42,101 results match your criteria Sedation


The SNAP 101 Double-Blind, Placebo/Active-Controlled, Safety, Pharmacokinetic, and Pharmacodynamic Study of INP105 (Nasal Olanzapine) in Healthy Adults.

J Clin Psychiatry 2020 Jun 30;81(4). Epub 2020 Jun 30.

Impel NeuroPharma, Inc, Seattle, Washington, USA.

Objective: INP105 is a drug-device combination of olanzapine and technology that delivers a powder formulation of olanzapine to the vascular-rich upper nasal space. This study evaluated the pharmacokinetics, pharmacodynamics, safety, and tolerability of single ascending doses of INP105, olanzapine intramuscular (OLZ IM), and olanzapine oral disintegrating tablet (OLZ ODT).

Methods: This was a phase 1, active and double-blind placebo comparator-controlled, ascending-dose, 2-period, incomplete-block, 1-way crossover study in 40 healthy subjects, randomized to single doses of OLZ IM (5 or 10 mg) or OLZ ODT (10 mg) in Period 1 and then 1 of 3 doses (5 mg, 10 mg, or 15 mg) of INP105 or placebo in Period 2 between July and October 2018. Read More

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http://dx.doi.org/10.4088/JCP.19m13086DOI Listing

Protocol-directed sedation versus nonprotocol-directed sedation in mechanically ventilated intensive care adults and children (Review).

Authors:
Elizabeth Scruth

Int J Nurs Pract 2020 Jul 1:e12846. Epub 2020 Jul 1.

Northern California Kaiser Permanente, Clinical Quality Programs and Data Analytics, Tele Critical Care, Northern California Kaiser Permanente, Regional Quality Division, Oakland, California, USA.

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http://dx.doi.org/10.1111/ijn.12846DOI Listing

3D transesophageal echocardiography in TAVR.

Echocardiography 2020 Jun 30. Epub 2020 Jun 30.

Department of Cardiology, Kings College Hospital, London, UK.

Recently, there has been an increasingly minimalistic approach to transcatheter aortic valve replacement (TAVR), with most procedures now performed under conscious sedation without real time transesophageal echocardiography (TEE) guidance. Proponents of echo should not feel discouraged by this; it is the initial insights that were gained with procedural TEE during the early years of TAVR that have allowed the procedure's gradual maturation and sophistication. Experienced centers that have promoted extensive TAVR TEE programs continue to maximize the benefits of echocardiography in both procedural planning and execution. Read More

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http://dx.doi.org/10.1111/echo.14777DOI Listing

Relationship Between Intensive Care Unit Delirium Severity and 2-Year Mortality and Health Care Utilization.

Am J Crit Care 2020 Jul;29(4):311-317

Babar Khan is an associate professor, Division of Pulmonary, Critical Care, Sleep and Occupational Medicine, Department of Medicine, Indiana University School of Medicine; and a research scientist, Indiana University Center for Aging Research, Regenstrief Institute.

Background: Critical care patients with delirium are at an increased risk of functional decline and mortality long term.

Objective: To determine the relationship between delirium severity in the intensive care unit and mortality and acute health care utilization within 2 years after hospital discharge.

Methods: A secondary data analysis of the Pharmacological Management of Delirium and Deprescribe randomized controlled trials. Read More

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http://dx.doi.org/10.4037/ajcc2020498DOI Listing

Nalbuphine versus Midazolam as an Adjuvant to Intrathecal Bupivacaine for Postoperative Analgesia in Patients Undergoing Cesarean Section.

J Pain Res 2020 11;13:1369-1376. Epub 2020 Jun 11.

Anesthesia and Surgical Intensive Care Department, Faculty of Medicine, Zagazig University, Alsharkia, Egypt.

Background And Purpose: Adding adjuvants to intrathecal hyperbaric bupivacaine provides long analgesic duration with less adverse effects. The aim of this study was to compare intrathecal nalbuphine versus midazolam in patients undergoing cesarean section.

Clinical Trial Id: NCT03918187. Read More

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http://dx.doi.org/10.2147/JPR.S242545DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7295533PMC

Performing High-resolution Impedance Manometry After Endoscopy With Conscious Sedation Has Negligible Effects on Esophageal Motility Results.

J Neurogastroenterol Motil 2020 Jun;26(3):352-361

Division of Gastroenterology and Hepatology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.

Background/aims: High-resolution manometry (HRM) performed without sedation is the standard procedure. However, some patients cannot tolerate transnasal placement of the manometry catheter. We aim to assess the practice of performing manometry after endoscopy with conscious sedation by evaluating its impact on esophageal motility findings. Read More

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http://dx.doi.org/10.5056/jnm20006DOI Listing

Comparison of the Cost and Efficacy of Axillary Anesthesia and Wide-Awake Anesthesia in Finger Surgeries.

