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https://www.readbyqxmd.com/read/28650904/pediatric-procedural-sedation-using-the-combination-of-ketamine-and-propofol-outside-of-the-emergency-department-a-report-from-the-pediatric-sedation-research-consortium
#1
Jocelyn R Grunwell, Curtis Travers, Anne G Stormorken, Patricia D Scherrer, Corrie E Chumpitazi, Jana A Stockwell, Mark G Roback, Joseph Cravero, Pradip P Kamat
OBJECTIVES: Outcomes associated with a sedative regimen comprised ketamine + propofol for pediatric procedural sedation outside of both the pediatric emergency department and operating room are underreported. We used the Pediatric Sedation Research Consortium database to describe a multicenter experience with ketamine + propofol by pediatric sedation providers. DESIGN: Prospective observational study of children receiving IV ketamine + propofol for procedural sedation outside of the operating room and emergency department using data abstracted from the Pediatric Sedation Research Consortium during 2007-2015...
June 23, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28650239/use-of-gadoxetic-acid-for-computed-tomographic-cholangiography-in-healthy-dogs
#2
Jennifer Chau, Juan M Podadera, Alex C Young, Mariano A Makara
OBJECTIVE To evaluate the effect of gadoxetic acid (contrast) dose on biliary tract enhancement, determine the optimal time after contrast injection for CT image acquisition, and assess the feasibility of CT cholangiography in sedated dogs. ANIMALS 8 healthy dogs. PROCEDURES The study had 2 parts. In part 1, 4 dogs were anesthetized and underwent CT cholangiography twice. Gadoxetic acid was administered IV at a low dose (0.025 mmol/kg) for the first procedure and high dose (0.3 mmol/kg) for the second procedure...
July 2017: American Journal of Veterinary Research
https://www.readbyqxmd.com/read/28649909/safety-of-iv-pulse-methylprednisolone-therapy-during-breastfeeding-in-patients-with-multiple-sclerosis
#3
Cavit Boz, Murat Terzi, Serap Zengin Karahan, Sedat Sen, Yasemin Sarac, Murat Emrah Mavis
BACKGROUND: Women with multiple sclerosis (MS) experience an increased risk of relapse in the postpartum period. High-dose methylprednisolone is the first-line treatment for acute relapses. OBJECTIVES: To determine the transfer of methylprednisolone into human milk in breastfeeding MS patients. METHODS: Methylprednisolone therapy was given for postpartum relapse to nine patients for three consecutive days, and seven patients received a daily infusion once a month...
June 1, 2017: Multiple Sclerosis: Clinical and Laboratory Research
https://www.readbyqxmd.com/read/28638303/the-use-of-gabapentin-for-pain-and-agitation-in-neonates-and-infants-in-a-neonatal-icu
#4
Gretchen L Sacha, Maria G Foreman, Kay Kyllonen, Ricardo J Rodriguez
OBJECTIVES: Limited data support how to safely and effectively treat refractory pain and agitation in neonates and infants. Gabapentin has been used in this patient population and has shown promising results, yet there is still a paucity of data about its clinical efficacy. There is a need for a larger evaluation to determine its effectiveness. This study describes one institution's experience with gabapentin for the treatment of refractory pain and agitation in the neonatal intensive care unit (NICU)...
May 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28626868/intrathecal-dexamethasone-vs-meperidine-for-prevention-of-shivering-during-transurethral-prostatectomy-a-randomized-controlled-trial
#5
S M Moeen, A M Moeen
BACKGROUND: Shivering is a common complication after spinal anesthesia. Also, during transurethral prostatectomy a large amount of irrigating fluids is used which may cause hypothermia and shivering. We hypothesized that intrathecal dexamethasone could effectively attenuate post-spinal shivering following transurethral prostatectomy as intrathecal meperidine. METHODS: Ninety male patients, ASA II-III, 50-75 years old were included in this prospective and randomized double-blind study...
