A postal questionnaire inquiring about routine sedation and premedication practice for upper gastrointestinal endoscopy was sent to 1048 doctors. Of 665 appropriate returns, 81% were from consultant physicians and surgeons. Most endoscopists (90%) reported using an intravenous benzodiazepine for at least three quarters of endoscopies and 54% of physicians and 69% of surgeons always did so. Mida...

Interhospital transport presents a challenge for pediatricians, and airway protection is often a significant concern. The severely agitated child without respiratory compromise poses an extremely difficult dilemma, as most sedative agents can cause respiratory depression. Intubation offers definitive control of the airway but is not without risk, especially in an environment where experience an...

The purpose of this study was to evaluate the effects of flumazenil (1 mg i.v.) on the ventilatory response of premedicated patients receiving a continuous infusion of midazolam for sedation. After assessing baseline ventilatory function using a modified Read rebreathing method for determining hypercapnic ventilatory drive, 16 healthy outpatients were administered fentanyl, 50 micrograms i.v., ...

The use of monitored anaesthesia care (MAC) is increasing with the discovery of newer, more effective and appropriate drugs and techniques. MAC is intended to achieve patient comfort with safety and optimal clinical outcome and is being extensively used worldwide for cataract and other ophthalmic surgeries. This article briefly reviews the conceptual basis of MAC, its use in ophthalmic surgerie...

Procedural pain is an important aspect of care in pediatrics, and particularly in pediatric oncology where children often consider this to be the most painful experience during their illness. Best recommended practice to control procedural pain includes both sedative-analgesic administration and non-pharmacological treatments, practiced in an adequate and pleasant setting by skilled staff. A na...

Background. The reticular and thalamocortical system is known to play a prominent role in spindle wave activity, and the spindle wave is related to the sedative effects of anaesthetics. Recently, bispectral analysis of the EEG has been developed as a better method to indicate nonlinear regulation including the thalamocortical system linking to the cortical area. In the present study, in order t...

Issues concerning the use of nitrous oxide (N2O) and sedative agents by pediatric dentists in relation to recent changes in sedation guidelines of the American Academy of Pediatric Dentistry (AAPD) and the American Academy of Pediatrics (AAP) are relatively unexplored. A 48-item questionnaire addressing demographics, N2O equipment, N2O use, safety, and personnel was mailed to 2,650 active AAPD ...

Seventy-four mothers were surveyed to determine their attitudes toward the use of a Papoose Board (PB, Olympic Medical Corporation, Seattle, WA) to treat their uncooperative children (mean age 3.1 years). If, at the initial exam, it was agreed that the PB might be an acceptable treatment modality, the child was prescribed a sedative for the next appointment. At that appointment, the child was p...

Rapid, accurate, and precise gas-chromatographic methods are reported for measurement of propoxyphene (“Darvon”) in serum. A sample of 5 ml of serum is required for quantitation in blood after a therapeutic dose of 130-195 mg of propoxyphene; in cases of overdose of propoxyphene, only 1 ml of serum is required in a “toxic method” variation. Neither serum from healthy controls or from hospitaliz...

Dexmedetomidine is a useful drug to provide sedation and maintain spontaneous ventilation. Its use in pediatrics has increased over the last decade. Despite its utility as a cooperative sedative during difficult airway management in the adult population, this use in pediatrics is often not possible. As a result we present 3 cases of difficult pediatric airways that were secured using high dose ...