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Sedation, analgesia and patient observation in interventional radiology
Published in William H. Bush, Karl N. Krecke, Bernard F. King, Michael A. Bettmann, Radiology Life Support (Rad-LS), 2017
Jeffrey E. Quam, Michael A. Bettmann
In healthy patients, benzodiazepines have only slight respiratory depressive effects when used alone and appear primarily to block the ventilatory response to hypoxia.10 However, the addition of a narcotic markedly increases the risk of hypoxemia.11 Respiratory depression is mainly due to depression of both the hypoxic and the hypercapnic respiratory centers in the brainstem. General skeletal muscle relaxation may also contribute to the respiratory depression.10 A recent study by Bailey et al. suggested that blunting of the ventilatory response to hypoxia occurred earlier and to a greater degree than did the response to hypercarbia, when a benzodiazepine and narcotic were given.11 In theory, therefore, arterial oxygen partial pressure (PO2) may drop to critically low levels before increased ventilation would be stimulated by a sufficiently high blood CO2 tension.
HospiAvontuur: development of a serious game to help young children and their parents during the preparation for an admission at the hospital for elective surgery
Published in Behaviour & Information Technology, 2021
Jo Vrancken, Liesbeth De Gryse, Annemie I. F. Spooren
In order to reduce preoperative anxiety in children, several pharmacological and non-pharmacological methods have been proven useful. A common pharmacological intervention with proven effectiveness and efficacy is the administration of midazolam (Wright et al. 2007). The use of midazolam is however not without disadvantages (Bergendahl, Lönnqvist, and Eksborg 2006). Common disadvantages are amnesia, the lack of analgesic effect, hiccups, dose-dependent postoperative agitation, increased requirement of postoperative oxygen supplementation, long-term behavioural disturbances, disturbed memory/cognition, potential opioid-induced respiratory depression, bitter taste, nasal sting and anterograde amnesia (Kain et al. 2000; Watson and Visram 2003).