Sisli Etfal Hastan Tip Bul 2018 12;52(2):119-123. Epub 2018 Jun 12.

Department of Orthopedics, University of Health Sciences, Erzurum Regional Training and Research Hospital, Erzurum, Turkey.

Objectives: Wide-awake anesthesia is a type of local anesthesia consisting of a combined application of lidocaine, epinephrine, and bicarbonate and has a wide potential in hand surgery as it offers the advantage of being applied without sedation and without using a tourniquet. In light of recent studies, its use has increased with the disappearance of the belief among surgeons that epinephrine can cause circulatory disturbance in fingers.

Methods: Patients with finger pathologies who were operated upon at the Baltalimani Bone Diseases Teaching and Research Hospital between January 2015 and February 2016 were divided into two groups according to anesthesia type: wide-awake anesthesia and axillary block anesthesia, with 52 patients in each group. Read More

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http://dx.doi.org/10.14744/SEMB.2017.17363DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7315058PMC

Clinical and electroencephalographic features of benign childhood epilepsy with centrotemporal spikes comorbidity with attention-deficit hyperactivity disorder in Southwest China.

Epilepsy Behav 2020 Jun 27;111:107240. Epub 2020 Jun 27.

Department of Neurology, West China Hospital, Sichuan University, Wai Nan Guo Xue Lane 37#, Chengdu, Sichuan 610041, China. Electronic address:

Purpose: This study was conducted to analyze the clinical and electroencephalographic (EEG) features of attention-deficit hyperactivity disorder (ADHD) in children with benign partial epilepsy with centrotemporal spikes (BECTS) in Southwest China, to address the question of what the risk factors are for patients with BECTS who suffer from ADHD.

Methods: Overall 118 right-handed children with BECTS were included from two medical centers. Of them, 29 patients were with diagnosed ADHD according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) at baseline, and the remaining were considered as typical BECTS. Read More

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http://dx.doi.org/10.1016/j.yebeh.2020.107240DOI Listing

Pain characteristics in medication-related osteonecrosis of the jaws.

Support Care Cancer 2020 Jun 29. Epub 2020 Jun 29.

Department of Oral Medicine, Sedation and Maxillofacial Imaging, School of Dental Medicine, Hebrew University-Hadassah medical center, Jerusalem, Israel.

Purpose: To characterise pain from medication-related osteonecrosis of the jaws (MRONJ) and the effects of antimicrobial treatment on it.

Methods: Data from files of patients diagnosed with MRONJ according to the position paper of the American Association of Oral and Maxillofacial Surgeons (2014) and Multinational Association of Supportive Care in Cancer and American Society of Clinical Oncology (2019) were collected retrospectively, including gender, age, primary disease, bone-modifying agents (BMAs)/anti-angiogenics, administration route, involved jaw, location, and exposure size. The patients were treated according to the abovementioned position papers' recommendations, i. Read More

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http://dx.doi.org/10.1007/s00520-020-05600-zDOI Listing

Transradial middle meningeal artery embolization for chronic subdural hematoma using Onyx: case series.

J Neurointerv Surg 2020 Jun 29. Epub 2020 Jun 29.

Neurosurgery, Gates Vascular Institute, Buffalo, New York, USA

Background: Middle meningeal artery (MMA) embolization is an emerging therapy for the resolution of subacute or chronic subdural hematoma (CSDH). CSDH patients are often elderly and have several comorbidities. We evaluated our experience with transradial access (TRA) for MMA embolization using predominantly Onyx under conscious sedation. Read More

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http://dx.doi.org/10.1136/neurintsurg-2020-016185DOI Listing

Risk factors for failure of reduction for anterior glenohumeral dislocation without sedation.

J Shoulder Elbow Surg 2020 Jun 26. Epub 2020 Jun 26.

Department of Orthopaedic Surgery, National Hospital Organization Tokyo Medical Center, Meguro-ku, Tokyo, Japan.

Background: Although anterior glenohumeral dislocations are common, the reduction procedure is often difficult, requiring sedation or anesthesia. To date, the risk factors for reduction failure without sedation has not been fully investigated. The present study aimed to clarify the predictive factors that render the reduction of anterior glenohumeral dislocation without sedation difficult using multivariate analyses. Read More

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http://dx.doi.org/10.1016/j.jse.2020.06.005DOI Listing

Changing practices in the use of continuous sedation at the end of life. A systematic review of the literature.

