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    1627 results match your criteria Procedural Sedation

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    1% Versus 2% Lignocaine for Airway Anesthesia in Flexible Bronchoscopy Without Lignocaine Nebulization (LIFE): A Randomized Controlled Trial.
    J Bronchology Interv Pulmonol 2018 Jan 16. Epub 2018 Jan 16.
    Department of Pulmonary Medicine and Sleep Disorders.
    Background: The ideal concentration of lignocaine for topical anesthesia in bronchoscopy remains investigational. In this randomized, double blind study, we compared 1% versus 2% lignocaine for topical anesthesia.

    Methods: Consecutive patients undergoing bronchoscopy were randomized to receive either 1% or 2% lignocaine solution by spray-as-you-go technique. Read More

    Sedation in cardiac arrhythmias management.
    Expert Rev Cardiovasc Ther 2018 Jan 17. Epub 2018 Jan 17.
    a Cardiology and Arrhythmology Clinic , Marche Polytechnic University, University Hospital "Ospedali Riuniti" , Ancona , Italy.
    Introduction: 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. Read More

    Endovascular recanalization for nonmalignant obstruction of the inferior vena cava.
    J Vasc Surg Venous Lymphat Disord 2018 Jan 11. Epub 2018 Jan 11.
    Division of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, Minn.
    Objective: The aim of this study was to evaluate outcomes of endovascular recanalization of the inferior vena cava (IVC) and iliac veins with long-standing chronic venous obstruction caused by nonmalignant disease.

    Methods: Medical records for 66 patients who underwent endovascular recanalization of the IVC with or without iliac veins from January 2001 to December 2014 at our medical center were retrospectively reviewed. Primary outcomes included morbidity and mortality; secondary outcomes included primary, primary assisted, and secondary patency and resolution of symptoms. Read More

    The Morbidity of Ureteral Strictures in Patients with Prior Ureteroscopic Stone Surgery: Multi-Institutional Outcomes.
    J Endourol 2018 Jan 12. Epub 2018 Jan 12.
    University of Washington, Department of Urology , 1959 NE Pacific Street , Box 356510 , Seattle, Washington, United States , 98195 ;
    Purpose Nephrolithiasis is an increasingly common ailment in the United States. Ureteroscopic management has supplanted shockwave lithotripsy as the most common treatment of upper tract stone disease. Ureteral stricture is a rare but serious complication of stone disease and its management. Read More

    Balloon-assisted tracking: A practical solution to avoid radial access failure due to difficult anatomical challenges.
    Cardiovasc Revasc Med 2017 Dec 6. Epub 2017 Dec 6.
    St. Thomas Hospital, London, UK; Queen Elizabeth Hospital, Woolwich, London, UK.
    Aim: The balloon assisted tracking (BAT) technique is utilised to overcome various anatomical difficulties during radial procedures when standard measures such as adequate sedation, pain relief, vasodilators and use of hydrophilic guidewires, fail. The aim of this study was to evaluate the success rates of the BAT technique in overcoming anatomical difficulties during radial coronary interventional procedures.

    Methods: We retrospectively reviewed 1100 consecutive patients undergoing coronary procedures from the transradial approach (TRA) between May 2015 and May 2017. Read More

    Considerations for physicians using ketamine for sedation of children in emergency departments.
    Clin Exp Emerg Med 2017 Dec 30;4(4):244-249. Epub 2017 Dec 30.
    Department of Biostatistic Consulting, Clinical Trial Center, Bucheon Hospital of Soonchunhyang University, Bucheon, Korea.
    Objective: Ketamine use in emergency departments (EDs) for procedural sedation and analgesia is becoming increasingly common. However, few studies have examined patient factors related to adverse events associated with ketamine. This study investigated factors for consideration when using ketamine to sedate pediatric ED patients. Read More

    Benefits and harms of capnography during procedures involving moderate sedation: A rapid review and meta-analysis.
    J Am Dent Assoc 2018 Jan;149(1):38-50.e2
    Background: Patient safety is a priority in dentistry. Evaluating the benefits and harms associated with the addition of capnography to standard monitoring during moderate sedation for adult patients in the dental practice setting is needed.

