Paediatr Anaesth 2017 Sep 20. 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

BMJ Open 2017 Sep 21;7(9):e015727. Epub 2017 Sep 21.

Department of Pharmacology, College of Pharmacy, Ningxia Medical University, Yinchuan, China.

Objective: To obtain in-depth insight into the perceptions of parents and paediatricians in China regarding current procedural pain management on bone marrow aspirations and lumbar punctures in paediatric haemato-oncology department.

Design, Setting And Participants: This qualitative study was conducted in a 4500-bed university hospital in northwest China. To collect data, in-depth semistructured interviews were conducted with parents of children with acute leukaemia (n=12) and haemato-oncology paediatricians (n=11) using purposive sampling. Read More

Acad Emerg Med 2017 Sep 19. Epub 2017 Sep 19.

Carolinas Medical Center, Department of Emergency Medicine, Charlotte, North Carolina.

Objective: We compared the tolerability and efficacy of intranasal sub-dissociative ketamine to intranasal fentanyl for analgesia of children with acute traumatic pain and investigated the feasibility of a larger non-inferiority trial that could investigate the potential opioid sparing effects of intranasal ketamine.

Methods: This randomized controlled trial compared intranasal ketamine 1 mg/kg to intranasal fentanyl 1.5 μg/kg in children 4-17 years old with acute pain from suspected, isolated extremity fractures presenting to an urban level II pediatric trauma center from December 2015 to November 2016. Read More

Cardiovasc Revasc Med 2017 Aug 12. Epub 2017 Aug 12.

University of Minnesota Fairview Medical Center, Minneapolis, MN, United States; Minneapolis VA Healthcare System, Minneapolis, MN, United States. Electronic address:

Background: Transcatheter Aortic Valve Replacement (TAVR) is increasingly performed using a minimalist approach under monitored anesthesia care (MAC). The safety of this approach remains controversial and adoption has been low in the US.

Methods: The study cohort was comprised of 130 patients (98% male) who underwent TAVR between 4/2015 and 4/2017 at the Minneapolis VA. Read More

Anesth Analg 2017 Sep 14. Epub 2017 Sep 14.

From the *Department of Anesthesiology, University of Rochester School of Medicine and Dentistry, Rochester, New York; †Department of Anesthesiology, Robert Wood Johnson - Saint Barnabas Health System, Livingston, New Jersey; ‡Department of Anesthesiology, University of Florida, Jacksonville, Florida; §Division of Pediatric Hospital Medicine, Washington University, St Louis Children's Hospital, St Louis, Missouri; ‖Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts; ¶Department of Pediatrics, University of Massachusetts Medical School, UMass Memorial Children's Medical Center, Worcester, Massachusetts; #Division of Pediatric Dentistry, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; **Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington; ††Departments of Anesthesiology, Neurology, and Psychiatry, University of Rochester School of Medicine and Dentistry, Rochester, New York; ‡‡Department of Anesthesiology, University of Rochester School of Medicine and Dentistry, Rochester, New York; and §§Department of Anesthesiology, Tufts School of Medicine, Boston, Massachusetts.

Objective evaluations comparing different techniques and approaches to pediatric procedural sedation studies have been limited by a lack of consistency among the outcome measures used in assessment. This study reviewed those existing measures, which have undergone psychometric analysis in a pediatric procedural sedation setting, to determine to what extent and in what circumstances their use is justified across the spectrum of procedures, age groups, and techniques. The results of our study suggest that a wide range of measures has been used to assess the efficacy and effectiveness of pediatric procedural sedation. Read More

J Vasc Interv Radiol 2017 Sep 13. Epub 2017 Sep 13.

Division of Vascular and Interventional Radiology, Department of Medical Imaging, University of Toronto, University Health Network, 200 Elizabeth St., Toronto, M5G 2C4, Canada.

Purpose: To evaluate oncologic outcomes and graft viability after percutaneous RF ablation of renal cell carcinoma (RCC) developing within renal transplant allografts.

