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    1512 results match your criteria Procedural Sedation

    1 OF 31

    One year experience with computer-assisted propofol sedation for colonoscopy.
    World J Gastroenterol 2017 Apr;23(16):2964-2971
    Otto S Lin, Danielle La Selva, Richard A Kozarek, Deborah Tombs, Johannes Koch, Susan McCormick, Michael Chiorean, Fred Drennan, Michael Gluck, Nanda Venu, Michael Larsen, Andrew Ross, Digestive Disease Institute, Virginia Mason Medical Center, Seattle, WA 98101, United States.
    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. Read More

    Comparison of Pain Within 24 h after Uterine Artery Embolization with Tris-Acryl Gelatin Microspheres Versus Gelatin Sponge Particles for Leiomyoma.
    Cardiovasc Intervent Radiol 2017 May 15. Epub 2017 May 15.
    Department of Radiology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kyoto, 602-8566, Japan.
    Purpose: To compare acute pain after uterine artery embolization (UAE) with tris-acryl gelatin microspheres (TAGM) versus gelatin sponge particles (GS) for leiomyoma.

    Materials And Methods: This was a single-institution, retrospective study. Between July 2008 and November 2016, 101 consecutive patients with symptomatic uterine leiomyoma underwent UAE with the same protocol for post-procedural pain. Read More

    Predictors of procedural complications in adult Fontan patients undergoing non-cardiac procedures.
    Heart 2017 May 13. Epub 2017 May 13.
    Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.
    Objective: Limited data exist regarding the outcomes of non-cardiac procedures (NCPs) in adult patients after Fontan operations (Fontan patients).

    Methods: To compare procedural outcomes after NCPs in Fontan patients with outcomes for two matched control groups: patients with repaired congenital heart disease and biventricular circulation (CHD-BiV) and patients with no heart disease (NHD). We defined cyanosis as oxygen saturation <90% and procedural hypoxia as saturation <80% or a decrease in saturation >10% from baseline. Read More

    Improving the quality of the intensive care follow-up of ventilated patients during a national registration program.
    Public Health 2017 May 11;148:159-166. Epub 2017 May 11.
    Ministry of Public Health, Belgium.
    Objectives: The Belgian Public Health Organization is concerned with rates of hospital-acquired infections like ventilator-associated pneumonia (VAP). Implementing best practice guidelines for these nosocomial infections has variable success in the literature. This retrospective study was undertaken to see whether implementation of the evidence-based practices as a bundle was feasible, would influence compliance, and could reduce the rates of VAP. Read More

    Promising Modalities to Identify and Monitor Eosinophilic Esophagitis.
    Clin Gastroenterol Hepatol 2017 May 10. Epub 2017 May 10.
    Professor of Clinical Pediatrics and Internal Medicine, Division of Pediatric Gastroenterology, Hepatology and Nutrition, University of Illinois College of Medicine at Peoria, IL. Electronic address:
    Eosinophilic esophagitis (EoE) is an allergen-mediated condition characterized by symptoms of esophageal dysfunction and histological evidence of intense eosinophilic inflammation involving the esophagus in absence of overlapping conditions such as gastroesophageal reflux disease. Since the initial description as a distinct entity about two decades ago, there has been a remarkable rise in the recognition of this clinico-pathologic entity. Current approach to diagnose and monitor EoE requires repeated esophagogastroduodenoscopies (EGDs), with associated sedation/anesthesia, to visualize mucosal abnormalities, and to obtain multiple biopsies for histologic assessment and to evaluate treatment response. Read More

    Adverse events with ketamine versus ketofol for procedural sedation on adults: a double-blinded, randomized controlled trial.
    Acad Emerg Med 2017 May 11. Epub 2017 May 11.
    Emergency Department, Centre Hospitalier Universitaire de Nice, France.
    Objectives: The goal of our study was to compare the frequency and severity of recovery reactions between ketamine and ketamine-propofol 1:1 admixture ("ketofol").

