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procedural sedation analgesia

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https://www.readbyqxmd.com/read/29125398/the-management-of-peri-and-postprocedural-pain-in-interventional-radiology-a-narrative-review
#1
Jeremy N Cashman, Lenny Ng
Interventional radiology encompasses a wide range of procedures and the degree of associated pain depends predominantly on the procedure being undertaken. Procedures may be painful during but not after the procedure, relatively painless during but painful after the procedure, or relatively painless during and after the procedure. However, there is a lack of good quality publications in interventional radiology that specifically address the subject of peri- and postprocedural pain management. Nevertheless, a variety of more or less complex protocols exist for intraprocedural sedation and for peri- and postprocedural analgesia...
November 10, 2017: Pain Management
https://www.readbyqxmd.com/read/29121287/analgesia-nociception-index-for-the-assessment-of-pain-in-critically-ill-patients-a-diagnostic-accuracy-study
#2
G Chanques, T Tarri, A Ride, A Prades, A De Jong, J Carr, N Molinari, S Jaber
Background: Behavioural pain tools are used in Intensive Care Unit (ICU) patients unable to self-report their pain-intensity but need sustained efforts to educate and train the ICU team because of the subjective nature of these clinical tools. This study measured the validity and performance of an electrophysiological monitoring tool based on the spectral analysis of heart rate variability, the Analgesia Nociception Index (ANI) which varies from 0 (minimal parasympathetic tone, maximal stress-response and pain) to 100 (maximal parasympathetic tone, minimal stress-response and pain)...
October 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29114414/comparison-between-the-two-injection-technique-and-the-four-injection-technique-in-axillary-brachial-plexus-block-with-articaine
#3
Aysun Ertikin, Güldeniz Argun, Mesut Mısırlıoğlu, Murat Aydın, Murat Arıkan, Nihal Kadıoğulları
Objective: In this study, we aimed to compare axillary brachial plexus block using the two-injection and four-injection techniques assisted with ultrasonography (USG) and nerve stimulator in patients operated for carpal tunnel syndrome with articaine. To evaluate which technique is more effective, we compared the onset time, effectiveness, and duration of block procedures, patient satisfaction, adverse effect of the drug, and complication rates of the motor and sensory blocks. Methods: Sixty patients were randomly divided into two groups...
October 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/29114334/anesthesia-and-analgesia-in-the-patient-with-an-unstable-shoulder
#4
Ismael Acevedo Bambaren, Fernando Dominguez, Maria Elena Elias Martin, Silvia Domínguez
Introduction: The patient with an unstable shoulder represents a challenge for the anesthesiologist. Most patients will be young individuals in good health but both shoulder dislocation reduction, a procedure that is usually performed under specific analgesia in an urgent setting, and instability surgery anesthesia and postoperative management present certain peculiarities. Material and Methods: For the purpose of the article, 78 references including clinical trials and reviews were included...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/29108407/periprocedural-analgesic-efficacy-of-a-single-pre-emptive-administration-of-propacetamol-in-catheter-ablation-for-atrial-fibrillation-a-randomized-controlled-trial
#5
Sung Yeon Ham, Jong-Wook Song, Jae-Kwang Shim, Woo Kyung Lee, Hee-Jung Kim, Young-Lan Kwak
BACKGROUND: Anesthetic care for termination of atrial fibrillation with catheter ablation poses significant challenges due to significant pain lengthy procedure. A delicate polypharmacy combining anaesthetic agents to minimize respiratory depression and hemodynamic changes and to provide satisfactory sedation and analgesia is needed. METHODS: Ninety-eight patients were randomized into two groups receiving either two gram of propacetamol or normal saline intravenously for 20 min before anesthesia...
November 6, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29101958/interventional-pulmonology
#6
REVIEW
David M DiBardino, Andrew R Haas, Richard C Month
Bronchoscopy presents a unique challenge and need for collaboration between anesthesia providers and bronchoscopists. The approach to topical anesthesia, analgesia, and sedation must be customized based on complexity, duration, and setting. The bronchoscopy team must work together in each phase of the procedure to ensure patient safety and allow completion of a quality bronchoscopy. Airway access may change depending on the type of procedure planned and must be discussed before each case. Intraprocedural difficulties with ventilation, airway pressure, and sedation may arise that must be addressed together...
