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Sedation in endoscopy

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https://www.readbyqxmd.com/read/28095614/over-the-scope-clip-closure-for-treatment-of-post-pancreaticogastrostomy-occurring-pancreatic-fistula-a-case-series
#1
Santi Mangiafico, Angelo Caruso, Raffaele Manta, Giuseppe Grande, Helga Bertani, Vincenzo Mirante, Flavia Pigò, Luigi Magnano, Mauro Manno, Rita Conigliaro
BACKGROUND AND AIM: The over-the-scope clip (OTSC) system is a recently developed endoscopic device. In the last few years it has been successfully used for severe bleeding or deep wall lesions, or perforations of the GI tract. We hereby report a series of patients with post pancreaticogastrostomy occuring pancreatic fistula in whom OTSCs were used as endoscopic treatment. METHODS: We prospectively collected data from January 2012 to July 2015 about cases of postoperative pancreatic fistula...
January 17, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28079763/the-comparison-of-etomidate-and-propofol-anesthesia-in-patients-undergoing-gastrointestinal-endoscopy-a-systematic-review-and-meta-analysis
#2
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...
January 10, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28076483/sedation-in-colonoscopy-by-using-three-different-propofol-infusion-methods-and-analysis-of-plasma-concentration-levels-a-prospective-comparative-study
#3
Paulo Henrique Boaventura de Carvalho, José Pinhata Otoch, Mohamad Ali Khan, Paulo Sakai, Hugo Gonçalo Guedes, Everson Luiz de Almeida Artifon
Background: The propofolemia becomes directly linked to the clinical effects of this anesthetic and is the focus for studies comparing propofol clinical use, in different administration methods routinely used in endoscopy units where sedation is widely administered to patients. Aim: To evaluate the effects of three different regimens of intravenous propofol infusion in colonoscopies. Methods: A total of 50 patients that underwent colonoscopies were consecutively assigned to three groups: 1) intermittent bolus infusion; 2) continuous manually controlled infusion; 3) continuous automatic infusion...
November 2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
https://www.readbyqxmd.com/read/28070096/acute-kidney-injury-following-vomiting-and-diarrhea-after-endoscopy-in-a-duodenal-gastrinoma-patient
#4
Miyabi Miura, Kazuya Kitamura, Kuniaki Arai, Kazunori Kawaguchi, Taro Yamashita, Yoshio Sakai, Tatsuya Yamashita, Eishiro Mizukoshi, Masao Honda, Shuichi Kaneko
A 51-year-old woman complaining of weakness in the limbs was diagnosed as having a duodenal gastrinoma on performing a further evaluation. Surgical resection was performed with selective arterial calcium injection for localization. During preoperative hospitalization, she experienced recurrent severe vomiting and diarrhea after endoscopy, leading to acute kidney injury. To our knowledge, this is the first report of gastrinoma with post-endoscopy symptom exacerbation. Although the etiology is unknown, the findings in this case suggest that sufficient fluid replacement, sedation, and high-dose proton pump inhibitor administration should be taken into consideration when performing endoscopy in gastrinoma patients...
2017: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
https://www.readbyqxmd.com/read/28060257/drug-induced-sleep-endoscopy-dise-with-target-controlled-infusion-tci-and-bispectral-analysis-in-obstructive-sleep-apnea
#5
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/28058020/high-flow-nasal-oxygen-availability-for-sedation-decreases-the-use-of-general-anesthesia-during-endoscopic-retrograde-cholangiopancreatography-and-endoscopic-ultrasound
#6
Roman Schumann, Nikola S Natov, Klifford A Rocuts-Martinez, Matthew D Finkelman, Tom V Phan, Sanjay R Hegde, Robert M Knapp
AIM: To examine whether high-flow nasal oxygen (HFNO) availability influences the use of general anesthesia (GA) in patients undergoing endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS) and associated outcomes. METHODS: In this retrospective study, patients were stratified into 3 eras between October 1, 2013 and June 30, 2014 based on HFNO availability for deep sedation at the time of their endoscopy. During the first and last 3-mo eras (era 1 and 3), no HFNO was available, whereas it was an option during the second 3-mo era (era 2)...
December 21, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28042391/identification-of-factors-associated-with-sedation-tolerance-in-5000-patients-undergoing-outpatient-colonoscopy-canadian-tertiary-center-experience
#7
Alexandra Shingina, George Ou, Oliver Takach, Sigrid Svarta, Ricky Kwok, Jessica Tong, Kieran Donaldson, Eric Lam, Robert Enns
AIM: To develop a prediction model aimed at identifying patients that may require higher than usual sedation doses during colonoscopy. METHODS: A retrospective chart review on 5000 patients who underwent an outpatient colonoscopy at St. Paul's Hospital from 2009 to 2010 was conducted in order to develop a model for identifying patients who will require increased doses of sedatives. Potential predictor variables including age, gender, endoscopy indication, high sedation requirements during previous endoscopies, difficulty of the procedure, bowel preparation quality, interventions, findings as well as current use of benzodiazepines, opioids and alcohol were analyzed...
