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Anesth Analg 2019 Jan 8. Epub 2019 Jan 8.

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

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

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

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

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

Emerg Med J 2019 Jan 10. Epub 2019 Jan 10.

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

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

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

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

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

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

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

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

J Anesth 2019 Jan 7. Epub 2019 Jan 7.

Department of Emergency Medicine, University of New Mexico, MSC11 6025, 1 UNM, Albuquerque, NM, 87131-0001, USA.

Purpose: Procedural sedation and analgesia (PSA) is widely performed outside of the operating theater, often in emergency departments (EDs). The practice and safety of PSA in the ED in an aging society such as in Japan have not been well described. We aimed to characterize the practice pattern of PSA including indications, pharmacology and incidence of adverse events (AEs) in Japan. Read More

Ann Emerg Med 2019 Jan 3. Epub 2019 Jan 3.

Department of Emergency Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Study Objective: We evaluate the effect of midazolam and haloperidol premedication for reducing ketamine-induced recovery agitation in adult patients undergoing procedural sedation. We also compare physician satisfaction and recovery time.

Methods: We randomized emergency department patients older than 18 years who needed procedural sedation to receive 1 of the following 3 interventions in double-blind fashion 5 minutes before receiving intravenous ketamine at 1 mg/kg: intravenous distilled water, intravenous midazolam at 0. Read More

J Clin Monit Comput 2019 Jan 4. Epub 2019 Jan 4.

Department of Anesthesiology, CUB Erasme, Université Libre de Bruxelles, Route de Lennik 808, 1070, Brussels, Belgium.

Perioperative complications related to obstructive sleep apnea still occur despite the use of partial pressure end-tidal CO[Formula: see text] and pulse oximetry. Airway obstruction can complicate propofol sedation and a novel monitor combining mandibular movement analysis with capnography may facilitate its detection. Patients scheduled for sleep endoscopy were recruited and monitored with standard monitoring, [Formula: see text] and Jaw Activity (JAWAC) mandibular movement sensors. Read More

Eur J Gastroenterol Hepatol 2018 Dec 21. Epub 2018 Dec 21.

Department of Neurology, University Medical Centre Groningen (UMCG), University of Groningen, Groningen, The Netherlands.

Objective: This study explored the willingness of patients to start colonoscopy with virtual reality (VR) instead of procedural sedation and analgesia (PSA), as well as their motives and characteristics. There is a growing interest in colonoscopy without PSA. Offering VR as a distraction technique instead of PSA may increase the percentage of colonoscopies without PSA. Read More

Emerg (Tehran) 2018 2;6(1):e57. Epub 2018 Oct 2.

Introduction: Need for procedural sedation and analgesia (PSA) is felt in emergency department (ED) more and more each day. This study aimed to compare the effectiveness of low-dose fentanyl, propofol, midazolam, ketamine and lidocaine combination with regular dose of propofol and fentanyl combination for induction of deep sedation.

Methods: In this single-blind clinical trial, candidate patients for sedation and analgesia aged more than 15 and less than 60 years old, with pain score ≥6 were allocated to one of the groups using block randomization and were compared regarding onset of action, recovery time, and probable side effects. Read More

JMIR Res Protoc 2018 Dec 21;7(12):e10363. Epub 2018 Dec 21.

Division of Pediatric Emergency Medicine, Montreal Children's Hospital, McGill University Health Centre, Montreal, QC, Canada.

Background: Distal forearm fractures are among the most common injuries presenting to the pediatric emergency department (PED). Bier block (BB), or intravenous regional anesthesia, is a safe and effective alternative to procedural sedation for closed reduction of forearm fractures; it is associated with fewer adverse events, a shorter length of stay, and reduced costs. BB has long remained relatively underutilized; however, with an increasing emphasis on efficient resource use and patient-centered care, there is renewed interest in this technique. Read More

Surg Technol Int 2018 Dec 20;34. Epub 2018 Dec 20.

Department of Diagnostic Imaging, Rhode Island Hospital, Providence, RI.

