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Procedural sedation

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https://www.readbyqxmd.com/read/28810964/a-study-on-the-tactical-safety-of-endotracheal-intubation-under-darkness
#1
Sedat Bilge, Attila Aydin, Meltem Bilge, Cemile Aydin, Erdem Cevik, Mehmet Eryilmaz
OBJECTIVE: Strict blackout discipline is extremely important for all military units. To be able to effectively determine wound characteristics and perform the necessary interventions at nighttime, vision and light restrictions can be mitigated through the use of tactical night vision goggles (NVGs). The lamp of the classical laryngoscope (CL) can be seen with the naked eye; infrared light, on the other hand, cannot be perceived without the use of NVGs. The aim of the study is to evaluate the safety of endotracheal intubation (ETI) procedures in the dark under tactically safe conditions with modified laryngoscope (ML) model...
July 2017: Military Medicine
https://www.readbyqxmd.com/read/28803323/effect-of-footshock-stress-on-place-conditioning-produced-by-%C3%AE-9-tetrahydrocannabinol-and-the-fatty-acid-amide-hydrolase-faah-inhibitor-urb597-in-sprague-dawley-rats
#2
Marieka V DeVuono, Kiri L Wills, Danielle V MacPherson, Kelly M Hrelja, Linda A Parker
RATIONALE: Unlike other drugs of abuse, Δ(9)-tetrahydrocanabinol (THC) is generally aversive in rodent conditioned place preference models, but little is known about how stress may modify THC affective properties. OBJECTIVE: We evaluate the potential of footshock stress to enhance the rewarding effects of THC and the fatty acid amide hydrolase inhibitor, URB597, as it has been shown to enhance their anxiolytic effects. MATERIALS AND METHODS: The effect of footshock stress 24 h prior to each conditioning trial on the rewarding/aversive effects of THC (1, 0...
August 12, 2017: Psychopharmacology
https://www.readbyqxmd.com/read/28802082/ketamine-or-ketofol-do-we-have-enough-evidence-to-know-which-one-to-use
#3
James Miner
Ketamine and propofol are both commonly used emergency department (ED) procedural sedation agents. Their concurrent administration, often referred to as "ketofol", is widely used for procedural sedation. A simple google search can lead to a lot of opinions on why we should use propofol, ketamine, or ketofol in a given situation for moderate or deep procedural sedation in the ED, but finding evidence that supports differences these opinions assume is much harder to come by. This article is protected by copyright...
August 12, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28800982/pain-measurement-in-mechanically-ventilated-patients-after-cardiac-surgery-comparison-of-the-behavioral-pain-scale-bps-and-the-critical-care-pain-observation-tool-cpot
#4
Saskia Rijkenberg, Willemke Stilma, Robert J Bosman, Nardo J van der Meer, Peter H J van der Voort
OBJECTIVES: The Behavioral Pain Scale (BPS) and Critical-Care Pain Observation Tool (CPOT) are behavioral pain assessment tools for sedated and unconscious critically ill patients. The aim of this study was to compare the reliability, internal consistency, and discriminant validation of the BPS and the CPOT simultaneously in mechanically ventilated patients after cardiac surgery. DESIGN: A prospective, observational cohort study. SETTING: A 20-bed closed-format intensive care unit with mixed medical, surgical, and cardiac surgery patients in a teaching hospital in Amsterdam, The Netherlands...
August 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28799428/full-spectrum-endoscopy-fuse-versus-standard-forward-viewing-endoscope-sfv-in-a-high-risk-population
#5
Søren Roepstorff, Sabah Anwar Hadi, Morten Rasmussen
OBJECTIVES: To investigate the diagnostic performance of Full Spectrum Endoscopy (FUSE) compared to a conventional standard forward-viewing endoscope (SFV). The primary outcome was adenoma detection rate (ADR) and mean adenoma detection. Secondary outcome was feasibility of FUSE opposed to SFV. MATERIALS AND METHODS: Consecutive patients participating in the Danish colorectal cancer (CRC) screening programme were prospectively included in the study (n = 205)...
