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procedural sedation analgesia

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https://www.readbyqxmd.com/read/28629738/nitrous-oxide-versus-oral-sedation-for-pain-management-of-first-trimester-surgical-abortion-a-randomized-study
#1
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/28592279/the-effect-of-post-traumatic-stress-disorder-on-intra-operative-analgesia-in-a-veteran-population-during-cataract-procedures-carried-out-using-retrobulbar-or-topical-anesthesia-a-retrospective-study
#2
Yuna Rapoport, Laura L Wayman, Amy S Chomsky
BACKGROUND: A growing proportion of veterans treated at the Veterans Health Administration (VA) have a history of post-traumatic-stress-disorder (PTSD), and there exists a higher rate of PTSD amongst veterans than the general population. The purpose of this study is to determine the correlation between PTSD and intra-operative analgesia, intra-operative time, and anesthesia type for cataract surgery in a veteran population. Secondary objectives are to determine if patient age, and first or second eye surgery affect intra-operative pain control or are correlated with type of anesthesia modality...
June 7, 2017: BMC Ophthalmology
https://www.readbyqxmd.com/read/28570293/mother-s-lived-experience-during-repair-of-long-gap-esophageal-atresia-a-phenomenological-inquiry
#3
Patricia Fleck, Carole Kenner, Rhonda Board, Sandra Mott
BACKGROUND: Infants born with long-gap esophageal atresia (LGEA) pose unique physiologic risks in the newborn period. Anatomic and physiologic anomalies require an extended hospitalization with procedural analgesia and sedation that impact the mother's experience of birth, maternal response, and nurturing of her infant. PURPOSE: The aim of this study was to understand the meaning of experiences that mothers of infants born with LGEA encounter in the neonatal intensive care unit while their infant undergoes esophageal repair...
May 31, 2017: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/28566870/temporomandibular-joint-dislocation-in-an-18-month-old-child
#4
Jaeson Mohanan Painatt, Ravi Veeraraghavan, Ushass Puthalath
Temporomandibular joint (TMJ) dislocation in children is extremely rare. In our case, an 18-month-old child presented with a history of inability to close her mouth. To confirm the clinical diagnosis, a computed tomogram was taken. Clinical examination and X-ray of the TMJ revealed bilateral TMJ dislocation. Bilateral TMJ reduction was achieved manually after giving analgesia and procedural sedation. This is one of the few case reports of an acute dislocation in a toddler.
January 2017: Contemporary Clinical Dentistry
https://www.readbyqxmd.com/read/28551063/-superior-gluteal-nerve-a-new-block-on-the-block
#5
Miguel Sá, Rita Graça, Hugo Reis, José Miguel Cardoso, José Sampaio, Célia Pinheiro, Duarte Machado
BACKGROUND AND OBJECTIVES: The superior gluteal nerve is responsible for innervating the gluteus medius, gluteus minimus and tensor fascia latae muscles, all of which can be injured during surgical procedures. We describe an ultrasound-guided approach to block the superior gluteal nerve which allowed us to provide efficient analgesia and anesthesia for two orthopedic procedures, in a patient who had significant risk factors for neuraxial techniques and deep peripheral nerve blocks. CLINICAL REPORT: An 84-year-old female whose regular use of clopidogrel contraindicated neuraxial techniques or deep peripheral nerve blocks presented for urgent bipolar hemiarthroplasty in our hospital...
May 24, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28536837/controlled-sedation-with-midazolam-and-analgesia-with-nalbuphine-to-alleviate-pain-in-patients-undergoing-subcutaneous-implantable-cardioverter-defibrillator-implantation
#6
Michaël Peyrol, Jérémie Barraud, Jennifer Cautela, Baptiste Maille, Marc Laine, Laurent Bonello, Franck Thuny, Franck Paganelli, Frédéric Franceschi, Linda Koutbi, Samuel Levy
PURPOSE: Subcutaneous implantable cardioverter defibrillator (S-ICD) is an alternative to transvenous ICD to prevent sudden cardiac death. Subcutaneous ICD implantation frequently requires general anesthesia because of procedure nociceptive steps during creation of a large device pocket and lead tunneling. This study aims to determine if a strategy of operator-guided controlled sedation with midazolam and analgesia with nalbuphine is effective in alleviating pain during S-ICD implantation...
May 23, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28526145/alpha-2-agonists
#7
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/28508254/comparison-of-pain-within-24%C3%A2-h-after-uterine-artery-embolization-with-tris-acryl-gelatin-microspheres-versus-gelatin-sponge-particles-for-leiomyoma
#8
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/28497160/spinal-osteoid-osteoma-efficacy-and-safety-of-radiofrequency-ablation
#9
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...
