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Mil Med 2019 Mar;184(Supplement_1):542-544

Mayo Clinic, 200 1st St., Rochester, MN.

Background: The military use of ketamine is well established. The benefits of prehospital civilian use have not been extensively reported.

Methods: A retrospective review was performed of patients with prehospital ketamine use in Mayo One's air and critical care ground transport. Read More

J Cardiothorac Vasc Anesth 2019 Feb 13. Epub 2019 Feb 13.

Unit of Arrhythmology and Electrophysiology, IRCCS San Raffaele Scientific Institute, Milan, Italy.

Objective: To identify reliable predictors of periprocedural intensive care unit (ICU) admission after transvenous lead extraction (LE) in a high-volume center.

Design: Retrospective observational study.

Setting: University tertiary-care hospital. Read More

Anesth Analg 2019 Apr;128(4):706-717

From the Department of Anesthesia, The University of Iowa, Roy J. and Lucille A. Carver College of Medicine, Iowa City, Iowa.

The 2018 American Heart Association stroke care guidelines consider endovascular thrombectomy to be the standard of care for patients who have acute ischemic stroke in the anterior circulation when arterial puncture can be made: (1) within 6 h of symptom onset; or (2) within 6-24 h of symptom onset when specific eligibility criteria are satisfied. The aim of this 2-part review is to provide practical perspective on the clinical literature regarding anesthesia care of endovascular thrombectomy patients. In the preceding companion article (part 1), the rationale for rapid workflow and maintenance of blood pressure before reperfusion were reviewed. Read More

West J Emerg Med 2019 Mar 14;20(2):232-236. Epub 2019 Feb 14.

University of Iowa Carver College of Medicine, Department of Emergency Medicine, Iowa City, Iowa.

Introduction: Procedural sedation and analgesia (PSA) provides safe and effective relief for pain, anxiety and discomfort during procedures performed in the emergency department (ED). Our objective was to identify hospital-level factors associated with routine PSA capnography use in the ED.

Methods: This study was a cross-sectional telephone survey of ED nurse managers and designees in a Midwestern state. Read More

Clin Exp Gastroenterol 2019 26;12:105-110. Epub 2019 Feb 26.

Gastroenterology and Hepatology Department, Hillel Yaffe Medical Center, affiliated to the Ruth and Rappaport Faculty of Medicine, Haifa, Israel,

Background: Propofol-mediated sedation is safe and clearly associated with increased patient satisfaction. However, whether it results in a favorable effect on colonoscopy outcomes and performance compared to standard sedation with benzodiazepines/opiates remains unclear.

Objectives: To determine the effect of propofol-mediated sedation on colonoscopy-quality measures compared to traditional sedation. Read More

Afr J Emerg Med 2019 Mar 13;9(1):8-13. Epub 2018 Oct 13.

Department of Emergency Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

Introduction: Procedural sedation and analgesia allows the clinician to safely and efficiently administer sedation, analgesia, anxiolysis and sometimes amnesia to facilitate the performance of various procedures in the emergency centre. The aim of this study is to determine current sedation practices, common indications and major obstacles in selected emergency centres across Southern Gauteng, South Africa, with a view to improving future standards and practices.

Methods: This was a prospective, questionnaire based, cross-sectional interview of emergency centre managers or their designee of selected private-sector and public-sector hospitals in Southern Gauteng. Read More

Ann Burns Fire Disasters 2018 Sep;31(3):223-227

Critical Care Unit, Complexo Hospitalario Universitario de A Coruña (CHUAC), A Coruña, Spain.

Procedural sedation and analgesia (PSA) is a widely used strategy in various fields to carry out numerous diagnostic and therapeutic procedures. However, there is limited information on its efficacy and safety during enzymatic debridement of burn patients with Nexobrid®. The aim of our study was to describe the U-type PSA procedure in a series of patients requiring enzymatic debridement. Read More

J Dent Anesth Pain Med 2019 Feb 28;19(1):67-72. Epub 2019 Feb 28.

