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Sedation in endoscopy

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https://www.readbyqxmd.com/read/28799428/full-spectrum-endoscopy-fuse-versus-standard-forward-viewing-endoscope-sfv-in-a-high-risk-population
#1
Søren Roepstorff, Sabah Anwar Hadi, Morten Rasmussen
OBJECTIVES: To investigate the diagnostic performance of Full Spectrum Endoscopy (FUSE) compared to a conventional standard forward-viewing endoscope (SFV). The primary outcome was adenoma detection rate (ADR) and mean adenoma detection. Secondary outcome was feasibility of FUSE opposed to SFV. MATERIALS AND METHODS: Consecutive patients participating in the Danish colorectal cancer (CRC) screening programme were prospectively included in the study (n = 205)...
August 11, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28759483/alarm-limits-for-intraoperative-drug-infusions-a-report-from-the-multicenter-perioperative-outcomes-group
#2
Mitchell F Berman, Nikhil Iyer, Leon Freudzon, Shuang Wang, Robert E Freundlich, Michelle Housey, Sachin Kheterpal
BACKGROUND: Continuous medication infusions are commonly used during surgical procedures. Alarm settings for infusion pumps are considered important for patient safety, but limits are not created in a standardized manner from actual usage data. We estimated 90th and 95th percentile infusion rates from a national database for potential use as upper limit alarm settings. METHODS: We extracted infusion rate data from 17 major hospitals using intraoperative records provided by Multicenter Perioperative Outcomes Group for adult surgery between 2008 and 2014...
July 27, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28741364/propofol-sedation-implementation-utility-of-the-failure-mode-and-effect-analysis-patient-focused-quality-and-safety
#3
Adrián Huergo Fernández, Pedro Amor Martín, Fernando Fernández Cadenas
Sedation is a key component of digestive endoscopy. While ensuring procedural safety and quality represents a primary goal, a detailed assessment of patient-focused risks and improvements is lacking on most occasions. Failure mode and effect analysis (FMEA) is a useful tool in this context as a means of raising barriers and defense mechanisms to prevent adverse events from developing.
July 25, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28730132/investigation-of-efficacy-of-lidocaine-spray-for-sedated-esophagogastroduodenoscopy-in-children
#4
Ahmet Basturk, Reha Artan, Aygen Yılmaz
PURPOSE: Our aim in this study is to investigate efficacy of topical lidocaine spray for sedated esophagogastroduodenoscopy (EGD) in children. METHODS: The endoscopy of children aged between 3-18 years who underwent EGD in our endoscopy unit. Intravenous (IV) midazolam and ketamine were used for sedation. Prior to sedation, endoscopy nurse applied topical lidocaine 10% with pump spray at 1 mg/kg dose in group 1, and distilled water via identically scaled pump spray in group 2, in a double blinded fashion...
June 2017: Pediatric Gastroenterology, Hepatology & Nutrition
https://www.readbyqxmd.com/read/28691048/feasibility-of-transnasal-endoscopy-in-screening-for-esophageal-and-gastric-varices-in-patients-with-chronic-liver-disease
#5
Anderson Antônio de Faria, Carlos Alberto Freitas Dias, Luciana Dias Moetzsohn, Silas de Castro Carvalho, Tereza Abreu Ferrari, Vitor Nunes Arantes
BACKGROUND AND STUDY AIMS:  Screening for esophageal and gastric varices is indicated for patients with portal hypertension or cirrhosis. Typically, conventional endoscopy is used; however, the need for sedation increases the costs and risks, especially in cirrhotic patients. Use of transnasal endoscopy with an ultrathin endoscope enables study of the upper gastrointestinal tract without the need for sedation. The objective of this study is to evaluate the feasibility of transnasal endoscopy in screening for esophageal and gastric varices in patients with chronic liver disease...
