44,456 results match your criteria Sedation

Efficacy and safety of ciprofol for the sedation/anesthesia in patients undergoing colonoscopy: Phase IIa and IIb multi-center clinical trials.

Eur J Pharm Sci 2021 Jun 8:105904. Epub 2021 Jun 8.

Department of Anesthesiology, West China Hospital, Sichuan University & The Research Units of West China (2018RU012), Chinese Academy of Medical Sciences Chengdu, China. Electronic address:

Objective: Ciprofol is a new intravenous anesthetic agent similar to propofol that has the pharmacodynamic characteristics of a rapid rate of onset and recovery in pre-clinical experiments. The aims of the present clinical trials were to compare the efficacy and safety of ciprofol emulsion for sedation or general anesthesia during colonoscopy and to define optimal doses for a subsequent phase III clinical trial.

Methods: A phase IIa multi-center, open-label, non-randomized, positive control, dose-escalating study was performed to determine a recommended phase IIb dose (RP2D) of ciprofol to induce sedation or anesthesia in patients undergoing colonoscopy. Read More

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ICU Survivorship-The Relationship of Delirium, Sedation, Dementia, and Acquired Weakness.

Crit Care Med 2021 Jun 9. Epub 2021 Jun 9.

Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN. Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center, Nashville, TN. Department of Anesthesiology, Division of Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN. The Institute for Medicine and Public Health, Vanderbilt Center for Health Services Research, Vanderbilt University Medical Center, Nashville, TN. Veterans Affairs Tennessee Valley Healthcare System Geriatric Research Education and Clinical Center (GRECC), Nashville, TN. The Institute for Medicine and Public Health, Vanderbilt Center for Quality Aging, Nashville, TN.

The advent of modern critical care medicine has revolutionized care of the critically ill patient in the last 50 years. The Society of Critical Care Medicine (was formed in recognition of the challenges and need for specialized treatment for these fragile patients. As the specialty has grown, it has achieved impressive scientific advances that have reduced mortality and saved lives. Read More

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Discordance Between Respiratory Drive and Sedation Depth in Critically Ill Patients Receiving Mechanical Ventilation.

Crit Care Med 2021 Jun 9. Epub 2021 Jun 9.

Center for Acute Respiratory Failure, Columbia University College of Physicians and Surgeons and New York-Presbyterian Hospital, New York, NY. Department of Pharmacy, NewYork-Presbyterian Hospital, New York, NY. Division of Pulmonary and Critical Care Medicine, Department of Medicine, Taibah University, Medina, Saudi Arabia. Department of Pharmacy, UC San Diego Health, San Diego, CA. Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY.

Objectives: In mechanically ventilated patients, deep sedation is often assumed to induce "respirolysis," that is, lyse spontaneous respiratory effort, whereas light sedation is often assumed to preserve spontaneous effort. This study was conducted to determine validity of these common assumptions, evaluating the association of respiratory drive with sedation depth and ventilator-free days in acute respiratory failure.

Design: Prospective cohort study. Read More

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Sedation strategy for gastroscopy in obese patients.

J Anesth 2021 Jun 11. Epub 2021 Jun 11.

Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong-An Road, Xi-Cheng District, Beijing, 100050, People's Republic of China.

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Analysis of socioeconomic and demographic factors and imaging exam characteristics associated with missed appointments in pediatric radiology.

Pediatr Radiol 2021 Jun 11. Epub 2021 Jun 11.

Department of Radiology, Massachusetts General Hospital, 55 Fruit St., BLK SB-0029A, Boston, MA, 02114, USA.

Background: Missed appointments can have an adverse impact on health outcomes by delaying appropriate imaging, which can be critical in influencing treatment decisions.

Objective: To assess for socioeconomic and imaging exam factors associated with missed appointments among children scheduled for diagnostic imaging.

Materials And Methods: We retrospectively analyzed children (<18 years) scheduled for outpatient diagnostic imaging during a 12-month period. Read More

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Guidelines on analgosedation, monitoring, and recovery time for flexible bronchoscopy: a systematic review.

BMC Pulm Med 2021 Jun 10;21(1):198. Epub 2021 Jun 10.