Triangle Implant Center, Durham, NC, USA.

Myasthenia gravis (MG) is a neuromuscular autoimmune disorder which clinically presents as muscular weakness and fatigue due to autoantibody formation against acetylcholine receptors (AChR), leading to their subsequent destruction. Due to the neuromuscular implications of MG, certain considerations must be taken into account when providing anesthesia to MG patients. In the following case report, we have outlined procedural considerations for the anesthetic management of a patient with MG undergoing deep sedation for an elective oral surgery in an outpatient setting, as well as a discussion of relevant literature. Read More

Acad Pediatr 2019 Mar 8. Epub 2019 Mar 8.

Children's Healthcare of Atlanta at Egleston, Atlanta, GA, USA; Departments of Pediatrics and Emergency Medicine, Emory University School of Medicine, Atlanta, GA, USA.

Objectives: To determine the characteristics of children who met the risk criteria for potential neurotoxicity defined by the US Food and Drug Administration (2016 warning) in a procedural sedation (PS) service.

Study Design: A single center retrospective review of all infants and children aged <3 years receiving PS outside the operating room from 2014 to 2016. Demographics, duration of, and the reason for PS were analyzed. Read More

PLoS One 2019 11;14(3):e0213074. Epub 2019 Mar 11.

Health Sciences Graduate Program, Faculdade de Medicina, Universidade Federal de Goiás, Goiânia, Goiás, Brazil.

Purpose: The optimal sedative regime that provides the greatest comfort and the lowest risk for procedural sedation in young children remains to be determined. The aim of this randomized, blinded, controlled, parallel-design trial was to evaluate the efficacy of intranasal ketamine and midazolam as the main component of the behavioral guidance approach for preschoolers during dental treatment.

Materials And Methods: Children under seven years of age, with caries and non-cooperative behavior, were randomized into three groups: (KMIN) intranasal ketamine and midazolam; (KMO) oral ketamine and midazolam; or (MO) oral midazolam. Read More

Swiss Med Wkly 2019 Feb 10;149:w20027. Epub 2019 Mar 10.

Paediatric Emergency Department, University Children's Hospital Zurich, Switzerland.

Aims Of The Study: The spectrum of agents available for procedural analgosedation (PAS) in paediatric emergency departments (EDs) has increased over the last few decades, yet the pharmacological agents most used in our ED are ketamine and nitrous oxide (N2O). The aim of this study was to assess which patient characteristics in an ambulatory setting were associated with physicians selecting N2O 70% or ketamine as the sedating agent in our paediatric ED, after N2O 70% was introduced.

Methods: Patients aged 0 to 16 years who received PAS in a tertiary children’s hospital ED in 2007 (before N2O 70% implementation) and 2016 (after N2O implementation) were included in this retrospective, single-centre cohort study. Read More

J Oral Maxillofac Surg 2019 Feb 12. Epub 2019 Feb 12.

Chief Resident, Department of Oral and Maxillofacial Surgery, Louisiana State University Health Sciences Center, New Orleans, LA.

Purpose: The nasal cannula and modified nasal hood are methods used by oral and maxillofacial surgeons to detect expired carbon dioxide during procedural sedation in an open airway system. The purpose of this study was to compare the accuracy of the detection of expired carbon dioxide between the nasal cannula and modified nasal hood.

Materials And Methods: The authors designed a parallel-group randomized controlled trial to compare the nasal cannula and modified nasal hood. Read More

Arch Acad Emerg Med 2019 25;7(1):e10. Epub 2019 Jan 25.

Department of Emergency Medicine, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.

Introduction: Procedural sedation and analgesia (PSA) is a fundamental skill for every emergency physician. This study aimed to compare the PSA characteristics of remifentanil with propofol/fentanyl combination.

