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Conscious sedation

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https://www.readbyqxmd.com/read/28738447/comparison-of-local-versus-general-anesthesia-in-patients-undergoing-transcatheter-aortic-valve-replacement-a-meta-analysis
#1
Pedro A Villablanca, Divyanshu Mohananey, Katarina Nikolic, Sripal Bangalore, David P Slovut, Verghese Mathew, Vinod H Thourani, Josep Rode's-Cabau, Iván J Núñez-Gil, Tina Shah, Tanush Gupta, David F Briceno, Mario J Garcia, Jacob T Gutsche, John G Augoustides, Harish Ramakrishna
BACKGROUND: Transcatheter aortic valve replacement (TAVR) is typically performed under general anesthesia (GA). However, there is increasing data supporting the safety of performing TAVR under local anesthesia/conscious sedation (LA). We performed a meta-analysis to gain better understanding of the safety and efficacy of LA versus GA in patients with severe aortic stenosis undergoing TAVR. METHODS AND RESULTS: We comprehensively searched EMBASE, PubMed, and Web of Science...
July 24, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28735717/real-time-cineangiography-visualization-of-cerebral-aneurysm-rupture-in-an-awake-patient-anatomic-physiological-and-functional-correlates
#2
Tasha L Welch, Waleed Brinjikji, Guiseppe Lanzino, William L Lanier
Intracranial aneurysms are common and, on a population-based perspective, are a major cause of morbidity and mortality as a result of mass effect or rupture. Cerebral angiography is the primary technique used for the diagnosis of cerebral aneurysms, and the imaging data have additional utility for planning medical, endovascular, or surgical treatments. An extremely rare periprocedural complication of cerebral angiography is rupture of the aneurysm, either as a chance phenomenon or as a result of some physiologic change or mechanical effect...
July 20, 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28734853/the-impact-of-mk-467-on-sedation-heart-rate-and-arterial-blood-pressure-after-intramuscular-coadministration-with-dexmedetomidine-in-conscious-cats
#3
Juhana Honkavaara, Bruno Pypendop, Jan Ilkiw
OBJECTIVE: To study the effects of MK-467, a peripheral α2-adrenoceptor antagonist, on sedation, heart rate and blood pressure after intramuscular (IM) coadministration with 25 μg kg(-1) of dexmedetomidine in cats. STUDY DESIGN: Prospective, randomized, controlled, blinded, cross-over, experimental study. ANIMALS: A total of eight healthy, adult, neutered male cats. METHODS: Cats were administered five IM treatments at least 2 weeks apart, consisting of dexmedetomidine 25 μg kg(-1) (D25), MK-467 600 μg kg(-1) (M600) and D25 combined with 300, 600 and 1200 μg kg(-1) of MK-467 (D25M300, D25M600 and D25M1200, respectively)...
March 22, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28723732/role-of-anesthesia-in-endovascular-stroke-therapy
#4
Arthur Wang, Apolonia E Abramowicz
PURPOSE OF REVIEW: Recent randomized clinical trials have demonstrated strong efficacy of endovascular therapy (EVT) for acute ischemic stroke (AIS) from large vessel occlusions; in the USA alone, tens of thousands of patients annually may benefit. The impact of the type of anesthesia used during mechanical thrombectomy on patient outcomes remains controversial. This review discusses the current literature on the effects of anesthesia type on patient outcome following endovascular stroke therapy...
July 18, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28720746/-a-rare-case-of-ruptured-internal-carotid-posterior-communicating-artery-aneurysm-associated-with-contralateral-delayed-oculomotor-nerve-palsy
#5
Chika Somagawa, Yutaka Fukuda, Shota Yoshimura, Kei Satoh, Takeshi Hiu, Tomonori Ono, Ryujirou Ushijima, Keisuke Toda, Keisuke Tsutsumi
A 55-year-old man presented with difficulty breathing, chest pain, and disturbance of consciousness, and was transferred to our hospital. Initial whole body CT revealed a diffuse subarachnoid hemorrhage(SAH)with severe pulmonary edema that was considered neurogenic in origin. He received controlled ventilation under sedation and conservative care for the SAH. One day after the onset of the SAH, his left pupil suddenly became dilated to 6mm, with no reaction to light. Head CT showed no new bleeding. Subsequent CT angiogram revealed a right internal carotid-posterior communicating artery aneurysm(IC-PC AN)with a posterior-lateral projection; however, no vessel abnormality was observed in the left anterior or posterior circulations...
