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https://www.readbyqxmd.com/read/28604090/anesthetic-management-of-a-patient-with-multiple-sclerosis
#1
Naohiro Ohshita, Shoko Gamoh, Masahiko Kanazumi, Masahiro Nakajima, Yoshihiro Momota, Yasuo M Tsutsumi
A 54-year-old woman diagnosed with multiple sclerosis (MS) at the age of 19 years was scheduled to undergo temporomandibular joint mobilization. She was currently in a remission phase from her MS but with persistent sequelae, including impaired eyesight and muscle weakness of the limbs. In addition, the blood vessels in her upper limbs were compromised by the formation of internal shunts secondary to vascular prosthesis replacements for plasma exchange therapy in MS. After a previous joint mobilization surgery, her temporomandibular joint developed adhesions with resultant trismus...
2017: Anesthesia Progress
https://www.readbyqxmd.com/read/28597354/pharmacologic-considerations-for-pediatric-sedation-and-anesthesia-outside-the-operating-room-a-review-for-anesthesia-and-non-anesthesia-providers
#2
REVIEW
Narjeet Khurmi, Perene Patel, Molly Kraus, Terrence Trentman
Understanding the pharmacologic options for pediatric sedation outside the operating room will allow practitioners to formulate an ideal anesthetic plan, allaying anxiety and achieving optimal immobilization while ensuring rapid and efficient recovery. The authors identified relevant medical literature by searching PubMed, MEDLINE, Embase, Scopus, Web of Science, and Google Scholar databases for English language publications covering a period from 1984 to 2017. Search terms included pediatric anesthesia, pediatric sedation, non-operating room sedation, sedation safety, and pharmacology...
June 8, 2017: Paediatric Drugs
https://www.readbyqxmd.com/read/28584346/analgesic-efficacy-of-ultrasound-guided-paravertebral-block-versus-serratus-plane-block-for-modified-radical-mastectomy-a-randomised-controlled-trial
#3
Kapil Gupta, Kadapa Srikanth, Kiran Kumar Girdhar, Vincent Chan
BACKGROUND AND AIMS: Modified radical mastectomy (MRM) may be associated with severe post-operative pain, leading to chronic pain syndrome. We compared the post-operative analgesic profile of two ultrasound-guided nerve blocks: Paravertebral block (PVB) and serratus plane block (SPB). METHODS: This double-blind, randomised study was conducted on fifty adult females, scheduled for MRM with axillary dissection. After inducing general anaesthesia with intravenous midazolam 1 mg, fentanyl 1...
May 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28571040/videolaryngoscopy-during-conscious-sedation-in-patients-not-suitable-for-phonosurgery-by-microlaryngoscopy-a-pilot-study
#4
Vincenzo Saita, Eugenia Allegra, Nicolò Marino, Serena Trapasso, Maria Concetta Monea
BACKGROUND: Microlaryngoscopy is the preferred and most widely used technique in phonosurgery for the treatment of benign and early malignant glottic lesions. However, the procedure may be technically difficult or impossible due to alterations of the cervical spine that may not allow hyperextension of the head or may present general anesthesia contraindications. The aim of this study is to evaluate the efficacy and safety of our surgical approach for lesions of the vocal folds in patients who are not suitable for phonosurgery by microlaryngoscopy...
June 2, 2017: ORL; Journal for Oto-rhino-laryngology and its related Specialties
https://www.readbyqxmd.com/read/28568894/intravital-investigation-of-rat-mesenteric-small-artery-tone-and-blood-flow
#5
Jakob Nyvad, Aleksandra Mazur, Dmitry D Postnov, Marthe Simonsen Straarup, Asger Maare Soendergaard, Christian Staehr, Emil Brøndum, Christian Aalkjaer, Vladimir V Matchkov
Functional characteristics of rat mesenteric small arteries (internal diameter ∼150-200 μm) have been extensively studied in vitro using isometric and isobaric myographs. In vivo, precapillary arterioles (internal diameter< 50 μm) have been studied, but only few studies have investigated the function of mesenteric small arteries. We here present a novel approach for intravital studies of rat mesenteric small artery segments (∼5 mm long) isolated in a chamber. The agonist-induced changes in arterial diameter and blood flow were studied using video imaging and laser speckle analysis in rats anaesthetized by isoflurane, pentobarbital, ketamine/xylazine, or by a combination of fentanyl, fluanison and midazolam (rodent mixture)...
June 1, 2017: Journal of Physiology
https://www.readbyqxmd.com/read/28551041/emergency-departments-increasingly-administering-medications-through-the-nose
#6
REVIEW
Deborah L McBride
Administering medications through the nose as an alternative to intramuscular or intravenous injections is increasingly popular in emergency departments and out-of hospital settings because it is simple, fast, and can be used in situations where obtaining intravenous access is difficult or time intensive. This article examines the literature and indications for the out-of-hospital and emergency department administration of five commonly used intranasal medications: midazolam (used to sedate children and treat seizures), fentanyl (for pain relief), naloxone (for opioid overdoses), ketamine (to induce anesthesia) and dexmedetomidine (to sedate and relieve pain in children)...
