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procedural sedation analgesia

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
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
Ivan Utrobičić, Frane Utrobičić, Ivona Prološčić, Toni Utrobičić, Milka Jerić, Antonia Jeličić Kadić, Livia Puljak
The management of postoperative pain after carpal tunnel syndrome surgical treatment at a tertiary hospital was analyzed and compared with the guidelines for perioperative pain management. This retrospective study included 579 patients operated on for carpal tunnel syndrome at the Split University Hospital Center in Split, Croatia. The following key data were collected from patient medical records: age, gender, type and dosage of premedication, type and dosage of anesthesia, type and dosage of postoperative analgesia per each postoperative day...
September 2017: Acta Clinica Croatica
Ana Luisa Hernandez-Perez, Ana Gabriela Gallardo-Hernandez, German Ordoñez-Espinosa, Beatriz Martinez-Carrillo, Manuel Gerardo Bermudez-Ochoa, Cristina Revilla-Monsalve, Jose Antonio Sanchez-Lopez, Guillemo Saturno-Chiu, Ronald Leder
OBJECTIVE: A previous multidisciplinary pilot study based on computer simulations for the geriatric population showed that a dose of 0.5 mg/kg/h of propofol could sedate patients older than 65 for pacemaker implantation. The present study validates that the pacemaker implantation can be done in the elderly using 0.5-1 mg/kg/h of propofol with hemodynamic stability. METHODS: 66 patients from 65 to 88 years old scheduled for pacemaker implantation were randomly assigned one of three doses of propofol...
February 21, 2018: Aging Clinical and Experimental Research
Javad Seyedhosseini, Jaleh Saiidian, Amirpejman Hashemi Taheri, Elnaz Vahidi
Background: Ultrasound (US) is an effective modality in the evaluation of shoulder dislocation and reduction. In most studies, high frequency US probes have been used. Objective: To determine the sensitivity and specificity of low frequency US in the diagnosis of shoulder dislocation and its proper reduction in the emergency department (ED). Methods: In a prospective observational study 84 patients, suspicious of shoulder dislocation, were enrolled in our study...
December 2017: Turkish Journal of Emergency Medicine
Reza Azizkhani, Azadeh Bahadori, Mohammadreza Shariati, Keyhan Golshani, Omid Ahmadi, Babak Masoumi
Background: The present study was designed to evaluate the effectiveness of magnesium sulfate (MgSO4 ) in procedural sedation and analgesia (PSA) when combined with ketamine in patients with fractures in emergency departments and required short and painful emergency procedures. Materials and Methods: In this study, 100 patients with fractures and dislocations who were presented to the emergency departments and required PSA for short and painful emergency procedures were randomly allocated to groups of ketamine plus MgSO4 or ketamine alone...
2018: Advanced Biomedical Research
Øyvind Holme, Ina Borgenheim Pedersen, Asle W Medhus, Lars Aabakken, Tom Glomsaker, Jan Magnus Kvamme, Magnus Løberg, Michael Bretthauer, Birgitte Seip, Øystein Kjellevold, Anita Jørgensen, Siv Furholm, Geir Hoff, Thomas de Lange
BACKGROUND:  Colonoscopy performance varies between endoscopists, but little is known about the impact of endoscopy assistants on key performance indicators. We used a large prospective colonoscopy quality database to perform an exploratory study to evaluate differences in selected quality indicators between endoscopy assistants. METHODS:  All colonoscopies reported to the Norwegian colonoscopy quality assurance register Gastronet can be used to trace individual endoscopy assistants...
February 14, 2018: Endoscopy
Jan-Willem Potters, Markus Klimek
This review summarizes the added value of local anesthetics in patients undergoing craniotomy for brain tumor resection, which is a procedure that is carried out frequently in neurosurgical practice. The procedure can be carried out under general anesthesia, sedation with local anesthesia or under local anesthesia only. Literature shows a large variation in the postoperative pain intensity ranging from no postoperative analgesia requirement in two-thirds of the patients up to a rate of 96% of the patients suffering from severe postoperative pain...
2018: Local and Regional Anesthesia
Diana Crisan, Karin Scharffetter-Kochanek, Sabine Kastler, Maria Crisan, Avram Manea, Katja Wagner, Lars Alexander Schneider
BACKGROUND: Children undergoing dermatosurgical procedures require, unlike adults, particular attention; the administration of various analgesics, anesthetics or sedatives requires a thorough knowledge of drug pharmacokinetics and pharmacodynamics. Furthermore, there are concerns that drugs used for sedation/general anesthesia may result in anesthetic/analgesic complications in children undergoing surgery, with a risk of impaired mental development. OBJECTIVES: Based on our clinical experience and a literature review, we illustrate the most commonly used analgesic, anesthetic and sedative drugs in pediatric dermatosurgery, and identify risk factors and complications following dermatosurgical procedures...
February 12, 2018: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
Haisam Atta, Mohamed F Mostafa, Mahmoud Shalaby
Background: Transrectal ultrasound-guided prostate biopsy (TRUSPB) is considered the procedure of choice for the diagnosis of prostate cancer. Men undergoing this biopsy experience high psychological stress. Different studies recommend techniques as sedation, lidocaine gel intrarectally, periprostatic nerve block alone, or nitrous oxide inhalation as effective methods of analgesia during procedural-related pain or discomfort. We evaluated three techniques for pain relief during TRUSPB and evaluated if there was any increase in the incidence of complications when employing either technique...
