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Conscious Sedation
Conscious Sedation
Conscious Sedation refers to a state of reduced awareness and decreased responsiveness to external stimuli, while the patient maintains the ability to independently maintain ventilatory function and respond to verbal commands.
This technique is commonly used in medical and dental procedures to relieve anxiety and pain without the need for general anesthesia.
PubCompare.ai's AI-driven platform can help researchers easily locate the best conscious sedation protocols from literature, preprints, and patents, enhacing research accuracy through cutting-edge comparisons.
Explore the powerful tools today to take your research to new hieghts.
This technique is commonly used in medical and dental procedures to relieve anxiety and pain without the need for general anesthesia.
PubCompare.ai's AI-driven platform can help researchers easily locate the best conscious sedation protocols from literature, preprints, and patents, enhacing research accuracy through cutting-edge comparisons.
Explore the powerful tools today to take your research to new hieghts.
Most cited protocols related to «Conscious Sedation»
Antimony
Atmospheric Pressure
Catheters
Conscious Sedation
Endoscopes
Endoscopy, Gastrointestinal
Esophagus
Fentanyl
Manometry
Midazolam
Neoplasm Metastasis
Pressure
Swallows
Upper Esophageal Sphincter
Patients admitted over a period of one year (from May 2013 to May 2014) to the ICU of the University of Bari Academic Hospital were considered for enrollment in the study. The local ethics committee (Azienda Ospedaliero-Universitaria Policlinico di Bari Ethic Committee, protocol number: 257/C.E. March 2013) approved the investigative protocol, and written informed consent was obtained from each patient or next of kin. A physician not involved in the study was always present for patient care. Our clinical trial was registered with clinicalTrials.gov, identifier: NCT02473172 .
Patients were eligible for the study if they were older than 18 years, oro-tracheally or naso-tracheally intubated, had been ventilated for acute respiratory failure with CMV (flow-limited, pressure-limited or volume-targeted pressure-limited) for at least 72 hours consecutively and were candidates for assisted ventilation. The criteria for defining the readiness to assisted ventilation were: a) improvement of the condition leading to acute respiratory failure; b) positive end-expiratory pressure (PEEP) lower than 10 cmH2O and inspiratory oxygen fraction (FiO2) lower than 0,5; c) Richmond agitation sedation scale (RASS) score between 0 and –1 [23 (link)] obtained with no or moderate levels of sedation and, d) ability to trigger the ventilator, i.e., to decrease pressure airway opening (PAO) >3–4 cmH2O during a brief (5–10 s) end-expiratory occlusion test. Other criteria included hemodynamic stability without vasopressor or inotropes (excluding a dobutamine and dopamine infusion <5 gamma/Kg/min and 3 gamma/Kg/min, respectively) and normothermia. Patients were excluded from the study if they were affected by neurological or neuromuscular pathology and/or known phrenic nerve dysfunction, or if they had any contraindication to the insertion of a nasogastric tube (for example: recent upper gastrointestinal surgery, esophageal varices).
Patients were eligible for the study if they were older than 18 years, oro-tracheally or naso-tracheally intubated, had been ventilated for acute respiratory failure with CMV (flow-limited, pressure-limited or volume-targeted pressure-limited) for at least 72 hours consecutively and were candidates for assisted ventilation. The criteria for defining the readiness to assisted ventilation were: a) improvement of the condition leading to acute respiratory failure; b) positive end-expiratory pressure (PEEP) lower than 10 cmH2O and inspiratory oxygen fraction (FiO2) lower than 0,5; c) Richmond agitation sedation scale (RASS) score between 0 and –1 [23 (link)] obtained with no or moderate levels of sedation and, d) ability to trigger the ventilator, i.e., to decrease pressure airway opening (PAO) >3–4 cmH2O during a brief (5–10 s) end-expiratory occlusion test. Other criteria included hemodynamic stability without vasopressor or inotropes (excluding a dobutamine and dopamine infusion <5 gamma/Kg/min and 3 gamma/Kg/min, respectively) and normothermia. Patients were excluded from the study if they were affected by neurological or neuromuscular pathology and/or known phrenic nerve dysfunction, or if they had any contraindication to the insertion of a nasogastric tube (for example: recent upper gastrointestinal surgery, esophageal varices).
