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Conscious sedation

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https://www.readbyqxmd.com/read/28217048/radiofrequency-ablation-of-hepatocellular-carcinomas-a-new-spectrum-of-anesthetic-experience-at-a-tertiary-care-hospital-in-pakistan
#1
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
https://www.readbyqxmd.com/read/28215468/outcome-of-patients-undergoing-tavr-with-and-without-the-attendance-of-an-anesthesiologist
#2
Maayan Konigstein, Jeremy Ben-Shoshan, David Zahler, Nir Flint, Gilad Margolis, Yoav Granot, Galit Aviram, Amir Halkin, Gad Keren, Shmuel Banai, Ariel Finkelstein
BACKGROUND: During the last few years there is a shift from performing Transcatheter Aortic Valve Replacement (TAVR) under general anesthesia towards conscious sedation and local anesthesia only. In the vast majority of centers, sedation is guided by a qualified anesthesiologist. In our center, all TAVR procedures are being performed under local anesthesia and mild sedation, however, since September 2014, a large portion of TAVR procedures are being performed under local anesthesia without the presence of an anesthesiologist...
February 9, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28213758/influence-of-a-combined-ct-c-arm-system-on-periprocedural-workflow-and-procedure-times-in-mechanical-thrombectomy
#3
Johannes Pfaff, Silvia Schönenberger, Christian Herweh, Mirko Pham, Simon Nagel, Peter Arthur Ringleb, Sabine Heiland, Martin Bendszus, Markus Alfred Möhlenbruch
OBJECTIVE: To achieve the fastest possible workflow in ischaemic stroke, we developed a CT/C-arm system, which allows imaging and endovascular treatment on the same patient table. METHODS: This prospective, monocentric trial was conducted between October 2014 and August 2016. Patients received stroke imaging and mechanical thrombectomy under general anaesthesia (GA) or conscious sedation (CS) using our combined setup comprising a CT-scanner and a mobile C-arm X-ray device...
February 17, 2017: European Radiology
https://www.readbyqxmd.com/read/28210094/endoscopic-ultrasound-sedation-in-the-united-kingdom-is-life-without-propofol-tolerable
#4
Jennifer Anne Campbell, Andrew James Irvine, Andrew Derek Hopper
There is compelling evidence to support the quality, cost effectiveness and safety profile of non-anesthesiologist-administered propofol for endoscopic ultrasound (EUS). However in the United Kingdom, it is recommended that the administration and monitoring of propofol sedation for endoscopic procedures should be the responsibility of a dedicated and appropriately trained anaesthetist only. The majority of United Kingdom EUS procedures are performed with opiate and benzodiazepine sedation rather than anaesthetist led propofol lists due to anaesthetist resource availability...
January 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28206896/survey-of-current-clinical-and-curriculum-practices-of-postgraduate-pediatric-dentistry-programs-in-nonintravenous-conscious-sedation-in-the-united-states
#5
Aline Morin, Romer Ocanto, Lesbia Drukteinis, Patrick C Hardigan
PURPOSE: The purposes of this study were to: (1) describe the sedation protocols of postgraduate pediatric dentistry programs (PPDPs) in the U.S.; (2) evaluate how consistent they were with current American Academy of Pediatric Dentistry sedation guidelines and Commission on Dental Accreditation (CODA) sedation curriculum requirements; (3) identify barriers to and tools for implementing these guidelines; and (4) determine the independent association between PPDPs' adherence to guidelines and the program setting...
October 15, 2016: Pediatric Dentistry
https://www.readbyqxmd.com/read/28206886/guideline-for-monitoring-and-management-of-pediatric-patients-before-during-and-after-sedation-for-diagnostic-and-therapeutic-procedures-update-2016
#6
(no author information available yet)
The safe sedation of children for procedures requires a systematic approach that includes the following: no administration of sedating medication without the safety net of medical/dental supervision, careful presedation evaluation for underlying medical or surgical conditions that would place the child at increased risk from sedating medications, appropriate fasting for elective procedures and a balance between the depth of sedation and risk for those who are unable to fast because of the urgent nature of the procedure, a focused airway examination for large (kissing) tonsils or anatomic airway abnormalities that might increase thepotential for airway obstruction, a clear understanding of the medication's pharmacokinetic and pharmacodynamic effects and drug interactions, appropriate training and skills in airway management to allow rescue of the patient, age- and size-appropriate equipment for airway management and venous access, appropriate medications and reversal agents, sufficient numbers of staff to both carry out the procedure and monitor the patient, appropriate physiologic monitoring during and after the procedure, a properly equipped and staffed recovery area, recovery to the presedation level of consciousness before discharge from medical/dental supervision, and appropriate discharge instructions...
