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Conscious sedation

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https://www.readbyqxmd.com/read/28916485/moderate-intravenous-sedation-for-first-trimester-surgical-abortion-a-comparison-of-adverse-outcomes-between-obese-and-normal-weight-women
#1
Gillian Horwitz, Danielle Roncari, Kari Braaten, Rie Maurer, Jennifer Fortin, Alisa B Goldberg
OBJECTIVE: To determine if obese women experience increased rates of adverse outcomes with moderate intravenous sedation during first trimester surgical abortion compared to normal weight women. STUDY DESIGN: We performed a retrospective cohort study of all first trimester surgical abortions with moderate intravenous sedation at an outpatient facility between September 2010 and June 2015. The primary outcome was supplemental oxygen administration. Secondary outcomes included reversal agent administration, anesthesia-related adverse events, and intraoperative lowest level of consciousness (LLOC)...
September 13, 2017: Contraception
https://www.readbyqxmd.com/read/28916346/radiofrequency-ablation-of-t1a-renal-cell-carcinomas-within-renal-transplant-allografts-oncologic-outcomes-and-graft%C3%A2-viability
#2
Derek W Cool, John R Kachura
PURPOSE: To evaluate oncologic outcomes and graft viability after percutaneous RF ablation of renal cell carcinoma (RCC) developing within renal transplant allografts. MATERIALS AND METHODS: A single-institution, retrospective study reviewed all patients treated with RF ablation for RCC between February 2004 and May 2016. Ten patients were identified (age 49.6 y ± 12.6; 9 men, 1 woman) with 12 biopsy-confirmed RCC tumors within the allograft (all T1a, mean diameter 2...
September 13, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28904794/dexmedetomidine-provides-less-body-motion-and-respiratory-depression-during-sedation-in-double-balloon-enteroscopy-than-midazolam
#3
Hiroshi Oshima, Masanao Nakamura, Osamu Watanabe, Takeshi Yamamura, Kohei Funasaka, Eizaburo Ohno, Hiroki Kawashima, Ryoji Miyahara, Hidemi Goto, Yoshiki Hirooka
OBJECTIVES: Patients undergoing double-balloon enteroscopy require sedatives such as midazolam; however, patient's body motion often hampers the outcome of double-balloon enteroscopy. Recently, dexmedetomidine has been used for endoscopic sedation and was reported to effectively reduce body motion. This study aimed to evaluate the efficacy and safety of sedation with dexmedetomidine in double-balloon enteroscopy (UMIN ID000015785). METHODS: A prospective, observational study was conducted in 81 patients who underwent 111 double-balloon enteroscopy from July to December 2015 (dexmedetomidine group)...
2017: SAGE Open Medicine
https://www.readbyqxmd.com/read/28904501/patient-experience-with-conscious-sedation-as-a-method-of-pain-relief-for-transvaginal-oocyte-retrieval-a-cross-sectional-study
#4
Himanshu Singhal, Prasanna S Premkumar, Achamma Chandy, Aleyamma T Kunjummen, Mohan S Kamath
AIM: The aim of the study was to measure patient's satisfaction level and acceptance of conscious sedation as a method of pain relief following transvaginal oocyte retrieval (TVOR) during assisted reproduction technology treatment. We also evaluated the factors that may influence the efficacy of conscious sedation method. SETTING AND DESIGN: A prospective cross-sectional study. MATERIALS AND METHODS: Prospective study was conducted from October 2015 to January 2016 at a university-level hospital and 100 women were recruited...
April 2017: Journal of Human Reproductive Sciences
https://www.readbyqxmd.com/read/28904228/anesthesia-related-outcomes-for-endovascular-stroke-revascularization-a-systematic-review-and-meta-analysis
#5
Waleed Brinjikji, Jeffrey Pasternak, Mohammad H Murad, Harry J Cloft, Tasha L Welch, David F Kallmes, Alejandro A Rabinstein
BACKGROUND AND PURPOSE: There is currently controversy on the ideal anesthesia strategy during mechanical thrombectomy for acute ischemic stroke. We performed a systematic review and meta-analysis of studies comparing clinical and angiographic outcomes of patients undergoing general anesthesia (GA group) and those receiving either local anesthesia or conscious sedation (non-GA group). METHODS: A literature search on anesthesia and endovascular treatment of acute ischemic stroke was performed...