Conscious Sedation
Dental Occlusion
Dobutamine
Dopamine
Esophageal Varices
Ethics Committees
Exhaling
Gamma Rays
Gastrointestinal Surgical Procedure
Hemodynamics
Inhalation
Inotropism
Intubation, Nasogastric
Oxygen
Patients
Phrenic Nerve
Physicians
Positive End-Expiratory Pressure
Precipitating Factors
Pressure
Regional Ethics Committees
Respiratory Failure
Sedatives
Vasoconstrictor Agents
Aspiration Biopsy, Fine-Needle
Conscious Sedation
Echo Endoscopy
Endoscopic Ultrasound-Guided Fine Needle Aspiration
Endoscopy
Head
Human Body
Needles
Nurses
Pancreas
Patients
Suction Drainage
Tail
Anesthesia
Atmospheric Pressure
Conscious Sedation
Endoscopes
Endoscopy
Endoscopy, Gastrointestinal
Esophagus
Fentanyl
Manometry
Midazolam
Motility, Cell
Movement
Neoplasm Metastasis
Pharmaceutical Preparations
Propofol
Sedatives
Adolescent
Autism Spectrum Disorders
Brain Concussion
Child
Conscious Sedation
Craniocerebral Trauma
Disorder, Attention Deficit-Hyperactivity
Drug Abuse
Emergencies
Ethanol
Face
Facial Injuries
Foster Child
Fracture, Bone
Head
Headache
Hospitalization
Hypoxia
Infant
Injuries
Intellectual Disability
Learning Disabilities
Legal Guardians
Lower Extremity
Mental Disorders
Migraine Disorders
Neurodevelopmental Disorders
Operative Surgical Procedures
Parent
Pharmaceutical Preparations
Seizures
Shock
Sprain
Strains
Most recents protocols related to «Conscious Sedation»
The variable of interest was primary anesthetic management type, and we specifically compared general anesthesia to monitored anesthesia care. We combined the variable “conscious sedation”, which was a less precise “catchall” data field used prior to 2016 when NACOR data was compiled largely based on local definitions, and “monitored anesthesia care”, which became the standard terminology adopted in 2017 when the AQI released standardized data definitions. The AQI's current definition of monitored anesthesia care is, “A specific type of anesthesia service in which a qualified anesthesia provider has been requested to participate in the care of a patient undergoing a diagnostic or therapeutic procedure. Indications for monitored anesthesia care depend on the nature of the procedure, the patient's clinical condition, and/or the potential need to convert to a general or regional anesthetic. Deep sedation/analgesia is also included in monitored anesthesia care.”[16 ] Thus, according to the ASA's Standards and Guidelines, monitored anesthesia care does not necessarily denote the continuum of depth of sedation; rather, monitored anesthesia care may include minimal sedation anxiolysis, moderate sedation/analgesia (”conscious sedation”), or deep sedation/analgesia in which qualified anesthesia personnel have been requested to participate in the care of a patient undergoing a diagnostic or therapeutic procedure.
We evaluated the frequency of use of each of the two anesthesia management types over time. Cochran-Armitage testing was used to determine whether or not the trends were statistically significant. We used multivariable logistic regression model to evaluate patient, hospital, and procedural characteristics to identify variables associated with the primary outcome. We did not use variables that had rates of missing data >10%. Other variables were either imputed to the mode, median, or complete case analysis was used. Investigators selected factors based on clinical and theoretical reasoning. The models were adjusted for age, sex, race, ASA physical status, US census region in which a center is located, procedural approach, median income by patient zip code, and center volume of transcatheter aortic valve replacements. Volume of transcatheter aortic valve replacements was calculated as the total number of all transcatheter aortic valve replacements for each practice during each year for our study period. In order to account for practice level variation, we used three-level hierarchical modeling and nested patients within practices within each year to properly generate our variance estimates. Model fit was assessed using C-statistic, Hosmer-Lemeshow test, as well as a model calibration plot. Continuous variables were presented as medians (interquartile range, 25th and 75th percentile) and differences across anesthesia type were assessed using Mann-Whitney U tests. Categorical variables were presented as counts (proportions) and differences across anesthesia type were assessed using the Chi-square test.
The secondary outcome was case duration in minutes, defined as duration in minutes from the recorded anesthesia start to anesthesia finish. Based on the distribution of this outcome, we excluded cases with duration less than or equal to 60 min as this was considered to be the lower 1% and deemed unlikely to be realistic. Additionally, in order to account for the skewed nature of the data, we log-transformed the outcome. We fit a multivariable linear model to assess the association between anesthesia management type and case duration. We also utilized the same three-level hierarchical structure as described above, also adjusting for the same covariates. All statistics were performed using SAS v 9.4 (SAS, Cary, NC).