    Methods: We performed a multicentric, randomized, double-blinded trial in which adult patients received emergency procedural sedations with ketamine or ketofol. Our primary outcome was the proportion of unpleasant recovery reactions. Read More

    Experience with the use of propofol for radiologic imaging in infants younger than 6 months of age.
    Pediatr Radiol 2017 May 9. Epub 2017 May 9.
    Department of Pediatrics, Emory University School of Medicine, 1405 Clifton Road NE, Atlanta, GA, 30322, USA.
    Background: There is an increased risk associated with procedural sedation of infants younger than 6 months of age. The use of propofol for radiologic imaging of this age group is not well studied.

    Objective: We hypothesize that adverse events are higher in the infant population receiving propofol for radiologic imaging. Read More

    Biopsy of CT-Occult Bone Lesions Using Anatomic Landmarks for CT Guidance.
    AJR Am J Roentgenol 2017 May 2:1-8. Epub 2017 May 2.
    1 Mallinckrodt Institute of Radiology, Washington University in St. Louis, 510 S Kingshighway Blvd, St. Louis, MO 63110.
    Objective: The purpose of this study is to evaluate the histopathologic diagnostic yield, sample size, procedural time, and dose-length product (DLP) for the biopsy of CT-occult lesions found at MRI or PET or both.

    Materials And Methods: A retrospective review of our radiology information system for biopsies of CT-occult lesions using CT guidance from January 1, 2010, through December 31, 2014, was performed and compared with a selection of CT-guided biopsies of CT-evident bone lesions during the same period. The data were then evaluated for diagnostic yield of histopathologic diagnosis, procedural time, use of sedation medication, DLP, and size of specimens obtained. Read More

    Ultrasound-guided interscalene nerve block vs procedural sedation by propofol and fentanyl for anterior shoulder dislocations.
    Am J Emerg Med 2017 Apr 14. Epub 2017 Apr 14.
    Department of Emergency Medicine, Kerman University of Medical Sciences, Kerman, Iran. Electronic address:
    Background: Few studies were performed to compare ultrasound guided brachial plexus block with procedural sedation for reduction of shoulder dislocations in the Emergency Department (ED). This study was done to provide further evidence regarding this comparison.

    Methods: This was a randomized clinical trial performed on patients presenting with anterior shoulder dislocations to the emergency department of an academic level 2 trauma center. Read More

    The information needs of patients receiving procedural sedation in a hospital emergency department.
    Int Emerg Nurs 2017 Apr 27. Epub 2017 Apr 27.
    Eastern Institute of Technology, Taradale, Hawkes Bay, New Zealand. Electronic address:
    This research investigated the information needs of patients receiving ED procedural sedation to determine the best format to consistently deliver key information in a way acceptable to all involved. Of particular interest was the question concerning patients' need for receiving written information. A descriptive exploratory study gathered qualitative data through face-to-face interviews and focus groups involving patients, nurses and medical staff. Read More

    Pharmacokinetics after a single dose of naloxone administered as a nasal spray in healthy volunteers.
    Acta Anaesthesiol Scand 2017 Apr 25. Epub 2017 Apr 25.
    Department of Anesthesia and Intensive Care, Visby Hospital, Visby, Sweden.
    Background: There is increasing interest in the use of intranasal naloxone to reverse adverse opioid effects during management of procedural pain in children and in adults after overdose. There are limited data on the pharmacokinetics of intranasal naloxone so in this study we aimed to detail the pharmacokinetic profile of the commercially marketed injectable solution of naloxone 0.4 mg/ml when administered as an intranasal spray. Read More

    Cricoid ring: Shape, size, and variability in infants and children.
    Saudi J Anaesth 2017 Apr-Jun;11(2):203-207
    Department of Anesthesiology and Pain Medicine, The Research Institute, Nationwide Children's Hospital, Columbus, Ohio, USA.
    Background: Knowledge regarding the shape, size, and variability of the cricoid ring is important to properly choose the correct endotracheal tube (ETT) in the pediatric patient. Studies have measured the size of the cricoid ring using methodologies such as moulages, magnetic resonance imaging, and video-bronchoscopy. In the present study, computed tomography (CT) -based images were used to determine the shape, size, and configuration of the cricoid ring in the pediatric population taking into considerations growth and development. Read More

    Randomized clinical trial of propofol versus alfentanil for moderate procedural sedation in the emergency department.
    Am J Emerg Med 2017 Apr 21. Epub 2017 Apr 21.
    Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, MN, United States.
    Study Objective: To compare the frequency of airway and respiratory adverse events leading to an intervention between moderate sedation using alfentanil or propofol.

