Aims. (1) To assess the efficacy and safety of pediatric office-based sedation for ophthalmologic procedures using a pediatric sedation service model. (2) To assess the reduction in hospital charges of this model of care delivery compared to the operating room (OR) setting for similar procedures. Background. Sedation is used to facilitate pediatric procedures and to immobilize patients for imag...

OBJECTIVES Palmar hyperhidrosis (PH) is a common dysfunctional disorder, with endoscopic thoracic sympathectomy (ETS) being the most popular treatment method. However, until now, there is little improvement to this technique. In this paper, we present a new alternative to the conventional surgical method. METHODS We performed ETS with flexible thoracoscopy under deep sedation without intubati...

THE STATE OF AWARENESS is known to have a functional relationship with the brain stem reticular formation. This follows the work of Moruzzi and Magoun. 1 The concept of the ascending (reticular activating) fibres arising from the reticular formation and influencing widespread central nervous system centres is illustrated in Figure 1. It is known that thalamocurtieal trafl~e is multidirectional....

The majority of dental procedures can be performed with an awake patient and the use of a local anesthetic, but when deep sedation and general anesthesia are needed, they typically are provided by those dentists with advanced training in anesthesiology, i.e., oral and maxillofacial surgeons and dentist anesthesiologists. Dental anesthesiology began with the discovery of anesthesia by a dentist ...

BACKGROUND In 2002, the euthanasia act came into effect in the Netherlands, which was followed by a slight decrease in the euthanasia frequency. We assessed frequency and characteristics of euthanasia, physician-assisted suicide, and other end-of-life practices in 2010, and assessed trends since 1990. METHODS In 1990, 1995, 2001, 2005, and 2010 we did nationwide studies of a stratified sample...

BACKGROUND A relationship between the depth of sedation as measured by the bispectral index (BIS) and spinal sensory block height in patients with light to no additional sedation has been described previously. The present study was designed to investigate the hypothesis that BIS values closely correlate with the spread of spinal sensory block in patients deeply sedated with an i.v. target-contr...

Colonoscopy is typically performed with sedation. Intravenous benzodiazepines with or without opioids have long been used to induce sedation for both colonoscopy and more complex endoscopic procedures. In recent years, we have observed a rapid transformation from the use of opioids and benzodiazepines to sedation with propofol in Western countries.1 However, most endoscopy centers in the Middle...

Various techniques have been proposed to reduce anterior shoulder dislocation in the emergency department (ED). The superiority of one approach over another has yet to be established. The key role of good muscle relaxation in successful reduction by any method has been recognized in the literature,1,2 but instructions on how to best achieve it are lacking. Usually, a pharmacologic solution is p...

Early mobilization of patients in the hospital and the intensive care unit has a strong historical precedent. However, in more recent times, deep sedation and bed rest have been part of routine medical care for many mechanically ventilated patients. A growing body of literature demonstrates that survivors of severe critical illness commonly have significant and prolonged neuromuscular complicat...

INTRODUCTION Adequate sedation is one of the cornerstones of good quality gastrointestinal endoscopy (GIE). Propofol sedation has increased significantly but there has been much debate over whether it can be administered by endoscopists. The aim of this prospective trial was to compare nonanesthesiologist-administered propofol (NAAP) and monitored anesthesia care (MAC). METHODS A total of 200...