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Procedural sedation

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https://www.readbyqxmd.com/read/28339558/impact-of-sedation-vs-general-anaesthesia-on-percutaneous-epicardial-access-safety-and-procedural-outcomes
#1
Ammar M Killu, Alan Sugrue, Thomas M Munger, David O Hodge, Siva K Mulpuru, Christopher J McLeod, Douglas L Packer, Samuel J Asirvatham, Paul A Friedman
Aims: Patient movement while under moderate/deep sedation may complicate percutaneous epicardial access (EpiAcc), mapping and ablation. We sought to compare procedural outcomes in patients undergoing EpiAcc under sedation vs. general anaesthesia (GA) for ablation. Methods and results: Patients undergoing EpiAcc between January 2004 and July 2014 were included. Safety, procedural, and clinical outcomes were compared between patients undergoing EpiAcc under sedation or GA for ventricular tachycardia or premature ventricular complex ablation...
November 15, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28338301/analgesia-for-patients-undergoing-shockwave-lithotripsy-for-urinary-stones-a-systematic-review-and-meta-analysis
#2
Omar M Aboumarzouk, Rami Hasan, Ali Tasleem, Martin Mariappan, Rachael Hutton, John Fitzpatrick, Laura Beatty, Gareth E Jones, Tarik Amer
BACKGROUND: Shock wave lithotripsy (SWL) is the first line treatment modality for a significant proportion of patients with upper urinary tracts stones. Simple analgesics, opioids and non-steroidal anti-inflammatory drugs (NSAIDs) are all suitable agents but the relative efficacy and tolerability of these agents is uncertain. OBJECTIVES: To determine the efficacy of the different types of analgesics used for the control of pain during SWL for urinary stones. MATERIALS AND METHODS: We searched the Cochrane Renal Group's Specialised Register, MEDLINE, EMBASE and also hand-searched reference lists of relevant articles (Figure-1)...
March 24, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/28338031/preoperative-analgesia-for-children-and-adolescents-to-reduce-pain-associated-with-dental-treatment
#3
Catherine McCann
Data sourcesCochrane Oral Health Group's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), Medline, Embase, LILACS, ISI Web of Science, ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform.Study selectionRandomised controlled clinical trials of analgesics given before dental treatment versus placebo or no analgesics in children and adolescents up to 17 years of age. Children and adolescents having dental treatment under sedation (including nitrous oxide/oxygen) or general anaesthesia were excluded...
March 2017: Evidence-based Dentistry
https://www.readbyqxmd.com/read/28337480/intra-channel-stent-release-technique-for-fluoroless-endoscopic-ultrasound-guided-lumen-apposing-metal-stent-placement-changing-the-paradigm
#4
Andrea Anderloni, Fabia Attili, Silvia Carrara, Domenico Galasso, Milena Di Leo, Guido Costamagna, Alessandro Repici, Rastislav Kunda, Alberto Larghi
Background Recently, a novel lumen-apposing fully covered self-expanding metal stent (LA-FCSEMS) mounted on an electrocautery-enhanced delivery system has been developed to perform endoscopic ultrasound (EUS)-guided transluminal drainage. From early experience, however, release of the proximal flange of the stent has mostly been done using endoscopic view guidance to ensure proper positioning. Aim We describe a new technique that we have named the Intra-Channel Stent Release Technique (ICSRT) to perform stent placement under complete EUS control, without the use of either fluoroscopic or endoscopic views...
January 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28337075/intranasal-dexmedetomidine-as-a-sedative-for-pediatric-procedural-sedation
#5
Natalie Behrle, Esma Birisci, Jordan Anderson, Sara Schroeder, Abdallah Dalabih
OBJECTIVE: This study seeks to evaluate the efficacy and safety of intranasal (IN) dexmedetomidine as a sedative medication for non-invasive procedural sedation. METHODS: Subjects 6 months to 18 years of age undergoing non-invasive elective procedures were included. Dexmedetomidine (3 mcg/kg) was administered IN 40 minutes before the scheduled procedure time. The IN dexmedetomidine cohort was matched and compared to a cohort of 690 subjects who underwent sedation for similar procedures without the use of dexmedetomidine to evaluate for observed events/interventions and procedural times...