J Pain Symptom Manage 2020 Jun 26. Epub 2020 Jun 26.

Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands.

Background: The use of continuous sedation until death (CSD) has been highly debated for many years. It is unknown how the use of CSD evolves over time. Reports suggest that there is an international increase in the use of CSD for terminally ill patients. Read More

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http://dx.doi.org/10.1016/j.jpainsymman.2020.06.019DOI Listing

Population analysis to assess the influence of age and body weight on pharmacokinetics and pharmacodynamics of dexmedetomidine in New Zealand White rabbits.

Biopharm Drug Dispos 2020 Jun 29. Epub 2020 Jun 29.

Department of Biopharmacy and Pharmacodynamics, Medical University of Gdańsk, ul. Hallera 107, 80-416, Gdańsk, Poland.

Objectives: To develop population pharmacokinetic (PK) and pharmacodynamic (PD) model of dexmedetomidine in New Zealand White rabbits and investigate the influence of animals' age and weight on the model parameters. To assess the linearity of pharmacokinetics of the drug in the examined dose range.

Study Design: Prospective, crossover study. Read More

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http://dx.doi.org/10.1002/bdd.2248DOI Listing

Virtual reality assisted conscious sedation during transcatheter aortic valve implantation - a randomized pilot study.

EuroIntervention 2020 Jun 30. Epub 2020 Jun 30.

Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, University Hospital Düsseldorf, Düsseldorf, Germany.

Aims: Virtual Reality (VR) has been used successfully in different clinical settings to treat anxiety. This prospective, randomized pilot study investigates the feasibility and safety of VR in patients undergoing conscious sedation during transfemoral transcatheter aortic valve implantation (TAVI).

Methods And Results: Thirty-two patients were included and randomized to VR intervention (n=16) or control (n=16). Read More

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http://dx.doi.org/10.4244/EIJ-D-20-00269DOI Listing

Terminal withdrawal of mechanical ventilation in adult intensive care units: A systematic review and narrative synthesis of perceptions, experiences and practices.

Palliat Med 2020 Jun 27:269216320935002. Epub 2020 Jun 27.

Divisions of Critical Care and Palliative Care, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.

Background: During the terminal withdrawal of life-sustaining measures for intensive care patients, the removal of respiratory support remains an ambiguous practice. Globally, perceptions and experiences of best practice vary due to the limited evidence in this area.

Aim: To identify, appraise and synthesise the latest evidence around terminal withdrawal of mechanical ventilation in adult intensive care units specific to perceptions, experiences and practices. Read More

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http://dx.doi.org/10.1177/0269216320935002DOI Listing

Comparison in Sedative Effects between Dexmedetomidine and Midazolam in Dental Implantation: A Randomized Clinical Trial.

Biomed Res Int 2020 2;2020:6130162. Epub 2020 Jun 2.

The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei 430079, China.

Dexmedetomidine refers to an -adrenergic receptor agonist causing potent sedative, analgesic, and minimal respiratory depression compared with alternative drugs. The present study was aimed at comparing the efficaciousness and safety of midazolam and dexmedetomidine as sedatives for dental implantation. We recruited 60 patients belonging to group I or II of the American Society of Anesthesiologists (ASA) and treated them with either midazolam or dexmedetomidine in a random manner. Read More

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http://dx.doi.org/10.1155/2020/6130162DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7288223PMC

Tele-monitoring and tele-sedation for systemic management during dental treatment.

J Dent Sci 2020 Jun 24;15(2):230-231. Epub 2019 Dec 24.

Division of Dental Anesthesiology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.

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http://dx.doi.org/10.1016/j.jds.2019.11.007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7305435PMC

Effect of dexmedetomidine sedation on swallowing reflex: A pilot study.

J Dent Sci 2020 Jun 18;15(2):207-213. Epub 2019 Oct 18.

Division of Clinical Physiology, Department of Translational Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, 852-8523, Japan.

Background/purpose: Swallowing reflex depression during dental treatment or oral surgery may cause water to enter the lower respiratory tract, leading to coughing, thus hindering these procedures. Based on the hypothesis that dexmedetomidine (DEX) sedation may depress swallowing reflex, we aimed to characterize its effects on swallowing reflex and elucidate the affected functions.

Materials And Methods: Swallowing reflex was induced in 9 young healthy male volunteers using a 5 mL-distilled water bolus injection over 3 s through a polyethylene catheter 3 times, both under wakefulness and DEX sedation. Read More

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http://dx.doi.org/10.1016/j.jds.2019.09.004DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7305434PMC

[Meta-analysis of the effects of dexmedetomidine combined with ketamine during dressing changes in burn patients].

