Latest & greatest articles for sedation

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Top results for sedation

101. Sedation versus general anaesthesia for provision of dental treatment in under 18 year olds.

Sedation versus general anaesthesia for provision of dental treatment in under 18 year olds. BACKGROUND: A significant proportion of children have caries requiring restorations or extractions, and some of these children will not accept this treatment under local anaesthetic. Historically this has been managed in children by the use of a general anaesthetic, however use of sedation may lead to reduced morbidity and cost. The aim of this review is to compare the efficiency of sedation versus (...) general anaesthesia for the provision of dental treatment for children and adolescents aged under 18 years.This review was originally published in 2009 and updated in 2012. OBJECTIVES: We evaluated the intra- and postoperative morbidity, effectiveness and cost effectiveness of sedation versus general anaesthesia for the provision of dental treatment for under 18 year olds. SEARCH METHODS: In this updated review we searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane

Cochrane2012

102. Chloral hydrate or midazolam: which is better for sedating children for painless diagnostic imaging?

Chloral hydrate or midazolam: which is better for sedating children for painless diagnostic imaging? BestBets: Chloral hydrate or midazolam: which is better for sedating children for painless diagnostic imaging? Chloral hydrate or midazolam: which is better for sedating children for painless diagnostic imaging? Report By: Dr Michelle Hare - Consultant in Paediatrics Institution: Sheffield Children's Hospital, Western Bank, Sheffield, South Yorkshire, UK Date Submitted: 14th September 2012 Last (...) Modified: 14th September 2012 Status: Green (complete) Three Part Question In [children who require sedation for painless diagnostic imaging] is [chloral hydrate better than midazolam] in achieving [effective and safe sedation]? Clinical Scenario A 2-year-old child is acutely admitted at night to a district general hospital following a prolonged focal seizure. A CT scan of the head without sedation fails as the child is too active and distressed, and as the on-call paediatric registrar, you

BestBETS2012

103. Safe and effective procedural sedation for gastrointestinal endoscopy in children

Safe and effective procedural sedation for gastrointestinal endoscopy in children Safe and effective procedural sedation for gastrointestinal endoscopy in children Safe and effective procedural sedation for gastrointestinal endoscopy in children Van Beek EJ, Leroy PL CRD summary The review concluded that propofol-based therapy was the most effective regimen for procedural sedation during gastrointestinal endoscopy in children. Given the potential for bias in the review process, limitations (...) in quality assessments, and variation in study outcomes, the authors' conclusions may not be reliable. Authors' objectives To assess the safety and effectiveness of procedural sedation in children undergoing gastrointestinal endoscopy. Searching MEDLINE, EMBASE and The Cochrane Library were searched for published studies from January 1995 up to January 2011; search terms were reported. Reference lists of retrieved articles, reviews, editorials and guidelines were also searched. Study selection Studies

DARE.2012

104. Conscious Sedation in Dentistry

Conscious Sedation in Dentistry Scottish Dental Clinical Effectiveness Programme - SDCEP Scottish Dental Clinical Effectiveness Programme Navigate this website Welcome The Scottish Dental Clinical Effectiveness Programme (SDCEP) is an initiative of the National Dental Advisory Committee (NDAC) and part of the within (NES’s) Dental Directorate . SDCEP provides user-friendly, evidence-based guidance to support dental teams to provide high quality healthcare that is safe, effective and person

Scottish Dental Clinical Effectiveness Programme2012

105. In IV sedation used for dental surgery, neither fentanyl or nalbuphine more effective as an analgesic

In IV sedation used for dental surgery, neither fentanyl or nalbuphine more effective as an analgesic UTCAT2298, Found CAT view, CRITICALLY APPRAISED TOPICs University: | | ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM View the CAT / Title In IV Sedation Used for Dental Surgery, Neither Fentanyl or Nalbuphine More Effective As An Analgesic Clinical Question In a patient undergoing IV moderate conscious sedation associated with dental surgery, is fentanyl or nalbuphine more effective as a peri (...) -operative analgesic? Clinical Bottom Line Neither fentanyl or nalbuphine is shown to have a clinical advantage as a peri-operative analgesic associated with IV moderate sedation in the dental office. Best Evidence (you may view more info by clicking on the PubMed ID link) PubMed ID Author / Year Patient Group Study type (level of evidence) #1) Dolan/1998 50 patients, ASA 1 or 2 RCT Key results Dental surgery patients who required IV sedation, were given equipotent doses of either fentanyl or nalbuphine

UTHSCSA Dental School CAT Library2012

106. Dexmedetomidine vs midazolam or propofol for sedation during prolonged mechanical ventilation: two randomized controlled trials

Dexmedetomidine vs midazolam or propofol for sedation during prolonged mechanical ventilation: two randomized controlled trials PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?

