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procedural sedation analgesia

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https://www.readbyqxmd.com/read/29779912/how-often-do-we-perform-painful-and-stressful-procedures-in-the-paediatric-intensive-care-unit-a-prospective-observational-study
#1
Manuel A Baarslag, Sharan Jhingoer, Erwin Ista, Karel Allegaert, Dick Tibboel, Monique van Dijk
BACKGROUND: Adequate analgesia and sedation is crucial in critical care. There is little knowledge on the extent of painful and stressful procedures on children admitted to a paediatric intensive care unit (PICU) and its analgesic and/or sedative management. OBJECTIVE: The primary objective was to determine the number of painful and stressful procedures per patient per day in our PICU patients, including the numbers of attempts. A secondary objective was to map PICU nurses' perceptions of the painfulness of the included procedures...
May 17, 2018: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29774961/influence-of-caudal-epidural-analgesia-on-cortisol-concentrations-and-pain-related-behavioral-responses-in-mares-during-and-after-ovariectomy-via-colpotomy
#2
Aileen L Rowland, Kati G Glass, Sicilia T Grady, Kevin J Cummings, Katrin Hinrichs, Ashlee E Watts
OBJECTIVE: To determine the influence of epidural detomidine and morphine on serum corticosteroid concentrations and pain-related behavioral responses in mares during and after ovariectomy via colpotomy. STUDY DESIGN: Blinded prospective study. ANIMALS: Nine university-owned mares. METHODS: Five of 9 horses received caudal epidural detomidine hydrochloride (0.01 mg/kg) and morphine sulfate (0.1 mg/kg) prior to surgery...
May 18, 2018: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/29761478/pain-relief-for-women-undergoing-oocyte-retrieval-for-assisted-reproduction
#3
REVIEW
Irene Kwan, Rui Wang, Emily Pearce, Siladitya Bhattacharya
BACKGROUND: Various methods of conscious sedation and analgesia (CSA) have been used during oocyte retrieval for assisted reproduction. The choice of agent has been influenced by the quality of sedation and analgesia and by concerns about possible detrimental effects on reproductive outcomes. OBJECTIVES: To assess the effectiveness and safety of different methods of conscious sedation and analgesia for pain relief and pregnancy outcomes in women undergoing transvaginal oocyte retrieval...
May 15, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29759099/procedural-sedation-by-advanced-care-paramedics-for-emergency-gastrointestinal-endoscopy
#4
Hana M Wiemer, Michael B Butler, Patrick C Froese, Allan Lapierre, Chris Carriere, Glen R Etsell, Dana Farina, Jennifer Jones, Jock Murray, Samuel G Campbell
CLINICIAN'S CAPSULE What is known about the topic? Advanced care paramedics (ACPs) in our emergency department (ED) successfully perform procedural sedation and analgesia (PSA) for several procedures, including orthopedic manipulations. What did this study ask? How does the novel practice of ACP-led ED PSA for upper gastrointestinal (UGI) endoscopy compare to that for orthopedic procedures? What did this study find? Adverse events occurred more frequently during UGI endoscopy sedations than orthopedic sedations (41...
May 15, 2018: CJEM
https://www.readbyqxmd.com/read/29754394/anesthesia-for-subcutaneous-implantable-cardioverter-defibrillator-implantation-perspectives-from-the-clinical-experience-of-a-us-panel-of-physicians
#5
Michael K Essandoh, George E Mark, Johan D Aasbo, Charles A Joyner, Saumya Sharma, Beningo F Decena, Eric D Bolin, Raul Weiss, Martin C Burke, Timothy R McClernon, Emile G Daoud, Michael R Gold
BACKGROUND AND OBJECTIVE: Worldwide adoption of the subcutaneous implantable cardioverter-defibrillator (S-ICD) for preventing sudden cardiac death continues to increase, as longer-term evidence demonstrating the safety and efficacy of the S-ICD expands. As a relatively new technology, comprehensive anesthesia guidance for the management of patients undergoing S-ICD placement is lacking. This article presents advantages and disadvantages of different peri-procedural sedation and anesthesia options for S-ICD implants including general anesthesia, monitored anesthesia care, regional anesthesia, and nonanesthesia personnel administered sedation and analgesia...
May 13, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29754157/-patient-satisfaction-with-procedural-sedation-in-oral-and-maxillofacial-surgery
#6
J T Deferm, M Burger, T Prudon, M van Bergen, M Vaneker, W A Borstlap
Fear of treatment by an oral and maxillofacial (OMF) surgeon or the dentist is a widespread and deep-rooted phenomenon. A patient can be taught to cope with dental phobia by means of psychological, cognitive behavioural therapy, but in cases of invasive oral treatment, such therapy may be insufficiently effective. For these invasive procedures, sedation serves as an alternative treatment option. The department of Oral and Maxillofacial Surgery at the Radboud University Medical Centre in Nijmegen, the Netherlands, offers the possibility to utilise intravenous sedation with midazolam (Dormicum®) and remifentanil (Ultiva®)...