Methods: In this double-blind randomized clinical trial, the procedural characteristics and number of failures, as well as adverse events were compared between groups treated with either remifentanil or propofol/fentanyl combination consisting of 15-60 year old patients referring to emergency department following acute anterior shoulder dislocation. Read More

JACC Cardiovasc Interv 2019 Mar;12(5):459-469

Centre for Heart Valve Innovation, University of British Columbia, Vancouver, British Columbia, Canada.

Objectives: The authors sought to prospectively determine the safety and efficacy of next-day discharge using the Vancouver 3M (Multidisciplinary, Multimodality, but Minimalist) Clinical Pathway.

Background: Transfemoral transcatheter aortic valve replacement (TAVR) is an alternative to surgery in high- and intermediate-risk patients; however, hospital stays average at least 6 days in most trials. The Vancouver 3M Clinical Pathway is focused on next-day discharge, made possible by the use of objective screening criteria as well as streamlined peri- and post-procedural management guidelines. Read More

Pediatr Crit Care Med 2019 Mar;20(3):296-297

Department of Anesthesiology and Critical Care Medicine; and Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.

Pediatr Emerg Care 2019 Feb 25. Epub 2019 Feb 25.

Department of Emergency Medicine, University of Nebraska School of Medicine, Omaha, NE.

Ketamine is a dissociative anesthetic commonly used for procedural sedation owing to its perceived favorable safety profile. Despite its frequent use, overdoses of ketamine are rarely reported, and no cases with serum levels of ketamine or its metabolite have previously been reported. We report a case of an iatrogenic pediatric ketamine 20 mg/kg intramuscular overdose with serial ketamine and norketamine levels that resulted in minimal toxicity. Read More

Neurointervention 2019 Mar 28;14(1):17-26. Epub 2019 Feb 28.

Department of Neurosurgery, Hallym University College of Medicine, Chuncheon, Korea.

Purpose: To assess clinical and angiographic outcomes after endovascular treatment (EVT) in ischemic stroke patients according to anesthesia types (general anesthesia vs. conscious sedation).

Materials And Methods: A systematic literature review through an online data base between January 1990 and September 2017 was performed. Read More

Pilot Feasibility Stud 2019 18;5:27. Epub 2019 Feb 18.

2Glasgow University Section of Anaesthesia, Pain and Critical Care, Glasgow, Scotland.

Background: Procedural sedation is a core skill of the emergency physician. Bolus administration of propofol is widely utilised in UK emergency departments to provide procedural sedation. Bolus administration of propofol, titrated to an endpoint of sedation, has a rapid effect but can easily result in apnoea and loss of airway patency. Read More

Pediatr Emerg Care 2019 Feb 19. Epub 2019 Feb 19.

University of TriesteTrieste, Emergency DepartmentInstitute for Maternal and Child HealthIRCCS Burlo GarofoloTrieste, Italy University of TriesteTrieste, Italy. and Emergency DepartmentInstitute for Maternal and Child HealthIRCCS Burlo GarofoloTrieste, Italy Emergency DepartmentInstitute for Maternal and Child HealthIRCCS Burlo GarofoloTrieste, Italy.

Paediatr Anaesth 2019 Feb 23. Epub 2019 Feb 23.

Department of Pediatrics, University of Wisconsin, Madison, Wisconsin.

Background: Monitoring of ventilation with capnography or a stethoscope is recommended because the detection of ventilatory abnormalities can be significantly delayed by the use of pulse oximetry alone in patients receiving supplemental oxygen. The aim of this study was to evaluate the diagnostic performance of the pretracheal stethoscope with pulse oximetry and capnography in detecting adverse respiratory events during propofol sedation in nonintubated children. We hypothesized that use of the pretracheal stethoscope would facilitate earlier detection of adverse respiratory events. Read More

Paediatr Anaesth 2019 Feb 21. Epub 2019 Feb 21.

University of Glasgow, Glasgow, UK.