July 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28718208/quantification-of-nasal-airflow-resistance-in-english-bulldogs-using-computed-tomography-and-computational-fluid-dynamics
#6
Eric T Hostnik, Brian A Scansen, Rachel Zielinski, Samir N Ghadiali
Stenotic nares, edematous intranasal turbinates, mucosal swelling, and an elongated, thickened soft palate are common sources of airflow resistance for dogs with brachycephalic airway syndrome. Surgery has focused on enlarging the nasal apertures and reducing tissue of the soft palate. However, objective measures of surgical efficacy are lacking. Twenty-one English bulldogs without previous surgery were recruited for this prospective, pilot study. Computed tomography was performed using conscious sedation and without endotracheal intubation using a 128 multidetector computed tomography scanner...
July 17, 2017: Veterinary Radiology & Ultrasound
https://www.readbyqxmd.com/read/28708923/preoperative-anxiety-and-its-influence-on-patient-and-surgeon-satisfaction-in-patients-receiving-dental-implant-surgeries-performed-under-intravenous-conscious-sedation
#7
Maite Bovaira, Alberto Herrero Babiloni, María Jovaní, Miguel Peñarrocha-Diago, Sandra González-Lemonnier, David Peñarrocha-Oltra
PURPOSE: The aims of this study were to evaluate the relationship of age, sex, and type and duration of the surgery with preoperative anxiety in patients undergoing dental implant surgeries under intravenous conscious sedation, and to assess preoperative anxiety association with the postoperative satisfaction of both the patient and surgeon. MATERIALS AND METHODS: This prospective study included 180 patients receiving dental implant surgeries under intravenous conscious sedation by means of midazolam, fentanyl, and propofol...
July 2017: International Journal of Oral & Maxillofacial Implants
https://www.readbyqxmd.com/read/28698343/protocol-for-an-observational-study-of-delirium-in-the-post-anaesthesia-care-unit-pacu-as-a-potential-predictor-of-subsequent-postoperative-delirium
#8
Victoria Cui, Catherine M Tedeschi, Vanessa L Kronzer, Sherry L McKinnon, Michael S Avidan
INTRODUCTION: Postoperative delirium can be a serious consequence of major surgery, associated with longer hospital stays, readmission, cognitive and functional deterioration and mortality. Delirium is an acute, reversible disorder characterised by fluctuating course, inattention, disorganised thinking and altered level of consciousness. Delirium occurring in the hours immediately following anaesthesia and delirium occurring in the postoperative period of 1-5 days have been described as distinct clinical entities...
July 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28687379/moderate-sedation-changes-for-bronchoscopy-in-2017
#9
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/28682828/criteria-for-intensive-care-admission-and-monitoring-after-elective-craniotomy
#10
Rafael Badenes, Lara Prisco, Armando Maruenda, Fabio S Taccone
PURPOSE OF REVIEW: The current article revises the recent evidence on ICU admission criteria and postoperative neuromonitoring for patients undergoing elective craniotomy. RECENT FINDINGS: Only a small proportion of elective postoperative neurosurgical patients require specific medical interventions and invasive monitoring. Among these, patients undergoing elective craniotomy are frequently admitted to neuro-ICU, specialist postanaesthesia care units or intermediate-level care unit in the postoperative period...
