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https://www.readbyqxmd.com/read/28441273/case-report-of-physiologic-phenibut-dependence-treated-with-a-phenobarbital-taper-in-a-patient-being-treated-with-buprenorphine
#1
Emily Brunner, Robert Levy
: This case report describes the development of dependence to phenibut, a gamma-aminobutyric acid-receptor type B agonist, in a patient concurrently being treated with buprenorphine. The patient experienced withdrawal symptoms which were successfully treated with a phenobarbital taper based on a protocol to treat sedative use disorder. This case report provided an example of the development of a phenibut use disorder and also brought up a public health question of whether phenibut should therefore be officially classified and monitored...
April 24, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28441238/diaphragm-activation-in-ventilated-patients-using-a-novel-transvenous-phrenic-nerve-pacing-catheter
#2
Steven Reynolds, Adrian Ebner, Tracy Meffen, Viral Thakkar, Matt Gani, Kaity Taylor, Linda Clark, Gautam Sadarangani, Ramasamy Meyyappan, Rodrigo Sandoval, Elizabeth Rohrs, Joaquín A Hoffer
OBJECTIVES: Over 30% of critically ill patients on positive-pressure mechanical ventilation have difficulty weaning from the ventilator, many of whom acquire ventilator-induced diaphragm dysfunction. Temporary transvenous phrenic nerve pacing using a novel electrode-bearing catheter may provide a means to prevent diaphragm atrophy, to strengthen an atrophied diaphragm, and mitigate the harms of mechanical ventilation. We tested the initial safety, feasibility, and impact on ventilation of this novel approach...
April 22, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28424537/awake-craniotomy-anesthetic-management-using-dexmedetomidine-propofol-and-remifentanil
#3
Andrea Prontera, Stefano Baroni, Andrea Marudi, Franco Valzania, Alberto Feletti, Francesca Benuzzi, Elisabetta Bertellini, Giacomo Pavesi
INTRODUCTION: Awake craniotomy allows continuous monitoring of patients' neurological functions during open surgery. Anesthesiologists have to sedate patients in a way so that they are compliant throughout the whole surgical procedure, nevertheless maintaining adequate analgesia and anxiolysis. Currently, the use of α2-receptor agonist dexmedetomidine as the primary hypnotic-sedative medication is increasing. METHODS: Nine patients undergoing awake craniotomy were treated with refined monitored anesthesia care (MAC) protocol consisting of a combination of local anesthesia without scalp block, low-dose infusion of dexmedetomidine, propofol, and remifentanil, without the need of airways management...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/28420386/sedation-levels-in-dogs-a-validation-study
#4
Marika C Wagner, Kent G Hecker, Daniel S J Pang
BACKGROUND: The aim of this study was to assess validation evidence for a sedation scale for dogs. We hypothesized that the chosen sedation scale would be unreliable when used by different raters and show poor discrimination between sedation protocols. A sedation scale (range 0-21) was used to score 62 dogs scheduled to receive sedation at two veterinary clinics in a prospective trial. Scores recorded by a single observer were used to assess internal consistency and construct validity of the scores...
April 18, 2017: BMC Veterinary Research
https://www.readbyqxmd.com/read/28416498/deprescribing-anticholinergic-and-sedative-medicines-protocol-for-a-feasibility-trial-defeat-polypharmacy-in-residential-aged-care-facilities
#5
Nagham Ailabouni, Dee Mangin, Prasad S Nishtala
INTRODUCTION: Targeted deprescribing of anticholinergic and sedative medicines can lead to positive health outcomes in older people; as they have been associated with cognitive and physical functioning decline. This study will examine whether the proposed intervention is feasible at reducing the prescription of anticholinergic and sedative medicines in older people. METHODS AND ANALYSIS: The Standard Protocol Items: Recommendations for Interventional trials (SPIRIT checklist) was used to develop and report the protocol...