Materials And Methods: A single-institution, retrospective study reviewed all patients treated with RF ablation for RCC between February 2004 and May 2016. Ten patients were identified (age 49. Read More

Rom J Anaesth Intensive Care 2016 Oct;23(2):149-153

Department of Anesthesiology, Mayo Clinic, Jacksonville, FL, USA.

Background And Aims: To assess the efficacy of bilateral thoracic paravertebral nerve blocks (PVB) in providing procedural anesthesia and post-procedural analgesia for placement of percutaneous radiologic gastrostomy tubes (PRG) in patients with amyotrophic lateral sclerosis (ALS).

Methods: We prospectively observed 10 patients with ALS scheduled for PRG placement that had bilateral thoracic PVBs at thoracic 7, 8, and 9 levels with administration of a mixture of 3 mL of 1% ropivacaine, 0.5 mg/mL dexamethasone, and 5 μg/mL epinephrine at each level. Read More

Cardiol Young 2017 Sep 11:1-12. Epub 2017 Sep 11.

1Advanced Cardiac Imaging,Minneapolis Heart Institute and Foundation,Minneapolis,Minnesota,United States of America.

Objective: We sought to evaluate the risk and image quality from cardiovascular CT in patients across all stages of single-ventricle palliation, and to define accuracy by comparing findings with intervention and surgery.

Methods: Consecutive CT scans performed in patients with single-ventricle heart disease were retrospectively reviewed at a single institution. Diagnosis, sedation needs, estimated radiation dose, and adverse events were recorded. Read More

Neth Heart J 2017 Sep 8. Epub 2017 Sep 8.

Department of Cardiology, St Antonius Hospital, Nieuwegein, The Netherlands.

Introduction: Structural heart interventions are guided by transoesophageal or intracardiac echocardiography (TEE/ICE). MicroTEE, developed for paediatric purposes, is smaller and therefore less invasive and traumatic, avoiding the need for general anaesthesia. We aimed to show feasibility of procedural guidance by comparing image quality of microTEE with standard TEE and ICE during adult transcatheter interventions, and assess the accuracy in obtaining left atrial appendage (LAA) measurements between the microTEE probe and standard TEE. Read More

Anasthesiol Intensivmed Notfallmed Schmerzther 2017 Sep 8;52(9):630-639. Epub 2017 Sep 8.

Remifentanil is a short-acting opioid of high analgetic potency and superior controllability. It is widely used in day-case surgery, procedural sedation, for reduction of recovery-times and obstetrics and whenever excellent controllability of opioid effects is needed. Especially in combination with propofol it is used for target controlled infusion (TCI). Read More

Orthopedics 2017 Sep 6:1-7. Epub 2017 Sep 6.

Effective treatment of pediatric both bone forearm fractures consists of timely restoration of anatomic alignment with manipulation and immobilization, often accomplished with the aid of procedural sedation in the emergency department setting. The current lack of consensus regarding a safe and optimal regimen may result in inadequate sedation, compromised quality of reduction, or patient harm. The current study was conducted to answer the following questions for pediatric both bone forearm fractures treated with closed reduction with either ketamine or propofol procedural sedation: (1) Is there a difference in the rate of unacceptable alignment 4 weeks after reduction? (2) Is there a difference in the rates of major sedation-related complications? Medical records, data on procedural sedation, and radiographs of 74 skeletally immature patients with diaphyseal or distal metaphyseal both bone forearm fractures treated with manipulation were reviewed (ketamine sedation, 26; propofol sedation, 48). Read More

Eur J Anaesthesiol 2017 Sep 5. Epub 2017 Sep 5.