PedsCCM Evidence-Based Journal Club2012

107. Ketamine-propofol combination (ketofol) versus propofol alone for emergency department procedural sedation and analgesia: a randomized double-blind trial

Ketamine-propofol combination (ketofol) versus propofol alone for emergency department procedural sedation and analgesia: a randomized double-blind trial 22401952 2012 05 25 2012 08 09 2013 11 21 1097-6760 59 6 2012 Jun Annals of emergency medicine Ann Emerg Med Ketamine-propofol combination (ketofol) versus propofol alone for emergency department procedural sedation and analgesia: a randomized double-blind trial. 504-12.e1-2 10.1016/j.annemergmed.2012.01.017 We determine whether a 1:1 mixture (...) of ketamine and propofol (ketofol) for emergency department (ED) procedural sedation results in a 13% or more absolute reduction in adverse respiratory events compared with propofol alone. Participants were randomized to receive either ketofol or propofol in a double-blind fashion. Inclusion criteria were aged 14 years or older and American Society of Anesthesiology class 1 to 3 status. The primary outcome was the number and proportion of patients experiencing an adverse respiratory event as defined

EvidenceUpdates2012

109. Capnographic Monitoring Reduces the Incidence of Arterial Oxygen Desaturation and Hypoxemia During Propofol Sedation for Colonoscopy: A Randomized, Controlled Study (ColoCap Study)

Capnographic Monitoring Reduces the Incidence of Arterial Oxygen Desaturation and Hypoxemia During Propofol Sedation for Colonoscopy: A Randomized, Controlled Study (ColoCap Study) 22641306 2012 08 07 2012 10 11 2016 11 25 1572-0241 107 8 2012 Aug The American journal of gastroenterology Am. J. Gastroenterol. Capnographic monitoring reduces the incidence of arterial oxygen desaturation and hypoxemia during propofol sedation for colonoscopy: a randomized, controlled study (ColoCap Study). 1205 (...) -12 10.1038/ajg.2012.136 The aim of this randomized study was to determine whether intervention based on additional capnographic monitoring reduces the incidence of arterial oxygen desaturation during propofol sedation for colonoscopy. Patients (American Society of Anesthesiologists classification (ASA) 1-3) scheduled for colonoscopy under propofol sedation were randomly assigned to either a control arm with standard monitoring (standard arm) or an interventional arm in which additional

EvidenceUpdates2012

110. Should capnography be routinely used during procedural sedation in the Emergency Department?

Should capnography be routinely used during procedural sedation in the Emergency Department? BestBets: Should capnography be routinely used during procedural sedation in the Emergency Department? Should capnography be routinely used during procedural sedation in the Emergency Department? Report By: Dr Fiona Burton - ST6 Emergency Medicine Search checked by Mr Philip Anderson - Consultant Emergency Medicine Institution: Western Infirmary Date Submitted: 25th April 2011 Date Completed: 13th (...) February 2012 Last Modified: 15th February 2012 Status: Green (complete) Three Part Question In [a patient undergoing procedural sedation], does [the use of capnogrpahy] [reduce adverse respiratory events]? Clinical Scenario A 35 year old man has a dislocated shoulder that will need to be reduced. He will require sedation and will be monitored with standard monitoring (ECG, BP, SpO2). You wonder if addition of capnography would be beneficial for the patient? Search Strategy Ovid MEDLINE 1948

BestBETS2012

111. Procedural sedation with propofol for painful orthopaedic manipulation in the emergency department expedites patient management compared with a midazolam/ketamine regimen: a randomized prospective study