January 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28336579/implementation-of-a-modified-who-pediatric-procedural-sedation-safety-checklist-and-its-impact-on-risk-reduction
#6
Lindsay Kahlenberg, Lindsay Harsey, Mary Patterson, Don Wachsberger, Dave Gothard, Michael Holder, Michael Forbes, Urmila Tirodker
BACKGROUND AND OBJECTIVES: Major adverse events (AEs) related to pediatric deep sedation occur at a low frequency but can be of high acuity. The high volume of deep sedations performed by 3 departments at our institution provided an opportunity to reduce variability and increase safety through implementation of a procedural sedation safety checklist. We hypothesized that implementation of a checklist would improve compliance of critical safety elements (CSEs) (primary outcome variable) and reduce the sedation-related AE rate (secondary outcome variable)...
March 23, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28334767/discomfort-during-bronchoscopy-performed-after-endobronchial-intubation-with-fentanyl-and-midazolam-a-prospective-study
#7
Daisuke Minami, Nagio Takigawa, Hirohisa Kano, Takashi Ninomiya, Toshio Kubo, Eiki Ichihara, Kadoaki Ohashi, Akiko Sato, Katsuyuki Hotta, Masahiro Tabata, Mitsune Tanimoto, Katsuyuki Kiura
Objective: Although endobronchial intubation during a bronchoscopic examination is useful for invasive procedures, it is not routine practice in Japan. The present study evaluated discomfort due to endobronchial intubation using fentanyl and midazolam sedation during bronchoscopy. Methods: Thirty-nine patients were enrolled prospectively from November 2014 to September 2015 at Okayama University Hospital. Fentanyl (20 µg) was administered to the patients just before endobronchial intubation, and fentanyl (10 µg) and midazolam (1 mg) were added as needed during the procedure...
February 23, 2017: Japanese Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28334427/capnography-versus-standard-monitoring-for-emergency-department-procedural-sedation-and-analgesia
#8
REVIEW
Brian F Wall, Kirk Magee, Samuel G Campbell, Peter J Zed
BACKGROUND: Procedural sedation and analgesia (PSA) is used frequently in the emergency department (ED) to facilitate painful procedures and interventions. Capnography, a monitoring modality widely used in operating room and endoscopy suite settings, is being used more frequently in the ED setting with the goal of reducing cardiopulmonary adverse events. As opposed to settings outside the ED, there is currently no consensus on whether the addition of capnography to standard monitoring modalities reduces adverse events in the ED setting...
March 23, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28333707/the-effect-of-sedation-on-cortical-activation-a-randomized-study-comparing-the-effects-of-sedation-with-midazolam-propofol-and-dexmedetomidine-on-auditory-processing
#9
Michael A Frölich, Catiffaney Banks, Timothy J Ness
BACKGROUND: Every day, millions of people undergo surgical procedures facilitated by anesthesia. Yet, there is no clinically accepted measure to predict the effects of sedation or anesthesia on the central nervous system. Auditory brain activation may provide an objective and quantifiable method to measure of the effects of sedation on neuronal processing. METHODS: This is a randomized clinical trial. Forty-eight healthy volunteers were randomly assigned to receive 1 of 3 sedative drugs (midazolam [n = 11], propofol [n = 12], or dexmedetomidine [n = 12]) at a concentration adjusted to achieve mild sedation by self-rating, or to a no-drug control group (n = 13)...
March 22, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28330689/evaluation-of-methohexital-as-an-alternative-to-propofol-in-a-high-volume-outpatient-pediatric-sedation-service
#10
Nicholas E Jones, Michael S Kelleman, Harold K Simon, Jana A Stockwell, Courtney McCracken, Michael D Mallory, Pradip P Kamat
BACKGROUND: Propofol is a preferred agent for many pediatric sedation providers because of its rapid onset and short duration of action. It allows for quick turn around times and enhanced throughput. Occasionally, intravenous (IV) methohexital (MHX), an ultra-short acting barbiturate is utilized instead of propofol. OBJECTIVE: Describe the experience with MHX in a primarily propofol driven outpatient sedation program and to see if it serves as an acceptable alternative when propofol is not the preferred pharmacologic option...