    Types Of Studies Reviewed: The authors used rapid review methodology to identify relevant systematic reviews, which they updated through a systematic search by using the same search strategy as the identified reviews. Read More

    Consensus Statement of Standards for Interventional Cardiovascular Nursing Practice.
    Heart Lung Circ 2017 Nov 10. Epub 2017 Nov 10.
    Middlemore Hospital, Auckland, New Zealand.
    Interventional cardiovascular nursing is a critical care nursing specialty providing complex nursing interventions to patients prone to clinical deterioration, through the combined risks of the pathophysiology of their illness and undergoing technically complex interventional cardiovascular procedures. No guidelines were identified worldwide to assist health care providers and educational institutions in workforce development and education guidelines to minimise patients' risk of adverse events. The Interventional Nurses Council (INC) developed a definition and scope of practice for interventional cardiac nursing (ICN's) in 2013. Read More

    Impact of Developing Adult Ketamine Order Panels for the Emergency Department.
    Hosp Pharm 2017 Jul 20;52(7):483-487. Epub 2017 Jul 20.
    The Moses H. Cone Memorial Hospital, Greensboro, NC, USA.
    Background: Ketamine in adults has been identified as a safe and effective alternative for multiple indications, each with specific evidence-based dosing ranges. Emergency department (ED) providers are tasked with appropriate ordering of ketamine. A multi-institutional retrospective analysis within EDs at a large health system from November 2013 to October 2015 reviewed ED adult ketamine prescribing patterns for procedural sedation (PS), rapid sequence intubation (RSI), and analgesia. Read More

    Procedural sedation and analgesia practices by emergency physicians in the Netherlands: a nationwide survey.
    Int J Emerg Med 2017 Dec 15;10(1):33. Epub 2017 Dec 15.
    Department of Pediatrics, Tergooi Hospital, Blaricum, The Netherlands.
    Background: Several efforts have been made to assure and to improve the quality of procedural sedation and analgesia (PSA) performed by emergency physicians (EPs) in The Netherlands. This study investigated the current PSA practice and competences of EPs in both adult and paediatric patients. In particular, if residency and current training, awareness of guidelines is sufficient for registered EPs to adequately perform PSA and if the availability of both adult and paediatric PSA in the ED is adequate. Read More

    Paediatric procedural sedation and analgesia by emergency physicians in a country with a recent establishment of emergency medicine.
    Eur J Emerg Med 2017 Dec 13. Epub 2017 Dec 13.
    Anaesthesiology, Intensive Care and Pain, Catharina Hospital.
    Objectives: Paediatric patients receive less procedural sedation and analgesia (PSA) in the emergency department compared with adults, especially in countries where emergency medicine is at an early stage of development. The objectives of this study were to evaluate the adverse events and efficacy of paediatric PSA in a country with a recent establishment of emergency medicine and to describe which factors aided implementation.

    Methods: This is a prospective, multicentre, observational study of paediatric patients undergoing PSA by the first trained emergency physicians (EPs) in The Netherlands. Read More

    Feasibility of single- vs two-physician procedural sedation in a small community emergency department.
    Am J Emerg Med 2017 Nov 3. Epub 2017 Nov 3.
    The Permanente Medical Group, the Kaiser Permanente Division of Research, and the KP CREST Network, Oakland, CA, United States; Kaiser Permanente Sacramento Medical Center, Sacramento, CA, United States.
    Objective: Sedation is commonly required for painful procedures in the emergency department (ED). Some facilities mandate two physicians be present for deep sedation cases. Evidence is lacking, however, that a two-physician approach improves safety outcomes. Read More

    Variation in Pediatric Procedural Sedations Across Children's Hospital Emergency Departments.
    Hosp Pediatr 2018 Jan 12;8(1):36-43. Epub 2017 Dec 12.
    Division of Emergency Medicine, Boston Children's Hospital, Boston, Massachusetts; and.
    Objectives: Describe the trends in pediatric sedation use over time and determine variation in use of procedural sedation across children's hospital emergency departments (EDs).

    Methods: We analyzed ED data from 35 hospitals within the Pediatric Health Information System for patients <19 years old who received sedation medications and were discharged from 2009 to 2014. Patients with chronic comorbidities or undergoing intubation were excluded. Read More

    Does the reporting of gastro-intestinal endoscopy meet the minimal terminology standard at King Edward VIII Hospital?
    S Afr J Surg 2017 Nov;55(4):36-42
    Department of Surgery, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban and GI Cancer Research Centre, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban.
    Background: The Minimal Standard Terminology (MST) was developed to standardise endoscopic reporting. This study is aimed at assessing current reporting at a tertiary hospital and whether it meets this Minimal Standard Terminology.