September 13, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28887807/feasibility-of-multiplane-microtransoesophageal-echocardiographic-guidance-in-structural-heart-disease-transcatheter-interventions-in-adults
#6
V J Nijenhuis, A Alipour, N C Wunderlich, B J W M Rensing, G Gijsbers, J M Ten Berg, M J Suttorp, L V A Boersma, J A S van der Heyden, M J Swaans
INTRODUCTION: Structural heart interventions are guided by transoesophageal or intracardiac echocardiography (TEE/ICE). MicroTEE, developed for paediatric purposes, is smaller and therefore less invasive and traumatic, avoiding the need for general anaesthesia. We aimed to show feasibility of procedural guidance by comparing image quality of microTEE with standard TEE and ICE during adult transcatheter interventions, and assess the accuracy in obtaining left atrial appendage (LAA) measurements between the microTEE probe and standard TEE...
September 8, 2017: Netherlands Heart Journal
https://www.readbyqxmd.com/read/28887680/cervical-vertebroplasty-under-sedoanalgesia-using-combined-ultrasonography-and-fluoroscopy-guidance-a-novel-technique
#7
Serbülent Gökhan Beyaz, Havva Sayhan, Mustafa Erkan İnanmaz, Mustafa Orhan
PURPOSE: The aim of this report was to describe a case using combined USG and fluoroscopy for cervical VP via a percutaneous route under sedoanalgesia. METHODS: A 70-year-old male patient had severe neck pain for 6 weeks because of metastatic mass lesions in C6. After the decision to VP, the patient was placed on the operating table and 2 mg midazolam and 75 µg fentanyl were administered for conscious sedation. Localisation of the carotid artery, internal jugular vein, and trachea had been determined with USG...
September 8, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28879313/developmental-procedures-for-the-clinical-practice-guidelines-for-conscious-sedation-in-dentistry-for-the-korean-academy-of-dental-sciences
#8
So-Youn An, Kwang-Suk Seo, Seungoh Kim, Jongbin Kim, Deok-Won Lee, Kyung-Gyun Hwang, Hyun Jeong Kim
BACKGROUND: Evidence-based clinical practice guidelines (CPGs) are defined as "statements that are scientifically reviewed about evidence and systematically developed to assist in the doctors' and patients' decision making in certain clinical situations." This recommendation aims to promote good clinical practice for the provision of safe and effective practices of conscious sedation in dentistry. METHODS: The development of this clinical practice guideline was conducted by performing a systematic search of the literature for evidence-based CPGs...
December 2016: J Dent Anesth Pain Med
https://www.readbyqxmd.com/read/28877087/percutaneous-endoscopic-gastrostomy-under-conscious-sedation-in-patients-with-amyotrophic-lateral-sclerosis-is-safe-an-observational-study
#9
Denise Strijbos, José Hofstede, Daniel Keszthelyi, Ad A M Masclee, Lennard P L Gilissen
OBJECTIVES: Amyotrophic lateral sclerosis (ALS) is a progressive neuromuscular disease that causes muscle weakness with respiratory and swallowing dysfunction, eventually leading to death. Permanent enteral feeding is indicated in almost all patients. A percutaneous endoscopic gastrostomy (PEG) tube is considered the first choice, usually performed under conscious sedation (intravenous midazolam). Guidelines are very cautious with respect to sedation in ALS because of the risk for respiratory complications...
September 4, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28875137/risk-factor-analysis-of-additional-administration-of-sedative-agent-and-patient-dissatisfaction-in-intravenous-conscious-sedation-using-midazolam-for-third-molar-extraction
#10
Dong-Whan Shin, Jin-Yong Cho, Yoon-Sic Han, Hye-Young Sim, Hee-Sun Kim, Da-Un Jung, Ho Lee
OBJECTIVES: The primary purpose of this study was to investigate the factors related with additional administration of sedative agent during intravenous conscious sedation (IVS) using midazolam (MDZ). The secondary purpose was to analyze the factors affecting patient satisfaction. MATERIALS AND METHODS: Clinical data for 124 patients who had undergone surgical extraction of mandibular third molar under IVS using MDZ were retrospectively investigated in this case-control study...
