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Propofol apnea

E Deflandre, V Bonhomme, A-C Courtois, S Degey, R Poirrier, J-F Brichant
Postoperative development or worsening of obstructive sleep apnea is a potential complication of anesthesia. The objective of this study was to study the effects of a premedication with alprazolam on the occurrence of apneas during the immediate postoperative period. Fifty ASA 1 - 2 patients undergoing a colonoscopy were recruited. Patients with a history of obstructive sleep apnea (OSA) were excluded. Recruited patients were randomly assigned to one of two groups: in Group A, they received 0.5 mg of alprazolam orally one hour before the procedure; and in Group C, they received placebo...
August 2016: Journal of Physiology and Pharmacology: An Official Journal of the Polish Physiological Society
Hsueh-Yu Li, Yu-Lun Lo, Chao-Jan Wang, Li-Jen Hsin, Wan-Ni Lin, Tuan-Jen Fang, Li-Ang Lee
Surgical success for obstructive sleep apnea (OSA) depends on identifying sites of obstruction in the upper airway. In this study, we investigated sites of obstruction by evaluating dynamic changes in the upper airway using drug-induced sleep computed tomography (DI-SCT) in patients with OSA. Thirty-five adult patients with OSA were prospectively enrolled. Sleep was induced with propofol under light sedation (bispectral index 70-75), and low-dose 320-detector row CT was performed for 10 seconds over a span of 2-3 respiratory cycles with supporting a continuous positive airway pressure model...
October 20, 2016: Scientific Reports
Glenn Harvin, Eslam Ali, Amit Raina, William Leland, Sabeen Abid, Zahid Vahora, Hossein Movahed, Sumyra Kachru, Rick Tee
BACKGROUND: This pilot study examined airway characteristics during upper endoscopy to determine who is at high risk for obstructive sleep apnea. METHODS: Patients undergoing routine upper endoscopy were divided into 2 groups according to the Berlin Questionnaire (high and low risk for sleep disordered breathing). Patients underwent routine upper endoscopy using propofol sedation. The airway was then evaluated for no, partial, or complete collapse at the levels of the palate/uvula/tonsils, the tongue base, the hypopharynx, and the larynx...
October 2016: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
SangMin Choe, Byung-Moon Choi, Yong-Hun Lee, Soo-Han Lee, Eun-Kyung Lee, Ki-Seong Kim, Gyu-Jeong Noh
This study describes the pharmacodynamic interaction between propofol and remifentanil. Sixty patients who were scheduled for elective surgery under general anesthesia (30 males/30 females) were enrolled. Patients were randomly allocated to receive one of 15 combinations of drug levels. Baseline electroencephalograms (EEGs) were recorded for 5 min prior to administering the drugs. Patients received a target-controlled infusion at one of four predefined doses of propofol (high: 3 μg·ml(-1) , medium: 1.5 μg·ml(-1) , low: 0...
October 1, 2016: Clinical and Experimental Pharmacology & Physiology
Andrea Riphaus, Till Wehrmann, Tim Kronshage, Christoph Geist, Christian P Pox, Stefan Heringlake, Wolff Schmiegel, Analena Beitz, Alexander Meining, Michaela Müller, Stefan von Delius
BACKGROUND AND STUDY AIMS: The Integrated Pulmonary Index(®) (IPI) is a mathematically-determined factor based on parameters of capnography and pulse oximetry, which should enable sensitive detection of impaired respiratory function. Aim was to investigate whether an additional measurement of the IPI during sedation for interventional endoscopy, compared to standard monitoring alone, allows a reduction of sedation-related respiratory depression. PATIENTS AND METHODS: 170 patients with standard monitoring randomly underwent either a blinded recording of capnography (control group, n=87) or capnography, including automated IPI calculation (IPI group, n=83), during deep sedation with midazolam and propofol...
September 1, 2016: Digestive and Liver Disease
Ji Young Yoo, Hyun Jeong Kwak, Yong Beom Kim, Chu Kyung Park, Sook Young Lee, Jong Yeop Kim
BACKGROUND: We designed this study to investigate the effect of dexmedetomidine (1 μg/kg) pretreatment on the median effective dose (ED50) of propofol for facilitating successful laryngeal mask airway (LMA) insertion compared to propofol alone. METHODS: Forty patients were randomized to either the control group (n = 21) or the dexmedetomidine group (n = 19). After infusion of normal saline or dexmedetomidine 1 µg/kg over 10 min, 1 % lidocaine 0.5 mg/kg, followed by propofol 2...