The growing number of medical procedures performed in children that require cooperation of patients, lack of movement, anxiolysis or/and analgesia triggers the increased need for procedural sedation. This document presents the consensus statement of the European Society for Paediatric Anaesthesiology about the principles connected with the safe management of procedural sedation and analgesia (PSA) by anaesthesiologists for elective procedures in children. It does not aim to provide a legal statement on how and by whom PSA should be performed. Read More

Ann Emerg Med 2019 Feb 16. Epub 2019 Feb 16.

Departments of Pediatrics and Emergency Medicine, University of Minnesota, Minneapolis, MN.

We review the literature in regard to the accuracy, reliability, and feasibility of the Mallampati score as might be pertinent and applicable to emergency department (ED) airway management and procedural sedation. This 4-level pictorial tool was devised to predict difficult preoperative laryngoscopy and intubation, but is now also widely recommended as a routine screening element before procedural sedation. The literature evidence demonstrates that the Mallampati score is inadequately sensitive for the identification of difficult laryngoscopy, difficult intubation, and difficult bag-valve-mask ventilation, with likelihood ratios indicating a small and clinically insignificant effect on outcome prediction. Read More

Chest 2019 Feb 16. Epub 2019 Feb 16.

Divisions of Pulmonary and Critical Care Medicine, Duke University Medical Center, Durham, NC. Electronic address:

Flexible bronchoscopy has evolved over the last few decades, allowing chest physicians to use advanced high-definition scopes to inspect the airways and perform various sampling techniques. Although the techniques of basic bronchoscopic sampling have not changed dramatically, documentation requirements, coding, and billing have become more complex and require a better understanding on the part of the proceduralists and practice administrators. Areas in need of attention include learning about the multiple endoscopy rule, appropriate use of modifiers, and recent changes to the Current Procedural Terminology codes, associated work relative value units for moderate sedation, and therapeutic aspiration of secretions. Read More

J Invasive Cardiol 2019 Feb 15. Epub 2019 Feb 15.

Texas Children's Hospital, 6651 Main Street, E1920, Houston, TX 77030 USA.

Background: Traditional approaches to pediatric cardiac catheterization have relied on femoral venous access. Upper- extremity venous access may enable cardiac catheterization procedures to be performed safely for diagnostic and interventional catheterizations. The objective of this multicenter study was to demonstrate the feasibility and safety of upper-extremity venous access in a pediatric cardiac catheterization laboratory. Read More

PM R 2019 Feb 13. Epub 2019 Feb 13.

Division of Pediatric Critical Care Medicine, Indiana University School of Medicine, Riley Hospital for Children at Indiana University Health, Indianapolis, IN.

Background: Pediatric patients with cerebral palsy (CP) often undergo intramuscular botulinum toxin (BoNT-A) injections. These injections can be painful and may require procedural sedation. An ideal sedation protocol has yet to be elucidated. Read More

Trials 2019 Feb 13;20(1):129. Epub 2019 Feb 13.

Department of Anaesthesia and Critical Care, Nottingham University Hospitals NHS Trust, Nottingham, UK.

Background: The clinical efficacy of effect-site targeted patient-maintained propofol sedation (PMPS) compared to anaesthetist-controlled propofol sedation (ACPS) for patients undergoing awake joint replacement surgery is currently unknown. There is no commercially available medical device capable of delivering PMPS so we have designed and built such a device. We plan a clinical trial to compare PMPS to ACPS and to collect data relating to the safety of our prototype device in delivering sedation. Read More

BMC Anesthesiol 2019 Feb 13;19(1):22. Epub 2019 Feb 13.

Department of Anaesthesiology and Intensive Care, University of Turku, P.O. Box 51, Kiinamyllynkatu 4-8, FI-20521, Turku, Finland.

Background: Barbiturates are commonly used in ambulatory sedation of pediatric patients. However, use of barbiturates involve risks of respiratory complications. Dexmedetomidine, a highly selective α-adrenoceptor agonist, is increasingly used for pediatric sedation. Read More

J Arthroplasty 2019 Apr 7;34(4):686-692.e2. Epub 2019 Jan 7.