August 2017: Journal of the Korean Association of Oral and Maxillofacial Surgeons
https://www.readbyqxmd.com/read/28872988/effect-of-sedation-with-midazolam-and-time-to-discharge-among-pediatric-dental-patients
#11
Sigalit Blumer, Benjamin Peretz, Gali Zisman, Tal Ratson
OBJECTIVE: The aim of this study was to examine the recovery time of children who underwent conscious sedation with oral or rectal midazolam. STUDY DESIGN: The medical files in the Department of Pediatric Dentistry of all the children who underwent conscious sedation with midazolam between 3/2013-4/2016 were examined. The total duration of sedation and time to discharge were calculated. Descriptions of the children's behavior before and during sedation were compared...
2017: Journal of Clinical Pediatric Dentistry
https://www.readbyqxmd.com/read/28872700/optimal-procedural-sequence-for-same-day-bidirectional-endoscopy-with-moderate-sedation-a-prospective-randomized-study
#12
Shuo-Wei Chen, Chi-Liang Cheng, Nai-Jen Liu, Jui-Hsiang Tang, Yen-Lin Kuo, Cheng-Hui Lin, Yi-Ning Tsui, Bai-Ping Lee, Hsiang-Ling Hung
BACKGROUND AND AIM: Same-day bidirectional endoscopy (BDE) is a commonly performed procedure, but the optimal sequence for the procedure with moderate conscious sedation is not well-established. We investigated the optimal sequence for same-day BDE under moderate conscious sedation and carbon dioxide insufflation in terms of sedation doses, patient discomfort, and colonoscopy performance. METHODS: We performed a prospective randomized controlled study of 120 patients who were scheduled for BDE examination...
September 5, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28864443/conscious-sedation-versus-general-anesthesia-for-transcatheter-aortic-valve-replacement-insights-from-the-ncdr%C3%A2-sts-acc-tvt-registry
#13
Matthew C Hyman, Sreekanth Vemulapalli, Wilson Y Szeto, Amanda Stebbins, Prakash A Patel, Roland A Matsouaka, Howard C Herrmann, Saif Anwaruddin, Taisei Kobayashi, Nimesh D Desai, Prashanth Vallabhajosyula, Fenton H McCarthy, Robert Li, Joseph E Bavaria, Jay Giri
Background -Conscious sedation is used during transcatheter aortic valve replacement (TAVR) with limited evidence as to the safety and efficacy of this practice. Methods -The NCDR STS/ACC TVT Registry was used to characterize the anesthesia choice and clinical outcomes of all U.S. patients undergoing elective percutaneous transfemoral TAVR between April 1, 2014 and June 30, 2015. Raw and inverse probability of treatment weighted (IPTW) analyses were performed to compare general anesthesia patients with conscious sedation patients on an intention-to-treat basis for the primary outcome of in-hospital mortality, and secondary outcomes including 30-day mortality, in-hospital and 30-day death/stroke, procedural success, ICU and hospital length-of-stay, and rates of discharge to home...
September 1, 2017: Circulation
https://www.readbyqxmd.com/read/28858548/squamous-papilloma-causing-airway-obstruction-during-conscious-sedation
#14
Paul Brady, Christine McCreary, Ken D O'Halloran, Catherine Gallagher
Monitoring for respiratory depression is essential during conscious sedation. We report a case of a squamous papilloma as an unusual cause of intermittent partial airway obstruction in a 43-year-old man undergoing intravenous conscious sedation with midazolam. The Integrated Pulmonary Index (IPI) is an algorithm included in some commercially available monitors that constitutes a representation of 4 parameters: end-tidal carbon dioxide, respiratory rate, oxygen saturation, and pulse rate. We discuss the potential of the IPI as a monitoring tool during sedation...
