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Procedural sedation obese

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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
#1
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
#2
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
#3
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
#4
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
#5
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)...
October 18, 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
#6
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)...
September 13, 2017: Contraception
https://www.readbyqxmd.com/read/28915133/complications-and-unplanned-admissions-in-nonoperating-room-procedures
#7
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
#8
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
#9
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...
August 24, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28823144/factors-impacting-patient-cooperation-during-elective-gastroscopy
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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/m(2)) 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
#16
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
https://www.readbyqxmd.com/read/27595264/sedation-for-bronchoscopy-and-complications-in-obese-patients
#17
Irtaza Khan, Arjun B Chatterjee, Christina R Bellinger, Edward Haponik
BACKGROUND: Bronchoscopy is a safe and minimally invasive diagnostic tool, but no studies have reported prospectively on sedation and outcomes in patients with objectively defined obesity. OBJECTIVES: The purpose of the study is to determine if obese patients require more sedation or had more procedural complications during bronchoscopy under moderate sedation than non-obese patients. METHODS: We evaluated complications and sedation requirements in non-obese versus obese patients, defined by multiple criteria including body mass index (BMI), neck circumference, abdominal height, and Mallampati scores...
2016: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/27372775/sedation-challenges-obesity-and-sleep-apnea
#18
REVIEW
Pichamol Jirapinyo, Christopher C Thompson
This article reviews the data for diagnostic and uncomplicated therapeutic upper endoscopy, which show it is safe and effective to perform the procedure under moderate sedation with a combination of benzodiazepine and opioids. For more complex procedures or for superobese patients anesthesia support is recommended. Performing endoscopy in this population should alert providers to plan carefully and individualize sedation plans because there is no objective way to quantify this risk pre-endoscopically.
July 2016: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/27177015/intravenous-sedation-without-intubation-and-the-risk-of-anesthesia-complications-for-obese-and-non-obese-women-undergoing-surgical-abortion-a-retrospective-cohort-study
#19
COMPARATIVE STUDY
Priyanka Gokhale, Justin R Lappen, Jonathan H Waters, Lisa K Perriera
BACKGROUND: The primary objective of this study was to assess the risk of perioperative anesthesia-related complications in a cohort of obese and non-obese women undergoing outpatient surgical abortion under IV sedation without tracheal intubation. METHODS: We performed a retrospective cohort study of all surgical abortions through 22 6/7 weeks' gestation at an outpatient clinic from 2012 to 2013. Women receiving IV sedation were included. Obesity status was defined by the World Health Organization criteria...
June 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27067606/successful-percutaneous-management-of-symptomatic-central-posterior-epidural-baastrup-cyst-a-potential-surgical-sparing-option
#20
Jordan Breed, Tony Goldschlager, Ronil V Chandra
BACKGROUND CONTEXT: Neurogenic claudication from posterior epidural extension of a Baastrup interspinous bursal cyst is rare. Surgical decompression is the gold standard of treatment. This case report describes successful percutaneous treatment with good early clinicoradiological outcome. PURPOSE: This study aimed to describe the successful percutaneous treatment of a central posterior epidural Baastrup cyst causing neurogenic claudication. STUDY DESIGN: This is a case report study...
September 2016: Spine Journal: Official Journal of the North American Spine Society
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