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https://www.readbyqxmd.com/read/29340293/can-sedation-using-a-combination-of-propofol-and-dexmedetomidine-enhance-the-satisfaction-of-the-endoscopist-in-endoscopic-submucosal-dissection
#1
Takashi Nonaka, Masahiko Inamori, Tetsuya Miyashita, Yumi Inoh, Kenji Kanoshima, Takuma Higurashi, Hidenori Ohkubo, Hiroshi Iida, Koji Fujita, Akihiko Kusakabe, Takahisa Gotoh, Atsushi Nakajima
Background and study aims:  The aim of this pilot randomized controlled trial was to evaluate and compare the satisfaction of the endoscopist along with the effectiveness and safety of sedation between sedation protocol using a combination of propofol (PF) and dexmedetomidine (DEX) (Combination group) and sedation protocol using PF alone (PF group) during gastric endoscopic submucosal dissection (ESD). Patients and methods : Fifty-eight patients with gastric neoplasias scheduled for gastric ESD were enrolled and randomly assigned to the two groups...
January 2018: Endoscopy International Open
https://www.readbyqxmd.com/read/29338772/incidence-risk-factors-and-impact-of-protocolised-care-on-exposure-keratopathy-in-critically-ill-adults-a-two-phase-prospective-cohort-study
#2
Obaid Kousha, Zubaid Kousha, Jonathan Paddle
BACKGROUND: Exposure keratopathy (EK) has a high incidence in critically ill patients. We aimed to determine the rate of EK in patients admitted to our intensive care unit (ICU), identify risk factors for developing EK and ascertain the effectiveness of a protocol to prevent EK. METHODS: We undertook a two-phase prospective cohort single-centre study in a general adult ICU. The first phase of the study was observational. In the second phase of the study an eye care protocol was introduced...
January 16, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29338549/sedation-in-cardiac-arrhythmias-management
#3
Federico Guerra, Giulia Stronati, Alessandro Capucci
Procedural sedation is of paramount importance for a plethora of electrophysiological procedures. From electrical cardioversion to electrophysiology studies, device implantations, and catheter ablations, intraprocedural sedation and anesthesia have a pivotal role in allowing procedural success while ensuring patient safety and avoiding discomfort. Areas covered: The present review will discuss the current state-of-the-art in sedation and anesthesia during electrical cardioversion, cardiac implantable electronic device implantation, catheter ablation and electrophysiology studies...
January 17, 2018: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/29331966/effectiveness-and-safety-of-oral-sedation-in-adult-patients-undergoing-dental-procedures-protocol-for-a-systematic-review
#4
Jimmy de Oliveira Araújo, Rogério Heládio Lopes Motta, Cristiane de Cássia Bergamaschi, Caio Chaves Guimarães, Juliana Cama Ramacciato, Natalia Karol de Andrade, Mabel Fernandes Fiqueiró, Luciane Cruz Lopes
INTRODUCTION: The management of anxious patients undergoing dental procedures is still a challenge in clinical practice. Despite a wide variety of drugs for oral sedation in adult patients, there are relatively few systematic reviews that compare the effectiveness and safety of different drugs administered via this route. Thus, this study will evaluate the effectiveness and safety of oral sedation with benzodiazepines and other agents to patients undergoing dental surgical procedures...
January 13, 2018: BMJ Open
https://www.readbyqxmd.com/read/29326491/comparison-of-midazolam-with-fentanyl-midazolam-combination-during-flexible-bronchoscopy-a-randomized-double-blind-placebo-controlled-study
#5
Amithash Marulaiah Prabhudev, Bharti Chogtu, Rahul Magazine
BACKGROUND: Sedation during flexible bronchoscopy is desirable, but the drugs and the dosage protocols that are used vary. OBJECTIVE: To study and compare the effects of midazolam with fentanyl-midazolam combination during flexible bronchoscopy. MATERIALS AND METHODS: The study was conducted on 144 patients, from October 2013 to July 2015. They answered Hospital Anxiety and Depression Scale-Anxiety subscale and a prebronchoscopy questionnaire to assess their expectation toward flexible bronchoscopy...