    Methods: We performed a randomized clinical trial in which adults undergoing moderate sedation in the ED received either alfentanil or propofol. Our primary outcome was the frequency of airway and respiratory adverse events leading to an intervention. Read More

    Gastric hypomotility after second-generation cryoballoon ablation-Unrecognized silent nerve injury after cryoballoon ablation.
    Heart Rhythm 2017 May;14(5):670-677
    Cardiovascular Center, Tsuchiura Kyodo Hospital, Tsuchiura, Ibaraki, Japan.
    Background: Few data are available on gastric hypomotility (GH) after cryoballoon pulmonary vein isolation. Also, the use of esophageal temperature monitoring for the prevention of endoscopically detected esophageal lesions (EDELs) is not well established.

    Objective: The purpose of this study was to investigate GH and the impact of an esophageal probe on EDELs during second-generation cryoballoon ablation. Read More

    Adverse Events During a Randomized Trial of Ketamine Versus Co-Administration of Ketamine and Propofol for Procedural Sedation in a Pediatric Emergency Department.
    J Emerg Med 2017 Apr 19. Epub 2017 Apr 19.
    Department of Emergency Medicine, Denver Health Hospital, Denver, Colorado.
    Background: The co-administration of ketamine and propofol (CoKP) is thought to maximize the beneficial profile of each medication, while minimizing the respective adverse effects of each medication.

    Objective: Our objective was to compare adverse events between ketamine monotherapy (KM) and CoKP for procedural sedation and analgesia (PSA) in a pediatric emergency department (ED).

    Methods: This was a prospective, randomized, single-blinded, controlled trial of KM vs. Read More

    Prospective Assessment of Pain and Comfort in Chronic Pain Patients Undergoing Interventional Pain Management Procedures.
    Pain Med 2017 Apr 18. Epub 2017 Apr 18.
    Harvard Medical School, Beth Israel Deaconess Medical Center, Brookline, Massachusetts, USA.
    Objective.:  Interventional pain management procedures have an important role in the management of chronic pain. The present study seeks to identify the proportion of patients who experience severe pain during pain procedures either with or without sedation. Read More

    Comparison of outcomes for pediatric paraphimosis reduction using topical anesthetic versus intravenous procedural sedation.
    Am J Emerg Med 2017 Apr 11. Epub 2017 Apr 11.
    Division of Pediatric Emergency Medicine, The Montreal Children's Hospital, McGill University Health Center, Montreal, Quebec, Canada.
    Background: Paraphimosis is an acute urologic emergency requiring urgent manual reduction, frequently necessitating procedural sedation (PS) in the pediatric population. The present study sought to compare outcomes among pediatric patients undergoing paraphimosis reduction using a novel topical anesthetic (TA) technique versus PS.

    Methods: We performed a retrospective analysis of all patients <18years old, presenting to a tertiary pediatric ED requiring analgesia for paraphimosis reduction between October 2013 and September 2016. Read More

    Novel propofol derivatives and implications for anesthesia practice.
    J Anaesthesiol Clin Pharmacol 2017 Jan-Mar;33(1):9-15
    Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA, USA.
    Propofol (2,6-diisopropylphenol) is the most commonly used intravenous agent for induction of anesthesia. It is also used for maintenance of anesthesia and sedation in both Intensive Care Units and outpatient procedural settings. Its success in the clinical setting has been a result of its rapid onset, short duration of action, and minimal side effects despite disadvantages associated with its oil emulsion formulation. Read More

    Impact of a new distal attachment on colonoscopy performance in an academic screening center.
    Gastrointest Endosc 2017 Apr 12. Epub 2017 Apr 12.
    Wolfson Unit for Endoscopy, St Mark's Hospital/Academic Institute, London, UK.
    Background And Aims: Distal attachments placed on the colonoscope tip may positively affect performance by assisting insertion and polyp detection. The Endocuff-original appears to improve adenoma detection rate, but there are no data assessing the performance of the second generation Endocuff-vision.

