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Procedural sedation obese

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https://www.readbyqxmd.com/read/29743844/difficult-colonoscopy-air-carbon-dioxide-or-water-insufflation
#1
Alisha Chaubal, Vikas Pandey, Ruchir Patel, Prateik Poddar, Aniruddha Phadke, Meghraj Ingle, Prabha Sawant
Background/Aims: This study aimed to compare tolerance to air, carbon dioxide, or water insufflation in patients with anticipated difficult colonoscopy (young, thin, obese individuals, and patients with prior abdominal surgery or irradiation). Methods: Patients with body mass index (BMI) less than 18 kg/m2 or more than 30 kg/m2 , or who had undergone previous abdominal or pelvic surgeries were randomized to air, carbon dioxide, or water insufflation during colonoscopy...
April 2018: Intestinal Research
https://www.readbyqxmd.com/read/29719796/use-of-high-flow-nasal-cannula-in-obese-patients-receiving-colonoscopy-under-intravenous-propofol-sedation-a-case-series
#2
Chi Chan Lee, Osman Perez, Faryal I Farooqi, Trupti Akella, Sameer Shaharyar, Melissa Elizee
Intravenous sedation during colonoscopy has become the standard practice in the United States given its higher patient satisfaction and procedural quality. This practice is not free of side effects as a significant proportion of patients undergoing this procedure tend to have respiratory depression and desaturation events. Obesity, as it relates to higher levels of body mass index (BMI) has a positive correlation with the incidence of hypoxemia. During colonoscopy High flow nasal cannula (HFNC) may potentially improve oxygen performance in patients receiving colonoscopy under intravenous sedation...
2018: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/29409833/a-randomized-comparison-of-intravenous-sedation-using-a-dosing-algorithm-compared-to-standard-care-during-first-trimester-surgical-abortion
#3
Kari P Braaten, Richard D Urman, Rie Maurer, Jennifer Fortin, Alisa B Goldberg
OBJECTIVE: The objective was to compare the safety and efficacy of an algorithm for abortion intravenous sedation dosing (AAID) to standard dosing during first-trimester surgical abortion. STUDY DESIGN: This was a randomized, single-blinded, controlled trial in which women undergoing first-trimester surgical abortion received fentanyl and midazolam dosed per either an algorithm or clinic standard. Patient-level factors including weight, airway risk, anxiety, and drug and alcohol use determined AAID doses...
February 2, 2018: Contraception
https://www.readbyqxmd.com/read/29305305/the-safety-and-efficacy-of-the-procedureless-intragastric-balloon
#4
Salman Alsabah, Eliana Al Haddad, Shehab Ekrouf, Ahmad Almulla, Saud Al-Subaie, Mubarak Al Kendari
BACKGROUND: Obesity is on a continuous rise worldwide, and with it, novel bariatric procedures have emerged. The introduction of gastric balloons has opened up a nonsurgical option for patients opting for it. However, they still require some form of sedation and endoscopy for insertion and/or removal. OBJECTIVES: The Elipse balloon is a novel creation that has managed to bypass both these procedures; therefore, the investigation into its effectiveness is of importance...
March 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29226110/comparison-effect-of-promethazine-dexamethasone-and-metoclopramide-dexamethasone-on-postoperative-nausea-and-vomiting-after-laparascopic-gastric-placation-a-randomized-clinical-trial
#5
Mohammad Talebpour, Naser Ghiasnejad Omrani, Farsad Imani, Reza Shariat Moharari, Pejman Pourfakhr, Mohammad Reza Khajavi
Background: Laparoscopic gastric plication (LGP) is a technique in the restrictive category of bariatric procedures that reduces the gastric volume and increases intragastric pressure. Nausea and vomiting are the most common complications after this procedure. The goal of this research is to compare the combined effect of promethazine/dexamethasone versus Metoclopramide/ dexamethasone on the prevention of nausea and vomiting after LGP. Methods: In recovery, the patients were divided into two groups, the Metoclopramide group which was given Metoclopramide 10 mg plus dexamethasone 4 mg/8 hours intravenous for 48 hours, and the promethazine group which was given promethazine 50 mg /12 hours, intramuscular for the first 24 hours and then promethazine 25 mg/12 hours for the next 24 hours plus dexamethasone 4 mg/8 hours intravenous for 48 hours...
August 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/29201800/effect-of-different-sedation-regimes-on-cognitive-functions-in-colonoscopy
#6
Perihan Ekmekçi, Gulbanu Erkan, Hakan Yilmaz, Baturay K Kazbek, Ulku C Köksoy, Güler Doganay, Doganay Filiz Tüzüner
Aim: To compare the effects of propofol/remifentanil and meperidine/midazolam on postprocedure cognitive function. Materials and methods: A total of 100 American Society of Anesthesiologists (ASA) score I to III patients undergoing elective colonoscopy were taken into the study and divided into two groups. Exclusion criteria were patient refusal, mini mental test (MMT) <26, The Amsterdam Preoperative Anxiety and Information Scale (APAIS) >10, advanced cardiopulmonary or psychiatric disease, chronic alcohol abuse, morbid obesity, and known allergy to study drugs...
