39,517 results match your criteria Sedation


Activating α4β2 Nicotinic Acetylcholine Receptors Alleviates Fentanyl-induced Respiratory Depression in Rats.

Anesthesiology 2019 Apr 16. Epub 2019 Apr 16.

From the Department of Physiology, University of Alberta, Edmonton, Alberta, Canada.

What We Already Know About This Topic: Opioid-induced respiratory depression results in part from direct activation of μ-opioid receptors expressed in the inspiratory rhythm generator located in the ventrolateral medulla, the preBötzinger ComplexRespiratory neurons within the medulla also express nicotinic acetylcholine receptors, which are made up of five subunits, arranged symmetrically around a central poreActivation of the nicotinic acetylcholine receptor α4, α7, and β2 subunits increases respiratory rhythm, whereas activation of the nicotinic acetylcholine receptor α4β2 or α7 subunits induces analgesia in multiple forms of pain WHAT THIS ARTICLE TELLS US THAT IS NEW: The nonselective nicotinic acetylcholine receptor agonist nicotine and the α4β2 nicotinic acetylcholine receptor agonist A85380, but not the α7 nicotinic acetylcholine receptor agonist PNU282987, reversed respiratory depression induced by activation of μ-opioid receptors in rats both in vitro and in vivoCoadministration of A85380 with fentanyl not only markedly reduced respiratory depression and apneas but also enhanced the fentanyl-induced analgesia BACKGROUND:: Opioid analgesics are widely used for treatment of acute, postoperative, and chronic pain. However, activation of opioid receptors can result in severe respiratory depression. There is an unmet clinical need to develop a pharmacologic therapy to counter opioid-induced respiratory depression without interfering with analgesia. Read More

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http://dx.doi.org/10.1097/ALN.0000000000002676DOI Listing

Whole Egg Consumption Impairs Insulin Sensitivity in a Rat Model of Obesity and Type 2 Diabetes.

Curr Dev Nutr 2019 Apr 11;3(4):nzz015. Epub 2019 Mar 11.

Department of Food Science and Human Nutrition, Iowa State University, Ames, IA 50011.

Background: The literature regarding the relation between egg consumption and type 2 diabetes (T2D) is inconsistent and there is limited evidence pertaining to the impact of egg consumption on measures of insulin sensitivity.

Objectives: The aim of this study was to investigate the effect of dietary whole egg on metabolic biomarkers of insulin resistance in T2D rats.

Methods: Male Zucker diabetic fatty (ZDF) rats ( = 12; 6 wk of age) and age-matched lean controls ( = 12) were randomly assigned to be fed a casein- or whole egg-based diet. Read More

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http://dx.doi.org/10.1093/cdn/nzz015DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6462456PMC

Dexmedetomidine versus fentanyl added to bupivacaine for epidural analgesia in combination with general anesthesia for elective lumbar disc operations: A prospective, randomized double-blinded study.

Saudi J Anaesth 2019 Apr-Jun;13(2):119-125

Department of Anesthesiology, Intensive Care and Pain Management, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

Background: The literature on drugs used for combined general anesthesia and epidural analgesia (CGE) in lumbar operations is scarce. The purpose of the study was to compare the addition of either dexmedetomidine or fentanyl to bupivacaine for epidural analgesia in combination with general anesthesia with regard to efficacy and adverse events in such operations.

Materials And Methods: This prospective, randomized, double-blinded study was conducted on 80 patients who were scheduled for an elective lumbar disc operation, age 20-65 years, of either sex and American Society of Anesthesiologists physical status I or II. Read More

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http://dx.doi.org/10.4103/sja.SJA_600_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6448444PMC

Postoperative analgesia with ropivacaine and dexmedetomidine for ultrasound-guided fascia iliaca compartment block after arthroscopic knee surgery.

Saudi J Anaesth 2019 Apr-Jun;13(2):100-105

Department of Anesthesiology, Jiangyin Hospital, Affiliated to Southeast University Medical School, Jiangyin, China.

Objective: The objective of this study is to evaluate the postoperative analgesic effect of a combination of ropivacaine and dexmedetomidine for ultrasound-guided fascia iliaca compartment block (FICB) after knee arthroscopy.

Materials And Methods: Forty patients scheduled for knee arthroscopy were randomized to receive either 30 ml of 0.25% ropivacaine alone (Group A, = 20) or combined with dexmedetomidine 1 μg/kg (Group B, = 20). Read More

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http://dx.doi.org/10.4103/sja.SJA_533_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6448445PMC

Evaluation of the effect and safety of dexmedetomidine as an additive to local anesthesia in peribulbar block for vitreoretinal surgery.

Indian J Ophthalmol 2019 May;67(5):636-640

Department of Vitreoretina, Dr. Shroff's Charity Eye Hospital, New Delhi, India.

Purpose: We conducted a prospective, randomized study to evaluate the efficacy of dexmedetomidine as an additive to peribulbar block for vitreoretinal surgery in terms of onset time of block, hemodynamic stability profile, patient comfort, and surgeon satisfaction.