Lung cancer remains the leading cause of cancer death in the United States, and accounts for more deaths than breast, colon, and prostate cancer combined. Over the past decade, percutaneous thermal ablative therapy (PTA) has become a useful adjunctive therapy in combination with longer-standing methods, or as a standalone treatment. The physiologic basis of thermal ablation is that coagulative necrosis and cell death occur at temperatures above 60°C. Read More

United European Gastroenterol J 2018 Dec 15;6(10):1556-1562. Epub 2018 Sep 15.

Trinity Academic Gastroenterology Group, Trinity College Dublin & Tallaght University Hospital, Dublin, Ireland.

Background: Same-day colon capsule endoscopy (CCE) immediately following incomplete optical colonoscopy (OC) would have a number of advantages for patients, while also presenting unique procedural challenges including the effect of sedation on capsule propulsion and patient tolerance of protracted preparation and fasting.

Aim: The aim of this article is to prospectively assess the efficacy of same-day CCE after incomplete OC in an unselected patient cohort.

Methods: This was an observational, prospective, single-centre study of CCE post-incomplete colonoscopies. Read More

Neonatal Netw 2018 Jul 1;37(4):238-247. Epub 2018 Jul 1.

Endotracheal intubation, a common procedure in neonatal intensive care, results in distress and disturbs physiologic homeostasis in the newborn. Analgesics, sedatives, vagolytics, and/or muscle relaxants have the potential to blunt these adverse effects, reduce the duration of the procedure, and minimize the number of attempts necessary to intubate the neonate. The medical care team must understand efficacy, safety, and pharmacokinetic data for individual medications to select the optimal cocktail for each clinical situation. Read More

J Neonatal Perinatal Med 2018 Dec 11. Epub 2018 Dec 11.

Department of Pediatrics, Division of Neonatal-Perinatal Medicine, Duke University Medical Center, Durham, NC, USA.

Background: The intranasal route is a minimally invasive method for rapidly delivering midazolam and fentanyl to provide short-term analgesia and sedation in infants. However, intranasal use of midazolam and fentanyl is not labeled for infants and safety data are sparse. The objective of this study is to evaluate the safety of intranasal midazolam and intranasal fentanyl in infants admitted to the Neonatal Intensive Care Unit (NICU). Read More

Can J Urol 2018 Dec;25(6):9596-9600

MD/PhD Program, Texas A & M Health Science Center College of Medicine, Temple, Texas, USA.

Introduction: Stent placement is a common procedure for addressing obstructive uropathy. However, lack of operating room (OR) availability can substantially delay this procedure. In this study, we sought to assess the feasibility, safety, and efficacy of this procedure in a clinical setting using nitrous oxide (N2O) and local anesthesia. Read More

Pediatr Pulmonol 2019 Feb 11;54(2):200-204. Epub 2018 Dec 11.

Case Western Reserve University School of Medicine, Cleveland, Ohio.

Background: Periostin is a protein that serves as a downstream marker of the T-helper type 2 (Th2) cell response. It may serve to identify drug-responsive inflammatory phenotypes, particularly in children with asthma and possibly bronchiolitis. There are no published levels of periostin in healthy children <2 years of age, limiting interpretation of periostin levels in disease. Read More

Hosp Pediatr 2019 Jan 12;9(1):16-23. Epub 2018 Dec 12.

Department of Pediatrics, Herman and Walter Samuelson Children's Hospital at Sinai, Baltimore, Maryland.

Background And Objectives: Anaphylaxis is rare but life-threatening. Its incidence during pediatric procedural sedation outside of the operating room is unknown. We used data from the Pediatric Sedation Research Consortium (PSRC) to determine the incidence and nature of allergic and anaphylactic reactions in this practice. Read More

AACN Adv Crit Care 2018 ;29(4):405-414

John J. Gallagher is Trauma Program Manager/Clinical Nurse Specialist at Penn Presbyterian Medical Center, 51 N 39th Street, Medical Office Building, Suite 120, Philadelphia, PA 19104

Procedural sedation is used to alleviate pain and anxiety associated with diagnostic procedures in the acute care setting. Although commonly used, procedural sedation is not without risk. Key to reducing this risk is early identification of risk factors through presedation screening and monitoring during the procedure. Read More

Eur Rev Med Pharmacol Sci 2018 Nov;22(22):7916-7919

Department of Anesthesiology and Intensive Care, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.

