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Procedural sedation

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https://www.readbyqxmd.com/read/28527548/propofol-versus-midazolam-fentanyl-sedation-for-colonoscopy-in-the-elderly-patient-population
#1
Pamela Lovett, Victoria Gómez, David O Hodge, Beth Ladlie
PURPOSE: Despite current literature, data on the most effective sedation and best patient outcomes are insufficient for providing recovery time recommendations for elderly patients undergoing colonoscopy with sedation. We sought to identify the best sedation practice for shorter recovery times. Therefore, a study was conducted to examine recovery times among patients older than 65 years undergoing elective colonoscopy with intravenous sedation with either propofol or the combination of midazolam/fentanyl...
June 2017: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/28527521/association-between-allergies-and-psychiatric-disorders-in-patients-undergoing-invasive-procedures
#2
Dwight Aberle, Stephanie E Wu, Rahmi Oklu, Joseph Erinjeri, Amy R Deipolyi
BACKGROUND: Associations between allergies and psychiatric disorders have been reported in the context of depression and suicide; psychiatric disorders may affect pain perception. OBJECTIVE: To investigate the relationship of allergies with psychiatric disorders and pain perception in the context of invasive procedures, specifically during tunneled hemodialysis catheter placement. METHODS: We identified 89 patients (51 men, 38 women), mean age 66 years (range: 23-96), who underwent tunneled hemodialysis catheter placement (1/2014-2/2015), recording numeric rating scale pain scores, medications, psychiatric history, allergies, and smoking status...
March 28, 2017: Psychosomatics
https://www.readbyqxmd.com/read/28526145/alpha-2-agonists
#3
REVIEW
Viet Nguyen, Dawn Tiemann, Edward Park, Ali Salehi
Alpha-2 adrenergic receptors are spread throughout the central and peripheral nervous system, specifically in the pontine locus coeruleus, medullospinal tracts, rostral ventrolateral medulla, and the dorsal horn of the spinal cord. Alpha-2 agonist agents cause neuromodulation in these centers, leading to sedation, analgesia, vasodilatation, and bradycardia with little effect on the respiratory drive, which accounts for their good safety profile. The 2 major drugs in this group are clonidine and dexmedetomidine...
June 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28522914/one-year-experience-with-computer-assisted-propofol-sedation-for-colonoscopy
#4
Otto S Lin, Danielle La Selva, Richard A Kozarek, Deborah Tombs, Wade Weigel, Ryan Beecher, Johannes Koch, Susan McCormick, Michael Chiorean, Fred Drennan, Michael Gluck, Nanda Venu, Michael Larsen, Andrew Ross
AIM: To report our one-year experience with computer assisted propofol sedation (CAPS) for colonoscopy as the first United States Medical Center to adopt CAPS technology for routine clinical use. METHODS: Between September 2014 and August 2015, 2677 patients underwent elective outpatient colonoscopy with CAPS at our center. All colonoscopies were performed by 1 of 17 gastroenterologists certified in the use of the CAPS system, with the assistance of a specially trained nurse...
April 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28514343/-effect-of-dexmedetomidine-on-perfusion-of-free-flaps-transferred-to-head-and-neck
#5
A S Dobrodeev, S A Rabinovich, I F Malykhina
The paper presents the impact of perioperative care on feasibility of free fibula flap transfer for facial reconstruction. Flaps vitality was measured by means of somatic oximetry in 85 patients aged 20-74 years receiving reconstruction procedures in midfacial and lower facial areas. The patients were divided in three groups according to sedation agent used postoperatively. It has been demonstrated that dexmedetomidine postoperative sedation significantly improved free fibula flaps perfusion compared to propofol sedation...