May 2018: Nederlands Tijdschrift Voor Tandheelkunde
https://www.readbyqxmd.com/read/29744381/complications-caused-by-nitrous-oxide-in-dental-sedation
#7
REVIEW
Seong In Chi
The first clinical application of nitrous oxide (N2 O) was in 1844, by an American dentist named Horace Wells who used it to control pain during tooth extraction. Since then, N2 O has shared a 170-year history with modern dental anesthesia. N2 O, an odorless and colorless gas, is very appealing as a sedative owing to its anxiolytic, analgesic, and amnestic properties, rapid onset and recovery, and, in particular, needle-free application. Numerous studies have reported that N2 O can be used safely and effectively as a procedural sedation and analgesia (PSA) agent...
April 2018: Journal of Dental Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29680176/perianesthesia-nurses-survey-of-their-knowledge-and-practice-with-obstructive-sleep-apnea
#8
Andrea M Erwin, Kim A Noble, June Marshall, Susan Cooper
PURPOSE: Anesthesia, sedation, and analgesia can negatively impact adult patients with obstructive sleep apnea (OSA). Despite known risks, current evidence, and practice guidelines, insufficient evidence exists that standardization and clinical application of OSA screening tools, problem identification, and perioperative nursing intervention and management strategies are consistently implemented for OSA patients across perianesthesia settings. The purpose of this study was to conduct a knowledge and practice assessment of perianesthesia nurses who care for adult patients with diagnosed or undiagnosed OSA...
April 18, 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/29677389/population-pharmacokinetics-of-intramuscular-and-intravenous-ketamine-in-children
#9
Christoph P Hornik, Daniel Gonzalez, John van den Anker, Andrew M Atz, Ram Yogev, Brenda B Poindexter, Kee Chong Ng, Paula Delmore, Barrie L Harper, Chiara Melloni, Andrew Lewandowski, Casey Gelber, Michael Cohen-Wolkowiez, Jan Hau Lee
Ketamine is an N-methyl D-aspartate receptor antagonist used off-label to facilitate dissociative anesthesia in children undergoing invasive procedures. Available for both intravenous and intramuscular administration, ketamine is commonly used when vascular access is limited. Pharmacokinetic (PK) data in children are sparse, and the bioavailability of intramuscular ketamine in children is unknown. We performed 2 prospective PK studies of ketamine in children receiving either intramuscular or intravenous ketamine and combined the data to develop a pediatric population PK model using nonlinear mixed-effects methods...
April 20, 2018: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29661381/a-review-of-the-safety-and-efficacy-of-inhaled-methoxyflurane-as-an-analgesic-for-outpatient-procedures
#10
REVIEW
C Jephcott, J Grummet, N Nguyen, O Spruyt
Methoxyflurane delivered via a hand-held inhaler is a proven analgesic which has been used in Australasia for emergency relief of trauma associated pain since the 1970s. The agent is self-administered by the patient under the supervision of trained personnel. More than 5 million patients have received inhaled methoxyflurane without significant side effects. Methoxyflurane is also licensed in Australasia for the relief of pain in monitored conscious patients requiring analgesia for minor surgical procedures...
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29658896/safety-and-quality-of-procedural-sedation-and-analgesia-practice-for-adult-patients-throughout-europe-a-step-forward
#11
Edoardo De Robertis, Dan Longrois, Thomas Fuchs-Buder
No abstract text is available yet for this article.
January 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29650431/-efficacy-safety-and-satisfaction-of-sedation-analgesia-in-spanish-emergency-departments
#12
Concepción Míguez Navarro, Niki Oikonomopoulou, Arístides Rivas García, Andrea Mora Capín, Gloria Guerrero Márquez
OBJECTIVES: To offer analgesia and sedation should be a priority in paediatric emergency departments. The aim of this study was to determine the effectiveness and safety of the sedation-analgesia procedure, as well as the satisfaction of the doctors, patients and parents. METHODS: A multicentre, observational, and prospective analytical study was conducted on the sedation-analgesia procedure performed on children younger than 18 years old in 18 paediatric emergency departments in Spain from February 2015 until January 2016...
April 9, 2018: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/29628833/efficacy-and-safety-of-dexmedetomidine-infusion-for-patients-undergoing-awake-craniotomy-an-observational-study
#13
Charu Mahajan, Girija Prasad Rath, Gyaninder Pal Singh, Nitasha Mishra, Suman Sokhal, Parmod Kumar Bithal
Background: The goal of awake craniotomy is to maintain adequate sedation, analgesia, respiratory, and hemodynamic stability and also to provide a cooperative patient for neurologic testing. An observational study carried out to evaluate the efficacy of dexmedetomidine sedation for awake craniotomy. Materials and Methods: Adult patients with age >18 year who underwent awake craniotomy for intracranial tumor surgery were enrolled. Those who were uncooperative and had difficult airway were excluded from the study...
