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Conscious sedation

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https://www.readbyqxmd.com/read/28340389/minilaparotomy-without-general-anesthesia-for-the-treatment-of-sigmoid-volvulus-in-high-risk-patients-a-case-series-of-4-patients
#1
Ernesto L Enrique, Kareem A Hamdy
BACKGROUND: Sigmoid volvulus (SV) is a common cause of large bowel obstruction worldwide. Presenting symptoms can be nonspecific and varied amongst the elderly population, making medical and surgical management challenging. This population is at markedly increase risk of complications and mortality with surgery under general anesthesia. In this case series, we describe 4 cases of sigmoid volvulus in octogenarians. GOALS: To demonstrate that sigmoid colectomy under local anesthesia, with or without intravenous conscious sedation, is feasible and can be done safely and with a low rate of converting to a general anesthetic...
March 2, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28337480/intra-channel-stent-release-technique-for-fluoroless-endoscopic-ultrasound-guided-lumen-apposing-metal-stent-placement-changing-the-paradigm
#2
Andrea Anderloni, Fabia Attili, Silvia Carrara, Domenico Galasso, Milena Di Leo, Guido Costamagna, Alessandro Repici, Rastislav Kunda, Alberto Larghi
Background Recently, a novel lumen-apposing fully covered self-expanding metal stent (LA-FCSEMS) mounted on an electrocautery-enhanced delivery system has been developed to perform endoscopic ultrasound (EUS)-guided transluminal drainage. From early experience, however, release of the proximal flange of the stent has mostly been done using endoscopic view guidance to ensure proper positioning. Aim We describe a new technique that we have named the Intra-Channel Stent Release Technique (ICSRT) to perform stent placement under complete EUS control, without the use of either fluoroscopic or endoscopic views...
January 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28335900/percutaneous-tricuspid-valve-annuloplasty-under-conscious-sedation-with-only-fluoroscopic-and-intracardiac-echocardiography-monitoring
#3
Azeem Latib, Antonio Mangieri, Luca Vicentini, Luca Ferri, Matteo Montorfano, Gennaro Ismeno, Damiano Regazzoli, Marco B Ancona, Manuela Giglio, Paolo Denti, Antonio Colombo, Eustachio Agricola
No abstract text is available yet for this article.
March 27, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28327922/factors-influencing-the-reliability-of-the-glasgow-coma-scale-a-systematic-review
#4
Florence Cm Reith, Anneliese Synnot, Ruben van den Brande, Russell L Gruen, Andrew Ir Maas
BACKGROUND: The Glasgow Coma Scale (GCS) characterizes patients with diminished consciousness. In a recent systematic review, we found overall adequate reliability across different clinical settings, but reliability estimates varied considerably between studies, and methodological quality of studies was overall poor. Identifying and understanding factors that can affect its reliability is important, in order to promote high standards for clinical use of the GCS. OBJECTIVE: The aim of this systematic review was to identify factors that influence reliability and to provide an evidence base for promoting consistent and reliable application of the GCS...
March 15, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28301923/korean-society-of-gastrointestinal-endoscopy-guidelines-for-endoscope-reprocessing
#5
Byoung Kwan Son, Byung-Wook Kim, Won Hee Kim, Dae-Sung Myung, Young-Seok Cho, Byung Ik Jang
The Korean Society of Gastrointestinal Endoscopy (KSGE) issued guidelines for endoscope reprocessing for the first time in 1995, and the version of the guidelines was updated in August 2009, August 2012, and March 2015. Guidelines for endoscope reprocessing should be revised continuously, because new disinfectants and devices are developed and introduced. The current official version of the KSGE guidelines for endoscope reprocessing is explained herein to assist the reader in understanding the KSGE requirements for cleaning and disinfecting endoscopes...