aFrom the Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Cologne, Germany (JH), Anaesthesiology Institute, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates (ML), Department of Clinical Sciences Malmö, Anaesthesiology and Intensive Care Medicine, Lund University Faculty of Medicine, Malmö, Sweden (JA), Centre for Evidence-Based Medicine, Faculty of Medicine, University of Lisbon, Lisbon, Portugal (JS,JC), Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples 'Federico II', Naples, Italy (EDR), Department of Anaesthesiology and Intensive Care, Hôpitaux Universitaires Paris Nord Val de Sein, Paris, France (DL), Clinical Department of Anaesthesiology and Intensive Care, University Medical Centre, Ljubljana, Slovenia (VNJ), Perioperative Medicine, Pain Therapy, RRS and Intensive Care Department, Anaesthesiology and Intensive Care University of Chieti-Pescara, Chieti, Italy (FP), Department of Anaesthesiology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands (MMRFS), Anesthésie, Hôpital Jeanne de Flandre, Lille (FV), Fuchs-Buder T. Department of Anaesthesiology and Critical Carel, CHRU Nancy, University of Lorraine, Nancy, France (TFB); and Karl Landsteiner Institute for Anaesthesiology and Intensive Care Medicine, Vienna, Austria (RF) *Chairman of the ESA/EBA taskforce for procedural sedation and analgesia guidelines in adults. †Co-chairman of the ESA/EBA taskforce for procedural sedation and analgesia guidelines in adults.

: Procedural sedation and analgesia (PSA) has become a widespread practice given the increasing demand to relieve anxiety, discomfort and pain during invasive diagnostic and therapeutic procedures. The role of, and credentialing required by, anaesthesiologists and practitioners performing PSA has been debated for years in different guidelines. For this reason, the European Society of Anaesthesiology (ESA) and the European Board of Anaesthesiology have created a taskforce of experts that has been assigned to create an evidence-based guideline and, whenever the evidence was weak, a consensus amongst experts on: the evaluation of adult patients undergoing PSA, the role and competences required for the clinicians to safely perform PSA, the commonly used drugs for PSA, the adverse events that PSA can lead to, the minimum monitoring requirements and post-procedure discharge criteria. Read More

J Gastroenterol Hepatol 2017 Sep 5. Epub 2017 Sep 5.

Division of Gastroenterology, Department of Medicine, Evergreen General Hospital, Taoyuan, Taiwan.

Background And Aim: Same-day bidirectional endoscopy (BDE) is a commonly performed procedure, but the optimal sequence for the procedure with moderate conscious sedation is not well-established. We investigated the optimal sequence for same-day BDE under moderate conscious sedation and carbon dioxide insufflation in terms of sedation doses, patient discomfort, and colonoscopy performance.

Methods: We performed a prospective randomized controlled study of 120 patients who were scheduled for BDE examination. Read More

Circulation 2017 Sep 1. Epub 2017 Sep 1.

Division of Cardiovascular Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA & Penn Cardiovascular Quality, Outcomes, and Evaluative Research Center, Philadelphia, PA

Background -Conscious sedation is used during transcatheter aortic valve replacement (TAVR) with limited evidence as to the safety and efficacy of this practice. Methods -The NCDR STS/ACC TVT Registry was used to characterize the anesthesia choice and clinical outcomes of all U.S. Read More

Vasc Health Risk Manag 2017 10;13:305-309. Epub 2017 Aug 10.

Division of Vascular Surgery, Department of Surgery, King Abdulaziz Medical City, Riyadh, Saudi Arabia.

Background: Endoluminal laser ablation is now considered the method of choice for treating greater saphenous vein insufficiency. General anesthesia and peripheral nerve blocks with sedation have the risk of post-procedural delay in discharge and prolonged immobilization with the risk of deep vein thrombosis. The main pain experienced by patients during the procedure is during the laser ablation and the multiple needle punctures given along and around the great saphenous vein. Read More

Curr Med Res Opin 2017 Sep 1:1-9. Epub 2017 Sep 1.

a Department of Anesthesiology and Pain Medicine , Chung-Ang University College of Medicine , Seoul , Republic of Korea.

Objective: To compare the efficacy and safety of bolus infusion versus continuous infusion for propofol sedation.

Methods: We searched OVID-MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Google Scholar, Koreamed, and Kmbase databases to identify all randomized controlled trials that compared bolus infusion with continuous infusion for propofol sedation. We evaluated propofol dose used, procedure, sedation, and recovery time. Read More

Catheter Cardiovasc Interv 2017 Aug 24. Epub 2017 Aug 24.