March 8, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28325486/mri-utilization-and-the-associated-use-of-sedation-and-anesthesia-in-a-pediatric-aco
#11
Joshua C Uffman, Dmitry Tumin, Vidya Raman, Arlyne Thung, Brent Adler, Joseph D Tobias
BACKGROUND AND OBJECTIVES: MRI is commonly used in the pediatric population and often requires sedation or general anesthesia to complete. This study used data from a pediatric accountable care organization (ACO) to investigate trends in MRI utilization and in the requirement for anesthesia to complete MRI examinations. METHODS: The Partners for Kids (PFK) ACO claims database was queried for MRI examination encounters involving patients 0 to 18 years old from 2009 to 2014, with utilization expressed as encounters per 10,000 PFK members-months...
March 15, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28325160/-procedural-sedation-and-analgesia-with-nitrous-oxide-for-children-in-the-emergency-department
#12
W P Kluijfhout, R T C Welsing
Procedural sedation and analgesia with nitrous oxide in children who are anxious or in pain is a relatively new type of sedation in emergency departments in the Netherlands. The gas is inhaled through a face mask and does not require intravenous access. Furthermore, nitrous oxide does not influence the circulatory and respiratory systems and airway reflexes remain intact, which means that the child does not need to be fasted. Children who are treated with nitrous oxide experience significantly less pain and discomfort compared to the application of conventional analgesia...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28323725/bronchoscopy-oral-or-nasal-insertion
#13
Geertje M de Boer, Yasemin Türk, Virginie H Meuleman-van Waning, Gert-Jan Braunstahl
BACKGROUND: Flexible bronchoscopy is a frequently used procedure for the diagnosis and treatment of various lung disorders. As there is no standardized guideline on the insertion of the bronchoscope, and few studies are available on the subject, we conducted a prospective randomized controlled trial to compare nasal and oral insertion. METHODS: In total, 66 patients who underwent bronchoscopy without sedation were randomly assigned to either oral or nasal insertion...
April 2017: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/28319511/the-first-us-clinical-experience-with-computer-assisted-propofol-sedation-a-retrospective-observational-comparative-study-on-efficacy-safety-efficiency-and-endoscopist-and-patient-satisfaction
#14
Otto S Lin, Richard A Kozarek, Deborah Tombs, Danielle La Selva, Wade Weigel, Ryan Beecher, Ana Jensen, Michael Gluck, Andrew Ross
BACKGROUND: Computer-assisted propofol sedation (CAPS) is now approved for moderate sedation of American Society of Anesthesiologists (ASA) class I and II patients undergoing routine endoscopy. As the first US medical center to adopt CAPS for routine clinical use, we compared patient and endoscopist satisfaction with CAPS versus midazolam and fentanyl (MF) sedation. METHODS: Patients who underwent elective outpatient upper endoscopy and colonoscopy with CAPS were compared with concurrent patients sedated with MF...
March 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28319161/intranasal-ketamine-for-procedural-sedation-and-analgesia-in-children-a-systematic-review
#15
Naveen Poonai, Kyle Canton, Samina Ali, Shawn Hendrikx, Amit Shah, Michael Miller, Gary Joubert, Michael Rieder, Lisa Hartling
BACKGROUND: Ketamine is commonly used for procedural sedation and analgesia (PSA) in children. Evidence suggests it can be administered intranasally (IN). We sought to review the evidence for IN ketamine for PSA in children. METHODS: We performed a systematic review of randomized trials of IN ketamine in PSA that reported any sedation-related outcome in children 0 to 19 years. Trials were identified through electronic searches of MEDLINE (1946-2016), EMBASE (1947-2016), Google Scholar (2016), CINAHL (1981-2016), The Cochrane Library (2016), Web of Science (2016), Scopus (2016), clinical trial registries, and conference proceedings (2000-2016) without language restrictions...