July 2017: Euroasian journal of hepato-gastroenterology
https://www.readbyqxmd.com/read/29121287/analgesia-nociception-index-for-the-assessment-of-pain-in-critically-ill-patients-a-diagnostic-accuracy-study
#7
G Chanques, T Tarri, A Ride, A Prades, A De Jong, J Carr, N Molinari, S Jaber
Background: Behavioural pain tools are used in Intensive Care Unit (ICU) patients unable to self-report their pain-intensity but need sustained efforts to educate and train the ICU team because of the subjective nature of these clinical tools. This study measured the validity and performance of an electrophysiological monitoring tool based on the spectral analysis of heart rate variability, the Analgesia Nociception Index (ANI) which varies from 0 (minimal parasympathetic tone, maximal stress-response and pain) to 100 (maximal parasympathetic tone, minimal stress-response and pain)...
October 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29090250/complications-associated-with-intravenous-midazolam-and-fentanyl-sedation-in-patients-undergoing-minor-oral-surgery
#8
Krittika Saiso, Pornnarin Adnonla, Jitpisut Munsil, Benjamas Apipan, Duangdee Rummasak, Natthamet Wongsirichat
BACKGROUND: Anxiety control remains an important concern in dental practice. We evaluated the incidence, nature, and sequelae of complications during and after minor oral surgeries performed under intravenous midazolam and fentanyl sedation using the titration technique. METHODS: The medical records of patients who had undergone minor oral surgeries under moderate intravenous midazolam and fentanyl sedation at our institution between January 1, 2015 and December 31, 2015 were retrospectively evaluated...
September 2017: Journal of Dental Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29046933/-regional-anesthesia-are-the-standards-changing
#9
REVIEW
T Volk, C Kubulus
Regional anesthesia has undergone many changes over the years and the increasing use of ultrasound has certainly played an important role in this. Apart from individual case reports in the literature of very different blocking options, some new procedures seem to have become established and can be broadly applied. Among these are blockades, by which ultrasound-guided injection of local anesthetics is carried out in fascial or muscular layers rather than around target nerves (e.g. cervical plexus blocks and truncal blocks)...
December 2017: Der Anaesthesist
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
#10
Gillian Horwitz, Danielle Roncari, Kari P 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)...
January 2018: Contraception
https://www.readbyqxmd.com/read/28915133/complications-and-unplanned-admissions-in-nonoperating-room-procedures
#11
Kate Leslie, Benjamin Kave
PURPOSE OF REVIEW: The purpose of this article is to review complications and unplanned hospital admissions in patients presenting for ambulatory procedures requiring anesthesia care in the gastrointestinal endoscopy, bronchoscopy, and radiology suites. RECENT FINDINGS: The range of ambulatory diagnostic and therapeutic procedures being undertaken in the gastrointestinal endoscopy, bronchoscopy, and radiology suites is expanding rapidly. Recent observational studies in gastrointestinal endoscopy confirm low incidences of complications and unplanned admissions...
December 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28884402/obstructive-sleep-apnea-increases-the-risk-of-cardiopulmonary-adverse-events-associated-with-ambulatory-colonoscopy-independent-of-body-mass-index
#12
Vaishali A Patel, Paul St Romain, Juan Sanchez, Deborah A Fisher, Ryan D Schulteis
BACKGROUND: The relationship between body mass index (BMI) and cardiopulmonary adverse events (CAEs) for ambulatory colonoscopy is unclear. AIM: To assess the association of BMI and CAEs associated with ambulatory colonoscopy. METHODS: This is a retrospective cohort analysis of 418 patients who underwent outpatient colonoscopy at the Durham Veterans Affairs Medical Center categorized as normal/overweight (BMI < 30), obese (BMI 30-34), or morbidly obese (BMI ≥ 35)...
October 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28843955/predictors-of-use-of-monitored-anesthesia-care-for-outpatient-gastrointestinal-endoscopy-in-a-capitated-payment-system
#13
Megan A Adams, Katherine M Prenovost, Jason A Dominitz, Robert G Holleman, Eve A Kerr, Sarah L Krein, Sameer D Saini, Joel H Rubenstein
BACKGROUND & AIMS: Use of monitored anesthesia care (MAC) for gastrointestinal endoscopy has increased in the Veterans Health Administration (VHA) as in fee-for-service environments, despite the absence of financial incentives. We investigated factors associated with use of MAC in an integrated health care delivery system with a capitated payment model. METHODS: We performed a retrospective cohort study using multilevel logistic regression, with MAC use modeled as a function of procedure year, patient- and provider-level factors, and facility effects...
December 2017: Gastroenterology
https://www.readbyqxmd.com/read/28823144/factors-impacting-patient-cooperation-during-elective-gastroscopy
#14
Sang Pyo Lee, In-Kyung Sung, Jeong Hwan Kim, Sun-Young Lee, Hyung Seok Park, Chan Sup Shim
BACKGROUND/AIMS: Some people have difficulty tolerating upper endoscopy. The cause of and risk factors for this are not well known. The aim of this study was to investigate the factors involved in poor cooperation during screening upper endoscopy. METHODS: A total of 4,422 subjects who underwent a health inspection with upper endoscopy carried out by a single experienced endoscopist were included. We retrospectively investigated subjects' self-reporting questionnaires and medical records, including endoscopic and histologic findings...
