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Sedation in endoscopy

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https://www.readbyqxmd.com/read/29781859/nonoperating-room-anesthesia-for-gastrointestinal-endoscopic-procedures
#1
Otto S Lin, Wade Weigel
PURPOSE OF REVIEW: To assess the trends in nonoperating room anesthesia (NORA) for gastrointestinal endoscopy over the past few years, and to describe alternative methods of delivering propofol sedation in selected low-risk patients. RECENT FINDINGS: The use of NORA for routine gastrointestinal endoscopic procedures has been rising steadily over the past decade in the United States, considerably increasing healthcare costs. Because of this, there have been attempts to develop nonanesthesiologist-administered propofol sedation methods in low-risk patients...
May 16, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29774151/gastrointestinal-endoscopy-under-sedation-is-associated-with-pneumonia-in-older-inpatients-results-of-a-retrospective-case-control-study
#2
Christopher M Kollmann, Wolff Schmiegel, Thorsten Brechmann
Background and aims: Apparent aspiration is a notable adverse event during gastrointestinal endoscopy under sedation (GIES), but data about inapparent aspiration are scarce. Generally, particularly older patients are at higher risk of suffering from adverse events. Objective: The objective of this article is to determine the risk of pneumonia, lower respiratory tract infection (LRI) and systemic inflammatory activation after GIES, especially in patients of at least 65 years...
April 2018: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/29759099/procedural-sedation-by-advanced-care-paramedics-for-emergency-gastrointestinal-endoscopy
#3
Hana M Wiemer, Michael B Butler, Patrick C Froese, Allan Lapierre, Chris Carriere, Glen R Etsell, Dana Farina, Jennifer Jones, Jock Murray, Samuel G Campbell
CLINICIAN'S CAPSULE What is known about the topic? Advanced care paramedics (ACPs) in our emergency department (ED) successfully perform procedural sedation and analgesia (PSA) for several procedures, including orthopedic manipulations. What did this study ask? How does the novel practice of ACP-led ED PSA for upper gastrointestinal (UGI) endoscopy compare to that for orthopedic procedures? What did this study find? Adverse events occurred more frequently during UGI endoscopy sedations than orthopedic sedations (41...
May 15, 2018: CJEM
https://www.readbyqxmd.com/read/29738382/the-comparison-of-midazolam-and-propofol-in-gastrointestinal-endoscopy-a-systematic-review-and-meta-analysis
#4
Rongzan Zhang, Quan Lu, Younong Wu
INTRODUCTION: Midazolam and propofol are both used for sedation in gastrointestinal endoscopy. We conducted a systematic review and meta-analysis to compare the efficacy and safety of midazolam and propofol in gastrointestinal endoscopy. MATERIALS AND METHODS: PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases were systematically searched. Randomized controlled trials assessing the effect of midazolam versus propofol on sedation in gastrointestinal endoscopy are included...
May 5, 2018: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/29703990/topical-pharyngeal-anesthesia-provides-no-additional-benefit-to-propofol-sedation-for-esophagogastroduodenoscopy-a-randomized-controlled-double-blinded-clinical-trial
#5
Xiaotian Sun, Yang Xu, Xueting Zhang, Aitong Li, Hanqing Zhang, Teng Yang, Yan Liu
Propofol sedation has been applied during esophagogastroduodenoscopy procedures, but whether topical pharyngeal anesthesia should be administered at the same time has rarely been reported. Our study examined the role of topical pharyngeal anesthesia in sedated endoscopies in a randomized controlled double-blinded clinical trial. A total of 626 patients who underwent sedated esophagogastroduodenoscopy were randomized into the experimental group (n = 313) or the control group (n = 313). The discomfort score, immediately and one day after the procedure, was not statistically significant [7...
April 27, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29678932/sedation-in-gi-endoscopy-a-paradigm-shift-has-taken-place
#6
Angelika Behrens, Christian Ell
No abstract text is available yet for this article.
April 20, 2018: Gut
https://www.readbyqxmd.com/read/29652031/association-between-patient-characteristics-and-magnetically-controlled-capsule-endoscopy-findings
#7
Huasheng Lai, Junsheng Huang, Yangzhi Xu, Jie Zhang, Zhenyu Chen, Fengcheng Xi, Aimin Li, Side Liu
Background/Aim: Magnetically-controlled capsule endoscopy (MCE) is a potential option for the evaluation of gastric diseases in cases that are unsuited for conventional endoscopy, avoiding discomfort, sedation, and related complications. This retrospective study investigated associations between MCE findings and patient gender, age, and inpatient/outpatient status. Patients and Methods: The data of 580 consecutive patients who underwent MCE from 2015 to 2016 were analyzed...
