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Procedural sedation

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https://www.readbyqxmd.com/read/29156176/management-of-patients-with-left-ventricular-assist-devices-requiring-teeth-extraction-is-halting-anticoagulation-appropriate
#1
Visakha Suresh, Muath Bishawi, Michael W Manning, Chetan Patel, Joseph Rogers, Carmelo Milano, Jacob Schroder, Mani Daneshmand, David Powers
PURPOSE: An increasing number of patients with end-stage heart failure are supported with left ventricular assist device (LVAD) implantation and must be maintained on a consistent anticoagulation regimen. Pre-emptive extraction of carious teeth in these patients is necessary to prevent seeding of the implanted device and endocarditis. Thus, the objective of this study was to evaluate bleeding complications after minor oral surgery, specifically teeth extractions, in this unique patient population requiring long-term anticoagulation...
October 31, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29152464/intensivist-based-deep-sedation-using-propofol-for-pediatric-outpatient-flexible-bronchoscopy
#2
Kamal Abulebda, Samer Abu-Sultaneh, Sheikh Sohail Ahmed, Elizabeth A S Moser, Renee C McKinney, Riad Lutfi
AIM: To evaluate the safety and efficacy of sedating pediatric patients for outpatient flexible bronchoscopy. METHODS: A retrospective chart review was conducted for all children, age 17 years or under who underwent flexible bronchoscopy under deep sedation in an outpatient hospital-based setting. Two sedation regimens were used; propofol only or ketamine prior to propofol. Patients were divided into three age groups; infants (less than 12 mo), toddlers (1-3 years) and children (4-17 years)...
November 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29145742/improving-mechanical-thrombectomy-time-metrics-in-the-angiography-suite-stroke-cart-parallel-workflows-and-conscious-sedation
#3
Fabio Settecase, David B McCoy, Robert Darflinger, Matthew D Alexander, Daniel L Cooke, Christopher F Dowd, Steven W Hetts, Randall T Higashida, Van V Halbach, Matthew R Amans
Purpose Earlier reperfusion of large-vessel occlusion (LVO) stroke improves functional outcomes. We hypothesize that use of a stroke cart in the angiography suite, containing all commonly used procedural equipment in a mechanical thrombectomy, combined with parallel staff workflows, and use of conscious sedation when possible, improve mechanical thrombectomy time metrics. Methods We identified 47 consecutive LVO patients who underwent mechanical thrombectomy at our center, retrospectively and prospectively from implementation of these three workflow changes (19 pre- and 28 post-)...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/29142513/sedation-for-routine-gastrointestinal-endoscopic-procedures-a-review-on-efficacy-safety-efficiency-cost-and-satisfaction
#4
REVIEW
Otto S Lin
Most gastrointestinal endoscopic procedures are now performed with sedation. Moderate sedation using benzodiazepines and opioids continue to be widely used, but propofol sedation is becoming more popular because its unique pharmacokinetic properties make endoscopy almost painless, with a very predictable and rapid recovery process. There is controversy as to whether propofol should be administered only by anesthesia professionals (monitored anesthesia care) or whether properly trained non-anesthesia personnel can use propofol safely via the modalities of nurse-administered propofol sedation, computer-assisted propofol sedation or nurse-administered continuous propofol sedation...
October 2017: Intestinal Research
https://www.readbyqxmd.com/read/29138937/effects-of-propofol-sedation-on-pacing-thresholds-results-from-an-observational-cohort-study
#5
Jakob Lüker, Arian Sultan, Tobias Plenge, Samuel Lee, Jan-Hendrik van den Bruck, Daniel Steven
BACKGROUND: Propofol is one of the most commonly used intravenous anaesthetic drugs for surgical procedures. The use of propofol for sedation is also common practice during endoscopic procedures, electrophysiology studies, and ablation procedures, as well as pacemaker and defibrillator implantation. It was found that propofol alters the electrophysiologic properties of the heart and its conduction system. The effects of propofol on pacing thresholds are unknown and could have implications for pacemaker (PM) and defibrillator (ICD) implantation procedures, as well as sedation and anaesthesia in PM and ICD patients in general...
