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Procedural sedation

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https://www.readbyqxmd.com/read/28644939/an-economic-analysis-of-mac-versus-walant-a-trigger-finger-release-surgery-case-study
#1
Jason L Codding, Suneel B Bhat, Asif M Ilyas
BACKGROUND: There has been recent interest in wide awake hand surgery, also referred to as "wide awake local anesthesia with no tourniquet" (WALANT) surgery. Using a model of single trigger finger release (TFR) surgery, a hypothesis was made that WALANT would result in decreased hospital time and cost than patients receiving sedation with monitored anesthetic care (MAC). METHODS: Consecutive cases of single TFR surgery with MAC were compared with WALANT. All surgeries were performed in the same manner, at the same facility, and by the same surgeon...
July 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28644314/prone-or-left-for-colonoscopy-a-randomized-controlled-trial-of-prone-versus-left-sided-starting-position-for-colonoscopy
#2
Nikhil Vergis, Alexander J Scarborough, James A Morris, Jonathan M Hoare
BACKGROUND AND AIMS: Data have emerged supporting the right-lateral starting position in reducing time to cecum and improving patient comfort for minimally sedated colonoscopy. We aimed to test whether prone starting position results in similar advantages in procedure time and patient tolerability in comparison to traditional left-sided starting position. MATERIALS AND METHODS: We conducted a randomized controlled trial in which patients were randomized to begin in either the prone or left-lateral (LL) position...
June 21, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28642966/procedural-sedation-and-analgesia-for-pediatric-shock-wave-lithotripsy-a-10-year-experience-of-single-institution
#3
Banu Cevik, Murat Tuncer, Kutlu Hakan Erkal, Bilal Eryildirim, Kemal Sarica
The aim of this study was to evaluate anesthesia practice for pediatric extracorporeal shock wave lithotripsy (ESWL) according to the age groups and discuss the anesthetic management of these patients. Pediatric patients treated with ESWL because of urolithiasis under anesthesia in our department between December 2007 and January 2017 were evaluated retrospectively. A total of 251 patients were divided into two groups as Group PS: preschool children (<6 years) and Group S: school children (≥6 years)...
June 22, 2017: Urolithiasis
https://www.readbyqxmd.com/read/28637064/safety-and-efficacy-of-glycopyrrolate-as-a-premedication-for-endoscopic-submucosal-dissection-a-randomized-double-blind-placebo-controlled-study
#4
Eui Joo Kim, Min Young Um, Kyoung Oh Kim, Jung Ho Kim, Su Young Kim, Dong Kyun Park, Kwang An Kwon, Jun Won Chung, Yoon Jae Kim
Background and study aims Anticholinergic premedication has not been validated for endoscopic submucosal dissection (ESD). In this randomized, double-blind, placebo-controlled trial, we investigated the efficacy and safety of glycopyrrolate as a premedication for ESD. Methods A total of 196 patients undergoing ESD at a single tertiary medical center between December 2014 and February 2016 were randomly allocated to receive one of the following two premedications: glycopyrrolate (0.004 mg/kg intramuscularly [IM]) or placebo (2...
June 21, 2017: Endoscopy
https://www.readbyqxmd.com/read/28633263/structural-valve-deterioration-of-a-subcoronary-implanted-stentless-bioprosthesis-how-to-treat
#5
Eva Karolina Harmel, Lenard Conradi, Ulrich Schäfer, Florian Deuschl, Niklas Schofer, Stefan Blankenberg, Hermann Reichenspurner, Evaldas Girdauskas
We present a case of transcatheter valve-in-valve replacement performed because of structural valve deterioration of a subcoronary implanted stentless aortic bioprosthesis. A 23-mm self-expandable transcatheter heart valve (THV) with supraannular seating was chosen. The procedure was performed with the patient under conscious sedation. After anchoring and partial valve deployment, the patient experienced an acute onset of angina. The angiogram showed left main coronary artery obstruction. Prompt resheathing and retrieval of the THV was performed, and the procedure was aborted...
