scholarly journals Squamous Papilloma Causing Airway Obstruction During Conscious Sedation

2017 ◽  
Vol 64 (3) ◽  
pp. 168-170
Author(s):  
Paul Brady ◽  
Christine McCreary ◽  
Ken D. O'Halloran ◽  
Catherine Gallagher

Monitoring for respiratory depression is essential during conscious sedation. We report a case of a squamous papilloma as an unusual cause of intermittent partial airway obstruction in a 43-year-old man undergoing intravenous conscious sedation with midazolam. The Integrated Pulmonary Index (IPI) is an algorithm included in some commercially available monitors that constitutes a representation of 4 parameters: end-tidal carbon dioxide, respiratory rate, oxygen saturation, and pulse rate. We discuss the potential of the IPI as a monitoring tool during sedation.

2018 ◽  
Vol 63 (No. 12) ◽  
pp. 546-554
Author(s):  
O. Guzel ◽  
D.A. Kaya ◽  
K. Altunatmaz ◽  
G. Sevim ◽  
D. Sezer ◽  
...  

In this study, we compared the effects of xylazine, medetomidine and dexmedetomidine in combination with ketamine on heart rate, respiratory rate, blood gas values, temperature and sedation scores. A total of 30 dogs were evaluated. The dogs were randomly allocated into three anaesthesia groups, each of which included ten dogs. The first group, denoted the xylazine/ketamine group, intravenously received xylazine (0.5 mg/kg) for premedication and ketamine (5 mg/kg) for induction. The second group, the medetomidine/ketamine group, intravenously received medetomidine (10 µg/kg) followed by ketamine (5 mg/kg). The third group received the dexmedetomidine/ketamine combination. This group intravenously received dexmedetomidine (3 µg/kg) for premedication and ketamine (5 mg/kg). Heart rate, respiratory rate, oxygen saturation, blood gas parameters and temperature were recorded for all patients immediately before sedation onset (T<sub>0</sub>), five minutes after sedation onset (T<sub>1</sub>) and five minutes after endotracheal intubation following ketamine injection (T<sub>2</sub>). The end tidal carbon dioxide level was recorded at T<sub>2</sub>. A significant decrease in heart rate occurred following premedication in all groups. However, the decrease was most marked in the medetomidine/ketamine group. An increase was observed in venous partial pressure of carbon dioxide values at T<sub>2</sub> in the xylazine/ketamine group compared to the medetomidine/ketamine and dexmedetomidine/ketamine groups. The end tidal carbon dioxide levels were higher in the medetomidine/ketamine group than in the other two groups, and oxygen saturation of haemoglobin levels in the same group were found to be lower than in the others. It was determined that none of α<sub>2</sub>-agonists, namely xylazine, medetomidine or dexmedetomidine, had superior properties over the others. If medetomidine is used, special care should be taken because of the rapid decrease in heart rate.


2020 ◽  
Vol 2 (2) ◽  
pp. 1-9
Author(s):  
Fabrizio di Virgilio ◽  
Sara Manfredini ◽  
Luca Formaggini

This pilot study aims to compare cardiorespiratory parameters in female dogs that underwent either laparoscopic or open elective gonadectomy with spontaneous ventilation anaesthesia. Records of 77 client-owned female dogs were reviewed. Patients were divided into two groups: laparoscopic surgery (L group, n 47) and open abdominal surgery (O group, n 30). The end-tidal carbon dioxide, respiratory rate, oxygen saturation, heart rate, non-invasive arterial blood pressure and length of procedure were recorded and statistically evaluated. Once normality of the sample data has been assessed, equality between the groups was analysed with two-sample Student’s or Welch’s t-test, whether the hypothesis of variance equality, through an F-test, was verified or not. A value of p <0.05 was considered statistically significant. No statistically significant difference was found between groups regarding the end-tidal carbon dioxide, oxygen saturation, respiratory rate, heart rate, systolic and medium arterial pressure values. Mean diastolic pressure was lower in the L group. The procedure length between the two groups was statistically different: laparoscopy was shorter than open surgery. In spontaneously ventilating female dogs, the cardiorespiratory parameters evaluated seem not to be affected by the presence of pneumoperitoneum when intrabdominal pressure is kept between 8 and 10 mmHg. The pilot nature of the study and the shorter laparoscopic surgery length could bias these results. However, in the author’s opinion, these findings confirm the interest of laparoscopy and the small impact of this mini-invasive technique in healthy patients.


Author(s):  
Jamie Mount Wood ◽  
Laura Tabacof ◽  
Jenna Tosto-Mancuso ◽  
Dayna McCarthy ◽  
Amy Kontorovich ◽  
...  

Abstract N/A - Letter to the Editor


2018 ◽  
Vol 128 (2) ◽  
pp. 293-304 ◽  
Author(s):  
Anne-lee J. Hoorweg ◽  
Wietze Pasma ◽  
Leo van Wolfswinkel ◽  
Jurgen C. de Graaff

Abstract Background Vital parameter data collected in anesthesia information management systems are often used for clinical research. The validity of this type of research is dependent on the number of artifacts. Methods In this prospective observational cohort study, the incidence of artifacts in anesthesia information management system data was investigated in children undergoing anesthesia for noncardiac procedures. Secondary outcomes included the incidence of artifacts among deviating and nondeviating values, among the anesthesia phases, and among different anesthetic techniques. Results We included 136 anesthetics representing 10,236 min of anesthesia time. The incidence of artifacts was 0.5% for heart rate (95% CI: 0.4 to 0.7%), 1.3% for oxygen saturation (1.1 to 1.5%), 7.5% for end-tidal carbon dioxide (6.9 to 8.0%), 5.0% for noninvasive blood pressure (4.0 to 6.0%), and 7.3% for invasive blood pressure (5.9 to 8.8%). The incidence of artifacts among deviating values was 3.1% for heart rate (2.1 to 4.4%), 10.8% for oxygen saturation (7.6 to 14.8%), 14.1% for end-tidal carbon dioxide (13.0 to 15.2%), 14.4% for noninvasive blood pressure (10.3 to 19.4%), and 38.4% for invasive blood pressure (30.3 to 47.1%). Conclusions Not all values in anesthesia information management systems are valid. The incidence of artifacts stored in the present pediatric anesthesia practice was low for heart rate and oxygen saturation, whereas noninvasive and invasive blood pressure and end-tidal carbon dioxide had higher artifact incidences. Deviating values are more often artifacts than values in a normal range, and artifacts are associated with the phase of anesthesia and anesthetic technique. Development of (automatic) data validation systems or solutions to deal with artifacts in data is warranted.


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