July 2017: Indian Journal of Pharmacology
https://www.readbyqxmd.com/read/29313710/long-term-outcomes-after-protocolized-sedation-vs-usual-care-in-ventilated-pediatric-patients
#6
R Scott Watson, Lisa A Asaro, James H Hertzog, Lauren R Sorce, Alicia G Kachmar, Leslie A Dervan, Derek C Angus, David Wypij, Martha A Q Curley
RATIONALE: Whether a nurse-implemented goal-directed sedation protocol resulting in more awake yet calm intubated children affects post-discharge functional status, health-related quality of life, or risk for post-traumatic stress disorder is unknown. OBJECTIVES: To compare post-discharge outcomes in children with acute respiratory failure cluster randomized to a sedation protocol or usual care. METHODS: A stratified random sample of 1360 patients from 31 centers in the Randomized Evaluation of Sedation Titration for Respiratory Failure trial was assessed by mail, electronically, and/or telephone six months after intensive care unit discharge...
January 9, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29303138/is-age-a-determinant-for-nausea-and-vomiting-in-disabled-patients-after-dental-treatment-under-sedation
#7
Hüseyin Cihad Turgut, Metin Alkan, Gülay Kip, Mustafa Sancar Ataç, Sevil Kahraman Altundağ, Süleyman Bozkaya, Berrin Işik, Mustafa Arslan
BACKGROUND AND AIM: Postoperative nausea and vomiting (PONV) is one of most frequently encountered problems after dental treatment of mentally and/or motor disabled patients under sedation or general anesthesia. In this study, we aimed to investigate whether PONV incidence in disabled patients differs between adults (≥18 years) and children/teenage (<18 years). Also investigating complication rates related with anesthesia protocols were additional objectives of the study. MATERIALS AND METHODS: We retrospectively evaluated anesthesia reports of 664 cases undergone different dental treatment procedures under deep sedation with various anesthetic agents...
November 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/29299518/an-updated-review-of-pediatric-drug-induced-sleep-endoscopy
#8
REVIEW
Lyndy J Wilcox, Mathieu Bergeron, Saranya Reghunathan, Stacey L Ishman
Objectives: Drug-induced sleep endoscopy (DISE) involves assessment of the upper airway using a flexible endoscope while patients are in a pharmacologically-induced sleep-like state. The aim of this article is to review the current literature regarding the role of DISE in children with obstructive sleep apnea (OSA). The indications, typical anesthetic protocol, comparison to other diagnostic modalities, scoring systems, and outcomes are discussed. Methods: A comprehensive review of literature regarding pediatric DISE up through May 2017 was performed...
December 2017: Laryngoscope Investigative Otolaryngology
https://www.readbyqxmd.com/read/29287024/low-dose-noncontrast-examination-of-the-paranasal-sinuses-using-volumetric-computed-tomography
#9
Berhan Pirimoglu, Recep Sade, Muhammed Sedat Sakat, Hayri Ogul, Akin Levent, Mecit Kantarci
OBJECTIVES: The objective of this study was to evaluate image quality of low dose in noncontrast paranasal sinus computed tomography (CT) using single volumetric 320-row multidetector CT technique. METHODS: The low-dose protocol including tube voltage of 135 kV and tube current of 5 mAs was chosen based on results of the present phantom study. Forty-six patients were assigned to control group with factory standard settings (120 kVp, 75 mAs), and 46 patients were assigned to study group and underwent noncontrast CT of paranasal sinus with low-dose protocol using single volumetric 320-row multidetector CT device...
December 28, 2017: Journal of Computer Assisted Tomography
https://www.readbyqxmd.com/read/29284510/the-napressim-trial-the-use-of-low-dose-prophylactic-naloxone-infusion-to-prevent-respiratory-depression-with-intrathecally-administered-morphine-in-elective-hepatobiliary-surgery-a-study-protocol-and-statistical-analysis-plan-for-a-randomised-controlled-trial
#10
David Cosgrave, Marie Galligan, Era Soukhin, Victoria McMullan, Siobhan McGuinness, Anand Puttappa, Niamh Conlon, John Boylan, Rabia Hussain, Peter Doran, Alistair Nichol
BACKGROUND: Intrathecally administered morphine is effective as part of a postoperative analgesia regimen following major hepatopancreaticobiliary surgery. However, the potential for postoperative respiratory depression at the doses required for effective analgesia currently limits its clinical use. The use of a low-dose, prophylactic naloxone infusion following intrathecally administered morphine may significantly reduce postoperative respiratory depression. The NAPRESSIM trial aims to answer this question...