April 13, 2018: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
https://www.readbyqxmd.com/read/29643961/cecal-intubation-rates-in-different-eras-of-endoscopic-technological-development
#8
Maciej Matyja, Artur Pasternak, Mirosław Szura, Michał Pędziwiatr, Piotr Major, Kazimierz Rembiasz
Introduction: Colonoscopy plays a critical role in colorectal cancer (CRC) screening and has been widely regarded as the gold standard. Cecal intubation rate (CIR) is one of the well-defined quality indicators used to assess colonoscopy. Aim: To assess the impact of new technologies on the quality of colonoscopy by assessing completion rates. Material and methods: This was a dual-center study at the 2nd Department of Surgery at Jagiellonian University Medical College and at the Specialist Center "Medicina" in Krakow, Poland...
March 2018: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
https://www.readbyqxmd.com/read/29627276/a-review-on-drug-induced-sedation-endoscopy-technique-grading-systems-and-controversies
#9
REVIEW
Matt Lechner, Dominic Wilkins, Bhik Kotecha
Sleep disordered breathing (SDB) comprises a spectrum of disorders, ranging from simple snoring to severe obstructive sleep apnoea (OSA), with a significant burden to health care systems in high income countries. If left untreated, OSA has significant cumulative, long-term health consequences. In the 1990s drug induced sedation endoscopy (DISE) has been developed to become a primary tool in the diagnosis and management of OSA. It allows meticulous endoscopic evaluation of the airway and identifies areas of collapse, thereby informing both on the selection of surgical techniques, where efficacy depends entirely on success at relieving obstruction at a certain level and on the usefulness of conservative measures, such as mandibular advancement splints...
February 24, 2018: Sleep Medicine Reviews
https://www.readbyqxmd.com/read/29620411/patients-perspective-on-sedation-during-upper-gastrointestinal-endoscopy-systematic-use-of-sedation-or-systematic-prior-information
#10
Juan Ángel Ferrer Rosique, Héctor Julián Canaval Zuleta, Guillermo Cacho Acosta
Although sedation in endoscopy is increasingly used and contributes to the quality of procedures, its role in upper gastrointestinal endoscopy (UGE) is not as well defined as in other procedures. For this reason, we conducted a prospective pilot study where the patient, once informed of the different options, decided whether or not to undergo sedation for UGE. Remarkably, almost 60% preferred not to undergo sedation, with a high degree of satisfaction and no adverse effects in any of the groups (Ferrer Rosique JA, et al...
April 2018: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/29620410/sedation-assisted-by-an-endoscopist-sae-for-complex-endoscopic-procedures-is-it-time-to-change-the-current-guidelines
#11
Pablo Hernán Ocaña
Currently, sedation in endoscopic procedures is considered a necessary condition and a criterion of quality in digestive endoscopy. The role of SAE in conventional endoscopic procedures is clearly established in clinical guidelines, but this is not so clear in complex endoscopic procedures, such as ERCP. In recent years, numerous studies have been published, with results similar to those noticed in this article, endorsing the safety, efficacy and efficiency of SAE, when performed by properly trained staff.
April 2018: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/29620409/is-the-education-available-to-anesthetists-adequate-to-provide-sedation-in-endoscopy-units
#12
Francisco Pérez Roldán
It is a letter that aims to emphasize the type of sedation that is sometimes used by anesthetists to perform a standard endoscopy and the excessive use of the operating room, which increases the cost of endoscopy and reduces the resources of surgical time.
April 2018: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/29620407/enhancing-the-current-evidence-on-endoscopist-directed-propofol-based-sedation
#13
COMMENT
Enrique Pérez-Cuadrado-Robles, Alexandre Ferreira, Jesús García-Cano
During the last years, there is more and more scientific evidence about the safety and feasibility of non-anesthesiologist administration of propofol (NAAP) in gastrointestinal endoscopy, reducing sedation induction and recovery time as well as increasing patient and endoscopist satisfaction. Furthermore, a similar risk of adverse events compared with traditional agents or anesthesiologist administration of propofol (AAP) has been described. The present special issue of the Spanish Journal of Gastroenterology (Revista Española de Enfermedades Digestivas) focusses on NAAP in different settings, including complex endoscopic procedures...
April 2018: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/29611112/sedation-practices-in-gastrointestinal-endoscopy-a-survey-from-southern-india
#14
Prakash Zacharias, Shibi Mathew, John Mathews, Aby Somu, Maya Peethambaran, Menon Prashanth, Mathew Philip
Gastrointestinal endoscopies can cause an unpleasant experience for the patient. In India, most endoscopists follow a common institutional policy for sedation. The aim of this study was to analyze the sedation practices in various endoscopy centers across southern India. Data were collected with the help of a structured questionnaire given to a senior endoscopist of the center. Data from the completed questionnaire were later analyzed. Data were obtained from 19 centers across southern India. All endoscopy suites had central oxygen supply and emergency cart...