We evaluated the frequency of use of each of the two anesthesia management types over time. Cochran-Armitage testing was used to determine whether or not the trends were statistically significant. We used multivariable logistic regression model to evaluate patient, hospital, and procedural characteristics to identify variables associated with the primary outcome. We did not use variables that had rates of missing data >10%. Other variables were either imputed to the mode, median, or complete case analysis was used. Investigators selected factors based on clinical and theoretical reasoning. The models were adjusted for age, sex, race, ASA physical status, US census region in which a center is located, procedural approach, median income by patient zip code, and center volume of transcatheter aortic valve replacements. Volume of transcatheter aortic valve replacements was calculated as the total number of all transcatheter aortic valve replacements for each practice during each year for our study period. In order to account for practice level variation, we used three-level hierarchical modeling and nested patients within practices within each year to properly generate our variance estimates. Model fit was assessed using C-statistic, Hosmer-Lemeshow test, as well as a model calibration plot. Continuous variables were presented as medians (interquartile range, 25th and 75th percentile) and differences across anesthesia type were assessed using Mann-Whitney U tests. Categorical variables were presented as counts (proportions) and differences across anesthesia type were assessed using the Chi-square test.
The secondary outcome was case duration in minutes, defined as duration in minutes from the recorded anesthesia start to anesthesia finish. Based on the distribution of this outcome, we excluded cases with duration less than or equal to 60 min as this was considered to be the lower 1% and deemed unlikely to be realistic. Additionally, in order to account for the skewed nature of the data, we log-transformed the outcome. We fit a multivariable linear model to assess the association between anesthesia management type and case duration. We also utilized the same three-level hierarchical structure as described above, also adjusting for the same covariates. All statistics were performed using SAS v 9.4 (SAS, Cary, NC).
Anesthesia
Anesthetics
Anti-Anxiety Agents
Conscious Sedation
Deep Sedation
Diagnosis
General Anesthesia
Local Anesthesia
Management, Pain
Patients
Physical Examination
Sedatives
Therapeutics
Training Programs
Transcatheter Aortic Valve Replacement
The anesthetic method was determined mainly according to the patients' preferences. Whereas, patients who were incapable of enduring awake DBS, including those with extreme anxiety, reduced cooperation, severe convulsions and difficult breathing, were operated under GA. We also showed reasons for the patients who were operated under GA in Supplementary Table 1 . According to the anesthetic method applied, patients were assigned to LA group and GA group. In LA group, patients received local scalp anesthesia with 0.5% ropivacaine and kept conscious without sedation during MER and electrode implantation. In GA group, patients were administered a bolus of 2 mg/kg BW propofol and 1 mg/kg BW remifentanil for induction. Then, anesthesia was maintained at 2 mg/kg BW propofol and 1 mg/kg BW remifentanil by a target-controlled infusion (TCI) system. Bispectral index (BIS) was applied to monitor the depth of anesthesia. The infusion of anesthetics was adjusted before MER and BIS was maintained at 40–60 to ensure the recognition of STN signals.
Anesthesia
Anesthetics
Anxiety
Conscious Sedation
Local Anesthesia
Ovum Implantation
Patients
Propofol
Remifentanil
Ropivacaine
Scalp
Seizures
All procedures were performed using CO
2insufflation with the patient in prone or left lateral decubitus position under conscious sedation controlled by an anesthesiologist and a nurse. The study procedures were performed using a floor-mounted Siemens Artis zee multi-purpose (MP) fluoroscopy system (Siemens Healthcare, Erlangen, Germany) or a mobile Siemens Cios Alpha c-arm device (Siemens Healthcare, Erlangen, Germany). Fixed, mobile, and ceiling-mounted radiation shields and personal protective equipment, such as protective aprons, thyroid shields, and leaded eyewear were used during all the procedures. A more detailed description of the imaging protocols and radiation protection tools implemented is provided as supplementary material.
Other data collected for each procedure included patient characteristics (age, height, weight, and body mass index [BMI]), fluoroscopy time, KAP, and air-kerma at reference point (K
a,r). Moreover, the procedural complexity of each ERCP was determined and collected based on the 4-point American Society for Gastrointestinal Endoscopy (ASGE) complexity-grading system
18 (link)
19
. The radiation doses in ERCP and other gastrointestinal endoscopy procedures were compared. ERCPs performed for diagnosis and follow up of PSC included a significantly larger number of single image exposures compared to other ERCPs and were thus categorized separately. The effect of ERCP procedural complexity level and fluoroscopy system on radiation doses was then analyzed.
