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Procedural sedation

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https://www.readbyqxmd.com/read/28431636/systemic-air-embolism-after-endoscopy-without-vessel-injury-a-summary-of-reported-cases
#1
Peter Voigt, Stefan Schob, Sebastian Gottschling, Thomas Kahn, Alexey Surov
INTRODUCTION: Systemic air embolism (SAE) is a rare but serious complication following endoscopic procedures. It may occur with or without direct vessel injury. The aim of this work is to review cases of SAE following endoscopy without proven vessel injury. METHODS: In this systematic review PubMed database was screened for SAE following endoscopy from 1990 to 2015. Only cases without proven major vessel injury were included in the analysis. Including one case of SAE after colonoscopy from our hospital the analysis comprised 40 cases...
May 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28431040/prospective-assessment-of-pain-and-comfort-in-chronic-pain-patients-undergoing-interventional-pain-management-procedures
#2
Thomas Simopoulos, Daniel Leffler, Sheila Barnett, Devon Campbell, Shu Jing Lian, Jatinder S Gill
Objective.:  Interventional pain management procedures have an important role in the management of chronic pain. The present study seeks to identify the proportion of patients who experience severe pain during pain procedures either with or without sedation. There is then an attempt to identify any association of high pain levels with factors such as age, gender, ethnicity, preprocedure pain level, procedure type, tobacco use, and baseline pharmaceuticals taken for both pain and/or mood disorder management...
April 18, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28424537/awake-craniotomy-anesthetic-management-using-dexmedetomidine-propofol-and-remifentanil
#3
Andrea Prontera, Stefano Baroni, Andrea Marudi, Franco Valzania, Alberto Feletti, Francesca Benuzzi, Elisabetta Bertellini, Giacomo Pavesi
INTRODUCTION: Awake craniotomy allows continuous monitoring of patients' neurological functions during open surgery. Anesthesiologists have to sedate patients in a way so that they are compliant throughout the whole surgical procedure, nevertheless maintaining adequate analgesia and anxiolysis. Currently, the use of α2-receptor agonist dexmedetomidine as the primary hypnotic-sedative medication is increasing. METHODS: Nine patients undergoing awake craniotomy were treated with refined monitored anesthesia care (MAC) protocol consisting of a combination of local anesthesia without scalp block, low-dose infusion of dexmedetomidine, propofol, and remifentanil, without the need of airways management...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/28424007/anesthetic-related-neurotoxicity-and-neuroimaging-in-children-a-call-for-conversation
#4
Kara A Bjur, Eric T Payne, Michael E Nemergut, Danqing Hu, Randall P Flick
Each year millions of young children undergo procedures requiring sedation or general anesthesia. An increasing proportion of the anesthetics used are provided to optimize diagnostic imaging studies such as magnetic resonance imaging. Concern regarding the neurotoxicity of sedatives and anesthetics has prompted the US Food and Drug Administration to change labeling of anesthetics and sedative agents warning against repeated or prolonged exposure in young children. This review aims to summarize the risk of anesthesia in children with an emphasis on anesthetic-related neurotoxicity, acknowledge the value of pediatric neuroimaging, and address this call for conversation...
May 2017: Journal of Child Neurology
https://www.readbyqxmd.com/read/28419616/the-provision-of-pediatric-cardiac-anesthesia-services-in-germany-current-status-of-structural-and-personnel-organization
#5
Torsten Baehner, Oliver Dewald, Ingo Heinze, Matthias Mueller, Ehrenfried Schindler, Uwe Schirmer, Georg Baumgarten, Andreas Hoeft, Richard K Ellerkmann
BACKGROUND: Anesthesia for pediatric cardiac surgery requires a high level of expert knowledge. There are currently no recommendations and standards for anesthetic management for congenital cardiac surgery in Germany. AIM: The aim of the present study was to assess the current status of structural and personnel anesthetic standards at pediatric cardiac surgery centers in Germany. METHOD: All cardiac surgical centers in Germany were reviewed for an active program for congenital heart surgery...