2017: Stomatologii︠a︡
https://www.readbyqxmd.com/read/28509772/safety-of-deep-sedation-in-the-endoscopy-suite
#6
Megan L Allen
PURPOSE OF REVIEW: As the complexity of endoscopic procedures increases, the use of propofol and the desire for deep sedation are becoming more common in the endoscopy suite. This review explores sedation depth, agents used for sedation, recommended monitoring, and adverse event risks that occur during sedation for endoscopy. RECENT FINDINGS: The sedation provider for endoscopy varies by practice location and with regulatory requirements. As increasingly deep levels of sedation are used in this setting, the need for all providers to have training in the ability to rescue patients from sedation-related side effects is paramount...
May 15, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28509771/sedation-for-advanced-procedures-in-the-bronchoscopy-suite-proceduralist-or-anesthesiologist
#7
Michael Kern, Thoralf Kerner, Sascha Tank
PURPOSE OF REVIEW: This article focuses on the issue of sedation provided either by proceduralists or anesthesiologists for advanced bronchoscopy procedures. The relative merits of both approaches are presented. Current evidence from the literature and guideline recommendations relevant to this topic are reviewed. RECENT FINDINGS: In general, patient and proceduralist satisfaction as well as patient safety are increased when intravenous sedation is provided for advanced bronchoscopic procedures...
May 15, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28508918/-local-anaesthesia-in-ruminants
#8
Karl Nuss, Andrea Schwarz, Simone Ringer
The use of local anaesthesia in ruminants allows many surgical procedures to be conducted free of pain, efficiently and inexpensively in the field. Local anaesthesia combined with sedation and immobilisation of the animal can replace general anaesthesia for many procedures (e. g. castration, claw amputation). The level of difficulty differs among various local anaesthetic techniques: local infiltration of tissue or anaesthesia of the cornual nerve are easily performed, whereas local anaesthesia of the eye, regional anaesthesia in limbs or anaesthesia for umbilical surgery are more difficult to carry out...
May 16, 2017: Tierärztliche Praxis. Ausgabe G, Grosstiere/Nutztiere
https://www.readbyqxmd.com/read/28508254/comparison-of-pain-within-24%C3%A2-h-after-uterine-artery-embolization-with-tris-acryl-gelatin-microspheres-versus-gelatin-sponge-particles-for-leiomyoma
#9
Tetsuya Katsumori, Hisatomi Arima, Shunsuke Asai, Natsuko Hayashi, Hiroshi Miura
PURPOSE: To compare acute pain after uterine artery embolization (UAE) with tris-acryl gelatin microspheres (TAGM) versus gelatin sponge particles (GS) for leiomyoma. MATERIALS AND METHODS: This was a single-institution, retrospective study. Between July 2008 and November 2016, 101 consecutive patients with symptomatic uterine leiomyoma underwent UAE with the same protocol for post-procedural pain. GS was employed with near-stasis endpoint for the first 49 patients, whereas TAGM was used with limited endpoint for the next 52 patients...
May 15, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28501797/predictors-of-procedural-complications-in-adult-fontan-patients-undergoing-non-cardiac-procedures
#10
Alexander C Egbe, Arooj R Khan, Naser M Ammash, David W Barbara, William C Oliver, Sameh M Said, Emmanuel Akintoye, Carole A Warnes, Heidi M Connolly
OBJECTIVE: Limited data exist regarding the outcomes of non-cardiac procedures (NCPs) in adult patients after Fontan operations (Fontan patients). METHODS: To compare procedural outcomes after NCPs in Fontan patients with outcomes for two matched control groups: patients with repaired congenital heart disease and biventricular circulation (CHD-BiV) and patients with no heart disease (NHD). We defined cyanosis as oxygen saturation <90% and procedural hypoxia as saturation <80% or a decrease in saturation >10% from baseline...
May 13, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28501533/promising-modalities-to-identify-and-monitor-eosinophilic-esophagitis
#11
Girish Hiremath, Sandeep K Gupta
Eosinophilic esophagitis (EoE) is an allergen-mediated condition characterized by symptoms of esophageal dysfunction and histological evidence of intense eosinophilic inflammation involving the esophagus in absence of overlapping conditions such as gastroesophageal reflux disease. Since the initial description as a distinct entity about two decades ago, there has been a remarkable rise in the recognition of this clinico-pathologic entity. Current approach to diagnose and monitor EoE requires repeated esophagogastroduodenoscopies (EGDs), with associated sedation/anesthesia, to visualize mucosal abnormalities, and to obtain multiple biopsies for histologic assessment and to evaluate treatment response...