August 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28460809/ultrasound-guided-interscalene-nerve-block-vs-procedural-sedation-by-propofol-and-fentanyl-for-anterior-shoulder-dislocations
#10
Esmaeil Raeyat Doost, Mohammad Mehdi Heiran, Mitra Movahedi, Amirhossein Mirafzal
BACKGROUND: Few studies were performed to compare ultrasound guided brachial plexus block with procedural sedation for reduction of shoulder dislocations in the Emergency Department (ED). This study was done to provide further evidence regarding this comparison. METHODS: This was a randomized clinical trial performed on patients presenting with anterior shoulder dislocations to the emergency department of an academic level 2 trauma center. Exclusion criteria were any contraindications to the drugs used, any patient which may not be potentially assigned into both groups because of an underlying medical condition, presence of neurovascular compromise related to the dislocation, presence of concomitant fractures, and patient refusal to participate in the study...
April 14, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28458575/anesthesia-and-perioperative-pain-management-during-cardiac-electronic-device-implantation
#11
Marina Biocic, Dijana Vidosevic, Matija Boric, Teo Boric, Lovel Giunio, Damir Fabijanic, Livia Puljak
BACKGROUND: The degree of pain caused by the implantation of cardiac electronic devices (CEDs) and the type of anesthesia or perioperative pain management used with the procedure have been insufficiently studied. The aim of this study was to analyze perioperative pain management, as well as intensity and location of pain among patients undergoing implantation of CED, and to compare the practice with published guidelines. PATIENTS AND METHODS: This was a combined retrospective and prospective study conducted at the tertiary hospital, University Hospital Split, Croatia...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28433211/adverse-events-during-a-randomized-trial-of-ketamine-versus-co-administration-of-ketamine-and-propofol-for-procedural-sedation-in-a-pediatric-emergency-department
#12
Keith Weisz, Lalit Bajaj, Sara J Deakyne, Lina Brou, Alison Brent, Joseph Wathen, Genie E Roosevelt
BACKGROUND: The co-administration of ketamine and propofol (CoKP) is thought to maximize the beneficial profile of each medication, while minimizing the respective adverse effects of each medication. OBJECTIVE: Our objective was to compare adverse events between ketamine monotherapy (KM) and CoKP for procedural sedation and analgesia (PSA) in a pediatric emergency department (ED). METHODS: This was a prospective, randomized, single-blinded, controlled trial of KM vs...
April 19, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28424537/awake-craniotomy-anesthetic-management-using-dexmedetomidine-propofol-and-remifentanil
#13
Andrea Prontera, Stefano Baroni, Andrea Marudi, Franco Valzania, Alberto Feletti, Francesca Benuzzi, Elisabetta Bertellini, Giacomo Pavesi
INTRODUCTION: Awake craniotomy allows continuous monitoring of patients' neurological functions during open surgery. Anesthesiologists have to sedate patients in a way so that they are compliant throughout the whole surgical procedure, nevertheless maintaining adequate analgesia and anxiolysis. Currently, the use of α2-receptor agonist dexmedetomidine as the primary hypnotic-sedative medication is increasing. METHODS: Nine patients undergoing awake craniotomy were treated with refined monitored anesthesia care (MAC) protocol consisting of a combination of local anesthesia without scalp block, low-dose infusion of dexmedetomidine, propofol, and remifentanil, without the need of airways management...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/28416265/comparison-of-outcomes-for-pediatric-paraphimosis-reduction-using-topical-anesthetic-versus-intravenous-procedural-sedation
#14
Brett Burstein, Raphael Paquin
BACKGROUND: Paraphimosis is an acute urologic emergency requiring urgent manual reduction, frequently necessitating procedural sedation (PS) in the pediatric population. The present study sought to compare outcomes among pediatric patients undergoing paraphimosis reduction using a novel topical anesthetic (TA) technique versus PS. METHODS: We performed a retrospective analysis of all patients <18years old, presenting to a tertiary pediatric ED requiring analgesia for paraphimosis reduction between October 2013 and September 2016...