August 29, 2016: Journal of Anesthesia
Baruch S Krauss, Gary Andolfatto, Benjamin A Krauss, Rebecca J Mieloszyk, Michael C Monuteaux
STUDY OBJECTIVE: We describe the characteristics of and predictors for apnea and clinical interventions during emergency department (ED) procedural sedation. METHODS: High-resolution data were collected prospectively, using a convenience sample of ED patients undergoing propofol or ketofol sedation. End tidal CO2 (etco2), respiratory rate, pulse rate, and SpO2 were electronically recorded in 1-second intervals. Procedure times, drug delivery, and interventions were electronically annotated...
August 20, 2016: Annals of Emergency Medicine
Johanna M M van Breugel, Joost W Wijlemans, Hermanus H B Vaessen, Martijn de Greef, Chrit T W Moonen, Maurice A A J van den Bosch, Mario G Ries
BACKGROUND: Previous studies demonstrated both pre-clinically and clinically the feasibility of magnetic resonance-guided high-intensity focused ultrasound (MR-HIFU) ablations in the liver. To overcome the associated problem of respiratory motion of the ablation area, general anesthesia (GA) and mechanical ventilation was used in conjunction with either respiratory-gated energy delivery or energy delivery during induced apnea. However, clinical procedures requiring GA are generally associated with increased mortality, morbidity, and complication rate compared to procedural sedation and analgesia (PSA)...
2016: Journal of Therapeutic Ultrasound
Ki-Bum Park, Junggun Ann, Haemi Lee
OBJECTIVES: To investigate the effectiveness of oxycodone compared with fentanyl for attenuating the hemodynamic response during endotracheal intubation. METHODS: This study was conducted from June 2014 to February 2015 on healthy adults undergoing general anesthesia at the Yeungnam University Hospital, Daegu, Republic of Korea. Ninety-five patients were randomly assigned to one of 3 groups to receive the following drugs; Group F: fentanyl 2 μg/kg; Group O/70: oxycodone 140 μg/kg; Group O/100: oxycodone 200 μg/kg...
August 2016: Saudi Medical Journal
Ian Ferguson, Anthony Bell, Greg Treston, Lisa New, Mingshuang Ding, Anna Holdgate
STUDY OBJECTIVE: We determine whether emergency physician-provided deep sedation with 1:1 ketofol versus propofol results in fewer adverse respiratory events requiring physician intervention when used for procedural sedation and analgesia. METHODS: Consenting patients requiring deep sedation were randomized to receive either ketofol or propofol in a double-blind fashion according to a weight-based dosing schedule. The primary outcome was the occurrence of a respiratory adverse event (desaturation, apnea, or hypoventilation) requiring an intervention by the sedating physician...
July 22, 2016: Annals of Emergency Medicine
Julia Termühlen, Antje Gottschalk, Nicole Eter, Esther M Hoffmann, Hugo Van Aken, Ulrike Grenzebach, Verena Prokosch
BACKGROUND: Reliable measurement of intraocular pressure (IOP) is crucial in pediatric patients with suspected glaucoma. General anesthesia (GA) is usually needed in infants to allow a thorough examination. However, anesthesia itself may influence IOP, depending on the type used and the depth of sedation. The purpose of this study was to evaluate the normal distribution of IOP during GA in healthy children and to analyze differences in IOP relative to the anesthetics used and the measurement time point...
September 2016: Paediatric Anaesthesia
Reza Akhondzadeh, Ali Ghomeishi, Sholeh Nesioonpour, Sanaz Nourizade
BACKGROUND: The efficient and secure techniques of anesthesia and sedation have always been needed for. One of these procedures is endoscopic retrograde cholangiopancreatography (ERCP), due to its painfulness and long duration, has high sensitivity. We compare the effects of propofol-fentanyl (PF) with propofol-ketamine (PK) to sedate patients undergoing ERCP. METHODS: In this clinical trial, patients were divided into two groups of 49 people. A group received a pharmaceutical combination of PK, and another group received a pharmaceutical combination of PF...
April 2016: Biomedical Journal
Ana Celia Faria, Luis Vicente Garcia, Antonio Carlos Santos, Alan Luiz Eckeli, Denny Marcos Garcia, Francisco Verissimo Mello-Filho
PURPOSE: To compare the dynamic differences occurring in the pharynx during sleep after maxillomandibular advancement (MMA) surgery for the treatment of patients with obstructive sleep apnea syndrome. METHODS: This was a prospective, cross-sectional study conducted on 20 patients (15 men and 5 women) with a polysomnography diagnosis of obstructive sleep apnea (OSA) submitted to surgical treatment with MMA. All patients were submitted to magnetic resonance (MR) during propofol-induced sleep before and 6 months after surgery...
