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Moderate sedation

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https://www.readbyqxmd.com/read/28921528/practitioner-review-treatment-of-chronic-insomnia-in-children-and-adolescents-with-neurodevelopmental-disabilities
#1
REVIEW
Oliviero Bruni, Marco Angriman, Fabrizio Calisti, Alessandro Comandini, Giovanna Esposito, Samuele Cortese, Raffaele Ferri
BACKGROUND: Sleep disturbances, in particular insomnia, represent a common problem in children with neurodevelopmental disabilities (NDDs). Currently, there are no approved medications for insomnia in children by the US Food and Drug Administration or European Medicines Agency and therefore they are prescribed off-label. We critically reviewed pediatric literature on drugs as well as nonpharmacological (behavioral) interventions used for sleep disturbances in children with NDDs. METHODS: PubMed, Ovid (including PsycINFO, Ovid MEDLINE(®) , and Embase), and Web of Knowledge databases were searched through February 12, 2017, with no language restrictions...
September 18, 2017: Journal of Child Psychology and Psychiatry, and Allied Disciplines
https://www.readbyqxmd.com/read/28921380/relationship-between-drug-burden-and-physical-and-cognitive-functions-in-a-sample-of-nursing-home-patients-with-dementia
#2
L M J Sanders, T Hortobágyi, G van Staveren, K Taxis, F Boersma, H C Klein, W J R Bossers, C G Blankevoort, E J A Scherder, E A Van der Zee, M J G van Heuvelen
PURPOSE: The Drug Burden Index (DBI) is a tool to quantify the anticholinergic and sedative load of drugs. Establishing functional correlates of the DBI could optimize drug prescribing in patients with dementia. In this cross-sectional study, we determined the relationship between DBI and cognitive and physical functions in a sample of patients with dementia. METHODS: Using performance-based tests, we measured physical and cognitive functions in 140 nursing home patients aged over 70 with all-cause dementia...
September 18, 2017: European Journal of Clinical Pharmacology
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
#3
Gillian Horwitz, Danielle Roncari, Kari 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/28904501/patient-experience-with-conscious-sedation-as-a-method-of-pain-relief-for-transvaginal-oocyte-retrieval-a-cross-sectional-study
#4
Himanshu Singhal, Prasanna S Premkumar, Achamma Chandy, Aleyamma T Kunjummen, Mohan S Kamath
AIM: The aim of the study was to measure patient's satisfaction level and acceptance of conscious sedation as a method of pain relief following transvaginal oocyte retrieval (TVOR) during assisted reproduction technology treatment. We also evaluated the factors that may influence the efficacy of conscious sedation method. SETTING AND DESIGN: A prospective cross-sectional study. MATERIALS AND METHODS: Prospective study was conducted from October 2015 to January 2016 at a university-level hospital and 100 women were recruited...
April 2017: Journal of Human Reproductive Sciences
https://www.readbyqxmd.com/read/28898796/transjugular-biopsy-case-report-of-inferior-vena-cava-hepatocellular-carcinoma-with-intracardiac-extension
#5
Laurence Weinberg, Diana Abu-Ssaydeh, Chris Macgregor, Jason Wang, Clarence Wong, Manfred Spanger, Vijayragavan Muralidharan
BACKGROUND: Diagnosis of hepatocellular carcinoma (HCC) can be established with near certainty by correlating radiological imaging with clinical presentation. However, in the absence of diagnostic certainty, biopsy of liver tissue is mandatory for optimal management. We present our management of a patient with advanced liver disease who presented with an IVC mass extending into the right atrium, with co-existing liver lesions not meeting criteria for an imaging diagnosis of HCC. CASE PRESENTATION: A 62-year-old male with Child-Pugh C liver cirrhosis presented with decompensated liver failure...
September 5, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28891701/sedative-effects-of-intranasal-midazolam-administration-in-wild-caught-blue-fronted-amazon-amazona-aestiva-and-orange-winged-amazon-amazona-amazonica-parrots
#6
Débora P H Schaffer, Nayone L L C de Araújo, Ana Cláudia S Raposo, Emanoel F Martins Filho, João Victor R Vieira, Arianne P Oriá
Safe and effective sedation protocols are important for chemical restraint of birds in clinical and diagnostic procedures, such as clinical evaluations, radiographic positioning, and blood collection. These protocols may reduce stress and ease the management of wild-caught birds, which are susceptible to injury or death when exposed to stressful situations. We compare the sedative effect of intranasal midazolam in wild-caught blue-fronted (Amazona aestiva) and orange-winged (Amazona amazonica) Amazon parrots...