December 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/29073928/safety-of-tubal-ligation-by-minilaparotomy-provided-by-clinical-officers-versus-assistant-medical-officers-study-protocol-for-a-noninferiority-randomized-controlled-trial-in-tanzanian-women
#7
Mark A Barone, Zuhura Mbuguni, Japhet Ominde Achola, Carmela Cordero, Joseph Kanama, Projestine S Muganyizi, Jamilla Mwanga, Caitlin Shannon, Leopold Tibyehabwa
BACKGROUND: Female sterilization by tubal ligation is a safe, extremely effective, and permanent way to limit childbearing. It is the most popular modern contraceptive method worldwide. The simplest way to provide tubal ligation is by a procedure called minilaparotomy, generally performed with the client under local anesthesia with systemic sedation and analgesia. In Tanzania, unmet need for family planning is high and has declined little in the past decade. Access to tubal ligation is limited throughout the country, in large part because of a lack of trained providers...
October 26, 2017: Trials
https://www.readbyqxmd.com/read/29072063/conscious-sedation-during-cryoballoon-ablation-of-atrial-fibrillation-the-feasibility-and-safety-study
#8
Dawid Miśkowiec, Jarosław D Kasprzak, Paulina Wejner-Mik, Ewa Szymczyk, Haval D Qawoq, Paweł Życiński, Tomasz Wcisło, Piotr Pagórek, Karolina Kupczyńska, Piotr Lipiec
BACKGROUND: Cryoballoon ablation for atrial fibrillation (cryoAF) is relatively simple, cost-effective and easy procedure. However, general anesthesia during this procedure may have negative impact on patients mortality and morbidity, as well as procedure costs. AIM: We sought to assess the feasibility and safety of conscious sedation during cryoAF. METHODS: Patients (pts) with paroxysmal or persistent, drug-refractory AF who underwent a first procedure of cryoAF were included in our single-center, retrospective study...
October 25, 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29052286/high-risk-respiratory-patients-experiences-of-bronchoscopy-with-conscious-sedation-and-analgesia-a-qualitative-study
#9
Catherine Saxon, Paul Fulbrook, Kwun Fong, Chantal F Ski
AIM: To understand the experiences of high-risk respiratory patients undergoing bronchoscopy with conscious sedation. BACKGROUND: Due to possible complications, high-risk respiratory patients are usually given smaller, cautious doses of sedation and analgesia for bronchoscopy. Described as 'conscious sedation', this facilitates depression of the patient's consciousness without causing respiratory compromise. Previously, studies have investigated patient experience using quantitative methods...
October 20, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29037478/five-hundred-seventy-six-cases-of-video-assisted-thoracic-surgery-utilizing-local-anesthesia-and-sedation-lessons-learned
#10
Mark R Katlic
BACKGROUND: General anesthesia and endotracheal intubation are a luxury rather than a necessity for many video-assisted thoracic surgery (VATS) operations. Twenty-three years ago the author began utilizing local anesthesia and sedation for pleural disease and subsequently for pericardial and lung disease. STUDY DESIGN: The records of all patients undergoing VATS utilizing local anesthesia and sedation at hospitals of the Geisinger Health System (Danville and Wilkes-Barre, PA) June 1, 2002 to June 30, 2011 and the Lifebridge Health System (Baltimore, MD) July 1, 2011 to March 1, 2017 were retrospectively reviewed...
October 13, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28974135/propofol-and-fentanyl-sedation-for-laser-treatment-of-retinopathy-of-prematurity-to-avoid-intubation
#11
Fiammetta Piersigilli, Alessandra Di Pede, Gino Catena, Simona Lozzi, Cinzia Auriti, Iliana Bersani, Irma Capolupo, Anna Lipreri, Vincenzo Di Ciommo, Andrea Dotta, Stefania Sgrò
BACKGROUND: Despite the optimization of neonatal assistance, severe retinopathy of prematurity (ROP, stage III-IV) remains a common condition among preterm infants. Laser photocoagulation usually requires general anesthesia and intubation, but extubation can be difficult and these infants often affected by chronic lung disease. We retrospectively evaluated the clinical charts of 13 neonates that were sedated with propofol in association with fentanyl for the laser treatment of ROP. This protocol was introduced in our unit to avoid intubation and minimize side effects of anesthesia and ventilation...