August 11, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28798230/association-of-bmi-with-propofol-dosing-and-adverse-events-in-children-with-cancer-undergoing-procedural-sedation
#6
Colin M Rogerson, Kamal Abulebda, Michael J Hobson
OBJECTIVES: Obesity increases the risk of complications during pediatric procedural sedation. The risk of being underweight has not been evaluated in this arena. We therefore investigated the association of BMI with sedation dosing and adverse events in children across a range of BMIs. METHODS: A total of 1976 patients ages 2 to 21 years old with oncologic diagnoses underwent lumbar punctures and/or bone marrow aspirations. All children received a standard adjunctive dose of ketamine before sedation with propofol...
August 10, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28796153/optimum-drug-combinations-for-the-sedation-of-growing-boars-prior-to-castration
#7
Heidi S Lehmann, Dominique Blache, Eleanor Drynan, Pema Tshewang, David J C Blignaut, Gabrielle C Musk
Juvenile male pigs were sedated for castration. Eight five-month old boars were sedated twice (two weeks apart) with a combination of detomidine (0.1 mg/kg), midazolam (0.2 mg/kg) and either butorphanol (0.2 mg/kg) (Group MDB, n = 8) or morphine (0.2 mg/kg) (Group MDM, n = 8) intramuscularly. The boars were positioned in lateral recumbency and lidocaine (200 mg total) was injected into the testicle and scrotal skin. Castration of a single testicle was performed on two occasions. Sedation and reaction (to positioning and surgery) scores, pulse rate, respiratory rate, haemoglobin oxygen saturation, body temperature, arterial blood gas parameters and the times to immobility and then recovery were recorded...
August 10, 2017: Animals: An Open Access Journal From MDPI
https://www.readbyqxmd.com/read/28794840/virtual-reality-distraction-decreases-routine-intravenous-sedation-and-procedure-related-pain-during-preoperative-adductor-canal-catheter-insertion-a-retrospective-study
#8
Pooja G Pandya, T Edward Kim, Steven K Howard, Erica Stary, Jody C Leng, Oluwatobi O Hunter, Edward R Mariano
BACKGROUND: Virtual reality (VR) distraction is a nonpharmacological method to prevent acute pain that has not yet been thoroughly explored for anesthesiology. We present our experience using VR distraction to decrease routine intravenous sedation for patients undergoing preoperative perineural catheter insertion. METHODS: This 1-month quality improvement project involved all elective unilateral primary total knee arthroplasty patients who received a preoperative adductor canal catheter...
August 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28791043/systematic-review-outcomes-by-duration-of-npo-status-prior-to-colonoscopy
#9
REVIEW
Aasma Shaukat, Ashish Malhotra, Nancy Greer, Roderick MacDonald, Joseph Wels, Timothy J Wilt
BACKGROUND/AIMS: Variation exists among anesthesia providers as to acceptable timing of NPO ("nothing by mouth") for elective colonoscopy procedures. There is a need to balance optimal colonic preparation, patient convenience, and scheduling efficiency with anesthesia safety concerns. We reviewed the evidence for the relationship between NPO timing and aspiration incidence and colonoscopy rescheduling. METHODS: We searched MEDLINE (1990-April 2015) for English language studies of any design and included them if at least one bowel preparation regimen was completed within 8 hours of colonoscopy...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/28790863/great-auricular-neuropraxia-with-beach-chair-position
#10
Minal Joshi, Ruth Cheng, Hattiyangadi Kamath, Joel Yarmush
Shoulder arthroscopy has been shown to be the procedure of choice for many diagnostic and therapeutic interventions. Neuropraxia of the great auricular nerve (GAN) is an uncommon complication of shoulder surgery, with the patient in the beach chair position. We report a case of great auricular neuropraxia associated with direct compression by a horseshoe headrest, used in routine positioning for uncomplicated shoulder surgery. In this case, an arthroscopic approach was taken, under regional anesthesia with sedation in the beach chair position...
