Sedation and paralysis.

Inadequate Sedation During Therapeutic Paralysis: Use of Bispectral Index in Critically Ill Patients

BACKGROUND Patients receiving therapeutic paralysis may experience inadequate sedation due to intrinsic limitations of behavioral sedation assessment. Bispectral index (BIS™) provides an objective measure of sedation; however, the role of BIS™ is not well defined in intensive care unit (ICU) patients on neuromuscular blocking agents (NMBA). OBJECTIVE The aim of this study was to delineate the...

Is periprocedural sedation during acute stroke therapy associated with poorer functional outcomes?

BACKGROUND To safely perform acute intra-arterial revascularization procedures, use of sedative medications and paralytics is often necessary. During the conduct of the Interventional Management of Stroke trials (I and II), the level of sedation used periprocedurally varied. At some institutions, patients were paralyzed and intubated as part of the procedural standard of care while at other ins...

Parotidectomy under sedation and locoregional anesthesia with monitoring of brain activity.

BACKGROUND Parotidectomy is usually performed while the patient is under general anesthesia, however, sedation with locoregional anesthesia could be an alternative. METHODS Fifteen adult patients with parotid tumors of the superficial lobe were included in this study. Anesthetic procedure consisted of sedation associated with cervical plexus and auriculotemporal nerve block. Sedation was mana...

Never use neuromuscular blocking agents for sedation.

We read with appreciation and concern the review article by Isenstein et al,’ which appeared in the October 1992 issue of Chest. The authors have provided clinically relevant information that is familiar to most anesthesiologists, but it may not be the case for other specialists. With more newly available drugs and better monitoring techniques, there is a current trend toward increasing usage o...

Sedation, analgesia, and paralysis in the intensive care unit.

Thyroplasty under general anesthesia using a laryngeal mask airway and fibreoptic bronchoscope.

PURPOSE To report the management of a patient, with unilateral vocal cord paralysis, undergoing thyroplasty, under general anesthesia. CLINICAL FEATURES A 25-yr-old man developed hoarseness and occasional episodes of pulmonary aspiration, caused by unilateral vocal cord paralysis. He was scheduled for thyroplasty, in an attempt to ease phonation and to decrease or prevent further episodes of ...