We performed a systematic review of the literature starting from a real case of venous air embolism (VAE) in a young infant undergoing central catheterization during procedural sedation. Air embolism due to internal jugular vein catheterization during procedural sedation is very rare, but it is a potentially life-threatening complication of central catheterization that warrants attention. To our knowledge, this is the first case published in a similar scenario. Read More

Am J Emerg Med 2018 Oct 16. Epub 2018 Oct 16.

Wayne State University School of Medicine, Carman and Ann Adams Department of Pediatrics, Division of Emergency Medicine, Children's Hospital of Michigan, 3901 Beaubien Blvd, Detroit, MI 48201, United States of America.

Background And Objectives: Children with autism spectrum disorder (ASD) present more frequently to the emergency department (ED) than children with normal development, and frequently have injuries requiring procedural sedation. Our objective was to describe sedation practice and outcomes in children with ASD in the ED.

Methods: We performed a retrospective chart review of children with ASD who underwent sedation at two tertiary care EDs between January 2009-December 2016. Read More

Pharmacology 2018 Dec 5;103(1-2):82-92. Epub 2018 Dec 5.

Key Laboratory of Cellular Function and Pharmacology of Jilin Province, Yanbian University, Yanji,

Etomidate is an imidazole, nonbarbiturate hypnotic agent that is increasingly used in procedural sedation. However, the effects of etomidate on the spontaneous activity of cerebellar Purkinje cells (PCs) in living mouse have not been fully understood. In this study, we investigated the effects of etomidate on the spontaneous simple spike (SS) activity of PCs in urethane-anesthetized mice by cell-attached recording and pharmacological methods. Read More

BMJ Open Qual 2018 10;7(4):e000161. Epub 2018 Nov 10.

Department of Plastic Surgery, North Bristol NHS Trust, Bristol, UK.

Preoperative fasting is necessary to reduce the risk of regurgitation of gastric contents and pulmonary aspiration in patients undergoing general anaesthetic and procedural sedation. Excessive fasting is associated with metabolic, cardiovascular and gastrointestinal complications and patient discomfort. We aimed to reduce the fasting time for patients on the plastic surgery trauma list. Read More

Rev Esp Enferm Dig 2018 Dec 3;111. Epub 2018 Dec 3.

Anestesiología y Reanimación, Complejo Hospitalario Universitario de Santiago de Compostela. Universidad de Santiago de Compostela, España.

Introduction: sedation is a key component for the improvement of sedation quality. A correct administration requires appropriate training. We performed a study to compare sedation effectiveness, safety and patient satisfaction when administered by gastroenterologists, with and without specific training. Read More

Paediatr Anaesth 2019 Jan 28;29(1):85-91. Epub 2018 Nov 28.

Department of Anesthesiology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.

Background: Intranasal procedural sedation using dexmedetomidine is well described in the literature. The combination of intranasal dexmedetomidine and ketamine is a novel approach for which there are little data on the rate of successful sedation or adverse events.

Objectives: The aim of this study is to evaluate the rate of successful sedation and adverse events of intranasal procedural sedation using a combination of dexmedetomidine and ketamine for diagnostic examination in children. Read More

Paediatr Anaesth 2019 Jan 19;29(1):77-84. Epub 2018 Nov 19.

Department of Anesthesiology, Children's Hospital of Chongqing Medical University, Chongqing, China.

Background: Sedation is often required for young children during transthoracic echocardiography. Dexmedetomidine and ketamine are two sedatives that are commonly used in children for procedural sedation, but they have some disadvantages when they are used alone.

Aims: The aim of this retrospective study was to analyze the effects and safety of intranasal sedation with a combination of dexmedetomidine and ketamine during transthoracic echocardiography in young children and to analyze risk factors for sedation failure. Read More

Gen Dent 2018 Nov-Dec;66(6):19-22

Most children are able to cooperate during conventional, in-office dental treatment using traditional, communicative behavior guidance techniques that are carefully selected and applied to the developmental needs of a particular child. Children who are unable to cooperate during conventional treatment due to a lack of psychological or emotional maturity and/or the existence of a mental, physical, or medical disability may require pharmacologic techniques such as procedural sedation or general anesthesia to complete rehabilitative dental treatment. Patient safety dictates that careful preparation and robust case selection processes guide clinical decision-making related to pharmacologic behavior guidance. Read More

Br J Anaesth 2018 Dec 18;121(6):1236-1241. Epub 2018 Sep 18.