    Method: This was a retrospective observational study of upper endoscopy reports between January and December 2014. Read More

    Improving patient safety during procedural sedation via respiratory volume monitoring: A randomized controlled trial.
    J Clin Anesth 2017 Dec 7. Epub 2017 Dec 7.
    University of Vermont Larner College of Medicine, Department of Anesthesiology, 111 Colchester Avenue, West Pavilion, Level 2, Burlington, VT 05401, United States. Electronic address:
    Study Objective: Assess the utility of a respiratory volume monitor (RVM) to reduce the incidence of low minute ventilation events in procedural sedation.

    Design: Randomized control trial SETTING: Endoscopy suite PATIENTS: Seventy-three total patients (ASA Physical Status 1-3) undergoing upper endoscopies were analyzed.

    Intervention: Patients were randomized into two groups using a computer generated randomization table: Control (n=41): anesthesia provider was unable to see the screen of the RVM; RVM (n=32): anesthesia provider had access to RVM data to assist with management of the case. Read More

    Factors associated with patient-reported procedural memory following emergency department procedural sedation with ketamine and propofol: A prospective cohort of 563 patients.
    Emerg Med Australas 2017 Dec 6. Epub 2017 Dec 6.
    Emergency Department, Mater Hospital, Brisbane, Queensland, Australia.
    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. Read More

    Respiratory Volume Monitoring Reduces Hypoventilation and Apnea in Subjects Undergoing Procedural Sedation.
    Respir Care 2017 Dec 5. Epub 2017 Dec 5.
    The University of Texas Medical Branch at Galveston, Galveston, Texas.
    Introduction: The use of monitored anesthesia care for endoscopic procedures increases the risk of respiratory depression, necessitating careful monitoring of patient ventilation. We examined the effectiveness of an impedance-based respiratory volume monitor (RVM) in improving the safety of patients undergoing upper and lower gastrointestinal endoscopies under total intravenous anesthesia. We hypothesized that feedback from the RVM would allow anesthesiologists to maintain adequate ventilation, which would reduce the duration of respiratory depression (ie, hypoventilation and apnea) compared to a blinded control group. Read More

    Perioperative management of gastrostomy tube placement in Duchenne muscular dystrophy adolescent and young adult patients: A role for a perioperative surgical home.
    Paediatr Anaesth 2018 Feb 5;28(2):127-133. Epub 2017 Dec 5.
    Department of Anesthesiology, Pain and Perioperative Medicine, Boston Children's Hospital, Boston, MA, USA.
    Background: In past decades, Duchenne muscular dystrophy patients have been living longer and as the disease advances, patients experience multisystemic deterioration. Older patients often require gastrostomy tube placement for nutritional support. For optimizing the perioperative care, a practice of multidisciplinary team can better anticipate, prevent, and manage possible complications and reduce the overall perioperative morbidity and mortality. Read More

    Comparison of Deep Sedation With General Anesthesia in Patients Undergoing Percutaneous Mitral Valve Repair.
    J Am Heart Assoc 2017 Dec 2;6(12). Epub 2017 Dec 2.
    Department of Cardiology and Cardiovascular Medicine, University Hospital Eberhard Karls University Tuebingen, Tuebingen, Germany
    Background: Percutaneous edge-to-edge mitral valve repair (PMVR) has become an established treatment option for mitral regurgitation in patients not eligible for surgical repair. Currently, most procedures are performed under general anesthesia (GA). An increasing number of centers, however, are performing the procedure under deep sedation (DS). Read More

    Capnography sensor use is associated with reduction of adverse outcomes during gastrointestinal endoscopic procedures with sedation administration.
    BMC Anesthesiol 2017 Nov 28;17(1):157. Epub 2017 Nov 28.
    Health Economics and Outcomes Research, Medtronic, Mansfield, MA, USA.
    Background: Evidence to date suggests that capnography monitoring during gastrointestinal endoscopic procedures (GEP) reduces the incidence of hypoxemia, but the association of capnography monitoring with the incidence of other adverse outcomes surrounding these procedures has not been well studied. Our aims were to estimate the incidence of pharmacological rescue events and death at discharge from an inpatient or outpatient hospitalization where GEP was performed with sedation, and to determine if capnography monitoring was associated with reduced incidence of these adverse outcomes.