Methods: One hundred patients of American Society of Anesthesiologists grade 1 and 2 scheduled for vitreoretinal surgery were randomly assigned into two groups: control group (n = 50) received lignocaine bupivacaine block, and Dex group (n = 50) received lignocaine bupivacaine plus 20 μg dexmedetomidine peribulbar block. Information regarding time for onset of block, hemodynamic data, visual analog scale for pain, sedation levels, total duration of surgery, and surgeon satisfaction levels were collected. Read More

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http://dx.doi.org/10.4103/ijo.IJO_1386_18DOI Listing

International prospective observational study on intracranial pressure in intensive care (ICU): the SYNAPSE-ICU study protocol.

BMJ Open 2019 Apr 20;9(4):e026552. Epub 2019 Apr 20.

Department of Public Health, Erasmus MC, Rotterdam, Netherlands.

Introduction: Intracranial pressure (ICP) monitoring is commonly used in neurocritical care patients with acute brain injury (ABI). Practice about indications and use of ICP monitoring in patients with ABI remains, however, highly variable in high-income countries, while data on ICP monitoring in low and middle-income countries are scarce or inconsistent. The aim of the SYNAPSE-ICU study is to describe current practices of ICP monitoring using a worldwide sample and to quantify practice variations in ICP monitoring and management in neurocritical care ABI patients. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-026552DOI Listing
April 2019
1 Read

Deep continuous patient-requested sedation until death: a multicentric study.

BMJ Support Palliat Care 2019 Apr 20. Epub 2019 Apr 20.

Department of Palliative Care, Hospices Civils de Lyon, Lyon, France

Objectives: In 2016, a new law was adopted in France granting patients the right, under specific conditions, to continuous deep sedation until death (CDSUD). The goal of this study was to measure the frequency of requests for CDSUD from patients in palliative care.

Methods: The data collected from the medical records of patients in palliative care units (PCU) or followed by palliative care support teams (PCST) in the Rhône-Alpes area, who died after CDSUD, focused on the patient's characteristics, the drugs used (and compliance with regulatory processes). Read More

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http://spcare.bmj.com/lookup/doi/10.1136/bmjspcare-2018-0017
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http://dx.doi.org/10.1136/bmjspcare-2018-001712DOI Listing
April 2019
1 Read

Ethics of crisis sedation: questions of performance and consent.

J Med Ethics 2019 Apr 20. Epub 2019 Apr 20.

Institute of Ethics, Dublin City University, Dublin, Ireland.

This paper focuses on the practice of injecting patients who are dying with a relatively high dose of sedatives in response to a catastrophic event that will shortly precipitate death, something that we term 'crisis sedation.' We first present a confabulated case that illustrates the kind of events we have in mind, before offering a more detailed account of the practice. We then comment on some of the ethical issues that crisis sedation might raise. Read More

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http://dx.doi.org/10.1136/medethics-2018-105285DOI Listing

Healthcare professionals' use of augmentative and alternative communication in an intensive care unit: A survey study.

Intensive Crit Care Nurs 2019 Apr 17. Epub 2019 Apr 17.

Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Box 457, 405 30 Gothenburg, Sweden. Electronic address:

Introduction: Successful communication between staff and patients plays a key role in the well-being of critically ill patients within an intensive care unit. The use of augmentative and alternative communication strategies could contribute to better pain management, medical outcomes and shorter hospital stays for patients in critical care units.

Objective: To describe healthcare professionals' use of augmentative and alternative communication strategies to communicate with critically ill patients regarding pain in an intensive care unit. Read More

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http://dx.doi.org/10.1016/j.iccn.2019.04.002DOI Listing

The silent epidemic of chronic pain in older adults.

Prog Neuropsychopharmacol Biol Psychiatry 2019 Apr 17. Epub 2019 Apr 17.

Lipid Peroxidation Unit, Laboratory of Clinical Investigation, National Institute on Aging, Baltimore, MD, USA; Intramural Program of the National Institute on Alcohol Abuse and Alcoholism, USA. Electronic address:

Chronic pain is highly prevalent among older adults where it is associated with significant suffering, disability, social isolation, and greater costs and burden to health care systems. Pharmaceutical treatment of chronic pain in older adults is usually only partially effective and is often limited by side effects including urinary retention, constipation, sedation, cognitive impairment, and increased risk of falls. Since older adults are underrepresented in clinical trials testing treatments for chronic pain, the potential impacts of polypharmacy and frailty on reported outcomes and side effect profiles are largely unknown. Read More

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http://dx.doi.org/10.1016/j.pnpbp.2019.04.006DOI Listing
April 2019
2 Reads

Intravenous Oxycodone Versus Other Intravenous Strong Opioids for Acute Postoperative Pain Control: A Systematic Review of Randomized Controlled Trials.

Pain Ther 2019 Apr 19. Epub 2019 Apr 19.

Mundipharma Singapore Holding Pte. Ltd., Singapore, Singapore.

Introduction: Optimal pain management is crucial to the postoperative recovery process. We aimed to evaluate the efficacy and safety of intravenous oxycodone with intravenous fentanyl, morphine, sufentanil, pethidine, and hydromorphone for acute postoperative pain.