Academic Department of Emergency Medicine, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK. Electronic address:

Background: The elderly are perceived as a high-risk group for procedural sedation. Concern exists regarding the safety of sedation of this patient group by emergency physicians, particularly when using propofol.

Methods: We analysed prospectively collected data on patients aged 75 yr or older undergoing sedation between October 2006 and March 2017 in the emergency department of a single centre. Read More

BJU Int 2018 Nov 15. Epub 2018 Nov 15.

Department of Urology, Guy's at St Thomas' Hospitals, London, UK.

Introduction: Systematic transperineal (TP) and targeted prostate biopsies can be achieved using a freehand access system through perineal punctures, with the potential for reduced morbidity and enabling the procedure under local anesthesia (LA), particularly sepsis.

Objectives: To evaluate the histopathological outcomes, morbidity and tolerability of freehand TP prostate biopsies using the PrecisionPoint access system under local anaesthetic (LA) in the day surgery and outpatient environments.

Methods: 176 patients underwent freehand TP prostate biopsies from May 2016 to November 2017. Read More

Pediatr Crit Care Med 2018 Nov 13. Epub 2018 Nov 13.

Pediatric Critical Care Medicine, Yale School of Medicine, New Haven, CT.

Objectives: Pediatric procedural sedation has been increasingly performed by pediatric intensivists over the past decade. Pediatric Critical Care Medicine fellowship guidelines do not specify how fellows obtain proficiency in pediatric procedural sedation. We sought to survey the state of pediatric procedural sedation training during fellowship and whether fellows thought it was sufficient. Read More

World J Surg 2018 Nov 13. Epub 2018 Nov 13.

Department of Surgery, Örebro University and University Hospital, Örebro & Institute of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.

Background: This is the fourth updated Enhanced Recovery After Surgery (ERAS) Society guideline presenting a consensus for optimal perioperative care in colorectal surgery and providing graded recommendations for each ERAS item within the ERAS protocol.

Methods: A wide database search on English literature publications was performed. Studies on each item within the protocol were selected with particular attention paid to meta-analyses, randomised controlled trials and large prospective cohorts and examined, reviewed and graded according to Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system. Read More

Gut 2019 Feb 12;68(2):186-197. Epub 2018 Nov 12.

Digestive Diseases Center, Showa University Koto-Toyosu Hospital, Tokyo, Japan.

Background: This is a consensus developed by a group of expert endoscopists aiming to standardise the preparation, process and endoscopic procedural steps for diagnosis of early upper gastrointestinal (GI) cancers.

Method: The Delphi method was used to develop consensus statements through identification of clinical questions on diagnostic endoscopy. Three consensus meetings were conducted to consolidate the statements and voting. Read More

J Emerg Med 2018 Nov 8. Epub 2018 Nov 8.

Division of Pediatric Emergency Medicine, Saint Louis University School of Medicine, Saint Louis, Missouri.

Background: Patients undergoing procedural sedation with intravenous ketamine often receive repeat doses to maintain dissociation; however, data between doses are lacking.

Objectives: The purpose of this study was to characterize the frequency, time interval, and dosages of ketamine received by children undergoing procedural sedation and to explore the effects of age and body mass index on these parameters.

Methods: This was a retrospective study of patients 1 to 18 years of age undergoing procedural sedation with intravenous ketamine in a pediatric emergency department between October 2016 and June 2017. Read More

Minerva Anestesiol 2018 Dec 30;84(12):1413-1419. Epub 2018 Oct 30.

Departments of General Anesthesiology and Outcomes Research, Cleveland Clinic, Cleveland, OH, USA.

Preoperative nil per os (NPO) guidelines have been in existence since the recognition of the risk of perioperative aspiration. These guidelines aim at reducing the risk for gastric content aspiration to the lowest possible, to avoid associated morbidity, unplanned hospital and/or an intensive care admission. Thus, such guidelines are not only considered for patients having major surgeries, but more so in those having ambulatory surgery including those performed at non-operating room anesthesia locations. Read More

J Clin Anesth 2018 Nov 1;54:19-24. Epub 2018 Nov 1.