Lung Clinic Cologne-Merheim, Thoracic Surgery, Hospital of Cologne, University of Witten/Herdecke, Ostmerheimer Str. 200, 51109, Cologne, Germany.

Background: Patients undergoing bronchoscopy in spontaneous breathing are prone to hypoxaemia and hypercapnia. Sedation, airway obstruction, and lung diseases impair respiration and gas exchange. The restitution of normal respiration takes place in the recovery room. Read More

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Early recovery of frontal EEG slow wave activity during propofol sedation predicts outcome after cardiac arrest.

Resuscitation 2021 Jun 7. Epub 2021 Jun 7.

Department of Anaesthesiology, Intensive Care and Pain Medicine, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.

Aim Of The Study: EEG slow wave activity (SWA) has shown prognostic potential in post-resuscitation care. In this prospective study, we investigated the accuracy of continuously measured early SWA for prediction of the outcome in comatose cardiac arrest (CA) survivors.

Methods: We recorded EEG with a disposable self-adhesive frontal electrode and wireless device continuously starting from ICU admission until 48 hours from return of spontaneous circulation (ROSC) in comatose CA survivors sedated with propofol. Read More

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Endovascular interventions in management of renal artery aneurysm.

Br J Radiol 2021 Jun 10:20201151. Epub 2021 Jun 10.

Department of Interventional Cardiology, B.P.Poddar Hospital and Medical Research Ltd. 71/1, Humayun Kabir Sarani, Block - G, New Alipore, Kolkata, West Bengal.

Renal artery aneurysm is a rare disease. With modern non-invasive imaging modalities, the disease is being increasingly diagnosed. It is a slow-growing aneurysm with high mortality in the event of rupture; especially in pregnant females and patients with multiple comorbidities. Read More

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Anterior Chamber Measurements in Healthy Children: A Cross-Sectional Study Using Optical Coherence Tomography.

Transl Vis Sci Technol 2021 May;10(6):13

University of Leicester Ulverscroft Eye Unit, Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK.

Purpose: To establish anterior chamber measurements in children and investigate the influence of demographic factors on anterior chamber development.

Methods: Handheld optical coherence tomography was used to scan the anterior chamber of participants' eyes, without sedation. ImageJ was used to generate quantitative anterior chamber measurements, including central corneal thickness (CCT), anterior chamber width, trabecular meshwork length (TML), Schwalbe's line-angle opening distance (SL-AOD), and trabecular iris surface area (SL-TISA). Read More

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Influences of Gender on Intravenous Nalbuphine Actions After Major Abdominal Surgery: A Multicenter Study.

Pain Ther 2021 Jun 10. Epub 2021 Jun 10.

Research and Development, Paolo Procacci Foundation, via Tacito 7, 00193, Rome, Italy.

Introduction: Nalbuphine, a synthetic kappa-opioid receptor (KOR) agonist and a partial µ-opioid receptor (MOR) antagonist, has been used for years as an effective analgesic. It has been shown to have a better safety profile than morphine. Considering the long history of use of this drug, it is interesting that only a limited amount of information exists on how gender differences influence nalbuphine responses. Read More

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Monitoring nociception and awareness during palliative sedation: A systematic review.

Palliat Med 2021 Jun 10:2692163211022943. Epub 2021 Jun 10.

Division of Anaesthesiology, Department of Anaesthesiology, Pharmacology, Intensive Care and Emergency Medicine, Geneva University Hospitals, Geneva, Switzerland.

Background: Providing unawareness and pain relief are core elements of palliative sedation. In addition to clinical scales, nociception and electroencephalogram-based depth of sedation monitoring are used to assess the level of consciousness and analgesia during sedation in intensive care units and during procedures.

Aim: To determine whether reported devices impact the outcomes of palliative sedation. Read More

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Evaluation of Dexmedetomidine Dosing in Obese Critically Ill Patients.

J Pharm Pract 2021 Jun 10:8971900211021578. Epub 2021 Jun 10.

Department of Pharmacy, The Ohio State University Wexner Medical Center, Columbus, OH, USA.

Background: Dexmedetomidine is a highly selective α-adrenoreceptor agonist that produces dose-dependent sedation, anxiolysis, and analgesia without respiratory depression. Due to these ideal sedative properties, there has been increased interest in utilizing dexmedetomidine as a first-line sedative for critically ill patients requiring light sedation.

