No abstract available.
Conscious Sedation ; Endoscopy*

No abstract available.
Conscious Sedation* ; Endoscopy*

No abstract available.
Conscious Sedation* ; Porifera*

Conscious Sedation ; Humans ; Intubation, Intratracheal ; instrumentation ; methods

Anesthesia ; Conscious Sedation ; Endoscopy, Gastrointestinal ; Humans

Anesthesia ; Conscious Sedation ; Endoscopy, Gastrointestinal ; Humans ; Singapore

BACKGROUND: As the clinical-end point is not clear-cut in conscious sedation, there are no objective and feedback-providing methods to assess the depth of sedation within the levels appropriate for conscious sedation. METHODS: The investigation was carried out on 19 ASA PS 1 patients. The authors developed a system to measure the reaction time to visual (red colored flash, 40 lux for 30 msec) and auditory (beep, 1,000 Hz, 67.5 dB for 30 msec) stimulations. The authors confirmed the beeps to be audible to all the patients before the test began. When they perceived a visual or auditory stimulation, the authors instructed the patients to signal by pushing a button as soon as possible. The reaction time was defined as the time from the beginning of stimulation to the push of a button. The patients were gradually sedated with propofol TCI. The authors measured the visual and auditory reaction time and BIS after every 0.1 microgram/ml increment of the effect site concentration of propofol. RESULTS: As the effect site concentration of propofol increased, the reaction time to visual and auditory stimulations tended to be prolonged (P < 0.0001, respectively). The estimate was 409 and 498, respectively, which means the slope a in y = ax; x means unit change of the effect site concentration of propofol; y means the estimated values of the reaction time. The BIS values at loss of response to visual and auditory stimulations were 86 +/- 7 and 78 +/- 7 (mean +/- SD). CONCLUSIONS: The responses to visual and auditory stimulations were prolonged and ultimately abolished as the effect site concentration of propofol increased. The loss of response to visual stimulations preceded the loss of response to auditory stimulations. The BIS values at loss of responses to visual and auditory stimulations suggested light and moderate sedation, respectively.
Acoustic Stimulation ; Conscious Sedation* ; Humans ; Photic Stimulation ; Propofol* ; Reaction Time*

BACKGROUND/AIMS: Sedative use is common in endoscopic examinations. The anxiety regarding sedative use may be different between doctors and nonmedical individuals. METHODS: A questionnaire survey was conducted by a research company (DOOIT Survey), and responses were collected from 649 doctors and 1,738 individuals who perform typical jobs in nonmedical fields. In this study, these ordinary workers are considered to represent nonmedical individuals. Anxiety was measured using a 5-point Likert scale. RESULTS: The nonmedical individuals exhibited more anxiety regarding the sedative use than the doctors. Age <40 years (odds ratio [OR], 2.27; p<0.001), female sex (OR, 1.62; p=0.002), experience of an adverse event (OR, 1.79; p=0.049), and insufficient explanation (OR, 2.05; p<0.001) were the significant factors that increased the anxiety of the nonmedical individuals. The doctors who experienced a sedative-related adverse event reported increased anxiety compared with the doctors who did not report this experience (OR, 1.73; p=0.031). CONCLUSIONS: Anxiety regarding sedative use during an endoscopic examination was significantly different between doctors and non-medical individuals. A younger age, female sex, an adverse event, and insufficient explanation affect the anxiety of nonmedical individuals. An adverse event also affects the anxiety of doctors.
Anxiety* ; Conscious Sedation ; Endoscopy ; Female ; Humans ; Seoul* ; Surveys and Questionnaires

Midazolam is a type of anesthetic agent frequently used for conscious sedation during a variety of medical procedures. Anaphylactic reactions to midazolam are rarely reported. However, we observed a case of midazolam hypersensitivity in which emergency measures were required to ensure patient recovery after administration of midazolam as a sedative. The occurrence of the anaphylactic reaction to midazolam was confirmed by elevated serum tryptase levels. The current case report presents a discussion of our findings.
Anaphylaxis* ; Conscious Sedation ; Emergencies ; Humans ; Hypersensitivity ; Midazolam* ; Tryptases

PURPOSE: We aimed to analyze the effectiveness and safety of low-dose midazolam and ketamine combination for upper gastrointestinal endoscopy (UGIE) in children. METHODS: The study included the children (n=425, 10.78+/-3.81 years) who underwent UGIE for diagnostic purpose during 1 year period. All children were sedated with low dose midazolam (0.1 mg/kg) and ketamine (0.5 mg/kg) intravenously. Effectiveness of the sedation and complications during the procedure and recovery period were recorded. RESULTS: Endoscopic procedure was successfully completed in 414 patients (97.4%; 95% confidence interval, 95.8-98.9). Mean+/-standard deviation (SD) duration of procedure was 6.36+/-1.64 minutes (median, 6.0 minutes; range, 4-12 minutes). Minor complications occurred during the procedure in 39.2% of the patients. The most common complication was increased oral secretion (33.1%). No major complications were observed in any patient. Age and Ramsay sedation scores of patients with complications during the procedure were lower than the others (9.49+/-4.05 years vs. 11.61+/-3.43 years, p=0.002 and 2.10+/-1.46 vs. 4.37+/-1.16, p=0.001). Mean recovery time was 22 minutes (range, 10-90 minutes; mean+/-SD, 25+/-12.32 minutes). Minor complications developed during recovery in 60.1% of the patients. The most common complication was transient double vision (n=127, 30.7%). Emergence reaction was observed in 5 patients (1.2%). CONCLUSION: The procedure was completed with high level of success without any major complication in our study. Combination of low-dose midazolam and ketamine is a suitable sedation protocol for pediatric endoscopists in UGIE.
Child* ; Conscious Sedation ; Diplopia ; Endoscopy ; Endoscopy, Gastrointestinal* ; Humans ; Ketamine* ; Midazolam*