July 5, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28676733/evaluation-of-paracervical-block-and-iv-sedation-for-pain-management-during-hysteroscopic-polypectomy-a-randomized-clinical-trial
#11
Zahra Asgari, Maryam Razavi, Reihaneh Hosseini, Masoumeh Nataj, Mahroo Rezaeinejad, Mahdi Sepidarkish
BACKGROUND: The aim of this study was to compare the effectiveness of paracervical block (PB) and IV sedation (IVS) on women's pain perception during operative hysteroscopy. METHODS: A total of 84 patients with uterine polyps were randomized to either PB or IV sedation or general anesthesia (GA) as control group. In PB group, the patients received oral diazepam 10 mg and 100 mg diclofenac Na suppository 60 min before surgery and 10 cc of 2% buffered lidocaine was injected at cervix...
2017: Pain Research & Management: the Journal of the Canadian Pain Society
https://www.readbyqxmd.com/read/28670686/anaesthesia-practices-for-endovascular-therapy-of-acute-ischaemic-stroke-a-nordic-survey
#12
M Rasmussen, C Z Simonsen, L H Sørensen, S Dyrskog, D A Rusy, D Sharma, N Juul
BACKGROUND: The optimal method of anaesthesia for endovascular therapy (EVT) in acute ischaemic stroke (AIS) has not been identified. Nordic departments of anaesthesiology may handle EVT cases for AIS differently. The aim of this survey was to describe the current practice patterns of Nordic anaesthesia departments in anaesthetic management of EVT in AIS. METHODS: A survey consisting of 13 questions was sent to one qualified individual at all Nordic departments of anaesthesiology who manage anaesthesia for EVT interventions...
July 2, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28667541/serotonergic-medications-herbal-supplements-and-perioperative-serotonin-syndrome
#13
Mary E Warner, Julian Naranjo, Emily M Pollard, Toby N Weingarten, Mark A Warner, Juraj Sprung
PURPOSE: Perioperative use of serotonergic agents increases the risk of serotonin syndrome. We describe the occurrence of serotonin syndrome after fentanyl use in two patients taking multiple serotonergic agents. CLINICAL FEATURES: Two patients who had been taking multiple serotonergic medications or herbal supplements (one patient taking fluoxetine, turmeric supplement, and acyclovir; the other taking fluoxetine and trazodone) developed serotonin syndrome perioperatively when undergoing outpatient procedures...
June 30, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28664022/intracerebral-hemorrhage-caused-by-cerebral-hyperperfusion-after-superficial-temporal-artery-to-middle-cerebral-artery-bypass-for-atherosclerotic-occlusive-cerebrovascular-disease
#14
Fumihiro Matano, Yasuo Murai, Takayuki Mizunari, Koji Adachi, Shiro Kobayashi, Akio Morita
Few papers have reported detailed accounts of intracerebral hemorrhage caused by cerebral hyperperfusion after superficial temporal artery to middle cerebral artery bypass (STA-MCA) bypass for atherosclerotic occlusive cerebrovascular disease. We report a case of vasogenic edema and subsequent intracerebral hemorrhage caused by the cerebral hyperperfusion syndrome (CHS) after STA-MCA bypass for atherosclerotic occlusive cerebrovascular disease disease without intense postoperative blood pressure control. A 63-year-old man with repeating left hemiparesis underwent magnetic resonance angiography (MRA), which revealed right internal carotid artery (ICA) occlusion...
January 2017: NMC Case Rep J
https://www.readbyqxmd.com/read/28663606/conscious-sedation-emerging-trends-in-pediatric-dentistry
#15
REVIEW
Joginder Pal Attri, Radhe Sharan, Vega Makkar, Kewal Krishan Gupta, Ranjana Khetarpal, Amar Parkash Kataria
Dental fear and anxiety is a common problem in pediatric patients. There is considerable variation in techniques used to manage them. Various sedation techniques using many different anesthetic agents have gained considerable popularity over the past few years. Children are not little adults; they differ physically, psychologically, and emotionally. The purpose of this review is to survey recent trends and concerning issues in the rapidly changing field of pediatric sedation. We will study the topic from the perspective of an anesthesiologist...