November 14, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29137967/procedural-and-thirty-day-outcomes-following-transfemoral-implantation-of-the-fully-repositionable-and-retrievable-lotus-valve-without-routine-pre-dilatation-in-a-consecutive-patient-cohort-a-single-centre-experience
#6
Neil Ruparelia, Katharine Thomas, James D Newton, Kate Grebenik, Amar Keiralla, George Krasopoulos, Rana Sayeed, Adrian P Banning, Rajesh K Kharbanda
BACKGROUND / PURPOSE: The Lotus valve (Boston Scientific, Natick, MA, USA) is a contemporary transcatheter aortic valve implantation (TAVI) device that is fully repositionable and retrievable to aid implantation and optimise procedural results. The ability to implant the device without routine pre-dilatation is another possible advantage reducing associated risks and procedure times. The aim of this study is to report procedural and 30-day outcomes following TAVI in a consecutive patient group presenting with severe symptomatic aortic stenosis with the Lotus valve system without routine pre-dilatation...
November 4, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29137881/comparison-between-chloral-hydrate-and-propofol-ketamine-as-sedation-regimens-for-pediatric-auditory-brainstem-response-testing
#7
Kamal Abulebda, Vinit J Patel, Sheikh S Ahmed, Alvaro J Tori, Riad Lutfi, Samer Abu-Sultaneh
INTRODUCTION: The use of diagnostic auditory brainstem response testing under sedation is currently the "gold standard" in infants and young children who are not developmentally capable of completing the test. OBJECTIVE: The aim of the study is to compare a propofol-ketamine regimen to an oral chloral hydrate regimen for sedating children undergoing auditory brainstem response testing. METHODS: Patients between 4 months and 6 years who required sedation for auditory brainstem response testing were included in this retrospective study...
October 28, 2017: Brazilian Journal of Otorhinolaryngology
https://www.readbyqxmd.com/read/29136523/the-advantages-of-hypnosis-intervention-on-breast-cancer-surgery-and-adjuvant-therapy
#8
M Berlière, F Roelants, C Watremez, M A Docquier, N Piette, S Lamerant, V Megevand, A Van Maanen, P Piette, A Gerday, F P Duhoux
BACKGROUND: In oncology, hypnosis has been used for pain relief in metastatic patients but rarely for induction of anesthesia. MATERIAL AND METHOD: Between January 2010 and October 2015, 300 patients from our Breast Clinic (Cliniques universitaires Saint-Luc, Université catholique de Louvain) were included in an observational, non-randomized study approved by our local ethics committee (ClinicalTrials.gov - NCT03003611). The hypothesis of our study was that hypnosis intervention could decrease side effects of breast surgery...
November 11, 2017: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/29132231/the-use-of-desflurane-for-neurosurgical-procedures-in-rhesus-macaque-macaca-mulatta
#9
Henri Gmj Bertrand, Charlotte Sandersen, Paul A Flecknell
Volatile agents are widely used to anaesthetise laboratory non-human primates as they allow a rapid induction and recovery as well as an easy adjustment of the anaesthesia plan. Desflurane is currently the volatile agent with the lowest solubility in blood, and hence enables the most rapid onset of anaesthesia and most rapid recovery. This study aimed to investigate the suitability of desflurane for maintenance of general anaesthesia in rhesus macaques undergoing elective experimental neurosurgery. Fourteen primates (five males and nine females) were sedated with ketamine (10 mg kg(-1)) and anaesthesia was induced with propofol (usually 8 mg kg(-1) IV)...
January 1, 2017: Laboratory Animals
https://www.readbyqxmd.com/read/29131352/grik1-and-gabra2-variants-have-distinct-effects-on-the-dose-related-subjective-response-to-intravenous-alcohol-in-healthy-social-drinkers
#10
Bao-Zhu Yang, Albert J Arias, Richard Feinn, John H Krystal, Joel Gelernter, Ismene L Petrakis
BACKGROUND: The heritable risk for alcohol use disorder (AUD) is expressed partly through alterations in subjective alcohol response. In this study, we investigated the effects of 2 AUD-risk-associated single nucleotide polymorphisms, GABRA2 rs279858 and GRIK1 rs2832407, on the subjective response to alcohol administered intravenously to healthy social drinkers in a laboratory setting. METHODS: In total, 93 self-identified European American social drinkers underwent 3 blinded laboratory sessions in which they received intravenous infusions of ethanol at 3 target blood alcohol levels (0...