May 10, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28499653/customized-hinged-covered-metallic-stents%C3%A2-for-the-treatment-of-benign-main-bronchial-stenosis
#12
Xinwei Han, Quazi Al-Tariq, Yanle Zhao, Lei Li, Zhe Cheng, Huaqi Wang, Chao Liu, Dechao Jiao, Gang Wu
BACKGROUND: To address the limitations of silicone stents, we designed a hinged self-expandable covered metallic stent. The aim of this study was to evaluate the safety and efficacy of the customized stents in clinical applications. METHODS: This was a retrospective analysis. Under conscious sedation and local anesthesia, the stents were implanted or removed by interventional radiologists, with fluoroscopic guidance. RESULTS: Of 24 patients with benign main bronchial stenosis, stents were successfully placed in 21 (87...
May 9, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28497160/spinal-osteoid-osteoma-efficacy-and-safety-of-radiofrequency-ablation
#13
Ugo Albisinni, Giancarlo Facchini, Paolo Spinnato, Alessandro Gasbarrini, Alberto Bazzocchi
OBJECTIVE: The aim of this study was to evaluate the efficacy and complications of CT-guided radiofrequency ablation (RFA) of spinal osteoid osteoma (OO). MATERIALS AND METHODS: Between 2002 and 2012, a total of 61 patients (46 male and 15 female, mean age 26.4 ± 12.7 years) were subjected to RFA for spinal OO. The diagnosis of OO was made after a period of pain and symptoms of 20.6 ± 14.4 months. RFA was performed under conscious sedation and local analgesia...
May 11, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28493642/adverse-events-with-ketamine-versus-ketofol-for-procedural-sedation-on-adults-a-double-blinded-randomized-controlled-trial
#14
Fabien Lemoel, Julie Contenti, Didier Giolito, Mathieu Boiffier, Jocelyn Rapp, Jacques Istria, Marc Fournier, François-Xavier Ageron, Jacques Levraut
OBJECTIVES: The goal of our study was to compare the frequency and severity of recovery reactions between ketamine and ketamine-propofol 1:1 admixture ("ketofol"). METHODS: We performed a multicentric, randomized, double-blinded trial in which adult patients received emergency procedural sedations with ketamine or ketofol. Our primary outcome was the proportion of unpleasant recovery reactions. Other outcomes were frequency of interventions required by these recovery reactions, rates of respiratory or hemodynamic events, emesis, and satisfaction of patients as well as providers...
May 11, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28492195/evaluation-of-nitrous-oxide-oxygen-and-triclofos-sodium-as-conscious-sedative-agents
#15
Priya Subramaniam, K L Girish Babu, Disha Lakhotia
BACKGROUND: Conscious sedation is used in the pediatric dentistry to reduce fear and anxiety in children and promote favorable treatment outcomes. To achieve them, the primary clinical need is for a well-tolerated, effective, and expedient analgesic and sedative agent that is safe to use. AIM: The aim of the present study was to evaluate the efficacy of nitrous oxide-oxygen and triclofos sodium as conscious sedative agents in 5-10-year-old children. METHODOLOGY: Sixty children aged 5-10 years showing anxious, uncooperative, and apprehensive behavior were randomly divided and assigned into two groups (Groups A and B) such that Group A received 40% nitrous oxide-60% oxygen and Group B received triclofos sodium in the dose of 70 mg/kg body weight, given 30 min before the treatment procedure...
