Effect of conscious sedation and deep sedation on the vagal response characteristics during ganglionated plexus ablation

2021 ◽  
Author(s):  
Tolga Aksu ◽  
Kivanc Yalin ◽  
Leah John ◽  
Jose Osorio ◽  
Jeffrey Winterfield ◽  
...  
Keyword(s):  
Conscious Sedation ◽  
Deep Sedation ◽  
Response Characteristics ◽  
Ganglionated Plexus

Sedation Protocols—Why So Many Variations?

PEDIATRICS ◽  
1994 ◽  
Vol 94 (3) ◽  
pp. 281-283 ◽  
Author(s):  
Charles J. Coté
Keyword(s):  
Adverse Events ◽  
Word Of Mouth ◽  
Pediatric Patients ◽  
Conscious Sedation ◽  
Deep Sedation ◽  
Considerable Time ◽  
American Academy Of Pediatrics ◽  
Appropriate Care ◽  
Dental Office ◽  
Difficult Issue

The Committee on Drugs (COD) of the American Academy of Pediatrics (AAP), along with its many consultants, has spent considerable time addressing the difficult issue of appropriate care for sedated pediatric patients. The Committee's concern has been the continued appearance of reports, nearly always from nonmedical journal sources ("word of mouth", newspapers), of children suffering adverse events (morbidity and mortality) after sedation for procedares that in themselves should not result in any such complications, eg, radiologic investigations.1-4 The original "Guidelines for the Elective Use of Conscious Sedation, Deep Sedation, and General Anesthesia in Pediatric Patients" were published in 1985.5 These were constructed because of concern regarding a number of deaths that occurred in the dental office.6

Guidelines for the Elective Use of Conscious Sedation, Deep Sedation, and General Anesthesia in Pediatric Patients

PEDIATRICS ◽  
1985 ◽  
Vol 76 (2) ◽  
pp. 317-321
Author(s):  
◽  
Keyword(s):  
General Anesthesia ◽  
Pediatric Patients ◽  
Conscious Sedation ◽  
Deep Sedation ◽  
Loss Of Consciousness ◽  
Physical Stimulation ◽  
Verbal Command ◽  
Patent Airway ◽  
Level Of Consciousness ◽  
Definition Of

The goals of sedation and general anesthesia in the ambulatory patient are: (1) patient welfare; (2) control of patient behavior; (3) production of positive psychological response to treatment; and (4) return to pretreatment level of consciousness by time of discharge. DEFINITION OF TERMS Terms used in this document are defined as follows: Pediatric patients: Includes all patients who are infants, children, and adolescents less than age of majority. Must or shall: Indicates an imperative need and/or duty; as essential or indispensable; mandatory. Should: Indicates the recommended manner of obtaining the standard; highly desirable. May or could: Indicates freedom or liberty to follow a suggested or reasonable alternative. Conscious sedation: Conscious sedation is a minimally depressed level of consciousness that retains the patient's ability to maintain a patent airway independently and continuously, and respond appropriately to physical stimulation and/or verbal command, eg, "Open your eyes." For the very young or handicapped individual, incapable of the usually expected verbal responses, a minimally depressed level of consciousness for that individual should be maintained. The caveat that loss of consciousness should be unlikely is a particularly important part of the definition of conscious sedation, and the drugs and techniques used should carry a margin of safety wide enough to render unintended loss of consciousness unlikely. Deep sedation: Deep sedation is a controlled state of depressed consciousness or unconsciousness from which the patient is not easily aroused, which may be accompanied by a partial or complete loss of protective reflexes, including the ability to maintain a patent airway independently and respond purposefully to physical stimulation or verbal command.