July 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28689426/enough-discussions-about-who-should-use-propofol-in-gastrointestinal-endoscopy
#6
Juan Jose Sebastián Domingo, Tomás Cabrera Chaves, Miguel Ángel Simón Marco
Reflections in order to agree on who should be responsible for the deep sedation with propofol in gastrointestinal endoscopies, after so many squabble between anaesthesiologists and endoscopists.
July 10, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28687379/moderate-sedation-changes-for-bronchoscopy-in-2017
#7
REVIEW
Michael E Nelson
The reimbursement for procedures using moderate (conscious) sedation has changed significantly as of January 1, 2017. Due to the increasing use of anesthesia services to provide moderate sedation during endoscopy, the Centers for Medicare & Medicaid Services made the decision to remove work relative value units from many of the services requiring moderate sedation, including the bronchoscopy codes. If a bronchoscopist provides moderate sedation to a patient without using anesthesia services or another qualified provider, that work (and revenue) can be reclaimed by using the relevant codes...
July 4, 2017: Chest
https://www.readbyqxmd.com/read/28681569/diagnostic-use-of-endoscopic-full-thickness-wall-resection-eftr-a-novel-minimally-invasive-technique-for-colonic-tissue-sampling-in-patients-with-severe-gastrointestinal-motility-disorders
#8
P V Valli, D Pohl, M Fried, R Caduff, P Bauerfeind
BACKGROUND: Complex gastrointestinal (GI) motility disorders such as chronic intestinal pseudo-obstruction (CIPO) or Hirschsprung's disease (HD) are challenging to diagnose and treat appropriately. Thorough assessment of patient history, radiographic exams, endoscopy, and motility measurements aid in diagnostic workup, yet underlying histology is the cornerstone to enable a more distinct diagnosis of neuromuscular GI disorders. Traditionally, surgical procedures have been performed to obtain specimen suitable for accurate histologic analysis...
July 6, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/28662195/the-relationship-between-minute-ventilation-and-end-tidal-co2-in-intubated-and-spontaneously-breathing-patients-undergoing-procedural-sedation
#9
Jaideep H Mehta, George W Williams, Brian C Harvey, Navneet K Grewal, Edward E George
BACKGROUND: Monitoring respiratory status using end tidal CO2 (EtCO2), which reliably reflects arterial PaCO2 in intubated patients under general anesthesia, has often proven both inaccurate and inadequate when monitoring non-intubated and spontaneously breathing patients. This is particularly important in patients undergoing procedural sedation (e.g., endoscopy, colonoscopy). This can be undertaken in the operating theater, but is also often delivered outside the operating room by non-anesthesia providers...
2017: PloS One
https://www.readbyqxmd.com/read/28654639/improvement-of-atropine-on-esophagogastric-junction-observation-during-sedative-esophagogastroduodenoscopy
#10
Zhihao Chen, Lingang Liu, Jiangfeng Tu, Guangming Qin, Weiwei Su, Xiaoge Geng, Xiaojun Chen, Hongguang Wu, Wensheng Pan
BACKGROUND AND STUDY AIMS: Although sedation esophagogastroduodenoscopy (EGD) is now widely used, previous research has reported that sedation during EGD exhibits a negative effect on esophagogastric junction (EGJ) exposure. Atropine might improve EGJ exposure, as noted in clinical practice. The aim of this study was to examine whether sedation had a negative effect on EGJ observation in the Chinese population, and whether atropine had some ability to act as an antidote to this unexpected secondary effect of sedation...
2017: PloS One
https://www.readbyqxmd.com/read/28643999/dexmedetomidine-and-general-anesthesia-a-narrative-literature-review-of-its-major-indications-for-use-in-adults-undergoing-non-cardiac-surgery
#11
Arthur Davy, Julien Fessler, Marc Fischler, Morgan le Guen
BACKGROUND: In Europe, dexmedetomidine has marketing approval only for sedation in intensive care units. However, its use during general anesthesia has been widely reported. The aim of this narrative review is to draw a picture of potential indications in anesthesia. METHODS: We searched in MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials using the keywords "Dexmedetomidine, Dexdor, Precedex and Dexdomitor". The research ended in December 2016...