San Borja Arriaran Hospital and University of Chile, Santiago, Región Metropolitana, Chile.

Objective: This registry aimed to describe the safety and feasibility of a single trans-septal (TS) access technique for left intracardiac echocardiography (ICE) guidance of left-atrial appendage (LAA) closure procedure.

Background: LAA closure is currently accepted as an alternative to oral anticoagulation (OAC) in patients with non-valvular atrial fibrillation (NVAF) who are at high-risk for bleeding. Currently, LAA closure procedure is typically performed under trans-esophageal echocardiogram (TEE) guidance. Read More

JAMA Pediatr 2017 Aug 21. Epub 2017 Aug 21.

Department of Pediatrics, University of Minnesota Medical School, Minneapolis.

Importance: Procedural sedation for children undergoing painful procedures is standard practice in emergency departments worldwide. Previous studies of emergency department sedation are limited by their single-center design and are underpowered to identify risk factors for serious adverse events (SAEs), thereby limiting their influence on sedation practice and patient outcomes.

Objective: To examine the incidence and risk factors associated with sedation-related SAEs. Read More

Korean J Intern Med 2017 Sep 22;32(5):819-826. Epub 2017 Aug 22.

Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.

Background/aims: Some people have difficulty tolerating upper endoscopy. The cause of and risk factors for this are not well known. The aim of this study was to investigate the factors involved in poor cooperation during screening upper endoscopy. Read More

Acad Emerg Med 2017 Aug 12. Epub 2017 Aug 12.

Department of Emergency Medicine, Hennepin County Medical Center, Department of Emergency Medicine, University of Minnesota, Minneapolis, MN.

Scand J Gastroenterol 2017 Nov 11;52(11):1298-1303. Epub 2017 Aug 11.

a Digestive Disease Center , Bispebjerg Hospital, University of Copenhagen , Copenhagen , Denmark.

Objectives: To investigate the diagnostic performance of Full Spectrum Endoscopy (FUSE) compared to a conventional standard forward-viewing endoscope (SFV). The primary outcome was adenoma detection rate (ADR) and mean adenoma detection. Secondary outcome was feasibility of FUSE opposed to SFV. Read More

Hosp Pediatr 2017 Sep 10;7(9):542-546. Epub 2017 Aug 10.

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

Objectives: Obesity increases the risk of complications during pediatric procedural sedation. The risk of being underweight has not been evaluated in this arena. We therefore investigated the association of BMI with sedation dosing and adverse events in children across a range of BMIs. Read More

Korean J Anesthesiol 2017 Aug 15;70(4):439-445. Epub 2017 Mar 15.

Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA, USA.

Background: Virtual reality (VR) distraction is a nonpharmacological method to prevent acute pain that has not yet been thoroughly explored for anesthesiology. We present our experience using VR distraction to decrease routine intravenous sedation for patients undergoing preoperative perineural catheter insertion.

Methods: This 1-month quality improvement project involved all elective unilateral primary total knee arthroplasty patients who received a preoperative adductor canal catheter. Read More

J Pediatr Adolesc Gynecol 2017 Aug 3. Epub 2017 Aug 3.

Department of Obstetrics and Gynecology, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri; Section of Gynecological Surgery, Department of Surgery, Children's Mercy Hospital, Kansas City, Missouri.

Study Objective: To evaluate the characteristics of girls with accidental genital trauma (AGT) who can be managed in the emergency department (ED) versus the operating suite (OS).

Design: Retrospective cohort.

Setting: ED at a children's hospital in a metropolitan area. Read More

Orthop Traumatol Surg Res 2017 Aug 3. Epub 2017 Aug 3.