April 17, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28417892/discharge-criteria-impact-of-the-patient-and-the-procedure-what-the-oral-surgeon-should-know
#6
REVIEW
Kyle J Kramer
This article is a concise review of discharge criteria following sedation or anesthesia relevant to the oral and maxillofacial surgeon. Topics covered include a general overview of the need for objective discharge criteria, a review of standardized criteria, and a brief discussion on specific anesthetic, patient, and surgical factors that can impact the safety of the immediate postoperative recovery and postdischarge periods.
May 2017: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/28417851/nuclear-medicine-techniques-in-pediatric-bone-imaging
#7
REVIEW
Laura A Drubach
An important mandate when imaging pediatric patients is the reduction of radiation exposure to the lowest possible level consistent with good quality diagnostic imaging, so individual selection of radiopharmaceutical dosage and imaging technique is essential. Although the logistics of image acquisition and the approach to interpretation mirror the more common use in adults, the challenges of imaging young children typically require greater attention to patient preparation, positioning, and supervision during imaging, with the use of parental or family engagement in the procedure, gentle restraint, and occasionally the need for sedation...
May 2017: Seminars in Nuclear Medicine
https://www.readbyqxmd.com/read/28416960/medical-thoracoscopy-in-pleural-disease-experience-from-a-one-center-study
#8
Soo Jung Kim, Sun Mi Choi, Jinwoo Lee, Chang-Hoon Lee, Sang-Min Lee, Jae-Joon Yim, Chul-Gyu Yoo, Young Whan Kim, Sung Koo Han, Young Sik Park
BACKGROUND: Medical thoracoscopy (MT) is a minimally invasive, endoscopic procedure for exploration of the pleural cavity under conscious sedation and local anesthesia. MT has been performed at the Seoul National University Hospital since February 2014. This paper summarizes the findings and outcomes of MT cases at this hospital. METHODS: Patients who had undergone MT were enrolled in the study. MT was performed by pulmonologists, using both rigid and semi-rigid thoracoscopes...
April 2017: Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/28416265/comparison-of-outcomes-for-pediatric-paraphimosis-reduction-using-topical-anesthetic-versus-intravenous-procedural-sedation
#9
Brett Burstein, Raphael Paquin
BACKGROUND: Paraphimosis is an acute urologic emergency requiring urgent manual reduction, frequently necessitating procedural sedation (PS) in the pediatric population. The present study sought to compare outcomes among pediatric patients undergoing paraphimosis reduction using a novel topical anesthetic (TA) technique versus PS. METHODS: We performed a retrospective analysis of all patients <18years old, presenting to a tertiary pediatric ED requiring analgesia for paraphimosis reduction between October 2013 and September 2016...
April 11, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28413268/novel-propofol-derivatives-and-implications-for-anesthesia-practice
#10
REVIEW
Aiden Y Feng, Alan D Kaye, Rachel J Kaye, Kumar Belani, Richard D Urman
Propofol (2,6-diisopropylphenol) is the most commonly used intravenous agent for induction of anesthesia. It is also used for maintenance of anesthesia and sedation in both Intensive Care Units and outpatient procedural settings. Its success in the clinical setting has been a result of its rapid onset, short duration of action, and minimal side effects despite disadvantages associated with its oil emulsion formulation. Early attempts to alter the standard emulsion or to develop new formulations with cyclodextrins and micelles to resolve issues with pain upon injection, the need for antimicrobial agents, and possible hyperlipidemia have mostly failed...