2017: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/28786744/working-in-the-dark-a-hermeneutic-inquiry-into-health-professionals-stories-of-ketamine-sedation-with-children
#11
Michael Neufeld, Deborah Spence, Tineke Water
Background Ketamine provides an efficient and economical way to perform painful procedures without general anaesthesia. The physiological risks of ketamine have been well researched in adult and paediatric populations, yet for health professionals (HPs) undertaking paediatric ketamine sedation, questions of benefit and harm remain. Uncertainty around children's experiences of emergence phenomenon, bring moral and ethical tensions. Research question What are health care professionals' experiences of undertaking ketamine sedation with children? Methodology This study was underpinned by a hermeneutic narrative approach...
August 8, 2017: Contemporary Nurse
https://www.readbyqxmd.com/read/28782658/patterns-of-treatment-of-accidental-genital-trauma-in-girls
#12
Tazim Dowlut-McElroy, Jeanette Higgins, Karen B Williams, Julie L Strickland
STUDY OBJECTIVE: To evaluate the characteristics of girls with accidental genital trauma (AGT) who can be managed in the emergency department (ED) versus the operating suite (OS). DESIGN: Retrospective cohort. SETTING: ED at a children's hospital in a metropolitan area. PARTICIPANTS: Girls aged 0 to 18 years with AGT. MAIN OUTCOME MEASURES: Factors associated with need for evaluation and repair of AGT in the OS...
August 3, 2017: Journal of Pediatric and Adolescent Gynecology
https://www.readbyqxmd.com/read/28782097/interactions-between-cannabidiol-and-commonly-used-antiepileptic-drugs
#13
Tyler E Gaston, E Martina Bebin, Gary R Cutter, Yuliang Liu, Jerzy P Szaflarski
OBJECTIVE: To identify potential pharmacokinetic interactions between the pharmaceutical formulation of cannabidiol (CBD; Epidiolex) and the commonly used antiepileptic drugs (AEDs) through an open-label safety study. Serum levels were monitored to identify interactions between CBD and AEDs. METHODS: In 39 adults and 42 children, CBD dose was started at 5 mg/kg/day and increased every 2 weeks by 5 mg/kg/day up to a maximum of 50 mg/kg/day. Serum AED levels were obtained at baseline prior to CBD initiation and at most study visits...
August 6, 2017: Epilepsia
https://www.readbyqxmd.com/read/28781041/advancements-in-evidence-based-anesthesia-of-exotic-animals
#14
REVIEW
Julie A Balko, Sathya K Chinnadurai
Anesthesia and sedation of pet nondomestic species are often necessary for both invasive and noninvasive procedures. Even minimally invasive procedures can be stressful for small prey species that are not domesticated or acclimated to human contact and restraint. Recent advancements in evidence-based practice will continue to improve the field based on scientifically sound best practices and rely less on anecdotal recommendations. This article focuses on new scientific literature that has been published in the past 5 years...
September 2017: Veterinary Clinics of North America. Exotic Animal Practice
https://www.readbyqxmd.com/read/28780003/outcomes-of-gartland-type-iii-supracondylar-fractures-treated-using-blount-s-method
#15
C Muccioli, S ElBatti, I Oborocianu, O Rosello, F Solla, E Chau, J L Clement, V Rampal
BACKGROUND: Supracondylar fractures of the elbow with major displacement are usually treated by surgical pinning and less often non-operatively as described by Blount.The objective of this study was to assess the clinical and radiological outcomes of Gartland type III supracondylar fractures treated at least 3 years earlier using Blount's method. HYPOTHESIS: Blount's method produces good outcomes after more than 3 years when used to treat Gartland type III supracondylar fractures of the humerus...