Service d'orthopédie infantile, hôpitaux pédiatriques de Nice CHU-Lenval, 57, avenue de la Californie, 06000 Nice, France. Electronic address:

Background: Supracondylar fractures of the elbow with major displacement are usually treated by surgical pinning and less often non-operatively as described by Blount. The objective of this study was to assess the clinical and radiological outcomes of Gartland type III supracondylar fractures treated at least 3 years earlier using Blount's method.

Hypothesis: Blount's method produces good outcomes after more than 3 years when used to treat Gartland type III supracondylar fractures of the humerus. Read More

Pediatrics 2017 Jul;140(1)

Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Harvard University, Boston, Massachusetts.

Background: Upper respiratory infections (URIs) are associated with airway adverse events (AAEs) during general anesthesia. There have been no large studies examining the relationship between URIs and AAEs during pediatric procedural sedation. We hypothesized that there would be a relationship between URI status and AAEs in pediatric procedural sedation. Read More

Ann Emerg Med 2017 Jul 26. Epub 2017 Jul 26.

Department of Emergency Medicine, Rush University Medical Center, Chicago, IL.

Gastrointest Endosc 2017 Jul 24. Epub 2017 Jul 24.

Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China; Department of Anaesthesia and Intensive Care, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.

Background And Aims: The role of electroacupuncture (EA) in reducing sedative and analgesic requirements during EUS is uncertain. The aim of the current study is to investigate the efficacy of EA in reducing procedure-related pain and discomfort during EUS.

Methods: This was a double-blinded randomized controlled study conducted between March 2014 and July 2016. Read More

Anasthesiol Intensivmed Notfallmed Schmerzther 2017 Jul 25;52(7-08):543-553. Epub 2017 Jul 25.

Remifentanil is a short-acting opioid of high analgetic potency and superior controllability. It is widely used in day-case surgery, procedural sedation, for reduction of recovery-times and obstetrics and whenever excellent controllability of opioid effects is needed. Especially in combination with Propofol it is used for target-controlled infusion (TCI). Read More

Rev Esp Enferm Dig 2017 Aug;109(8):602-603

Aparato Digestivo, Hospital Universitario Central de Asturias, España.

Sedation is a key component of digestive endoscopy. While ensuring procedural safety and quality represents a primary goal, a detailed assessment of patient-focused risks and improvements is lacking on most occasions. Failure mode and effect analysis (FMEA) is a useful tool in this context as a means of raising barriers and defense mechanisms to prevent adverse events from developing. Read More

Catheter Cardiovasc Interv 2017 Jul 24. Epub 2017 Jul 24.

Department of Anesthesiology, Mayo Clinic, Scottsdale, Arizona.

Background: Transcatheter aortic valve replacement (TAVR) is typically performed under general anesthesia (GA). However, there is increasing data supporting the safety of performing TAVR under local anesthesia/conscious sedation (LA). We performed a meta-analysis to gain better understanding of the safety and efficacy of LA versus GA in patients with severe aortic stenosis undergoing TAVR. Read More

Anesth Analg 2017 Aug;125(2):703-704

University of Rochester School of Medicine and Dentistry, Rochester, New York, Tufts School of Medicine, Boston, Massachusetts, of Anesthesiology, University of Rochester School of Medicine and Dentistry, Rochester, New YorkDepartment of Anesthesiology and Pain Medicine, University of Washington, Seattle, WashingtonDepartment of Anesthesiology, University of Rochester School of Medicine and Dentistry, Rochester, New YorkDepartment of Outcomes Research, Anesthesiology Institute, Cleveland Clinic, Cleveland, OhioDepartment of Anesthesia, University of Iowa, Iowa City, Iowa.

J Obstet Gynecol Neonatal Nurs 2017 Sep - Oct;46(5):755-763. Epub 2017 Jul 17.

Objective: To evaluate the provision of procedural sedation during abortion by expert nurses and to describe the factors that are associated with time to discharge for women who receive this sedation.

Design: Retrospective chart review.

Methods: Descriptive statistics were generated to describe a retrospective cohort of women presenting for abortion under procedural sedation. Read More

Lasers Med Sci 2017 Jul 12. Epub 2017 Jul 12.