June 22, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28621297/endoscopic-ultrasound-with-or-without-fine-needle-aspiration-has-a-meaningful-impact-on-clinical-care-in-the-pediatric-population
#12
Amit Raina, Maire A Conrad, Benjamin Sahn, Alireza Sedarat, Gregory G Ginsberg, Nuzhat A Ahmad, Vinay Chandrasekhara, Petar Mamula, Michael L Kochman
BACKGROUND AND OBJECTIVES: The safety and utility of endoscopic ultrasound (EUS) for the evaluation and management of gastrointestinal (GI) tract disorders among adults has been established. The literature on safety and efficacy in a pediatric referral population (under 21 years of age) is limited. We hypothesized that EUS is safe and useful in the pediatric population. We reviewed the pediatric EUS experience at a single tertiary-care system. We describe the indications, findings, safety, technical success rate, and impact on clinical outcomes...
May 2017: Endoscopic Ultrasound
https://www.readbyqxmd.com/read/28611336/safety-of-non-anesthesia-provider-administered-propofol-sedation-in-non-advanced-gastrointestinal-endoscopic-procedures-a-meta-analysis
#13
REVIEW
Basavana Gouda, Gowri Gouda, Anuradha Borle, Akash Singh, Ashish Sinha, Preet M Singh
BACKGROUND/AIMS: The aim of the study was to evaluate the safety of non-anesthesia provider (NAPP) administered propofol sedation in patients undergoing non-advanced gastrointestinal (GI) endoscopic procedures. MATERIALS AND METHODS: Pubmed, Embase, Cochrane central register of controlled trials, Scopus, and Web of Science databases were searched for prospective observational trials involving non-advanced endoscopic procedures. From a total of 608 publications, 25 [colonoscopy (9), upper GI endoscopy (5), and combined procedures (11)] were identified to meet inclusion criteria and were analyzed...
May 2017: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
https://www.readbyqxmd.com/read/28584940/drug-induced-sedation-endoscopy-dise-classification-systems-a-systematic-review-and-meta-analysis
#14
REVIEW
Esuabom Dijemeni, Gabriele D'Amone, Israel Gbati
PURPOSE: Drug-induced sedation endoscopy (DISE) classification systems have been used to assess anatomical findings on upper airway obstruction, and decide and plan surgical treatments and act as a predictor for surgical treatment outcome for obstructive sleep apnoea management. The first objective is to identify if there is a universally accepted DISE grading and classification system for analysing DISE findings. The second objective is to identify if there is one DISE grading and classification treatment planning framework for deciding appropriate surgical treatment for obstructive sleep apnoea (OSA)...
June 6, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/28579345/efficacy-and-safety-of-midazolam-and-ketamine-in-paediatric-upper-endoscopy
#15
Ahmet Basturk, Reha Artan, Aygen Yılmaz
BACKGROUND AND STUDY AIM: Upper endoscopy can be successfully carried out in children under deep sedation and anaesthesia. However, the best method of upper endoscopy for children who require gastrointestinal intervention has yet to be defined. The aim of this study is to investigate the efficacy and safety of the sedation induced by intravenous midazolam and ketamine during upper endoscopy in children. PATIENTS AND METHODS: This study included patients ages 3-18years who had undergone upper endoscopy...
