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analgosedation

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https://www.readbyqxmd.com/read/29149387/analgosedation-in-paediatric-severe-traumatic-brain-injury-tbi-practice-pitfalls-and-possibilities
#1
N Ketharanathan, Y Yamamoto, U Rohlwink, E D Wildschut, M Hunfeld, E C M de Lange, D Tibboel
Analgosedation is a fundamental part of traumatic brain injury (TBI) treatment guidelines, encompassing both first and second tier supportive strategies. Worldwide analgosedation practices continue to be heterogeneous due to the low level of evidence in treatment guidelines (level III) and the choice of analgosedative drugs is made by the treating clinician. Current practice is thus empirical and may result in unfavourable (often hemodynamic) side effects. This article presents an overview of current analgosedation practices in the paediatric intensive care unit (PICU) and addresses pitfalls both in the short and long term...
October 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29112108/nitrous-oxide-70-for-procedural-analgosedation-in-a-pediatric-emergency-department-with-or-without-intranasal-fentanyl-analgesic-efficacy-and-adverse-events-if-combined-with-intranasal-fentanyl
#2
Michelle Seiler, Markus A Landolt, Georg Staubli
OBJECTIVES: Nitrous oxide 70% (N20 70%) is an excellent medication for procedural analgosedation in a pediatric emergency department. However, its analgesic efficacy remains uncertain for painful procedures; therefore, a combination with intranasal fentanyl (INF), an opioid, was suggested. This study aimed at observing and assessing the analgesic efficacy and rate of adverse events using N20 70% with and without INF. METHODS: Children who received N20 70% in a tertiary children's hospital emergency department from January 1, 2014 to June 30, 2015 were included in this observational study with prospective data collection...
July 3, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29050060/-ambulant-anesthesia-regional-anesthesia-for-ambulatory-patients
#3
Andreas Krier, Jörg Karst
Although regional anesthesia for ambulatory patients is feasible, effective and recommended, general anesthesia, analgosedation and monitored anesthesia care traditionally play a major role in the ambulatory setting. This discrepancy is at least partially caused by a more standardized and predictable process when using general anesthesia. High patient comfort, a low rate of complications and a rapid postoperative recovery are expected by all patients, irrespective of the type of anesthesia chosen and lie in the common interest of the anesthesiologist and the surgeon...
October 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29045997/the-influence-of-bis-monitoring-on-sedative-dose-in-pediatric-patients-undergoing-open-muscle-biopsies-a-randomized-controlled-trial
#4
Eva Tschiedel, Oliver Müller, Adela Della Marina, Ursula Felderhoff-Müser, Christian Dohna-Schwake
Background The use of Propofol and Remifentanil for analgosedation in children is common and safe. For sedation monitoring clinical scores as Comfort Score (CS) as well as bispectral index (BIS) are frequently applied. The impact of BIS for sedation monitoring in pediatric patients is still under debate. This prospective study aims to investigate whether dual sedation monitoring of CS and BIS compared with monitoring of CS alone during muscle biopsies in children can reduce sedative doses, reduce awakening time and prevent complications...
October 18, 2017: Klinische Pädiatrie
https://www.readbyqxmd.com/read/28762591/ean-consensus-review-on-prevention-diagnosis-and-management-of-tick-borne-encephalitis
#5
REVIEW
P Taba, E Schmutzhard, P Forsberg, I Lutsar, U Ljøstad, Å Mygland, I Levchenko, F Strle, I Steiner
BACKGROUND AND PURPOSE: Tick-borne encephalitis (TBE) is an infection of the central nervous system (CNS) caused by tick-borne encephalitis virus (TBEV) and transmitted by ticks, with a variety of clinical manifestations. The incidence of TBE in Europe is increasing due to an extended season of the infection and the enlargement of endemic areas. Our objectives are to provide recommendations on the prevention, diagnosis and management of TBE, based on evidence or consensus decisions. METHODS: For systematic evaluation, the literature was searched from 1970 to 2015 (including early online publications of 2016), and recommendations were based on evidence or consensus decisions of the Task Force when evidence-based data were not available...
August 1, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28733841/analgosedation-of-adult-patients-with-elevated-intracranial-pressure-survey-of-current-clinical-practice-in-austria
#6
Guenther Herzer, Claudia Mirth, Udo M Illievich, Wolfgang G Voelckel, Helmut Trimmel
BACKGROUND: Analgesia and sedation are key items in intensive care. Recently published S3 guidelines specifically address treatment of patients with elevated intracranial pressure. METHODS: The Austrian Society of Anesthesiology, Resuscitation and Intensive Care Medicine carried out an online survey of neurointensive care units in Austria in order to evaluate the current state of practice in the areas of analgosedation and delirium management in this high-risk patient group...
