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Moderate sedation

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https://www.readbyqxmd.com/read/29142513/sedation-for-routine-gastrointestinal-endoscopic-procedures-a-review-on-efficacy-safety-efficiency-cost-and-satisfaction
#1
REVIEW
Otto S Lin
Most gastrointestinal endoscopic procedures are now performed with sedation. Moderate sedation using benzodiazepines and opioids continue to be widely used, but propofol sedation is becoming more popular because its unique pharmacokinetic properties make endoscopy almost painless, with a very predictable and rapid recovery process. There is controversy as to whether propofol should be administered only by anesthesia professionals (monitored anesthesia care) or whether properly trained non-anesthesia personnel can use propofol safely via the modalities of nurse-administered propofol sedation, computer-assisted propofol sedation or nurse-administered continuous propofol sedation...
October 2017: Intestinal Research
https://www.readbyqxmd.com/read/29137881/comparison-between-chloral-hydrate-and-propofol-ketamine-as-sedation-regimens-for-pediatric-auditory-brainstem-response-testing
#2
Kamal Abulebda, Vinit J Patel, Sheikh S Ahmed, Alvaro J Tori, Riad Lutfi, Samer Abu-Sultaneh
INTRODUCTION: The use of diagnostic auditory brainstem response testing under sedation is currently the "gold standard" in infants and young children who are not developmentally capable of completing the test. OBJECTIVE: The aim of the study is to compare a propofol-ketamine regimen to an oral chloral hydrate regimen for sedating children undergoing auditory brainstem response testing. METHODS: Patients between 4 months and 6 years who required sedation for auditory brainstem response testing were included in this retrospective study...
October 28, 2017: Brazilian Journal of Otorhinolaryngology
https://www.readbyqxmd.com/read/29131465/psychometric-analysis-of-subjective-sedation-scales-used-for-critically-ill-paediatric-patients
#3
Xiaohua Ge, Tingting Zhang, Lingling Zhou
AIMS: This study evaluated the psychometric properties of subjective sedation scales using one psychometric scoring system to identify the appropriate scale that is most suitable for clinical care practice. BACKGROUND: A number of published sedation assessment scales for paediatric patients are currently used to attempt to achieve a moderate depth of sedation to avoid the undesirable effects caused by over- or undersedation. However, there has been no systematic review of these scales...
November 12, 2017: Nursing in Critical Care
https://www.readbyqxmd.com/read/29114060/ethics-rounds-death-after-pediatric-dental-anesthesia-an-avoidable-tragedy
#4
Helen Lee, Peter Milgrom, Colleen E Huebner, Philip Weinstein, Wylie Burke, Erika Blacksher, John D Lantos
Early childhood caries (ECC) is the single most common chronic childhood disease. In the treatment of ECC, children are often given moderate sedation or general anesthesia. An estimated 100 000 to 250 000 pediatric dental sedations are performed annually in the United States. The most common medications are benzodiazepines, opioids, local anesthetics, and nitrous oxide. All are associated with serious adverse events, including hypoxemia, respiratory depression, airway obstruction, and death. There is no mandated reporting of adverse events or deaths, so we don't know how often these occur...
November 7, 2017: Pediatrics
https://www.readbyqxmd.com/read/29101957/anesthesia-for-colonoscopy-and-lower-endoscopic-procedures
#5
REVIEW
John Michael Trummel, Vinay Chandrasekhara, Michael L Kochman
Demand for anesthesiologist-assisted sedation is expanding for gastrointestinal lower endoscopic procedures and may add to the cost of these procedures. Most lower endoscopy can be accomplished with either no, moderate, or deep sedation; general anesthesia and active airway management are rarely needed. Propofol-based sedation has advantages in terms of satisfaction and recovery over other modalities, but moderate sedation using benzodiazepines and opiates work well for low-risk patients and procedures. No sedation for routine colonoscopy works well for selected patients and eliminates sedation-related risks...
