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Fentanyl and midazolam

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https://www.readbyqxmd.com/read/29755018/ambulatory-colonoscopy-under-sedoanalgesia-in-adult-patients-with-and-without-irritable-bowel-syndrome-a-prospective-cross-sectional-and-double-blind-comparison
#1
Bahattin Tuncalı, Coşkun Araz, Arzu Çelebi
BACKGROUND/AIMS: It is unclear whether patients with irritable bowel syndrome (IBS) require a high dose of sedatives during colonoscopy. In this study, we investigated the pre-procedural anxiety levels, sedative consumption, procedure times, complications, and patient's satisfaction between patients with IBS and controls for ambulatory colonoscopy under sedation. MATERIALS AND METHODS: Rome III criteria were used in the diagnosis of IBS. Anxiety levels were measured using Spielberger's State-Trait Anxiety Inventory (STAI) and Beck Anxiety Inventory (BAI)...
May 2018: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/29743682/preoperative-screening-for-illicit-drug-use-in-patients-undergoing-emergency-surgery-a-prospective-observational-study
#2
Jingyi Li, He Ma, Ren Liao, Yanjuan Huang, Guiyong Chen
Knowledge of illicit drug users (IDUs) is important because of the comorbidity related to drug use. In this prospective, observational study, we screened 1007 patients undergoing emergency surgery and found that 75 of them (7.5%) were IDUs The results of preoperative screening showed that the rates of HIV and syphilis infection were significantly higher in IDUs (HIV (+) 2.6%, syphilis (+) 10.7%) than in non-IDUs (HIV (+) 0, syphilis (+) 0.5%). Intraoperative consumption of remifentanil (IDUs: 1.85 ± 1...
May 9, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29740019/feasibility-and-safety-of-using-local-anaesthesia-with-conscious-sedation-during-complex-cardiac-implantable-electronic-device-procedures
#3
Elif Kaya, Hendrik Südkamp, Julia Lortz, Tienush Rassaf, Rolf Alexander Jánosi
We assessed the feasibility and safety of using local anaesthesia with conscious sedation as an alternative to general anaesthesia during complex and noncomplex cardiac implantable device procedures. We enrolled 279 consecutive patients who underwent cardiac device implantation/replacement at our tertiary/quaternary cardiac specialist hospital during a 17-month study period. Continuous combined intravenous conscious sedation with propofol and midazolam plus fentanyl and local anaesthesia were used for all procedures...
May 8, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29723512/a-phase-iii-study-evaluating-the-efficacy-and-safety-of-remimazolam-cns-7056-compared-with-placebo-and-midazolam-in-patients-undergoing-colonoscopy
#4
Douglas K Rex, Raj Bhandari, Taddese Desta, Michael DeMicco, Cynthia Schaeffer, Kyle Etzkorn, Charles Barish, Ronald Pruitt, Brooks D Cash, Daniel Quirk, Felix Tiongco, Shelby Sullivan, David Bernstein
BACKGROUND: Remimazolam is an ultrashort-acting benzodiazepine. METHODS: We performed a randomized double-blind comparison of remimazolam to placebo for outpatient colonoscopy. This study design was a requirement of the U.S. Food and Drug Administration. An additional group was randomized to open-label midazolam administered according to its package insert instructions (randomization ratio for remimazolam:placebo:midazolam was 30:6:10). Study medications were administered under the supervision of the endoscopist, without any involvement of an anesthesia specialist...
April 30, 2018: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29720907/sedation-and-analgesia-using-medications-delivered-via-the-extravascular-route-in-children-undergoing-laceration-repair
#5
REVIEW
Jamie L Miller, Amanda C Capino, Amber Thomas, Kevin Couloures, Peter N Johnson
OBJECTIVES: To describe the method of delivery, dosage regimens, and outcomes of sedatives and analgesics administered via the extravascular route for laceration repair in children. METHODS: Medline, Embase, and International Pharmaceutical Abstracts were searched using the keywords "child," "midazolam," "ketamine," dexmedetomidine," "fentanyl," "nitrous oxide" (N2 O), and "laceration repair." Articles evaluating the use of extravascular sedation in children for laceration repair published in the English language between 1946 and June 2017 were included...