July 21, 2017: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/28645462/analgosedation-practices-and-the-impact-of%C3%A2-sedation-depth-on-clinical-outcomes-among-patients-requiring-mechanical-ventilation-in-the-ed-a-cohort-study
#7
Robert J Stephens, Enyo Ablordeppey, Anne M Drewry, Christopher Palmer, Brian T Wessman, Nicholas M Mohr, Brian W Roberts, Stephen Y Liang, Marin H Kollef, Brian M Fuller
BACKGROUND: Analgesia and sedation are cornerstone therapies for mechanically ventilated patients. Despite data showing that early deep sedation in the ICU influences outcome, this has not been investigated in the ED. Therefore, ED-based sedation practices, and their influence on outcome, remain incompletely defined. This study's objectives were to describe ED sedation practices in mechanically ventilated patients and to test the hypothesis that ED sedation depth is associated with worse outcomes...
June 21, 2017: Chest
https://www.readbyqxmd.com/read/28618123/-pain-relieved-but-still-struggling-critically-ill-patients-experiences-of-pain-and-other-discomforts-during-analgosedation
#8
Helene Berntzen, Ida Torunn Bjørk, Hilde Wøien
AIM & OBJECTIVE: To explore how critically ill patients treated according to a strategy of analgosedation experience and handle pain, other discomforts, and wakefulness. BACKGROUND: Patients experience both pain and discomfort while in the intensive care unit (ICU). International guidelines recommend focused pain treatment and light sedation. An analgosedation protocol favoring pain management, light sedation and early mobilization was implemented in our university hospital medical and surgical ICU in Norway in 2014...
June 15, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28571040/videolaryngoscopy-during-conscious-sedation-in-patients-not-suitable-for-phonosurgery-by-microlaryngoscopy-a-pilot-study
#9
Vincenzo Saita, Eugenia Allegra, Nicolò Marino, Serena Trapasso, Maria Concetta Monea
BACKGROUND: Microlaryngoscopy is the preferred and most widely used technique in phonosurgery for the treatment of benign and early malignant glottic lesions. However, the procedure may be technically difficult or impossible due to alterations of the cervical spine that may not allow hyperextension of the head or may present general anesthesia contraindications. The aim of this study is to evaluate the efficacy and safety of our surgical approach for lesions of the vocal folds in patients who are not suitable for phonosurgery by microlaryngoscopy...
June 2, 2017: ORL; Journal for Oto-rhino-laryngology and its related Specialties
https://www.readbyqxmd.com/read/28379017/-radiofrequency-catheter-ablation-of-atrial-fibrillation-performed-under-general-anesthesia-results-of-a-unicentric-randomized-trial
#10
RANDOMIZED CONTROLLED TRIAL
Klára Stašková, Alan Bulava, Richard Tesařík, František Toušek
INTRODUCTION: Radiofrequency catheter ablation (RFA) has recently become a routine part of atrial fibrillation (AF) treatment. The goal of our study was to determine whether the implementation of RFA of AF under general anesthesia (GA), compared to analgosedation (AS), will affect important characteristics of the ablation procedure, comfort of the patient and whether there is any clinical impact on the complication rate and the overall success of the procedure. METHODS: 50 patients with AF were randomized in a ratio of 1 : 1 into two groups for RFA in AS and in GA...
December 0: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/28275614/considerations-for-analgosedation-and-antithrombotic-management-during-extracorporeal-life-support
#11
REVIEW
Pamela K Burcham, Alan J Rozycki, Erik E Abel
Despite the immense growth in extracorporeal life support (ECLS) technology and experience, opportunity remains to better characterize the pharmacotherapeutic considerations during ECLS. Analgosedation can be particularly challenging in the ECLS population due to in drug-circuit interactions that may lead to decreased systemic concentrations and pharmacodynamic effect. ECLS also requires the use of antithrombotic agents to mitigate the prothrombotic state created by the artificial surface in the ECLS circuit...
February 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28194747/local-anaesthesia-with-analgosedation-in-patients-qualified-for-transcatheter-aortic-valve-implantation-tavi-first-institute-s-results-and-experiments
#12
Robert Musiał, Magdalena Lipińska-Strasik, Agnieszka Piątkiewicz, Jarosław Stoliński, Rafał Drwiła
BACKGROUND: The authors present their own experience of the treatment of patients qualified for transcatheter aortic valve implantation (TAVI) carried out in a modern hybrid operating room. The objective of the present study was to demonstrate the initial results of conducting anaesthesia in high-risk patients qualified for the TAVI procedure (transcatheter aortic valve implantation). In addition, the authors' aim was also to point out to the special challenges of an anaesthesiologist conducting local anaesthesia in such a type of procedures and to evaluate the safety and efficacy of the TAVI procedure conducted under remifentanil analgosedation...
