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Moderate sedation

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https://www.readbyqxmd.com/read/29346245/diagnostic-yield-and-safety-of-bronchoscopist-directed-moderate-sedation-with-a-bolus-dose-administration-of-propofol-during-endobronchial-ultrasound-bronchoscopy
#1
Danai Khemasuwan, Krittika Teerapuncharoen, David C Griffin
BACKGROUND: The propofol use for moderate sedation (MS) during endobronchial ultrasound (EBUS) bronchoscopy is primarily restricted for use by an anesthesiologist because of safety concerns. The goals of this study were to demonstrate the safety and the diagnostic yield of the use of propofol by bronchoscopists and trained endoscopy nurses during EBUS bronchoscopy without intubation. METHODS: We tested a bolus propofol administration protocol targeting MS for EBUS bronchoscopy...
January 16, 2018: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/29334501/practice-guidelines-for-moderate-procedural-sedation-and-analgesia-2018-a-report-by-the-american-society-of-anesthesiologists-task-force-on-moderate-procedural-sedation-and-analgesia-the-american-association-of-oral-and-maxillofacial-surgeons-american-college
#2
https://www.readbyqxmd.com/read/29328000/conscious-sedation-with-dexmedetomidine-compared-with-asleep-awake-asleep-craniotomies-in-glioma-surgery-an-analysis-of-180-patients
#3
Eric Suero Molina, Stephanie Schipmann, Isabelle Mueller, Johannes Wölfer, Christian Ewelt, Matthias Maas, Benjamin Brokinkel, Walter Stummer
OBJECTIVE Awake craniotomies have become a feasible tool over time to treat brain tumors located in eloquent regions. Different techniques have been applied in neurooncology centers. Both "asleep-awake-asleep" (asleep) and "conscious sedation" were used subsequently at the authors' neurosurgical department. Since 2013, the authors have only performed conscious sedation surgeries, predominantly using the α2-receptor agonist dexmedetomidine as the anesthetic drug. The aim of this study was to compare both mentioned techniques and evaluate the clinical use of dexmedetomidine in the setting of awake craniotomies for glioma surgery...
January 12, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29325180/sertindole-eeg-analysis-tolerability-and-clinical-efficacy
#4
Adam Kroc, Marta Dębicka, Aleksandra Wierzbicka, Lidia Wołkow, Wojciech Jernajczyk, Adam Wichniak
INTRODUCTION: One of the common side effects of antipsychotic drugs is excessive sedation. The treatment with antipsychotics often manifests as an increase in slow wave activity in electroencephalography (EEG). The aim of this study was to analyze EEG recordings of patients treated with a non-sedative antipsychotic drug sertindole with regard to its adverse effects and clinical efficacy. PATIENTS AND METHODS: EEG recordings of 45 patients (27 females, mean age 30...
January 11, 2018: Pharmacopsychiatry
https://www.readbyqxmd.com/read/29304910/benefits-and-harms-of-capnography-during-procedures-involving-moderate-sedation-a-rapid-review-and-meta-analysis
#5
William Parker, Cameron G Estrich, Elliot Abt, Alonso Carrasco-Labra, Jonathan B Waugh, Aaron Conway, Ruth D Lipman, Marcelo W B Araujo
BACKGROUND: Patient safety is a priority in dentistry. Evaluating the benefits and harms associated with the addition of capnography to standard monitoring during moderate sedation for adult patients in the dental practice setting is needed. TYPES OF STUDIES REVIEWED: The authors used rapid review methodology to identify relevant systematic reviews, which they updated through a systematic search by using the same search strategy as the identified reviews. The authors searched PubMed and Google Scholar and through the references of the identified systematic reviews, which yielded 2,892 studies...