    Methods: This retrospective Premier Database analysis included medical inpatients and all outpatients undergoing GEP with sedation. Read More

    Effects of propofol on ventricular repolarization and incidence of malignant arrhythmias in adults.
    J Electrocardiol 2017 Nov 11. Epub 2017 Nov 11.
    Department of Cardiology, Charité - Universitaetsmedizin Berlin, Campus Virchow-Klinikum, Germany.
    Background: Propofol is commonly used for procedural sedation in interventional electrophysiology. However, ventricular arrhythmias under Propofol have been reported. Our aim was to investigate ventricular repolarization and incidence of ventricular arrhythmias under Propofol infusion in adults with cardiac arrhythmias. Read More

    Emergency Intubations in a High-Volume Pediatric Emergency Department.
    Pediatr Emerg Care 2017 Nov 21. Epub 2017 Nov 21.
    From the Children's Emergency, KK Women's and Children's Hospital, Singapore.
    Introduction: Resuscitation of critically ill children can be chaotic, and emergency airway management is often fraught with difficulties. This study aimed to characterize the Singaporean landscape of tracheal intubation in a pediatric emergency unit, placing emphasis on safety outcomes, procedural process of care, and provider training.

    Methods: A retrospective review of all cases presented to the KK Women's and Children's Hospital from January 2009 to December 2013 with intubation carried out within the pediatric emergency unit was done. Read More

    Intensivist-based deep sedation using propofol for pediatric outpatient flexible bronchoscopy.
    World J Crit Care Med 2017 Nov 4;6(4):179-184. Epub 2017 Nov 4.
    Department of Pediatrics, Section of Critical Care, Indiana University School of Medicine, Riley Hospital for Children at Indiana University Health, Indianapolis, IN 46202, United States.
    Aim: To evaluate the safety and efficacy of sedating pediatric patients for outpatient flexible bronchoscopy.

    Methods: A retrospective chart review was conducted for all children, age 17 years or under who underwent flexible bronchoscopy under deep sedation in an outpatient hospital-based setting. Two sedation regimens were used; propofol only or ketamine prior to propofol. Read More

    Improving mechanical thrombectomy time metrics in the angiography suite: Stroke cart, parallel workflows, and conscious sedation.
    Interv Neuroradiol 2017 Jan 1:1591019917742326. Epub 2017 Jan 1.
    3 Division of Interventional Neuroradiology, Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, USA.
    Purpose Earlier reperfusion of large-vessel occlusion (LVO) stroke improves functional outcomes. We hypothesize that use of a stroke cart in the angiography suite, containing all commonly used procedural equipment in a mechanical thrombectomy, combined with parallel staff workflows, and use of conscious sedation when possible, improve mechanical thrombectomy time metrics. Methods We identified 47 consecutive LVO patients who underwent mechanical thrombectomy at our center, retrospectively and prospectively from implementation of these three workflow changes (19 pre- and 28 post-). Read More

    Procedural and thirty-day outcomes following transfemoral implantation of the fully repositionable and retrievable Lotus valve without routine pre-dilatation in a consecutive patient cohort: a single centre experience.
    Cardiovasc Revasc Med 2017 Nov 4. Epub 2017 Nov 4.
    Oxford Heart Centre, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU, United Kingdom.
    Background / Purpose: The Lotus valve (Boston Scientific, Natick, MA, USA) is a contemporary transcatheter aortic valve implantation (TAVI) device that is fully repositionable and retrievable to aid implantation and optimise procedural results. The ability to implant the device without routine pre-dilatation is another possible advantage reducing associated risks and procedure times. The aim of this study is to report procedural and 30-day outcomes following TAVI in a consecutive patient group presenting with severe symptomatic aortic stenosis with the Lotus valve system without routine pre-dilatation. Read More

    Comparison between chloral hydrate and propofol-ketamine as sedation regimens for pediatric auditory brainstem response testing.
    Braz J Otorhinolaryngol 2017 Oct 28. Epub 2017 Oct 28.
    Indiana University Health, Indiana University School of Medicine and Riley Hospital for Children, Department of Pediatrics - Section of Pediatric Critical Care Medicine, Indianapolis, IN, United States.
    Introduction: The use of diagnostic auditory brainstem response testing under sedation is currently the "gold standard" in infants and young children who are not developmentally capable of completing the test.