April 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/28410672/effects-of-sedation-and-salbutamol-administration-on-hyperpnoea-and-tidal-breathing-spirometry-in-healthy-horses
#6
S L Raidal, K Burnheim, D Evans, K J Hughes
Sedation is often required to perform pulmonary function testing (PFT) in horses, but drug effects may influence respiratory function. The current study was designed to characterise the effects of sedation and bronchodilator administration on absolute and relative indices of pulmonary function during eupnoeic respiration and carbon dioxide-induced hyperpnoea (rebreathing) in healthy horses using a pneumotachographic spirometry system. Sedation with acetylpromazine (ACP), xylazine, or both drugs in combination was associated with significant reductions in respiratory frequency, minute ventilation and peak airflows during eupnoeic respiration...
April 2017: Veterinary Journal
https://www.readbyqxmd.com/read/28410275/implementation-of-an-icu-bundle-an-interprofessional-quality-improvement-project-to-enhance-delirium-management-and-monitor-delirium-prevalence-in-a-single-picu
#7
Shari Simone, Sarah Edwards, Allison Lardieri, L Kyle Walker, Ana Lia Graciano, Omayma A Kishk, Jason W Custer
OBJECTIVES: To examine the impact of an ICU bundle on delirium screening and prevalence and describe characteristics of delirium cases. DESIGN: Quality improvement project with prospective observational analysis. SETTING: Nineteen-bed PICU in an urban academic medical center. PATIENTS: All consecutive patients admitted from December 1, 2013, to September 30, 2015. INTERVENTIONS: A multidisciplinary team implemented an ICU bundle consisting of three clinical protocols: delirium, sedation, and early mobilization using the Plan-Do-Study-Act cycles as part of a quality improvement project...
April 13, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28409254/pediatric-brain-mri-part-1-basic-techniques
#8
REVIEW
Mai-Lan Ho, Norbert G Campeau, Thang D Ngo, Unni K Udayasankar, Kirk M Welker
Pediatric neuroimaging is a complex and specialized field that uses magnetic resonance (MR) imaging as the workhorse for diagnosis. Standard MR techniques used in adult neuroimaging are suboptimal for imaging in pediatrics because there are significant differences in the child's developing brain. These differences include size, myelination and sulcation. MR protocols need to be tailored to the specific indication and reviewed by the supervising radiologist in real time, and the specialized needs of this population require careful consideration of issues such as scan timing, sequence order, sedation, anesthesia and gadolinium administration...
May 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28399933/intranasal-sedation-using-ketamine-and-midazolam-for-pediatric-dental-treatment-naso-study-protocol-for-a-randomized-controlled-trial
#9
Heloisa Sousa Gomes, Analya Rodrigues Miranda, Karolline Alves Viana, Aline Carvalho Batista, Paulo Sucasas Costa, Anelise Daher, Geovanna de Castro Morais Machado, Joji Sado-Filho, Liliani Aires Candido Vieira, Patrícia Corrêa-Faria, Marie Therese Hosey, Luciane Rezende Costa
BACKGROUND: Uncooperative children may need to receive dental treatment under sedation, which is indicated when nonpharmacological behavior guidance is unsuccessful. There are randomized controlled trials (RCTs) comparing different sedative protocols for dental procedures; however, the evidence for superiority of one form over another is weak. The primary aim of this study is to investigate the efficacy of intranasally administered ketamine plus midazolam for the dental treatment of children...
April 11, 2017: Trials
https://www.readbyqxmd.com/read/28395002/monitored-anesthesia-care-vs-intubation-for-vertebrobasilar-stroke-endovascular-therapy
#10
Ashutosh P Jadhav, Mehdi Bouslama, Amin Aghaebrahim, Leticia C Rebello, Matthew T Starr, Diogo C Haussen, Manasa Ranginani, Matthew K Whalin, Tudor G Jovin, Raul G Nogueira
Importance: No consensus regarding the ideal sedation treatment for stroke endovascular therapy has been reached, and practices remain largely based on local protocols and clinician preferences. Most studies have focused on anterior circulation strokes; therefore, little is known regarding the optimal anesthesia type for vertebrobasilar occlusion strokes. Objective: To compare clinical and angiographic outcomes between monitored anesthesia care (MAC) and general anesthesia (GA) in patients presenting with vertebrobasilar occlusion strokes...
