BACKGROUND The objective of this study was to determine the mechanisms involved in the hypotension associated with sedative doses of propofol in humans. METHODS Ten healthy volunteers (aged 21-37 yr) participated on two occasions and in random order received placebo or propofol infusions. Standard monitoring and radial artery blood pressure were combined with measurement of forearm blood flow...

AIM To define practice in managing repeated invasive procedures in selected paediatric oncology centres in North America and Europe, especially the United Kingdom; to define and contrast concerns that shape policy making, and to contrast practice, particularly regarding procedures performed on conscious patients. METHODS Postal survey: 118 centres of the Pediatric Oncology Group and the Unite...

BACKGROUND Continuous deep sedation at the end of life is a practice that has been the topic of considerable ethical debate, for example surrounding its perceived similarity or dissimilarity with physician-assisted dying. The practice is generally considered to be legal as a form of symptom control, although this is mostly only assumed. France has passed an amendment to the Public Health Act th...

BACKGROUND AND STUDY AIM The purpose of this study was to evaluate whether moderate-to-deep sedation with propofol and alfentanil can be administered safely by nonmedical sedation practitioners, and the outcomes of this practice in the Netherlands. We retrospectively analyzed the occurrence of sedation-related complications in patients undergoing gastrointestinal endoscopic procedures. PATIEN...

Moderate and deep sedation can be provided using several routes of drug administration including oral (PO), inhalation, and parental injection. The safety and efficacy of these various techniques is largely dependent on pharmacokinetic principles. This continuing education article will highlight essential principles of absorption, distribution, and elimination of commonly used sedative agents.

The risk for complications while providing any level of sedation or general anesthesia is greatest when caring for patients having significant medical compromise. It is reassuring that significant untoward events can generally be prevented by careful preoperative assessment, along with attentive intraoperative monitoring and support. Nevertheless, we must be prepared to manage untoward events s...

This study attempted to determine if sevoflurane in oxygen inhaled via a nasal hood as a sole sedative agent would provide an appropriate level of deep sedation for outpatient third molar surgery. Twenty-four patients scheduled for third molar removal were randomly assigned to receive either nasal hood inhalation sevoflurane or an intravenous deep sedation using midazolam and fentanyl followed ...

OBJECTIVES To study the practice of continuous deep sedation in 2005 in the Netherlands and compare it with findings from 2001. DESIGN Questionnaire study about random samples of deaths reported to a central death registry in 2005 and 2001. SETTING Nationwide physician study in the Netherlands. PARTICIPANTS Reporting physicians received a questionnaire about the medical decisions that pre...

OBJECTIVE To determine the depth of sedation required for bone marrow aspiration and intrathecal injection of chemotherapeutic agents in children using a bispectral (BIS) index monitor and clinical assessment by an independent observer. METHODS Sixteen children who were undergoing 19 intrathecal chemotherapy and bone marrow aspirations were enrolled in the study. Their ages ranged from 23 mon...

BACKGROUND Continuous deep sedation until death is a highly debated medical practice, particularly regarding its potential to hasten death and its proper use in end-of-life care. A thorough analysis of important trends in this practice is needed to identify potentially problematic developments. This study aims to examine trends in the prevalence and practice characteristics of continuous deep s...