December 16, 2016: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28039246/safety-of-sedation-for-gastrointestinal-endoscopy-in-a-group-of-university-affiliated-hospitals-a-prospective-cohort-study
#8
K Leslie, M L Allen, E C Hessian, P J Peyton, J Kasza, A Courtney, P A Dhar, J Briedis, S Lee, A R Beeton, D Sayakkarage, S Palanivel, J K Taylor, A J Haughton, C X O'Kane
BACKGROUND: Service models for gastrointestinal endoscopy sedation must be safe, as endoscopy is the most common procedure performed under sedation in many countries. The aim of this prospective cohort study was to determine the patient risk profile, and incidence of and risk factors for significant unplanned events, in adult patients presenting for gastrointestinal endoscopy in a group of university-affiliated hospitals where most sedation is managed by anaesthetists. METHODS: Patients aged ≥18 yr presenting for elective and emergency gastrointestinal endoscopy under anaesthetist-managed sedation at nine hospitals affiliated with the University of Melbourne, Australia, were included...
January 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28009665/capnography-compared-to-pulse-oximetry-for-early-detection-of-respiratory-compromise-in-non-intubated-patients-undergoing-gastrointestinal-endoscopy-procedures-a-systematic-review-protocol
#9
Jace Holton, Bryan Flattery
Does the use of capnography versus pulse oximetry increase the early detection of respiratory compromise and improve safety in non-intubated patients undergoing moderate sedation for gastrointestinal endoscopy procedures?Respiratory compromise will be detected by alveolar hypoventilation/hyperventilation (EtCO2 < 35 mmHg/EtCO2 > 50 mmHg), arterial oxygen desaturation (defined as a pulse oximetry reading of <95% for >5 s), visual assessments of abnormal ventilation including apnea detection and adverse respiratory events that involve the need for bag-mask ventilation...
December 2016: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28004964/patient-safety-under-deep-sedation-for-digestive-endoscopic-procedures
#10
Julián Álvarez, Rafael Cabadas, Manuel de la Matta
Deep sedation with Propofol has become popular in recent years. The safety of this technique when administered by non-anaesthesiologists has created much controversy which at times is masked in a contentious debate on the economic sustainability of the health system. In 2011, the Spanish Society of Anaesthesiology, Resuscitation and Pain Therapy, along with 20 other organisations from European countries, revoked the recommendations of the European Society of Gastrointestinal Endoscopy on the administration of Propofol by non-anaesthesiologists, citing that it is "extremely dangerous for the safety and quality of endoscopic procedures"...
December 22, 2016: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/27995433/direct-percutaneous-endoscopic-jejunostomy-dpej-tube-placement-a-single-institution-experience-and-outcomes-to-30-days-and-beyond
#11
Andrew T Strong, Gautam Sharma, Matthew Davis, Michael Mulcahy, Suriya Punchai, Colin P O'Rourke, Stacy A Brethauer, John Rodriguez, Jeffrey L Ponsky, Matthew D Kroh
INTRODUCTION: Patients with prior foregut surgery requiring long-term enteral access typically undergo operative jejunostomy tube placement; however, direct percutaneous endoscopic jejunostomy (DPEJ) is a viable alternative. METHODS: All de novo DPEJ procedures performed by surgical and advanced endoscopists from May 2003 to June 2015 were retrospectively reviewed following approval by the Institutional Review Board. There were 59 cases identified. RESULTS: Our cohort had a mean age of 50...
December 19, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/27931639/complications-in-pediatric-endoscopy
#12
REVIEW
Andrea Tringali, Valerio Balassone, Paola De Angelis, Rosario Landi
The experience of the "endoscopic community" in pediatric patients is limited, but during recent years increased skills of the endoscopists and technological improvements lead to a standardization of pediatric endoscopy and the development of specialized pediatric endoscopy unit. Adverse events related to diagnostic and therapeutic endoscopy in children are usually rare. Diagnosis, prevention and treatment of complications in pediatric endoscopy is crucial when dealing with benign diseases in children. The complication rate of diagnostic EGD and colonoscopy in children are extremely low...
October 2016: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/27902596/portable-disposable-ultrathin-endoscopy-tested-through-percutaneous-endoscopic-gastrostomy
#13
Myong Ki Baeg, Chul-Hyun Lim, Jin Su Kim, Yu Kyung Cho, Jae Myung Park, Bo-In Lee, In-Seok Lee, Myung-Gyu Choi
BACKGROUND: A portable disposable ultrathin endoscope (DUE) with high visual quality and maneuverability would reduce the need for expensive facilities and emergency endoscopy could be available anywhere. It would increase patient satisfaction, prevent unnecessary sedation, and reduce infection. Our aim was to evaluate the usefulness of portable DUE in performing percutaneous endoscopic gastrostomy (PEG). METHODS: We prospectively enrolled patients who underwent PEG under DUE guidance and compared them with historical controls who underwent PEG under conventional ultrathin endoscopy (CUE) guidance...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27893159/modified-technique-for-common-carotid-artery-transposition-in-standing-horses
#14
Heidi Tapio, David Argüelles, Luis A Gracia-Calvo, Marja Raekallio
OBJECTIVE: To describe a modified technique for permanent translocation of the common carotid artery (CCA) to a subcutaneous position in standing horses. STUDY DESIGN: Experimental study. ANIMALS: Healthy adult Standardbred and Warmblood horses (n = 8). METHODS: Surgery was performed with the horses standing under sedation and with local anesthesia. A combination of previously described techniques was used modifying the approach and closure of the incision...