May 24, 2017: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/28527548/propofol-versus-midazolam-fentanyl-sedation-for-colonoscopy-in-the-elderly-patient-population
#7
Pamela Lovett, Victoria Gómez, David O Hodge, Beth Ladlie
PURPOSE: Despite current literature, data on the most effective sedation and best patient outcomes are insufficient for providing recovery time recommendations for elderly patients undergoing colonoscopy with sedation. We sought to identify the best sedation practice for shorter recovery times. Therefore, a study was conducted to examine recovery times among patients older than 65 years undergoing elective colonoscopy with intravenous sedation with either propofol or the combination of midazolam/fentanyl...
June 2017: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/28523268/the-sedative-effect-of-propranolol-on-critically-ill-patients-a-case-series
#8
Junji Shiotsuka, Andrew Steel, James Downar
INTRODUCTION: Recent studies have examined the effectiveness of alpha-2 adrenergic agonists for controlling delirium and agitation. Propranolol, a non-selective beta-adrenergic antagonist with good penetration of the blood-brain barrier, has not been investigated for this purpose. MATERIALS AND METHODS: We retrospectively reviewed the medical records of all patients who were prescribed propranolol in our Medical Surgical ICU from January 1, 2010, to December 31, 2013...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28522914/one-year-experience-with-computer-assisted-propofol-sedation-for-colonoscopy
#9
Otto S Lin, Danielle La Selva, Richard A Kozarek, Deborah Tombs, Wade Weigel, Ryan Beecher, Johannes Koch, Susan McCormick, Michael Chiorean, Fred Drennan, Michael Gluck, Nanda Venu, Michael Larsen, Andrew Ross
AIM: To report our one-year experience with computer assisted propofol sedation (CAPS) for colonoscopy as the first United States Medical Center to adopt CAPS technology for routine clinical use. METHODS: Between September 2014 and August 2015, 2677 patients underwent elective outpatient colonoscopy with CAPS at our center. All colonoscopies were performed by 1 of 17 gastroenterologists certified in the use of the CAPS system, with the assistance of a specially trained nurse...
April 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28515519/desflurane-for-ambulatory-anaesthesia-a-comparison-with-sevoflurane-for-recovery-profile-and-airway-responses
#10
Kajal Sachin Dalal, Meghana Vijay Choudhary, Adit Jagdish Palsania, Pratibha Vinayak Toal
BACKGROUND AND AIMS: Desflurane and sevoflurane have low blood gas solubility co-efficients, allowing a rapid awakening from anaesthesia. However, desfluraneis pungent and may cause airway irritability. We compared desflurane and sevoflurane with respect to recovery and occurrence of adverse airway responses in spontaneously breathing patients while using the ProSeal™ laryngeal mask airway (LMA). METHODS: Ninety-four adult patients undergoing hysteroscopic procedures were divided into sevoflurane (S) group or desflurane (D) group...
April 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28488361/clonidine-for-sedation-and-analgesia-for-neonates-receiving-mechanical-ventilation
#11
REVIEW
Olga Romantsik, Maria Grazia Calevo, Elisabeth Norman, Matteo Bruschettini
BACKGROUND: Although routine administration of pharmacologic sedation or analgesia during mechanical ventilation in preterm neonates is not recommended, its use in clinical practice remains common. Alpha-2 agonists, mainly clonidine and dexmedetomidine, are used as adjunctive (or alternative) sedative agents alongside opioids and benzodiazepines. Clonidine has not been systematically assessed for use in neonatal sedation during ventilation. OBJECTIVES: To assess whether clonidine administered to term and preterm newborn infants receiving mechanical ventilation reduces morbidity and mortality rates...
May 10, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28485318/a-national-multicenter-survey-on-management-of-pain-agitation-and-delirium-in-intensive-care-units-in-china
#12
Jing Wang, Zhi-Yong Peng, Wen-Hai Zhou, Bo Hu, Xin Rao, Jian-Guo Li
BACKGROUND: The management of pain, agitation, and delirium (PAD) in Intensive Care Unit (ICU) is beneficial for patients and makes it widely applied in clinical practice. Previous studies showed that the clinical practice of PAD in ICU was improving; yet relatively little information is available in China. This study aimed to investigate the practice of PAD in ICUs in China. METHODS: A multicenter, nationwide survey was conducted using a clinician-directed questionnaire from September 19 to December 18, 2016...
May 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28474988/premedication-with-fentanyl-midazolam-improves-sevoflurane-anesthesia-for-surgical-intervention-in-laboratory-mice
#13
Miriam Lipiski, Margarete Arras, Paulin Jirkof, Nikola Cesarovic
Balanced anesthesia allows for a reduced dosage of each component, while inducing general anesthesia of sufficient depth with potentially fewer side effects. Here, we compare two anesthetic protocols combining sevoflurane anesthesia with pre-medication (ketamine [K] or fentanyl-midazolam [FM]) to a sevoflurane monoanesthesia (S) concerning their ability to provide reliable anesthesia suitable for moderate surgery in laboratory mice. Twenty-one female C57BL/6J mice assigned randomly to one of three protocols underwent a 50-min anesthesia and a sham embryo transfer...
