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Latest & greatest articles for sedation
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CRACKCast E195 – Procedural Sedation and Analgesia CRACKCast E195 - Procedural Sedation and Analgesia - CanadiEM CRACKCast E195 – Procedural Sedation and Analgesia In , by Owen Scheirer November 5, 2018 This updated episode of CRACKCast cover’s Rosen’s Chapter 004, Procedural Sedation and Analgesia (9th Ed.). These topics are core knowledge that we use every day in the Emergency Department. Shownotes – Key Concepts Safe, effective procedural sedation requires high-level skills and information (...) and sound protocols, including patient monitoring. Patients should be discharged in the company of a responsible adult and should remain with a responsible adult for 4 to 8 hours after recovery and discharge Propofol is the agent of choice for deep sedation in the ED but requires supplementation with an opioid analgesic when a painful procedure is planned. Absence of a pre-procedure fasting period is not a contraindication to procedural sedation for an emergent and/or time-sensitive condition. Pulse
Policy for Selecting Anesthesia Providers for the Delivery of Office-based Deep Sedation/General Anesthesia AMERICAN ACADEMY OF PEDIATRIC DENTISTRY ORAL HEALTH POLICIES 139 Purpose The American Academy of Pediatric Dentistry ( AAPD) recognizes that it is the exclusive responsibility of dental prac- titioners, when employing anesthesia providers to administer office-based deep sedation/general anesthesia, to verify and carefully review the credentials and experience of those providers. 1 (...) sedation/general anesthesia was provided in a surgical center or hospital-based setting by an anesthesiologist selected and vetted by the facility or insti- tution. The dental surgeon had little, if any, choice as to who would provide these services. Current trends find an increasing number of dental providers electing to complete such care in the confines of their office using the services of an anesthesia provider. 2 Over the last decade, office-based deep sedation/ general anesthesia in the dental
Sedation during minimal invasive surfactant therapy: a randomised controlled trial Although sedation for endotracheal intubation of infants is widely adopted, there is no consensus whether sedation should be used for minimal invasive surfactant therapy (MIST). We compared, in a randomised controlled setting, the level of stress and comfort of preterm infants during MIST with and without receiving low-dose sedation.Infants between 26 and 36 weeks gestational age were randomised to receive either (...) low-dose sedation (1 mg/kg propofol intravenous) or no premedication during MIST procedure. Standard comfort care was given in both groups, which consisted of administering sucrose in the cheek pouch of the infant and containment. Primary end point was the percentage of infants assessed to be comfortable during the procedure (COMFORTneo-score <14). Secondary parameters included complications of both the MIST procedure and low-dose sedation administration.In total, 78 infants were randomised
Randomized Clinical Trial Comparing Procedural Amnesia and Respiratory Depression Between Moderate and Deep Sedation With Propofol in the Emergency Department The objective was to determine if there is a difference in procedural amnesia and adverse respiratory events (AREs) between the target sedation levels of moderate (MS) and deep (DS) procedural sedation.This was a prospective, randomized clinical trial of consenting adult patients planning to undergo DS with propofol between March 5, 2015 (...) , and May 24, 2017. Patients were randomized to a target sedation level of MS or DS using the American Society of Anesthesiologist's definitions. Drug doses, vital signs, observer's assessment of alertness/sedation (OAAS) score, end-tidal CO2 (ETCO2 ), and the need for supportive airway maneuvers (SAMs; bag-valve mask use, repositioning, and stimulation to induce respirations) were monitored continuously. A standardized image was shown every 30 seconds starting 3 minutes before the procedure continuing
Effect of Depth of Sedation in Older Patients Undergoing Hip Fracture Repair on Postoperative Delirium: The STRIDE Randomized Clinical Trial Postoperative delirium is the most common complication following major surgery in older patients. Intraoperative sedation levels are a possible modifiable risk factor for postoperative delirium.To determine whether limiting sedation levels during spinal anesthesia reduces incident delirium overall.This double-blind randomized clinical trial (A Strategy (...) to Reduce the Incidence of Postoperative Delirum in Elderly Patients [STRIDE]) was conducted from November 18, 2011, to May 19, 2016, at a single academic medical center and included a consecutive sample of older patients (≥65 years) who were undergoing nonelective hip fracture repair with spinal anesthesia and propofol sedation. Patients were excluded for preoperative delirium or severe dementia. Of 538 hip fractures screened, 225 patients (41.8%) were eligible, 10 (1.9%) declined participation, 15