Anesthesiologist
Conscious Sedation
Cranioosteoarthropathy
Diagnosis
Endoscopic Retrograde Cholangiopancreatography
Endoscopy, Gastrointestinal
Fluoroscopy
Index, Body Mass
Nurses
Patients
Radiation Protection
Radiotherapy
Surgical Procedures, Endoscopic Gastrointestinal
Thyroid Gland
After local anesthesia with lidocaine and moderate sedation with intravenous midazolam, a UTB (BF-MP290F; Olympus Medical Systems, Tokyo, Japan: distal-end diameter, 3.0 mm and working channel diameter, 1.7 mm) was advanced to engage the target bronchus using VBN (SYNAPSE VINCENT; Fujifilm Medical, Tokyo, Japan) and conventional fluoroscopy (Artis Zeego, Siemens Healthcare, Forchheim, Germany). After reaching the target bronchus, a 1.4-mm R-EBUS probe (UM-S20-17S; Olympus Medical Systems) was advanced toward the lesion through the working channel under the guidance of conventional fluoroscopy. The obtained EBUS images were classified into three types based on the classification by Kurimoto et al. (17 (link)) (primary EBUS image). Type 1 EBUS images indicated “within”, type 2 indicated “adjacent to”, and type 3 indicated “invisible”. The type with a smaller image number was considered a better EBUS and CBCT image (Figures 1,2
After the biopsy forceps engaged the target bronchus, CBCT was performed during breath-holding using a 6-s acquisition protocol with 400 projection images acquired over a 200-degree rotation (Artis Zeego, Siemens Healthcare). Multi-planar reconstruction images were generated automatically on a dedicated workstation (Syngo X Workplace, Siemens Healthcare). Based on the relationship between the lesion and the forceps position, we classified the obtained images into three groups, as described in our previous report (primary CBCT image) (14 (link)). Type 1 CBCT image indicated that the forceps clearly reached the inside of the target lesion, type 2 indicated that the forceps reached adjacent to the lesion, and type 3 indicated that the forceps did not reach the lesion. Type 1 EBUS and CBCT, type 2 EBUS and CBCT, and type 3 EBUS and CBCT were recognized as equivalent images. If the primary CBCT image was type 1, a biopsy was performed. If it was type 2 or 3, the three-dimensional re-navigation toward the lesion was determined on the CBCT image and re-navigation was performed using R-EBUS. In the re-navigation procedure, first, based on the multi-planar reconstruction image obtained from the CBCT image, it was determined whether the target bronchus was ventral or dorsal and lateral or medial to the current forceps tip position. It was also determined if the position of the bronchoscope tip needed to be adjusted. Next, while viewing the two-dimensional fluoroscopic image of the front or side, the position and direction of the tip of the bronchoscope were adjusted, and the R-EBUS probe was advanced in the direction of the target bronchus. This EBUS image was defined as the secondary EBUS image. Thereafter, CBCT was performed if required and defined as the secondary CBCT image. Subsequently, tertiary or more EBUS or CBCT images were obtained and defined as required. The best image obtained during the examination (smaller numbers in each image type) was defined as the best EBUS/CBCT image. We obtained six biopsy samples and two brushing samples and performed bronchial alveolar lavage with 20 mL saline. If the tip of the forceps did not reach the lesion, only bronchial alveolar lavage with 20 mL saline was performed.
After the biopsy forceps engaged the target bronchus, CBCT was performed during breath-holding using a 6-s acquisition protocol with 400 projection images acquired over a 200-degree rotation (Artis Zeego, Siemens Healthcare). Multi-planar reconstruction images were generated automatically on a dedicated workstation (Syngo X Workplace, Siemens Healthcare). Based on the relationship between the lesion and the forceps position, we classified the obtained images into three groups, as described in our previous report (primary CBCT image) (14 (link)). Type 1 CBCT image indicated that the forceps clearly reached the inside of the target lesion, type 2 indicated that the forceps reached adjacent to the lesion, and type 3 indicated that the forceps did not reach the lesion. Type 1 EBUS and CBCT, type 2 EBUS and CBCT, and type 3 EBUS and CBCT were recognized as equivalent images. If the primary CBCT image was type 1, a biopsy was performed. If it was type 2 or 3, the three-dimensional re-navigation toward the lesion was determined on the CBCT image and re-navigation was performed using R-EBUS. In the re-navigation procedure, first, based on the multi-planar reconstruction image obtained from the CBCT image, it was determined whether the target bronchus was ventral or dorsal and lateral or medial to the current forceps tip position. It was also determined if the position of the bronchoscope tip needed to be adjusted. Next, while viewing the two-dimensional fluoroscopic image of the front or side, the position and direction of the tip of the bronchoscope were adjusted, and the R-EBUS probe was advanced in the direction of the target bronchus. This EBUS image was defined as the secondary EBUS image. Thereafter, CBCT was performed if required and defined as the secondary CBCT image. Subsequently, tertiary or more EBUS or CBCT images were obtained and defined as required. The best image obtained during the examination (smaller numbers in each image type) was defined as the best EBUS/CBCT image. We obtained six biopsy samples and two brushing samples and performed bronchial alveolar lavage with 20 mL saline. If the tip of the forceps did not reach the lesion, only bronchial alveolar lavage with 20 mL saline was performed.