Procedural sedation with propofol for painful orthopaedic manipulation in the emergency department expedites patient management compared with a midazolam/ketamine regimen: a randomized prospective study 22258771 2012 01 19 2012 03 12 2016 05 12 1535-1386 93 24 2011 Dec 21 The Journal of bone and joint surgery. American volume J Bone Joint Surg Am Procedural sedation with propofol for painful orthopaedic manipulation in the emergency department expedites patient management compared (...) with a midazolam/ketamine regimen: a randomized prospective study. 2255-62 10.2106/JBJS.J.01307 The use of procedural sedation and analgesia to allow painful orthopaedic manipulations in the emergency department has become a standard practice over the last decade. Both propofol and midazolam/ketamine are attractive sedative regimens for routine use in the emergency department. We hypothesized that sedation with propofol as compared with midazolam/ketamine will save time in the emergency department. The purpose

EvidenceUpdates2012

112. Dexmedetomidine sedation in children after cardiac surgery

Dexmedetomidine sedation in children after cardiac surgery PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?

PedsCCM Evidence-Based Journal Club2012

113. Daily sedation interruption in mechanically ventilated critically ill patients cared for with a sedation protocol: a randomized controlled trial.

Daily sedation interruption in mechanically ventilated critically ill patients cared for with a sedation protocol: a randomized controlled trial. 23180503 2012 11 23 2012 11 26 2016 10 17 1538-3598 308 19 2012 Nov 21 JAMA JAMA Daily sedation interruption in mechanically ventilated critically ill patients cared for with a sedation protocol: a randomized controlled trial. 1985-92 Protocolized sedation and daily sedation interruption are 2 strategies to minimize sedation and reduce the duration (...) of mechanical ventilation and intensive care unit (ICU) stay. We hypothesized that combining these strategies would augment the benefits. To compare protocolized sedation with protocolized sedation plus daily sedation interruption in critically ill patients. Randomized controlled trial of 430 critically ill, mechanically ventilated adults conducted in 16 tertiary care medical and surgical ICUs in Canada and the United States between January 2008 and July 2011. Continuous opioid and/or benzodiazepine

JAMA2012

114. Dexmedetomidine vs midazolam or propofol for sedation during prolonged mechanical ventilation: two randomized controlled trials.

Dexmedetomidine vs midazolam or propofol for sedation during prolonged mechanical ventilation: two randomized controlled trials. 22436955 2012 03 22 2012 03 25 2016 10 17 1538-3598 307 11 2012 Mar 21 JAMA JAMA Dexmedetomidine vs midazolam or propofol for sedation during prolonged mechanical ventilation: two randomized controlled trials. 1151-60 10.1001/jama.2012.304 Long-term sedation with midazolam or propofol in intensive care units (ICUs) has serious adverse effects. Dexmedetomidine, an α(2 (...) )-agonist available for ICU sedation, may reduce the duration of mechanical ventilation and enhance patient comfort. To determine the efficacy of dexmedetomidine vs midazolam or propofol (preferred usual care) in maintaining sedation; reducing duration of mechanical ventilation; and improving patients' interaction with nursing care. Two phase 3 multicenter, randomized, double-blind trials carried out from 2007 to 2010. The MIDEX trial compared midazolam with dexmedetomidine in ICUs of 44 centers in 9

JAMA2012

115. Universal adoption of capnography for moderate sedation in adults

Universal adoption of capnography for moderate sedation in adults 1 | Page 02/ 20 1 2 Statement Universal adoption of capnography for moderate sedation in adults undergoing upper endoscopy and colonoscopy has not been shown to improve patient safety or clinical outcomes and significantly increases costs for moderate sedation. Capnography is a method of physiologic monitoring that takes advantage of carbon dioxide properties of absorption in the near-infrared region of the electromagnetic (...) spectrum. This allows for a near continuous assessment of the carbon dioxide level throughout the respiratory cycle as well as a near real-time graphic assessment of respiratory activity. The American Society of Anesthesiologists’ Standards for Basic Anesthetic Monitoring was revised to further expand the role of capnography for procedural sedation and became effective July 1, 2011. (1) In section 3.2.4, this document recommends capnography monitoring to include moderate sedation commonly used

American Society for Gastrointestinal Endoscopy2012

116. Successful implementation of a pediatric sedation protocol for mechanically ventilated patients

Successful implementation of a pediatric sedation protocol for mechanically ventilated patients PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?