December 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/29099542/chloral-hydrate-as-a-sedating-agent-for-neurodiagnostic-procedures-in-children
#6
REVIEW
Choong Yi Fong, Chee Geap Tay, Lai Choo Ong, Nai Ming Lai
BACKGROUND: Paediatric neurodiagnostic investigations, including brain neuroimaging and electroencephalography (EEG), play an important role in the assessment of neurodevelopmental disorders. The use of an appropriate sedative agent is important to ensure the successful completion of the neurodiagnostic procedures, particularly in children, who are usually unable to remain still throughout the procedure. OBJECTIVES: To assess the effectiveness and adverse effects of chloral hydrate as a sedative agent for non-invasive neurodiagnostic procedures in children...
November 3, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29090250/complications-associated-with-intravenous-midazolam-and-fentanyl-sedation-in-patients-undergoing-minor-oral-surgery
#7
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: J Dent Anesth Pain Med
https://www.readbyqxmd.com/read/29060888/propofol-induced-sedation-diminishes-the-strength-of-frontal-parietal-occipital-eeg-network
#8
Dheeraj Rathee, Hubert Cecotti, Girijesh Prasad
The level of conscious experience can be effectively and reversibly altered by the administration of sedative agents. Several studies attempted to explore the variations in frontal-parietal network during propofol-induced sedation. However, contradictory outcomes warrant further investigations. In this study, we implemented the Neural Gas algorithm-based delay symbolic transfer entropy (NG-dSTE) for investigation of frontal-parietal-occipital (F-P-O) network using scalp EEG signals recorded during altered levels of consciousness...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/29050627/outcomes-for-the-commercial-use-of%C3%A2-self-expanding-prostheses-in-transcatheter-aortic-valve-replacement-a-report-from-the-sts-acc-tvt-registry
#9
Paul Sorajja, Susheel Kodali, Michael J Reardon, Wilson Y Szeto, Stanley J Chetcuti, James Hermiller, Sharla Chenoweth, David H Adams, Jeffrey J Popma
OBJECTIVES: The authors sought to compare the outcomes of commercial transcatheter aortic valve replacement (TAVR) with the repositionable Evolut R platform to those observed with the CoreValve device in the Society of Thoracic Surgeons (STS)/American College of Cardiology (ACC) Transcatheter Valve Therapy (TVT) Registry. BACKGROUND: TAVR continues to evolve, with rapid adoption of iterative changes for commercial practice. Insight into the outcomes of this adoption is needed...
October 23, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29048708/effect-of-the-midazolam-addition-the-propofol-based-sedation-in-esophagogastroduodenoscopy-a-randomized-trial
#10
Eun Hye Kim, Jun Chul Park, Sung Kwan Shin, Yong Chan Lee, Sang Kil Lee
BACKGROUND: Although propofol has been widely used for sedation during esophagogastroduodenoscopy (EGD), adverse events including hypoxia and hypotension may be a concern in the propofol-based sedation. We aimed to analyze whether administration of midazolam would improve safety and efficacy of propofol-based sedation in EGD. METHODS: One hundred twenty patients who were scheduled to undergo diagnostic EGD were randomly assigned to either midazolam plus propofol (MP) or propofol alone groups...
October 19, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29042486/parameters-for-simulation-of-adult-patients-during-mechanical-ventilation
#11
Jean-Michel Arnal, Aude Garnero, Mathieu Saoli, Robert L Chatburn
BACKGROUND: Simulation studies are often used to examine ventilator performance. However, there are no standards for selecting simulation parameters. This study collected data in passively-ventilated adult human subjects and summarized the results as a set of parameters that can be used for simulation studies of intubated, passive, adult subjects with normal lungs, COPD, or ARDS. METHODS: Consecutive adult patients admitted to the ICU were included if they were deeply sedated and mechanically ventilated for <48 h without any spontaneous breathing activity...