Objective: To evaluate the ability to achieve goal intensive care unit (ICU) sedation before and after an institutional change of dosing from actual (ABW) to adjusted (AdjBW) body weight in obese patients on dexmedetomidine. Read More

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Caution during endotracheal suctioning in case of skull base fractures!

Eur Rev Med Pharmacol Sci 2021 May;25(10):3803-3806

Department of Adult Intensive Care Medicine, Lausanne University Hospital (CHUV), Lausanne, Switzerland.

Objective: Cerebral exteriorization through the cribriform plate during routine endotracheal suctioning (ETS) in a coughing patient without sedation with multiple complex skull base fracture; this case has never been reported in the literature.

Clinical Presentation: We report the case of a polytrauma patient admitted in our ICU with severe traumatic brain injury (TBI) and multiple complex skull base fractures. After 48 hours of neurocritical care and stable neuromonitoring parameters, sedation was stopped for neurological assessment. Read More

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[Effect of dexmedetomidine on swallowing function of patients undergoing awake intubation in oral and maxillofacial surgery].

Shanghai Kou Qiang Yi Xue 2021 Apr;30(2):206-209

Department of Anesthesiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai 200011, China.

Purpose: To evaluate the sedative effect of dexmedetomidine in awake intubation and its influence on swallowing function.

Methods: Fifty patients with awake intubation in oral and maxillofacial surgery were randomly divided into two groups: dexmedetomidine(DEX) group and midazolam+fentanyl(MF) group. 15 min before intubation, patients in DEX group were intravenously given 50 mL dexmedetomidine(1. Read More

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Choosing the Best Treatment Approach for Axial Vein Reflux: Thermal versus Nonthermal Approaches.

Semin Intervent Radiol 2021 Jun 3;38(2):209-214. Epub 2021 Jun 3.

Northwestern University, Feinberg School of Medicine, Chicago, Illinois.

Chronic venous insufficiency is a common and treatable medical condition which has a high morbidity if left untreated, progressing to lower extremity edema, skin changes of lipodermatosclerosis, and venous ulceration. Treatment options have significantly expanded over the last several decades, shifting away from the traditional surgical approach to more minimally invasive procedures such as endoluminal venous laser ablation or radiofrequency ablation. Even more recently, several techniques using nonthermal methods to ablate varicose veins have been developed, which offer the advantage of not requiring labor-intensive and painful tumescent anesthesia to protect the surrounding tissues. Read More

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Varicocele Embolization: Patient Selection: Preprocedure Workup, and Technical Considerations.

Semin Intervent Radiol 2021 Jun 3;38(2):176-181. Epub 2021 Jun 3.

Departments of Urology and Radiology, Weill Cornell Medicine, New York City, New York.

Varicocele refers to an abnormally dilated and tortuous pampiniform venous plexus within the spermatic cord. The prevalence of varicocele is reported to be approximately 15% in the general male population. Its incidence increases with age and has a higher incidence in infertile men. Read More

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Neonatal unplanned extubations: an unsolved safety issue.

Bol Med Hosp Infant Mex 2021 Jun 9. Epub 2021 Jun 9.

Servicio de Neonatología del Área de Gestión Clínica de Pediatría, Hospital Universitario Central de Asturias, Oviedo, España.

Background: Unplanned extubations are safety events relatively frequent in the neonatal intensive care units (NICU). This study aimed to describe the frequency and characteristics of unplanned extubations in a NICU.

Methods: We conducted a retrospective observational study of unplanned extubations in the NICU of a tertiary regional referral hospital. Read More

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Successful diagnosis and treatment of pulmonary aspergillosis-related malignant catatonia using propofol and quetiapine: A case report.

Medicine (Baltimore) 2021 May;100(19):e25967

Department of Emergency Medicine, Sapporo Medical University Hospital, Sapporo-shi.