March 2018: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/29701421/rapid-pacing-for-thoracic-endovascular-aortic-repair-a-case-report
#6
Hugo Silva, Andreia Fernandes, João Rodrigues, Daniel Brandão, Manuela Vieira, Catarina Celestino
INTRODUCTION: Endovascular aortic interventions are suitable alternatives to open surgery, being less invasive and having lower mortality and complications. Accurate positioning of the stent graft is a critical point because of systolic thrush. Techniques used to prevent it include pharmacological (antihypertensive drugs, nitroglycerin, adenosine) and mechanical methods (temporary caval occlusion by balloon). Rapid Right Ventricular Pacing (RRVP) is an emerging alternative with good patient tolerance and low level of complications...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29689257/use-of-diphenhydramine-as-an-adjunctive-sedative-for-colonoscopy-in-patients-on-chronic-opioid-therapy-a-randomized-controlled-trial
#7
Salman Nusrat, Mohammed F Madhoun, William M Tierney
BACKGROUND AND AIMS: Chronic opioid use increases tolerance to sedatives. Diphenhydramine is recommended for difficult-to-sedate patients during endoscopic procedures. We hypothesized that the addition of diphenhydramine to midazolam and fentanyl would improve objective and subjective measures of procedural sedation. METHODS: This randomized, double-blind, placebo-controlled trial included patients on chronic opioids undergoing colonoscopy. Patients were randomized to receive intravenous 50 mg of diphenhydramine (N=61) or placebo (N=58), in addition to fentanyl and midazolam...
April 21, 2018: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29679692/impact-of-fellowship-training-level-on-colonoscopy-quality-and-efficiency-metrics
#8
Hussein Bitar, Hassaan Zia, Muhammad Bashir, Pratyusha Parava, Muhammad Hanafi, William Tierney, Mohammad Madhoun
BACKGROUND & AIMS: Previous studies have described variable effects of fellow involvement on the adenoma detection rate (ADR), but few have stratified this effect by level of training. We aimed to evaluate the "fellow effect" on multiple procedural metrics including a newly defined adenoma management efficiency index, which may have a role in documenting colonoscopy proficiency for trainees. We also describe the impact of level of training on moderate sedation use. METHODS: We performed a retrospective review of 2024 patients (mean age 60...
April 18, 2018: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29652752/practice-change-from-intermittent-medication-boluses-to-bolusing-from-a-continuous-infusion-in-pediatric-critical-care-a-quality-improvement-project
#9
Jessica L Hochstetler, A Jill Thompson, Natalie M Ball, Melissa C Evans, Shaun C Frame, A Lauren Haney, Amelia K Little, Jaime L O'Donnell, Bryna M Rickett, Elizabeth H Mack
OBJECTIVES: To determine whether implementing a guideline to bolus medications from continuous infusions in PICUs affects nursing satisfaction, patient safety, central line entries, medication utilization, or cost. DESIGN: This is a pre- and postimplementation quality improvement study. SETTING: An 11-bed ICU and 14-bed cardiac ICU in a university-affiliated children's hospital. PATIENTS: Patients less than 18 years old admitted to the PICU or pediatric cardiac ICU receiving a continuous infusion of dexmedetomidine, midazolam, fentanyl, morphine, vecuronium, or cisatracurium from May 2015 to May 2016, excluding November 2015 (washout period), were eligible for inclusion...
