Search results for "Sedation"

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…

A Randomized Controlled Trial Comparing Inhaled Isoflurane Via the Anaesthetic Conserving Device (Sedaconda <sup>®</sup> ACD) with Propof…

2021

Background: Small studies indicate that isoflurane may be useful for sedation during invasive ventilation of ICU patients. There are no published large prospective efficacy trials. Methods: This phase 3, non-inferiority trial evaluated the efficacy and safety of ≤54 hours of isoflurane via the anaesthetic conserving device (ACD) compared with propofol in invasively ventilated ICU patients (30-day follow-up). Primary endpoint was percentage of time in Richmond Agitation–Sedation Scale (RASS) range –1 to –4; the predefined non-inferiority margin was 15% below the propofol mean. Secondary endpoints: opioid requirements, spontaneous breathing during sedation, time to wake-up and extubation, adv…

Indication and Timing

2016

Tracheostomy is performed in patients requiring prolonged mechanical ventilation aiming at avoiding the potential detrimental effect of a sustained translaryngeal intubation (e.g. laryngeal oedema, mucosal ulcerations). Potential benefits of tracheostomy in critically ill patients are improved comfort and reduced need for sedation, easier clearance of secretions and oral hygiene, and a possible faster weaning from mechanical ventilation. Controversy exists over optimal timing (early, tracheostomy placement compared with later time points) in patients with respiratory failure. Among the published randomised controlled trials, two large studies did not report a significant advantage of an ear…

Regional analgesia in postsurgical critically ill patients

2017

Regional analgesia intrinsically, based on its physiological effects, is routinely used for the perioperative treatment of pain associated with surgical procedures. However, in other areas such as the non-surgical treatment of acute pain for patients in a critical condition, it has not been subjected to specific prospective studies. If we confine ourselves to the physiological effects of the nerve block, in a situation of stress, the indications for regional anaesthesia in this group of patients extend to the management of a wide variety of medical as well as postsurgical conditions, of trauma patients and of other painful procedures performed in the patient's bed. The critical patient cert…

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…

Adequate analgesia and sedation should be given to neonates during non‐emergency endotracheal intubation

2019

État des lieux des pratiques actuelles de l’hypnose au sein des centres hospitaliers universitaire français

2017

Hypnosis is very fashionable as an entertainment through TV shows searching for new sensational experiences. What about its practice in the medical world? The aim of this article is to answer to this question. Therefore, we contacted every French University Hospital of each region to find out if hypnosis was practiced for the care of pain (hypnoanalgesia), for chirurgical procedures (hypnosedation) and in adult psychiatry care units (hypnotherapy). For this last practice, we also questioned the type of indications. All 30 of the French University Hospitals had replied by November 2015. Hypnoanalgesia is practiced by all and two-thirds offer hypnosedation. Hypnotherapy is practiced by 40 % o…

An ethological analysis of the effects of diazepam and nitrazepam on the responses of female mice to anosmic males encountered in a novel arena

1992

The effects of acutely administered benzodiazepines have largely been validated in male animals, in spite of the fact that the majority of anti-anxiety drugs are prescribed for female patients. A study was carried out assessing the potential of female mice in the testing of the anxiolytic properties of drugs. Three doses (0.5, 1.0 and 2.0mg/kg) of the benzodiazepines diazepam and nitrazepam were given to individually-housed female Swiss mice before dyadic encounters with anosmic, group-housed males. Videotape analysis of the encounters, using an ethopharmacological technique, revealed suppressive effects of diazepam (1.0 and 2.0mg/kg) and nitrazepam (all doses) on avoidance/flee, confirming…

Kombiniertes Simulationstraining: Ein neues Kurskonzept trainiert und verbessert das Krisenmanagement der gastroenterologischen Endoskopie

2005

Introduction Crisis management as well as realistic emergency situations can be trained in the new developed simulation workshop "Gastrointestinal Endoscopy and Crisis Resource Management" by combining a full-scale simulator and the Erlanger Endoscopy Trainer. The aim of the current study was to evaluate the efficiency of the newly developed simulation workshop. Methods Endoscopists with more than 12 months experience can train their endoscopic skills and crisis resource management with the help of different simulators. In addition, two different scenarios (GI bleeding with significant blood loss and sedation overdoses) embedded in a realistic surrounding (emergency room) have to be managed…

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,…