April 2017: Journal of the Indian Society of Pedodontics and Preventive Dentistry
https://www.readbyqxmd.com/read/28489838/-diagnostic-and-therapeutic-approach-to-small-bowel-disorders-through-capsule-endoscopy-and-double-balloon-endoscopy
#16
Federico De Simone, Pablo Machado, Edson Guzmán Calderon
Many small bowel disorders represent a great challenge for gastroenterologists and endoscopists due to the very low rates of success showed by the different agnosis techniques. The advent of the capsule endoscopy and double-balloon endoscopy has allowed a total, secure and efficient examination of the small bowel, which represents a real impact in diagnosis, treatment, and prognosis of our patients. The capsule endoscopy is a safe, minimally invasive procedure, which does not need sedation, does not cause pain, and allows the observation of the totality of the small bowel...
January 2017: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
https://www.readbyqxmd.com/read/28488178/a-prospective-randomized-study-of-the-use-of-an-ultrathin-colonoscope-versus-a-pediatric-colonoscope-in-sedation-optional-colonoscopy
#17
Koichiro Sato, Sayo Ito, Tomoyuki Kitagawa, Koichi Hirahata, Daisuke Hihara, Kenji Tominaga, Ichiro Yasuda, Iruru Maetani
BACKGROUND: Ultrathin colonoscopes (UTC) reportedly produce less pain during colonoscopy than standard colonoscopes. The aim of this study was to assess the tolerability of an UTC compared with that of a pediatric colonoscope. METHODS: A total of 270 adult patients scheduled to undergo colonoscopy were randomized, with 134 allocated to the UTC group and 136 to the pediatric colonoscope group. Pain was assessed using a visual analog scale. For all procedures, sedation was administered only if requested...
May 9, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28488002/experience-with-the-use-of-propofol-for-radiologic-imaging-in-infants-younger-than-6-months-of-age
#18
Elan Jenkins, Kiran B Hebbar, Katie K Karaga, Daniel A Hirsh, James D Fortenberry, Courtney E McCracken, Stephen F Simoneaux, Michael D Mallory, Pradip P Kamat
BACKGROUND: There is an increased risk associated with procedural sedation of infants younger than 6 months of age. The use of propofol for radiologic imaging of this age group is not well studied. OBJECTIVE: We hypothesize that adverse events are higher in the infant population receiving propofol for radiologic imaging. MATERIALS AND METHODS: A retrospective chart review was undertaken of 304 infants younger than 6 months old who received propofol for procedural sedation from October 2012 to February 2015...
May 9, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28485461/safety-and-efficacy-of-chloral-hydrate-sedation-in-paediatric-sedation-for-ophthalmic-procedures
#19
Amy Mh Chan, Geok Koon Tan, Huey Peng Loh, Sock Huang Lim, Audrey Wl Chia
INTRODUCTION: Chloral hydrate (CH) sedation is routinely used in paediatric ophthalmic examination in Singapore as an alternative to examination under general anaesthesia. Despite CH's traditionally high success rates and relatively low rate of adverse events, there is little data on its safety and efficacy as a sedative for ophthalmic procedures in an Asian population. MATERIALS AND METHODS: A retrospective chart review was performed, including children who underwent CH sedation at the Singapore National Eye Centre from January 2012 to January 2015...
April 2017: Annals of the Academy of Medicine, Singapore
https://www.readbyqxmd.com/read/28484734/comparative-quality-assessment-of-esophageal-examination-with-transnasal-and-sedated-endoscopy
#20
Nicholas R Crews, Emmanuel C Gorospe, Michele L Johnson, Louis-Michel Wong Kee Song, David A Katzka, Prasad G Iyer
Background Unsedated transnasal esophagoscopy (TNE) may offer a less expensive, mobile alternative to sedated esophagogastroduodenoscopy (EGD) for evaluations of reflux related complications. Comparisons of imaging quality by these methods are lacking. Methods Two reviewers evaluated videos of TNE and EGD procedures, performed during a community randomized study comparing endoscopic techniques. Subjects were randomized to EGD, TNE in endoscopy suite, or TNE in mobile research unit. Endoscopic quality was assessed using a validated scoring tool...
May 2017: Endoscopy International Open
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