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https://www.readbyqxmd.com/read/28891855/patient-satisfaction-with-propofol-for-outpatient-colonoscopy-a-prospective-randomized-double-blind-study
#1
Anantha Padmanabhan, Christoforos Frangopoulos, Lynn E T Shaffer
BACKGROUND: Previous literature has shown that propofol has ideal anesthetic properties for patients undergoing colonoscopy, a common procedure at outpatient surgery centers. However, there is a paucity of information regarding patient satisfaction with propofol. OBJECTIVE: The aim of this study was to evaluate patient satisfaction with propofol compared with nonpropofol (fentanyl/midazolam) anesthesia for outpatient colonoscopies. Safety and complications were secondary end points...
October 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28865733/anesthesia-assistance-in-outpatient-colonoscopy-and-risk-of-aspiration-pneumonia-bowel-perforation-and-splenic-injury
#2
Barbara Bielawska, Lawrence C Hookey, Rinku Sutradhar, Marlo Whitehead, Jianfeng Xu, Lawrence F Paszat, Linda Rabeneck, Jill Tinmouth
BACKGROUND & AIMS: The increase in use of anesthesia assistance (AA) to achieve deep sedation with propofol during colonoscopy has significantly increased colonoscopy costs without evidence for increased quality and with possible harm. We investigated the effects of AA on colonoscopy complications, specifically bowel perforation, aspiration pneumonia, and splenic injury. METHODS: In a population-based cohort study using administrative databases, we studied adults in Ontario, Canada undergoing outpatient colonoscopy from 2005 through 2012...
August 30, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28843955/predictors-of-use-of-monitored-anesthesia-care-for-outpatient-gastrointestinal-endoscopy-in-a-capitated-payment-system
#3
Megan A Adams, Katherine M Prenovost, Jason A Dominitz, Robert G Holleman, Eve A Kerr, Sarah L Krein, Sameer D Saini, Joel H Rubenstein
BACKGROUND & AIMS: Use of monitored anesthesia care (MAC) for gastrointestinal endoscopy has increased in the Veterans Health Administration (VHA), as in fee-for-service environments, despite the absence of financial incentives. We investigated factors associated with use of MAC in an integrated healthcare delivery system with a capitated payment model. METHODS: We performed a retrospective cohort study using multi-level logistic regression, with MAC use modeled as a function of procedure year, patient- and provider-level factors, and facility effects...
August 23, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28791043/systematic-review-outcomes-by-duration-of-npo-status-prior-to-colonoscopy
#4
REVIEW
Aasma Shaukat, Ashish Malhotra, Nancy Greer, Roderick MacDonald, Joseph Wels, Timothy J Wilt
BACKGROUND/AIMS: Variation exists among anesthesia providers as to acceptable timing of NPO ("nothing by mouth") for elective colonoscopy procedures. There is a need to balance optimal colonic preparation, patient convenience, and scheduling efficiency with anesthesia safety concerns. We reviewed the evidence for the relationship between NPO timing and aspiration incidence and colonoscopy rescheduling. METHODS: We searched MEDLINE (1990-April 2015) for English language studies of any design and included them if at least one bowel preparation regimen was completed within 8 hours of colonoscopy...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/28662195/the-relationship-between-minute-ventilation-and-end-tidal-co2-in-intubated-and-spontaneously-breathing-patients-undergoing-procedural-sedation
#5
Jaideep H Mehta, George W Williams, Brian C Harvey, Navneet K Grewal, Edward E George
BACKGROUND: Monitoring respiratory status using end tidal CO2 (EtCO2), which reliably reflects arterial PaCO2 in intubated patients under general anesthesia, has often proven both inaccurate and inadequate when monitoring non-intubated and spontaneously breathing patients. This is particularly important in patients undergoing procedural sedation (e.g., endoscopy, colonoscopy). This can be undertaken in the operating theater, but is also often delivered outside the operating room by non-anesthesia providers...
2017: PloS One
https://www.readbyqxmd.com/read/28611336/safety-of-non-anesthesia-provider-administered-propofol-sedation-in-non-advanced-gastrointestinal-endoscopic-procedures-a-meta-analysis
#6
REVIEW
Basavana Gouda, Gowri Gouda, Anuradha Borle, Akash Singh, Ashish Sinha, Preet M Singh
BACKGROUND/AIMS: The aim of the study was to evaluate the safety of non-anesthesia provider (NAPP) administered propofol sedation in patients undergoing non-advanced gastrointestinal (GI) endoscopic procedures. MATERIALS AND METHODS: Pubmed, Embase, Cochrane central register of controlled trials, Scopus, and Web of Science databases were searched for prospective observational trials involving non-advanced endoscopic procedures. From a total of 608 publications, 25 [colonoscopy (9), upper GI endoscopy (5), and combined procedures (11)] were identified to meet inclusion criteria and were analyzed...
