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https://www.readbyqxmd.com/read/28915133/complications-and-unplanned-admissions-in-nonoperating-room-procedures
#1
Kate Leslie, Benjamin Kave
PURPOSE OF REVIEW: The purpose of this article is to review complications and unplanned hospital admissions in patients presenting for ambulatory procedures requiring anesthesia care in the gastrointestinal endoscopy, bronchoscopy, and radiology suites. RECENT FINDINGS: The range of ambulatory diagnostic and therapeutic procedures being undertaken in the gastrointestinal endoscopy, bronchoscopy, and radiology suites is expanding rapidly. Recent observational studies in gastrointestinal endoscopy confirm low incidences of complications and unplanned admissions...
September 14, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28879332/anesthetic-management-for-simultaneous-drug-induced-sleep-endoscopy-and-maxillomandibular-advancement-in-a-patient-with-obstructive-sleep-apnea
#2
Tae Seong Kuk, Eunsun So, Myong-Hwan Karm, Jimin Kim, Seong In Chi, Hyun Jeong Kim, Kwang-Suk Seo, Sung Woon On, Jin-Young Choi
Drug-induced sleep endoscopy (DISE) is used to identify areas of upper airway obstruction, which occurs when patients with obstructive sleep apnea (OSA) snore. DISE enables effective diagnosis and appropriate treatment of the obstruction site. Among surgical treatment methods for OSA, maxillomandibular advancement surgery (MMA) is performed to move a jaw forward; the surgery has a high success rate for OSA treatment. In DISE, anesthetics such as propofol and midazolam must be administered to induce snoring while the patient is deeply sedated for an accurate diagnosis to be made...
March 2017: J Dent Anesth Pain Med
https://www.readbyqxmd.com/read/28853427/ear-nose-and-throat-ent-aspects-of-obstructive-sleep-apnea-syndrome-osas-diagnosis-and-therapy
#3
Desiderio Passali, Maria Carla Spinosi, Francesco Maria Passali
This article analyzes the role played by the ear, nose and throat (ENT) specialist in the diagnosis and treatment of the Obstructive Sleep Apnea Syndrome (OSAS). DIAGNOSIS: The instrumental methods of investigation of otolaryngology expertise are fiberoptic rhinolaryngoscopy and sleep endoscopy. To better define and treat OSAS it is essential to define location, extension and degree of obstruction. The major limitation of rhinolaryngoscopy is that it is conducted while the patient is awake...
August 28, 2017: La Medicina del Lavoro
https://www.readbyqxmd.com/read/28829527/does-caffeine-improve-respiratory-rate-during-remifentanil-target-controlled-infusion-sedation-a-case-report-in-endoscopic-sedation
#4
Fabio Sbaraglia, Mariella De Riso, Maria Elena Riccioni, Guido Costamagna, Maria Sammartino
Sedation for endoscopic procedures may be challenging when facing patients with high risk. Traditional techniques, as propofol or meperidine/midazolam administration, cannot ensure an adequate level of safety and efficacy for these patients. Remifentanil infusion is a common alternative, but the incidence of apneic events does not allow achieving safely a good level of analgesia. To overcome with this issue, the authors borrowed suggestions from other medical fields. The clinical practice has recognized a wide utility of methylxanthines (caffeine, theophylline, etc)...
March 2017: Journal of Opioid Management
https://www.readbyqxmd.com/read/28819181/capnography-monitoring-the-hypoventilation-during-the-induction-of-bronchoscopic-sedation-a-randomized-controlled-trial
#5
Ting-Yu Lin, Yueh-Fu Fang, Shih-Hao Huang, Tsai-Yu Wang, Chih-Hsi Kuo, Hau-Tieng Wu, Han-Pin Kuo, Yu-Lun Lo
We hypothesize that capnography could detect hypoventilation during induction of bronchoscopic sedation and starting bronchoscopy following hypoventilation, may decrease hypoxemia. Patients were randomized to: starting bronchoscopy when hypoventilation (hypopnea, two successive breaths of at least 50% reduction of the peak wave compared to baseline or apnea, no wave for 10 seconds) (Study group, n = 55), or when the Observer Assessment of Alertness and Sedation scale (OAAS) was less than 4 (Control group, n = 59)...