Introduction: Malignant catatonia (MC) is a movement disorder syndrome characterized by immobility, rigidity, and consciousness disorders that develops in association with mental and physical diseases. It is often fatal due to hyperthermia, rhabdomyolysis, and acute kidney injury. Its clinical symptoms are similar to those of another disorder, neuroleptic malignant syndrome (NMS), and it is often difficult to distinguish between the 2 disorders. Read More

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Prescription attitudes and practices regarding clozapine among Serbian psychiatrists: results of a nationwide survey.

Ther Adv Psychopharmacol 2021 29;11:20451253211020235. Epub 2021 May 29.

Faculty of Medicine, University of Belgrade, Belgrade, Serbia.

Objective: Despite clozapine being the most effective treatment for treatment-resistant schizophrenia (TRS), a clear explanation as to why it is underutilized and why its initiation is delayed remains unclear. The first aim of the study was to conduct a nation-wide assessment of both the psychiatrists' attitudes of the obstacles for prescribing clozapine as well as their prescription practices. The second aim was to make recommendations, based on the results obtained, for improving the Serbian clozapine guidelines. Read More

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The Efficacy and Safety of Local Anesthetic Techniques for Postoperative Analgesia After Cesarean Section: A Bayesian Network Meta-Analysis of Randomized Controlled Trials.

J Pain Res 2021 2;14:1559-1572. Epub 2021 Jun 2.

Department of Obstetrics, The First Affiliated Hospital of China Medical University, Shenyang, People's Republic of China.

Objective: Cesarean section (CS) is one of the most frequently performed major surgical interventions. Local anesthetic techniques, a universal component of perioperative multimodal analgesia, are reportedly effective in reducing pain scores and opioid requirements. However, the optimal local anesthetic technique for postoperative CS pain remains unclear. Read More

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Comparison of morphine, dexmedetomidine and dexamethasone as an adjuvant to ropivacaine in ultrasound-guided supraclavicular brachial plexus block for postoperative analgesia-a randomized controlled trial.

J Anaesthesiol Clin Pharmacol 2021 Jan-Mar;37(1):102-107. Epub 2021 Apr 10.

Department of Anaesthesiology, SRM Medical College Hospital and Research Centre, Potheri, Tamil Nadu, India.

Background And Aims: An ideal adjuvant to local anesthetic in a nerve block should prolong the duration of analgesia, and hasten the onset of sensory and motor blockade without significant adverse effects. The aim of this study was to compare morphine, dexmedetomidine, and dexamethasone as an additive to ropivacaine in ultrasound-guided supraclavicular brachial plexus block (SBPB) for postoperative analgesia.

Material And Methods: In this randomized, double-blinded study, 150 patients undergoing upper extremity surgery were randomly divided into three groups: group A (morphine 5 mg), group B (dexmedetomidine 50 μg), and group C (dexamethasone 8 mg). Read More

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Effect of oral gabapentin premedication on hemodynamic parameters and postoperative pain in patients of laparoscopic cholecystectomy: A randomized double-blind controlled study.

J Anaesthesiol Clin Pharmacol 2021 Jan-Mar;37(1):67-72. Epub 2021 Apr 10.

Department of Surgery, University College of Medical Sciences and Guru Tegh Bahadur Hospital, Delhi, India.

Background And Aims: Carbon dioxide (CO) pneumoperitoneum created during laparoscopic cholecystectomy causes adverse hemodynamic changes such as rise in arterial pressure. The aim of this study was to assess the effect of oral gabapentin premedication on hemodynamic parameters in addition to postoperative nausea and vomiting (PONV) and pain in patients of laparoscopic cholecystectomy conducted under general anesthesia.

Material And Methods: Randomly selected 60 American Society of Anesthesiologists (ASA) class I patients scheduled for laparoscopic cholecystectomy were premedicated with either gabapentin 1200 mg (Group GB) or placebo (Group PL) 2 h prior to induction of anesthesia. Read More

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Subarachnoid aneurysm coiling under conscious sedation.

Indian J Anaesth 2021 Apr 15;65(4):339-340. Epub 2021 Apr 15.

Department of Anaesthesiology, ASTER MIMS, Calicut, Kerala, India.

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[Continuous deep sedation until death for COVID-19 patients].

