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Pharmaceutical Approaches
Published in Eli Ilana, Oral Psychophysiology, 2020
The purpose of intravenous sedation (i.v.) is to achieve relaxation and cooperation without obtundation and compromise of vital functions. The aim is to diminish anxiety and apprehension rather than to dull protective reflexes.25 During intravenous sedation, the patient remains conscious and appropriately responsive to questions or commands. In some dental and oral surgical procedures, local anesthesia is added to avoid possible pain involved with the treatment.
Upper Gastrointestinal Surgery
Published in Gozie Offiah, Arnold Hill, RCSI Handbook of Clinical Surgery for Finals, 2019
Intravenous sedation➢ Typically given IV Midazolam (a benzodiazepine) as sedation➢ Be cautious for benzodiazepine overdose➢ Always have Flumazenil (benzodiazepine antagonist) availableThey will be slightly drowsy and relaxed but not unconscious. They may not be able to remember the procedure.They can breathe normally throughout the procedure through their nose.If you opt for sedation you may not operate machinery, drive, consume alcohol, or sign legally binding documents for 24 hours after receiving the medication and you need someone to accompany you home.
Implantation of a sustained-release ganciclovir implant
Published in A Peyman MD Gholam, A Meffert MD Stephen, D Conway MD FACS Mandi, Chiasson Trisha, Vitreoretinal Surgical Techniques, 2019
April Harris, Stephen A Meffert, Mandi D Conway
The patient must be able to tolerate mild intravenous sedation and injection of local anesthetic. General anesthesia is occasionally indicated in cases of dementia or psychological disturbance. Preoperative evaluation by the patient’s internist is valuable if there is concern regarding the patient’s medical status and ability to tolerate the procedure.
Efficacy of virtual reality distraction technique for anxiety and pain control in orthopedic forearm surgeries performed under supraclavicular brachial plexus block: A randomized controlled study
Published in Egyptian Journal of Anaesthesia, 2023
Medhat Gamal, Ashraf Rady, Mohamed Gamal, Haitham Hassan
Moreover, peripheral nerve blocks have been used regularly as a form of anesthesia due to the ubiquitous usage of ultrasonography in daily anesthesia practice. The preoperative anxiety level may also be impacted by the anesthetic technique used separately from the surgical procedure [3]. Intravenous sedation is frequently used to ensure patient comfort. This includes the administration of powerful opioids like fentanyl and benzodiazepines like midazolam. These drugs are not safe to take particularly opioids. Routine administration of opioid and sedatives should be avoided due to potential side effects like respiratory depression, which are more common in patients who have sleep apnea [4] as well as the risk of long-term opioid abuse in even patients who have never used opioids before [5] and received opioids during the perioperative period. Additionally, in susceptible individuals, such as the elderly, benzodiazepines and intravenous opioids may cause postoperative delirium [6].
A dose-response study of nanosecond electric energy pulses on facial skin
Published in Journal of Cosmetic and Laser Therapy, 2020
James Newman, Lauren Jauregui, William A. Knape, Edward Ebbers, Darrin Uecker, Darius Mehregan, Richard Nuccitelli
The clinical subject’s skin was marked with gentian violet marker confirming previously treated NPS sites with the aid of the plastic templates immediately prior to beginning their planned surgery. The patients were then prepared for surgery with intravenous sedation in an accredited outpatient surgical facility. After sterile prepping and draping the patients’ face and neck, local anesthetic of 2% lidocaine with epinephrine (1:100,000) was injected along marked incision lines along with field infiltration of dilute anesthetic subcutaneously for facelift surgery. A punch biopsy ranging from 4 to 6 mm was then used to completely excise the treatment areas through the subcutaneous fat with an orientation suture when possible noting the anterior superomedial edge of each treatment zone. There was minimal bleeding encountered during the biopsy process and no electrocautery was used during the harvesting of the specimens. Once all specimens were harvested, the patients underwent their planned surgical facelift procedure under intravenous sedation. The individual samples collected were placed in collection jars with 10% neutral formalin for preservation and shipped to a histopathology lab, Pinkus Dermatopathology Laboratory, for staining and evaluation by a dermatopathologist.
Incidence of paroxysmal sympathetic hyperactivity following traumatic brain injury using assessment tools
Published in Brain Injury, 2018
Sophie Samuel, Monica Lee, Robert J Brown, Huimahn A. Choi, Ian J Baguley
In our cohort, PSH was clinically diagnosed in 16/45 patients with TBI (36%) in the acute setting compared to 45/65 (69%) utilising the PSH-AM within the first week of admission. This is a higher incidence than previous publications (3,8–14). Using the assessment tool, clinical features of PSH were evident from day one in 42/45 patients (93%) (see Table 3), but, as the diagnosis of PSH is currently one of exclusion, other diagnostic workups were required. During the acute phase of brain injury, subjects received continuous intravenous sedation medications (i.e. fentanyl, propofol, and benzodiazepines) for symptomatic control, intracranial pressure management and/or analog-sedation while intubated. There was a significant difference between the two groups in utilisation of these medications up to day 6; however, on day 4, PSH symptoms increased to scores ≥17 in patients with possible PSH+. By day 5, all 45 patients exhibited clinical features of PSH which continued up to day 8.