September 2017: Journal of Avian Medicine and Surgery
https://www.readbyqxmd.com/read/28889811/cardiovascular-ct-for-evaluation-of-single-ventricle-heart-disease-risks-and-accuracy-compared-with-interventional-findings
#7
B Kelly Han, Marnie Huntley, David Overman, Dawn Witt, David Dassenko, Ross F Garberich, John R Lesser
OBJECTIVE: We sought to evaluate the risk and image quality from cardiovascular CT in patients across all stages of single-ventricle palliation, and to define accuracy by comparing findings with intervention and surgery. METHODS: Consecutive CT scans performed in patients with single-ventricle heart disease were retrospectively reviewed at a single institution. Diagnosis, sedation needs, estimated radiation dose, and adverse events were recorded. Anatomical findings, image quality (1-4, 1=optimal), and discrepancy compared with interventional findings were determined...
September 11, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28880899/effects-of-sedation-on-subjective-perception-of-pain-intensity-and-autonomic-nervous-responses-to-pain-a-preliminary-study
#8
Hongling Kang, Aya Nakae, Hiroshi Ito, Piyasak Vitayaburananont, Takehiro Minamoto, Takashi Ikeda, Mariko Osaka, Takashi Mashimo, Yuji Fujino, Satoshi Hagihira
Rather than relying solely on subjective pain evaluation using means such as the visual analogue scale (VAS), in clinical situations it is possible to observe evoked responses of the autonomic nervous system (ANS) as objective indicators. Few studies, however, have reported these relationships under finely controlled sedation. 16 healthy male participants were administrated in intravenous sedation with either propofol or midazolam randomly. We initially determined, using pharmacokinetic simulation, the effect-site concentration (Ce) of anaesthetic at loss of response to verbal command and eyelash reflex (Ce-LOR)...
2017: PloS One
https://www.readbyqxmd.com/read/28877087/percutaneous-endoscopic-gastrostomy-under-conscious-sedation-in-patients-with-amyotrophic-lateral-sclerosis-is-safe-an-observational-study
#9
Denise Strijbos, José Hofstede, Daniel Keszthelyi, Ad A M Masclee, Lennard P L Gilissen
OBJECTIVES: Amyotrophic lateral sclerosis (ALS) is a progressive neuromuscular disease that causes muscle weakness with respiratory and swallowing dysfunction, eventually leading to death. Permanent enteral feeding is indicated in almost all patients. A percutaneous endoscopic gastrostomy (PEG) tube is considered the first choice, usually performed under conscious sedation (intravenous midazolam). Guidelines are very cautious with respect to sedation in ALS because of the risk for respiratory complications...
September 4, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28872700/optimal-procedural-sequence-for-same-day-bidirectional-endoscopy-with-moderate-sedation-a-prospective-randomized-study
#10
Shuo-Wei Chen, Chi-Liang Cheng, Nai-Jen Liu, Jui-Hsiang Tang, Yen-Lin Kuo, Cheng-Hui Lin, Yi-Ning Tsui, Bai-Ping Lee, Hsiang-Ling Hung
BACKGROUND AND AIM: Same-day bidirectional endoscopy (BDE) is a commonly performed procedure, but the optimal sequence for the procedure with moderate conscious sedation is not well-established. We investigated the optimal sequence for same-day BDE under moderate conscious sedation and carbon dioxide insufflation in terms of sedation doses, patient discomfort, and colonoscopy performance. METHODS: We performed a prospective randomized controlled study of 120 patients who were scheduled for BDE examination...
September 5, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28869237/nasal-route-for-endobronchial-ultrasound-guided-transbronchial-needle-aspiration-ebus-tbna-an-alternative-modality-in-difficult-oral-bronchoscope-insertion
#11
Saurabh Mittal, Karan Madan, Vijay Hadda, Anant Mohan, Randeep Guleria
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is usually performed under moderate sedation through the oral approach. Oral insertion is performed owing to the larger size of the EBUS bronchoscope as well as the delicate and rigid distal end with an integrated ultrasound transducer assembly. Nasal route for EBUS scope insertion has been described as a feasible alternative. We herein report a patient wherein inability to introduce the EBUS bronchoscope through the mouth necessitated nasal insertion of the bronchoscope to successfully perform EBUS-TBNA...