October 3, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28971157/comparing-the-analgesic-effect-of-intranasal-with-intravenous-ketamine-in-isolated-orthopedic-trauma-a-randomized-clinical-trial
#12
Ramin Parvizrad, Abdolghader Pakniyat, Bita Malekianzadeh, Amir Almasi-Hashiani
OBJECTIVES: Ketamine is commonly used in anesthetic and sedation before surgical procedures and acts as an analgesic in smaller doses. The aim of this study was to assess the effects of intranasal (IN) ketamine in patients with moderate to severe limb trauma (visual analog scale (VAS) > 60 mm). METHODS: In a triple-blind randomized controlled clinical trial; 154 patients with isolated orthopedic trauma and visual analog scale (VAS) ≥60 mm were included on the basis of inclusion and exclusion criteria...
September 2017: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28971155/comparison-of-ketamine-propofol-ketofol-and-etomidate-fentanyl-etofen-combinations-for-procedural-sedation-and-analgesia-in-the-emergency-department-an-observational-study
#13
Erkman Sanri, Sinan Karacabey, Haldun Akoglu, Bora Kaya, Ozlem Guneysel
OBJECTIVES: The primary aim of this study was to report the vital signs, hemodynamic parameters and pain scores of the patients who have received procedural sedation and analgesia (PSA) with either ketofol (combination of ketamine and propofol) or etofen (combination of etomidate and fentanyl) and compare the proportion of patients with airway or respiratory adverse events (AEs) requiring an intervention and calculate the relative risk of AEs with each combination. METHODS: This study is a prospective observational study with survey analysis...
September 2017: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28970658/pain-measurement-in-mechanically-ventilated-patients-with-traumatic-brain-injury-behavioral-pain-tools-versus-analgesia-nociception-index
#14
Ali Jendoubi, Ahmed Abbes, Salma Ghedira, Mohamed Houissa
INTRODUCTION: Pain is highly prevalent in critically ill trauma patients, especially those with a traumatic brain injury (TBI). Behavioral pain tools such as the behavioral pain scale (BPS) and critical-care pain observation tool are recommended for sedated noncommunicative patients. Analysis of heart rate variability (HRV) is a noninvasive method to evaluate autonomic nervous system activity. The analgesia nociception index (ANI) device (Physiodoloris(®), MDoloris Medical Systems, Loos, France) allows noninvasive HRV analysis...
September 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28945987/sedation-and-analgesia-for-procedures-in-the-pediatric-emergency-room
#15
REVIEW
Carlos Eduardo Ramalho, Pedro Messeder Caldeira Bretas, Claudio Schvartsman, Amélia Gorete Reis
OBJECTIVE: Children and adolescents often require sedation and analgesia in emergency situations. With the emergence of new therapeutic options, the obsolescence of others, and recent discoveries regarding already known drugs, it became necessary to review the literature in this area. DATA SOURCES: Non-systematic review in the PubMed database of studies published up to December 2016, including original articles, review articles, systematic reviews, and meta-analyses...
November 2017: Jornal de Pediatria
https://www.readbyqxmd.com/read/28940868/effects-of-esketamine-sedation-compared-to-morphine-analgesia-on-hydrostatic-reduction-of-intussusception-a-case-cohort-comparison-study
#16
Jascha A van de Bunt, Esther S Veldhoen, Rutger A J Nievelstein, Caroline C C Hulsker, Antonius N J Schouten, Maud Y A van Herwaarden
BACKGROUND: Hydrostatic or pneumatic reduction of intussusception is an invasive procedure that is stressful and may be painful for a child. Resistance of the child may increase the duration of the procedure and decrease success rate of reduction. Analgesia can help to reduce pain, but not necessarily resistance. General anesthesia increases success rate of reduction. However, it requires the presence of an anesthesiologist, and may lead to anesthesia-related complications. Procedural sedation with esketamine could be a safe alternative...