    Objective: The aim of the study is to compare a propofol-ketamine regimen to an oral chloral hydrate regimen for sedating children undergoing auditory brainstem response testing.

    Methods: Patients between 4 months and 6 years who required sedation for auditory brainstem response testing were included in this retrospective study. Read More

    The management of peri- and postprocedural pain in interventional radiology: a narrative review.
    Pain Manag 2017 Nov 10;7(6):523-535. Epub 2017 Nov 10.
    Department of Anaesthetics, St George's Hospital, Blackshaw Road, London SW17 0QT, England.
    Interventional radiology encompasses a wide range of procedures and the degree of associated pain depends predominantly on the procedure being undertaken. Procedures may be painful during but not after the procedure, relatively painless during but painful after the procedure, or relatively painless during and after the procedure. However, there is a lack of good quality publications in interventional radiology that specifically address the subject of peri- and postprocedural pain management. Read More

    Periprocedural analgesic efficacy of a single, pre-emptive administration of propacetamol in catheter ablation for atrial fibrillation: a randomized controlled trial.
    Minerva Anestesiol 2017 Nov 6. Epub 2017 Nov 6.
    Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea -
    Background: Anesthetic care for termination of atrial fibrillation with catheter ablation poses significant challenges due to significant pain lengthy procedure. A delicate polypharmacy combining anaesthetic agents to minimize respiratory depression and hemodynamic changes and to provide satisfactory sedation and analgesia is needed.

    Methods: Ninety-eight patients were randomized into two groups receiving either two gram of propacetamol or normal saline intravenously for 20 min before anesthesia. Read More

    Short-Term Propofol Infusion and Associated Effects on Serum Lactate in Pediatric Patients.
    Pediatr Emerg Care 2017 Nov;33(11):e118-e121
    From the *Children's Hospital of Michigan, Detroit, MI; and †Rainbow Babies and Children's Hospital, University Hospitals, Case Medical Center, Cleveland, OH.
    Objectives: This study aimed to determine if short-duration procedural sedation in children with propofol is related to an adverse metabolic stress response measured by serum lactate. Propofol infusion syndrome is associated with high-dose and long-duration infusion. It has not been studied with short-duration, outpatient propofol administration. Read More

    Predictors of Good Outcome After Endovascular Therapy for Vertebrobasilar Occlusion Stroke.
    Stroke 2017 Dec 31;48(12):3252-3257. Epub 2017 Oct 31.
    From the Department of Neurology Grady Memorial Hospital and Emory University School of Medicine, Atlanta, GA (M.B., D.C.H., J.A.G., S.R., M.R.F., R.G.N.); Department of Neurology, University of Pittsburgh Medical Center, PA (G.W., A.H., T.G.J., A.P.J.); and Baptist Neurological Institute, Jacksonville, FL (A.A.).
    Background And Purpose: Endovascular therapy is increasingly used in acute ischemic stroke treatment and is now considered the gold standard approach for selected patient populations. Prior studies have demonstrated that eventual patient outcomes depend on both patient-specific factors and procedural considerations. However, these factors remain unclear for acute basilar artery occlusion stroke. Read More

    Conscious sedation during cryoballoon ablation of atrial fibrillation: the feasibility and safety study.
    Minerva Cardioangiol 2017 Oct 25. Epub 2017 Oct 25.
    Department of Cardiology, Medical University of Lodz, Lodz, Poland.
    Background: Cryoballoon ablation for atrial fibrillation (cryoAF) is relatively simple, cost-effective and easy procedure. However, general anesthesia during this procedure may have negative impact on patients mortality and morbidity, as well as procedure costs.

    Aim: We sought to assess the feasibility and safety of conscious sedation during cryoAF. Read More

    Intravenous regional anaesthesia (Bier's block) for pediatric forearm fractures in a pediatric emergency department-Experience from 2003 to 2014.
    Injury 2017 Dec 16;48(12):2784-2787. Epub 2017 Oct 16.
    Children's Emergency, KKWomen's and Children's Hospital, Singapore. Electronic address:
    Study Objectives: To evaluate the efficacy (length of stay in the emergency department and failure rate of Bier's block) and safety profile (death and major complications) of Bier's block in its use for manipulation and reduction of paediatric forearm fractures.