May 2017: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
https://www.readbyqxmd.com/read/28333816/committee-opinion-no-696-nonobstetric-surgery-during-pregnancy
#7
(no author information available yet)
The American College of Obstetricians and Gynecologists' Committee on Obstetric Practice acknowledges that the issue of nonobstetric surgery during pregnancy is an important concern for physicians who care for women. It is important for a physician to obtain an obstetric consultation before performing nonobstetric surgery and some invasive procedures (eg, cardiac catheterization or colonoscopy) because obstetricians are uniquely qualified to discuss aspects of maternal physiology and anatomy that may affect intraoperative maternal-fetal well-being...
April 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28317231/prospective-evaluation-of-same-day-versus-next-day-colon-manometry-results-in-children-with-medical-refractory-constipation
#8
R A Arbizu, S Nurko, N Heinz, M Amicangelo, L Rodriguez
BACKGROUND: We evaluated the change in colon manometry (CM) parameters and interpretation comparing results when the study is performed the same day after the motility catheter is placed under anesthesia or the following day. METHODS: CM catheter was placed with colonoscopy under anesthesia and recorded on day 1 and repeated on day 2. Study parameters including motility index during fasting, post-prandial and post-Bisacodyl challenge phase; gastrocolonic response; number, presence and propagation of high amplitude propagating contractions (HAPCs); and, study interpretation were compared between both the days...
July 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/28253730/endoscopic-colostomy-with-percutaneous-colopexy-an-animal-feasibility-study
#9
Leonardo Alfonso Bustamante-Lopez, Marianny Sulbaran Nava, Sergio Carlos Nahas, Eduardo Guimaraes Horneaux de Moura, Caio Sergio Nahas, Carlos Frederico Sparapam Marques, Christiano Sakai, Ivan Cecconello, Paulo Sakai
BACKGROUND: Indications for colostomy in colorectal diseases are obstruction of the large bowel, such as in cancer, diverticular disease in the acute phase, post-radiotherapy enteritis, complex perirectal fistulas, anorectal trauma and severe anal incontinence. Some critically ill patients cannot tolerate an exploratory laparotomy, and laparoscopic assisted colostomy also requires general anesthesia. OBJECTIVE: To evaluate the feasibility, safety and efficacy of performing colostomy assisted by colonoscopy and percutaneous colopexy...
March 3, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28235507/hypnopraxia-a-new-hypnotic-technique-for-hypnoanesthesia
#10
Nicolas Drouet, Guy Chedeau
Various hypnotic techniques are used in anesthesia, either on their own or as adjuncts. A new hypnotic technique, hypnopraxia, was tested in 5 patients undergoing various procedures (4 colonoscopies, 1 inguinal hernia repair, and 1 transobturator tape procedure). The patients were accompanied throughout the procedure by an anesthetist trained in hypnoanesthesia and hypnopraxia. Initially developed for use in hypnotherapy, the accompaniment with hypnopraxia relied on the closeness of the link between the anesthetist and the patient...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28205108/water-assisted-colonoscopy
#11
REVIEW
Sergio Cadoni, Felix W Leung
The current review will attempt to describe the important lessons learned from published randomized controlled trials (RCT) comparing water immersion (WI) or water exchange (WE) techniques with gas insufflation colonoscopy. Air insufflation (AI) to distend the colon to permit visualization and passage through the lumen was developed for diagnostic colonoscopy. When screening colonoscopy was adopted, the same AI method was used. Interval cancers, diagnosed within 3 to 5 years after an index screening colonoscopy, appeared to be linked to low adenoma detection rate (ADR)...
March 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28154379/editorial-endoscopic-sedation-who-which-when
#12
John M Inadomi
The costs of medical care are rising and media has focused attention on the costs of colonoscopy as a potential cause. A major component of procedural costs is the sedation, which is a combination of the drugs used and who administers them. An analysis of advanced endoscopic procedures revealed that the rate of sedation failure was significantly lower among patients administered sedation by anesthesia compared with patients who received moderate sedation administered by endoscopy staff. The authors argue that all endoscopic retrograde cholangiopancreatography (ERCP) should be performed with anesthesia-administered sedation...
February 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28108788/outpatient-application-of-formalin-for-chronic-rectal-bleeding-after-prostate-irradiation-a-quasi-experimental-study
#13
Gustavo Arruda Viani, Aline Sakamoto
PURPOSE: The aim of this quasi-experimental study is to evaluate a novel technique for an outpatient application of formalin for chronic rectal bleeding after prostate irradiation. METHODS: This is a quasi- experimental clinical trial developed between January 2010 and July 2015, including 35 patients with chronic radiation rectitis (CRP) due to a previous prostate radiation course. The study's eligibility was (1) completed external beam radiation therapy for prostate carcinoma >6 months previously, (2) rectal bleeding, defined as a frequency of >1× per week and/or needing of blood transfusions, and (3) diagnosis of chronic proctitis at colonoscopy...
July 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28106610/-opt-out-and-access-to-anesthesia-care-for-elective-and-urgent-surgeries-among-u-s-medicare-beneficiaries
#14
Eric C Sun, Franklin Dexter, Thomas R Miller, Laurence C Baker
BACKGROUND: In 2001, the Centers for Medicare and Medicaid Services issued a rule allowing U.S. states to "opt out" of the regulations requiring physician supervision of nurse anesthetists in an effort to increase access to anesthesia care. Whether "opt out" has successfully achieved this goal remains unknown. METHODS: Using Medicare administrative claims data, we examined whether "opt out" reduced the distance traveled by patients, a common measure of access, for patients undergoing total knee arthroplasty, total hip arthroplasty, cataract surgery, colonoscopy/sigmoidoscopy, esophagogastroduodenoscopy, appendectomy, or hip fracture repair...