June 18, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28617422/reduced-narcotic-and-sedative-utilization-in-a-nicu-after-implementation-of-pain-management-guidelines
#6
D Rana, B Bellflower, J Sahni, A J Kaplan, N T Owens, E L Arrindell, A J Talati, R Dhanireddy
OBJECTIVE: To assess the opioid and benzodiazepine usage in a level IV NICU after implementation of pain guidelines. STUDY DESIGN: Guidelines were developed for infants undergoing surgical procedures and infants on mechanical ventilation. Data collected for period 1 (July to December 2013) and period 2 (March to August 2014). RESULTS: Gestational age, birth weight and infants with hypoxic respiratory failure or requiring major procedures were comparable in two periods...
June 15, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28614289/mri-in-postreduction-evaluation-of-developmental-dysplasia-of-the-hip-our-experience
#7
Daniela Dibello, Luca Odoni, Federica Pederiva, Valentina Di Carlo
BACKGROUND: Developmental dysplasia of the hip (DDH) is one of the most common congenital defects in the newborn. When its severe form is not corrected, it is associated with long-term morbidity. Closed reduction with casting is the standard primary treatment and reduction is confirmed by magnetic resonance imaging (MRI). We reported our experience on the reliability of MRI in postreduction assessment of DDH. METHODS: All children who underwent closed reduction for Graf type IV DDH at our institution between September 2010 and June 2016 were retrospectively reviewed...
June 13, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28604086/dexmedetomidine-infusion-for-routine-dental-management-of-an-asa-iv-patient-a-case-report
#8
Andrew S Young, Nicholas A Russell, Joseph A Giovannitti
Anesthetic management of elderly patients requires numerous physiological considerations. With aging, degenerative changes occur in the structure and functional capacity of tissues and organs. Typically, these patients experience clinical effects with lower doses of medication. Important considerations for the geriatric populations following anesthesia include increased time to recovery and avoidance of functional decline. A case is reported in which an 83-year-old Caucasian female with a complex medical history presented for routine dental treatment under intravenous sedation via dexmedetomidine infusion...
2017: Anesthesia Progress
https://www.readbyqxmd.com/read/28601599/innervated-dorsoradial-perforator-free-flap-a-reliable-supermicrosurgery-fingertip-reconstruction-technique
#9
Dajiang Song, Georgios Pafitanis, Peng Yang, Mitsunaga Narushima, Zan Li, Linfeng Liu, Zengtao Wang
INTRODUCTION: This study demonstrates the use of a modified free innervated DRAP flap utilizing the supermicrosurgery technique for fingertip reconstruction. MATERIALS AND METHODS: From January 2010 to February 2014, 20 cases of fingertip reconstruction were performed using a short pedicle mini innervated transverse DRAP flap. The patients demographics, the mechanism of injury, the defect size and anatomical location, the source of pedicle vessels, the recipient vessels, the nerve branch used for innervation, the follow-up and sensation outcomes are reported...
May 27, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28579345/efficacy-and-safety-of-midazolam-and-ketamine-in-paediatric-upper-endoscopy
#10
Ahmet Basturk, Reha Artan, Aygen Yılmaz
BACKGROUND AND STUDY AIM: Upper endoscopy can be successfully carried out in children under deep sedation and anaesthesia. However, the best method of upper endoscopy for children who require gastrointestinal intervention has yet to be defined. The aim of this study is to investigate the efficacy and safety of the sedation induced by intravenous midazolam and ketamine during upper endoscopy in children. PATIENTS AND METHODS: This study included patients ages 3-18years who had undergone upper endoscopy...