September 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/28798230/association-of-bmi-with-propofol-dosing-and-adverse-events-in-children-with-cancer-undergoing-procedural-sedation
#15
Colin M Rogerson, Kamal Abulebda, Michael J Hobson
OBJECTIVES: Obesity increases the risk of complications during pediatric procedural sedation. The risk of being underweight has not been evaluated in this arena. We therefore investigated the association of BMI with sedation dosing and adverse events in children across a range of BMIs. METHODS: A total of 1976 patients ages 2 to 21 years old with oncologic diagnoses underwent lumbar punctures and/or bone marrow aspirations. All children received a standard adjunctive dose of ketamine before sedation with propofol...
August 10, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28375709/a-novel-hands-free-abdominal-compression-device-for-colonoscopy-significantly-decreases-cecal-intubation-time-a-prospective-single-blinded-pilot-study
#16
RANDOMIZED CONTROLLED TRIAL
Allison R Schulman, Marvin Ryou, Walter W Chan
BACKGROUND: Colonoscopy outcome is limited by endoscope looping, which leads to patient discomfort, prolonged procedure, and increased sedation requirement. Traditional manual abdominal pressure is imprecise and manually intensive. A hands-free abdominal compression device (ACD) may improve colonoscopy outcome. We aimed to assess the effect of a novel ACD on colonoscopy outcomes compared to manual pressure. MATERIALS AND METHODS: This was a prospective single-blinded study of patients undergoing outpatient colonoscopy...
June 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28260464/incisional-hernia-after-liver-transplant
#17
Ebru H Ayvazoglu Soy, Mahir Kirnap, Sedat Yildirim, Gokhan Moray, Mehmet Haberal
OBJECTIVES: An incisional hernia seriously burdens the quality of life after liver transplant. The incidence of incisional hernia after liver transplant is reported to be 4% to 20%. Here, we evaluated incisional hernias that occurred after adult liver transplant and incisional hernias intentionally made in infant liver transplant procedures. MATERIALS AND METHODS: Between December 1988 and May 2016, we performed 536 liver transplant procedures in 515 patients. Demographic features, surgical outcomes, and predisposing factors were evaluated...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28245939/desaturation-in-procedural-sedation-for-children-with-long-bone-fractures-does-weight-status-matter
#18
Danielle G Hirsch, John Tyo, Brian H Wrotniak
INTRODUCTION: Childhood obesity remains a serious problem in the United States. Significant associated adverse incidents have been reported with sedation of children with obesity, namely hypoxemia. The objective of our study was to determine if overweight and obesity were associated with increased desaturations during procedural sedation compared with patients of healthy weight. METHODS: This was a single-center retrospective chart review of data from a three-year period of patient's age 2-17years...
August 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27885537/safety-analysis-of-bariatric-patients-undergoing-outpatient-upper-endoscopy-with-non-anesthesia-administered-propofol-sedation
#19
Tyler McVay, John C Fang, Linda Taylor, Alexander Au, Wesley Williams, Angela P Presson, Ragheed Al-Dulaimi, Eric Volckmann, Anna Ibele
BACKGROUND: Non-anesthesia administered propofol (NAAP) has been shown to be a safe and effective method of sedation for patients undergoing gastrointestinal endoscopy. Bariatric surgery patients are potentially at a higher risk for sedation-related complications due to co-morbidities including obstructive sleep apnea. The outcomes of NAAP in bariatric patients have not been previously reported. METHODS: In this retrospective cohort study, severely obese patients undergoing pre-surgical outpatient esophagogastroduodenoscopy (EGD) were compared to non-obese control patients (BMI ≤ 25 kg/m2 ) undergoing diagnostic EGD at our institution from March 2011-September 2015 using our endoscopy database...
June 2017: Obesity Surgery
https://www.readbyqxmd.com/read/27761556/alfentanil-versus-ketamine-combined-with-propofol-for-sedation-during-upper-gastrointestinal-system-endoscopy-in-morbidly-obese-patients
#20
RANDOMIZED CONTROLLED TRIAL
Ertugrul Kılıc, Barış Demiriz, Nurgül Isıkay, Abdullah E Yıldırım, Selman Can, Cem Basmacı
OBJECTIVES: To observe the effects of both propofol/alfentanil and propofol/ketamine on sedation during upper gastrointestinal system endoscopy in morbidly obese patients (UGSEMOP). METHODS: In a prospective, double-blinded, randomized clinical study, 52 patients scheduled for UGSEMOP were assigned to either group A (n=26; 10 µg/kg intravenous [IV] alfentanil) or group K (n=26; 0.5 mg/kg IV ketamine). Each patient was administered 0.7 mg/kg propofol for induction...
November 2016: Saudi Medical Journal
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