University of Texas Southwestern Medical Center, Dallas, TX, United States of America.

Study Objective: Morbid obesity is associated with adverse airway events including desaturation during deep sedation. Prior works have suggested that proprietary high-flow nasal cannula devices generate positive pressure to all airway structures and may be superior to standard (low-flow) nasal cannula for prevention of desaturation. We hypothesized that, at a similar fraction of inspired oxygen (FiO), use of a High-Flow Nasal Cannula (HFNC) at maximum flow rate would result in a lower incidence of intra-procedural desaturation episodes in morbidly obese patients compared to standard nasal cannula (SNC) during deep sedation with propofol. Read More

Lung India 2018 Nov-Dec;35(6):467-471

Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.

Background And Objectives: No previous study has compared different concentrations of lignocaine for topical anesthesia during endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). In this pilot study, we compared 1% versus 2% lignocaine for topical airway anesthesia during EBUS-TBNA.

Methods: In this double-blind, randomized trial, subjects were randomized to receive either 1% or 2% lignocaine for "spray-as-you-go" administration. Read More

Monaldi Arch Chest Dis 2018 Oct 3;88(3):967. Epub 2018 Oct 3.

Hospital of Vittorio Veneto, Pulmonary Diseases Unit.

The sedation plays an important role in the endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA) procedure. The sedation can be Minimal (anxiolysis), Moderate (conscious sedation) or Deep. The ACCP guidelines suggest that moderate or deep sedation (DS) is an acceptable approach. Read More

Paediatr Anaesth 2018 Dec 29;28(12):1116-1122. Epub 2018 Oct 29.

Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Background: Mucopolysaccharidosis type II patients are reported to have an elevated incidence of difficult airway. Propofol is a commonly used sedative for magnetic resonance imaging in pediatric patients, but patients who receive it may exhibit dose-dependent upper airway obstruction and respiratory depression. Dexmedetomidine also provides adequate procedural sedation with a relatively low risk of airway obstruction. Read More

Acad Emerg Med 2018 Oct 29. Epub 2018 Oct 29.

Departments of Emergency Medicine and Pediatrics, Alpert Medical School of Brown University, Hasbro Children's Hospital/Rhode Island Hospital, Providence, RI.

Objectives: The objective was to use gastric point-of-care ultrasound (POCUS) to assess gastric contents and volume, summarize the prevalence of "full stomach," and explore the relationship between fasting time and gastric contents at the time of procedural sedation.

Methods: This was a prospective study of patients aged 2 to 17 years fasting prior to procedural sedation. A single sonographer scanned each patient's gastric antrum in two positions: supine with the upper body elevated and right lateral decubitus (RLD). Read More

Cardiovasc Drugs Ther 2018 Dec;32(6):625-632

Department of Cardiology, Santa Maria della Misericordia Hospital, Viale Tre Martiri 140, 45100, Rovigo, Italy.

Over the last years, fentanyl, a potent synthetic μ receptor-stimulating opioid, has become one of the most used drugs for both procedural analgesia and sedation in patients undergoing coronary angiography (CA) and/or percutaneous coronary intervention (PCI). However, few studies have been performed to evaluate the efficacy and the impact of this drug in patients with coronary artery disease (CAD) treated with PCI. Most of the previous studies have investigated the self-reported discomfort pain, demonstrating that patients premedicated with fentanyl generally reported a lower pain/discomfort when compared to placebo, benzodiazepines, or local anesthesia at the site of the artery cannulation, without significant variation in the hemodynamic response. Read More

Pediatr Dent 2018 Sep;40(5):346-351

Assistant professor, Department of Research and Graduate Programs, School of Dentistry, University of Missouri, Kansas City, Mo., USA.

The purpose of this study was to assess the use of a dosing scalar for association with the success of procedural sedation in pediatric dentistry. This cross-sectional, retrospective study assessed healthy two- to 12-year-olds who received an elixir of midazolam (0.3 mg/kg), meperidine (1. Read More

J Crit Care 2019 Feb 13;49:14-20. Epub 2018 Oct 13.