Zhonghua Shao Shang Za Zhi 2020 Jun;36(6):458-464

Department of Burns and Plastic Surgery, Jiangsu Subei People's Hospital, Yangzhou 225001, China.

To systematically evaluate the safety and efficacy of dexmedetomidine combined with ketamine during dressing changes in burn patients using meta-analysis. Foreign language databases including PubMed, Cochrane Central, Embase, and Web of Science were searched with the terms of " burns, dexmedetomidine, ketamine, and dressing" , and Chinese databases including Chinese Journal Full-Text Database, Wanfang Data, and China Academic Journal Network Publishing Database were searched with the terms in Chinese version of ",,,,," to retrieve the publicly published randomized controlled trials on the application of dexmedetomidine combined with ketamine for sedation and analgesia during dressing changes in burn patients from the establishment of each database to March 2019. The outcome indexes included systolic blood pressure at 5 minutes after administration, arousal restlessness score, ketamine dosage, dressing change time, body movement/recovery time, pain score, Ramsay sedation scores at 10 minutes after the start of dressing change and 1 hour after dressing change, physician satisfaction score, neuropsychological symptoms, nausea and vomiting times, nausea and vomiting score. Read More

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http://dx.doi.org/10.3760/cma.j.cn501120-20190327-00145DOI Listing

Intracerebroventricular administration of N-type calcium channel blocker ziconotide displays anticonvulsant, anxiolytic, and sedative effects in rats: A preclinical and pilot study.

Epilepsy Behav 2020 Jun 25;111:107251. Epub 2020 Jun 25.

Department of Pharmacology, Research Center of Physiology, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran. Electronic address:

Objective: Ziconotide (ω-conotoxin MVIIA peptide) is a novel analgesic agent acting on voltage-gated calcium channels and is administered intrathecally for neuropathic pain. While antiepileptic activities of other types of calcium channel blockers (T- or L-type) are well established, there is no information regarding the effect of ziconotide as an N-type calcium channel antagonist in pentylenetetrazol-induced seizures or its anxiolytic and sedative activities. The present study is the first to report on these effects. Read More

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http://dx.doi.org/10.1016/j.yebeh.2020.107251DOI Listing

The Reincarnation of Methoxyflurane.

Authors:
Shigemasa Ikeda

J Anesth Hist 2020 Jun 15;6(2):79-83. Epub 2019 Oct 15.

Department of Anesthesiology and Critical Care, St. Louis University School of Medicine, St. Louis, MO 63141. Electronic address:

Methoxyflurane was an inhaled agent commonly used for general anesthesia in the 1960s, but its clinical role gradually decreased in the 1970s because of reports of dose-dependent nephrotoxicity. In 1999 its manufacturer, Abbott Laboratories, discontinued distribution of methoxyflurane in the United States and Canada. Outside of North America, however, methoxyflurane has been reborn as an inhaled analgesic used for pain relief in the prehospital setting and for minor surgical procedures. Read More

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http://dx.doi.org/10.1016/j.janh.2019.07.001DOI Listing

High-flow nasal cannula improves clinical efficacy of airway management in patients undergoing awake craniotomy.

BMC Anesthesiol 2020 Jun 27;20(1):156. Epub 2020 Jun 27.

Department of Anesthesiology, Huashan Hospital, Fudan University, No.12 Wulumuqi Zhong Road, Shanghai, 200040, China.

Background: Awake craniotomy requires specific sedation procedure in an awake patient who should be able to cooperate during the intraoperative neurological assessment. Currently, limited number of literatures on the application of high-flow nasal cannula (HFNC) in the anesthetic management for awake craniotomy has been reported. Hence, we carried out a prospective study to assess the safety and efficacy of humidified high-flow nasal cannula (HFNC) airway management in the patients undergoing awake craniotomy. Read More

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http://dx.doi.org/10.1186/s12871-020-01073-zDOI Listing

Fadolmidine - Favourable adverse effects profile for spinal analgesia suggested by in vitro and in vivo models.

Eur J Pharmacol 2020 Jun 24:173296. Epub 2020 Jun 24.

Institute of Biomedicine, Faculty of Medicine, University of Turku, Kiinanmyllynkatu 10, FI-20520, Turku, Finland.

Fadolmidine is an α-adrenoceptor full agonist developed for spinal analgesia with a local mode of action. The purpose of this study was to demonstrate the safety of fadolmidine on known α-adrenoceptor-related effects: kidney function, urodynamics and cardiovascular variables. Furthermore, the binding affinity of fadolmidine for the 5-HT receptor prompted functional studies on 5-HT. Read More

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http://dx.doi.org/10.1016/j.ejphar.2020.173296DOI Listing

Preoperative factors associated with adverse events during awake craniotomy: analysis of 609 consecutive cases.