August 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28798230/association-of-bmi-with-propofol-dosing-and-adverse-events-in-children-with-cancer-undergoing-procedural-sedation
#6
Colin M Rogerson, Kamal Abulebda, Michael J Hobson
OBJECTIVES: Obesity increases the risk of complications during pediatric procedural sedation. The risk of being underweight has not been evaluated in this arena. We therefore investigated the association of BMI with sedation dosing and adverse events in children across a range of BMIs. METHODS: A total of 1976 patients ages 2 to 21 years old with oncologic diagnoses underwent lumbar punctures and/or bone marrow aspirations. All children received a standard adjunctive dose of ketamine before sedation with propofol...
August 10, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28680511/emergency-department-procedural-sedation-for-primary-electrical-cardioversion-a-comparison-with-procedural-sedations-for-other-reasons
#7
Michael Butler, Patrick Froese, Peter Zed, George Kovacs, Robert MacKinley, Kirk Magee, Mary-Lynn Watson, Samuel G Campbell
BACKGROUND: Atrial fibrillation (AF) is the most common arrhythmia treated in the emergency department (ED), with primary electrical cardioversion (PEC) the preferred method of rhythm control. Anecdotally, patients undergoing ED procedural sedation (EDPS) for PEC differ from those requiring EDPS for other procedures: they are at higher risk of adverse events, and require fewer drugs and lower doses. We attempt to verify this using an EDPS registry at a Canadian, tertiary care teaching hospital...
2017: World Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28465784/does-deep-sedation-with-propofol-affect-adenoma-detection-rates-in-average-risk-screening-colonoscopy-exams
#8
Selvi Thirumurthi, Gottumukkala S Raju, Mala Pande, Joseph Ruiz, Richard Carlson, Katherine B Hagan, Jeffrey H Lee, William A Ross
AIM: To determine the effect of sedation with propofol on adenoma detection rate (ADR) and cecal intubation rates (CIR) in average risk screening colonoscopies compared to moderate sedation. METHODS: We conducted a retrospective chart review of 2604 first-time average risk screening colonoscopies performed at MD Anderson Cancer Center from 2010-2013. ADR and CIR were calculated in each sedation group. Multivariable regression analysis was performed to adjust for potential confounders of age and body mass index (BMI)...
April 16, 2017: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28413280/comparison-of-sevoflurane-and-propofol-for-laryngeal-mask-airway-insertion-and-pressor-response-in-patients-undergoing-gynecological-procedures
#9
Shirishkumar Gulabrao Chavan, Surita Mandhyan, Sandhya Haridas Gujar, Gourish Prakash Shinde
BACKGROUND AND AIMS: A popular method of providing anesthesia for laryngeal mask airway (LMA) insertion is with the use of propofol. However, bolus propofol has been associated with adverse effects such as hypotension, apnea and pain on injection. Hence, time is needed to search an alternative. We aimed to compare the induction characteristics, ease of LMA insertion, hemodynamic changes and complications with inhalation of 8% sevoflurane vital capacity breath and propofol. MATERIAL AND METHODS: A prospective randomized study of 60 American Society of Anesthesiologists' Grade I and II patients was conducted and distributed among two groups with 30 each undergoing gynecological procedures under general anesthesia...
January 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28364198/drug-induced-sleep-endoscopy-with-target-controlled-infusion-using-propofol-and-monitored-depth-of-sedation-to-determine-treatment-strategies-in-obstructive-sleep-apnea
#10
Clemens Heiser, Phillippe Fthenakis, Alexander Hapfelmeier, Sebastian Berger, Benedikt Hofauer, Winfried Hohenhorst, Eberhard F Kochs, Klaus J Wagner, Guenther M Edenharter
BACKGROUND: Drug-induced sleep endoscopy (DISE) has become an important diagnostic examination tool in the treatment decision process for surgical therapies in the treatment of obstructive sleep apnea (OSA). Currently, there is a variety of regimes for the performance of DISE, which renders comparison and assessment across results difficult. It remains unclear how the different regimes influence the findings of the examination and the resulting conclusions and treatment recommendations...