April 10, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28390557/immobilisation-in-australian-paediatric-medical-imaging-a-pilot-study
#11
S Noonan, K Spuur, S Nielsen
AIMS: The primary aim of this study is to document the use of paediatric immobilisation techniques in medical imaging. Secondary aims are to investigate differences between current practice of paediatric and non-paediatric facilities and radiographer gender and to investigate immobilisation protocols. METHODS: A SurveyMonkey link was distributed through the Australian Society of Medical Imaging and Radiation Therapy (ASMIRT) newsletter. Radiographer members of ASMIRT were invited to participate...
May 2017: Radiography
https://www.readbyqxmd.com/read/28384736/examining-a-new-method-to-studying-velopharyngeal-structures-in-a-child-with-22q11-2-deletion-syndrome
#12
Lakshmi Kollara, Graham Schenck, Michael Jaskolka, Jamie L Perry
Purpose: To date, no studies have imaged the velopharynx in children with 22q11.2 deletion syndrome (22q11.2 DS) without the use of sedation. Dysmorphology in velopharyngeal structures has been shown to have significant negative implications on speech among these individuals. This single case study was designed to assess the feasibility of a child-friendly magnetic resonance imaging (MRI) scanning protocol in this clinically challenging population and to determine the utility of this MRI protocol for future work in this area...
April 6, 2017: Journal of Speech, Language, and Hearing Research: JSLHR
https://www.readbyqxmd.com/read/28379112/comparison-of-two-sedation-protocols-for-short-electroretinography-in-cats
#13
María J Del Sole, Pablo Nejamkin, Verónica Cavilla, Paula Schaiquevich, Laura Moreno
Objectives The objectives were to compare two different sedative combinations, xylazine-ketamine and dexmedetomidine-ketamine, on the short electroretinography (ERG) protocol and their impact on sedative effect, reversal times and physiological variables in cats. Methods Six healthy spayed female domestic cats were sedated using one of two ketamine-containing protocols: intramuscular xylazine hydrochloride (1 mg/kg) plus ketamine hydrochloride (3 mg/kg) (XK), and dexmedetomidine hydrochloride (5 µg/kg) plus ketamine hydrochloride (3 mg/kg) (DK)...
April 1, 2017: Journal of Feline Medicine and Surgery
https://www.readbyqxmd.com/read/28377246/awake-surgery-for-brain-vascular-malformations-and-moyamoya-disease
#14
Rami James N Aoun, Mithun G Sattur, Chandan Krishna, Amen Gupta, Matthew E Welz, Allan D Nanney, Antoun H Koht, Matthew C Tate, Katherine H Noe, Joseph I Sirven, Barrett J Anderies, Patrick B Bolton, Terry L Trentman, Richard S Zimmerman, Kristin R Swanson, Bernard R Bendok
OBJECTIVE: While a significant amount of experience has accumulated for awake procedures for brain tumor, epilepsy and carotid surgery, its utility for intracranial neurovascular indications remains largely undefined. Awake surgery, for select neurovascular cases, offers the advantage of precise brain mapping and robust neurological monitoring during surgery for lesions in eloquent areas, avoidance of potential hemodynamic instability, and possible faster recovery. Additionally, it opens the window for perilesional epileptogenic tissue resection with potentially less risk for iatrogenic injury...
April 1, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28371158/the-effect-of-gabapentin-on-delayed-discharge-from-the-postanesthesia-care-unit-a-retrospective-analysis
#15
Naveed T Siddiqui, Amir Yousefzadeh, Maaz Yousuf, Dileep Kumar, Farah K Choudhry, Zeev Friedman
BACKGROUND: Enhanced recovery after surgery programs have incorporated gabapentin as part of a multimodal analgesia protocol. The preemptive use of gabapentin was found to be beneficial due to its opioid-sparing effect. However, excessive sedation and delayed discharge from postanesthesia recovery units are of concern. The aim of this study was to investigate whether preoperative gabapentin increased the length of stay in the recovery unit. METHODS: This retrospective cross-sectional study was carried out over a period of 2 months in the postanesthesia care unit (PACU) of a tertiary care hospital in Canada...