J Neurosurg 2020 Jun 26:1-9. Epub 2020 Jun 26.

Objective: Awake surgery is becoming more standard and widely practiced for neurosurgical cases, including but not limited to brain tumors. The optimal selection of patients who can tolerate awake surgery remains a challenge. The authors performed an updated cohort study, with particular attention to preoperative clinical and imaging characteristics that may have an impact on the viability of awake craniotomy in individual patients. Read More

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http://dx.doi.org/10.3171/2020.4.JNS20378DOI Listing

Incidence and predictors of respiratory adverse events in children undergoing procedural sedation with intramuscular ketamine in a paediatric emergency department.

Singapore Med J 2020 Jun 26. Epub 2020 Jun 26.

Department of Emergency Medicine, KK Women's and Children's Hospital, Singapore.

Introduction: Although ketamine is one of the commonest medications used in procedural sedation of children, to our knowledge, there is currently no published report on predictors of respiratory adverse events during ketamine sedation in Asian children. We aimed to determine the incidence of and factors associated with respiratory adverse events in children undergoing procedural sedation with intramuscular (IM) ketamine in a paediatric emergency department (ED) in Singapore.

Methods: A retrospective analysis was done of all children who underwent procedural sedation with IM ketamine in the paediatric ED between 1 April 2013 and 31 October 2017. Read More

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http://dx.doi.org/10.11622/smedj.2020095DOI Listing

Implementation of the European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) sedation training course in a regular endoscopy unit.

Endoscopy 2020 Jun 25. Epub 2020 Jun 25.

Gastroenterology and Digestive Endoscopy Unit, Azienda USL Modena, Carpi, Italy.

Background:  Several scientific societies have endorsed non-anesthesiologist sedation (NAS) during gastrointestinal endoscopy, considering it a safe procedure when administered by adequately trained personnel. This study aimed to evaluate the occurrence of adverse events after implementation of the European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) sedation training program.

Methods:  From January 2017 to August 2018, data from all consecutive endoscopic procedures in adults (≥ 18 years) performed at our endoscopy unit were collected using an electronic reporting system. Read More

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http://dx.doi.org/10.1055/a-1197-6762DOI Listing

Inhalational volatile-based sedation for COVID-19 pneumonia and ARDS.

Intensive Care Med 2020 Jun 25. Epub 2020 Jun 25.

Interdepartmental Division of Critical Care Medicine, University of Toronto, University Health Network, Toronto, Canada.

Hospitals worldwide are experiencing a shortage in essential intravenous sedative medications. This is attributable to high number and high sedative needs of COVID-19 critical care patients with disruption of drug supply chains. Inhaled volatile anesthetic agents are an abundant resource and readily implementable solution for providing ICU sedation. Read More

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http://dx.doi.org/10.1007/s00134-020-06154-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7315695PMC

Variable Refocusing Flip Angle Single-Shot Imaging for Sedation-Free Fast Brain MRI.

AJNR Am J Neuroradiol 2020 Jun 25. Epub 2020 Jun 25.

Department of Radiology (T.M.C., U.Y., S.S.V., K.W.Y.), Lucile Packard Children's Hospital, Stanford University, Palo Alto, California

Background And Purpose: Conventional single-shot FSE commonly used for fast MRI may be suboptimal for brain evaluation due to poor image contrast, SNR, or image blurring. We investigated the clinical performance of variable refocusing flip angle single-shot FSE, a variation of single-shot FSE with lower radiofrequency energy deposition and potentially faster acquisition time, as an alternative approach to fast brain MR imaging.

Materials And Methods: We retrospectively compared half-Fourier single-shot FSE with half- and full-Fourier variable refocusing flip angle single-shot FSE in 30 children. Read More

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http://dx.doi.org/10.3174/ajnr.A6616DOI Listing

The Efficacy and Safety of Gabapentinoids in Total Joint Arthroplasty: A Direct Meta-Analysis.

J Arthroplasty 2020 May 26. Epub 2020 May 26.

Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL.

Background: Gabapentinoids are commonly used as an adjunct to traditional pain management strategies after total joint arthroplasty (TJA). The purpose of this study is to evaluate the efficacy and safety of gabapentinoids in primary TJA to support the combined clinical practice guidelines of the American Association of Hip and Knee Surgeons, American Academy of Orthopedic Surgeons, Hip Society, Knee Society, and the American Society of Regional Anesthesia and Pain Management.