2017: Anesthesia Progress
https://www.readbyqxmd.com/read/28856114/total-intravenous-anesthesia-for-neurosurgical-procedures-in-narcoleptic-patients-two-case-reports
#15
Sara Pedrosa, Nuno Lareiro, Pedro Amorim
INTRODUCTION: Narcoleptic patients may be at increased risk of prolonged emergence, postoperative hypersomnia, apneic episodes, and sleep paralysis after general anesthesia. Modafinil is the first-line treatment, however, the implication it has on general anesthesia is not clear. This report present 2 cases of narcoleptic patients medicated with modafinil that were submitted to total intravenous anesthesia for neurosurgical procedures. CASE PRESENTATION: Informed consent was obtained from both patients...
June 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/28843663/risk-factors-and-outcomes-of-critically-ill-patients-with-acute-brain-failure-a-novel-end-point
#16
Tarun D Singh, John C O'Horo, Ognjen Gajic, Amra Sakusic, Courtney N Day, Jay Mandrekar, Rahul Kashyap, Dereddi Raja Shekar Reddy, Alejandro A Rabinstein
OBJECTIVE: To determine the incidence, risk factors and outcomes of acute brain failure (ABF) in a mixed medical and surgical cohort of critically ill patients and its effect on ICU & hospital mortality. DESIGN: Observational electronic medical record (EMR) based retrospective cohort study of critically ill patients admitted to the ICU between 2006 and 2013. SETTING: Tertiary academic medical center. PATIENTS: Consecutive adult (>18years) critically ill patients admitted to medical and surgical ICUs...
August 18, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28831314/surgery-averted-using-a-novel-minimally-invasive-approach-to-treat-very-severe-radial-artery-spasm
#17
Anthony A Cochet, Daniel A Bellin
A 42-year-old male admitted with a non-ST elevation myocardial infarction was referred for invasive angiographic assessment. Based on preprocedural assessment, the right radial artery approach was selected. Despite possessing none of the consensus risk factors for radial artery spasm, in addition to receiving standard arterial spasm prophylaxis and conscious sedation, the patient suffered very severe radial artery spasm with initial catheter placement, resulting in entrapment of a 5 Fr pigtail catheter within the left ventricle...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28819211/dynamic-local-connectivity-uncovers-altered-brain-synchrony-during-propofol-sedation
#18
Rose Dawn Bharath, Rajanikant Panda, Jitender Saini, Kamath Sriganesh, G S Umamaheswara Rao
Human consciousness is considered a result of the synchronous "humming" of multiple dynamic networks. We performed a dynamic functional connectivity analysis using resting state functional magnetic resonance imaging (rsfMRI) in 14 patients before and during a propofol infusion to characterize the sedation-induced alterations in consciousness. A sliding 36-second window was used to derive 59 time points of whole brain integrated local connectivity measurements. Significant changes in the connectivity strength (Z Corr) at various time points were used to measure the connectivity fluctuations during awake and sedated states...
August 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28808576/-awake-ecco2r-superseded-intubation-in-a-near-fatal-asthma-attack
#19
Thomas-Michael Schneider, Tibor Bence, Franz Brettner
BACKGROUND: Near-fatal asthma attacks are life threatening events that often require mechanical ventilation. Extracorporeal carbon dioxide removal (ECCO2R) is, beside extracorporeal membrane oxygenation (ECMO), a well-established rescue option whenever ventilation gets to its limits. But there seems to be very rare experience with those techniques in avoiding mechanical ventilation in severe asthma attacks. CASE PRESENTATION: A 67-year-old man with a near-fatal asthma attack deteriorated under non-invasive ventilation conditions...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28800575/disruption-of-frontal-parietal-connectivity-during-conscious-sedation-by-propofol-administration
#20
Pil-Jong Kim, Hong-Gee Kim, Gyu-Jeong Noh, Yong-Seo Koo, Teo Jeon Shin
The sedative state is a transitional state from wakefulness to general anesthesia. However, little is understood regarding the mechanism of conscious sedation, different from general anesthesia while maintaining wakefulness. In this study, we aimed to investigate changes in functional connectivity of the parietal-frontal network, implicated in wakefulness during conscious sedation induced by propofol infusion. The electroencephalography was obtained at the frontal and parietal areas of adult volunteers who maintain wakefulness during low-dose propofol infusion (1...
September 27, 2017: Neuroreport
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