January 2018: Saudi Journal of Anaesthesia
Hamed Aminiahidashti, Sajad Shafiee, Seyed Mohammad Hosseininejad, Abulfazl Firouzian, Ayyub Barzegarnejad, Alieh Zamani Kiasari, Behzad Feizzadeh Kerigh, Farzad Bozorgi, Misagh Shafizad, Ahmad Geraeeli
OBJECTIVE: Many procedures performed in emergency department are stressful and painful, and creating proper and timely analgesia and early and effective assessment are the challenges in this department. This study has been conducted in order to compare the efficacy of propofol and fentanyl combination with propofol and ketamine combination for procedural sedation and analgesia (PSA) in trauma patients in the emergency department. METHOD: This is a randomized prospective double-blind clinical trial conducted in the emergency department of Imam Khomeini Hospital, a tertiary academic trauma center in northern Iran...
February 4, 2018: American Journal of Emergency Medicine
Corrie E Chumpitazi, Elizabeth A Camp, Divya R Bhamidipati, Almea M Montillo, A Chantal Caviness, Lesby Mayorquin, Faria A Pereira
BACKGROUND: There is no evidence of an association between fasting time and the incidence of adverse events during procedural sedation and analgesia. Pediatric and adult emergency medicine guidelines support avoiding delaying procedures based on fasting time. General pediatric guidelines outside emergent care settings continue to be vague and do not support a set fasting period for urgent and emergent procedures. OBJECTIVE: To describe shortened preprocedural fasting and vomiting event rates during the implementation of a shortened fasting protocol...
January 9, 2018: American Journal of Emergency Medicine
Varun Nagpal, Tejinder Kaur, Sarika Kapila, Ramandeep Singh Bhullar, Amit Dhawan, Yashmeet Kaur
Background: Minor oral surgical procedures are the most commonly performed procedures by oral and maxillofacial surgeons. Performance of painless surgical procedure is highly appreciated by the patients and is possible through the use of local anesthesia, conscious sedation or general anesthesia. Postoperative pain can also be controlled by the use of opioids, as opioid receptors exist in the peripheral nervous system and offers the possibility of providing postoperative analgesia in the surgical patient...
July 2017: National Journal of Maxillofacial Surgery
Michel Galinski, Laure Hoffman, Delphine Bregeaud, Mounir Kamboua, François-Xavier Ageron, Catherine Rouanet, Jean-Christophe Hubert, Jacques Istria, Mirko Ruscev, Karim Tazarourte, Florence Pevirieri, Frédéric Lapostolle, Frédéric Adnet
BACKGROUND: The quality of procedural analgesia and sedation among trauma patients has not been studied much in the prehospital setting. The main objective of this study was to characterize the quality of procedural analgesia sedation practices in prehospital settings in trauma patients. METHODS: This was an open-label observational prospective multicenter study (January 01, 2012-December 31, 2013). We included all consecutive trauma victims undergoing a potentially painful procedure on the accident scene...
January 31, 2018: Prehospital Emergency Care
Fraser John Gould
Acute shoulder dislocation is a common injury in the outdoor environment. The objective of this systematic review of the literature was to determine if intra-articular local anesthetic (IAL) is an effective treatment that could have prehospital application. A methodical search of MEDLINE, PubMed, and EMBASE databases targeted publications from January 1, 1990 until January 1, 2017. Eligible articles compared IAL with other analgesic techniques in patients 16 years or older experiencing acute glenohumeral dislocation...
January 16, 2018: Wilderness & Environmental Medicine
C Fantacci, G C Fabrizio, P Ferrara, F Franceschi, A Chiaretti
OBJECTIVE: Pain relief is a very important aspect in Pediatrician's clinical practice. It is often thought that young children, particularly infants, do not perceive as much pain as adults because of their immature nervous system and that untreated pain would not have adverse long-term consequences. Instead, it has been demonstrated that infants and children experience pain in a similar manner to adults. Many factors, particularly emotional factors, can increase the child's pain perception...
January 2018: European Review for Medical and Pharmacological Sciences
A Pawa, J Wight, D N Onwochei, R Vargulescu, I Reed, L Chrisman, E Pushpanathan, A Kothari, K El-Boghdadly
Avoidance of general anaesthesia for breast surgery may be because of clinical reasons or patient choice. There is emerging evidence that the use of regional anaesthesia and the avoidance of volatile anaesthetics and opioid analgesia may have beneficial effects on oncological outcomes. We conducted a prospective observational case series of 16 breast cancer surgeries performed under thoracic paravertebral plus pectoral nerve block with propofol sedation to demonstrate feasibility of technique, patient acceptability and surgeon satisfaction...
January 12, 2018: Anaesthesia
Woo Sung Kim, Ji Yeon Ku, Hanbyul Choi, Hyo Jeong Choi, Ho Jung Kim, Bora Lee
OBJECTIVE: Ketamine use in emergency departments (EDs) for procedural sedation and analgesia is becoming increasingly common. However, few studies have examined patient factors related to adverse events associated with ketamine. This study investigated factors for consideration when using ketamine to sedate pediatric ED patients. METHODS: The study included pediatric patients receiving ketamine for laceration repair in the ED. Before sedation, information was collected about upper respiratory tract infection symptoms, allergy history, and fasting time...
December 2017: Clinical and Experimental Emergency Medicine
Alper Yenigun, Sinan Yilmaz, Remzi Dogan, Seda Sezen Goktas, Muhittin Calim, Orhan Ozturan
OBJECTIVE: Tonsillectomy is one of the oldest and most commonly performed surgical procedure in otolaryngology. Postoperative pain management is still an unsolved problem. In this study, our aim is to demonstrate the efficacy of intranasal ketamine and intranasal fentanyl for postoperative pain relief after tonsillectomy in children. MATERIAL AND METHOD: This randomized-controlled study was conducted to evaluate the effects of intranasal ketamine and intranasal fentanyl in children undergoing tonsillectomy...
January 2018: International Journal of Pediatric Otorhinolaryngology
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