    Methods: A pilot service evaluation study (April-2013/September-2014) was conducted on patients with positive faecal occult blood tests within the National Bowel Cancer Programme during 3 consecutive periods: pre-cuff/no device used, during-cuff/device used and post-cuff/no device used. Read More

    Non-anesthesiologist-administered Propofol is not Related to an Increase in Transcutaneous CO2 Pressure During Flexible Bronchoscopy Compared to Guideline-based Sedation: A Randomized Controlled Trial.
    Arch Bronconeumol 2017 Apr 11. Epub 2017 Apr 11.
    Pulmonary and Critical Care Medicine Department, "Dr. José E. González" University Hospital, Nuevo León Autonomous University, Monterrey, N.L., Mexico. Electronic address:
    Introduction: Evidence for the use of non-anesthesiologist-administered propofol for sedation during flexible bronchoscopy is scarce. The main objective of this study was to determine whether non-anesthesiologist-administered propofol balanced sedation was related to higher transcutaneous CO2 pressure compared with current guideline-based sedation (combination midazolam and opioid). Secondary outcomes were post-procedural recuperation time, patient satisfaction and frequency of adverse events. Read More

    Correction: Correction to 'Clinical Policy: Procedural Sedation and Analgesia in the Emergency Department' [Annals of Emergency Medicine 63 (2014) 247-258.e18].
    Ann Emerg Med 2017 Apr 7. Epub 2017 Apr 7.
    Due to a miscommunication during the process of transferring this manuscript from our editorial team to Production, the Members of the American College of Emergency Physicians Clinical Policies Committee (Oversight Committee) were not properly indexed in PubMed. This has now been corrected online. The publisher would like to apologize for any inconvenience caused. Read More

    Long-Term Outcomes of 560 Consecutive Patients Treated With Transcatheter Aortic Valve Implantation and Propensity Score-Matched Analysis of Early- Versus New-Generation Valves.
    Am J Cardiol 2017 Jun 16;119(11):1821-1831. Epub 2017 Mar 16.
    Cardiology Department, "Rabin Medical Center," Petah Tikva, Israel; "Sackler" School of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address:
    Transcatheter aortic valve implantation (TAVI) is an established treatment for severe aortic stenosis in patients at high or prohibitive surgical risk. Nevertheless, long-term clinical and echocardiographic data are still lacking. We carried out an analysis of 560 consecutive patients who underwent TAVI at our institution from 2008 to 2016 to evaluate temporal changes in TAVI characteristics, predictors of 1-year and long-term outcomes, and to compare the performance of the early- and new-generation valve systems. Read More

    Cardio-anesthesiology considerations for the trans-catheter aortic valve implantation (TAVI) procedure.
    Hellenic J Cardiol 2016 Oct 6. Epub 2016 Oct 6.
    1st Department of Cardiology, Medical School, University of Athens, Hippokration Hospital, Athens, Greece.
    Transcatheter aortic valve implantation (TAVI) has become the mainstay for high-risk or inoperable patients with symptomatic aortic valve stenosis, and research regarding the use of transcatheter valves in intermediate or low-risk patients is currently ongoing. The aim of this article is to provide comprehensive insight into the anesthetic management of patients undergoing TAVI and to highlight possible gaps in the current knowledge. One important procedural characteristic that is imperative to consider is the type of anesthesia being used and its possible complications. Read More

    The sedative effects of the intranasal administration of dexmedetomidine in children undergoing surgeries compared to other sedation methods: A systematic review and meta-analysis.
    J Clin Anesth 2017 May 15;38:33-39. Epub 2017 Jan 15.
    Department of Anesthesia and Pain Medicine, College of Medicine, Hanyang University, Seoul, South Korea.
    Study Objective: Administration of intranasal dexmedetomidine for sedation is comfortable and effective in children who are afraid of needles, and it offers efficient sedation similar to that of intravenous administration. We performed a systematic review and meta-analysis to evaluate the clinical effects of the pre-procedural administration of intranasal dexmedetomidine.