Methods: A systematic literature search of PubMed, Cochrane Library, and EMBASE databases was performed for randomized controlled trials published from 2008 through 2017 (inclusive) that evaluated the acute postoperative analgesic efficacy of intravenous oxycodone against fentanyl, morphine, sufentanil, pethidine, and hydromorphone in adult patients (age ≥ 18 years). Read More

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http://dx.doi.org/10.1007/s40122-019-0122-4DOI Listing

A Protocol for Sedation Free MRI and PET Imaging in Adults with Autism Spectrum Disorder.

J Autism Dev Disord 2019 Apr 19. Epub 2019 Apr 19.

Massachusetts General Hospital, Boston, MA, USA.

Imaging technologies such as positron emission tomography (PET) and magnetic resonance imaging (MRI) present unparalleled opportunities to investigate the neural basis of autism spectrum disorder (ASD). However, challenges such as deficits in social interaction, anxiety around new experiences, impaired language abilities, and hypersensitivity to sensory stimuli make participating in neuroimaging studies challenging for individuals with ASD. In this commentary, we describe the existent training protocols for preparing individuals with ASD for PET/MRI scans and our own experience developing a training protocol to facilitate the inclusion of low-functioning adults with ASD in PET-MRI studies. Read More

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http://link.springer.com/10.1007/s10803-019-04010-3
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http://dx.doi.org/10.1007/s10803-019-04010-3DOI Listing
April 2019
1 Read

Assessment of analgesia, sedation, physical restraint and delirium in patients admitted to Spanish intensive care units. Proyecto ASCyD.

Enferm Intensiva 2019 Apr 16. Epub 2019 Apr 16.

Grupo de Trabajo de Analgesia, Sedación, Contenciones y Delirio de la Sociedad Española de Enfermería Intensiva y Unidades Coronarias (GT-ASCyD-SEEIUC), España; Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Madrid, España; Instituto de Investigación Sanitaria Puerta de Hierro-Segovia de Arana (IDIPHISA), Majadahonda, Madrid, España.

Aims: Main aim: To determine the Spanish intensive care units (ICU) that assess and record pain levels, sedation/agitation, delirium and the use of physical restraint (PR) as standard practice. Secondary aims: To determine the use of validated assessment tools and to explore patients' levels of pain and sedation/agitation, the prevalence of delirium, and the use of PR.

Method: An observational, descriptive, cross-sectional, prospective and multicentre study using an ad hoc survey with online access that consisted of 2 blocks. Read More

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http://dx.doi.org/10.1016/j.enfi.2018.11.002DOI Listing

First in-Human Gallbladder Cryoablation in a Patient with Acute Calculous Cholecystitis Initially Treated with a Cholecystostomy Tube.

J Vasc Interv Radiol 2019 Apr 16. Epub 2019 Apr 16.

Department of Medical Imaging, University of Arizona, 1501 N. Campbell Avenue, Tucson, AZ 85724.

A 71-year-old poor surgical candidate with acute calculous cholecystitis was initially managed with cholecystostomy tube drainage for 28 days. He subsequently underwent gallbladder cryoablation under moderate sedation with 3 cryoprobes and 2 separate 10-8-10 freeze-thaw cycles targeting the gallbladder neck/body and fundus followed by cholecystostomy tube removal. He was discharged 1 day after ablation. Read More

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http://dx.doi.org/10.1016/j.jvir.2018.12.011DOI Listing
April 2019
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Patient Satisfaction with Oral Versus Intravenous Sedation for Cataract Surgery : A Randomized Clinical Trial.

Ophthalmology 2019 Apr 16. Epub 2019 Apr 16.

Department of Ophthalmology, Boston Medical Center, Boston University School of Medicine, Boston, MA.

Purpose: To determine whether patient satisfaction with oral sedation is non-inferior to intravenous (IV) sedation for cataract surgery.

Design: A prospective, randomized, double-masked clinical trial.

Subjects: A volunteer sample of patients age 18 or older from diverse ethnic, racial, and socioeconomic backgrounds scheduled for cataract surgery. Read More

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http://dx.doi.org/10.1016/j.ophtha.2019.04.022DOI Listing

Procainamide vs. Amiodarone for Stable Ventricular Tachycardia.

Acad Emerg Med 2019 Apr 19. Epub 2019 Apr 19.

Department of Emergency Medicine, SUNY Downstate Medical Center, 450 Clarkson Ave., Box: 1228, Brooklyn, NY, 11203.

Electrical cardioversion is an effective treatment for termination of ventricular tachycardia (VT) but is typically performed with procedural sedation, and thus involves associated risk. In hemodynamically stable VT, pharmacologic cardioversion is an option. Historically, lidocaine, amiodarone, procainamide, and sotalol have been used for pharmacologic cardioversion, based mostly upon expert opinion. Read More

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http://dx.doi.org/10.1111/acem.13767DOI Listing
April 2019
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Lornoxicam with Low-Dose Ketamine versus Pethidine to Control Pain of Acute Renal Colic.