Guidelines for the Elective Use of Conscious Sedation, Deep Sedation, and General Anesthesia in Pediatric Patients

PEDIATRICS ◽  
1986 ◽  
Vol 77 (5) ◽  
pp. 754-754
Author(s):  
Keyword(s):  
General Anesthesia ◽  
Pediatric Patients ◽  
Conscious Sedation ◽  
Deep Sedation ◽  
Intravenous Access ◽  
Intravenous Line ◽  
Intravenous Infusions

Clarification The AAP Committee on Drugs and Section on Anesthesiology wish to clarify those portions of the Guidelines (Pediatrics 1985;76:317-321, August) that pertain to an intravenous line. Under some circumstances (eg, very short procedures, availability of persons skilled in establishing intravenous lines in children), it may not be necessary that an intravenous line be in place. Therefore, the Guidelines are modified as follows. In section II, "Deep Sedation," the recommendation should read: Patients receiving deep sedation should have an intravenous line in place or have immediately available a person skilled in establishing intravenous infusions in pediatric patients. In section III, "General Anesthesia: Intravenous Access," the recommendation should read: Patients receiving ambulatory general anesthesia shall have an intravenous line in place or have immediately available a person skilled in establishing intravenous infusions in pediatric patients.

scholarly journals The superiority of midazolam-pethidine combination in three different anesthetic methods applied in conscious sedation during transesophageal echocardiography procedure

2022 ◽  
Vol 13 (1) ◽  
pp. 38-45
Author(s):  
Hulya Yilmaz AK ◽  
Yasemin Ozsahin ◽  
Mehmet Ali Yesiltas ◽  
Sukru Arslan ◽  
Cem Bostan ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Randomized Trial ◽  
Transesophageal Echocardiography ◽  
Conscious Sedation ◽  
Deep Sedation ◽  
Physician Satisfaction ◽  
Clinical Effects ◽  
Moderate Sedation ◽  
Probe Placement ◽  
Probe Insertion

Background: During the transesophageal echocardiography (TEE) procedure, as in many other diagnostic semi-invasive applications, moderate sedation is preferred over deep sedation. Rarely, patients who cannot tolerate moderate sedation may require deep sedation when difficulties are encountered during TEE probe insertion. Although many different methods have been tried for the TEE procedure in clinical practice, the most appropriate sedation method is still controversial. Aims and Objectives: We aimed to evaluate the clinical effects of three different sedoanalgesia methods consisting of midazolam, propofol, and midazolam-pethidine combination protocols applied for conscious sedation in the patients undergoing a TEE procedure, and to evaluate the patient and doctor satisfaction during the procedure. Materials and Methods: One-hundred twenty five patients who underwent TEE for diagnostic purposes in our hospital were included consecutively in our prospective randomized trial. The patients were divided into three groups as those who were administered midazolam (group M), propofol (group Pr), and midazolam-pethidine (group MPe) during the TEE procedure. Results: In the MPe group, both patient and doctor satisfaction were significantly higher than the two groups. The rate of difficulty in probe placement was lower in the Pr and MPe groups compared to the M group (P<0.05). Conclusion: In this study, it has been observed that conscious sedation with the combination of midazolam-pethidine was significantly advantageous in terms of patient and physician satisfaction compared to the use of only midazolam and only propofol.

Conscious sedation

2017 ◽  
Author(s):  
Johannes (Hans) T. A. Knape
Keyword(s):  
Pulse Oximetry ◽  
Conscious Sedation ◽  
Deep Sedation ◽  
Spontaneous Ventilation ◽  
Ecg Monitoring ◽  
Oxygen Administration ◽  
Emergency Interventions

After a thorough introduction to conscious sedation, including the reasons for the increase in demand for assistance for moderate (conscious)-to-deep sedation in medicine over recent decades, this chapter covers some key definitions, before moving on to morbidity, mortality, and safety. The chapter then discusses how to prepare the patient for sedation, including the issue of whether the patient should have fasted prior to sedation and the screening of patients for sedation. It looks at the necessary qualifications and responsibilities of a sedation practitioner, and the monitoring of patients undergoing moderate-to-deep sedation: this includes monitoring of the ventilation via pulse oximetry, monitoring the efficacy of spontaneous ventilation via capnography, monitoring of the circulation, ECG monitoring, and monitoring the depth of sedation. Routine oxygen administration is also discussed, as are emergency interventions and resuscitation, and recovery and discharge of the patient following moderate-to-deep sedation. The chapter finishes with a discussion of the techniques and drugs used in sedation, and specific considerations surrounding sedation in children.

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