Methods: The MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials were searched for studies published prior to September 2019 on gabapentinoids in TJA. Read More

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http://dx.doi.org/10.1016/j.arth.2020.05.033DOI Listing

Wearable technology during GI endoscopic procedures with sedation.

Gastrointest Endosc 2020 Jul;92(1):173-175

Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA.

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http://dx.doi.org/10.1016/j.gie.2020.02.048DOI Listing

[Drug-induced sleep endoscopy].

Laryngorhinootologie 2020 Jul 25;99(7):450-452. Epub 2020 Jun 25.

Klinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum Freiburg.

Drug-induced sleep endoscopy (DISE) is a procedure for the assessment of the upper airways in patients with obstructive sleep apnea (OSA) and was first described by Croft and Pringle in 1991 1. So far, it has not been clarified to what extent the DISE can be compared to natural sleep. Eastwood and colleagues ultimately described a correlation in terms of the tendency to collapse in sedation and during natural sleep. Read More

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http://dx.doi.org/10.1055/a-1157-9398DOI Listing

Population pharmacokinetic/pharmacodynamic modeling for remimazolam in the induction and maintenance of general anesthesia in healthy subjects and in surgical subjects.

J Clin Anesth 2020 Jun 22;66:109899. Epub 2020 Jun 22.

Nuventra Pharma Sciences, Durham, NC, USA. Electronic address:

Study Objective: To evaluate factors affecting variability in response to remimazolam in general anesthesia.

Design: Plasma concentration-time data from 11 Phase 1-3 clinical trials were pooled for the population pharmacokinetic (popPK) analysis and concentration-bispectral index (BIS) data were pooled from 8 trials for popPK-PD analysis. A 3-compartment model with allometric exponents on clearance and volume described remimazolam concentrations over time. Read More

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http://dx.doi.org/10.1016/j.jclinane.2020.109899DOI Listing

Cannabis constituents reduce seizure behavior in chemically-induced and scn1a-mutant zebrafish.

Epilepsy Behav 2020 Jun 22;110:107152. Epub 2020 Jun 22.

Department of BioMolecular Sciences, School of Pharmacy, University of Mississippi, University, MS 38677, United States of America. Electronic address:

Current antiepileptic drugs (AEDs) are undesirable for many reasons including the inability to reduce seizures in certain types of epilepsy, such as Dravet syndrome (DS) where in one-third of patients does not respond to current AEDs, and severe adverse effects that are frequently experienced by patients. Epidiolex, a cannabidiol (CBD)-based drug, was recently approved for treatment of DS. While Epidiolex shows great promise in reducing seizures in patients with DS, it is used in conjunction with other AEDs and can cause liver toxicity. Read More

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http://dx.doi.org/10.1016/j.yebeh.2020.107152DOI Listing

Evaluation of the thermal antinociceptive effects of subcutaneous administration of butorphanol tartrate or butorphanol tartrate in a sustained-release poloxamer 407 gel formulation to orange-winged Amazon parrots ().

Am J Vet Res 2020 Jul;81(7):543-550

Objective: To determine the thermal antinociceptive effects of butorphanol tartrate and butorphanol tartrate in a sustained-release 25% poloxamer 407 (P407) gel formulation (But-P407) in parrots.

Animals: 13 orange-winged Amazon parrots ().

Procedures: First, butorphanol tartrate (5 mg/kg) or saline (0. Read More

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http://dx.doi.org/10.2460/ajvr.81.7.543DOI Listing

[DIFFERENT ANESTHESIA APPROACHES IN THE TRANSCATHETER AORTIC VALVE IMPLANTATION (TAVI) PROCEDURE AND THEIR POSSIBLE EFFECT ON MORBIDITY AND MORTALITY].

Harefuah 2020 Jun;159(6):414-422

Department of Anesthesiology, Rambam Health Care Campus, Haifa, Israel.

Background: Transcatheter aortic valve implantation (TAVI) is used in patients with severe aortic stenosis (AS) who are at high surgical risk. Pre- and post-operative management is challenging as these patients are older, have significant comorbidities and a very high expected mortality rate in conventional surgery. There is no consensus in the literature about the preferred form of anesthesia, however, currently most centers perform the procedure using local anesthesia with sedation (LA-S). Read More

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High-flow nasal cannula oxygen therapy in acute hypoxemic respiratory failure in 22 dogs requiring oxygen support escalation.

J Vet Emerg Crit Care (San Antonio) 2020 Jun 24. Epub 2020 Jun 24.

