Disease relevance of Conscious Sedation

• The purpose of this study was (1) to test the ability of prophylactic ondansetron to prevent postoperative nausea and vomiting in plastic surgery cases performed under conscious sedation, and (2) to determine relative risk factors for postoperative nausea and vomiting and a selection policy for the administration of antiemetic prophylaxis [1].
• CONCLUSION: We conclude that intraoperative O2 supplementation prevents desaturations even in the presence of apnea during pediatric conscious sedation [2].
• Clonidine is a valuable adjunct for conscious sedation and can be used safely for sympathicolysis, even in patients with aortic stenosis [3].
• Continuous transcutaneous oxygen and carbon dioxide monitoring during conscious sedation using diazepam, fentanyl, and methohexital indicates that hypoxia occurs in all patients maintained on room air; 36% of the patients maintained on room air showed a decrease in transcutaneous oxygen of greater than 20 mg Hg [4].

Psychiatry related information on Conscious Sedation

• Flumazenil reversal of psychomotor impairment due to midazolam or diazepam for conscious sedation for upper endoscopy [5].
• Dramatic alterations in the EEG, P300 response, and reaction times were observed, especially with the higher plasma concentrations which produced conscious sedation [6].
• CONCLUSIONS: Both techniques of conscious sedation - midazolam and midazolam with fentanyl - are satisfactory for coronary angiography where hemodynamic stability and patient cooperation are required [7].
• Infusions of propofol for conscious sedation produce concentrations below those required for consistent amnesia [8].

High impact information on Conscious Sedation

• Flumazenil is best left for reversal of therapeutic conscious sedation and rare select cases of benzodiazepine overdose [9].
• Propofol for conscious sedation [10]?
• CONCLUSIONS: Both low-dose midazolam (35 micrograms/kg) and lidocaine spray have an additive beneficial effect on patients tolerance and rarely induce significant alterations in cardiorespiratory monitoring parameters, thus supporting the widespread use of conscious sedation [11].
• METHODS: In 162 patients, conscious sedation during ICD placement was achieved with combined intravenous midazolam, morphine and promethazine (Phenergan) [12].
• CONCLUSIONS: Implantation of ICDs under conscious sedation with combined hypnotic agents and deep sedation with etomidate is a safe and effective procedure with low perioperative morbidity and low long-term complication rates [12].

Biological context of Conscious Sedation

• Insertion of transvenous leads and prepectoral subfascial ICD implantation were performed in electrophysiology laboratories under local anesthesia and conscious sedation with intravenous midazolam and propofol [13].
• They were randomly allocated to have inhalation conscious sedation with either sevoflurane/nitrous oxide mixture or nitrous oxide alone [14].
• Pharmacokinetics of propofol during conscious sedation using target-controlled infusion [15].
• Heart rate (HR) and arterial blood pressure (BP) changes have been reported during conscious sedation with propofol and midazolam [16].
• METHODS: Pain related to device implantation was quantified in 21 consecutive patients (age, 61 +/- 11 years; 17 men and 21 women; 16 of 21 had coronary artery disease; left ventricular ejection fraction, 32% +/- 15%) undergoing pectoral ICD implantation with conscious sedation (fentanyl 118 +/- 72 micrograms midazolam 14 +/- 9 mg) [17].

Anatomical context of Conscious Sedation

• It appears that conscious sedation with midazolam, pethidine (meperidine) and fentanyl is nontoxic for oocyte recovery [18].
• Isoflurane 0.5% in oxygen for conscious sedation was compared with placebo (oxygen) and with an equipotent concentration of nitrous oxide in oxygen, in patients scheduled for surgical removal of bilateral, similarly impacted lower third molars [19].
• Ineffective ventilation during conscious sedation due to chest wall rigidity after intravenous midazolam and fentanyl [20].
• Flumazenil was found to reverse rapidly much of the central nervous system depression induced by fentanyl and diazepam conscious sedation [21].

Associations of Conscious Sedation with chemical compounds

• Conscious sedation was achieved with intermittent boluses of intravenous midazolam and fentanyl [22].
• A randomized, prospective, double-blind comparison of midazolam (Versed) and emulsified diazepam (Dizac) for opioid-based, conscious sedation in endoscopic procedures [23].
• The feasibility of using isoflurane in conscious sedation procedures is discussed [24].
• Carbon dioxide monitoring during deep conscious sedation using nasopharyngeal airways [25].
• OBJECTIVE: Propofol (2,6-diisopropyl phenol) is a relatively new intravenous sedative hypnotic with an ideal pharmacokinetic profile for conscious sedation [26].

Gene context of Conscious Sedation

• Most treatments in the lung, kidney and for HCC are performed under conscious sedation with an overnight hospital stay or as a day-case [27].
• CONCLUSIONS: Patients undergoing screening colonoscopy with conscious sedation are less likely to experience peri-procedural discomfort than those undergoing screening flexible sigmoidoscopy [28].
• Validation of the BIS monitor during conscious sedation and deep sedation in children [29].
• OBJECTIVE: To review the principles and practice of the use of conscious sedation for IVF [30].
• Incidence and extent of venous sequelae with intravenous diazepam utilizing a standardized conscious sedation technique. Part II: Effects of injection site [31].

Analytical, diagnostic and therapeutic context of Conscious Sedation

• OBJECTIVES: The objective of this study was to evaluate the feasibility, safety and efficacy of placing implantable cardioverter-defibrillators (ICDs) in the electrophysiology laboratory using conscious sedation with combined hypnotic agents and deep sedation with etomidate [12].
• CONCLUSIONS: Topographic brain EEG mapping techniques indicate that frontal brain beta 1 EEG activity may be useful as an objective brain index of propofol conscious sedation [32].
• Does localized flare reaction to intravenous meperidine reduce sedation and pain control during conscious sedation for endoscopy [33]?
• OBJECTIVE: Our aim was to evaluate if the routine use of the benzodiazepine antagonist flumazenil would shorten postprocedure recovery times after esophagogastroduodenoscopy in pediatric patients receiving standard intravenous conscious sedation with the benzodiazepine diazepam in combination with meperidine [34].
• A comparison of midazolam and diazepam for conscious sedation during colonoscopy in a prospective double-blind study [35].

References