January 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28412271/impact-of-a-new-distal-attachment-on-colonoscopy-performance-in-an-academic-screening-center
#11
Zacharias P Tsiamoulos, Ravi Misra, Rajaratanam Rameshshanker, Timothy R Elliott, Iosif Beintaris, Siwan Thomas-Gibson, Adam Haycock, Noriko Suzuki, Colin Rees, Brian P Saunders
BACKGROUND AND AIMS: Distal attachments placed on the colonoscope tip may positively affect performance by assisting insertion and polyp detection. The Endocuff-original appears to improve adenoma detection rate, but there are no data assessing the performance of the second generation Endocuff-vision. METHODS: A pilot service evaluation study (April-2013/September-2014) was conducted on patients with positive faecal occult blood tests within the National Bowel Cancer Programme during 3 consecutive periods: pre-cuff/no device used, during-cuff/device used and post-cuff/no device used...
April 12, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28411359/incidence-and-treatment-of-bile-stones-after-liver-transplant
#12
Mahir Kırnap, Ebru Hative Ayvazoğlu Soy, Aydıncan Akdur, Sedat Yıldırım, Ali Harman, Gökhan Moray, Mehmet Haberal
OBJECTIVES: Although the incidence of bile stones after liver transplant is rare (2%-6%), various complications can occur, including recurrent cholangitis, biliary strictures, graft loss, and patient mortality. MATERIALS AND METHODS: We retrospectively evaluated bile stone incidence, pathogenesis, and treatment in 352 liver transplant recipients, comparing demographics, transplant indication, blood lipid profile, bile reconstruction technique, postoperative complications, time of diagnosis, and treatment regimens...
April 14, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28410767/non-anesthesiologist-administered-propofol-is-not-related-to-an-increase-in-transcutaneous-co2-pressure-during-flexible-bronchoscopy-compared-to-guideline-based-sedation-a-randomized-controlled-trial
#13
Roberto Mercado-Longoría, Carolina Armeaga-Azoños, Jasel Tapia-Orozco, Julio E González-Aguirre
INTRODUCTION: Evidence for the use of non-anesthesiologist-administered propofol for sedation during flexible bronchoscopy is scarce. The main objective of this study was to determine whether non-anesthesiologist-administered propofol balanced sedation was related to higher transcutaneous CO2 pressure compared with current guideline-based sedation (combination midazolam and opioid). Secondary outcomes were post-procedural recuperation time, patient satisfaction and frequency of adverse events...
April 11, 2017: Archivos de Bronconeumología
https://www.readbyqxmd.com/read/28409844/balloon-eustachian-tuboplasty-under-local-anesthesia-is-it-feasible
#14
Veera Luukkainen, Ilkka Kivekäs, Sari Hammarén-Malmi, Markus Rautiainen, Leena Pöyhönen, Antti A Aarnisalo, Jussi Jero, Saku T Sinkkonen
OBJECTIVE: To study whether balloon Eustachian tuboplasty (BET) is a feasible and safe procedure under local anesthesia. STUDY DESIGN: Prospective multicenter case-control study. METHODS: Patients undergoing either BET (n = 13) or endoscopic sinus surgery (ESS) (n = 12) under local anesthesia, with the possibility of sedation and analgesia, were monitored during the procedure and recovery period for possible adverse effects. After the procedure, the patients responded to a questionnaire assessing their experience...
May 2017: Laryngoscope
https://www.readbyqxmd.com/read/28407560/genital-and-anal-injuries-a-cross-sectional-australian-study-of-1266-women-alleging-recent-sexual-assault
#15
Renate R Zilkens, Debbie A Smith, Maureen A Phillips, S Aqif Mukhtar, James B Semmens, Maire C Kelly
OBJECTIVES: To describe the frequency of genital and anal injury and associated demographic and assault characteristics in women alleging sexual assault. DESIGN: Cross-sectional study. SETTING: Sexual Assault Resource Centre (SARC), Western Australia. PARTICIPANTS: Total of 1266 women attending SARC from Jan-2009 to Mar-2015. METHODS: Women underwent a standardised data collection procedure by forensically trained doctors...