April 11, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28409844/balloon-eustachian-tuboplasty-under-local-anesthesia-is-it-feasible
#15
MULTICENTER STUDY
Veera Luukkainen, Ilkka Kivekäs, Sari Hammarén-Malmi, Markus Rautiainen, Leena Pöyhönen, Antti A Aarnisalo, Jussi Jero, Saku T Sinkkonen
OBJECTIVE: To study whether balloon Eustachian tuboplasty (BET) is a feasible and safe procedure under local anesthesia. STUDY DESIGN: Prospective multicenter case-control study. METHODS: Patients undergoing either BET (n = 13) or endoscopic sinus surgery (ESS) (n = 12) under local anesthesia, with the possibility of sedation and analgesia, were monitored during the procedure and recovery period for possible adverse effects. After the procedure, the patients responded to a questionnaire assessing their experience...
May 2017: Laryngoscope
https://www.readbyqxmd.com/read/28395927/correction-correction-to-clinical-policy-procedural-sedation-and-analgesia-in-the-emergency%C3%A2-department-annals-of-emergency-medicine-63-2014-247-258-e18
#16
Steven A Godwin, John H Burton, Charles J Gerardo, Benjamin W Hatten, Sharon E Mace, Scott M Silvers, Francis M Fesmire
Due to a miscommunication during the process of transferring this manuscript from our editorial team to Production, the Members of the American College of Emergency Physicians Clinical Policies Committee (Oversight Committee) were not properly indexed in PubMed. This has now been corrected online. The publisher would like to apologize for any inconvenience caused.
April 7, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28371158/the-effect-of-gabapentin-on-delayed-discharge-from-the-postanesthesia-care-unit-a-retrospective-analysis
#17
Naveed T Siddiqui, Amir Yousefzadeh, Maaz Yousuf, Dileep Kumar, Farah K Choudhry, Zeev Friedman
BACKGROUND: Enhanced recovery after surgery programs has incorporated gabapentin as part of a multimodal analgesia protocol. The preemptive use of gabapentin was found to be beneficial due to its opioid-sparing effect. However, excessive sedation and delayed discharge from postanesthesia recovery units are of concern. The aim of this study was to investigate whether preoperative gabapentin increased the length of stay in the recovery unit. METHODS: This retrospective cross-sectional study was carried out over a period of 2 months in the postanesthesia care unit (PACU) of a tertiary care hospital in Canada...
March 30, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/28368918/evaluating-the-effectiveness-of-end-tidal-carbon-dioxide-monitoring-during-burn-wound-care-in-the-nonintubated-patient-population
#18
Samantha Weimer, Justin Burleson, Mary Mancuso, Cameron Bell, Mary Beth Flynn Makic
Daily burn wound care for nonintubated patients involves administration of intravenous analgesic and sedation agents. Vital signs and oxygen saturation monitoring alone can result in late signs of oversedation and ineffective breathing. End-tidal carbon dioxide (EtCo2) monitoring provides immediate feedback of effective breathing during procedural sedation. The purpose of this study was to describe the nurse's sedation and analgesic therapy management of nonintubated patients during burn wound care when EtCo2 was used...
March 31, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28358177/survey-on-monitoring-analgesia-and-sedation-in-the-italian-pediatric-intensive-care-units
#19
Benedicta Tabacco, Claudio Tacconi, Angela Amigoni
BACKGROUND: Admission in Pediatric Intensive Care Unit requires management and monitoring of analgesia and sedation, in order to reduce their adverse effects, and to prevent withdrawal syndrome and delirium. The aim of this study is to evaluate the management of analgesia and sedation in critically ill children admitted in the Italian Pediatric Intensive Care Units. METHODS: For this survey we have submitted a telematics questionnaire to 24 nursing co- ordinators of the Pediatric Intensive Care Units or Neonatal Intensive Care Units admitting critically ill children...
March 28, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28338301/analgesia-for-patients-undergoing-shockwave-lithotripsy-for-urinary-stones-a-systematic-review-and-meta-analysis
#20
Omar M Aboumarzouk, Rami Hasan, Ali Tasleem, Martin Mariappan, Rachael Hutton, John Fitzpatrick, Laura Beatty, Gareth E Jones, Tarik Amer
BACKGROUND: Shock wave lithotripsy (SWL) is the first line treatment modality for a significant proportion of patients with upper urinary tracts stones. Simple analgesics, opioids and non-steroidal anti-inflammatory drugs (NSAIDs) are all suitable agents but the relative efficacy and tolerability of these agents is uncertain. OBJECTIVES: To determine the efficacy of the different types of analgesics used for the control of pain during SWL for urinary stones. MATERIALS AND METHODS: We searched the Cochrane Renal Group's Specialised Register, MEDLINE, EMBASE and also hand-searched reference lists of relevant articles (Figure-1)...
May 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
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