April 3, 2018: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/29598971/-gastrointestinal-endoscopy-in-patients-of-advanced-age
#15
Ana García García de Paredes, Beatriz Mateos Muñoz, Agustín Albillos
The dramatic increase in life expectancy is leading to a significant increase in the use of gastrointestinal endoscopy in the elderly. Taking into account these demographic changes, the use of gastrointestinal endoscopy in this age group is of great importance. Although these procedures are generally safe and well tolerated even in very elderly patients, the onset of physiological changes associated with aging and the increased prevalence of cardiovascular and pulmonary comorbidities raise the risk of sedation related complications in these patients...
March 26, 2018: Revista Española de Geriatría y Gerontología
https://www.readbyqxmd.com/read/29589170/computerized-tests-to-evaluate-recovery-of-cognitive-function-after-deep-sedation-with-propofol-and-remifentanil-for-colonoscopy
#16
Xavier Borrat, Marta Ubre, Raquel Risco, Pedro L Gambús, Angela Pedroso, Aina Iglesias, Gloria Fernandez-Esparrach, Àngels Ginés, Jaume Balust, Graciela Martínez-Palli
The use of sedation for diagnostic procedures including gastrointestinal endoscopy is rapidly growing. Recovery of cognitive function after sedation is important because it would be important for most patients to resume safe, normal life soon after the procedure. Computerized tests have shown being accurate descriptors of cognitive function. The purpose of the present study was to evaluate the time course of cognitive function recovery after sedation with propofol and remifentanil. A prospective observational double blind clinical study conducted in 34 young healthy adults undergoing elective outpatient colonoscopy under sedation with the combination of propofol and remifentanil using a target controlled infusion system...
March 27, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29588840/device-assisted-enteroscopy-in-the-uk-description-of-a-large-tertiary-case-series-under-conscious-sedation
#17
Vijay Pattni, David J Tate, Ana Terlevich, Peter Marden, Steve Hughes
Objective: Device-assisted enteroscopy (DAE) has developed rapidly, particularly with the advent of double-balloon enteroscopy (DBE). This study reports a case series from a UK tertiary centre for DAE across two modalities-DBE and spiral enteroscopy (SE)-under conscious sedation. Design: Retrospective observational study of 257 enteroscopy procedures from 2008 to 2014. Data were collected on demographics, indications, diagnosis, sedation requirements, duration, complications, tolerance, therapy performed and completion rate...
April 2018: Frontline Gastroenterology
https://www.readbyqxmd.com/read/29588837/nasal-unsedated-seated-percutaneous-endoscopic-gastrostomy-nupeg-a-safe-and-effective-technique-for-percutaneous-endoscopic-gastrostomy-placement-in-high-risk-candidates
#18
Adam McCulloch, Ovishek Roy, Dunecan Massey, Rachel Hedges, Serena Skerratt, Nicola Wilson, Jeremy Woodward
Objective: Percutaneous endoscopic gastrostomy (PEG) tube placement is associated with a high risk of cardiorespiratory complications in patients with significant respiratory compromise. This study reports a case series of high-risk patients undergoing PEG placement using a modified technique-nasal unsedated seated PEG (nuPEG) placement. Design: Retrospective review of 67 patients at high risk of complications undergoing PEG placement between September 2012 and December 2016...
April 2018: Frontline Gastroenterology
https://www.readbyqxmd.com/read/29580284/the-development-of-facility-standards-for-common-outpatient-procedures-and-implications-for-the-context-of-abortion
#19
Nancy F Berglas, Sarah C M Roberts
BACKGROUND: In recent years, an increasing number of states have enacted laws that impose specific requirements for facilities in which abortions are performed. In this study, we sought to understand the processes used to develop facility standards in the context of other, less politically charged areas of health care and consider implications for the context of abortion. METHODS: We conducted key informant interviews with 20 clinicians and accreditation professionals involved in facility standards development for common outpatient procedures (endoscopy, gynecology, oral surgery, plastic surgery)...
March 27, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29578351/endoscopy-and-sedation-an-inseparable-binomial-for-the-gastroenterologist
#20
Javier Crespo, Álvaro Terán
The development of endoscopy and its increasing demand among the population have led to a growing need for propofol-based sedation techniques. Benefit is indisputable for both patients and endoscopists, but some aspects require considering the "who" and "how" of sedation as related to safety and health care costs. Propofol is first-choice in endoscopy for the European Society of Gastrointestinal Endoscopy because of its fast onset of action and short half-life, and many reports exist on its safety when used by gastroenterologists rather than anesthesiologists...
April 2018: Revista Española de Enfermedades Digestivas
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