Department of Clinical Sciences, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada.

Objective: To determine the effect of high-flow nasal cannula (HFNC) oxygen therapy on cardiorespiratory variables and outcome in dogs with acute hypoxemic respiratory failure.

Design: Prospective, sequential clinical trial.

Setting: University veterinary teaching hospital. Read More

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http://dx.doi.org/10.1111/vec.12970DOI Listing

Mechanical Ventilation, Sedation and Neuromonitoring of Patients with Aneurysmal Subarachnoid Hemorrhage in Germany: Results of a Nationwide Survey.

Neurocrit Care 2020 Jun 24. Epub 2020 Jun 24.

Department of Neurosurgery, Medical Center, Georg-August University of Göttingen, Robert Koch Strasse 40, 37075, Göttingen, Germany.

Objective: Current evidence-based guidelines for the management of aneurysmal subarachnoid hemorrhage (aSAH) focus primarily on timing, modality and technique of aneurysm occlusion, and on prevention and treatment of delayed cerebral ischemia. Significant aspects of management in the intensive care unit (ICU) during the later course of aSAH such as ventilation and sedation (VST) remain unaddressed. aSAH patients present unique challenges not accounted for in general ICU recommendations and guidelines, which is why we attempted to further characterize ICU practices in aSAH patients in Germany. Read More

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http://dx.doi.org/10.1007/s12028-020-01029-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7314429PMC

Clinical Assessment of an Ipsilateral Cervical Spinal Nerve Block for Prosthetic Laryngoplasty in Anesthetized Horses.

Front Vet Sci 2020 2;7:284. Epub 2020 Jun 2.

Department of Clinical Studies, New Bolton Center, University of Pennsylvania, Kennett Square, PA, United States.

The nociceptive blockade of locoregional anesthesia prior to surgical stimulation can decrease anesthetic agent requirement and thereby potential dose-dependent side effects. The use of an ipsilateral second and third cervical spinal nerve locoregional anesthetic block for prosthetic laryngoplasty in the anesthetized horses has yet to be described. Anesthetic records of 20 horses receiving locoregional anesthesia prior to laryngoplasty were reviewed and compared to 20 horses of a similar patient cohort not receiving locoregional anesthesia. Read More

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http://dx.doi.org/10.3389/fvets.2020.00284DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7280443PMC

Efficacy of Dexmedetomidine vs Morphine as an Adjunct in a Paravertebral Block with Bupivacaine in Postoperative Analgesia Following Modified Radical Mastectomy.

Cureus 2020 May 22;12(5):e8231. Epub 2020 May 22.

Anaesthesia and Critical Care, Chaudhry Pervaiz Elahi Institute of Cardiology, Multan, PAK.

Objective To observe the efficacy of dexmedetomidine vs morphine as an adjunct in a paravertebral block (PVB) with bupivacaine in postoperative analgesia following modified radical mastectomy. Study design This was a randomized controlled trial performed from June 2018 to August 2019 in the Department of Anesthesia, Bakhtawar Amin Medical and Dental College, Ch. Pervaiz Ellahi Institute of Cardiology, Multan, Gurki Hospital, Services Institute of Medical Sciences, and Sheikh Zayed Hospital, Lahore. Read More

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http://dx.doi.org/10.7759/cureus.8231DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7306667PMC

Full-mouth Rehabilitation of a Ventriculoperitoneal Shunt-treated Hydrocephalic Pediatric Patient: A Case Report.

Int J Clin Pediatr Dent 2020 Jan-Feb;13(1):103-106

Department of Pedodontics and Preventive Dentistry, Army Dental Centre, Research and Referral, New Delhi, India.

Hydrocephalus is characterized by accumulation of cerebrospinal fluid in the lateral ventricles of the brain, which results in progressive ventricular dilatation and an increased intracranial pressure. A ventriculoperitoneal shunt (VPS) is the most common treatment for hydrocephalus. Delayed development, behavioral disturbance, chronological changes in the eruption of their teeth, changes in the occlusion, greater accumulation of plaque, and increased caries prevalence are some of the clinical manifestations in these patients, which are encountered by a pediatric dentist. Read More

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http://dx.doi.org/10.5005/jp-journals-10005-1744DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7299888PMC

Flualprazolam: Report of an Outbreak of a New Psychoactive Substance in Adolescents.

Pediatrics 2020 Jun 24. Epub 2020 Jun 24.

Clinical Toxicology and Environmental Biomonitoring Laboratory, University of California, San Francisco, San Francisco, California.