March 31, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/28213776/the-importance-of-drug-induced-sedation-endoscopy-d-i-s-e-techniques-in-surgical-decision-making-conventional-versus-target-controlled-infusion-techniques-a-prospective-randomized-controlled-study-and-a-retrospective-surgical-outcomes-analysis
#11
RANDOMIZED CONTROLLED TRIAL
Andrea De Vito, Vanni Agnoletti, Gianluca Zani, Ruggero Massimo Corso, Giovanni D'Agostino, Elisabetta Firinu, Chiara Marchi, Ying-Shuo Hsu, Stefano Maitan, Claudio Vicini
Drug-Induced Sedation Endoscopy (DISE) consists of the direct observation of the upper airways during sedative-induced sleep, allowing the identification of the sites of pharyngeal collapse, which is the main pathological event in Obstructive Sleep Apnea (OSA). The Authors have compared Target Controlled Infusion (TCI) sedation endoscopy (TCI-DISE) technique to conventional DISE (CDISE), performed by a manual bolus injection of sedative agent, to recreate accurately and safely snoring and apnea patterns comparable to natural sleep...
May 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28152385/propofol-fentanyl-interaction-in-beagles-apnea-response-to-mechanical-ventilation-endotracheal-tube-and-tetanic-stimulation
#12
T Iizuka, K Masui, T Miyabe-Nishiwaki, H Kanazawa, R Nishimura
The objective of this study was to characterize the propofol-fentanyl interaction in Beagles for four pharmacodynamic endpoints: apnea, response to mechanical ventilation, endotracheal tube, and tetanic stimulation. After anesthesia was induced with varying combinations of propofol and fentanyl, the pharmacodynamic endpoints were assessed in intubated dogs (n=6) using the cross-over design. Effective concentrations of propofol plasma concentration (Cp) and fentanyl Cp were assessed using additive, reduced Greco, Minto, and hierarchical interaction models...
January 23, 2017: Research in Veterinary Science
https://www.readbyqxmd.com/read/28079763/the-comparison-of-etomidate-and-propofol-anesthesia-in-patients-undergoing-gastrointestinal-endoscopy-a-systematic-review-and-meta-analysis
#13
REVIEW
Limin Ye, Xiangyang Xiao, Liyi Zhu
INTRODUCTION: Etomidate and propofol played an important role in the sedation of patients undergoing gastrointestinal endoscopy. We conducted a systematic review and meta-analysis to compare their efficacy and safety. MATERIALS AND METHODS: PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases were systematically searched. Randomized controlled trials assessing the effect of etomidate versus propofol for the anesthesia of patients undergoing gastrointestinal endoscopy were included...
February 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28073611/propofol-versus-midazolam-for-procedural-sedation-in-the-emergency-department-a-study-on-efficacy-and-safety
#14
MULTICENTER STUDY
Heleen Lameijer, Ytje T Sikkema, Albert Pol, Maike G E Bosch, Femke Beije, Rieneke Feenstra, Bas W J Bens, Ewoud Ter Avest
BACKGROUND: Procedural sedation for painful procedures in the emergency department (ED) can be accomplished with various pharmacological agents. The choice of the sedative used is highly dependent on procedure- and patient characteristics and on personal- or local preferences. METHODS: We conducted a multicenter retrospective cohort study of procedural sedations performed in the EDs of 5 hospitals in the Netherlands over a 4year period to evaluate the efficacy- (success rate of the intended procedure) and safety (incidence of sedation (adverse) events) of propofol sedations compared to midazolam sedations...