March 17, 2017: Clinical Endoscopy
https://www.readbyqxmd.com/read/28298753/a-prospective-randomized-trial-comparing-dexmedetomidine-and-midazolam-for-conscious-sedation-during-oocyte-retrieval-in-an-in-vitro-fertilization-program
#6
Ali Mohamed Ali Elnabtity, Mohamed Fouad Selim
BACKGROUND: Various sedative and analgesic techniques have been used for pain relief during oocyte retrieval which is the most painful part of in vitro fertilization (IVF) procedures. AIM: This study aimed at comparing dexmedetomidine and midazolam for conscious sedation in women undergoing transvaginal oocyte retrieval during an IVF program. SETTINGS AND DESIGN: Prospective randomized double-blinded comparative study. PATIENTS AND METHODS: Fifty-two patients undergoing oocyte retrieval in their first IVF cycle were randomly allocated into two equal groups...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28295476/the-interpersonal-work-of-dental-conscious-sedation-a-qualitative-analysis
#7
Stephen M Woolley, Barbara Chadwick, Lesley Pugsley
AIMS: Whilst there is a considerable body of literature examining the pharmacology of conscious sedation, the social tasks required to successfully provide conscious sedation have not been reported. This paper discusses data regarding the interpersonal work integral to effective conscious sedation provision, from a larger qualitative study exploring how patients and clinicians engage with secondary care conscious sedation provided within the UK. METHOD: Semi-structured interviews were conducted with 13 conscious sedation providers and nine patients within UK-based secondary care sedation settings...
March 14, 2017: Community Dentistry and Oral Epidemiology
https://www.readbyqxmd.com/read/28288298/detection-of-respiratory-adverse-events-in-pediatric-dental-patients-sedated-with-0-75mg-kg-of-midazolam-and-oxygen-by-continuous-pretracheal-auscultation-a-prospective-randomized-controlled-trial
#8
Mostafa Somri, Ibrahim Matter, Christopher Hadjittofi, Naser Hoash, Bian Moaddi, Johnny Kharouba, Constantinos A Parisinos, Benjamin Peretz
PURPOSE: Sedation is becoming more commonplace for pediatric patients undergoing minor procedures. Fortunately, electronic monitors have contributed to a reduction in the associated respiratory adverse events (RAEs). To test the hypothesis that adding the pretracheal stethoscope (PTS) to standard monitoring methods (SMMs) may improve RAE detection in sedated pediatric dental patients, the frequency of RAEs detected by SMMs (i.e. visual observation, capnography, and pulse oximetry) was compared to that detected by SMMs alongside continuous PTS auscultation...
2017: Journal of Clinical Pediatric Dentistry
https://www.readbyqxmd.com/read/28287519/endobronchial-ultrasound-guided-intratumoral-injection-of-cisplatin-for-the-treatment-of-isolated-mediastinal-recurrence-of-lung-cancer
#9
Hiren J Mehta, Michael A Jantz
Isolated hilar and mediastinal recurrence (IMHR) following external beam radiation therapy (EBRT) in patients with lung cancer is common. These patients do not have many treatment options and are usually offered palliative chemotherapy or best supportive care. Endobronchial ultrasound (EBUS)-guided intratumoral injection of cisplatin (ITC) is a novel approach for these patients. The procedure is performed under conscious sedation. The lesion is located with a bronchoscopy using EBUS, and a 22-gauge EBUS needle is advanced through the working channel of the scope and locked in position...
February 12, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28279774/conscious-sedation-versus-general-anesthesia-for-the-treatment-of-cerebral-aneurysms-with-flow-diversion-a-matched-cohort-study
#10
Christoph J Griessenauer, Hussain Shallwani, Nimer Adeeb, Raghav Gupta, Leonardo Rangel-Castilla, Adnan H Siddiqui, Elad I Levy, Myles D Boone, Ajith J Thomas, Christopher S Ogilvy
INTRODUCTION: Flow diversion has become a popular treatment option for a variety of cerebral aneurysms. We sought to compare conscious sedation and general anesthesia for flow diverter placement in a matched cohort study. MATERIALS AND METHODS: Patients who underwent flow diverter placement under conscious sedation were matched on the basis of age, sex, American Society of Anesthesiologists (ASA) classification, aneurysm location, and aneurysm size with patients who received general anesthesia...