Department of Applied Science, Al-Balqa Applied University, Al-Salt, Jordan. Electronic address:

Purpose: To investigate pain levels and factors that are predictive of pain for mechanically ventilated patients during rest and during routine nursing procedures.

Material And Methods: Pain levels were assessed using Behavioral Pain Scale (BPS) and physiological measures among 247 mechanically ventilated patients.

Results: At rest, 33. Read More

Br J Anaesth 2018 Nov 31;121(5):1052-1058. Epub 2018 Aug 31.

Department of Anesthesiology and Perioperative Medicine. Electronic address:

Background: Agitation after general anaesthesia can lead to self-harm, violence against staff, and increased resource utilisation. We aimed to assess patient and procedural characteristics associated with this complication in adults.

Methods: We identified cases of agitation (Richmond Agitation-Sedation Scale score +3 or +4, or administration of haloperidol) in patients after general anaesthesia in the PACU from July 1, 2010 to September 30, 2016. Read More

Front Vet Sci 2018 1;5:233. Epub 2018 Oct 1.

Department of Large Animal Clinical Sciences, Texas A&M University, College Station, TX, United States.

Bone marrow is commonly collected from horses for regenerative medicine applications. Little information is available regarding pain experienced by the horse during bone marrow aspiration. The objective of this study was to characterize horse reaction and pain response during bone marrow aspiration (BMA) compared to a sham (SHAM) procedure. Read More

J Indian Soc Pedod Prev Dent 2018 Oct-Dec;36(4):370-375

Department of Pedodontics and Preventive Dentistry, Uttranchal Dental and Medical Research Institute, Dehradun, Uttrakhand, India.

Objectives: The objective of this study was to assess the safety and efficacy of intranasal and oral dexmedetomidine for procedural sedation in pediatric dental patients.

Materials And Methods: Forty-four uncooperative American Society of Anesthesiologists Grade-I children, requiring dental treatment were randomly divided into four groups who received different doses of dexmedetomidine through intranasal and oral routes. The vital signs were monitored continuously during each visit. Read More

Patient Educ Couns 2018 Sep 29. Epub 2018 Sep 29.

School of Nursing, Midwifery and Paramedicine, Faculty of Health Sciences, Curtin University, Australia.

Objective: Radiation therapy (RT) is a cornerstone for management of pediatric cancer. For younger patients, unintended radiation to critical organs is a concern and children need to remain immobile. Distress in children is common so many centres sedate pediatric patients. Read More

J Med Imaging Radiat Oncol 2018 Dec 8;62(6):781-788. Epub 2018 Oct 8.

Queensland Diagnostic Imaging, Holy Spirit Northside Hospital, Brisbane, Queensland, Australia.

Introduction: Interventional Radiology procedures can provoke anxiety and may be painful. Current practice, Radiologist Controlled Sedation (RCS), involves titrating aliquots of midazolam and fentanyl to patient response but underdosing and overdosing may occur. This study tests a new method of titrating sedation/analgesia during the procedure, Patient Controlled Sedation (PCS), in which a combination of fentanyl and midazolam are administered using a patient-controlled analgesia pump. Read More

Paediatr Anaesth 2018 Nov 3;28(11):1022-1028. Epub 2018 Oct 3.

Department of Anaesthesiology, Guangzhou Women and Children's Medical Centre, Guangzhou Medical University, Guangzhou, Guangdong, China.

Background: Moderate to deep sedation is required for an auditory brainstem response test when high-intensity stimulation is used. Chloral hydrate is the most commonly used sedative, whereas intranasal dexmedetomidine is increasingly used in pediatric non-painful procedural sedations.

Objective: The aim of this study was to compare the sedation success rate after oral chloral hydrate at 50 mg kg and intranasal dexmedetomidine at 3 μg kg plus buccal midazolam at 0. Read More

Pediatr Allergy Immunol Pulmonol 2018 Sep 28;31(3):166-173. Epub 2018 Sep 28.

Division of Pediatric Pulmonology, Department of Pediatrics, University of Chicago, Chicago, Illinois.

Flexible bronchoscopy (FB) can be performed under bronchoscopist administered moderate sedation (BAMS) with a midazolam/fentanyl combination or general anesthesia (GA). However, the outcome of BAMS has not been well established in children. Currently, most of the centers prefer FB under GA. Read More