July 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28631539/regional-nerve-blocks-for-equine-dentistry
#6
Molly K Rice
Regional nerve blocks are necessary to facilitate equine oral surgery in the standing sedated patient. Step-by-step instruction on how to perform common regional nerve blocks are discussed, including infraorbital, maxillary, middle mental, and inferior alveolar nerve blocks. Regional nerve blocks are critical when performing dental procedures in the standing horse.(1) The infraorbital and maxillary nerve blocks provide anesthesia of the infraorbital nerve, which is a branch of the maxillary nerve. Both nerve blocks provide adequate anesthesia for all maxillary dental procedures...
June 2017: Journal of Veterinary Dentistry
https://www.readbyqxmd.com/read/28631452/the-impact-of-the-anaesthetic-conserving-device-on-occupational-exposure-to-isoflurane-among-intensive-care-healthcare-professionals
#7
Jennifer Herzog-Niescery, Heike Vogelsang, Philipp Gude, Hans-Martin Seipp, Horst Bartz, Waldemar Uhl, Thomas P Weber, Martin Bellgardt
BACKGROUND: Use of Anesthetic Conserving Devices (ACD) for inhalational isoflurane sedation in intensive care units (ICU) has grown in recent years, and healthcare professionals are concerned about isoflurane pollution and exposure-related health risks. Real-time measurements to determine isoflurane exposure in ICU personnel during short-term patient care procedures and ACD handling have not yet been performed. METHODS: Isoflurane concentrations in the breathing zones of ICU staff (25 cm around the nose and mouth) were measured, by photoacoustic gas monitoring, during daily practice including tracheal suctioning, oral hygiene, body care, and patient positioning...
June 14, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28629738/nitrous-oxide-versus-oral-sedation-for-pain-management-of-first-trimester-surgical-abortion-a-randomized-study
#8
Rameet H Singh, Maria Montoya, Eve Espey, Lawrence Leeman
OBJECTIVES: To compare nitrous oxide with oxygen (N2O/O2) to oral hydrocodone/acetaminophen and lorazepam (oral) for analgesia during first-trimester surgical abortion. STUDY DESIGN: This double-blind randomized trial assigned women undergoing first-trimester surgical abortion at<11weeks' gestation to inhaled N2O/O2 vs. oral sedation for pain management. The N2O/O2 group received up to 70:30 ratio during the procedure and placebo pills pre-procedure; the oral group received inhaled oxygen during the procedure and oral hydrocodone/acetaminophen 5mg/325mg and lorazepam 1mg pre-procedure...
June 16, 2017: Contraception
https://www.readbyqxmd.com/read/28625557/-more-than-3-hours-and-less-than-3-years-safety-of-anaesthetic-procedures-in-infants-less-than-3-years-old-subected-to-surgery-for-more-the-3-hours
#9
Julián Álvarez Escudero, Rosa María Paredes Esteban, Francisco José Cambra Lasaosa, Máximo Vento, Maite López Gil, Juan Carlos de Agustín Asencio, María Teresa Moral Pumarega
An FDA alert in December 2016 on the safety of general anesthesia and sedations in patients less than 3 years of age and pregnant women has raised doubts in relation to the attitude that professionals implicated in these procedures should adopt in relation to these specific group of patients. Confronted with this situation, the following medical scientific societies: Sociedad Española de Anestesia y Reanimación (SEDAR), Sociedad Española de Cirugía Pediátrica (SECP), Sociedad Española de Cuidados Intensivos Pediátricos (SECIP) y Sociedad Española de Neonatología (SENeo), have established a working group to analyze and clarify the safety of these techniques...