March 30, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/28358177/survey-on-monitoring-analgesia-and-sedation-in-the-italian-pediatric-intensive-care-units
#16
Benedicta Tabacco, Claudio Tacconi, Angela Amigoni
BACKGROUND: Admission in Pediatric Intensive Care Unit requires management and monitoring of analgesia and sedation, in order to reduce their adverse effects, and to prevent withdrawal syndrome and delirium. The aim of this study is to evaluate the management of analgesia and sedation in critically ill children admitted in the Italian Pediatric Intensive Care Units. METHODS: For this survey we have submitted a telematics questionnaire to 24 nursing co- ordinators of the Pediatric Intensive Care Units or Neonatal Intensive Care Units admitting critically ill children...
March 28, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28351829/innovations-in-the-management-of-musculoskeletal-pain-with-alpha-lipoic-acid-impala-trial-study-protocol-for-a-double-blind-randomized-placebo-controlled-crossover-trial-of-alpha-lipoic-acid-for-the-treatment-of-fibromyalgia-pain
#17
Ian Gilron, Dongsheng Tu, Ronald Holden, Tanveer Towheed, Dan Ziegler, Louie Wang, Roumen Milev, Christopher Gray
BACKGROUND: Fibromyalgia is a common disorder characterized by chronic widespread pain, sleep disturbance, fatigue, depression, and cognitive dysfunction, resulting in substantial disability. As current analgesics provide incomplete relief and disabling side effects that aggravate fatigue and cognitive dysfunction, there is a need for new pain treatments with better efficacy and tolerability. Alpha-lipoic acid (ALA) is an antioxidant proven effective in painful diabetic neuropathy with minimal side effects...
March 28, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28348503/gabapentin-does-not-appear-to-improve-postoperative-pain-and-sleep-patterns-in-patients-who-concomitantly-receive-regional-anesthesia-for-lower-extremity-orthopedic-surgery-a-randomized-control-trial
#18
Jean Daniel Eloy, Christy Anthony, Shawn Amin, Moorice Caparó, Mark C Reilly, Steven Shulman
In recent years, gabapentin has gained popularity as an adjuvant therapy for the treatment of postoperative pain. Numerous studies have shown a decrease in pain score, even with immediate postoperative activity, which is significant for early post-op ambulation and regaining functionality sooner. However, studies have been in conclusive in patients undergoing lower extremity orthopedic surgery. For this reason, we hoped to study the effect of gabapentin on postoperative pain in patients undergoing total knee arthroplasty, total hip arthroplasty, or a hip fracture repair...
2017: Pain Research & Management: the Journal of the Canadian Pain Society
https://www.readbyqxmd.com/read/28342115/ssh-versus-tse-sequence-protocol-in-rapid-mr-examination-of-pediatric-patients-with-programmable-drainage-system
#19
Eva Brichtová, J Šenkyřík
PURPOSE: A low radiation burden is essential during diagnostic procedures in pediatric patients due to their high tissue sensitivity. Using MR examination instead of the routinely used CT reduces the radiation exposure and the risk of adverse stochastic effects. Our retrospective study evaluated the possibility of using ultrafast single-shot (SSh) sequences and turbo spin echo (TSE) sequences in rapid MR brain imaging in pediatric patients with hydrocephalus and a programmable ventriculoperitoneal drainage system...
March 24, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28341980/implementation-and-evaluation-of-a-paediatric-nurse-driven-sedation-protocol-in-a-paediatric-intensive-care-unit
#20
Lélia Dreyfus, Etienne Javouhey, Angélique Denis, Sandrine Touzet, Fabienne Bordet
BACKGROUND: Optimal sedation and analgesia is a challenge in paediatric intensive care units (PICU) because of difficulties in scoring systems and specific metabolism inducing tolerance and withdrawal. Excessive sedation is associated with prolonged mechanical ventilation and hospitalisation. Adult and paediatric data suggest that goal-directed sedation algorithms reduce the duration of mechanical ventilation. We implemented a nurse-driven sedation protocol in a PICU and evaluated its impact...
December 2017: Annals of Intensive Care
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