2017: PloS One
https://www.readbyqxmd.com/read/28315010/comparison-of-efficacy-of-meperidine-and-fentanyl-in-terms-of-pain-management-and-quality-of-life-in-patients-with-cervical-cancer-receiving-intracavitary-brachytherapy-a-double-blind-randomized-controlled-trial
#16
Saengrawee Thanthong, Sirikorn Rojthamarat, Wipra Worasawate, Phongthara Vichitvejpaisal, Danupon Nantajit, Nantakarn Ieumwananontachai
OBJECTIVE: The aim of this study was to compare the effectiveness of two sedative regimens, a benzodiazepine with either meperidine or fentanyl, in relieving pain in patients with cervical cancer undergoing intracavitary brachytherapy in terms of pain score and quality of life. METHODS: Forty unselected outpatients undergoing brachytherapy (160 fractions) were enrolled with informed consent and randomized to receive a benzodiazepine with either meperidine or fentanyl...
March 18, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28314604/a-prospective-randomised-study-comparing-double-balloon-colonoscopy-and-conventional-colonoscopy-in-pre-defined-technically-difficult-cases
#17
Edward J Despott, Alberto Murino, Masanao Nakamura, Leonidas Bourikas, Chris Fraser
BACKGROUNDS AND AIM: Technically 'difficult' (TD) colonoscopy is associated with incomplete colonoscopy, discomfort and longer procedures. Double-balloon colonoscopy (DBC) may facilitate TD colonoscopy. The primary outcome was to compare the time taken to achieve caecal intubation during conventional colonoscopy (CC) and DBC in patient with a TD colon. METHODS: We performed a prospective, randomised study comparing DBC and CC for TD colonoscopy. Patients were screened for parameters predictive of TD colonoscopy using an original scoring system and randomised to DBC or CC...
February 14, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28306329/the-effect-of-listening-to-music-during-percutaneous-nephrostomy-tube-placement-on-pain-anxiety-and-success-rate-of-procedure-a-randomized-prospective-study
#18
Nurullah Hamidi, Erdem Ozturk
PURPOSE: To evaluate the effect of listening to music on pain, anxiety, and success of procedure during office-based percutaneous nephrostomy tube placement (PNTP). MATERIALS AND METHODS: One hundred consecutive patients (age >18 years) with hydronephrosis were prospectively enrolled in this study. All patients were prospectively randomized to undergo office-based PNTP with (Group I, n = 50) or without music (Group II, n = 50). Anxiety levels were evaluated with State Trait Anxiety Inventory...
March 17, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28302475/safety-and-effectiveness-of-a-percutaneous-first-approach-to-endovascular-aortic-aneurysm-repair
#19
Christopher Agrusa, Andrew Meltzer, Darren Schneider, Peter Connolly
BACKGROUND: Percutaneous endovascular aneurysm repair (PEVAR) has been increasingly employed in the endovascular treatment of abdominal aortic aneurysms. Furthermore, the percutaneous approach can be used with minimal sedation and local anesthesia in the majority of cases. The purpose of this study is to assess the safety and effectiveness of a "percutaneous first" approach to femoral access for EVAR. METHOD: From 2012 to 2014, PEVAR has been the preferred approach to femoral access for EVAR at our institution...
March 13, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28301996/management-of-hepatocellular-carcinoma-prevention-surveillance-diagnosis-and-staging
#20
Digdem Ozer Etik, Nurettin Suna, Ahmet Sedat Boyacioglu
More than 600 000 people die from hepatocellular carcinoma each year. Worldwide, research on the disease needs to be intensified in both the medical and pharmaceutical fields, with a focus on providing help to geographic areas where resources are limited. Treatment approaches depend on the stage of the disease at diagnosis and on access to complex treatment regimens. However, advanced disease is not curable, and treating these patients is expensive and only marginally effective for increasing quality-adjusted life-years...
March 2017: Experimental and Clinical Transplantation
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