November 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28939570/perceptions-of-parents-and-paediatricians-on-pain-induced-by-bone-marrow-aspiration-and-lumbar-puncture-among-children-with-acute-leukaemia-a-qualitative-study-in-china
#17
Yu Wang, Qiang Liu, Jia-Ning Yu, Hai-Xia Wang, Lu-Lu Gao, Ya-Liang Dai, Xin Jin, Feng Zuo, Juan Liu, Cai-Feng Bai, Guo-Xia Mu, Xiao-Min Chai, Yin-Juan Zhang, Yu-Xiang Li, Jian-Qiang Yu
OBJECTIVE: To obtain in-depth insight into the perceptions of parents and paediatricians in China regarding current procedural pain management on bone marrow aspirations and lumbar punctures in paediatric haemato-oncology department. DESIGN, SETTING AND PARTICIPANTS: This qualitative study was conducted in a 4500-bed university hospital in northwest China. To collect data, in-depth semistructured interviews were conducted with parents of children with acute leukaemia (n=12) and haemato-oncology paediatricians (n=11) using purposive sampling...
September 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28926159/randomized-controlled-feasibility-trial-of-intranasal-ketamine-compared-to-intranasal-fentanyl-for-analgesia-in-children-with-suspected-extremity-fractures
#18
Stacy L Reynolds, Kathleen K Bryant, Jonathan R Studnek, Melanie Hogg, Connell Dunn, Megan A Templin, Charity G Moore, James R Young, Katherine Rivera Walker, Michael S Runyon
OBJECTIVES: We compared the tolerability and efficacy of intranasal subdissociative ketamine to intranasal fentanyl for analgesia of children with acute traumatic pain and investigated the feasibility of a larger noninferiority trial that could investigate the potential opioid-sparing effects of intranasal ketamine. METHODS: This randomized controlled trial compared 1 mg/kg intranasal ketamine to 1.5 μg/kg intranasal fentanyl in children 4 to 17 years old with acute pain from suspected isolated extremity fractures presenting to an urban Level II pediatric trauma center from December 2015 to November 2016...
September 19, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28913488/bilateral-thoracic-paravertebral-nerve-blocks-for-placement-of-percutaneous-radiologic-gastrostomy-in-patients-with-amyotrophic-lateral-sclerosis-a-case-series
#19
Arun Kalava, Steven Clendenen, J Mark McKinney, Elird Bojaxhi, Roy A Greengrass
BACKGROUND AND AIMS: To assess the efficacy of bilateral thoracic paravertebral nerve blocks (PVB) in providing procedural anesthesia and post-procedural analgesia for placement of percutaneous radiologic gastrostomy tubes (PRG) in patients with amyotrophic lateral sclerosis (ALS). METHODS: We prospectively observed 10 patients with ALS scheduled for PRG placement that had bilateral thoracic PVBs at thoracic 7, 8, and 9 levels with administration of a mixture of 3 mL of 1% ropivacaine, 0...
October 2016: Rom J Anaesth Intensive Care
https://www.readbyqxmd.com/read/28904501/patient-experience-with-conscious-sedation-as-a-method-of-pain-relief-for-transvaginal-oocyte-retrieval-a-cross-sectional-study
#20
Himanshu Singhal, Prasanna S Premkumar, Achamma Chandy, Aleyamma T Kunjummen, Mohan S Kamath
AIM: The aim of the study was to measure patient's satisfaction level and acceptance of conscious sedation as a method of pain relief following transvaginal oocyte retrieval (TVOR) during assisted reproduction technology treatment. We also evaluated the factors that may influence the efficacy of conscious sedation method. SETTING AND DESIGN: A prospective cross-sectional study. MATERIALS AND METHODS: Prospective study was conducted from October 2015 to January 2016 at a university-level hospital and 100 women were recruited...
April 2017: Journal of Human Reproductive Sciences
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