    Methods: This is a retrospective cohort study of pediatric patients in KKWomen's and Children's Hospital Children's Emergency Department with forearm fractures between Jan 2003 and Dec 2014 who underwent manipulation and reduction using Bier's block. Demographic data, time from registration to discharge, major complications and success rate were collated in a standardized data collection form. Read More

    Safety and Efficiency in a Canadian Outpatient Gynaecological Surgical Centre.
    J Obstet Gynaecol Can 2017 Oct 17. Epub 2017 Oct 17.
    Department of Obstetrics and Gynecology, University of Saskatchewan, Saskatoon, SK. Electronic address:
    Objective: This study sought to describe safety and efficiency outcomes for patients undergoing procedures at the Women's Health Centre, an outpatient gynaecological surgical centre in Saskatoon, SK.

    Methods: A retrospective chart review of surgical outpatient health records was conducted for the period of July 2014 to June 2015. Data were abstracted using a standardized data form for patient admissions during the study period. Read More

    High-risk respiratory patients' experiences of bronchoscopy with conscious sedation and analgesia: A qualitative study.
    J Clin Nurs 2017 Oct 20. Epub 2017 Oct 20.
    Department of Psychiatry, University of Melbourne, Melbourne, Vic., Australia.
    Aims And Objectives: To understand the experiences of high-risk respiratory patients undergoing bronchoscopy with conscious sedation.

    Background: Due to possible complications, high-risk respiratory patients are usually given smaller, cautious doses of sedation and analgesia for bronchoscopy. Described as "conscious sedation," this facilitates depression of the patient's consciousness without causing respiratory compromise. Read More

    Outcomes for the Commercial Use of Self-Expanding Prostheses in Transcatheter Aortic Valve Replacement: A Report From the STS/ACC TVT Registry.
    JACC Cardiovasc Interv 2017 Oct;10(20):2090-2098
    Beth Israel Deaconess Medical Center, Boston, Massachusetts.
    Objectives: The authors sought to compare the outcomes of commercial transcatheter aortic valve replacement (TAVR) with the repositionable Evolut R platform to those observed with the CoreValve device in the Society of Thoracic Surgeons (STS)/American College of Cardiology (ACC) Transcatheter Valve Therapy (TVT) Registry.

    Background: TAVR continues to evolve, with rapid adoption of iterative changes for commercial practice. Insight into the outcomes of this adoption is needed. Read More

    Use of Digital Pupillometry to Measure Sedative Response to Propofol.
    Ochsner J 2017 ;17(3):250-253
    Section of Pulmonary/Critical Care and Allergy/Immunology, Louisiana State University School of Medicine, New Orleans, LA.
    Background: Digital pupillometry (DP) accurately and precisely measures pupillary responses. Little is known about using DP to measure the sedative effect of isolated propofol administration.

    Methods: We conducted a cross-sectional study of 19 adults undergoing moderate sedation with propofol during which we measured pupillary changes using DP. Read More

    Incidence and predictors of pericardial effusion as an early complication of catheter ablation for atrial fibrillation: The Japanese Catheter Ablation Registry of Atrial Fibrillation (J-CARAF).
    J Arrhythm 2017 Oct 12;33(5):430-433. Epub 2017 May 12.
    Heart Rhythm Center, Tokyo Medical and Dental University.
    Background: Pericardial effusion (PE) is one of the most frequent complications from catheter ablation of atrial fibrillation (AF). We assessed the prevalence and predictive factors of PE that require invasive treatment as an early complication of AF ablation.

    Methods: The Japanese Heart Rhythm Society requested electrophysiology centers to register the relevant data of patients who underwent AF ablation during 6 months from 2011 to 2015. Read More

    Sedation with propofol during ERCP: is the combination with esketamine more effective and safer than with alfentanil? Study protocol for a randomized controlled trial.
    Trials 2017 Oct 11;18(1):472. Epub 2017 Oct 11.
    Department of Anesthesiology, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, Amsterdam, 1100 DD, The Netherlands.
    Background: Endoscopic retrograde cholangiopancreatography (ERCP) is a gastrointestinal procedure that requires a relatively motionless patient during the intervention. Deep sedation by intravenous propofol combined with an opioid has recently become the preferred sedation technique. However, when high doses of propofol are used, side effects, namely respiratory depression, may occur. Read More

    Comparison of dexmedetomidine and ketamine versus propofol and ketamine for procedural sedation in children undergoing minor cardiac procedures in cardiac catheterization laboratory.
    Ann Card Anaesth 2017 Oct-Dec;20(4):422-426
    Department of Anaesthesiology and Critical Care, Command Hospital Air Force, Bengaluru, Karnataka, India.
    Background: The ideal anaesthetic technique for management of paediatric patients scheduled to undergo cardiac catheterisation is still not standardised.