November 13, 2017: Alcoholism, Clinical and Experimental Research
https://www.readbyqxmd.com/read/29131286/conscious-sedation-for-transcatheter-implantation-of-atrial-septal-occluders-with-the-2d-and-3d-transesophageal-echocardiography-guidance-the-feasibility-and-safety-study
#11
Piotr Lipiec, Dawid Miśkowiec, Jan Z Peruga, Michał Plewka, Ewa Szymczyk, Paulina Wejner-Mik, Karolina Kupczyńska, Jarosław D Kasprzak
BACKGROUND: General anesthesia may have negative impact on patients mortality and morbidity, as well as overall procedure costs in atrial septal occluders (ASO) implantation. AIM: We sought to evaluate the safety, efficacy and feasibility of conscious sedation for transcatheter implantation of ASO. METHODS: 122 patients (pts) referred for transcatheter implantation of ASO were included. Mean patients' age was 51±15 years, 43 patients were male (35%)...
November 13, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/29130583/endoscopic-retrograde-cholangio-pancreatography-in-the-management-of-biliary-complications-after-paediatric-liver-transplantation
#12
Sivaramakrishnan Venkatesh Karthik, Seng-Hock Quak, Marion M Aw
BACKGROUND: The published paediatric experience with Endoscopic retrograde cholangio-pancreatography (ERCP) in the diagnosis and management of biliary complications following liver transplantation (LT) is limited. AIMS: We describe our experience with ERCP in the management of children following LT who presented with biliary complications, over a 20 year period (1995-2014). METHODS: The retrospectively reviewed data is summarized descriptively...
November 11, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29130220/-current-research-progress-and-thinking-of-fecal-microbiota-transplantation-for-the-treatment-of-gastrointestinal-disorders
#13
Ning Li, Hongliang Tian
Fecal microbiota transplantation (FMT), also known as fecal bacteriotherapy or fecal infusion, consists of injection of a liquid filtrate of feces from a healthy donor into the gastrointestinal tract of a recipient individual. FMT has been proposed as a therapeutic approach for functional diseases of the gastrointestinal tract by reestablishment of a wide diversity of intestinal flora. Clostridium difficile infection (CDI) treatment guideline from American Gastroenterology Association (AGA) recommends that FMT can be used as the treatment protocols of relapse CDI...
October 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29129153/skin-biopsy-for-diagnosis-of-ullrich-congenital-muscular-dystrophy-an-observational-study
#14
Biswaroop Chakrabarty, M C Sharma, Sheffali Gulati, Chitra Sarkar
The gold standard diagnostic test for Ullrich congenital muscular dystrophy (UCMD) is molecular testing for COL6 mutation. The facility for genetic testing is sparingly available and it is usually diagnosed by muscle biopsy. The latter is an invasive procedure requiring expertise and sedation. Skin biopsy has shown promise as a simpler diagnostic modality. Eleven and 7 cases, respectively, of phenotypically suspected Ullrich congenital muscular dystrophy and dystrophinopathy underwent simultaneous skin and muscle biopsies, which were subjected to hematoxylin and eosin (H&E) and immunohistochemistry staining for collagen VI and dystrophin 1, 2, and 3...
December 2017: Journal of Child Neurology
https://www.readbyqxmd.com/read/29125398/the-management-of-peri-and-postprocedural-pain-in-interventional-radiology-a-narrative-review
#15
Jeremy N Cashman, Lenny Ng
Interventional radiology encompasses a wide range of procedures and the degree of associated pain depends predominantly on the procedure being undertaken. Procedures may be painful during but not after the procedure, relatively painless during but painful after the procedure, or relatively painless during and after the procedure. However, there is a lack of good quality publications in interventional radiology that specifically address the subject of peri- and postprocedural pain management. Nevertheless, a variety of more or less complex protocols exist for intraprocedural sedation and for peri- and postprocedural analgesia...