    Design: We identified randomized controlled trials (RCTs) that compared intranasal dexmedetomidine administration to other administration methods of various sedatives or placebo from MEDLINE, EMBASE, Cochrane, KoreaMed and hand searches of trial registries. Read More

    Patient satisfaction with procedural sedation in the emergency department.
    Emerg Med Australas 2017 Mar 29. Epub 2017 Mar 29.
    Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia.
    Objective: The aim of this study was to determine patient satisfaction with procedural sedation as a function of nature of the procedure and depth of sedation.

    Method: We undertook a prospective observational study of adult patients who received procedural sedation in two EDs (20 month period). The level of sedation was determined by an investigator, using the Observers Assessment of Anaesthesia/Sedation Scale (1 = awake to 6 = no response to noxious stimuli). Read More

    Evaluating the Effectiveness of End-Tidal Carbon Dioxide Monitoring During Burn Wound Care in the Nonintubated Patient Population.
    J Burn Care Res 2017 Mar 31. Epub 2017 Mar 31.
    From the *Critical Care, Pulmonary and Sleep Associates, Lakewood; †University of Colorado Hospital, Aurora; ‡Behavioral Health and Wellness Program, University of Colorado School of Medicine, Aurora; §Denver School of Medicine, Burn Services, Aurora, CO; and ‖College of Nursing, University of Colorado, Aurora.
    Daily burn wound care for nonintubated patients involves administration of intravenous analgesic and sedation agents. Vital signs and oxygen saturation monitoring alone can result in late signs of oversedation and ineffective breathing. End-tidal carbon dioxide (EtCo2) monitoring provides immediate feedback of effective breathing during procedural sedation. Read More

    When to Pick the Nose: Out-of-Hospital and Emergency Department Intranasal Administration of Medications.
    Ann Emerg Med 2017 Mar 25. Epub 2017 Mar 25.
    ScientiaCME, LLC, Highland Park, IL.
    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. Read More

    Bolus Administration of Fentanyl and Midazolam for Colonoscopy Increases Endoscopy Unit Efficiency and Safety Compared With Titrated Sedation.
    Clin Gastroenterol Hepatol 2017 Mar 29. Epub 2017 Mar 29.
    Division of Gastroenterology, Duke University School of Medicine, Durham, NC; Duke Clinical Research Institute, Durham, NC; Durham VA Medical Center, Durham NC.
    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. Read More

    Reasons for Interfacility Emergency Department Transfer and Care at the Receiving Facility.
    Pediatr Emerg Care 2017 Mar 27. Epub 2017 Mar 27.
    From the *Boston Children's Hospital, Harvard Medical School, Boston, MA; †Seattle Children's Hospital, University of Washington School of Medicine, Seattle, WA; ‡Texas Children's Hospital, Baylor College of Medicine, Houston, TX; and §The Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
    Objectives: The aims of this study were to (1) assess the reasons for pediatric interfacility transfers as identified by transferring providers and review the emergency medical care delivered at the receiving facilities and (2) investigate the emergency department (ED) care among the subpopulation of patients discharged from the receiving facility.

    Methods: We performed a multicenter, cross-sectional survey of ED medical providers transferring patients younger than 18 years to 1 of 4 US tertiary care pediatric hospitals with a subsequent medical record review at the receiving facility. Referring providers completed surveys detailing reasons for transfer. Read More

    A multinational, drug utilization study to investigate the use of dexmedetomidine (Dexdor®) in clinical practice in the EU.
    Br J Clin Pharmacol 2017 Mar 27. Epub 2017 Mar 27.
    RTI Health Solutions, Av. Diagonal 605, 9-1, 08028, Barcelona, Spain.
    Aims: Dexmedetomidine (dexdor®) is approved in the European Union (EU) for sedation of adults in the intensive care unit (ICU). The present observational, retrospective study was requested by the European Medicines Agency to investigate dexmedetomidine use in clinical practice, with a particular focus on off-label use, including the paediatric population.

    Methods: Study countries and sites were chosen from those with highest dexmedetomidine use, based on sales. Read More

    Does sevoflurane add to outpatient procedural sedation in children? A randomised clinical trial.
    BMC Pediatr 2017 Mar 24;17(1):86. Epub 2017 Mar 24.
    Department of Paediatrics, Universidade Federal de Goiás, Faculdade de Medicina, Rua 235 com Primeira Avenida, sem número, Setor Universitário, Goiânia, CEP 74605-020, Brazil.
    Background: There is little evidence concerning the effect of sevoflurane in outpatient procedural sedation, especially in children. We hypothesised that the addition of sevoflurane to a sedation regimen improves children's behaviour with minimal adverse events.