November 28, 2016: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/27889545/comparison-of-carbon-dioxide-and-air-insufflation-during-consecutive-esophagogastroduodenoscopy-and-colonoscopy-in-moderate-sedation-patients-a-prospective-double-blind-randomized-controlled-trial
#15
Su Young Kim, Jun-Won Chung, Dong Kyun Park, Kwang An Kwon, Kyoung Oh Kim, Yoon Jae Kim, Jung Ho Kim
BACKGROUND AND AIMS: Endoscopy is performed with air insufflation and is usually associated with abdominal pain. It is well recognized that carbon dioxide (CO2) is absorbed more quickly into the body than air; however, to date, few studies have investigated the use of CO2 insufflation during consecutive esophagogastroduodenoscopy and colonoscopy (CEC). Thus, this study evaluated the efficacy of CO2 insufflation compared with air insufflation in CEC. METHODS: From March 2014 to April 2016, a total of 215 consecutive patients were randomly assigned to receive CO2 insufflation (CO2 group, n=108) or air insufflation (air group, n=107)...
November 23, 2016: Gastrointestinal Endoscopy
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...
November 24, 2016: Obesity Surgery
https://www.readbyqxmd.com/read/27843963/comparative-evaluation-between-two-methods-of-induced-hypotension-with-infusion-of-remifentanil-and-labetalol-during-sinus-endoscopy
#17
Parvin Sajedi, Ali Rahimian, Gholamreza Khalili
OBJECTIVE: This study aimed to compare two methods of controlled hypotension using labetalol and remifentanil in terms of capability to create controlled hypotension and to investigate the obtained complications, and satisfaction rate of surgeon and patient during functional endoscopic sinus surgery. METHODS: In this prospective clinical trial, 62 patients underwent endoscopic sinus surgery in Al-Zahra and Ayatollah Kashani Hospitals of Isfahan were divided into two groups: in the first group, 20 mg bolus dose of labetalol and then infusion of it, at a rate of 0...
October 2016: Journal of Research in Pharmacy Practice
https://www.readbyqxmd.com/read/27832689/comparison-of-oral-midazolam-with-intravenous-midazolam-for-sedation-children-during-upper-gastrointestinal-endoscopy
#18
RANDOMIZED CONTROLLED TRIAL
Ahmad Khodadad, Majid Aflatoonian, Rozita Jalilian, Nazanin Babaei, Farzaneh Motamed, Alireza Ebrahime Soltani, Behnaz Rasoolzadeh, Fatemeh Motavasselian, Nima Rezaei
Upper endoscopy is a common procedure for the diagnosis and treatment of upper digestive tract diseases. The increasing number of pediatric gastrointestinal procedures has led to increasing attention on the safety and efficacy of medications used for sedation during the procedure. This randomized blinded interventional study was designed to compare the effect of oral midazolam with intravenous (IV) midazolam as a sedative medication in 119 children undergoing endoscopy. The mean time to sedation was 2.2±0...
September 2016: Acta Medica Iranica
https://www.readbyqxmd.com/read/27832555/driving-impairment-due-to-propofol-at-effect-site-concentrations-relevant-after-short-propofol-only-sedation
#19
J L Telles, S Agarwal, J Monagle, C Stough, R King, L Downey
Australian guidelines state "Following brief surgery or procedures with short acting anaesthetic drugs, the patient may be fit to drive after a normal night's sleep. After long surgery or procedures requiring longer lasting anaesthesia, it may not be safe to drive for 24 hours or more". The increasing use of the short-acting anaesthetic drug propofol as a solitary sedative medication for simple endoscopy procedures suggests a need to review this blanket policy. Thirty patients presenting for elective day surgery were recruited as volunteers for a pre-procedure driving simulation study and randomised to propofol or placebo arms...
November 2016: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/27829941/a-comparison-of-propofol-and-midazolam-meperidine-sedation-in-upper-gastrointestinal-endoscopy
#20
Sinan Uzman, Bunyamin Gurbulak, Esin Kabul Gurbulak, Turgut Donmez, Adnan Hut, Dogan Yildirim
INTRODUCTION: There is increasing interest in sedation for upper gastrointestinal endoscopy (UGE). Prospective randomized studies comparing sedation properties and complications of propofol and midazolam/meperidine in upper gastrointestinal endoscopy (UGE) are few. AIM: To compare propofol and midazolam/meperidine sedation for UGE in terms of cardiopulmonary side effects, patient and endoscopist satisfaction and procedure-related times. MATERIAL AND METHODS: This was a prospective, randomized, double-blind study of propofol versus midazolam and meperidine in 100 patients scheduled for diagnostic upper gastrointestinal endoscopy...
2016: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
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