June 15, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28625000/mechanical-restraint-in-an-emergency-department-a-consecutive-series-of-593-cases
#10
Nicolas Beysard, Bertrand Yersin, Pierre-Nicolas Carron
The objective is to describe the characteristics of mechanically restrained patients in the emergency department (ED) of a university hospital and to evaluate the quality of restraint documentation that was filled out according to the dedicated protocol with respect to the law on restraint. All adult patients (≥16 years) who were admitted to the ED from January 2009 to December 2010 and were mechanically restrained were included. We assessed medical and demographic characteristics, the completeness of the dedicated protocol, and the concomitant use of chemical sedation...
June 17, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28621297/endoscopic-ultrasound-with-or-without-fine-needle-aspiration-has-a-meaningful-impact-on-clinical-care-in-the-pediatric-population
#11
Amit Raina, Maire A Conrad, Benjamin Sahn, Alireza Sedarat, Gregory G Ginsberg, Nuzhat A Ahmad, Vinay Chandrasekhara, Petar Mamula, Michael L Kochman
BACKGROUND AND OBJECTIVES: The safety and utility of endoscopic ultrasound (EUS) for the evaluation and management of gastrointestinal (GI) tract disorders among adults has been established. The literature on safety and efficacy in a pediatric referral population (under 21 years of age) is limited. We hypothesized that EUS is safe and useful in the pediatric population. We reviewed the pediatric EUS experience at a single tertiary-care system. We describe the indications, findings, safety, technical success rate, and impact on clinical outcomes...
May 2017: Endoscopic Ultrasound
https://www.readbyqxmd.com/read/28621257/oral-transmucosal-detomidine-gel-in-new-zealand-white-rabbits-oryctolagus-cuniculus
#12
Morika D Williams, C Tyler Long, Jessica R Durrant, Gabriel P McKeon, Heather R Shive, Emily H Griffith, Kristen M Messenger, Richard E Fish
Handling and restraining rabbits for routine procedures may be impossible without prior sedation, result in unnecessarystress or injury to the rabbit or handler, and increase experimental variability. Parenteral administration of sedatives can cause stress also, as well as localized pain and tissue damage, especially in fractious animals. Detomidine hydrochloride, an α2-adrenergic receptor agonist, is commercially available in an oral transmucosal (OTM) gel formulation that is FDA-approved for sedation and restraint in horses...
June 15, 2017: Journal of the American Association for Laboratory Animal Science: JAALAS
https://www.readbyqxmd.com/read/28621182/-non-intubated-uniportal-video-assisted-thoracic-surgery-vats-lobectomy-as-a-new-procedure-in-our-department
#13
József Furák, Zsolt Szabó, Theodor Horváth, Tibor Géczi, Balázs Pécsy, Tibor Németh, Aurél Ottlakán, Zsolt Molnár, György Lázár
AIM: Due to the emerging experience in VATS (video assisted thoracic surgery) lobectomies, in some centers the so called "non-intubated" VATS lobectomies (NITS - non-intubated thoracic surgery) gained increased authority, during which endotracheal intubation and muscle relaxation of the patient is not carried out, thus surgery is being performed with the patient breathing spontaneously. The recent study deals with our initial experience gained during uniportal NITS VATS lobectomies. PATIENTS AND METHOD: Between 24...
June 2017: Magyar Sebészet
https://www.readbyqxmd.com/read/28618130/benefits-of-an-individualized-perioperative-plan-for-children-with-autism-spectrum-disorder
#14
Jo S Swartz, Karen E Amos, Mirna Brindas, Linda G Girling, M Ruth Graham
BACKGROUND: Perioperative care for children with autism spectrum disorder may be challenging. Previous investigators recommend development of an individualized perioperative management plan with caregiver involvement. AIM: The primary goal was to determine the usefulness of an individualized plan based on the decision to provide preoperative sedation stratified by autism spectrum severity level. Secondary goals were to assess the effectiveness of the plan based on subjective assessment of patient behavior at induction of anesthesia and caregiver satisfaction...