April 12, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29649029/dexmedetomidine-sedation-for-paroxysmal-supraventricular-tachycardia-ablation-is-not-associated-with-alteration-of-arrhythmia-inducibility
#10
Andrew M Slupe, Jessica Minnier, Merritt H Raitt, Ignatius Gerardo E Zarraga, Karen S MacMurdy, Peter M Jessel
BACKGROUND: Dexmedetomidine (Dex) is an attractive agent for procedural sedation due to its unique pharmacodynamic profile, specifically affording predictable sedation without concurrent respiratory depression. However, Dex has previously been reported to prevent or terminate arrhythmias. The purpose of this study was to investigate paroxysmal supraventricular tachycardia (PSVT) inducibility and homeostatic stability during electrophysiology studies (EPSs) and ablation when a standardized Dex protocol was used as the primary sedation agent...
April 11, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29628826/dexmedetomidine-vs-morphine-and-midazolam-in-the-prevention-and-treatment-of-delirium-after-adult-cardiac-surgery-a-randomized-double-blinded-clinical-trial
#11
Tamer M Abdel Azeem, Nahed E Yosif, Adel M Alansary, Ibrahim Mamdouh Esmat, Ahmed K Mohamed
Background: The aim of this clinical study was to evaluate the efficacy of neurobehavioral, hemodynamics and sedative characteristics of dexmedetomidine compared with morphine and midazolam-based regimen after cardiac surgery at equivalent levels of sedation and analgesia in improving clinically relevant outcomes such as delirium. Methods: Sixty patients were randomly allocated into one of two equal groups: group A = 30 patients received dexmedetomidine infusion (0...
April 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29626346/propofol-for-implantable-cardioverter-defibrillator-implantation-in-patients-with-brugada-syndrome
#12
Hye-Mee Kwon, Sung-Hoon Kim, Se-Ung Park, Jin-Ho Rhim, Hee-Sun Park, Wook-Jong Kim, Gi-Byoung Nam
AIMS: Avoiding propofol in patients with Brugada syndrome has been suggested because of the theoretical risk of provoking ventricular arrhythmias, although propofol may be selected for conscious sedation during electrophysiological procedures in catheterization laboratories. This study aimed to document periprocedural electrocardiographic changes and adverse events in patients with Brugada syndrome undergoing implantable cardioverter defibrillator (ICD) implantation using propofol sedation...
April 6, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29622309/anesthetic-agents-commonly-used-by-oral-and-maxillofacial-surgeons
#13
REVIEW
Kyle J Kramer, Jason W Brady
Oral and maxillofacial surgeons have a variety of anesthetic agents that can be used to provide anesthesia safely and efficiently in the office-based environment. However, it is critical to have a thorough understanding of the particulars for each agent. Commonly used anesthetic agents, administered either individually or in combination, include diazepam, midazolam, propofol, ketamine, opioid agonists such as fentanyl or remifentanil, dexmedetomidine, and inhalational agents, including nitrous oxide and sevoflurane...
May 2018: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/29595531/sedative-and-analgesic-drug-sequestration-after-a-single-bolus-injection-in-an-ex-vivo-extracorporeal-membrane-oxygenation-infant-circuit
#14
Viviane G Nasr, Jonathan Meserve, Luis M Pereira, David Faraoni, Steve Brediger, Susan Goobie, Ravi Thiagarajan, James A DiNardo
Patient sedation and analgesia on extracorporeal membrane oxygenation (ECMO) is vital for safety and comfort. However, adsorption to the circuit may alter drug pharmacokinetics and remains poorly characterized. This study characterizes drug adsorption of morphine, fentanyl, midazolam, and dexmedetomidine in an ex vivo infant ECMO circuit utilizing polymethylpentene (PMP) membrane oxygenator (MO) with protein-bounded polyvinylchloride (PVC) tubing. Twelve closed-loop ex vivo ECMO circuits were prepared using P...
March 26, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29588840/device-assisted-enteroscopy-in-the-uk-description-of-a-large-tertiary-case-series-under-conscious-sedation
#15
Vijay Pattni, David J Tate, Ana Terlevich, Peter Marden, Steve Hughes
Objective: Device-assisted enteroscopy (DAE) has developed rapidly, particularly with the advent of double-balloon enteroscopy (DBE). This study reports a case series from a UK tertiary centre for DAE across two modalities-DBE and spiral enteroscopy (SE)-under conscious sedation. Design: Retrospective observational study of 257 enteroscopy procedures from 2008 to 2014. Data were collected on demographics, indications, diagnosis, sedation requirements, duration, complications, tolerance, therapy performed and completion rate...