Department of Anaesthesiology and Intensive Care, University of Turku, Turku, Finland; Division of Perioperative Services, Intensive Care and Pain Medicine, Turku University Hospital, Turku, Finland.

Background: Patients undergoing total hip arthroplasty (THA) need substantial amount of opioids for postoperative pain management, which necessitates opioid-sparing modalities. Dexmedetomidine is a novel alpha-2-adrenoceptor-activating drug for procedural sedation. In addition to its sedative effect, dexmedetomidine has analgesic and antiemetic effects. Read More

Ann Emerg Med 2019 Feb 4. Epub 2019 Feb 4.

Division of Emergency Medicine, Boston Children's Hospital, and the Department of Pediatrics, Harvard Medical School, Boston, MA.

We update an evidence-based clinical practice guideline for the administration of propofol for emergency department procedural sedation. Both the unique considerations of using this drug in the pediatric population and the substantial new research warrant revision of the 2007 advisory. We discuss the indications, contraindications, personnel requirements, monitoring, dosing, coadministered medications, and adverse events for propofol sedation. Read More

Lancet Respir Med 2019 Feb;7(2):e4

New York, NY, USA.

Endosc Int Open 2019 Feb 30;7(2):E290-E297. Epub 2019 Jan 30.

Department of Pediatrics and Adolescent Medicine, University Medical Center Ulm, Ulm, Germany.

 Use of carbon dioxide (CO ) instead of room air (RA) during colonoscopy in adults revealed significantly less flatulence and abdominal pain in several studies. The objectives of this study were to investigate the effects of CO usage on post-interventional pain, abdominal discomfort, abdominal girth, pCO levels, and narcotic requirement in deeply sedated pediatric patients. A total of 97 children and adolescents aged 4 years to 17 years undergoing colonoscopy were randomized to RA or CO in a prospective, randomized, controlled trial. Read More

Endosc Int Open 2019 Feb 17;7(2):E225-E231. Epub 2019 Jan 17.

Gastroenterology and Hepatology, University of Alabama at Birmingham, Birmingham, Alabama, United States.

 Colonoscopy can be technically challenging and cause discomfort in patients. The integrated Scope Guide assist is built in to show that with its use outcomes are improved during colonoscopy. We aimed to test the usefulness of the Magnetic Scope Guide Assist (ScopeGuide with respect to cecal intubation time, and other procedural quality outcomes. Read More

Drug Des Devel Ther 2019 18;13:365-372. Epub 2019 Jan 18.

Department of Anesthesiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China,

Background: Percutaneous radiofrequency ablation (RFA) is a recently introduced alternative technique for the treatment of hepatic cancer. Anesthesia is required for RFA of hepatic cancer to achieve patient comfort and immobilization during this painful procedure. The purpose of this study was to investigate the analgesic efficacy and evaluate the safety of a single intravenous injection of oxycodone hydrochloride for this procedure. Read More

J Invasive Cardiol 2019 Feb;31(2):E30-E36

Division of Cardiovascular Medicine, Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106 USA.

Objectives: Urgent transcatheter aortic valve replacement (TAVR) is associated with worse short-term outcomes compared with elective TAVR; however, little is known about long-term outcomes or the safety of the minimalist strategy in this setting. This study investigated the short-term and long-term outcomes of urgent TAVR compared with elective TAVR under a minimalist strategy (transfemoral [TF] approach with conscious sedation and no transesophageal echocardiography guidance).

Methods: After excluding 2 emergent patients requiring immediate procedures, a total of 474 consecutive patients underwent elective TF-TAVR (396 patients; 83. Read More

Health Sci Rep 2019 Jan 1;2(1):e95. Epub 2018 Nov 1.

Department of Cardiology and Angiology University Hospital Schleswig-Holstein Germany.