June 1, 2017: Arab Journal of Gastroenterology: the Official Publication of the Pan-Arab Association of Gastroenterology
https://www.readbyqxmd.com/read/28569132/a-pilot-study-of-the-use-of-dexmedetomidine-for-the-control-of-delirium-by-reducing-the-serum-concentrations-of-brain-derived-neurotrophic-factor-neuron-specific-enolase-and-s100b-in-polytrauma-patients
#11
Yong Li, Zhi-Xin Yu, Mu-Sen Ji, Jun Yan, Yan Cai, Jing Liu, Hong-Feng Yang, Zhao-Chen Jin
BACKGROUND: Delirium is very common among patients with polytrauma, although no suitable means exist to feasibly reduce the incidence and duration of delirium in these patients. Recent reports have suggested that continuous intravenous (IV) infusions of dexmedetomidine, rather than benzodiazepine, be administered for sedation to reduce the duration of delirium in this population. However, serum neuron-specific enolase (NSE), S100 calcium binding protein B (S100B), and brain-derived neurotrophic factor (BDNF) levels have not yet been investigated in polytrauma patients who received sedation with dexmedetomidine rather than other conventional sedatives...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28561560/using-the-simplified-case-mix-tool-scmt-to-identify-cost-in-special-care-dental-services-to-support-commissioning
#12
B G Duane, R Freeman, D Richards, S Crosbie, P Patel, S White, G Humphris
To commission dental services for vulnerable (special care) patient groups effectively, consistently and fairly an evidence base is needed of the costs involved. The simplified Case Mixed Tool (sCMT) can assess treatment mode complexity for these patient groups. OBJECTIVE: To determine if the sCMT can be used to identify costs of service provision. CLINICAL SETTING: Patients (n=495) attending the Sussex Community NHS Trust Special Care Dental Service for care were assessed using the sCMT...
March 2017: Community Dental Health
https://www.readbyqxmd.com/read/28559128/performance-of-the-modified-richmond-agitation-sedation-scale-in-identifying-delirium-in-older-emergency-department-patients
#13
Florian F Grossmann, Wolfgang Hasemann, Reto W Kressig, Roland Bingisser, Christian H Nickel
BACKGROUND: Delirium in older emergency department (ED) patients is associated with severe negative patient outcomes and its detection is challenging for ED clinicians. ED clinicians need easy tools for delirium detection. We aimed to test the performance criteria of the modified Richmond Agitation Sedation Scale (mRASS) in identifying delirium in older ED patients. METHODS: The mRASS was applied to a sample of consecutive ED patients aged 65 or older by specially trained nurses during an 11-day period in November 2015...
May 22, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28541419/acute-toxicity-from-intravenous-use-of-the-tricyclic-antidepressant-tianeptine
#14
Sara K Dempsey, Justin L Poklis, Kacie Sweat, Kirk Cumpston, Carl E Wolf
Tianeptine (7-[([3-chloro-6,11]-dihydro-6-methyldibenzo[c,f][1,2]thiazepin-11-yl) amino] heptanoic acid S, S dioxide) is a tricyclic compound prescribed as an antidepressant in European countries, but is not currently approved for use in the United States. There are few published case reports of tianeptine intoxication. Presented is the first case of acute toxicity associated with the intravenous use of tianeptine. A 36-year-old male intentionally injected tianeptine powder intravenously to "help him see into the future"...
May 24, 2017: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/28540195/conversion-from-prolonged-intravenous-fentanyl-infusion-to-enteral-methadone-in-critically-ill-children
#15
Vijay Srinivasan, Daniel Pung, Sean P O'Neill
AIM: To describe our institutional experience with conversion from intravenous (IV) fentanyl infusion directly to enteral methadone and occurrence of withdrawal in critically ill mechanically ventilated children exposed to prolonged sedation and analgesia. METHODS: With Institutional Review Board approval, we retrospectively studied consecutively admitted invasively mechanically ventilated children (0-18 years) sedated with IV fentanyl infusion > 5 d and subsequently converted directly to enteral methadone...