January 2018: Journal of the American Dental Association
https://www.readbyqxmd.com/read/29290034/pharmacokinetics-of-dexmedetomidine-during-analgosedation-in-icu-patients
#6
Piotr Smuszkiewicz, Paweł Wiczling, Justyna Ber, Justyna Warzybok, Tomasz Małkiewicz, Jan Matysiak, Agnieszka Klupczyńska, Iwona Trojanowska, Zenon Kokot, Edmund Grześkowiak, Wojciech Krzyzanski, Agnieszka Bienert
Dexmedetomidine (DEX) is a fairly new alfa2-agonist which has been increasingly used in recent years for analgosedation, mostly because it offers a unique ability of providing both moderate level of sedation and analgesia without respiratory depression. Despite of many papers published, there are still only a few concerning the PK of the drug given as long-term infusion in ICU patients. The aim of this work was to characterize the population pharmacokinetics of dexmedetomidine and to investigate the potential benefits of individualization of drug dosing based on patient characteristics in the heterogeneous group of medical and surgical patients staying in intensive care unit...
December 30, 2017: Journal of Pharmacokinetics and Pharmacodynamics
https://www.readbyqxmd.com/read/29287158/pharmacokinetics-of-a-concentrated-buprenorphine-formulation-in-red-tailed-hawks-buteo-jamaicensis
#7
Molly D Gleeson, David Sanchez-Migallon Guzman, Heather K Knych, Philip H Kass, Tracy L Drazenovich, Michelle G Hawkins
OBJECTIVE To determine the pharmacokinetics and sedative effects of 2 doses of a concentrated buprenorphine formulation after SC administration to red-tailed hawks (Buteo jamaicensis). ANIMALS 6 adult red-tailed hawks. PROCEDURES Concentrated buprenorphine (0.3 mg/kg, SC) was administered to all birds. Blood samples were collected at 10 time points over 24 hours after drug administration to determine plasma buprenorphine concentrations. After a 4-week washout period, the same birds received the same formulation at a higher dose (1...
January 2018: American Journal of Veterinary Research
https://www.readbyqxmd.com/read/29284834/comparison-of-dexmedetomidine-and-midazolam-for-sedation-in-mechanically-ventilated-patients-guided-by-bispectral-index-and-sedation-agitation-scale
#8
Manoj Tripathi, Virendra Kumar, Mahendra B Kalashetty, Deepak Malviya, Prateek Singh Bais, Om Prakash Sanjeev
Background: Mechanical ventilation and sedation are inextricably linked components of critical care that represent, what we do for the patients during their vulnerable course in Intensive Care Unit (ICU). Aims: The aim of this study is to compare the efficacy and safety of midazolam and dexmedetomidine in patients on mechanical ventilator with the help of Bispectral Index (BIS) monitoring and correlation of BIS with Sedation-Agitation Scale (SAS). Settings and Design: Prospective, observational, and comparative study...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29276665/insights-since-fda-approval-of-hypoglossal-nerve-stimulation-for-the-treatment-of-obstructive-sleep-apnea
#9
Madeleine M Strohl, Motoo Yamauchi, Zhe Peng, Kingman P Strohl
Purpose: The literature on hypoglossal nerve stimulation (HNS) for the treatment of moderate-to-severe obstructive sleep apnea (OSA) was reviewed from 2014, the time of FDA approval for the Inspire Systems device, to 2017 for themes that might be useful conceptually and practically in the consideration of this new non-anatomic surgical therapy. Recent Findings: there are now further follow-up articles since the 12-month results for Apnea Reduction (STAR) trial of the Inspire device, and post-approval publications which report similar and/0r improved AHI outcomes...
September 2017: Current Sleep Medicine Reports
https://www.readbyqxmd.com/read/29275138/does-a-history-of-psychoactive-substances-abuse-play-a-role-in-the-level-of-pain-of-the-patient-with-severe-trauma
#10
C López-López, A Arranz-Esteban, M V Martinez-Ureta, M C Sánchez-Rascón, C Morales-Sánchez, M Chico-Fernández
OBJECTIVE: To analyse the influence of psychotropic substance use on the level of pain in patients with severe trauma. DESIGN: Longitudinal analytical study. SCOPE: Intensive Care Unit (ICU) of Trauma and Emergencies. PATIENTS: severe trauma, non-communicative and mechanical ventilation >48hours. Two groups of patients were created: users and non-users of psychotropic substances according to medical records. INTERVENTIONS: Measurement of pain level at baseline and during mobilization, using the Pain Indicator Behaviour Scale...