April 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28655027/zolpidem-for-the-treatment-of-neurologic-disorders-a-systematic-review
#16
Martin N Bomalaski, Edward S Claflin, Whitney Townsend, Mark D Peterson
Importance: Given its selective action on the ω1 subtype of the γ-aminobutyric acid A receptor, zolpidem tartrate presents a potential treatment mechanism for other neurologic disorders. Objective: To synthesize studies that used zolpidem to treat neurologic disorders. Evidence Review: Eligibility criteria included any published English-language article that examined the use of zolpidem for noninsomnia neurologic disorders in humans for all dates up to March 20, 2015...
June 26, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28652659/single-operator-cholangioscopy-for-biliary-complications-in-liver-transplant-recipients
#17
Anna Hüsing-Kabar, Hauke Sebastian Heinzow, Hartmut Hans-Jürgen Schmidt, Carina Stenger, Hans Ulrich Gerth, Michele Pohlen, Gerold Thölking, Christian Wilms, Iyad Kabar
AIM: To evaluate cholangioscopy in addition to endoscopic retrograde cholangiopancreatography (ERCP) for management of biliary complications after liver transplantation (LT). METHODS: Twenty-six LT recipients with duct-to-duct biliary reconstruction who underwent ERCP for suspected biliary complications between April and December 2016 at the university hospital of Muenster were consecutively enrolled in this observational study. After evaluating bile ducts using fluoroscopy, cholangioscopy using a modern digital single-operator cholangioscopy system (SpyGlass DS™) was performed during the same procedure with patients under conscious sedation...
June 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28647109/-meopa-use-practices-in-a-university-hospital-which-conformity
#18
Caroline Victorri-Vigneau, Cécile Paille, Caroline Joyau, Gwenaëlle Veyrac, Claire Cosset, Aline Le Pelletier, Pascale Jolliet, Julien Nizard, Emmanuelle Kuhn
INTRODUCTION: MEOPA (equimolar mixture of oxygen and nitrous oxide) is used for its analgesic and anxiolytic properties in order to obtain conscious sedation of the patient when performing painful care. It is subject to an enhanced pharmacovigilance and addictovigilance monitoring. In this context, it is important to dispose of hospital utilization data. This work aims to assess the compliance of the use of nitrous oxide regarding the recommendations of the summary of product characteristics, in a French university hospital (Nantes) and consider possible improvements...
May 26, 2017: Thérapie
https://www.readbyqxmd.com/read/28639240/approach-to-thyroid-carcinoma-in-pregnancy
#19
Cristina Modesti, Paola Aceto, Lucia Masini, Celestino Pio Lombardi, Rocco Bellantone, Liliana Sollazzi
Thyroid carcinoma is the first cancer found in general population and the second diagnosed during pregnancy following the breast one. Diagnostic and therapeutic approaches to thyroid malignancy in pregnant women pose several and serious issues to the physicians. Even if there is no consensus about the surgical treatment of thyroid carcinomas during pregnancy, a large number of women undergo surgery over the world. The best surgical and anesthesiological treatment should be chosen after reaching a consensus between surgeons, anesthesiologists, obstetrics, and the patients...
June 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28633263/structural-valve-deterioration-of-a-subcoronary-implanted-stentless-bioprosthesis-how-to-treat
#20
Eva Karolina Harmel, Lenard Conradi, Ulrich Schäfer, Florian Deuschl, Niklas Schofer, Stefan Blankenberg, Hermann Reichenspurner, Evaldas Girdauskas
We present a case of transcatheter valve-in-valve replacement performed because of structural valve deterioration of a subcoronary implanted stentless aortic bioprosthesis. A 23-mm self-expandable transcatheter heart valve (THV) with supraannular seating was chosen. The procedure was performed with the patient under conscious sedation. After anchoring and partial valve deployment, the patient experienced an acute onset of angina. The angiogram showed left main coronary artery obstruction. Prompt resheathing and retrieval of the THV was performed, and the procedure was aborted...
July 2017: Annals of Thoracic Surgery
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