Pain Res Treat 2019 13;2019:3976027. Epub 2019 Mar 13.

Department of Anesthesia, ICU and Pain Management, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

Objectives: This study was established to compare single-dose lornoxicam 8 mg (NSAID) in addition to 0.15 mg.kg ketamine with single-dose pethidine 50 mg, both administered intravenously (IV), on the quickness and extent of analgesia, disadvantage, and consequence on utilitarian situation. Read More

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http://dx.doi.org/10.1155/2019/3976027DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6436326PMC
March 2019
2 Reads

Anaesthetic management of an infant with tracheomalacia scheduled for computed tomography angiography: A challenge.

Indian J Anaesth 2019 Apr;63(4):312-315

Department of Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India.

Tracheomalacia is characterised by collapse of the tracheal wall with respiration. Computed tomography angiography (CTA) can be utilised for evaluation of airway abnormalities but providing sedation/anaesthesia for CTA in such a case carries the risk of airway catastrophe. We describe the anaesthetic management of an infant who had tracheomalacia with >90% collapse in lower two third of the intrathoracic trachea as diagnosed on videobronchoscpy and was scheduled for CTA. Read More

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http://www.ijaweb.org/text.asp?2019/63/4/312/255468
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http://dx.doi.org/10.4103/ija.IJA_874_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6460980PMC
April 2019
1 Read

Early-Onset Ventilator-Associated Pneumonia in Severe Traumatic Brain Injury: is There a Relationship with Prehospital Airway Management?

J Emerg Med 2019 Apr 15. Epub 2019 Apr 15.

Division of Anesthesia, Intensive Care, and Prehospital Emergency, Maggiore Hospital Carlo Alberto Pizzardi, Bologna, Italy.

Background: Prehospital airway management in severe traumatic brain injury (TBI) is widely recommended by international guidelines for the management of trauma. Early-onset ventilator-associated pneumonia (EOVAP) is a common occurrence in this population and can worsen mortality and functional outcome.

Objectives: In this retrospective observational study, we aimed to evaluate the association between different prehospital airway management variables and the occurrence of EOVAP. Read More

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http://dx.doi.org/10.1016/j.jemermed.2019.02.005DOI Listing
April 2019
1.175 Impact Factor

MRI-guided frame-based stereotactic brainstem biopsy procedure: A single-center experience.

Neurocirugia (Astur) 2019 Apr 15. Epub 2019 Apr 15.

Department of Neurosurgery, Kent Hospital, İzmir, Turkey.

Introduction And Objectives: This study aims at presenting our experience of the MRI-guided frame-based stereotactic brainstem biopsy method, and evaluating the outcomes of the procedure.

Patients And Methods: The current study involved 18 cases that underwent MRI-guided frame-based stereotactic biopsy for brainstem lesions between 2011 and 2018 in our clinic. The relevant data regarding the technique of the biopsy procedure, morbidity, histopathological diagnosis it yields and diagnostic accuracy was retrospectively analyzed. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S11301473193002
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http://dx.doi.org/10.1016/j.neucir.2019.03.001DOI Listing
April 2019
1 Read

Temperament in the prediction of proximal versus distal expectancies: An acquired preparedness model.

Exp Clin Psychopharmacol 2019 Apr 18. Epub 2019 Apr 18.

Department of Counseling and Psychology in Education.

In the acquired preparedness model of risk, alcohol expectancies mediate the association between personality and alcohol problems. In the current study, we tested the associations between temperament (i.e. Read More

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http://dx.doi.org/10.1037/pha0000283DOI Listing

Condyle dislocation following mandibular reconstruction using a fibula free flap: complication cases.

Maxillofac Plast Reconstr Surg 2019 Dec 1;41(1):14. Epub 2019 Apr 1.

1Department of Oral and Maxillofacial Surgery, Yonsei University, College of Dentistry, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722 Republic of Korea.

Background: Condylar dislocation can arise as a complication in patients who required mandibular and/or condylar reconstruction and were operated on with fibula free flap (FFF) using surgical guides designed using simulation surgery. Surgeons should be aware of the complications in these present cases when planning and performing reconstructions as well as predicting prognoses.

Cases Presentation: Two cases showed condylar dislocation in mandibular reconstruction using a FFF fixed with a reconstruction plate. Read More

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http://dx.doi.org/10.1186/s40902-019-0197-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6441667PMC
December 2019

Comparative Study Between Oral Lorazepam and Diazepam as Sedation in Oral and Maxillofacial Surgery.

J Maxillofac Oral Surg 2019 Jun 5;18(2):256-259. Epub 2018 Mar 5.

1Oral and Maxillofacial Surgery, National Dental College, Derabassi, Punjab India.

Purpose: The aim of the study was to compare the efficacy of oral lorazepam as night sedation and premedication with diazepam.

Methods: A prospective, randomized, and double-blind study was done in 50 healthy patients in each drug group. The impacted third molar impaction was taken as the study model. Read More

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http://dx.doi.org/10.1007/s12663-018-1096-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6441416PMC

A prospective investigation of interleukin-8 levels in pediatric acute respiratory failure and acute respiratory distress syndrome.