2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28006928/sufentanil-and-midazolam-dosing-and-pharmacogenetic-factors-in-pediatric-analgosedation-and-withdrawal-syndrome
#13
K Hronová, P Pokorná, L Posch, O Slanař
Our aim was to describe the effect of dosing and genetic factors on sufentanil- and midazolam-induced analgosedation and withdrawal syndrome (WS) in pediatric population. Analgosedation and withdrawal syndrome development were monitored using COMFORT-neo/-B scores and SOS score. Length of therapy, dosing of sufentanil and midazolam were recorded. Genotypes of selected candidate polymorphisms in CYP3A5, COMT, ABCB1, OPRM1 and PXR were analysed. In the group of 30 neonates and 18 children, longer treatment duration with midazolam of 141 h (2 - 625) vs...
December 21, 2016: Physiological Research
https://www.readbyqxmd.com/read/27851694/analgosedation-with-dexmedetomidine-in-a-patient-with-superior-vena-cava-syndrome-in-neurosurgery
#14
Vasilije Stambolija, Martina Miklić Bublić, Marin Lozić, Zvonka Gužvinec, Miroslav Vukić
No abstract text is available yet for this article.
November 15, 2016: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/27850555/917-evaluation-of-appropriate-analgesia-sedation-pre-versus-post-analgosedation-protocol-implementation
#15
Lesly Jurado, Micheal Strein, Lisa Hall Zimmerman, Joshua Steelman, Steven Nakajima, Charleen Gnisci, Zachery Bullard
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27850491/853-ketamine-continuous-infusion-for-analgosedation-in-critically-ill-mechanically-ventilated-adults
#16
Jenna Smith, Elizabeth Gearhart, Svetolik Djurkovic
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27677675/evolution-of-severe-sleep-wake-cycle-disturbances-following-traumatic-brain-injury-a-case-study-in-both-acute-and-subacute-phases-post-injury
#17
Catherine Duclos, Marie Dumont, Marie-Julie Potvin, Alex Desautels, Danielle Gilbert, David K Menon, Francis Bernard, Nadia Gosselin
BACKGROUND: Sleep-wake disturbances are frequently reported following traumatic brain injury (TBI), but they remain poorly documented in the acute stage of injury. Little is known about their origin and evolution. CASE PRESENTATION: This study presents the case of a patient in the acute phase of a severe TBI. The patient was injured at work when falling 12 m into a mine and was hospitalized in the regular wards of a level I trauma centre. From days 31 to 45 post-injury, once he had reached a level of medical stability and continuous analgosedation had been ceased, his sleep-wake cycle was monitored using actigraphy...
September 27, 2016: BMC Neurology
https://www.readbyqxmd.com/read/27644010/impact-of-an-analgesia-based-sedation-protocol-on-mechanically-ventilated-patients-in-a-medical-intensive-care-unit
#18
Andrew C Faust, Pearl Rajan, Lyndsay A Sheperd, Carlos A Alvarez, Phyllis McCorstin, Rebecca L Doebele
BACKGROUND: Recent attention to adverse effects of intensive care unit (ICU) sedation has led to the use of strategies that target a "lighter" depth of sedation. Among these strategies are "analgosedation" protocols, which prioritize pain management and preferentially use IV opioids before administration of continuously infused sedatives such as propofol or midazolam. We hypothesized that using an analgosedation protocol would result in a shorter duration of mechanical ventilation than a protocol with greater emphasis on IV sedatives METHODS: : We conducted a retrospective study comparing the duration of mechanical ventilation before and after implementation of an analgosedation protocol in a 24-bed medical ICU...
October 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27586065/does-the-presence-of-an-emergency-physician-influence-pre-hospital-time-pre-hospital-interventions-and-the-mortality-of-severely-injured-patients-a-matched-pair-analysis-based-on-the-trauma-registry-of-the-german-trauma-society-traumaregister-dgu-%C3%A2
#19
Dan Bieler, Axel Franke, Rolf Lefering, Sebastian Hentsch, Arnulf Willms, Martin Kulla, Erwin Kollig
PURPOSE: The role of emergency physicians in the pre-hospital management of severely injured patients remains controversial. In Germany and Austria, an emergency physician is present at the scene of an emergency situation or is called to such a scene in order to provide pre-hospital care to severely injured patients in approximately 95% of all cases. By contrast, in the United States and the United Kingdom, paramedics, i.e. non-physician teams, usually provide care to an injured person both at the scene of an incident and en route to an appropriate hospital...
January 2017: Injury
https://www.readbyqxmd.com/read/27585039/analgosedation-in-picus-one-size-fits-all-or-beyond
#20
Monique van Dijk, Erwin Ista, Dick Tibboel
No abstract text is available yet for this article.
September 2016: Pediatric Critical Care Medicine
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