March 2017: Anesthesiology
https://www.readbyqxmd.com/read/28057843/diphenhydramine-for-acute-extrapyramidal-symptoms-after-propofol-administration
#15
James Sherer, Tomas Salazar, Kevin B Schesing, Shannon McPartland, Jeffrey Kornitzer
Extrapyramidal symptoms are an uncommon but well-recognized side effect after the administration of general anesthesia in patients without a significant neurologic history. Several case reports implicate propofol as the likely causative agent producing these symptoms, which include ballismus, dystonia, choreoathetosis, and opisthotonus. Currently, there is no clear consensus on first-line treatment of these symptoms. In each of the published cases, anticholinergic medications and benzodiazepines were central to initial management, although the speed and extent of symptom resolution were variable...
February 2017: Pediatrics
https://www.readbyqxmd.com/read/28002204/anesthesia-service-use-and-the-uptake-of-screening-colonoscopies
#16
Samuel Hirshman, Soeren Mattke, Hangsheng Liu
BACKGROUND: The Center for Medicare & Medicaid Services recently defined "screening colonoscopy" to include separately furnished anesthesia services. OBJECTIVE: To examine the relationship between anesthesia service use and the uptake of screening colonoscopies. STUDY DESIGN: We correlated metropolitan statistical area (MSA) level anesthesia service use rates, derived from the 2008, 2010, and 2012 Medicare and MarketScan claims data, with the presence of individual level guideline concordant screening colonoscopy using the Behavioral Risk Factor Surveillance System data for the same years...
June 2017: Medical Care
https://www.readbyqxmd.com/read/27988287/endoscopic-multiple-biopsy-and-rapid-diagnosis-by-in-situ-fixation-and-histopathologic-processing
#17
David S Zimmon, Fred B Smith, Forrest Manheimer, Cathy Fan, Chantel Njiwaji, Sergei Aksenov, Premtesh Chattoo
BACKGROUND AND AIMS: Endoscopic forceps biopsy and fixation are laborious and prolong the procedure and anesthesia. Multiple biopsy overcomes these shortcomings with a single endoscope pass that cuts, like a needle biopsy, up to 25 biopsy samples of uniform size and depth during endoscope withdrawal. Biopsy specimens are collected in acquisition order and stored in a perforated plastic storage chamber within the perforated metal tip. The tip is cut off, immersed in fixative, and sent to pathology...
December 15, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27918331/growth-of-nonoperating-room-anesthesia-care-in-the-united-states-a-contemporary-trends-analysis
#18
Alexander Nagrebetsky, Rodney A Gabriel, Richard P Dutton, Richard D Urman
BACKGROUND: Although previous publications suggest an increasing demand and volume of nonoperating room anesthesia (NORA) cases in the United States, there is little factual information on either volume or characteristics of NORA cases at a national level. Our goal was to assess the available data using the National Anesthesia Clinical Outcomes Registry (NACOR). METHODS: We performed a retrospective analysis of NORA volume and case characteristics using NACOR data for the period 2010-2014...
April 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27779482/influence-of-premedication-with-alprazolam-on-the-occurence-of-obstructive-apneas-a-prospective-randomized-double-blind-study
#19
RANDOMIZED CONTROLLED TRIAL
E Deflandre, V Bonhomme, A-C Courtois, S Degey, R Poirrier, J-F Brichant
Postoperative development or worsening of obstructive sleep apnea is a potential complication of anesthesia. The objective of this study was to study the effects of a premedication with alprazolam on the occurrence of apneas during the immediate postoperative period. Fifty ASA 1 - 2 patients undergoing a colonoscopy were recruited. Patients with a history of obstructive sleep apnea (OSA) were excluded. Recruited patients were randomly assigned to one of two groups: in Group A, they received 0.5 mg of alprazolam orally one hour before the procedure; and in Group C, they received placebo...
August 2016: Journal of Physiology and Pharmacology: An Official Journal of the Polish Physiological Society
https://www.readbyqxmd.com/read/27687426/noninvasive-ventilation-during-spontaneous-breathing-anesthesia-an-observational-study-using-electrical-impedance-tomography
#20
Julien Bordes, Philippe Goutorbe, Pierre Julien Cungi, Marie Caroline Boghossian, Eric Kaiser
STUDY OBJECTIVE: To assess the effects of noninvasive ventilation (NIV) during spontaneous breathing anesthesia on functional residual capacity and ventilation distribution. DESIGN: Prospective and observational study. SETTING: Operating room, military teaching hospital. PATIENTS: Eighteen adult patients submitted to digestive endoscopic procedures under spontaneous breathing anesthesia. INTERVENTIONS: Anesthetic management was standardized...
November 2016: Journal of Clinical Anesthesia
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