstein, Rami Eliakim, Eytan Bardan
BACKGROUND: A sequential bidirectional endoscopy is commonly performed. However, the optimal sequence of procedures for same-day bidirectional endoscopy using moderate sedation has not been established. GOALS: The aim of this study was to characterize the optimal sequence of endoscopies for sequential bidirectional endoscopy. STUDY: This was a single-center, prospective, randomized study. A total of 163 patients aged 18 to 80 years, who were referred for bidirectional endoscopy for any indication, were randomized to start with upper or lower endoscopy...
March 2014: Journal of Clinical Gastroenterology
Conceição Rocha, Teresa Mendonça, Maria Eduarda Silva
In the last decades propofol became established as an intravenous agent for the induction and maintenance of both sedation and general anesthesia procedures. In order to achieve the desired clinical effects appropriate infusion rate strategies must be designed. Moreover, it is important to avoid or minimize associated side effects namely adverse cardiorespiratory effects and delayed recovery. Nowadays, to attain these purposes the continuous propofol delivery is usually performed through target-controlled infusion (TCI) systems whose algorithms rely on pharmacokinetic and pharmacodynamic models...
December 2014: Journal of Clinical Monitoring and Computing
E Boselli, M Daniela-Ionescu, G Bégou, L Bouvet, R Dabouz, C Magnin, B Allaouchiche
BACKGROUND: The analgesia/nociception index (ANI), a 0-100 non-invasive index calculated from heart rate variability, reflects the analgesia/nociception balance during general anaesthesia. The aim of this study was to evaluate the ANI in the assessment of immediate postoperative pain in adult patients undergoing general anaesthesia. METHODS: Two-hundred patients undergoing scheduled surgery or endoscopy with general anaesthesia were included in this prospective observational study...
September 2013: British Journal of Anaesthesia
Jarosław Miłoński, Hanna Zielińska-Bliźniewska, Wojciech Golusiński, Joanna Urbaniak, Rafał Sobański, Jurek Olszewski
The aim of the study was to assess the effect of three different types of anaesthesia on perioperative bleeding control and to analyse the mean arterial blood pressure and heart rate in patients undergoing endoscopic paranasal sinus surgery. Ninety patients (30 women and 60 men, aged 18-85 years) scheduled to undergo functional endoscopic sinus surgery in the years 2008-2010 were identified as candidates for inclusion in the study. Patients were randomly assigned to one of three groups (30 patients each) according to the type of general anaesthesia to be administered...
July 2013: European Archives of Oto-rhino-laryngology
Pin Wan, Qiang Guo, Tian He, Wei Yue, Jing Luo, Hua Jing, Li Wang, Ling Zhao
OBJECTIVE: To evaluate the feasibility and safety of patient controlled analgesia (PCA) technology during double balloon endoscopy(DBE) inspection. METHODS: According to the anesthesia, 120 patients with suspected intestinal disease were randomized into non-anaesthesia(Group A), propofol infusion with TCI vein pump(Group B), and remifentanil vein infusion with PCA pump(Group C), with 40 patients in each group. The feasibility and safety of the three methods in double balloon endoscopy(DBE) inspection were evaluated...
July 2012: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Jarosław Miłoński, Hanna Zielińska-Bliźniewska, Rafał Sobański, Jurek Olszewski
INTRODUCTION: The study aimed at evaluating the influence of targeted hypotension with three types of anaesthetics on the amount of blood loss in extensive endoscopic operations of polyps of the nose and paranasal sinuses. MATERIAL AND METHODS: Ninety patients, including 30 women aged 31-73 and 60 men aged 21-79, who were operated within the period of 2008-2010 at Department of Otolaryngology and Laryngological Oncology Military Medical Academy University Clinical Hospital in Lodz, were qualified for the study...
March 2012: Otolaryngologia Polska. the Polish Otolaryngology
Yasushi Hashimoto, L William Traverso
HYPOTHESIS: The method to lower postoperative pancreatic fistula (POPF) after distal pancreatectomy (DP) involves controlling risk factors for leakage from the pancreatic stump. GOAL: The aim of this study was to identify controllable risk factors for POPF. METHODS: In order to promote homogeneity, we used a single surgeon case series and then calculated POPF with a public web-based tool based on the severity classification system of the International Study Group of Pancreatic Surgery (ISGPS)...
May 2012: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Samuel DeMaria, Satish Govindaraj, Nina Chinosorvatana, Stanley Kang, Adam I Levine
BACKGROUND: Endoscopic sinus surgery (ESS) is a common procedure preferably done with an anesthetic technique ensuring effective postoperative analgesia while speeding discharge home. Although anesthesia administered locally in conjunction with vasoconstricting agents is known to minimize intraoperative bleeding, its usefulness in providing postoperative analgesia has not been well characterized. The results supporting the use of regional anesthesia for sinus surgery have also been limited...
January 2012: American Journal of Rhinology & Allergy
Hong Zhao, Yi Feng, Ying Wang, Baxian Yang, Zhimin Xing
OBJECTIVE: To demonstrate the efficacy and noninferiority of loading dose of celecoxib 200 mg compared with 400 mg in pain management after endoscopic nasal surgery. DESIGN: A prospective randomized controlled study. SETTING: A university hospital. PATIENTS: Consecutive 120 patients undergoing endoscopic nasal surgery under general anesthesia were randomly assigned to three groups of 40 patients each, celecoxib 400 mg, celecoxib 200 mg, or a control group with no celecoxib...
August 2011: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Elvin Kesimci, Levent Öztürk, Sami Bercin, Muzaffer Kırış, Ayşe Eldem, Orhan Kanbak
The aim of this study was to evaluate the analgesic efficacy of sphenopalatine ganglion block performed under general anesthesia in patients undergoing functional endoscopic sinus surgery (FESS) with operative blood loss and postoperative complications (headache, visual disturbances, nausea, vomiting, sore throat, swallow difficulty). Forty-five consenting patients were randomized to receive bilateral sphenopalatine ganglion block with saline (Group S, n = 15), bupivacaine 0.5% (Group B, n = 15), or levobupivacaine 0...
January 2012: European Archives of Oto-rhino-laryngology
Gianni De Berti, Massimo Maggi, Rita Conigliaro, Gabriele Levrini, Sandro Salzano, Reza Ghadirpour, Franco Servadei
INTRODUCTION: Percutaneous vertebroplasty, i.e. the consolidation of a vertebral body with polymethylmethacrylate, is a safe and effective image-guided technique increasingly used as a treatment option for different pathologic conditions, mainly vertebral body fractures secondary to osteoporosis, hemangiomas and metastasis. The procedure, although minimally invasive, could be painful and is better tolerated if a conscious sedation regimen is added to local anesthesia. An anesthesiologist usually performs the sedo/analgesia, but frequently, he is not available in our angiography unit, so we have begun to perform the sedo/analgesia ourselves following an analogous situation that physicians of the Digestive Endoscopic Unit of our institution experienced some years ago...
March 2012: Neuroradiology
Saad A Sheta
The number of noninvasive and minimally invasive procedures performed outside of the operating room has grown exponentially over the last several decades.Sedation, analgesia, or both may be needed for many of these interventional or diagnostic procedures. Individualized care is important when determining if a patient requires procedural sedation analgesia (PSA). The patient might need an anti-anxiety drug, pain medicine, immobilization, simple reassurance, or a combination of these interventions. The goals of PSA in four different multidisciplinary practices namely; emergency, dentistry, radiology and gastrointestinal endoscopy are discussed in this review article...
January 2010: Saudi Journal of Anaesthesia
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