September 2017: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/28864877/clinical-assessment-and-management-of-delirium-in-the-palliative-care-setting
#12
Shirley Harvey Bush, Sallyanne Tierney, Peter Gerard Lawlor
Delirium is a neurocognitive syndrome arising from acute global brain dysfunction, and is prevalent in up to 42% of patients admitted to palliative care inpatient units. The symptoms of delirium and its associated communicative impediment invariably generate high levels of patient and family distress. Furthermore, delirium is associated with significant patient morbidity and increased mortality in many patient populations, especially palliative care where refractory delirium is common in the dying phase. As the clinical diagnosis of delirium is frequently missed by the healthcare team, the case for regular screening is arguably very compelling...
September 1, 2017: Drugs
https://www.readbyqxmd.com/read/28863011/sedation-and-mobilization-during-venovenous-extracorporeal-membrane-oxygenation-for-acute-respiratory-failure-an-international-survey
#13
Jonathan D Marhong, Julian DeBacker, Julien Viau-Lapointe, Laveena Munshi, Lorenzo Del Sorbo, Lisa Burry, Eddy Fan, Sangeeta Mehta
OBJECTIVES: To characterize sedation, analgesia, delirium, and mobilization practices in patients supported with venovenous extracorporeal membrane oxygenation for severe acute respiratory failure. DESIGN: Cross-sectional electronic survey administered January 2016 to March 2016. SETTING: Three-hundred ninety-four extracorporeal membrane oxygenation centers registered with the Extracorporeal Life Support Organization. SUBJECTS: Extracorporeal membrane oxygenation medical directors and program coordinators...
August 31, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28858552/nitrous-oxide-inhalation-sedation-through-a-nasal-high-flow-system-the-possibility-of-a-new-technique-in-dental-sedation
#14
Takuro Sanuki, Gaku Mishima, Kensuke Kiriishi, Shinji Kurata, Ichiro Okaysu, Mari Kawai, Toshihiro Watanabe, Mizuki Tachi, Nobuyasu Komasawa, Takao Ayuse
High-flow nasal cannula (HFNC) systems are increasingly used for patients with both acute and chronic respiratory failure because of the clinical effectiveness and patient comfort associated with their use. Recently, HFNC has been used not only as a respiratory support device, but also as a drug delivery system. HFNC is designed to administer heated and humidified inspiratory oxygen flows (100% relative humidity at 37°C). Therefore, HFNC can provide high flows (up to 60 L/min) without discomfort. Moreover, HFNC improves oxygenation by exerting physiologic effects such as (a) dead-space washout and (b) moderate positive airway pressure...
2017: Anesthesia Progress
https://www.readbyqxmd.com/read/28856464/dosage-of-methylphenidate-and-traumatic-brain-injury-in-adhd-a-population-based-study-in-taiwan
#15
Yin-To Liao, Yao-Hsu Yang, Ting-Yu Kuo, Hsin-Yi Liang, Kuo-You Huang, Tsu-Nai Wang, Yena Lee, Roger S McIntyre, Vincent Chin-Hung Chen
Preventive effect of stimulants on the risk of brain injuries had been reported. The aim of this study is to determine the extent to which methylphenidate (MPH) prescription moderates the risk of traumatic brain injuries (TBI) in individuals with attention-deficit/hyperactivity disorder (ADHD). Individuals with a recent diagnosis of ADHD between January 1997 and December 2013 (n = 163,618) were identified from Taiwan's National Health Insurance Research Database. A total of 124,438 adolescents and children with ADHD and without prior TBI diagnoses were included and evaluated for subsequent TBI...