Intraoperative Sedation With Dexmedetomidine is Superior to Propofol for Elderly Patients Undergoing Hip Arthroplasty: A Prospective Randomized Controlled Study Peripheral nerve block is a preferable method for elderly patients receiving hip arthroplasty. Sedation with dexmedetomidine may reduce postoperative delirium (POD). The aim of this study was to investigate whether intraoperative sedation with dexmedetomidine, as a supplementary to peripheral nerve block for elderly patients receiving (...) total hip arthroplasty, can decrease the prevalence of POD.A prospective, randomized controlled study was conducted with patients 65 years of age or older who underwent total hip arthroplasty between June 2016 and June 2017. The patients were randomly assigned to receive a lumbosacral plexus plus T12 paravertebral block supplemented with propofol or dexmedetomidine for sedation. Incidence of POD was the primary endpoint and was determined with the confusion assessment method, and incidence
Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU Clinical Practice Guidelines for the Prevention and Manageme... : Critical Care Medicine You may be trying to access this site from a secured browser on the server. Please enable scripts and reload this page. Login No user account? Lippincott Journals Subscribers , use your username or email along with your password to log in. Remember me (...) connections included those unable to attend. A formal conflict of interest policy was developed a priori and enforced throughout the process. Teleconferences and electronic discussions among subgroups and whole panel were part of the guidelines ’ development. A general content review was completed face-to-face by all panel members in January 2017. Methods: Content experts, methodologists, and ICU survivors were represented in each of the five sections of the guidelines : Pain , Agitation/ sedation
Sedation Top results for sedation - Trip Database or use your Google+ account Find evidence fast ALL of these words: Title only Anywhere in the document ANY of these words: Title only Anywhere in the document This EXACT phrase: Title only Anywhere in the document EXCLUDING words: Title only Anywhere in the document Timeframe: to: Combine searches by placing the search numbers in the top search box and pressing the search button. An example search might look like (#1 or #2) and (#3 or #4 (...) ) Loading history... Population: Intervention: Comparison: Outcome: Population: Intervention: Latest & greatest articles for sedation The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted
Use of Anesthesia Providers in the Administration of Office-based Deep Sedation/General Anesthesia to the Pediatric Dental Patient AMERICAN ACADEMY OF PEDIATRIC DENTISTRY RECOMMENDATIONS: BEST PRACTICES 317 Purpose The American Academy of Pediatric Dentistry ( AAPD) recognizes that there are pediatric dental patients for whom routine dental care using nonpharmacologic behavior guidance techniques is not a viable approach. 1 The AAPD intends this guideline to assist the dental practitioner who (...) elects to use a licensed anesthesia provider for the administration of deep sedation/general anesthesia for pediatric dental patients in a dental office or other facility outside of an accredited hospital or ambulatory surgical center. This document discusses person - nel, facilities, documentation, and quality assurance mechanisms necessary to provide optimal and responsible patient care. Methods Recommendations on the use of anesthesia providers in the administration of office-based deep sedation
Recent Trends in the Practice of Procedural Sedation Under Local Anesthesia for Catheter Ablation, Gastrointestinal Endoscopy, and Endoscopic Surgery in Japan: A Retrospective Database Study in Clinical Practice from 2012 to 2015 To investigate changes in sedation practice during 2012-2015, using a large health claims database, for catheter ablation (CA), gastrointestinal endoscopic examination (EE), and surgery (ES) after dexmedetomidine (DEX) was approved for procedural sedation in 2013. We (...) or ES. The most common complications with CA, EE, and ES were bradycardia, nausea and vomiting, and respiratory depression, respectively. There were no changes in the complications' trends for the procedures.The approved use of DEX for procedural sedation resulted in changes for CA, but not for EE or ES. The complication trends did not change.
Practice Guidelines for Moderate Procedural Sedation and Analgesia Practice Guidelines for Moderate Procedural Sedation and Analgesia 2018:A Report by the American Society of Anesthesiologists Task Force on Moderate Procedural Sedation and Analgesia, the American Association of Oral and Maxillofacial Surgeons, American College of Radiology, American Dental Association, American Society of Dentist Anesthesiologists, and Society of Interventional Radiology* | Anesthesiology | ASA Publications (...) 2568626736 ASA Publications Log in to access full content You must be logged in to access this feature. ASA members enjoy complimentary access to ASA publications, as well as a variety of educational resources. Non-ASA Members Login Free Practice Parameter | March 2018 Practice Guidelines for Moderate Procedural Sedation and Analgesia 2018: A Report by the American Society of Anesthesiologists Task Force on Moderate Procedural Sedation and Analgesia, the American Association of Oral and Maxillofacial