    Methods: This is a randomised, triple-blind clinical trial conducted on an outpatient basis. Read More

    Intra-channel stent release technique for fluoroless endoscopic ultrasound-guided lumen-apposing metal stent placement: changing the paradigm.
    Endosc Int Open 2017 Jan;5(1):E25-E29
    Digestive Endoscopy Unit, Catholic University, Rome, Italy.
    Background Recently, a novel lumen-apposing fully covered self-expanding metal stent (LA-FCSEMS) mounted on an electrocautery-enhanced delivery system has been developed to perform endoscopic ultrasound (EUS)-guided transluminal drainage. From early experience, however, release of the proximal flange of the stent has mostly been done using endoscopic view guidance to ensure proper positioning. Aim We describe a new technique that we have named the Intra-Channel Stent Release Technique (ICSRT) to perform stent placement under complete EUS control, without the use of either fluoroscopic or endoscopic views. Read More

    Intranasal Dexmedetomidine as a Sedative for Pediatric Procedural Sedation.
    J Pediatr Pharmacol Ther 2017 Jan-Feb;22(1):4-8
    Objective: This study seeks to evaluate the efficacy and safety of intranasal (IN) dexmedetomidine as a sedative medication for non-invasive procedural sedation.

    Methods: Subjects 6 months to 18 years of age undergoing non-invasive elective procedures were included. Dexmedetomidine (3 mcg/kg) was administered IN 40 minutes before the scheduled procedure time. Read More

    Implementation of a Modified WHO Pediatric Procedural Sedation Safety Checklist and Its Impact on Risk Reduction.
    Hosp Pediatr 2017 Apr;7(4):225-231
    Division of Critical Care.
    Background And Objectives: Major adverse events (AEs) related to pediatric deep sedation occur at a low frequency but can be of high acuity. The high volume of deep sedations performed by 3 departments at our institution provided an opportunity to reduce variability and increase safety through implementation of a procedural sedation safety checklist. We hypothesized that implementation of a checklist would improve compliance of critical safety elements (CSEs) (primary outcome variable) and reduce the sedation-related AE rate (secondary outcome variable). Read More

    Capnography versus standard monitoring for emergency department procedural sedation and analgesia.
    Cochrane Database Syst Rev 2017 Mar 23;3:CD010698. Epub 2017 Mar 23.
    Faculty of Pharmaceutical Sciences, The University of British Columbia, 2146 East Mall, Vancouver, BC, Canada, V6T 1Z3.
    Background: Procedural sedation and analgesia (PSA) is used frequently in the emergency department (ED) to facilitate painful procedures and interventions. Capnography, a monitoring modality widely used in operating room and endoscopy suite settings, is being used more frequently in the ED setting with the goal of reducing cardiopulmonary adverse events. As opposed to settings outside the ED, there is currently no consensus on whether the addition of capnography to standard monitoring modalities reduces adverse events in the ED setting. Read More

    Evaluation of methohexital as an alternative to propofol in a high volume outpatient pediatric sedation service.
    Am J Emerg Med 2017 Mar 8. Epub 2017 Mar 8.
    Division of Pediatric Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States; Children's Healthcare of Atlanta, Atlanta, GA, United States. Electronic address:
    Background: Propofol is a preferred agent for many pediatric sedation providers because of its rapid onset and short duration of action. It allows for quick turn around times and enhanced throughput. Occasionally, intravenous (IV) methohexital (MHX), an ultra-short acting barbiturate is utilized instead of propofol. Read More

    [Procedural sedation and analgesia with nitrous oxide for children in the emergency department].
    Ned Tijdschr Geneeskd 2017 ;161(0):D992
    Meander Medisch Centrum, Amersfoort.
    Procedural sedation and analgesia with nitrous oxide in children who are anxious or in pain is a relatively new type of sedation in emergency departments in the Netherlands. The gas is inhaled through a face mask and does not require intravenous access. Furthermore, nitrous oxide does not influence the circulatory and respiratory systems and airway reflexes remain intact, which means that the child does not need to be fasted. Read More

