Search results for " Sedation"
showing 10 items of 31 documents
Randomised double-blind clinical trial of intermediate- versus high-dose chloral hydrate for neuroimaging of children.
1995
Orally administered chloral hydrate is the most widely used sedative in children undergoing MRI. We compared intermediate- and high-dose oral chloral hydrate in 97 consecutive children undergoing MRI in a prospective, controlled, double-blind, randomised clinical trial. There were 50 girls and 47 boys, mean weight (+/- SD) 14.7 +/- 6.4 kg, and mean age 38 +/- 31. The children were randomly allocated to receive chloral hydrate syrup either 70 mg/kg (group A, n = 50) or 100 mg/kg (group B, n = 47). These two groups were not significantly different in sex, weight, age, diagnosis or ambulatory medication. The mean initial dose (+/- SEM) was 64 +/- 2 mg/kg for group A and 93 +/- 2 mg/kg for grou…
Propofol sedation reduces diaphragm activity in spontaneously breathing patients: ultrasound assessment.
2017
BACKGROUND: The diaphragm is the most important respiratory muscle in humans, and the close relationship between inspired volume and diaphragmatic movement in normal subjects has led to investigations into diaphragmatic activity using ultrasound, during spontaneous breathing and sedative drug infusion. METHODS: A total of 36 consecutive patients undergoing diagnostic procedures under deep propofol sedation were studied. Ultrasound measurements included the following: diaphragmatic thickening end-inspiration (TEI) and endexpiration (TEE). Diaphragmatic thickening fraction (DTF) was calculated from [(TEI TEE) / TEE] at various time points (at T0 basal; at T1 during propofol infusion; at T2 aw…
Local Shock-Wave Lithotripsy of Distal Ureteral Calculi
1988
Abstract Since the initiation of the clinical trial utilizing a second-generation lithotripor (Lithostar, Siemens, Erlangen, FRG), 96 patients with distal ureteral calculi (i.e. calculi below the pelvic brim) underwent local shock-wave lithotripsy. Routine treatment was conducted under intravenous sedation and light analgesia only. Complete stone disintegration was achieved in 84 patients (87.5%), 11 requiring two sessions and 1 patient, three. In 7 patients ureteroscopy became necessary after unsuccessful local shock-wave treatment. In 2 of these patients a 9-french flexible ureteroscope and the Storz Q-switched neodymium-YAG laser was used for stone disintegration. In 3 cases loop extract…
Propofol sedation administered by cardiologists without assisted ventilation for long cardiac interventions: an assessment of 1000 consecutive patien…
2011
Aims Patients can expect a cure from atrial fibrillation (AF) with ablation. Procedural safety and success depend on patient comfort, compliance, and immobility. This is difficult to achieve with benzodiazepine and opiate boluses that are the mainstay of current practice. We sought to determine the safety and efficacy of propofol infusion sedation administered to patients without assisted ventilation for AF ablation. Methods and results Procedural data from 1000 consecutive patients undergoing AF ablation were analysed. Sedation with 2% propofol was used in all procedures without assisted ventilation and was administered, monitored, and controlled by electrophysiologists. Primary outcome me…
Oral chloral hydrate provides effective and safe sedation in paediatric magnetic resonance imaging.
1994
SUMMARY Sedation is routinely required for successful Magnetic Resonance imaging in infants and children. Five hundred and ninety-six paediatric patients (270 female and 326 male, age (mean±SD) 41±30 months and weight 14.8±6.5 kg) entered an open, non-comparative, prospective study to assess oral chloral hydrate sedation in a large and homogeneous paediatric population undergoing Magnetic Resonance imaging. Chloral hydrate syrup 70 mg/ml was administered 20–40 min prior to the procedure. Effective sedation was reached in 94.1% with a total dose (mean±SEM) of 68±1 mg/kg (range 20–170 mg/kg). Statistical analysis of sedation failures vs. successful examinations after the total dose showed sig…
Efficacy and safety of direct transnasal cholangioscopy with standard ultraslim endoscopes: results of a large cohort study.
2013
Background Direct cholangioscopy (DC) with ultraslim endoscopes and free-hand cannulation of the common bile duct (CBD) is a promising technique for evaluating and treating cholangiopathy. However, its safety and success rates are as yet unclear. Objective To evaluate the overall success rates and adverse events with the procedure. Design Single-center, prospective cohort study; 12 patients retrospectively enrolled. Setting Academic tertiary referral center. Patients A total of 100 DC procedures in 84 patients with biliary disease were evaluated prospectively. Interventions DC performed with the patient under conscious sedation. Main Outcome Measurements Overall success rates and adverse ev…
Controlled sedation for refractory symptoms in dying patients.
2008
Terminally ill cancer patients near the end of life may experience intolerable suffering refractory to palliative treatment. Although sedation is considered to be an effective treatment when aggressive efforts fail to provide relief in terminally ill patients, it remains controversial. The aim of this study was to assess the need and effectiveness of sedation in dying patients with intractable symptoms, and the thoughts of relatives regarding sedation. A prospective cohort study was performed on a consecutive sample of dying patients admitted to an acute pain relief and palliative care unit within a cancer center. Indications for sedation, opioid and midazolam doses, level of delirium and s…
Quality of life following third molar removal under conscious sedation
2012
Aim: The aim of this study was to assess quality of life (QoL) and degree of satisfaction among outpatients subjected to surgical extraction of all four third molars under conscious sedation. A second objective was to describe the evolution of self-reported pain measured in a visual analogue scale (VAS) in the 7 days after extraction. Study design: Fifty patients received a questionnaire assessing social isolation, working isolation, eating and speaking ability, diet modifications, sleep impairment, changes in physical appearance, discomfort at suture removal and overall satisfaction at days 4 and 7 after surgery. Pain was recorded by patients on a 100-mm pain visual analogue scale (VAS) ev…
Distinction Between Euthanasia and Valid Medical Decision and Its Impact on Unborn Life
2014
The article is dedicated to revealing those aspects which allow to distinguish euthanasia from valid medical decisions which are made by physicians within the scope of the care of incurably ill persons and their impact on the issue regarding yet unborn life. As in separate forms of euthanasia and the realisation of its kinds, analogies of valid medical procedure are observed, the article analyses the most common cases when the decision made by the physician and the resultant action or omission of the action binds him/her to unjustified criminal judgement by revealing the fundamental features which approve the legitimacy of the decision made, thus distinguishing it from the criminal offence,…
Prevalence and risk factors for delirium in critically ill patients with COVID-19 (COVID-D): a multicentre cohort study
2021
Background: To date, 750 000 patients with COVID-19 worldwide have required mechanical ventilation and thus are at high risk of acute brain dysfunction (coma and delirium). We aimed to investigate the prevalence of delirium and coma, and risk factors for delirium in critically ill patients with COVID-19, to aid the development of strategies to mitigate delirium and associated sequelae. Methods: This multicentre cohort study included 69 adult intensive care units (ICUs), across 14 countries. We included all patients (aged ≥18 years) admitted to participating ICUs with severe acute respiratory syndrome coronavirus 2 infection before April 28, 2020. Patients who were moribund or had life-suppo…