Stéphane Amar

Soins 2021 May;66(855):30-33

Groupe hospitalier Nord Essonne, 159 rue du Président-François-Mitterrand, 91160 Longjumeau, France. Electronic address:

The su rge of COVID-1 9 has been an unprecedented cataclysm requiring all health professionals to mobilise themselves in the face of a lethal risk threatening everyone. End-of-life issues have become relevant to all medical specialities, which have suddenly had to face up to a new, improvised clinical approach where deaths have become inevitable and frequent. Read More

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Impact of Benzodiazepines on Time to Awakening in Post Cardiac Arrest Patients.

Resuscitation 2021 Jun 5. Epub 2021 Jun 5.

UPMC Presbyterian-Shadyside Department of Pharmacy, 200 Lothrop street, Pittsburgh, PA 15213, United States; Departments of Emergency Medicine, Critical Care Medicine, and Neurology, University of Pittsburgh School of Medicine, 3550 Terrace St, Pittsburgh, PA 15213, United States.

Aim: Although guidelines recommend use of short acting sedation after cardiac arrest, there is significant practice variation. We examined whether benzodiazepine use is associated with delayed awakening in this population.

Methods: We performed a retrospective single center study including comatose patients treated after in- or out-of-hospital cardiac arrest from January 2010 to September 2019. Read More

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How We Do It: How We Prevent and Treat Delirium in the ICU.

Chest 2021 Jun 5. Epub 2021 Jun 5.

Oregon Health and Science University.

Delirium is a serious and complex problem facing critically ill patients, their families, and the healthcare system. When it develops, delirium is associated with prolonged hospital stays, increased costs, and long-term cognitive impairment in many patients. In this article, we use a clinical case to discuss our approach to delirium prevention and treatment in the intensive care unit (ICU). Read More

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Intranasal versus sublingual route of dexmedetomidine sedation in pediatric dentistry: a randomized controlled clinical trial.

Int J Paediatr Dent 2021 Jun 8. Epub 2021 Jun 8.

Pediatric Dentistry and Dental Public Health Department, Faculty of Dentistry, Alexandria University, Alexandria.

Background: Most of children suffer from dental anxiety during dental treatment. Conscious sedation is used to alleviate anxiety and enhance child's cooperation.

Aim: This study aimed to compare the efficacy of intranasal versus sublingual dexmedetomidine. Read More

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Analysis of Pediatric Dog Bite Injuries at a Level 1 Trauma Center Over 10 Years.

Ann Plast Surg 2021 Jun;86(6S Suppl 5):S510-S516

Division of Plastic and Reconstructive Surgery, Virginia Commonwealth University Medical Center; Richmond, VA.

Background: Dog bite injuries cause significant preventable patient morbidity and health care expenditure in children. This study aimed to characterize the patient and healthcare burden related to pediatric dog bite injuries at a level 1 trauma center.

Methods: This is a retrospective review of 356 pediatric patients who presented to Virginia Commonwealth University Pediatric Emergency Department between July 2007 and August 2017 after sustaining dog bite injuries. Read More

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Freehand Versus Grid-Based Transperineal Prostate Biopsy: A Comparison of Anatomic Region Yield and Complications.

J Urol 2021 Jun 8:101097JU0000000000001902. Epub 2021 Jun 8.

Department of Urology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.

Purpose: The freehand (FH) technique of transperineal (TP) prostate biopsy using commercialized needle access systems facilitates a reduction in anesthesia requirements from general to local or local/sedation. We sought to compare the efficacy and complication rates of the FH method with those of the standard grid-based (GB) method.

Materials And Methods: The GB method was performed from 2014 to 2018, and the updated FH technique was performed from 2018 to 2020, yielding comparative cohorts of 174 and 304, respectively. Read More

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Dexmedetomidine use and mortality in mechanically ventilated patients with severe burns: A cohort study using a national inpatient database in Japan.

Burns 2021 May 12. Epub 2021 May 12.

Health Services Research & Development Centre, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, Japan; Department of Health Services Research, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, Japan.

Background: Dexmedetomidine is an alpha 2-adrenergic receptor agonist. Apart from its sedative effects, dexmedetomidine can potentially reduce mortality through its anti-inflammatory effect. However, the impact of dexmedetomidine on in-hospital outcomes of patients with severe burns remains unclear. Read More

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