October 17, 2017: Respiratory Care
https://www.readbyqxmd.com/read/29031020/fetal-mri-lower-acceptance-by-women-in-research-vs-clinical-setting
#12
Bloeme J van der Knoop, Roland J Vermeulen, Jonathan I M L Verbeke, Lourens R Pistorius, Johanna I P de Vries
AIM: To determine acceptance of pregnant women to undergo fetal magnetic resonance imaging (MRI) examination in research and clinical setting. METHODS: A prospective study included a research group [part of a study comparing brain ultrasound (US) to MRI in fetuses at risk for acquired brain damage] and a clinical group [fetuses with suspected (brain) anomalies after structural US examination] from 2011 to 2014. All women were advised to use sedatives. MRI declinations, use of sedation, MRI duration and imaging quality were compared between both groups...
October 14, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/29026357/use-of-digital-pupillometry-to-measure-sedative-response-to-propofol
#13
Jody H Haddock, Donald E Mercante, Rose Paccione, Jacob L Breaux, Sarah E Jolley, Jessica L Johnson, Sean E Connolly, Bennett P deBoisblanc
BACKGROUND: Digital pupillometry (DP) accurately and precisely measures pupillary responses. Little is known about using DP to measure the sedative effect of isolated propofol administration. METHODS: We conducted a cross-sectional study of 19 adults undergoing moderate sedation with propofol during which we measured pupillary changes using DP. RESULTS: Maximum and minimum pupillary diameters decreased significantly with propofol (mean change from baseline to procedural termination -1...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/28988545/a-controlled-trial-of-screening-brief-intervention-and-referral-for-treatment-sbirt-implementation-in-primary-care-in-the-united-arab-emirates
#14
Catriona Matheson, Christiane Pflanz-Sinclair, Amna Almarzouqi, Christine M Bond, Amanda J Lee, Anwar Batieha, H Al Ghaferi, A El Kashef
Aim This project evaluated the effectiveness of screening brief intervention and referral for treatment (SBIRT) in primary care in Abu Dhabi to manage patients with problematic substance use. This study aimed to determine whether: (i) training primary care physicians on the SBIRT model increased the identification of patients using substances at a harmful, hazardous or dependent level; (ii) training improved physicians' knowledge, attitudes and beliefs in self-efficacy in managing substance use. BACKGROUND: Substance use is increasing in the United Arab Emirates yet there has been no formal primary care intervention...
October 9, 2017: Primary Health Care Research & Development
https://www.readbyqxmd.com/read/28979712/colonoscopy-quality-with-entonox-%C3%A2-vs-intravenous-conscious-sedation-18608-colonoscopy-retrospective-study
#15
Alexander R Robertson, Nicholas A Kennedy, James A Robertson, Nicholas I Church, Colin L Noble
AIM: To compare colonoscopy quality with nitrous oxide gas (Entonox(®)) against intravenous conscious sedation using midazolam plus opioid. METHODS: A retrospective analysis was performed on a prospectively held database of 18608 colonoscopies carried out in Lothian health board hospitals between July 2013 and January 2016. The quality of colonoscopies performed with Entonox was compared to intravenous conscious sedation (abbreviated in this article as IVM). Furthermore, the quality of colonoscopies performed with an unmedicated group was compared to IVM...
September 16, 2017: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28971157/comparing-the-analgesic-effect-of-intranasal-with-intravenous-ketamine-in-isolated-orthopedic-trauma-a-randomized-clinical-trial
#16
Ramin Parvizrad, Abdolghader Pakniyat, Bita Malekianzadeh, Amir Almasi-Hashiani
OBJECTIVES: Ketamine is commonly used in anesthetic and sedation before surgical procedures and acts as an analgesic in smaller doses. The aim of this study was to assess the effects of intranasal (IN) ketamine in patients with moderate to severe limb trauma (visual analog scale (VAS) > 60 mm). METHODS: In a triple-blind randomized controlled clinical trial; 154 patients with isolated orthopedic trauma and visual analog scale (VAS) ≥60 mm were included on the basis of inclusion and exclusion criteria...