January 1, 2017: Experimental Biology and Medicine
https://www.readbyqxmd.com/read/28416960/medical-thoracoscopy-in-pleural-disease-experience-from-a-one-center-study
#14
Soo Jung Kim, Sun Mi Choi, Jinwoo Lee, Chang-Hoon Lee, Sang-Min Lee, Jae-Joon Yim, Chul-Gyu Yoo, Young Whan Kim, Sung Koo Han, Young Sik Park
BACKGROUND: Medical thoracoscopy (MT) is a minimally invasive, endoscopic procedure for exploration of the pleural cavity under conscious sedation and local anesthesia. MT has been performed at the Seoul National University Hospital since February 2014. This paper summarizes the findings and outcomes of MT cases at this hospital. METHODS: Patients who had undergone MT were enrolled in the study. MT was performed by pulmonologists, using both rigid and semi-rigid thoracoscopes...
April 2017: Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/28403208/analogosedation-during-flexible-bronchoscopy-using-a-combination-of-midazolam-propofol-and-fentanyl-a-retrospective-analysis
#15
Tobias Müller, Kristina Thümmel, Christian G Cornelissen, Stefan Krüger, Michael Dreher
BACKGROUND: According to current guidelines flexible bronchoscopy is usually performed under sedation. Previously it has been demonstrated that combined sedation with e. g. the combination of midazolam and propofol or an opioid might have several advantages over sedation with just one sedative drug. However, little is known about the efficacy and safety of combined sedation with midazolam, fentanyl and propofol (MFP) compared to sedation with midazolam and fentanyl (MF) or midazolam and propofol (MP)...
2017: PloS One
https://www.readbyqxmd.com/read/28393775/conscious-sedation-for-balloon-mitral-valvotomy-a-comparison-of-fentanyl-versus-sufentanil
#16
Shailendra Deochandra Modak, Deepa G Kane
CONTEXT: Analgesia and sedation are required for the comfort of patient and the cardiologist during balloon mitral valvotomy. AIMS: In this study, efficacy of analgesia, sedation, and patient satisfaction with sufentanil was compared with fentanyl. SETTINGS AND DESIGN: Single-centered, prospective single-blind study of sixty patients. MATERIALS AND METHODS: Patients between 15 and 45 years of rheumatic mitral stenosis with valve area of 0...
April 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28385584/a-study-of-the-clinical-utility-of-a-20-minute-secretin-stimulated-endoscopic-pancreas-function-test-and-performance-according-to-clinical-variables
#17
Luis F Lara, Morihito Takita, James S Burdick, Daniel C DeMarco, Ronnie R Pimentel, Tolga Erim, Marlon F Levy
BACKGROUND AND AIMS: Direct pancreas juice testing of bicarbonate, lipase, or trypsin after stimulation by secretin or cholecystokinin is used to determine exocrine function, a surrogate for diagnosing chronic pancreatitis (CP). Endoscopic pancreas function tests (ePFTs), where a peak bicarbonate concentration (PBC) ≥80 mEq/L in pancreas juice is considered normal, are now used more frequently. In this ePFT, aspirates start 35 minutes after secretin administration because pancreas output peaks 30 minutes after secretagogue administration...
April 3, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28379614/balanced-propofol-sedation-for-endoscopic-retrograde-cholangiopancreatography-and-octogenarians-can-we-achieve-both-safety-and-efficacy
#18
EDITORIAL
John Vargo
No abstract text is available yet for this article.
May 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28366351/when-to-pick-the-nose-out-of-hospital-and-emergency-department-intranasal-administration-of-medications
#19
REVIEW
Megan A Rech, Brian Barbas, Whitney Chaney, Elizabeth Greenhalgh, Charles Turck
The intranasal route for medication administration is increasingly popular in the emergency department and out-of-hospital setting because such administration is simple and fast, and can be used for patients without intravenous access and in situations in which obtaining an intravenous line is difficult or time intensive (eg, for patients who are seizing or combative). Several small studies (mostly pediatric) have shown midazolam to be effective for procedural sedation, anxiolysis, and seizures. Intranasal fentanyl demonstrates both safety and efficacy for the management of acute pain...
March 25, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28365484/bolus-administration-of-fentanyl-and-midazolam-for-colonoscopy-increases-endoscopy-unit-efficiency-and-safety-compared-with-titrated-sedation
#20
Raymond Finn, Amanda Boyd, Li Lin, Ziad F Gellad
BACKGROUND & AIMS: Guidelines recommend slow titration of sedatives for moderate sedation. Bolus sedation, in which a larger weight-based dose of medication is given upfront, has been shown in a single trial to be beneficial. We evaluated the effects of bolus sedation on procedural safety, efficiency and patient experience. METHODS: We performed a retrospective analysis of colonoscopies performed between April 2010 and April 2011 at Duke Medical Center. Colonoscopies prior to October 2010 were performed with nurse-directed titration of sedative (n=966); colonoscopies performed after October 2010 were performed with physician-directed administration of bolus sedative (n=699)...
March 29, 2017: Clinical Gastroenterology and Hepatology
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