October 15, 2016: Pediatric Dentistry
https://www.readbyqxmd.com/read/28205108/water-assisted-colonoscopy
#7
REVIEW
Sergio Cadoni, Felix W Leung
The current review will attempt to describe the important lessons learned from published randomized controlled trials (RCT) comparing water immersion (WI) or water exchange (WE) techniques with gas insufflation colonoscopy. Air insufflation (AI) to distend the colon to permit visualization and passage through the lumen was developed for diagnostic colonoscopy. When screening colonoscopy was adopted, the same AI method was used. Interval cancers, diagnosed within 3 to 5 years after an index screening colonoscopy, appeared to be linked to low adenoma detection rate (ADR)...
February 15, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28194341/variables-influencing-the-depth-of-conscious-sedation-in-plastic-surgery-a-prospective-study
#8
Hyeonjung Yeo, Wonwoo Kim, Hyochun Park, Hoonnam Kim
BACKGROUND: Conscious sedation has been widely utilized in plastic surgery. However, inadequate research has been published evaluating adequate drug dosage and depth of sedation. In clinical practice, sedation is often inadequate or accompanied by complications when sedatives are administered according to body weight alone. The purpose of this study was to identify variables influencing the depth of sedation during conscious sedation for plastic surgery. METHODS: This prospective study evaluated 97 patients who underwent plastic surgical procedures under conscious sedation...
January 2017: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/28183479/transthoracic-echocardiography-guided%C3%A2-mitraclip-placement-under-conscious-sedation
#9
Einar A Hart, Arco J Teske, Michiel Voskuil, Pieter R Stella, Steven A J Chamuleau, Adriaan O Kraaijeveld
No abstract text is available yet for this article.
February 13, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28183467/initial-experience-of-a-second-generation-self-expanding-transcatheter-aortic-valve-the-uk%C3%A2-ireland-evolut-r-implanters-registry
#10
Sundeep S Kalra, Sami Firoozi, James Yeh, Daniel J Blackman, Shabnam Rashid, Simon Davies, Neil Moat, Miles Dalby, Tito Kabir, Saib S Khogali, Richard A Anderson, Peter H Groves, Darren Mylotte, David Hildick-Smith, Rajiv Rampat, Jan Kovac, Ashan Gunarathne, Jean-Claude Laborde, Stephen J Brecker
OBJECTIVES: The authors present the UK and Irish real-world learning curve experience of the Evolut R transcatheter heart valve. BACKGROUND: The Evolut R is a self-expanding, repositionable, and fully recapturable second-generation transcatheter heart valve with several novel design features to improve outcomes and reduce complications. METHODS: Clinical, procedural, and 30-day outcome data were prospectively collected for the first 264 patients to receive the Evolut R valve in the United Kingdom and Ireland...
February 13, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28175443/135%C3%A2-a-comparison-of-outcomes-between-deep-brain-stimulation-under-general-anesthesia-versus-conscious-sedation-with-awake-evaluation
#11
François Alesch, Roshini Jain, Lilly Chen, Thomas Brucke, Fernando Seijo, Esther Suarez San Martin, Claire Haegelen, Marc Verin, Mohammed Maarouf, Michael T Barbe, Steven Gill, Alan Whone, Mauro Porta, Domenico Servello, Lars Timmermann
No abstract text is available yet for this article.
August 1, 2016: Neurosurgery
https://www.readbyqxmd.com/read/28174148/local-anesthesia-versus-local-anesthesia-and-conscious-sedation-for-inguinal-hernioplasty-protocol-of-a-randomized-controlled-trial
#12
Pierre-Anthony Leake, Patrick J Toppin, Marvin Reid, Joseph M Plummer, Patrick O Roberts, Hyacinth Harding-Goldson, Michael E McFarlane
BACKGROUND: Conscious sedation is regularly used in ambulatory surgery to improve patient outcomes, in particular patient satisfaction. Reports suggest that the addition of conscious sedation to local anesthesia for inguinal hernioplasty is safe and effective in improving patient satisfaction. No previous randomized controlled trial has assessed the benefit of conscious sedation in this regard. OBJECTIVE: To determine whether the addition of conscious sedation to local anesthesia improves patient satisfaction with inguinal hernioplasty...
February 7, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28159731/a-prospective-multicenter-single-blind-study-assessing-indices-of-snap-ii-versus-bis-vista-on-surgical-patients-undergoing-general-anesthesia
#13
Sergio D Bergese, Alberto A Uribe, Erika G Puente, R-Jay L Marcus, Randall J Krohn, Steven Docsa, Roy G Soto, Keith A Candiotti
BACKGROUND: Traditionally, anesthesiologists have relied on nonspecific subjective and objective physical signs to assess patients' comfort level and depth of anesthesia. Commercial development of electrical monitors, which use low- and high-frequency electroencephalogram (EEG) signals, have been developed to enhance the assessment of patients' level of consciousness. Multiple studies have shown that monitoring patients' consciousness levels can help in reducing drug consumption, anesthesia-related adverse events, and recovery time...