Crit Care 2019 Apr 17;23(1):128. Epub 2019 Apr 17.

Division of Pediatric Critical Care Medicine, Department of Pediatrics and Communicable Diseases, University of Michigan, 1500 East Medical Center Dr, F6790/5243, Ann Arbor, MI, 48109, USA.

Background: The association of plasma interleukin-8 (IL-8), or IL-8 genetic variants, with pediatric acute respiratory distress syndrome (PARDS) in children with acute respiratory failure at risk for PARDS has not been examined. The purpose of this study was to examine the association of early and sequential measurement of plasma IL-8 and/or its genetic variants with development of PARDS and other clinical outcomes in mechanically ventilated children with acute respiratory failure.

Methods: This was a prospective cohort study of children 2 weeks to 17 years of age with acute airways and/or parenchymal lung disease done in 22 pediatric intensive care units participating in the multi-center clinical trial, Randomized Evaluation of Sedation Titration for Respiratory Failure (RESTORE). Read More

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http://dx.doi.org/10.1186/s13054-019-2342-8DOI Listing
April 2019
2 Reads

Sedation practices and clinical outcomes in mechanically ventilated patients in a prospective multicenter cohort.

Crit Care 2019 Apr 17;23(1):130. Epub 2019 Apr 17.

Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, 1830 E Monument St., Suite 555, Baltimore, MD, 21287, USA.

Objectives: We sought to study the association between sedation status, medications (benzodiazepines, opioids, and antipsychotics), and clinical outcomes in a resource-limited setting.

Design: A longitudinal study of critically ill participants on mechanical ventilation.

Setting: Five intensive care units (ICUs) in four public hospitals in Lima, Peru. Read More

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http://dx.doi.org/10.1186/s13054-019-2394-9DOI Listing
April 2019
1 Read

Can we use magnesium for sedation in the intensive care unit for critically ill patients: Is it as effective as other sedatives?

Agri 2019 Apr;31(2):86-92

Department of Anesthiology and Reanimation, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey.

Objectives: The aim of this prospective, randomized study was to investigate the effect of magnesium added to midazolam on the hemodynamics, transition time to a T-piece, mechanical ventilation duration, additional sedative-analgesic requirement using bispectral index (BIS) monitorization and sedation scales.

Methods: Fifty critically ill patients receiving mechanical ventilation support in the intensive care unit were randomly assigned to 2 groups. Group I received a 0. Read More

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http://dx.doi.org/10.14744/agri.2019.59244DOI Listing

Ultrasound-guided placement of pigtail cystostomy tubes in dogs with urethral obstruction.

J Vet Emerg Crit Care (San Antonio) 2019 Apr 17. Epub 2019 Apr 17.

College of Veterinary Medicine, North Carolina State University, Raleigh, NC.

Background: Circumstances such as the inability to pass a retrograde urinary catheter or a lack of surgeon availability may prevent immediate relief of urethral obstruction in dogs. In such situations, a cystostomy tube may be placed with ultrasound guidance to allow urinary diversion until further treatment is possible.

Key Findings: A case of a 5-year-old male neutered Swiss Mountain dog with an obstructive urolith at the level of the os penis is used to describe the technique. Read More

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https://onlinelibrary.wiley.com/doi/abs/10.1111/vec.12832
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http://dx.doi.org/10.1111/vec.12832DOI Listing
April 2019
1 Read

Anesthesia-administered sedation for endoscopic retrograde cholangiopancreatography: monitored anesthesia care or general endotracheal anesthesia?

Curr Opin Anaesthesiol 2019 Apr 15. Epub 2019 Apr 15.

Division of Gastroenterology, Washington University School of Medicine, Saint Louis, Missouri, USA.

Purpose Of Review: The decision to undertake monitored anesthesia care (MAC) or general endotracheal anesthesia (GEA) for patients undergoing endoscopic retrograde cholangiopancreatography (ERCP) is influenced by many factors. These include locoregional practice preferences, procedure complexity, patient position, and comorbidities. We aim to review the data regarding anesthesia-administered sedation for ERCP and identify the impact of airway management on procedure success, adverse event rates and endoscopy unit efficiency. Read More

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http://dx.doi.org/10.1097/ACO.0000000000000741DOI Listing

Buccally Absorbed vs Intravenous Prochlorperazine for Treatment of Migraines Headaches.

Acta Neurol Scand 2019 Apr 16. Epub 2019 Apr 16.

Department of Emergency Medicine, Harbor-UCLA Medical Center and Los Angeles Biomedical Research Institute, Los Angeles, US.

Objective: To compare the efficacy of buccally absorbed prochlorperazine (BAP) to intravenous prochlorperazine (IVP) for the abortive treatment of migraine headaches.