June 1, 2017: Arab Journal of Gastroenterology: the Official Publication of the Pan-Arab Association of Gastroenterology
https://www.readbyqxmd.com/read/28576517/retrieval-of-tracheobronchial-foreign-bodies-by-short-flexible-endoscopy-in-children
#16
Wen-Jue Soong, Pei-Chen Tsao, Yu-Sheng Lee, Chia-Feng Yang
OBJECTIVES: Flexible endoscopy (FE) is frequently used to diagnose tracheobronchial foreign bodies (TBFB). However, it is still controversial for retrieval of TBFB in pediatric field. This study aims at reporting and evaluating our experiences of using short-length FE with a non-invasive ventilation (NIV) technique and intensive care unit (ICU) support in retrieving pediatric TBFB. METHODS: A retrospective review of the hospital database and FE videos of pediatric patients aged less than 18 year-old who were diagnosed of TBFB and managed in our hospital over a 17-year period (1999-2015)...
April 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28567375/video-capsule-colonoscopy-in-routine-clinical-practice
#17
Ervin Toth, Diana E Yung, Artur Nemeth, Gabriele Wurm Johansson, Henrik Thorlacius, Anastasios Koulaouzidis
BACKGROUND: Colon capsule endoscopy (CCE) offers direct mucosal visualisation without sedation or gas insufflation required in conventional colonoscopy (CC). However, evidence for the role of CCE as an adjunct or alternative to CC remains equivocal. In this observational cohort study, we report our experience of using CCE to investigate patients with suspected colon pathology at a tertiary referral centre. METHODS: From 2007-2015, consecutive patients requiring colonoscopy were recruited from a tertiary care centre in Malmo, Sweden...
May 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28561345/outcome-after-one-year-of-upper-airway-stimulation-for-obstructive-sleep-apnea-in-a-multicenter-german-post-market-study
#18
Armin Steffen, J Ulrich Sommer, Benedikt Hofauer, Joachim T Maurer, Katrin Hasselbacher, Clemens Heiser
OBJECTIVE/HYPOTHESIS: Upper airway stimulation (UAS) of the hypoglossal nerve has been implemented in the routine clinical practice for patients with moderate-to-severe obstructive sleep apnea (OSA) who could not adhere to continuous positive airway pressure. This study reports objective and patient-reported outcome after 12 months of implantation. STUDY DESIGN: Multicenter prospective single-arm study. METHODS: Consecutive patients who received the UAS system (Inspire Medical Systems, Inc...
May 31, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28540613/oral-capnography-is-more-effective-than-nasal-capnography-during-sedative-upper-gastrointestinal-endoscopy
#19
Wei-Nung Teng, Chien-Kun Ting, Yu-Tzu Wang, Ming-Chih Hou, Mei-Yung Tsou, Huihua Chiang, Chun-Li Lin
The role of capnography in esophagogastroduodenoscopy (EGD) is controversial. Simultaneous supplemental oxygen, position of patient, open mouth breathing pattern, and anatomy of the oral and nasal cavity can influence capnography accuracy. This study first measured capnographic data via the nasal or oral cavity during sedated EGD. Secondly, we investigated the influence of supplementary oxygen through the oral cavity on the capnographic reading. Patients with ASA class I or II status admitted for routine EGD exams were enrolled...
May 24, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28533665/new-flexible-endoscopic-controlled-stapler-technique-for-the-treatment-of-zenker-s-diverticulum-a-case-series
#20
Johanna Wilmsen, Robert Baumbach, Dietmar Stüker, Vincens Weingart, Frank Neser, Stefan Karl Gölder, Christof Pfundstein, Ellen Claudia Nötzel, Thomas Rösch, Siegbert Faiss
AIM: To report about the combination and advantages of a stapler-assisted diverticulotomy performed by flexible endoscopy. METHODS: From November 2014 till December 2015 17 patients (8 female, 9 male, average age 69.8 years) with a symptomatic Zenker diverticulum (mean size 3.5 cm) were treated by inserting a new 5 mm fully rotatable surgical stapler (MicroCutter30 Xchange, Cardica Inc.) next to an ultrathin flexible endoscope through an overtube. The Patients were under conscious sedation with the head reclined in left position, the stapler placed centrally and pushed forward to the bottom of the diverticulum...
May 7, 2017: World Journal of Gastroenterology: WJG
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