March 6, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28272202/effects-of-combined-epidural-and-general-anesthesia-on-intraoperative-hemodynamic-responses-postoperative-cellular-immunity-and-prognosis-in-patients-with-gallbladder-cancer-a-randomized-controlled-trial
#11
Jun Zhu, Xue-Rong Zhang, Hu Yang
BACKGROUND: This study is supposed to investigate the effects of combined epidural and general anesthesia on intraoperative hemodynamic responses, postoperative cellular immunity, and prognosis in patients with gallbladder cancer (GBC). METHODS: One hundred forty-four GBC patients were selected and randomly divided into the general anesthesia (GA) group and the combined epidural-general anesthesia (CEGA) group. Before anesthesia induction (t0), at intubation (t1), at the beginning of surgery (t2), 5 minutes after pneumoperitoneum (t3), at the end of surgery (t4), after recovery of spontaneous breathing (t5), after regaining consciousness (t6), and after extubation (t7), the heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and the depth of anesthesia (bispectral index [BIS]) were detected...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28264690/presentations-to-an-urban-emergency-department-in-bern-switzerland-associated-with-acute-recreational-drug-toxicity
#12
Evangelia Liakoni, Sabine Müller, Adrian Stoller, Meret Ricklin, Matthias E Liechti, Aristomenis K Exadaktylos
BACKGROUND: Although the recreational use of psychoactive substances is common there is only limited systematic collection of data on acute drug toxicity or hospital presentations. Currently, data from Switzerland are only available from the University Hospital of Basel. The present study aimed to describe the presentations due to recreational drug use at an emergency department in Bern, Switzerland during a 4 year period. METHODS: Retrospective analysis of cases presenting from May 2012 to April 2016 at the emergency department of the University Hospital of Bern, Switzerland, with symptoms/signs consistent with acute toxicity of recreational drug use...
March 7, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28260190/general-anesthesia-improves-contact-force-and-reduces-gap-formation-in-pulmonary-vein-isolation-a-comparison-with-conscious-sedation
#13
Akio Chikata, Takeshi Kato, Takanori Yaegashi, Satoru Sakagami, Chieko Kato, Takahiro Saeki, Keiichi Kawai, Shin-Ichiro Takashima, Hisayoshi Murai, Soichiro Usui, Hiroshi Furusho, Shuichi Kaneko, Masayuki Takamura
Compared to conscious sedation (CS), the use of general anesthesia (GA) in pulmonary vein isolation (PVI) is associated with a lower recurrence rate of atrial fibrillation (AF). GA may improve catheter stability and mapping system accuracy compared to CS, but its influence on contact force (CF) parameters during ipsilateral PVI has not previously been investigated. The study population comprised 176 consecutive patients (107 in GA group and 69 in CS group) with AF who underwent their first PVI procedure. We retrospectively assessed CF parameters, force-time integral (FTI), FTI/wall thickness during anatomical ipsilateral PVI and long-term outcome after ablation...
March 4, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28258263/evaluation-of-the-role-of-music-as-a-nonpharmacological-technique-in-management-of-child-patients
#14
Neha Gupta, Himanshu Gupta, Prahlad Gupta, Nidhi Gupta
INTRODUCTION: Behavior management and reducing anxiety and pain are very important for success of treatment. Hence, apart from pharmacological management, such as conscious sedation, nonpharmacological interventions like music play a significant role. This study aims to evaluate the effects of music in reducing anxiety, pain, and behavior management. MATERIALS AND METHODS: This study was conducted at the Department of Pedodontics in 2015. It consisted of 60 patients, age ranging from 3 to 7 years, who required dental treatment with local anesthesia...
March 1, 2017: Journal of Contemporary Dental Practice
https://www.readbyqxmd.com/read/28249993/moderate-sedation-in-cardiac-electrophysiology-laboratory-a-retrospective-safety-analysis
#15
V Sawhney, E Bacuetes, M Wray, M Dhinoja, M J Earley, R J Schilling, S Sporton
OBJECTIVE: Cardiac electrophysiology (EP) procedures can be performed under moderate sedation without the direct involvement of an anaesthetist. However, concerns have been raised over the safety of this approach. This study examines the use of a standardised nurse-led physician-directed sedation protocol for EP procedures to determine the safety of moderate sedation administered by non-anaesthesia personnel who have been trained in sedation techniques. METHODS AND RESULTS: Consecutive EP procedures done under moderate sedation over 12 years at our institution were evaluated...