Methods: Randomized double-blind trial. Eighty subjects aged 18-65 presenting with migraines to the ED of a safety-net, urban hospital. Read More

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https://onlinelibrary.wiley.com/doi/abs/10.1111/ane.13104
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http://dx.doi.org/10.1111/ane.13104DOI Listing
April 2019
1 Read

Update in Neurocritical Care: a summary of the 2018 Paris international conference of the French Society of Intensive Care.

Ann Intensive Care 2019 Apr 16;9(1):47. Epub 2019 Apr 16.

Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles (ULB), Route de Lennik, 808, 1070, Brussels, Belgium.

The 2018 Paris Intensive Care symposium entitled "Update in Neurocritical Care" was organized in Paris, June 21-22, 2018, under the auspices of the French Intensive Care Society. This 2-day post-graduate educational symposium comprised several chapters, aiming first to provide all-board intensivists with current standards for the clinical assessment of altered consciousness states (including coma and delirium) and peripheral nervous system in critically ill patients, monitoring of brain function (specifically, electro-encephalography) and best practices for sedation-analgesia-delirium management. An update on the treatment of specific severe brain pathologies-including ischaemic/haemorrhagic stroke, cerebral venous thrombosis, hypoxic-ischaemic brain injury, immune-mediated and infectious encephalitis and refractory status epilepticus-was also provided. Read More

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http://dx.doi.org/10.1186/s13613-019-0523-xDOI Listing
April 2019
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Safety and efficacy of non-anesthesiologist administration of propofol sedation during esophagogastroduodenoscopy in the intensive care unit.

Endosc Int Open 2019 Apr 12;7(4):E625-E629. Epub 2019 Apr 12.

Department of Internal Medicine, Division of Gastroenterology and Hepatology, University of Utah School of Medicine, Salt Lake City, Utah, United States.

 Propofol sedation is an increasingly popular method of sedation for gastrointestinal endoscopic procedures. The safety and efficacy of the non-anesthesiologist administration of propofol (NAAP) sedation has been demonstrated in the ambulatory setting. However, NAAP sedation in intensive care unit (ICU) patients has not been reported. Read More

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http://dx.doi.org/10.1055/a-0829-6284DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6461546PMC

Clinician attitude and perspective on the use of coercive measures in clinical practice from tertiary care mental health establishment - A cross-sectional study.

Indian J Psychiatry 2019 Mar-Apr;61(2):151-155

Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India.

Background: Use of coercive measures in mental health care is an important issue for research. There are scarce data available on perception and attitudes toward coercion among Indian psychiatrists.

Aims: This study aims to study psychiatrists' attitude and perspectives on the use of coercive measure in clinical practice against the background of family and patients' opinion. Read More

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http://dx.doi.org/10.4103/psychiatry.IndianJPsychiatry_336_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6425791PMC
April 2019
2 Reads

Complications associated with stellate ganglion nerve block: a systematic review.

Reg Anesth Pain Med 2019 Apr 16. Epub 2019 Apr 16.

Anesthesiology, Clement Zablocki VA Medical Center/Medical College of Wisconsin, Milwaukee, Wisconsin, USA.

Stellate ganglion nerve blockade (SGNB) is a vital tool in our armamentarium for the treatment of various chronic pain syndromes. SGNB can be performed using the traditional landmark-based approach, or with image guidance using either fluoroscopy or ultrasound. In this review, we systematically analyzed reported SGNB-related complications between 1990 and 2018. Read More

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http://dx.doi.org/10.1136/rapm-2018-100127DOI Listing
April 2019
1 Read

The Effect of an Audiovisual Preoperative Intervention in Reducing Parental Anxiety Prior to a Child's Sedation Appointment: A Pilot Study.

Pediatr Dent 2019 Mar;41(2):112-118

Dr. Mathu-Muju is associate professor of pediatric dentistry, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada;, Email:

The purpose of this pilot study was to determine whether an audiovisual intervention was more effective than verbal instructions at reducing preoperative anxiety levels for parents whose children were having their first experience of dental treatment with the use of oral sedation. A prospective clinical trial was conducted. Parents were systematically assigned to either view an animated video (intervention group) or receive standardized verbal instructions (control group). Read More

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March 2019
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Studying alcohol use disorder using Drosophila melanogaster in the era of 'Big Data'.

Behav Brain Funct 2019 Apr 16;15(1). Epub 2019 Apr 16.

Program in Neuroscience, Middlebury College, Middlebury, VT, 05753, USA.

Our understanding of the networks of genes and protein functions involved in Alcohol Use Disorder (AUD) remains incomplete, as do the mechanisms by which these networks lead to AUD phenotypes. The fruit fly (Drosophila melanogaster) is an efficient model for functional and mechanistic characterization of the genes involved in alcohol behavior. The fly offers many advantages as a model organism for investigating the molecular and cellular mechanisms of alcohol-related behaviors, and for understanding the underlying neural circuitry driving behaviors, such as locomotor stimulation, sedation, tolerance, and appetitive (reward) learning and memory. Read More

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http://dx.doi.org/10.1186/s12993-019-0159-xDOI Listing
April 2019
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Current sedation practices in paediatric audiology clinics in gauteng, South Africa.