December 29, 2017: Trials
https://www.readbyqxmd.com/read/29279164/clinical-application-of-half-fourier-acquisition-single-shot-turbo-spin-echo-haste-imaging-accelerated-by-simultaneous-multi-slice-acquisition
#11
Jenni Schulz, José P Marques, Annemieke Ter Telgte, Anouk van Dorst, Frank-Erik de Leeuw, Frederick J A Meijer, David G Norris
As a single-shot sequence with a long train of refocusing pulses, Half-Fourier Acquisition Single-Shot Turbo-Spin-Echo (HASTE) suffers from high power deposition limiting use at high resolutions and high field strengths, particularly if combined with acceleration techniques such as simultaneous multi-slice (SMS) imaging. Using a combination of multiband (MB)-excitation and PINS-refocusing pulses will effectively accelerate the acquisition time while staying within the SAR limitations. In particular, uncooperative and young patients will profit from the speed of the MB-PINS HASTE sequence, as clinical diagnosis can be possible without sedation...
January 2018: European Journal of Radiology
https://www.readbyqxmd.com/read/29260390/parent-perspectives-and-preferences-for-strategies-regarding-nonsedated-mri-scans-in-a-pediatric-oncology-population
#12
Breya Walker, Heather M Conklin, Doralina L Anghelescu, Lacey P Hall, Wilburn E Reddick, Robert Ogg, Lisa M Jacola
PURPOSE: Children with cancer frequently require MRI scans for clinical purposes. Sedation with general anesthesia (GA) is often used to promote compliance, reduce motion, and alleviate anxiety. The use of GA for MRI scans is costly in terms of time, personnel, and medications. In addition, prominent risks are associated with anesthesia exposure in patients with complex medical conditions. Successful behavioral interventions have been implemented in clinical research settings to promote scan success and compliance...
December 19, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29258778/effects-of-deep-sedation-under-mechanical-ventilation-on-cognitive-outcome-in-patients-undergoing-surgery-for-oral-and-maxillofacial-cancer-and-microvascular-reconstruction
#13
Y Terada, S Inoue, M Konda, J Egawa, J Ueda, T Kirita, M Kawaguchi
OBJECTIVE: Cognitive impairment after intensive care unit (ICU) admission is becoming increasingly recognized. High-dose deep sedation has been suggested to play an important role in the development of cognitive impairment. However, the impact of heavy sedation as a single cause in the development of cognitive impairment in ICU patients remains unclear. In this study we investigated whether a three-day deep sedation protocol could reduce cognitive function in mechanically ventilated non-critical patients...
December 16, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/29243169/efficacy-of-two-types-of-palliative-sedation-therapy-defined-using-intervention-protocols-proportional-vs-deep-sedation
#14
Kengo Imai, Tatsuya Morita, Naosuke Yokomichi, Masanori Mori, Akemi Shirado Naito, Hiroaki Tsukuura, Toshihiro Yamauchi, Takashi Kawaguchi, Kaori Fukuta, Satoshi Inoue
PURPOSE: This study investigated the effect of two types of palliative sedation defined using intervention protocols: proportional and deep sedation. METHODS: We retrospectively analyzed prospectively recorded data of consecutive cancer patients who received the continuous infusion of midazolam in a palliative care unit. Attending physicians chose the sedation protocol based on each patient's wish, symptom severity, prognosis, and refractoriness of suffering. The primary endpoint was a treatment goal achievement at 4 h: in proportional sedation, the achievement of symptom relief (Support Team Assessment Schedule (STAS) ≤ 1) and absence of agitation (modified Richmond Agitation-Sedation Scale (RASS) ≤ 0) and in deep sedation, the achievement of deep sedation (RASS ≤ - 4)...