August 2, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28779544/a-randomized-double-blind-controlled-trial-comparing-3-sedation-regimens-during-flexible-bronchoscopy-dexmedetomidine-alfentanil-and-lidocaine
#16
Moussa Riachy, Georges Khayat, Ihab Ibrahim, Zeina Aoun, Georges Dabar, Taha Bazarbachi, Nadine Khalil, Bassem Habr
INTRODUCTION: No standardized sedation protocol is available for flexible bronchoscopy. OBJECTIVES: To evaluate the efficacy and safety of three regimens used for sedation during flexible bronchoscopy. METHODS: This randomized double-blind controlled trial assessed patients undergoing bronchoscopy and receiving lidocaine alone (C) or combined with dexmedetomidine (D) or alfentanil (A). Tolerance was assessed using the bronchoscopy score, and level of sedation was assessed using the Nursing Instrument for the Communication of Sedation...
August 5, 2017: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/28779192/sonographic-spinal-imaging-of-normal-anatomy-pathology-and-magnetic-growing-rods-in-children
#17
REVIEW
Arthur B Meyers, Tushar Chandra, Monica Epelman
The wide availability of ultrasound, along with its lack of ionizing radiation burden and need for sedation for most exams, often make sonography the first line in the imaging evaluation of children. The developing osseous anatomy of the spine in young infants provides a distinct window allowing for a detailed depiction of the spinal canal and its contents, which is not present in older children or adults. Here we review the clinical indications, sonographic technique, normal anatomy and pathology for imaging the lumbosacral spine in neonates and young infants...
August 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28778801/pre-operative-embolization-of-hypervascular-spinal-metastasis-using-percutaneous-direct-intra-tumoural-injection-with-onyx-under-local-anesthesia
#18
Kai-Zheong Lim, Tony Goldschlager, Ronil V Chandra
Intra-operative blood loss remains a major cause of perioperative morbidity for patients with hypervascular spinal metastasis undergoing surgery. Pre-operative embolization is used to reduce intraoperative blood loss and operative time. This is commonly performed under general anesthesia via a trans-arterial approach, which carries a risk of spinal stroke. We propose an alternative technique for embolization of hypervascular metastases using the Onyx embolic agent via a percutaneous direct intra-tumoural injection under local anesthesia and sedation to reduce embolization risks and procedure time, as well as operative blood loss and operative time...
August 1, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28778580/patient-reported-opioid-analgesic-requirements-after-elective-inguinal-hernia-repair-a-call-for%C3%A2-procedure-specific-opioid-administration-strategies
#19
Konstantinos S Mylonas, Michael Reinhorn, Lauren R Ott, Maggie L Westfal, Peter T Masiakos
BACKGROUND: A better understanding of the analgesia needs of patients who undergo common operative procedures is necessary as we address the growing opioid public health crisis in the United States. The aim of this study was to evaluate patient experience with our opioid prescribing practice after elective inguinal hernia repairs. METHODS: A prospective, observational study was conducted between October 1, 2015, and September 30, 2016, in a single-surgeon, high-volume, practice of inguinal hernia operation...
August 1, 2017: Surgery
https://www.readbyqxmd.com/read/28769979/safety-and-effectiveness-of-endoscopist-directed-nurse-administered-sedation-during-gastric-endoscopic-submucosal-dissection
#20
Yong Suk Cho, Sang Youn Shin, Changhyeok Hwang, Jeonghun Seo, Jong Won Choi, Byung Kyu Park, Sun Young Won, Chun Kyon Lee, Yong Kang Lee, Han Ho Jeon
BACKGROUND AND AIMS: Endoscopic submucosal dissection (ESD) is routinely performed in treating gastric neoplasia and requires long-term higher levels of sedation. Endoscopist-directed nurse-administered sedation (EDNAS) has not been well studied in ESD. This study aimed to evaluate the safety and effectiveness of EDNAS for ESD. METHODS: Patients treated with ESD for gastric tumors between 2013 and 2015 were retrospectively collected. Patients were divided into a midazolam-treated group (M group) and a midazolam plus propofol-treated group (MP group)...
2017: Gastroenterology Research and Practice
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