December 20, 2017: Enfermería Intensiva
https://www.readbyqxmd.com/read/29245289/perioperative-management-of-a-patient-with-coffin-lowry-syndrome-complicated-by-severe-obesity-a-case-report-and-literature-review
#11
Mikako Hirakawa, Tasuku Nishihara, Kazuo Nakanishi, Sakiko Kitamura, Sonoko Fujii, Keizo Ikemune, Kentaro Dote, Yasushi Takasaki, Toshihiro Yorozuya
RATIONALE: Coffin-Lowry syndrome (CLS) is a rare inherited disease with specific clinical features, such as mental retardation, facial dysmorphism, and cardiac abnormality. In particular, the characteristic facial features of CLS, including retrognathia and large tongue, are associated with difficult ventilation and/or intubation, which is a serious problem of anesthesia management. However, case reports on anesthesia management of CLS are very limited as there are only two published English reports till date...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29234838/clinical-characteristics-and-prognosis-of-traumatic-head-injury-following-road-traffic-accidents-admitted-in-icu-analysis-of-694-cases
#12
Hedi Chelly, Mabrouk Bahloul, Rania Ammar, Ahmed Dhouib, Khaireddine Ben Mahfoudh, Mohamed Zaher Boudawara, Olfa Chakroun, Imen Chabchoub, Anis Chaari, Mounir Bouaziz
BACKGROUND: The aim of the present study is to analyze the clinical and epidemiological characteristics of Traumatic Brain Injury (TBI) following Road Traffic Accidents (RTAs). Moreover, we aim to evaluate the outcome of the TBI victims referred to our medico-surgical Intensive Care Unit (ICU), and to define predictive factors associated with poor prognosis. METHODS: A retrospective study over a 4-year period (2009 to 2012) of 694 patients with head injuries, incurred during road traffic accidents, admitted to the Intensive Care Unit (ICU) of a university hospital (Sfax-Tunisia)...
December 12, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29229000/changes-in-specific-substance-involvement-scores-among-sbirt-recipients-in-an-hiv-primary-care-setting
#13
Carol Dawson-Rose, Jessica E Draughon, Yvette Cuca, Roland Zepf, Emily Huang, Bruce A Cooper, Paula J Lum
BACKGROUND: Substance use is common among people living with HIV (PLHIV) and is associated with worse outcomes along the HIV care continuum. One potentially effective clinic-based approach to addressing unhealthy substance use is screening, brief intervention, and referral to treatment (SBIRT). METHODS: We conducted a two-arm randomized trial to examine the effects of a self-administered, computerized SBIRT intervention compared to a clinician-administered SBIRT intervention in an HIV primary clinic...
December 12, 2017: Addiction Science & Clinical Practice
https://www.readbyqxmd.com/read/29227837/even-in-early-childhood-offspring-alcohol-expectancies-correspond-to-parental-drinking
#14
Emmanuel Kuntsche, Sandra Kuntsche
BACKGROUND: Research has found that children as young as preschoolers have an idea about the valence (positive vs. negative) and activation (arousal vs. sedation) of emotional change when adults drink alcohol. The development of alcohol expectancies at such a young age may be due to observed parental alcohol use. METHODS: Three measures of alcohol use (frequency, quantity and binge drinking) assessed among 115 fathers and 149 mothers were correlated with four alcohol expectancy factors (crossing valence and activation) of their offspring, aged three to six (70 boys and 82 girls)...
December 7, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/29214061/medical-thoracoscopy-and-its-evolving-role-in-the-diagnosis-and-treatment-of-pleural-disease
#15
REVIEW
Vivek Murthy, Jamie L Bessich
Establishing the etiology of exudative pleural effusions in the setting of an unrevealing pleural fluid analysis often requires biopsies from the parietal pleura. While closed pleural biopsy (CPB) has been a popular minimally-invasive approach, it has a poor diagnostic yield, barring a diagnosis of tuberculous pleurisy. Medical thoracoscopy (MT) is a minimally-invasive ambulatory procedure performed under local anesthesia or moderate sedation which allows for direct visualization of biopsy targets as well as simultaneous therapeutic interventions, including chemical pleurodesis and indwelling tunneled pleural catheter (ITPC) placement...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29212133/factors-associated-with-patient-reported-procedural-memory-following-emergency-department-procedural-sedation-with-ketamine-and-propofol-a-prospective-cohort-of-563-patients
#16
Andrew Greer, Greg Treston
OBJECTIVES: To describe the proportion of patients reporting procedural memory following procedural sedation and analgesia (PSA) with ketamine and propofol (KP) administered premixed together (ketofol) or individually (sequential KP) in ED attendees. Identify any clinical or demographic variables associated with procedural memory. METHODS: This was a convenience sample of 563 patients who received KP PSA as per the departmental protocol. A standardised script was used to assess for procedural memory...