June 15, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28617422/reduced-narcotic-and-sedative-utilization-in-a-nicu-after-implementation-of-pain-management-guidelines
#15
D Rana, B Bellflower, J Sahni, A J Kaplan, N T Owens, E L Arrindell, A J Talati, R Dhanireddy
OBJECTIVE: To assess the opioid and benzodiazepine usage in a level IV NICU after implementation of pain guidelines. STUDY DESIGN: Guidelines were developed for infants undergoing surgical procedures and infants on mechanical ventilation. Data collected for period 1 (July to December 2013) and period 2 (March to August 2014). RESULTS: Gestational age, birth weight and infants with hypoxic respiratory failure or requiring major procedures were comparable in two periods...
June 15, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28614528/is-dexmedetomidine-the-gold-standard-for-pediatric-procedural-sedation-and-anxiolysis
#16
Eduardo Mekitarian
No abstract text is available yet for this article.
April 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/28611336/safety-of-non-anesthesia-provider-administered-propofol-sedation-in-non-advanced-gastrointestinal-endoscopic-procedures-a-meta-analysis
#17
REVIEW
Basavana Gouda, Gowri Gouda, Anuradha Borle, Akash Singh, Ashish Sinha, Preet M Singh
BACKGROUND/AIMS: The aim of the study was to evaluate the safety of non-anesthesia provider (NAPP) administered propofol sedation in patients undergoing non-advanced gastrointestinal (GI) endoscopic procedures. MATERIALS AND METHODS: Pubmed, Embase, Cochrane central register of controlled trials, Scopus, and Web of Science databases were searched for prospective observational trials involving non-advanced endoscopic procedures. From a total of 608 publications, 25 [colonoscopy (9), upper GI endoscopy (5), and combined procedures (11)] were identified to meet inclusion criteria and were analyzed...
May 2017: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
https://www.readbyqxmd.com/read/28609332/the-use-of-intranasal-dexmedetomidine-and-midazolam-for-sedated-magnetic-resonance-imaging-in-children-a-report-from-the-pediatric-sedation-research-consortium
#18
Carmen Sulton, Pradip Kamat, Michael Mallory, Jason Reynolds
OBJECTIVE: The objective of this study was to describe the use of intranasal dexmedetomidine (IN DEX) for sedated magnetic resonance imaging (MRI) examinations in children. The use of IN DEX for MRI in children has not been well described in the literature. MATERIALS AND METHODS: The Pediatric Sedation Research Consortium (PSRC) is a collaborative and multidisciplinary group of sedation practitioners dedicated to understanding and improving the process of pediatric sedation...
June 12, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28607335/the-surgical-stress-response-and-the-potential-role-of-preoperative-glucocorticoids-on-post-anesthesia-care-unit-recovery
#19
Kristin J Steinthorsdottir, Henrik Kehlet, Eske K Aasvang
The immediate postoperative course in the post-anaesthesia care unit (PACU) remains a challenge across surgical procedures. Postoperative pain, sedation/cognitive dysfunction, nausea and vomiting (PONV), circulatory and respiratory problems and orthostatic intolerance constitute the bulk of the difficulties that may delay the postoperative recovery. A common feature in the observed organ dysfunctions is the inflammatory response to surgery during the acute postoperative recovery phase, suggesting that control of inflammation may improve outcomes and reduce complications...
June 12, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28604098/nitrous-oxide-and-midazolam-sedation-a-systematic-review-and-meta-analysis
#20
Gowri Sivaramakrishnan, Kannan Sridharan
Nitrous oxide and midazolam have been used as sedative agents to decrease fear and anxiety associated with dental procedures. Although these agents have been widely used individually, the combination of the two is also commonly used. Four clinical trials were identified that compared the combination technique with the individual use of the drugs. The standardized mean difference (SMD) for each outcome measure was considered for final analysis. Three studies with 534 participants were included in the final meta-analysis, and the SMD [95% CI] was obtained as -0...
2017: Anesthesia Progress
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