May 26, 2016: Sleep & Breathing, Schlaf & Atmung
Vida Ayatollahi, Maryam Vafaiyan, Maryam Hatami, Shekoufeh Behdad
OBJECTIVES: Ketofol is a mixture of propofol and ketamine in various concentrations. It is accepted as a suitable combination in procedural sedation and analgesia. The mixture of propofol and ketamine with different respiratory and hemodynamic effects may result in fewer dose-related side effects and a probable synergistic effect. This study was designed to compare the adverse effects and quality of analgesia of 2 different intravenous concentrations of ketofol in patients undergoing closed reduction of the nose...
June 2016: Journal of Craniofacial Surgery
Ali Kandil, Rajeev Subramanyam, Mohamed Monir Hossain, Stacey Ishman, Sally Shott, Anurag Tewari, Mohamed Mahmoud
AIM: Examination of dynamic airway collapse in patients with obstructive sleep apnea (OSA) during drug-induced sleep endoscopy (DISE) can help identify the anatomic causes of airway obstruction. We hypothesized that a combination of dexmedetomidine and ketamine (Group DK) would result in fewer oxygen desaturations and a higher successful completion rate during DISE in children with OSA when compared to propofol (Group P) or sevoflurane/propofol (Group SP). METHODS: In this retrospective study, we reviewed the records of 59 children who presented for DISE between October 2013 and March 2015...
July 2016: Paediatric Anaesthesia
Alonço da Cunha Viana, Daniella Leitão Mendes, Lucas Neves de Andrade Lemes, Luiz Claudio Santos Thuler, Denise Duprat Neves, Maria Helena de Araújo-Melo
Obstructive sleep apnea (OSA) is characterized by recurrent episodes of partial or complete collapse of the pharynx that result in a decrease in oxyhemoglobin saturation. Nasofibrolaryngoscopy under induced sleep is a promising alternative for identifying sites of upper airway obstruction in patients with OSA. This study aimed to compare the obstruction sites screened by drug-induced sleep endoscopy (DISE) using the Nose oropharynx hypopharynx and larynx (NOHL) and Velum oropharynx tongue base epiglottis (VOTE) classifications...
May 10, 2016: European Archives of Oto-rhino-laryngology
Supriya Aggarwal, Vipin Kumar Goyal, Shashi Kala Chaturvedi, Vijay Mathur, Birbal Baj, Alok Kumar
BACKGROUND AND OBJECTIVES: Induction of anesthesia is a critical part of anesthesia practice. Sudden hypotension, arrhythmias, and cardiovascular collapse are threatening complications following injection of induction agent in hemodynamically unstable patients. It is desirable to use a safe agent with fewer adverse effects for this purpose. Present prospective randomized study is designed to compare propofol and etomidate for their effect on hemodynamics and various adverse effects on patients in general anesthesia...
May 2016: Brazilian Journal of Anesthesiology
Mary C Fearon, Mary J Ogg
Creating a just culture Key words: just culture, TeamSTEPPS, human error, briefing, huddle. Circulating while administering moderate sedation/analgesia Key words: moderate sedation/analgesia, RN circulator. Monitoring RN leaving room during administration of moderate sedation Key words: moderate sedation/analgesia, propofol. Screening for obstructive sleep apnea before administering moderate sedation Key words: moderate sedation/analgesia, obstructive sleep apnea, OSA. Assessment for obstructive sleep apnea Key words: moderate sedation/analgesia, obstructive sleep apnea, OSA, OSA questionnaires, OSA checklist...
April 2016: AORN Journal
Supriya Aggarwal, Vipin Kumar Goyal, Shashi Kala Chaturvedi, Vijay Mathur, Birbal Baj, Alok Kumar
BACKGROUND AND OBJECTIVES: Induction of anesthesia is a critical part of anesthesia practice. Sudden hypotension, arrhythmias, and cardiovascular collapse are threatening complications following injection of induction agent in hemodynamically unstable patients. It is desirable to use a safe agent with fewer adverse effects for this purpose. Present prospective randomized study is designed to compare propofol and etomidate for their effect on hemodynamics and various adverse effects on patients in general anesthesia...
May 2016: Revista Brasileira de Anestesiologia
Adrian A Ong, Alexander W Murphey, Shaun A Nguyen, Ryan J Soose, B Tucker Woodson, Olivier M Vanderveken, Nico de Vries, M Boyd Gillespie
OBJECTIVE: To describe upper airway collapse patterns observed on drug-induced sedation endoscopy (DISE) during screening for a clinical trial and to evaluate the impact of collapse patterns found on preoperative DISE on response rates to upper airway stimulation (UAS) therapy. STUDY DESIGN: Retrospective review of an ongoing prospective multi-institutional cohort study. SETTING: Twenty-two participating institutions of the STAR trial. SUBJECTS AND METHOD: In total, 222 subjects were screened with DISE to determine eligibility for an implantable UAS device...
May 2016: Otolaryngology—Head and Neck Surgery
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