April 2018: Frontline Gastroenterology
https://www.readbyqxmd.com/read/29579581/midazolam-addition-to-analgosedation-for-pulmonary-vein-isolation-may-increase-risk-of-hypercapnia-and-acidosis
#16
Bernhard M Kaess, Florian Feurich, Gerd Bürkle, Joachim R Ehrlich
BACKGROUND: Pulmonary vein isolation (PVI) is generally performed under analgosedation, but sedation protocols vary and no optimal protocol has been defined. We investigated procedural, respiratory and hemodynamic parameters in patients undergoing PVI using analgosedation either with or without midazolam. METHODS: In a prospective observational study, we compared n = 43 consecutive patients (54% male, mean age 62 years) undergoing PVI using analgosedation either with or without midazolam added to propofol and fentanyl...
May 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29576825/comparison-of-sedative-effectiveness-of-thiopental-versus-midazolam-in-reduction-of-shoulder-dislocation
#17
Elnaz Vahidi, Rezvan Hemati, Mehdi Momeni, Amirhossein Jahanshir, Morteza Saeedi
BACKGROUND: Various sedative drugs have been proposed to control anxiety and agitation in shoulder dislocation, but none of them has been diagnosed as the best sedative and relaxant agent. The study aimed to compare the sedative effectiveness of thiopental versus midazolam in reduction of shoulder dislocation. METHODS: A randomized double-blind controlled trail was performed in 80 patients with shoulder dislocation recruited from the emergency department. Ten patients were excluded and 70 patients were enrolled in the study...
2018: World Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29557840/an-exploratory-study-of-sevoflurane-as-an-alternative-for-difficult-sedation-in-critically-ill-children
#18
Santiago Mencía, Alba Palacios, Miriam García, Ana M Llorente, Olga Ordóñez, Blanca Toledo, Jesús López-Herce
OBJECTIVES: To analyze the effectiveness of inhaled sevoflurane in critically ill children with challenging sedation. DESIGN: Prospective case series. SETTING: Two PICUs of university hospitals in Spain. INTERVENTIONS: Prospective observational study and exploratory investigation conducted in two PICUs in Madrid, Spain, over a 6-year period. Children treated with inhaled sevoflurane due to difficult sedation were included...
March 19, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29557601/sedation-and-analgesia-in-patients-on-mechanical-ventilation-in-pediatric-intensive-care-units-in-argentina
#19
Pedro Taffarel, German Bonetto, Facundo Jorro Barón, Claudia Meregalli
INTRODUCTION: Children in pediatric intensive care units (PICUs) are exposed to experiencing pain, stress and anxiety due to their disease, treatment or care setting. Adequate sedation and analgesia are key to their care, particularly in patients requiring mechanical ventilation (MV). OBJECTIVE: To determine the usual practice in sedation and analgesia management in patients requiring MV in PICUs in Argentina. MATERIAL AND METHODS: Descriptive, crosssectional, multi-center study conducted by means of e-mailed surveys...
April 1, 2018: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/29556559/administration-order-of-midazolam-fentanyl-for-moderate-dental-sedation
#20
Douglas Lobb, Alix Clarke, Hollis Lai
Background: The purpose of this study is to investigate the effects of administration order when a sedative drug (midazolam) and an opioid analgesic drug (fentanyl) is applied for moderate intravenous (IV) sedation in dentistry. Methods: A retrospective chart review was conducted in one dental clinic during its transition from a midazolam-first to a fentanyl-first protocol for dental procedures requiring moderate IV sedation. Physiological parameters, drug administration times, patient recovery times, drug dosages, and patient recall and satisfaction were investigated for differences...
February 2018: Journal of Dental Anesthesia and Pain Medicine
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