Department of Anesthesia, Medical Faculty University of Belgrade, Belgrade, Serbia.

The aim of our study was to research and evaluate cardiovascular and respiratory stability, clinical efficacy, and safety of two different anesthetic agents in pediatric patients who underwent Pulse dye (wavelength 595 nm, pulse duration 0-40 ms, power 0-40 J) and CO2 (wavelength 10,600 nm, intensity-fraxel mod with SX index 4 to 8, power 0-30 W) laser procedure. This prospective non-blinded study included 203 pediatric patients ASA I-II, aged between 1 month and 12 years who underwent short-term procedural sedation and analgesia for the laser procedure. After oral premedication with midazolam, 103 children were analgo-sedated with ketamine and fentanyl (K group) and 100 with ketofol and fentanyl (KT group). Read More

World J Emerg Med 2017 ;8(3):165-169

Department of Emergency Medicine, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia B3H 3A6, Canada.

Background: Atrial fibrillation (AF) is the most common arrhythmia treated in the emergency department (ED), with primary electrical cardioversion (PEC) the preferred method of rhythm control. Anecdotally, patients undergoing ED procedural sedation (EDPS) for PEC differ from those requiring EDPS for other procedures: they are at higher risk of adverse events, and require fewer drugs and lower doses. We attempt to verify this using an EDPS registry at a Canadian, tertiary care teaching hospital. Read More

J Cardiothorac Vasc Anesth 2017 Mar 27. Epub 2017 Mar 27.

Department of Anesthesiology and Critical Care, Cardiothoracic Division, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA.

The development of transcatheter aortic valve replacement (TAVR) has transformed the treatment of patients with aortic valve disease. This procedure now is used widely for patients at high and intermediate risk for surgical aortic valve replacement. The rapid acceptance and popularity of TAVR most clearly was enabled by advancements in device technology and procedural experience. Read More

Paediatr Respir Rev 2017 Jun 1. Epub 2017 Jun 1.

Department of Biology and Pharmacy, School of Medicine, Universidade de Santa Cruz do Sul (UNISC), Santa Cruz do Sul, Brazil.

Pneumonia is an important health problem in children, and parapneumonic pleural effusion (PPE) is a frequent complication. There is no standard strategy for treating PPE, reflected in the few international guidelines that have been published on the issue. Compared to adults, there is no consensus on the utility of pleural fluid analysis in paediatric PPE. Read More

BMJ Open 2017 Jun 30;7(6):e013402. Epub 2017 Jun 30.

Division of Pediatric Gastroenterology, UMass Memorial Children's Medical Center, Westborough, Massachusetts, USA.

Objective: To evaluate the effect of capnography monitoring on sedation-related adverse events during procedural sedation and analgesia (PSA) administered for ambulatory surgery relative to visual assessment and pulse oximetry alone.

Design And Setting: Systematic literature review and random effects meta-analysis of randomised controlled trials (RCTs) reporting sedation-related adverse event incidence when adding capnography to visual assessment and pulse oximetry in patients undergoing PSA during ambulatory surgery in the hospital setting. Searches for eligible studies published between 1 January 1995 and 31 December 2016 (inclusive) were conducted in PubMed, the Cochrane Library and EMBASE without any language constraints. Read More

Anesth Essays Res 2017 Apr-Jun;11(2):294-299

Department of Anaesthesiology and Critical Care, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth University, Puducherry, India.

Introduction: There is increasing evidence to include sedation as an integral part of regional anesthesia to ensure patient comfort. This may compromise patient cooperation, an important component of regional anesthesia. We decided to determine the efficacy of dexmedetomidine (0. Read More

PLoS One 2017 29;12(6):e0180187. Epub 2017 Jun 29.

Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts, United States of America.

Background: Monitoring respiratory status using end tidal CO2 (EtCO2), which reliably reflects arterial PaCO2 in intubated patients under general anesthesia, has often proven both inaccurate and inadequate when monitoring non-intubated and spontaneously breathing patients. This is particularly important in patients undergoing procedural sedation (e.g. Read More

Paediatr Drugs 2017 Aug;19(4):377

Emergency Department, Institute for Maternal and Child Health IRCCS "Burlo Garofolo", via dell'Istria 65/1, 34132, Trieste, Italy.