May 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28060257/drug-induced-sleep-endoscopy-dise-with-target-controlled-infusion-tci-and-bispectral-analysis-in-obstructive-sleep-apnea
#15
Maximilian Traxdorf, Klaus Tschaikowsky, Claudia Scherl, Judith Bauer, Heinrich Iro, Florian Angerer
The aim of this study was to establish a standardized protocol for drug-induced sleep endoscopy (DISE) to differentiate obstruction patterns in obstructive sleep apnea (OSA). Target-controlled infusion (TCI) of the sedative propofol was combined with real-time monitoring of the depth of sedation using bispectral analysis. In an observational study 57 patients (mean age 44.8 years, ± SD 10.5; mean apnea hypopnea Index (AHI) 30.8/hr, ± SD 21.6, mean BMI 28.2 kg/m(2), ± SD 5.3) underwent cardiorespiratory polysomnography followed by DISE with TCI and bispectral analysis...
December 6, 2016: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/27885537/safety-analysis-of-bariatric-patients-undergoing-outpatient-upper-endoscopy-with-non-anesthesia-administered-propofol-sedation
#16
Tyler McVay, John C Fang, Linda Taylor, Alexander Au, Wesley Williams, Angela P Presson, Ragheed Al-Dulaimi, Eric Volckmann, Anna Ibele
BACKGROUND: Non-anesthesia administered propofol (NAAP) has been shown to be a safe and effective method of sedation for patients undergoing gastrointestinal endoscopy. Bariatric surgery patients are potentially at a higher risk for sedation-related complications due to co-morbidities including obstructive sleep apnea. The outcomes of NAAP in bariatric patients have not been previously reported. METHODS: In this retrospective cohort study, severely obese patients undergoing pre-surgical outpatient esophagogastroduodenoscopy (EGD) were compared to non-obese control patients (BMI ≤ 25 kg/m(2)) undergoing diagnostic EGD at our institution from March 2011-September 2015 using our endoscopy database...
June 2017: Obesity Surgery
https://www.readbyqxmd.com/read/27871584/a-comparison-of-3-ventilation-strategies-in-children-younger-than-1-year-using-a-proseal-laryngeal-mask-airway-a-randomized-controlled-trial
#17
RANDOMIZED CONTROLLED TRIAL
T Wesley Templeton, Lauren K Hoke, Leah B Templeton, Douglas G Ririe, Danielle M Rose, Yvon F Bryan
STUDY OBJECTIVE: To determine quantitative differences in several routinely measured ventilation parameters using a standardized anesthetic technique and 3 different ventilation modalities in patients younger than 1 year with a ProSeal laryngeal mask airway (PLMA). DESIGN: Randomized prospective study. SETTING: Tertiary care pediatric hospital. PATIENTS: Thirty-nine American Society Anesthesiologists classifications 1 to 2, pediatric patients younger than 1 year...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27823709/the-utility-of-perioperative-polygraphy-in-the-diagnosis-of-obstructive-sleep-apnea
#18
Ivan Cundrle, Milos Belehrad, Milan Jelinek, Lyle J Olson, Ondrej Ludka, Vladimir Sramek
OBJECTIVE/BACKGROUND: Obstructive sleep apnea (OSA) is highly prevalent and often undiagnosed in surgical patients. The aim of this study was to compare polygraphy (PG) performed on sedated patients during surgery to overnight polysomnography (PSG). It was hypothesized that perioperative PG may be used to diagnose OSA. PATIENTS/METHODS: Overnight PSG was performed three days prior to surgery. For surgery, spinal anesthesia and sedation with propofol infusion were used...
September 2016: Sleep Medicine
https://www.readbyqxmd.com/read/27779482/influence-of-premedication-with-alprazolam-on-the-occurence-of-obstructive-apneas-a-prospective-randomized-double-blind-study
#19
RANDOMIZED CONTROLLED TRIAL
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
https://www.readbyqxmd.com/read/27762308/dynamic-drug-induced-sleep-computed-tomography-in-adults-with-obstructive-sleep-apnea
#20
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
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