February 3, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28149139/can-we-perform-distal-nerve-block-instead-of-brachial-plexus-nerve-block-under-ultrasound-guidance-for-hand-surgery
#14
Ilker Ince, Mehmet Aksoy, Mine Celik
OBJECTIVE: Distal nerve blocks are used in the event of unsuccessful blocks as rescue techniques. The primary purpose of this study was to determine the sufficiency for anesthesia of distal nerve block without the need for deep sedation or general anesthesia. The secondary purpose was to compare block performance times, block onset times, and patient and surgeon satisfaction. MATERIALS AND METHODS: Patients who underwent hand surgery associated with the innervation area of the radial and median nerves were included in the study...
October 2016: Eurasian Journal of Medicine
https://www.readbyqxmd.com/read/28148581/delirium-a-guide-for-the-general-physician
#15
Oliver M Todd, Elizabeth A Teale
Delirium describes a sudden onset change in mental status of fluctuating course. This is a state of altered consciousness characterised chiefly by inattention or lack of arousal, but can also include new impairment of language, perception and behaviour. Certain predisposing factors can make an individual more susceptible to delirium in the face of a stressor. Stressors include direct insults to the brain, insults peripheral to the brain or external changes in the environment of an individual. Delirium is varied in its presentation, and can be categorised by the psychomotor profile as: hyperactive type (overly vigilant, agitated, often wandersome), hypoactive type (sedate or withdrawn) or mixed types...
February 2017: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/28143993/transcatheter-closure-of-patent-ductus-arteriosus-in-adolescents-and-adults-a-case-series
#16
Sukman Tulus Putra, Mulyadi M Djer, Nikmah S Idris, Sudigdo Sastroasmoro
During 11 years period from January 2005 to December 2015 there were 18 adolescent and adult patients  who underwent transcatheter closure of PDA using PDA Amplatzer Duct Occluder (ADO). There were 9 cases with age of 14 to 18 years and 9 cases with age of more than 18 years where the oldest case was 46 years old. Two cases were male and 16 cases were female. Prior to procedures, clinical assessment, ECG, chest x-ray and transthoracic echocardiography (TTE) were performed to confirm the diagnosis of PDA. The procedures of device implantation was performed under conscious sedation in adults and using general anesthesia in adolescents...
October 2016: Acta Medica Indonesiana
https://www.readbyqxmd.com/read/28135792/-preparation-evaluation-and-recovery-before-and-after-conscious-sedative-endoscopy
#17
REVIEW
Hong Jun Park, Byoung Kwan Son, Hoon Sup Koo, Byung Wook Kim
No abstract text is available yet for this article.
January 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/28127013/can-intravenous-conscious-sedation-with-midazolam-be-effective-at-facilitating-surgical-dentistry-in-adolescent-orthodontic-patients-a-service-evaluation
#18
A J Stamp, M L Dorman, C R Vernazza, G Deeming, C Reid, K E Wilson, N M Girdler
Background Surgical dentistry during orthodontic care often occurs in adolescence and may involve surgical removal or exposure of teeth. The invasive nature of treatment, combined with dental anxiety, means care can often be provided under general anaesthesia (GA). Best-practice guidelines however endorse conscious sedation as an alternative, where appropriate. Although a limited number of studies have shown safe and effective use of intravenous conscious sedation (IVCS) with midazolam in this cohort, robust evidence to support routine use is lacking...
January 27, 2017: British Dental Journal
https://www.readbyqxmd.com/read/28124464/patients-experience-of-thirst-while-being-conscious-and-mechanically-ventilated-in-the-intensive-care-unit
#19
Caroline L Kjeldsen, Mette S Hansen, Kamilla Jensen, Anna Holm, Anita Haahr, Pia Dreyer
BACKGROUND: Because of changes in sedation strategies, more patients in the intensive care unit (ICU) are conscious. Therefore, new and challenging tasks in nursing practice have emerged, which require a focus on the problems that patients experience. Thirst is one such major problem, arising because the mechanical ventilator prevents the patients from drinking when they have the urge to do so. To gain a deeper understanding of the patients' experiences and to contribute new knowledge in nursing care, this study focuses on the patients' experiences of thirst during mechanical ventilation (MV) while being conscious...
January 25, 2017: Nursing in Critical Care
https://www.readbyqxmd.com/read/28123622/full-outline-of-unresponsiveness-score-and-the-glasgow-coma-scale-in-prediction-of-pediatric-coma
#20
Atahar Jamal, Naveen Sankhyan, Murlidharan Jayashree, Sunit Singhi, Pratibha Singhi
BACKGROUND: This study was done to compare the admission Full Outline of Unresponsiveness (FOUR) score and Glasgow Coma Scale (GCS) as predictors of outcome in children with impaired consciousness. METHODS: In this observational study, children (5-12 years) with impaired consciousness of <7 days were included. Children with traumatic brain injury, on sedatives or neuromuscular blockade; with pre-existing cerebral palsy, mental retardation, degenerative brain disease, vision/hearing impairment; and seizure within last 1 hour were excluded...
2017: World Journal of Emergency Medicine
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