April 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29628562/comparative-study-between-propofol-and-dexmedetomidine-for-conscious-sedation-in-patients-undergoing-outpatient-colonoscopy
#14
Harish Karanth, Sumesh Murali, Reshma Koteshwar, Vasanth Shetty, Karunakara Adappa
Introduction: Colonoscopy is a mildly painful procedure requiring conscious sedation. Though propofol is a widely used anesthetic agent in day-care procedures due to its rapid onset and quick recovery has a drawback of requiring resuscitation maneuvers more often than the conventional methods. Dexmedetomidine, a newly introduced, highly selective α2 -adrenergic receptor agonist possessing hypnotic, sedative, anxiolytic, sympatholytic, and analgesic properties with impressive safety margin, needs to be explored for use in conscious sedation for colonoscopy procedure among South Indian population...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29580286/hematoma-block-or-procedural-sedation-and-analgesia-which-is-the-most-effective-method-of-anesthesia-in-reduction-of-displaced-distal-radius-fracture
#15
Ping-Tao Tseng, Tsai-Hsueh Leu, Yen-Wen Chen, Yu-Pin Chen
BACKGROUND: Procedure sedation and analgesia (PSA) is often used to alleviate discomfort and to facilitate fracture reduction for patients with distal radius fracture in emergency departments and clinics, but risks of respiratory distress and needs for different levels of monitoring under PSA are still under concern. Hematoma block (HB) is a simple alternative method of providing rapid pain relief during reduction of distal radius fracture. However, there is still in lack of strong evidence to promote HB over PSA in clinical practice...
March 27, 2018: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29580166/anaesthetic-effects-of-alfaxalone-administered-intraperitoneally-alone-or-combined-with-dexmedetomidine-and-fentanyl-in-the-rat
#16
Mario Arenillas, Ignacio A Gomez de Segura
Alfaxalone is a neuroactive steroid used as a general anaesthetic in several species including dogs, cats, rabbits and ferrets. It has a wide margin of safety and a similar anaesthetic profile to propofol. To increase its aqueous solubility, a new formulation with cyclodextrins has been marketed recently. The objective of this study was to evaluate the anaesthetic effect of several doses of alfaxalone alone, considering differences between sexes, and alfaxalone combined with dexmedetomidine and fentanyl in the rat administered by the intraperitoneal route...
January 1, 2018: Laboratory Animals
https://www.readbyqxmd.com/read/29560077/higher-mallampati-scores-are-not-associated-with-more-adverse-events-during-pediatric-procedural-sedation-and-analgesia
#17
Maya S Iyer, Raymond D Pitetti, Melissa Vitale
Introduction: Procedural sedation and analgesia (PSA) is used by non-anesthesiologists (NAs) outside of the operating room for several types of procedures. Adverse events during pediatric PSA that pose the most risk to patient safety involve airway compromise. Higher Mallampati scores may indirectly indicate children at risk for airway compromise. Medical governing bodies have proposed guidelines for PSA performed by NAs, but these recommendations rarely suggest using Mallampati scores in pre-PSA evaluations...
March 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29559326/canadian-trends-in-carpal-tunnel-surgery
#18
Blair Peters, Jennifer L Giuffre
PURPOSE: Treatment patterns of carpal tunnel surgery by members of the American Society of Surgery of the Hand (ASSH) have recently been published. The majority of cases in this study were performed in the general operating room with intravenous (IV) sedation or a Bier block. Patients were most commonly prescribed hydrocodone for postoperative pain. The majority of carpal tunnel releases at our center are performed under local anesthesia alone, with plain acetaminophen (Tylenol) or codeine prescribed for postoperative pain...
March 17, 2018: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29491750/sedation-protocol-during-bevacizumab-intravitreal-injection-in-preterm-infants-with-retinopathy-of-prematurity
#19
Jamie L Miller, Peter N Johnson, Kari Harkey, R Michael Siatkowski
OBJECTIVES: This study describes outcomes of intravenous (IV) analgesics and sedatives for bedside intravitreal bevacizumab injections for retinopathy of prematurity. METHODS: This retrospective study included infants receiving intravitreal bevacizumab injections between January 2012 and May 2016. Infants were excluded if bevacizumab was administered under general anesthesia or for incomplete records. Data collection included demographics, sedation and analgesia regimen, and cardiopulmonary adverse events (AEs)...
January 2018: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/29479931/dexmedetomidine-as-an-adjunct-for-caudal-anaesthesia-and-analgesia-in-children-a-review
#20
Mehdi Trifa, Dmitry Tumin, Joseph D Tobias
BACKGROUND: The aim of this review was to evaluate the current evidence regarding the use of dexmedetomidine as an adjuvant to local anaesthetic agents (LAA) for caudal blockade anaesthesia and analgesia in children. METHODS: A literature search was performed of the Medline, Embase, and CINAHL databases using the keywords "dexmedetomidine" and "caudal". We included all studies that used caudal dexmedetomidine as an adjuvant to a LAA in children, excluding case reports, reviews, expert opinions, and animal studies...
February 22, 2018: Minerva Anestesiologica
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