    The First US Clinical Experience With Computer-Assisted Propofol Sedation: A Retrospective Observational Comparative Study on Efficacy, Safety, Efficiency, and Endoscopist and Patient Satisfaction.
    Anesth Analg 2017 Mar 17. Epub 2017 Mar 17.
    From the *Digestive Disease Institute, Virginia Mason Medical Center, Seattle, Washington; and †Department of Anesthesia, Virginia Mason Medical Center, Seattle, Washington.
    Background: Computer-assisted propofol sedation (CAPS) is now approved for moderate sedation of American Society of Anesthesiologists (ASA) class I and II patients undergoing routine endoscopy. As the first US medical center to adopt CAPS for routine clinical use, we compared patient and endoscopist satisfaction with CAPS versus midazolam and fentanyl (MF) sedation.

    Methods: Patients who underwent elective outpatient upper endoscopy and colonoscopy with CAPS were compared with concurrent patients sedated with MF. Read More

    Intranasal ketamine for procedural sedation and analgesia in children: A systematic review.
    PLoS One 2017 20;12(3):e0173253. Epub 2017 Mar 20.
    Alberta Research Centre for Health Evidence, Department of Pediatrics, University of Alberta, Edmonton, Alberta.
    Background: Ketamine is commonly used for procedural sedation and analgesia (PSA) in children. Evidence suggests it can be administered intranasally (IN). We sought to review the evidence for IN ketamine for PSA in children. Read More

    Safety and Effectiveness of a "Percutaneous-First" Approach to Endovascular Aortic Aneurysm Repair.
    Ann Vasc Surg 2017 Mar 14. Epub 2017 Mar 14.
    Division of Vascular Surgery, New York-Presbyterian/Weill Cornell Medical Center, New York, NY.
    Background: Percutaneous endovascular aneurysm repair (PEVAR) has been increasingly used in the endovascular treatment of abdominal aortic aneurysms. Furthermore, the percutaneous approach can be used with minimal sedation and local anesthesia in most cases. The purpose of this study was to assess the safety and effectiveness of a "percutaneous first" approach to femoral access for EVAR. Read More

    Intranasal Dexmedetomidine for Procedural Sedation in Children, a Suitable Alternative to Chloral Hydrate.
    Paediatr Drugs 2017 Apr;19(2):107-111
    Emergency Department, Institute for Maternal and Child Health IRCCS "Burlo Garofolo", via dell'Istria 65/1, 34132, Trieste, Italy.
    Sedation is often required for children undergoing diagnostic procedures. Chloral hydrate has been one of the sedative drugs most used in children over the last 3 decades, with supporting evidence for its efficacy and safety. Recently, chloral hydrate was banned in Italy and France, in consideration of evidence of its carcinogenicity and genotoxicity. Read More

    Moderate sedation in cardiac electrophysiology laboratory: a retrospective safety analysis.
    Heart 2017 Mar 1. Epub 2017 Mar 1.
    Department of Cardiology, St Bartholomew's Hospital, London, UK.
    Objective: Cardiac electrophysiology (EP) procedures can be performed under moderate sedation without the direct involvement of an anaesthetist. However, concerns have been raised over the safety of this approach. This study examines the use of a standardised nurse-led physician-directed sedation protocol for EP procedures to determine the safety of moderate sedation administered by non-anaesthesia personnel who have been trained in sedation techniques. Read More

    Remifentanil for procedural sedation: a systematic review of the literature.
    Emerg Med J 2017 May 1;34(5):294-301. Epub 2017 Mar 1.
    Department of Emergency Medicine, University of Ottawa, Ottawa, Ontario, Canada.
    Objective: We sought to determine the performance characteristics of remifentanil as an agent of procedural sedation and analgesia (PSA) for adult and paediatric patients undergoing procedures similar to those executed in the ED.