September 2017: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28970289/modifiable-factors-associated-with-patient-reported-pain-during-and-after-screening-colonoscopy
#17
Marek Bugajski, Paulina Wieszczy, Geir Hoff, Maciej Rupinski, Jaroslaw Regula, Michal Filip Kaminski
OBJECTIVE: Pain associated with colonoscopy is a major burden for patients. We investigated modifiable factors associated with patient-reported pain during and after colonoscopy. DESIGN: This cross-sectional analysis included database records from 23 centres participating in a population-based colonoscopy screening programme in Poland. Colonoscopies were performed under three sedation modalities: none, benzodiazepine-opioid sedation or propofol sedation. We used Gastronet (a validated tool) to assess patients' pain during and after colonoscopy; pain was scored on a four-point scale (no, little, moderate or severe pain), with moderate to severe defined as painful...
September 28, 2017: Gut
https://www.readbyqxmd.com/read/28967529/intranasal-fentanyl-and-quality-of-pediatric-acute-care
#18
Kathleen M Adelgais, Alison Brent, Joseph Wathen, Suhong Tong, Derrek Massanari, Sara Deakyne, Marion R Sills
BACKGROUND: Changes in the manner in which medications can be delivered can have significant effects on the quality of care in the acute care setting. OBJECTIVE: The objective of this study was to evaluate the change in three Institute of Medicine quality indicators (timeliness, safety, and effectiveness) in the pediatric emergency department (ED) after the introduction of the Mucosal Atomizer Device Nasal™ (MADn) for opioid analgesia. METHODS: This was a retrospective review of patients receiving opioid analgesia for certain conditions over a 5-year period...
November 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28959664/neuropharmacological-profile-and-chemical-analysis-of-fresh-rhizome-essential-oil-of-curcuma-longa-turmeric-cultivated-in-southwest-nigeria
#19
Idris A Oyemitan, Christianah A Elusiyan, Ayoola O Onifade, Moses A Akanmu, Adebola O Oyedeji, Armando G McDonald
BACKGROUND: Curcuma longa (turmeric) is commonly used as spice and also used to treat fever, cough and febrile convulsions in Nigeria. This study determined the chemical composition of the essential oil of C. longa and evaluated its neuropharmacological activity in mice. METHODS: Essential oil of C. longa (EOCL) fresh rhizome was obtained by hydrodistillation and its chemical composition determined by GC-MS. Acute toxicity (LD50) profile of the essential oil was determined orally (p...
2017: Toxicology Reports
https://www.readbyqxmd.com/read/28942033/nature-versus-intensity-of-intoxication-co-ingestion-of-alcohol-and-energy-drinks-and-the-effect-on-objective-and-subjective-intoxication
#20
Jessica Forward, Jane Akhurst, Raimondo Bruno, Xiao Leong, Amelia VanderNiet, Holly Bromfield, Jacqueline Erny, Tessa Bellamy, Amy Peacock
BACKGROUND: We report a series of studies examining the effect of alcohol mixed with energy drinks (AmEDs) versus alcohol on objective intoxication (breath alcohol concentration; BrAC), intensity, and nature of intoxication. We also aimed to disentangle the role of energy drink (ED) ingredients in any effects. METHOD: Three within-subject double-blind placebo-controlled studies measured BrAC, subjective intoxication and impairment ('intensity of intoxication'), stimulation and sedation ('nature of intoxication') following administration of ED, Cola, Caffeine+Sugar, and Placebo with alcohol (Study 1, n=18); ED, Caffeine-only, Sugar-only and Placebo with alcohol (Study 2, n=20); and ED and Placebo with alcohol (Study 3, n=27)...
September 7, 2017: Drug and Alcohol Dependence
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