PedsCCM Evidence-Based Journal Club2011

117. The utility of high-flow oxygen during emergency department procedural sedation and analgesia with propofol: a randomized, controlled trial

The utility of high-flow oxygen during emergency department procedural sedation and analgesia with propofol: a randomized, controlled trial 21680059 2011 09 29 2011 11 29 2016 11 25 1097-6760 58 4 2011 Oct Annals of emergency medicine Ann Emerg Med The utility of high-flow oxygen during emergency department procedural sedation and analgesia with propofol: a randomized, controlled trial. 360-364.e3 10.1016/j.annemergmed.2011.05.018 We determine whether high-flow oxygen reduces the incidence (...) of hypoxia by 20% in adults receiving propofol for emergency department (ED) sedation compared with room air. We randomized adults to receive 100% oxygen or compressed air at 15 L/minute by nonrebreather mask for 5 minutes before and during propofol procedural sedation. We administered 1.0 mg/kg of propofol, followed by 0.5 mg/kg boluses until the patient was adequately sedated. Physicians and patients were blinded to the gas used. Hypoxia was defined a priori as an oxygen saturation less than 93

EvidenceUpdates2011

118. Nurse-administered procedural sedation and analgesia in the cardiac catheter laboratory: an integrative review

Nurse-administered procedural sedation and analgesia in the cardiac catheter laboratory: an integrative review 21601855 2011 07 25 2011 11 18 2012 11 15 1873-491X 48 8 2011 Aug International journal of nursing studies Int J Nurs Stud Nurse-administered procedural sedation and analgesia in the cardiac catheter laboratory: an integrative review. 1012-23 10.1016/j.ijnurstu.2011.04.013 To identify and appraise the literature concerning nurse-administered procedural sedation and analgesia in (...) the cardiac catheter laboratory. An integrative review method was chosen for this study. MEDLINE and CINAHL databases as well as The Cochrane Database of Systematic Reviews and the Joanna Briggs Institute were searched. Nineteen research articles and three clinical guidelines were identified. The authors of each study reported nurse-administered sedation in the CCL is safe due to the low incidence of complications. However, a higher percentage of deeply sedated patients were reported to experience

EvidenceUpdates2011

119. A prospective comparison of procedural sedation and ultrasound-guided interscalene nerve block for shoulder reduction in the emergency department

A prospective comparison of procedural sedation and ultrasound-guided interscalene nerve block for shoulder reduction in the emergency department 21883635 2011 09 12 2012 01 05 2016 11 25 1553-2712 18 9 2011 Sep Academic emergency medicine : official journal of the Society for Academic Emergency Medicine Acad Emerg Med A prospective comparison of procedural sedation and ultrasound-guided interscalene nerve block for shoulder reduction in the emergency department. 922-7 10.1111/j.1553 (...) -2712.2011.01140.x Emergency physicians (EPs) are beginning to use ultrasound (US) guidance to perform regional nerve blocks. The primary objective of this study was to compare length of stay (LOS) in patients randomized to US-guided interscalene block or procedural sedation to facilitate reduction of shoulder dislocation in the emergency department (ED). The secondary objectives were to compare one-on-one health care provider time, pain experienced by the patient during reduction, and patient satisfaction

EvidenceUpdates2011

120. Conscious (Moderate) Sedation Can Be Used Safely On Patients With Obstructive Sleep Apnea

Conscious (Moderate) Sedation Can Be Used Safely On Patients With Obstructive Sleep Apnea UTCAT2112, Found CAT view, CRITICALLY APPRAISED TOPICs University: | | ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM View the CAT / Title Conscious (Moderate) Sedation Can Be Used Safely On Patients With Obstructive Sleep Apnea Clinical Question Is conscious (moderate) sedation safe in patients with obstructive sleep apnea compared to patients without sleep apnea? Clinical Bottom Line Conscious (moderate (...) ) sedation is a safe practice in patients with obstructive sleep apnea, though doses may have to be adjusted compared to patients without OSA. Best Evidence (you may view more info by clicking on the PubMed ID link) PubMed ID Author / Year Patient Group Study type (level of evidence) #1) Gill/2011 Veteran population/ 200 patients with OSA, 200 without OSA (control group) Retrospective Chart Review Key results This was a retrospective study on moderate (IV) sedation during endoscopy. The control group

UTHSCSA Dental School CAT Library2011