December 14, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29237514/the-effects-of-intraoperative-sedation-on-surgical-outcomes-of-deep-brain-stimulation-surgery
#15
Jason Chui, Rizq Alimiri, Andrew Parrent, Rosemary Ann Craen
BACKGROUND: Intraoperative sedation is often used to facilitate deep brain stimulation (DBS) surgery; however, these sedative agents also suppress microelectrode recordings (MER). To date, there have been no studies that have examined the effects of differing sedatives on surgical outcomes and the success of DBS surgery. METHODS: We performed a retrospective study to evaluate the effect of differing sedative agents on postoperative surgical outcomes at 6 months in parkinsonian adult patients who underwent DBS surgery, from January 2004 through December 2014, at one academic center...
December 14, 2017: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/29236279/the-maxillary-nerve-block-for-in-office-hybrid-balloon-sinus-dilation-procedures-a-preliminary-study
#16
Gary J Nishioka
Transitioning of rhinologic procedures from the operating room to the office setting in selected patients is a rising trend. An effective pain-control, patient-preparation protocol is essential, especially with advanced in-office rhinologic procedures such as hybrid balloon sinus dilation (BSD), in which other procedures such as ethmoidectomy, turbinate reduction, and other procedures are concomitantly performed. A regimen using oral sedation, topical tetracaine gel, topical tetracaine/epinephrine-soaked cottonoid packs, and intranasal local infiltrative anesthesia can vary significantly in effectiveness and be suboptimal at times (as determined by using treated patients as historical controls)...
December 2017: Ear, Nose, & Throat Journal
https://www.readbyqxmd.com/read/29214645/recovery-characteristics-of-patients-receiving-either-sugammadex-or-neostigmine-and-glycopyrrolate-for-reversal-of-neuromuscular-block-a-randomised-controlled-trial
#17
M J Paech, R Kaye, C Baber, E A Nathan
Sugammadex more rapidly and reliably reverses rocuronium-induced neuromuscular block compared with neostigmine, but it is not known if subsequent patient outcomes, including nausea, vomiting and other aspects of recovery are modified. In this study, we compared the recovery characteristics of sugammadex and neostigmine/glycopyrrolate following reversal of neuromuscular block. This was a single-centre, randomised, blinded, parallel-group clinical trial in women undergoing elective day-surgical laparoscopic gynaecological surgery, with a standardised general anaesthesia regimen that included rocuronium...
December 7, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29212478/effect-of-butorphanol-midazolam-or-ketamine-on-romifidine-based-sedation-in-horses-during-standing-cheek-tooth-removal
#18
Theresa Maria Müller, Klaus Hopster, Astrid Bienert-Zeit, Karl Rohn, Sabine B R Kästner
BACKGROUND: Standing surgery, especially dental procedures, are commonly performed in horses. This leads to an increasing demand for reliable sedation protocols. Therefore, it was the purpose of this study to investigate the influence of butorphanol, midazolam or ketamine on romifidine based sedation in horses during cheek tooth removal. METHODS: Forty horses presented for tooth extraction were divided in four groups using matched pair randomization. Group R was sedated with romifidine (bolus 0...
December 6, 2017: BMC Veterinary Research
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
#19
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/29208343/single-center-experience-with-intrathecal-administration-of-nusinersen-in-children-with-spinal-muscular-atrophy-type-1
#20
Astrid Pechmann, Thorsten Langer, Sabine Wider, Janbernd Kirschner
BACKGROUND: Spinal muscular atrophy (SMA) is a neuromuscular disorder mainly characterized by proximal muscle weakness. There have been enormous advances in therapeutic development with the possibility to influence the clinical course of the disease. Nusinersen is the first approved drug to treat SMA. It is administered intrathecally and acts as splicing modifier of the SMN2 gene. METHODS: Lumbar punctures were performed using a standardized protocol. To evaluate safety and feasibility of the intrathecal treatment, vital signs and the need for sedation, analgesia or mechanical ventilation during the procedure were monitored...
November 21, 2017: European Journal of Paediatric Neurology: EJPN
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