Int J Pediatr Otorhinolaryngol 2019 Apr 11;122:93-98. Epub 2019 Apr 11.

Department of Speech Pathology and Audiology, School of Human and Community Development, University of the Witwatersrand, Johannesburg, South Africa. Electronic address:

Aim: The aim was to describe the current practices in sedation during AEP testing in infants and young children in Gauteng.

Methods: An exploratory qualitative research design was employed, where telephonic and face-to face interviews were conducted with 48 participants in paediatric audiology clinics that have AEP testing facilities in Gauteng, South Africa. Qualitative analysis was done, with inductive thematic analysis used for open ended questions. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S01655876193016
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http://dx.doi.org/10.1016/j.ijporl.2019.04.007DOI Listing
April 2019
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How cure rates drive patients' preference for urethral bulking agent or mid-urethral sling surgery as therapy for stress urinary incontinence.

Neurourol Urodyn 2019 Apr 15. Epub 2019 Apr 15.

Department of Obstetrics and Gynecology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.

Aims: To assess the patients' median-accepted threshold of cure rate for urethral bulking agent (UBA) treatment compared to mid-urethral sling (MUS) surgery for treatment of female stress urinary incontinence (SUI). Secondly, to determine the correlation between treatment trade-off point and patient characteristics.

Methods: Women older than 18 years, with predominant SUI, seeking treatment, underwent a structured interview. Read More

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http://dx.doi.org/10.1002/nau.23997DOI Listing

Endoscopic Sedation of the Patient With Cirrhosis.

Clin Liver Dis (Hoboken) 2018 Dec 2;12(6):165-169. Epub 2019 Jan 2.

Department of Medicine Medical University of South Carolina Charleston SC.

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http://doi.wiley.com/10.1002/cld.762
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http://dx.doi.org/10.1002/cld.762DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6446456PMC
December 2018
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Alternative sedation premedication with intranasal dexmedetomidine before dental procedures.

J Dent Sci 2019 Mar 19;14(1):105-106. Epub 2018 Sep 19.

Department of Anesthesiology, Cathay General Hospital, Taipei, Taiwan.

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http://dx.doi.org/10.1016/j.jds.2018.08.007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6446005PMC

Implementation of strategies to liberate patients from mechanical ventilation in a tertiary-level medical center.

Am J Infect Control 2019 Apr 12. Epub 2019 Apr 12.

Research Group of Surgery, Anesthesiology and Intensive Care, Medical Research Center Oulu, Oulu, Finland; Division of Intensive Care, Department of Anesthesiology, Oulu University Hospital, Oulu, Finland.

Background: Considerable discrepancies have been observed in the implementation of strategies to liberate patients from mechanical ventilation. The aim of this study was to describe critical care nurses' knowledge of and self-reported and documented adherence to lung-protective ventilation, daily sedation interruption, and daily assessment of readiness to extubate and evaluate how these practices differ between patients with and without ventilator-associated pneumonia and between survivors and nonsurvivors.

Methods: The survey was conducted in a tertiary-level hospital in Finland from October 2014 to June 2015. Read More

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http://dx.doi.org/10.1016/j.ajic.2019.03.010DOI Listing
April 2019
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Incorporation of a polydioxanone absorbable plate in the successful repair of an iatrogenic oronasal fistula in a dog.

J Am Vet Med Assoc 2019 May;254(9):1094-1098

Case Description: A 10-year-old castrated male Siberian Husky that had undergone complete excision of an oral plasmacytoma was evaluated because of development of a large oronasal fistula following failure of primary defect repair.

Clinical Findings: Clinical examination findings for the dog were unremarkable. The dog was receiving nutrition via an esophagostomy tube, which had been placed at the time of mass excision. Read More

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http://dx.doi.org/10.2460/javma.254.9.1094DOI Listing
May 2019
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Effects of Cannabis Use on Sedation Requirements for Endoscopic Procedures.

J Am Osteopath Assoc 2019 Apr 15. Epub 2019 Apr 15.

Context: Cannabis (or marijuana) became legal for recreational use in Colorado in 2012, and this legislation change has created both challenges and opportunities in medicine. More patients are using cannabis, and more patients are now willing to admit cannabis use than in the past, which increases the likelihood that they will be forthcoming about use during medical questioning. Cannabis use may have implications during medical care, including procedural sedation. Read More

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http://jaoa.org/article.aspx?doi=10.7556/jaoa.2019.052
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http://dx.doi.org/10.7556/jaoa.2019.052DOI Listing
April 2019
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Effect of pretreatment with magnesium sulphate on the duration of intense and deep neuromuscular blockade with rocuronium: A randomised controlled trial.

Eur J Anaesthesiol 2019 Apr 5. Epub 2019 Apr 5.