Flualprazolam is a nonregistered drug in the benzodiazepine family and constitutes a new psychoactive substance (NPS). Since 2014, a growing number of designer benzodiazepines have become available over the Internet and on the counterfeit drug market. In June 2019, a cluster of patients intoxicated with flualprazolam was identified by the Oregon Poison Center. Read More

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http://dx.doi.org/10.1542/peds.2019-2953DOI Listing

Ileus in the critically ill: causes, treatment and prevention.

Minerva Anestesiol 2020 Jun 23. Epub 2020 Jun 23.

Department of Anesthesia and Surgical Intensive Care, Brest Teaching Hospital, Brest, France -

Bowel dysfunction, especially ileus, has been increasingly recognized in critically ill patients. Ileus is commonly associated to constipation, however abnormal motility can also concern the upper digestive tract, therefore impaired gastrointestinal transit (IGT) seems to be a more appropriate term. IGT, especially constipation, is common among patients under mechanical ventilation, occurring in up to 80 % of the patients during the first week, and has been associated with worse outcome in intensive care unit (ICU). Read More

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http://dx.doi.org/10.23736/S0375-9393.20.14778-3DOI Listing

Identification of risk factors for hypertension and tachycardia upon dexmedetomidine discontinuation.

J Crit Care 2020 Jun 12;59:81-85. Epub 2020 Jun 12.

Lahey Hospital & Medical Center, 41 Burlington Mall Road, Burlington, MA 01803, United States of America.

Purpose: Dexmedetomidine may cause hypertension and tachycardia upon discontinuation. Risk factors are poorly described but may include prolonged infusion, higher doses, a history of hypertension, and abrupt cessation. This study aims to identify risk factors for hypertension and tachycardia upon dexmedetomidine discontinuation. Read More

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http://dx.doi.org/10.1016/j.jcrc.2020.06.006DOI Listing

Novel Imaging Technology and Procedures for Studying Brain Function in Preadolescent Awake Marmosets.

J Neurosci Methods 2020 Jun 21:108823. Epub 2020 Jun 21.

Center for Translational NeuroImaging, Northeastern University, Boston, MA, United states.

Background: Novel imaging technology and procedures were developed to study brain function in preadolescent awake marmosets never exposed to anesthesia.

Methods: A radiofrequency transmit and receive, head only volume coil was designed and integrated into a holding system. An acclimation procedure was developed without the use of anesthesia or sedation that allowed for awake imaging. Read More

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http://dx.doi.org/10.1016/j.jneumeth.2020.108823DOI Listing

A Prospective Cohort Study of Bisphenol A Exposure from Dental Treatment.

J Dent Res 2020 Jun 24:22034520934725. Epub 2020 Jun 24.

Seattle Children's Research Institute, Seattle, WA, USA.

Laboratory studies show that bisphenol A (BPA) leaches from bisphenol A-glycidyl methacrylate (bisGMA)-based dental materials. We aimed to quantify the extent to which children are exposed to BPA from dental treatment with bisGMA materials, by amount of treatment and type of sedation. We hypothesized that posttreatment urinary BPA (uBPA) concentrations would be higher among patients with more surfaces treated with bisGMA-based materials and among patients receiving general anesthesia compared with pretreatment concentrations. Read More

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http://dx.doi.org/10.1177/0022034520934725DOI Listing

Nonsedation or Light Sedation in Critically Ill, Mechanically Ventilated Patients. Reply.

N Engl J Med 2020 06;382(26):e107

Odense University Hospital, Odense, Denmark

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http://dx.doi.org/10.1056/NEJMc2011055DOI Listing

Nonsedation or Light Sedation in Critically Ill, Mechanically Ventilated Patients.

N Engl J Med 2020 06;382(26):e107

Brugmann University Hospital, Brussels, Belgium

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http://dx.doi.org/10.1056/NEJMc2011055DOI Listing

Dynamic behavior of the locus coeruleus during arousal-related memory processing in a multi-modal 7T fMRI paradigm.

Elife 2020 Jun 24;9. Epub 2020 Jun 24.

Techna Institute & Koerner Scientist in MR Imaging, University Health Network, Toronto, Canada.

A body of animal and human evidence points to the norepinephrine (NE) locus coeruleus (LC) system in modulating memory for arousing experiences, but whether the LC would recast its role along memory stages remains unknown. Sedation precluded examination of LC dynamics during memory processing in animals. Here, we addressed the contribution of the LC during arousal-associated memory processing through a unique combination of dedicated ultra-high-field LC-imaging methods, a well-established emotional memory task, online physiological and saliva alpha-amylase measurements in young adults. Read More

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http://dx.doi.org/10.7554/eLife.52059DOI Listing