Paediatr Drugs 2017 Aug;19(4):375-376

Department of Anesthesiology, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth (SBV) University, Ammapettai, Kancheepuram Dt, Chennai, 603108, India.

Anaesthesia 2017 Jun;72(6):694-703

Guy's and St Thomas' NHS Foundation Trust, London, UK.

Contemporary data are lacking for procedural practice, training provision and outcomes for awake fibreoptic intubation in the UK. We performed a prospective cohort study of awake fibreoptic intubations at a tertiary centre to assess current practice. Data from 600 elective or emergency awake fibreoptic intubations were collected to include information on patient and operator demographics, technical performance and complications. Read More

Pediatr Crit Care Med 2017 Aug;18(8):e356-e363

1Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA. 2Department of Pediatrics, Emory University School of Medicine, Atlanta, GA. 3Department of Pediatrics, Case Western Reserve University, Rainbow Babies' and Children's Hospital, Cleveland, OH. 4Department of Pediatrics, Baylor College of Medicine, Children's Hospital of San Antonio, San Antonio, TX. 5Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX. 6Department of Pediatrics and Emergency Medicine, University of Minnesota Medical School, Minneapolis, MN. 7Department of Anesthesia, Pain, and Perioperative Medicine, Boston Children's Hospital, Boston, MA.

Objectives: Outcomes associated with a sedative regimen comprised ketamine + propofol for pediatric procedural sedation outside of both the pediatric emergency department and operating room are underreported. We used the Pediatric Sedation Research Consortium database to describe a multicenter experience with ketamine + propofol by pediatric sedation providers.

Design: Prospective observational study of children receiving IV ketamine + propofol for procedural sedation outside of the operating room and emergency department using data abstracted from the Pediatric Sedation Research Consortium during 2007-2015. Read More

Urolithiasis 2017 Jun 22. Epub 2017 Jun 22.

Dr. Lütfi Kirdar Training and Research Hospital, Urology Clinic, Şemsi Denizer caddesi, 34865, Cevizli-Kartal, Istanbul, Turkey.

The aim of this study was to evaluate anesthesia practice for pediatric extracorporeal shock wave lithotripsy (ESWL) according to the age groups and discuss the anesthetic management of these patients. Pediatric patients treated with ESWL because of urolithiasis under anesthesia in our department between December 2007 and January 2017 were evaluated retrospectively. A total of 251 patients were divided into two groups as Group PS: preschool children (<6 years) and Group S: school children (≥6 years). Read More

Contraception 2017 Aug 16;96(2):118-123. Epub 2017 Jun 16.

University of New Mexico, Department of Obstetrics and Gynecology; Department of Family and Community Medicine.

Objective: The objective of the study was to compare nitrous oxide with oxygen (N2O/O2) to oral hydrocodone/acetaminophen and lorazepam for analgesia during first-trimester surgical abortion.

Study Design: This double-blind randomized trial assigned women undergoing first-trimester surgical abortion at<11 weeks' gestation to inhaled N2O/O2 vs. oral sedation for pain management. Read More

Endosc Ultrasound 2017 May-Jun;6(3):195-200

Division of Gastroenterology and Hepatology, University of Pennsylvania Health System, Philadelphia, PA, USA.

Background And Objectives: The safety and utility of endoscopic ultrasound (EUS) for the evaluation and management of gastrointestinal (GI) tract disorders among adults has been established. The literature on safety and efficacy in a pediatric referral population (under 21 years of age) is limited. We hypothesized that EUS is safe and useful in the pediatric population. Read More

Rev Assoc Med Bras (1992) 2017 Apr;63(4):299-300

MD, MSc, PhD, Pediatric Intensive Care Unit, Universidade de São Paulo, São Paulo, SP, Brazil.