Objectives: The current 2017 ESC/EACTS guidelines recommend transcatheter aortic valve implantations (TAVIs) as the therapy of choice for inoperable patients with severe symptomatic aortic stenosis. Most of the TAVIs worldwide are performed under general anaesthesia (GA). Although conscious sedation (CS) concepts are increasingly applied in Europe, it is still a matter of debate which concept is associated with highest amount of safety for this high-risk patient population. Read More

J Pediatr Pharmacol Ther 2018 Nov-Dec;23(6):460-465

Objectives: Chloral hydrate had been extensively used for children undergoing sedation for imaging studies, but after the manufacturer discontinued production, pediatric sedation providers explored alternative sedation medications. Those medications needed to be at least as safe and as effective as chloral hydrate. In this study, we examined if pentobarbital is a suitable replacement for chloral hydrate. Read More

J Clin Med 2019 Jan 26;8(2). Epub 2019 Jan 26.

Department of Anesthesiology, Pain Medicine and Intensive Care, Catharina Hospital, 5623 Eindhoven, The Netherlands.

Peripheral intravenous cannulation is the most common invasive hospital procedure but is associated with a high failure rate. This study aimed to improve the A-DIVA scale (Adult Difficult Intra Venous Access Scale) by external validation, to predict the likelihood of difficult intravenous access in adults. This multicenter study was carried out throughout five hospitals in the Netherlands. Read More

Pediatr Hematol Oncol 2018 Aug - Sep;35(5-6):309-315. Epub 2019 Jan 25.

a Department of Pediatrics, Division of Critical Care Medicine , Emory University School of Medicine and Children's Healthcare of Atlanta at Egleston , Atlanta , GA , USA.

Background: Children with cancer undergo serial invasive, painful procedures as a part of their diagnosis, treatment, and surveillance regimens that require procedural sedation (PS). Some may have a delay in their treatment plan due to same-day cancelation (SDC) of the procedure due to issues related to sedation or other factors. The objective of this report was to evaluate the factors resulting in the SDC of hematology and oncology patients in an outpatient pediatric sedation service. Read More

Eur J Pediatr 2019 Jan 22. Epub 2019 Jan 22.

Department of Pediatrics, Institute for Maternal and Child Health-IRCCS 'Burlo Garofolo', Trieste, Italy.

Procedural sedation and analgesia with ketamine are part of daily practice for children undergoing painful procedures in the paediatric emergency department (ED) of North America. A massive number of studies demonstrate ketamine's safety and efficacy in the hands of trained ED paediatricians, with few severe adverse events (SAEs) recorded. Since there are no data on ketamine's usage in Italian paediatric EDs, we created a survey to examine procedural sedation with ketamine in the EDs of the Italian PIPER (Pain in Paediatric Emergency Room) group, which includes 36 paediatric EDs providing 1. Read More

Am J Otolaryngol 2019 Mar - Apr;40(2):147-151. Epub 2019 Jan 11.

Mayo Clinic, Department of Anesthesiology and Perioperative Medicine, Rochester, MN, USA. Electronic address:

Purpose: Medialization laryngoplasty (ML) ± arytenoid adduction (AA) surgery poses a unique anesthetic challenge that requires periods of deep sedation and patient cooperation with phonation to assess voice function. The purpose of this study was to assess if the protocolized administration of dexmedetomidine, remifentanil, and propofol (DRP) is associated with reduced procedural duration and administration of other sedating medications.

Materials And Methods: This was a retrospective 2:1 case matched study design; matched on age, sex, body mass index, AA, and surgical revision status. Read More

AJNR Am J Neuroradiol 2019 Feb 17;40(2):309-312. Epub 2019 Jan 17.

Mallinckrodt Institute of Radiology (T.J.H., J.W.J.), St. Louis, Missouri.