March 29, 2017: Forensic Science International
https://www.readbyqxmd.com/read/28403208/analogosedation-during-flexible-bronchoscopy-using-a-combination-of-midazolam-propofol-and-fentanyl-a-retrospective-analysis
#16
Tobias Müller, Kristina Thümmel, Christian G Cornelissen, Stefan Krüger, Michael Dreher
BACKGROUND: According to current guidelines flexible bronchoscopy is usually performed under sedation. Previously it has been demonstrated that combined sedation with e. g. the combination of midazolam and propofol or an opioid might have several advantages over sedation with just one sedative drug. However, little is known about the efficacy and safety of combined sedation with midazolam, fentanyl and propofol (MFP) compared to sedation with midazolam and fentanyl (MF) or midazolam and propofol (MP)...
2017: PloS One
https://www.readbyqxmd.com/read/28399933/intranasal-sedation-using-ketamine-and-midazolam-for-pediatric-dental-treatment-naso-study-protocol-for-a-randomized-controlled-trial
#17
Heloisa Sousa Gomes, Analya Rodrigues Miranda, Karolline Alves Viana, Aline Carvalho Batista, Paulo Sucasas Costa, Anelise Daher, Geovanna de Castro Morais Machado, Joji Sado-Filho, Liliani Aires Candido Vieira, Patrícia Corrêa-Faria, Marie Therese Hosey, Luciane Rezende Costa
BACKGROUND: Uncooperative children may need to receive dental treatment under sedation, which is indicated when nonpharmacological behavior guidance is unsuccessful. There are randomized controlled trials (RCTs) comparing different sedative protocols for dental procedures; however, the evidence for superiority of one form over another is weak. The primary aim of this study is to investigate the efficacy of intranasally administered ketamine plus midazolam for the dental treatment of children...
April 11, 2017: Trials
https://www.readbyqxmd.com/read/28395952/a-novel-methodology-for-assessing-laryngeal-and-vagus-nerve-integrity-in-patients-under-general-anesthesia
#18
Catherine F Sinclair, Maria J Téllez, Oscar R Tapia, Sedat Ulkatan, Vedran Deletis
OBJECTIVE: To describe a novel methodology for intraoperative neuro-monitoring of laryngeal and vagus nerves by utilizing the laryngeal adductor reflex (LAR). METHODS: Case series of 15 patients undergoing thyroid and cervical spine surgeries under total intravenous general anesthesia. Vocal fold mucosa was electrically stimulated to elicit a LAR using endotracheal tube based electrodes. Contralateral R1 (cR1) and R2 (cR2) responses were recorded using the endotracheal tube electrode contralateral to the simulating electrode...
March 14, 2017: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/28395927/correction-correction-to-clinical-policy-procedural-sedation-and-analgesia-in-the-emergency%C3%A2-department-annals-of-emergency-medicine-63-2014-247-258-e18
#19
Steven A Godwin, John H Burton, Charles J Gerardo, Benjamin W Hatten, Sharon E Mace, Scott M Silvers, Francis M Fesmire
Due to a miscommunication during the process of transferring this manuscript from our editorial team to Production, the Members of the American College of Emergency Physicians Clinical Policies Committee (Oversight Committee) were not properly indexed in PubMed. This has now been corrected online. The publisher would like to apologize for any inconvenience caused.
April 7, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28395002/monitored-anesthesia-care-vs-intubation-for-vertebrobasilar-stroke-endovascular-therapy
#20
Ashutosh P Jadhav, Mehdi Bouslama, Amin Aghaebrahim, Leticia C Rebello, Matthew T Starr, Diogo C Haussen, Manasa Ranginani, Matthew K Whalin, Tudor G Jovin, Raul G Nogueira
Importance: No consensus regarding the ideal sedation treatment for stroke endovascular therapy has been reached, and practices remain largely based on local protocols and clinician preferences. Most studies have focused on anterior circulation strokes; therefore, little is known regarding the optimal anesthesia type for vertebrobasilar occlusion strokes. Objective: To compare clinical and angiographic outcomes between monitored anesthesia care (MAC) and general anesthesia (GA) in patients presenting with vertebrobasilar occlusion strokes...
April 10, 2017: JAMA Neurology
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