    Aim: To compare the effects of ketamine-propofol and ketamine-dexmedetomidine combinations on hemodynamic parameters and recovery time in paediatric patients undergoing minor procedures and cardiac catheterisation under sedation for various congenital heart diseases.

    Material And Methods: 60 children of either sex undergoing cardiac catheterisation were randomly assigned into two groups Dexmedetomidine-ketamine group (DK) and Propofol-ketamine (PK) of 30 patients each. Read More

    Capnography in the Emergency Department: A Review of Uses, Waveforms, and Limitations.
    J Emerg Med 2017 Dec 7;53(6):829-842. Epub 2017 Oct 7.
    Department of Emergency Medicine, Joint Base Elmendorf-Richardson Medical Center, Joint Base Elmendorf-Richardson, Alaska.
    Background: Capnography has many uses in the emergency department (ED) and critical care setting, most commonly cardiac arrest and procedural sedation.

    Objective Of The Review: This review evaluates several indications concerning capnography beyond cardiac arrest and procedural sedation in the ED, as well as limitations and specific waveforms.

    Discussion: Capnography includes the noninvasive measurement of CO2, providing information on ventilation, perfusion, and metabolism in intubated and spontaneously breathing patients. Read More

    Behavioral Changes in Children After Emergency Department Procedural Sedation.
    Acad Emerg Med 2017 Oct 9. Epub 2017 Oct 9.
    Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI.
    Objective: The purpose of this study was to determine the proportion of children undergoing procedural sedation for fracture reduction in the emergency department (ED) observed to experience negative postdischarge behaviors. Predictors of negative behaviors were evaluated, including anxiety.

    Methods: This was a prospective cohort study of children receiving intravenous ketamine sedation for ED fracture reduction. Read More

    Comparison of ketamine/propofol (ketofol) and etomidate/fentanyl (etofen) combinations for procedural sedation and analgesia in the emergency department: An observational study.
    Turk J Emerg Med 2017 Sep 19;17(3):89-94. Epub 2017 Mar 19.
    Dr. Lutfi Kirdar Kartal Education and Research Hospital, Department of Emergency Medicine, Istanbul, Turkey.
    Objectives: The primary aim of this study was to report the vital signs, hemodynamic parameters and pain scores of the patients who have received procedural sedation and analgesia (PSA) with either ketofol (combination of ketamine and propofol) or etofen (combination of etomidate and fentanyl) and compare the proportion of patients with airway or respiratory adverse events (AEs) requiring an intervention and calculate the relative risk of AEs with each combination.

    Methods: This study is a prospective observational study with survey analysis. All patients received procedural sedation and analgesia (PSA) with either ketofol (combination of ketamine and propofol) or etofen (combination of etomidate and fentanyl) were prospectively observed. Read More

    Helping Children Cope with Medical Tests and Interventions.
    J Radiol Nurs 2017 Mar;36(1):44-50
    Department of Anesthesia, Radboud University Medical Center Nijmegen, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, Netherlands.
    Medical procedures and tests become a challenge when anxiety and pain make it difficult for the patient to cooperate or remain still when needed. Fortunately a short intervention with hypnoidal language at the onset of a procedure induces a positive and sustained change in the way pain and anxiety are processed. While anesthesia may appear to be a simple solution to eliminate pain, the adverse effects of pre-anesthesia anxiety on postoperative behavior and recovery are often not fully appreciated. Read More

    Effects of esketamine sedation compared to morphine analgesia on hydrostatic reduction of intussusception: A case-cohort comparison study.
    Paediatr Anaesth 2017 Nov 20;27(11):1091-1097. Epub 2017 Sep 20.
    Department of Pediatric Surgery, University Medical Centre Utrecht, Utrecht, The Netherlands.
    Background: Hydrostatic or pneumatic reduction of intussusception is an invasive procedure that is stressful and may be painful for a child. Resistance of the child may increase the duration of the procedure and decrease success rate of reduction. Analgesia can help to reduce pain, but not necessarily resistance. Read More

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