December 6, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29203151/population-pharmacokinetic-evaluation-of-adv6209-an-innovative-oral-solution-of-midazolam-containing-cyclodextrin
#17
Frédéric Marçon, Catherine Guittet, Maria A Manso, Ingrid Burton, Luc-André Granier, Philippe Jacqmin, Hervé Dupont
INTRODUCTION: In the absence of a licensed formulation in many countries worldwide, ADV6209, an innovative 2mg/mL oral solution of midazolam containing cyclodextrin, has been developed for moderate sedation in paediatric patients. Population pharmacokinetics for ADV6209 is reported. METHODS: Plasma concentration data were collected from 37 paediatric patients and 12 healthy adults recruited in a single dose, open-label phase II pharmacokinetic study and in a single dose, randomised, open-label two-period crossover bioavailability study, respectively...
December 1, 2017: European Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/29201797/effectiveness-of-sedoanalgesia-in-percutaneous-liver-biopsy-premedication
#18
Orhan Sezgin, Serkan Yaras, Fehmi Ates, Engin Altintas, Bunyamin Saritas
Aim: Percutaneous needle liver biopsy (PLB) is frequently associated with pain and anxiety. This may discourage the patients for biopsy, and rebiopsies, if needed. We planned a study to investigate the efficacy of additional analgesia or sedation for PLB. Materials and methods: The study has been designed as a single-center, prospective study. The PLB was planned for 18- to 65-year-old consecutive patients who were included in the study. The patients were divided into three premedication groups as control, Meperidine, and Midazolam...
July 2017: Euroasian Journal of Hepato-Gastroenterology
https://www.readbyqxmd.com/read/29194259/a-clinical-photographic-method-to-evaluate-the-need-for-helmet-therapy-in-deformational-plagiocephaly
#19
In Kook Cho, Jeung Ryeol Eom, Jeong Woo Lee, Jung Dug Yang, Ho Yun Chung, Byung Chae Cho, Kang Young Choi
PURPOSE: With an increase in positional plagiocephaly patients, various therapy methods have been researched and helmet therapy is the most widely used and effective treatment method. To devise a method that would allow medical professionals and patients' parents to more easily identify the shape and outcomes before and after the therapy. METHODS: This study included 399 patients who had helmet therapy from November 2014 to February 2016. Patients wore a cast helmet for more than 20 hours per day...
November 29, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29186485/indications-and-practical-approach-to-non-invasive-ventilation-in-acute-heart-failure
#20
Josep Masip, W Frank Peacock, Susanna Price, Louise Cullen, F Javier Martin-Sanchez, Petar Seferovic, Alan S Maisel, Oscar Miro, Gerasimos Filippatos, Christiaan Vrints, Michael Christ, Martin Cowie, Elke Platz, John McMurray, Salvatore DiSomma, Uwe Zeymer, Hector Bueno, Chris P Gale, Maddalena Lettino, Mucio Tavares, Frank Ruschitzka, Alexandre Mebazaa, Veli-Pekka Harjola, Christian Mueller
In acute heart failure (AHF) syndromes significant respiratory failure (RF) is essentially seen in patients with acute cardiogenic pulmonary oedema (ACPE) or cardiogenic shock (CS). Non-invasive ventilation (NIV), the application of positive intrathoracic pressure through an interface, has shown to be useful in the treatment of moderate to severe RF in several scenarios. There are two main modalities of NIV: continuous positive airway pressure (CPAP) and pressure support ventilation (NIPSV) with positive end expiratory pressure...
November 26, 2017: European Heart Journal
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