Background And Purpose: Although percutaneous musculoskeletal biopsies are routinely performed in the axial and appendicular skeleton, there are no published data on the systematic evaluation of the feasibility, safety, and diagnostic accuracy of percutaneous skull biopsy. In certain clinical encounters such as patients with primary skull tumors or patients with known cancer and isolated skull lesions suspected of calvarial metastasis or synchronous primary tumor, percutaneous skull biopsy may be considered a viable option. The purpose of this study was to evaluate the feasibility, safety profile, and diagnostic yield of percutaneous CT-guided skull biopsy. Read More

Scand J Surg 2019 Jan 17:1457496918822616. Epub 2019 Jan 17.

1 University of Helsinki, Helsinki, Finland.

Background And Aims:: Several studies and guidelines are questioning routine preoperative laboratory tests in surgical and endoscopic procedures. Their effect in endoscopic retrograde cholangiopancreatography is not currently known. This study was carried out to evaluate the risk of adverse effects in endoscopic retrograde cholangiopancreatography and their association with preoperative lab tests. Read More

Lakartidningen 2019 Jan 8;116. Epub 2019 Jan 8.

Skane's University Hospital - Akutkliniken Lund, Sweden Skane's University Hospital - Akutkliniken Lund, Sweden.

Emergency Medicine became a full-fledged speciality in Sweden in 2015. This prospective study analyzed the safety and implementation of Emergency Physician-administered propofol to sedate patients with hemodynamically stable atrial fibrillation prior to cardioversion. During the first 1. Read More

Anesth Analg 2019 Jan 8. Epub 2019 Jan 8.

From the Departments of Anesthesiology and Bioengineering, University of Utah, Salt Lake City, Utah.

Background: Supplemental oxygen is administered during procedural sedation to prevent hypoxemia. Continuous flow oxygen, the most widespread method, is generally adequate but distorts capnography. Pulsed flow oxygen is novel and ideally will not distort capnography. Read More

A A Pract 2019 Jan 4. Epub 2019 Jan 4.

From the Departments of Anesthesiology, Pain Medicine and Procedural Sedation and Analgesia and.

Acute angle-closure glaucoma is a rare complication of general anesthesia. If not treated in time, acute angle-closure glaucoma can potentially cause permanent loss of vision. Physicians should therefore be vigilant for the possibility of acute angle-closure glaucoma in patients who experience postoperative change or loss of vision. Read More

Emerg Med J 2019 Mar 10;36(3):142-147. Epub 2019 Jan 10.

Department of Psychosomatics and Psychiatry, University Children's Hospital Zurich, Zurich, Switzerland.

Objective: Nitrous oxide 70% (NO 70%) is an excellent medication for procedural analgosedation (PAS), yet the limit of its analgesic power remains uncertain; therefore, a combination with intranasal fentanyl (INF) was suggested. However, this combination seems to result in a higher rate of vomiting and deeper sedation. This study aimed at assessing the analgesic efficacy, sedation depth and rate of adverse events of PAS with NO 70% with and without INF. Read More

Curr Health Sci J 2018 Jan-Mar;44(1):14-18. Epub 2018 Mar 31.

Research Centre of Gastroenterology and Hepatology, University of Medicine and Pharmacy of Craiova, Romania.

Background: Most of endoscopic procedures, either diagnostic or therapeutic, are nowadays performed under sedation, used as a standard practice in most of the centers. Consequently, the number and complexity of endoscopic procedures has increased as sedation diminishes anxiety and discomfort for patients, also improving the quality of endoscopic examinations, and outcomes in therapeutic endoscopy. Compared to standard diagnostic upper or lower GI endoscopy, endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP) are often longer and more complicated procedures, thus requiring higher doses of sedatives. Read More

Saudi J Gastroenterol 2019 Jan 4. Epub 2019 Jan 4.

Department of Medicine, West Virginia University, WV, USA.

Background/aim: Most endoscopies performed in the United States utilize sedation. Anesthesia provides patient comfort and improved procedural quality but adds to the complexity of scheduling routine outpatient procedures. We aimed to assess the return of cognitive function after propofol administration in patients undergoing outpatient endoscopies. Read More