August 30, 2017: European Child & Adolescent Psychiatry
https://www.readbyqxmd.com/read/28854065/efficacy-of-thalidomide-in-preventing-delayed-nausea-and-vomiting-induced-by-highly-emetogenic-chemotherapy-a-randomized-multicenter-double-blind-placebo-controlled-phase-iii-trial-clog1302-study
#16
Lingyun Zhang, Xiujuan Qu, Yuee Teng, Jing Shi, Ping Yu, Tao Sun, Jingyan Wang, Zhitu Zhu, Xiuna Zhang, Mingfang Zhao, Jing Liu, Bo Jin, Ying Luo, Zan Teng, Yuyang Dong, Fugang Wen, Yuzhi An, Caijun Yuan, Tiejun Chen, Lizhong Zhou, Ying Chen, Jian Zhang, Zhenghua Wang, Jinglei Qu, Feng Jin, Jingdong Zhang, Xiuhua Jin, Xiaodong Xie, Jun Wang, Li Man, Lingyu Fu, Yunpeng Liu
Purpose We examined the efficacy and safety of thalidomide (THD) for the prevention of delayed nausea and vomiting in patients who received highly emetogenic chemotherapy (HEC). Patients and Methods In a randomized, double-blind, active-controlled, phase III trial, chemotherapy-naive patients with cancer who were scheduled to receive HEC that contained cisplatin or cyclophosphamide-doxorubicin/epirubincin ≥ 50 mg/m(2) regimens were randomly assigned to a THD group (100 mg twice daily on days 1 to 5) or placebo group, both with palonosetron (0...
August 30, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28851451/structured-physical-exercise-improves-neuropsychiatric-symptoms-in-acute-dementia-care-a-hospital-based-rct
#17
Tim Fleiner, Hannah Dauth, Marleen Gersie, Wiebren Zijlstra, Peter Haussermann
BACKGROUND: The primary objective of this trial is to investigate the effects of a short-term exercise program on neuropsychiatric signs and symptoms in acute hospital dementia care. METHODS: Within a hospital-based randomized controlled trial, the intervention group conducted a 2-week exercise program with four 20-min exercise sessions on 3 days per week. The control group conducted a social stimulation program. Effects on neuropsychiatric signs and symptoms were measured via the Alzheimer's Disease Cooperative Study-Clinical Global Impression of Change, the Neuropsychiatric Inventory, and the Cohen-Mansfield Agitation Inventory...
August 29, 2017: Alzheimer's Research & Therapy
https://www.readbyqxmd.com/read/28836848/evaluation-of-a-portable-media-device-for-use-in-determining-postural-stability-in-standing-horses
#18
Valerie J Moorman, Christopher E Kawcak, Melissa R King
OBJECTIVE To determine the ability of an accelerometer within a commercially available portable media device (PMD) to measure changes in postural stability of standing horses during various stance conditions and to compare these results with data obtained by use of a stationary force platform. ANIMALS 7 clinically normal horses. PROCEDURES A PMD was mounted on a surcingle; the surcingle was placed immediately caudal to the highest point of the shoulders (withers). Each horse was examined while standing on a stationary force platform system in a normal square stance, forelimb base-narrow stance, and normal square stance at 5 and 10 minutes after sedation induced by IV administration of xylazine hydrochloride...
September 2017: American Journal of Veterinary Research
https://www.readbyqxmd.com/read/28802082/ketamine-or-ketofol-do-we-have-enough-evidence-to-know-which-one-to-use
#19
James Miner
Ketamine and propofol are both commonly used emergency department (ED) procedural sedation agents. Their concurrent administration, often referred to as "ketofol", is widely used for procedural sedation. A simple google search can lead to a lot of opinions on why we should use propofol, ketamine, or ketofol in a given situation for moderate or deep procedural sedation in the ED, but finding evidence that supports differences these opinions assume is much harder to come by. This article is protected by copyright...
August 12, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28801295/-foshouningshen-decoction-improves-sleeping-via-the-serotonergic-system-in-a-rat-model-of-insomnia
#20
Jie-Cong Huang, Wei Xie, Ning Deng, Wen-Lin Liang, Dong-Rong Hu, Yu Hong, Yang Zhou
OBJECTIVE: To evaluate the sedative and hypnotic effects of Foshouningshen decoction (FSNSD) and study its effects on expressions of 5-hydroxy tryptamine (5-HT) and 5-HT1A receptor (5-HT1AR) in the hippocampus in a rat model of insomnia. METHODS: Male KM mice were divided into control group, estazolam (0.4 mg/kg daily) group, and low-, moderate-, and high-dose FSNSD groups (daily dose of 12, 24, and 48 g/kg, respectively). After corresponding treatments for 1 week, the mice underwent sleep-inducing test with subthreshold and threshold doses of sodium pentobarbital...
August 20, 2017: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
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