May 8, 2017: World Journal of Clinical Pediatrics
https://www.readbyqxmd.com/read/28514325/an-etomidate-analogue-with-less-adrenocortical-suppression-stable-hemodynamics-and-improved-behavioral-recovery-in-rats
#16
Bin Wang, Jun Yang, Jun Chen, Yi Kang, Ling-Hui Yang, Jin Liu, Wen-Sheng Zhang
BACKGROUND: ET-26 hydrochloride (ET-26HCl) is a novel etomidate analogue designed to alleviate the adrenocortical suppression caused by etomidate while retaining the rapid sedative-hypnotic onset and stable hemodynamic features of etomidate. This study compared the anesthetic effect, hemodynamic stability, and recovery profiles of ET-26HCl, etomidate, and the sedative-hypnotic drug propofol in rats. METHODS: The metabolic half-life of ET-26HCl was determined in vitro using high performance liquid chromatography analysis of samples of rat plasma and liver homogenates taken from 3 animals...
May 12, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28503730/cardiopulmonary-and-sedative-effects-of-intravenous-or-epidural-methadone-in-conscious-dogs
#17
B H B Vieira, L T Nishimura, L L Carvalho, A Auckburally, E Mattos-Junior
Cardiopulmonary and sedative effects of intravenous or epidural methadone were compared. Six beagles were randomly assigned to group MIV (methadone 0.5 mg/kg IV + NaCl 0.9% epidurally) or MEP (methadone 0.5 mg/kg epidurally + NaCl 0.9% IV). Cardiopulmonary, blood gas and sedation were assessed at time (T) 0, 15, 30, 60, 120, 240 and 480 min after drug administration. Compared to T0, heart rate decreased at T15-T120 in MIV (p < .001) and T15-T240 in MEP (p < .05); mean arterial pressure was reduced at T15-T60 in MEP (p < ...
May 15, 2017: Journal of Veterinary Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28500785/don-t-label-me-a-qualitative-study-of-patients-perceptions-and-experiences-of-sedation-during-behavioral-emergency-in-the-emergency-department
#18
Celene Y L Yap, Jonathan C Knott, David C M Kong, Marie Gerdtz, Kay Stewart, David McD Taylor
OBJECTIVES: Behavioral emergencies are commonly seen in emergency departments. Acutely agitated patients can be difficult to manage and sedation may be required to decrease dangerous behavior and to ensure the safety of both the patient and staff. While the experience of staff caring for this population has been reported, patients' experiences with their overall management remains unknown. We aimed to describe the perceptions and experiences of patients regarding the use of sedation during acute behavioral emergencies...
May 13, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28499448/comparison-of-demographic-characteristics-and-psychiatric-comorbidity-among-methamphetamine-heroin-and-methamphetamine-heroin-co-dependent-males-in-hunan-china
#19
Huixi Dong, Mei Yang, Liang Liu, Chenxi Zhang, Mengqi Liu, Yidong Shen, Huanzhong Liu, Wei Hao
BACKGROUND: There is little research of psychiatric comorbidity differences among people with different types of drug dependence in Chinese population. We explored demographic and comorbid psychiatric differences among methamphetamine- dependent males (MDs), heroin-dependent males (HDs) and methamphetamine and heroin co-dependent males (M/HDs) in Hunan province, China. METHODS: A cross-sectional, structured and clinical interview method was used to examine differences in DSM-IV-TR Axis I Disorders among 346 MDs, 698 HDs and 247 M/HDs from three compulsory rehabilitation centers and two voluntary rehabilitation centers in Hunan...
May 12, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28496358/analgesic-efficacy-adverse-effects-and-safety-of-oxycodone-administered-as-continuous-intravenous-infusion-in-patients-after-total-hip-arthroplasty
#20
Bogumił Olczak, Grzegorz Kowalski, Wojciech Leppert, Iwona Zaporowska-Stachowiak, Katarzyna Wieczorowska-Tobis
BACKGROUND: Total hip arthroplasty (THA) causes extensive tissue damage and severe pain. This study aimed to assess the analgesic efficacy, adverse effects (AEs), and safety of continuous intravenous (iv) oxycodone infusion with ketoprofen (injected into the iv line) in patients after THA, and to assay serum oxycodone levels. PATIENTS AND METHODS: Fourteen patients, aged 59‒82 years with American Society of Anesthesiologists (ASA) classification I or III, underwent THA with intrathecal analgesia and sedation induced by iv propofol...
2017: Journal of Pain Research
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