November 10, 2017: Pain Management
https://www.readbyqxmd.com/read/29124404/pediatric-patients-receiving-naloxone-within-48%C3%A2-h-of-anesthesia-a-case-control-study
#16
Vinay K Donempudi, Juraj Sprung, Toby N Weingarten
PURPOSE: Excessive narcotization in pediatric surgical patients has not been well characterized. This report describes the use of postoperative naloxone in pediatric patients. METHODS: Pediatric surgical patients from January 1, 2010, through June 30, 2016, who underwent general anesthesia and received naloxone within 48 h postoperatively were identified and matched 1:1 with controls by age, sex, and procedure. Cases and controls underwent retrospective chart review...
November 9, 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/29121287/analgesia-nociception-index-for-the-assessment-of-pain-in-critically-ill-patients-a-diagnostic-accuracy-study
#17
G Chanques, T Tarri, A Ride, A Prades, A De Jong, J Carr, N Molinari, S Jaber
Background: Behavioural pain tools are used in Intensive Care Unit (ICU) patients unable to self-report their pain-intensity but need sustained efforts to educate and train the ICU team because of the subjective nature of these clinical tools. This study measured the validity and performance of an electrophysiological monitoring tool based on the spectral analysis of heart rate variability, the Analgesia Nociception Index (ANI) which varies from 0 (minimal parasympathetic tone, maximal stress-response and pain) to 100 (maximal parasympathetic tone, minimal stress-response and pain)...
October 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29118889/successful-treatment-of-iatrogenic-external-iliac-artery-perforation-with-covered-stent-case-report-and-review-of-the-literature
#18
Muhammad Umer Awan, Bassam Omar, Ghazanfar Qureshi, Ghulam Mustafa Awan
Retroperitoneal hemorrhage from iliac artery injury is a potentially serious complication of vascular interventional procedures leading to hemorrhagic shock and death if not diagnosed early and treated promptly. We report a 70-year-old male admitted to our facility with non-ST-elevation myocardial infarction, whose heart catheterization revealed left anterior descending artery (LAD) with 80% proximal, 95% mid and 100% distal disease. The left circumflex and right coronary arteries were 100% occluded proximally and received collaterals from the LAD...
October 2017: Cardiology Research
https://www.readbyqxmd.com/read/29118800/septoplasty-scepter-balloon-angioplasty-for-vasospasm-after-aneurysmal-subarachnoid-hemorrhage
#19
Bradley A Gross, Daniel A Tonetti, Gregory M Weiner, David M Panczykowski, William J Ares, Cynthia L Kenmuir, Ashutosh P Jadhav, Tudor G Jovin, Brian T Jankowitz
Introduction: Balloon angioplasty can be a requisite approach for the treatment of symptomatic and/or severe vasospasm. Dual-lumen microcatheter balloons have multiple potential advantages for this indication including accommodating a 0.014-inch wire and the potential to deliver superselective vasodilators directly via the microcatheter prior to angioplasty. Methods: The authors reviewed a 3-year institutional experience with the Scepter XC balloon (Microvention, Tustin, CA, USA) in the treatment of postaneurysmal subarachnoid hemorrhage vasospasm, focusing on treatment methods, angiographic, and clinical results...
October 2017: Interventional Neurology
https://www.readbyqxmd.com/read/29117722/endoscopic-ultrasound-guided-pancreatic-fluid-collections-transmural-drainage-outcomes-in-100-consecutive-cases-of-pseudocysts-and-walled-off-necrosis-a-single-centre-experience-from-the-united-kingdom
#20
Chander Shekhar, Ben Maher, Colm Forde, Brinder Singh Mahon
BACKGROUND AND AIM: Endoscopic ultrasound-guided drainage is a minimally invasive first-line modality for the drainage of pancreatic fluid collection (PFC) resulting in a shorter hospital stay and less morbidity compared with surgical cystogastrostomy. Our aim is to evaluate potential differences in the outcomes of endoscopic ultrasound (EUS) guided transmural drainage (EUS-TD) drainage of pancreatic pseudocyst (PP) and walled-off necrosis (WON). METHOD: We retrospectively reviewed 100 consecutive EUS-guided drainages of PFC utilising EUS reports; clinical notes and imaging with follow-up (FU) to 12 months...
November 9, 2017: Scandinavian Journal of Gastroenterology
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