    Methods: We systematically reviewed electronically published literature, grey literature, conference proceedings and trial registries from 1946 to 2015. Outcome measures included PSA effectiveness, recovery time, patient safety and resource management. Read More

    Is transnasal TEE imaging a viable alternative to conventional TEE during structural cardiac interventions to avoid general anaesthesia? A pilot comparison study of image quality.
    Echo Res Pract 2017 Mar 1;4(1):1-7. Epub 2017 Mar 1.
    King's College Hospital, Cardiology Department, King's College Hospital NHS Trust, London, UK.
    Aim: The role of transoesophageal echocardiography in cardiac interventional structural procedures is well established and appreciated. However, the need for general anaesthesia (GA) throughout the procedure remains a controversial issue. The aim of the present study is to assess the feasibility and imaging quality of using a transnasal microrobe that allows the usage of conscious sedation in patients who undergo cardiac structural interventional procedures without missing the benefits, guidance and navigation of conventional trans-procedural TEE. Read More

    Desaturation in procedural sedation for children with long bone fractures: Does weight status matter?
    Am J Emerg Med 2017 Feb 20. Epub 2017 Feb 20.
    Women and Children's Hospital of Buffalo, University Pediatric Associates, Division of Pediatric Emergency Medicine, 219 Bryant Street, Buffalo, NY 14222, USA; Women and Children's Hospital of Buffalo, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, 3435 Main Street, Buffalo, NY 14214, USA.
    Introduction: Childhood obesity remains a serious problem in the United States. Significant associated adverse incidents have been reported with sedation of children with obesity, namely hypoxemia. The objective of our study was to determine if overweight and obesity were associated with increased desaturations during procedural sedation compared with patients of healthy weight. Read More

    Safety and efficacy of chloral hydrate for procedural sedation in paediatric ophthalmology: a systematic review and meta-analysis.
    Br J Ophthalmol 2017 Feb 27. Epub 2017 Feb 27.
    Department of Hygiene and Epidemiology, Aristotle University of Thessaloniki, Thessaloniki, Greece.
    Purpose: Although chloral hydrate (CH) has been used as a sedative for decades, it is not widely accepted as a valid choice for ophthalmic examinations in uncooperative children. This study aimed to systematically review the literature on the drug's safety and efficacy.

    Methods: We searched PubMed, EMBASE, ISI Web of Science, Scopus, CENTRAL, Google Scholar and Trip database to 1 October 2015, using the keywords 'chloral hydrate', 'paediatric' and 'procedural sedation OR diagnostic sedation'. Read More

    High Patient Satisfaction with Deep Sedation for Catheter Ablation of Cardiac Arrhythmia.
    Pacing Clin Electrophysiol 2017 Feb 27. Epub 2017 Feb 27.
    Department of Electrophysiology and Cardiac Rhythm Management, St. Josef-Hospital, Universitätsklinikum der Ruhr-Universität, Bochum, Germany.
    Background: Patients' satisfaction with invasive procedures largely relies on periprocedural perception of pain and discomfort. The necessity for intraprocedural sedation during catheter ablation of cardiac arrhythmias for technical reasons is widely accepted, but data on patients' experience of pain and satisfaction with the procedural sedation are scarce. We have assessed patients' pain and discomfort during and after the procedure using a standardized questionnaire. Read More

    Specialized Imaging and Procedures in Pediatric Pancreatology: A North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition Clinical Report.
    J Pediatr Gastroenterol Nutr 2017 Mar;64(3):472-484
    *Cincinnati Children's Hospital Medical Center, Cincinnati, OH †University of Texas Southwestern Medical School, Dallas, TX ‡Levine Children's Hospital, Charlotte, NC §Boston Children's Hospital, Boston, MA ||Baylor College of Medicine, Houston, TX ¶Montreal Children's Hospital, McGill University, Montreal, QC, Canada.
    Objectives: An increasing number of children are being diagnosed with pancreatitis and other pancreatic abnormalities. Dissemination of the information regarding existing imaging techniques and endoscopic modalities to diagnose and manage pancreatic disorders in children is sorely needed.

    Methods: We conducted a review of the medical literature on the use of the following imaging and procedural modalities in pediatric pancreatology: transabdominal ultrasonography (TUS), computed tomography (CT), magnetic resonance imaging (MRI)/magnetic resonance cholangiopancreatography (MRCP), endoscopic ultrasonography (EUS), and endoscopic retrograde cholangiopancreatography (ERCP). Read More

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