March 1, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28249937/is-transnasal-tee-imaging-a-viable-alternative-to-conventional-tee-during-structural-cardiac-interventions-a-comparison-of-image-quality
#16
Dimitris Klettas, Emma Alcock, Rafal Dworakowski, Philip MacCarthy, Mark Monaghan
AIM: The role of transoesophageal echocardiography in cardiac interventional structural procedures is well established and appreciated. However, the need for general anaesthesia (GA) throughout the procedure remains a controversial issue. The aim of the present study is to assess the feasibility and imaging quality of using a transnasal microrobe that allows the usage of conscious sedation in patients that undergo cardiac structural interventional procedures without missing the benefits, guidance and navigation of conventional trans-procedural TEE...
March 1, 2017: Echo Research and Practice
https://www.readbyqxmd.com/read/28246074/delirium-after-mechanical-ventilation-in-intensive-care-units-the-cognitive-and-psychosocial-assessment-capa-study-protocol
#17
Daniella Bulic, Michael Bennett, Helen Rodgers, Mary Nourse, Patrick Rubie, Jeffrey Cl Looi, Frank Van Haren
BACKGROUND: In the intensive care unit (ICU), critical illness delirium occurs in the context of multiple comorbidities, multi-organ failure, and invasive management techniques, such as mechanical ventilation, sedation, and lack of sleep. Delirium is characterized by an acute confusional state defined by fluctuating mental status, inattention, and either disorganized thinking or an altered level of consciousness. The long-term cognitive and psychosocial function of patients that experience delirium in the ICU is of crucial interest because preliminary data suggest a strong association between ICU-related delirium and long-term cognitive impairment...
February 28, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28243855/optimal-propofol-induction-dose-in-morbidly-obese-patients-a-randomized-controlled-trial-comparing-the-bispectral-index-and-lean-body-weight-scalar
#18
Yamini Subramani, Waleed Riad, Frances Chung, Jean Wong
PURPOSE: Propofol dosing based on total body weight (TBW) can lead to overdosing in morbidly obese (MO) patients. Our aim was to determine whether an induction dose of propofol based on a bispectral index (BIS) target is better for achieving loss of consciousness in MO patients than dosing based on lean body weight (LBW). METHODS: Sixty MO patients with a body mass index (BMI) of ≥ 40 kg·m(-2) were randomized to either BIS- or LBW-based propofol dosing groups...
February 27, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28237683/the-effect-of-mk-467-a-peripheral-%C3%AE-2-adrenoceptor-antagonist-on-dexmedetomidine-induced-sedation-and-bradycardia-after-intravenous-administration-in-conscious-cats
#19
Juhana Honkavaara, Bruno Pypendop, Heta Turunen, Jan Ilkiw
OBJECTIVE: To determine a dose of MK-467, a peripheral α2-adrenoceptor antagonist, which, when administered intravenously (IV) concomitantly with 25 μg kg(-1) of dexmedetomidine, will prevent bradycardia without altering sedation in cats. STUDY DESIGN: Prospective, randomized, controlled, blinded, experimental, crossover study. ANIMALS: Eight healthy, adult, purpose-bred cats. METHODS: Cats were administered seven IV treatments were administered at least 2 weeks apart, consisting of dexmedetomidine 12...
February 22, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28217048/radiofrequency-ablation-of-hepatocellular-carcinomas-a-new-spectrum-of-anesthetic-experience-at-a-tertiary-care-hospital-in-pakistan
#20
Faisal Shamim, Ali Asghar, Saman Tauheed, Muhammad Yahya
BACKGROUND: Radiofrequency ablation (RFA) is a minimally invasive technique of tumor destruction for patients with hepatic cancer who are not candidates for conventional therapy. The therapy required general anesthesia (GA) or sedation to ensure patient safety and comfort. The study is aimed to report and evaluate factors that influenced the periprocedural anesthetic management, drugs used, and complications during and immediately after RFA procedure for hepatocellular carcinoma. METHODS: For this retrospective study, we included 46 patients who underwent percutaneous RFA under GA or conscious sedation from January 2010 to June 2013 in Aga Khan University Hospital, Pakistan...
January 2017: Saudi Journal of Anaesthesia
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