From the Department of Anesthesiology, Bonsucesso Federal Hospital (Hospital Federal de Bonsucesso) (AJQRM, DDB), Department of Surgery, Anaesthesiology, Surgical Sciences Postgraduate Program, Federal University of Rio de Janeiro (Universidade Federal do Rio de Janeiro), Rio de Janeiro, Brazil (NV, PAGF), Department of Anesthesiology Pain Medicine and Procedural Sedation and Analgesia, Martini General Hospital, Groningen, The Netherlands (HDdB) and Department of General and Specialized Surgery, Anaesthesiology, Medical Sciences Postgraduate Program Federal University Fluminense (Universidade Federal Fluminense), Niterói, Brazil (ILC).

Background: Magnesium sulphate is an important adjuvant drug in multimodal anaesthesia. In combination with rocuronium it can enhance neuromuscular blockade (NMB). Limited data exist concerning the effect of magnesium sulphate on the duration of deep or intense NMB and the period of no response. Read More

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http://dx.doi.org/10.1097/EJA.0000000000001003DOI Listing
April 2019
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Is the Balance in Anesthesia Right? Multitarget Approach and Alteration of Systemic Inflammation.

Anesth Analg 2019 Apr 8. Epub 2019 Apr 8.

Department of Anesthesiology, Pain Medicine and Procedural Sedation and Analgesia, Martini General Hospital Groningen, Groningen, the Netherlands, Department of Anesthesiology, Child Institute - Hospital das Clinicas, São Paulo University Medical School, São Paulo, Brazil, Pro Matre Paulista Maternity Hospital, São Paulo, Brazil Department of Anesthesiology, Intensive Care and Reanimation, Academisch Ziekenhuis Sint-Jan Brugge-Oostende Campus Sint Jan Brugge, Bruges, Belgium.

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http://dx.doi.org/10.1213/ANE.0000000000004167DOI Listing
April 2019
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In the ICU - delirium post cardiac arrest.

Curr Opin Crit Care 2019 Apr 9. Epub 2019 Apr 9.

Division of Critical Care Medicine, Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Purpose Of Review: The present review aims to describe the clinical impact and assessment tools capable of identifying delirium in cardiac arrest survivors and providing strategies aimed at preventing and treating delirium.

Recent Findings: Patient factors leading to a cardiac arrest, initial resuscitation efforts, and postresuscitation management all influence the potential for recovery and the risk for development of delirium. Data suggest that delirium in cardiac arrest survivors is an independent risk factor for morbidity and mortality. Read More

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http://dx.doi.org/10.1097/MCC.0000000000000615DOI Listing
April 2019
2 Reads

Monitored Anesthesia Care by Sedation-Trained Providers in Acute Stroke Thrombectomy.

Front Neurol 2019 28;10:296. Epub 2019 Mar 28.

Department of Neurology, University of Toledo Medical Center, Toledo, OH, United States.

Mechanical thrombectomy (MT) for ischemic stroke can be performed under local anesthesia (LA), conscious sedation (CS), or general anesthesia (GA). The need for monitoring by anesthesia providers may be resource intensive. We sought to determine differences in outcomes of MT when sedation is performed by an anesthesia team compared to sedation-trained providers. Read More

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http://dx.doi.org/10.3389/fneur.2019.00296DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6447680PMC
March 2019
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Upper-Extremity Nerve Decompression Under Local Anesthesia: A Systematic Review of Methods for Reduction of Postoperative Pain and Opioid Consumption.

Hand (N Y) 2019 Apr 15:1558944719843635. Epub 2019 Apr 15.

2 Division of Plastic & Reconstructive Surgery, McGill University Health Centre, Montreal, QC, Canada.

Background: Opioid abuse is a major health concern in North America. Data have shown an alarming increase in opioid-related deaths and complications, which has shed light on current prescription practices across many specialties, including hand surgery. To that end, we sought to conduct a focused literature review to determine the available modalities to decrease postoperative pain and opioid consumption following upper-extremity nerve decompression procedures, taking advantage of the homogeneity and inherent pain pathways of this specific patient cohort. Read More

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http://dx.doi.org/10.1177/1558944719843635DOI Listing
April 2019
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Determination of the 90% effective dose of intranasal dexmedetomidine for sedation during electroencephalography in children.

Acta Anaesthesiol Scand 2019 Apr 14. Epub 2019 Apr 14.

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

Background: The intranasal route of dexmedetomidine (DEX) administration is becoming increasingly popular for providing adequate sedation during short examinations in infants and children. However, data on the 90% effective dose (ED90) of intranasal DEX are rare in children under 3 years old.

Methods: This is a double-blind trial using a biased coin design up-and-down sequential method (BCD-UDM). Read More

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http://dx.doi.org/10.1111/aas.13372DOI Listing
April 2019
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The effect of fluconazole on oral methadone in dogs.

Vet Anaesth Analg 2019 Feb 19. Epub 2019 Feb 19.

Vanderbilt University Center for Neuroscience Drug Discovery, Cool Springs Life Science Center, Nashville, TN, USA.

Objective: To determine the effects of fluconazole on oral methadone pharmacokinetics and central effects mediated by opioid receptors in dogs.

Study Design: Prospective, incomplete block.

Animals: A total of 12 healthy Beagle dogs. Read More

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http://dx.doi.org/10.1016/j.vaa.2019.02.003DOI Listing
February 2019
1 Read