Biopsy
Bronchi
Bronchoalveolar Lavage
Bronchoscopes
Conscious Sedation
Fluoroscopy
Forceps
Lidocaine
Local Anesthesia
Midazolam
Reconstructive Surgical Procedures
Saline Solution
Synapses
Informed consent of procedural modalities and risks was collected from each patient. GDS placement was performed under conscious sedation. The stricture was identified endoscopically, and the guidewire was passed through the stenosis. After confirming the location and length of duodenal stenosis using a contrast medium, the duodenal stent was positioned across the stricture under endoscopic and fluoroscopic guidance. Stent type and length were chosen according to stricture site and length. A WallFlex DS (6, 9, or 12 cm in length, 22 mm in body diameter; Boston Scientific, Marlborough, MA, USA), Niti-S DS (covered or uncovered types 6, 8, 10, or 12 cm in length, 22 mm in body diameter; Taewoong Medical, Seoul, Korea), or Evolution DS (6, 9, or 12 cm in length, 22 mm in body diameter; Cook Medical, Winston-Salem, NC, USA) was selected based on the physician’s judgment. Finally, the stent was deployed, and its patency was confirmed by injecting a contrast medium.
Biological Evolution
Conscious Sedation
Contrast Media
Duodenal stenosis
Duodenum
Endoscopy
Fluoroscopy
Human Body
Patients
Physicians
Stenosis
Stents
titanium nickelide
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More about "Conscious Sedation"
Conscious sedation, also known as moderate sedation or procedural sedation, is a technique used in medical and dental procedures to provide a relaxed and comfortable experience for the patient.
It involves the administration of sedative and analgesic medications to induce a state of reduced awareness and decreased responsiveness to external stimuli, while the patient remains able to independently maintain ventilatory function and respond to verbal commands.
This technique is commonly used in a variety of procedures, including endoscopies, colonoscopies, minor surgical procedures, and dental treatments, to alleviate anxiety and pain without the need for general anesthesia.
Conscious sedation is often preferred over general anesthesia as it allows for a faster recovery time and a lower risk of complications.
The TJF-260V, GF-UCT260, JF-260V, NA-201SX-4022, CARTO 3, UM-S20-17S, BF-P260F, GF-UCT240, and BF-UC260F-OL8 are some of the medical devices and systems that may be used in conjunction with conscious sedation to facilitate these procedures.
The EU-ME2 is another related term that may be encountered in this context.
When researching conscious sedation, it is important to identify the most effective and reproducible protocols from the available literature, preprints, and patents.
PubCompare.ai's AI-driven platform can help researchers easily locate and compare the best practices, enhancing the accuracy and reliability of their research.
It involves the administration of sedative and analgesic medications to induce a state of reduced awareness and decreased responsiveness to external stimuli, while the patient remains able to independently maintain ventilatory function and respond to verbal commands.
This technique is commonly used in a variety of procedures, including endoscopies, colonoscopies, minor surgical procedures, and dental treatments, to alleviate anxiety and pain without the need for general anesthesia.
Conscious sedation is often preferred over general anesthesia as it allows for a faster recovery time and a lower risk of complications.
The TJF-260V, GF-UCT260, JF-260V, NA-201SX-4022, CARTO 3, UM-S20-17S, BF-P260F, GF-UCT240, and BF-UC260F-OL8 are some of the medical devices and systems that may be used in conjunction with conscious sedation to facilitate these procedures.
The EU-ME2 is another related term that may be encountered in this context.
When researching conscious sedation, it is important to identify the most effective and reproducible protocols from the available literature, preprints, and patents.
PubCompare.ai's AI-driven platform can help researchers easily locate and compare the best practices, enhancing the accuracy and reliability of their research.