Guidelines for sedation and anesthesia in GI endoscopy GUIDELINE Guidelines for sedation and anesthesia in GI endoscopy Prepared by: ASGE STANDARDS OF PRACTICE COMMITTEE Dayna S. Early, MD, FASGE, Jenifer R. Lightdale, MD, MPH, FASGE, John J. Vargo, II, MD, MPH, FASGE (invited content expert, ad hoc member), Ruben D. Acosta, MD, Vinay Chandrasekhara, MD, Krishnavel V. Chathadi, MD, John A. Evans, MD, Deborah A. Fisher, MD, MHS, FASGE, Lisa Fonkalsrud, BSN, RN, CGRN, Joo Ha Hwang, MD, PhD, FASGE (...) , Mouen A. Khashab, MD, V. Raman Muthusamy, MD, FASGE, Shabana F. Pasha, MD, FASGE, John R. Saltzman, MD, FASGE, Amandeep K. Shergill, MD, Brooks D. Cash, MD, FASGE, Previous Committee Chair, John M. DeWitt, MD, FASGE, Committee Chair The ASGE guidelines for sedation and anesthesia in GI endoscopy were reviewed and endorsed by the American Association for the Study of Liver Diseases, the American College of Gastroenterology, and the American Gastroenterological Association. This document was reviewed
Guidelines for Safe Care for Patients Sedated in Health Care Facilities for Acute Behavioural Disturbance PS63 2018 Page 1 PS63 2018 Australasian College for Emergency Medicine (ACEM) – G637 Australian and New Zealand College of Anaesthetists (ANZCA) – PS63 College of Intensive Care Medicine (CICM) – IC-22 Royal Australian and New Zealand College of Psychiatrists (RANZCP) – see explanatory notes Guidelines for Safe Care for Patients Sedated in Health Care Facilities for Acute Behavioural (...) Disturbance 1. INTRODUCTION Acute health-related behavioural disturbance (ABD) can occur in any health setting at any time. Whilst ABD may present secondary to acute mental illness, there are many underlying aetiologies of this phenomenon. Not uncommonly comorbid conditions, particularly substance-related disorders, are present. Agitated delirium, a common type of ABD may complicate virtually any medical or surgical condition. Details of clinical conditions may not be known at the time sedation
Effectiveness and safety of gastrointestinal endoscopy during a specific sedation training program for non-anesthesiologists. sedation is a key component for the improvement of sedation quality. A correct administration requires appropriate training. We performed a study to compare sedation effectiveness, safety and patient satisfaction when administered by gastroenterologists, with and without specific training.a training program enrolled a group of gastroenterologists (trained group, n = 4 (...) ) and their results were compared to those from a non-trained group (n = 3). ASA 1-3 patients who had undergone sedation by a gastroenterologist using midazolam and fentanyl were included over a period of 30 months. Safety was assessed in terms of the complication rate, effectiveness was assessed via the rate of completed endoscopic procedures and patient satisfaction was evaluated via a phone interview the day after the procedure.a total of 3,475 patients were sedated by gastroenterologists during the study
Effectiveness and safety of nitrous oxide as sedation regimen in children Effectiveness and safety of nitrous oxide as sedation regimen in children – an HTA - NIPH Search for: Søk Menu To top level Close Infectious diseases & Vaccines Mental & Physical health Environment & Lifestyle Health in Norway Quality & Knowledge Research & Access to data About NIPH Close Effectiveness and safety of nitrous oxide as sedation regimen in children – an HTA Order Download: Key message Nitrous oxide, N 2 O (...) , has a sedative and analgesic effect by inhalation. N 2 O is used at maternity wards and at dental offices in Norway. Additionally, a few hospitals use N 2 O for sedation of children for minor hospital procedures. The objective for the present report, is to systematically summarize published results on effectiveness using nitrous oxide in a paediatric setting for small, but painful hospital procedures. Safety issues for both the patients and health personnel exposed to nitrous oxide will also
Propofol for Conscious Sedation During Endoscopies: Clinical Effectiveness, Cost-Effectiveness, and Guidelines Propofol for Conscious Sedation During Endoscopies: Clinical Effectiveness, Cost-Effectiveness, and Guidelines | CADTH.ca Find the information you need Propofol for Conscious Sedation During Endoscopies: Clinical Effectiveness, Cost-Effectiveness, and Guidelines Propofol for Conscious Sedation During Endoscopies: Clinical Effectiveness, Cost-Effectiveness, and Guidelines Published (...) on: November 14, 2017 Project Number: RB1157-000 Product Line: Research Type: Drug Report Type: Summary of Abstracts Result type: Report Question What is the comparative clinical effectiveness of propofol versus fentanyl or midazolam for conscious sedation during endoscopy procedures? What is the cost-effectiveness of propofol versus fentanyl or midazolam for conscious sedation during endoscopy procedures? What are the evidence-based guidelines for the use of propofol for conscious sedation during
Oral Midazolam and Intranasal Midazolam are equally effective when used for conscious sedations in short procedures in pediatric dentistry. UTCAT3283, Found CAT view, CRITICALLY APPRAISED TOPICs University: | | ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM View the CAT / Title Oral Midazolam and Intranasal Midazolam are equally effective when used for conscious sedations in short procedures in pediatric dentistry. Clinical Question For a dental pediatric patient, will intranasal midazolam (...) as compared to oral midazolam be more effective for use in conscious sedation? Clinical Bottom Line For dental pediatric patient intranasal midazolam and oral midazolam are equally effective when used in conscious sedation in short procedures in pediatric dentistry. Intranasal midazolam has a shorter onset and shorter working time when compared to oral midazolam. It is important to take the onset time and duration time into consideration when deciding which medications to use for treatment of pediatric