BACKGROUND: For logistical reasons sedation studies are often carried out in elective surgical patients and the results extrapolated to the general intensive care unit (ICU) population. We question the validity of this approach. We compared the two sedation regimens used in our general ICU in a trial structured to mimic clinical practice as closely as possible. RESULTS: Forty patients were rand...

OBJECTIVES To determine whether bispectral analysis (BIS) changes during nitrous oxide (N(2)O) sedation in anxious children undergoing extraction of primary teeth. METHODS In this prospective study 45, ASA physical status I children, aged between 7 to 12 years and scheduled for primary teeth extraction under N(2)O/O(2) sedation are included. At baseline (T0) and during the sedation procedure ...

BACKGROUND In the intensive care unit (ICU), analgesia and sedation are used to improve the comfort and safety of patients undergoing intensive care therapies. However, continuous administration of sedatives prolongs the time on mechanical ventilation and ICU stay. These adverse effects can be reduced by clear definition of the goals of sedation combined with a sedation protocol. METHODS The ...

BACKGROUND Procedural sedation guidelines were established for a tertiary care pediatric emergency department (ED). We developed a pediatric procedural sedation course to disseminate these guidelines. OBJECTIVE Our objective was to evaluate the effectiveness of a sedation course in improving physicians' knowledge of pediatric procedural sedation practices and guidelines, relative to individua...

INTRODUCTION As a result of the increased number of both diagnostic and therapeutic procedures in pediatric outpatients, sedation and analgesia have gained relevance in this context. OBJECTIVE To characterize the type of sedation and analgesia used by pediatric sedation teams in procedures done outside the operating room, as well as its safety and outcome. POPULATION AND METHODS All procedu...

INTRODUCTION Most clinicians give sedatives and analgesics according to their professional experience and the patient's estimated need for sedation. However, this approach is prone to error. Inadequate monitoring of sedation and analgesia may contribute to adverse outcomes and complications. With this in mind, data obtained continuously using nonstimulating methods such as bispectral index (BIS...

Anxiety and phobia in dental procedures are common deterrents for patients visiting the dental care unit. For these individuals, procedural sedation may aid in completion of dental treatments. In most cases, the patients are conscious during sedation, thereby allowing spontaneous ventilation. Intravenous sedation (IVS) is widely used during dental treatment to relieve patient anxiety. IVS is th...

AIM To assess the efficacy and safety of a balanced approach using midazolam in combination with propofol, administered by non-anesthesiologists, in a large series of diagnostic colonoscopies. METHODS Consecutive patients undergoing diagnostic colonoscopy were sedated with a single dose of midazolam (0.05 mg/kg) and low-dose propofol (starter bolus of 0.5 mg/kg and repeated boluses of 10 to 2...

In 1998, Thomas L. Petty expressed his concern about deep sedation and suggested a new link between sedation and severe complications.(1) His phrasing emphasized that it is not the underlying disease, but the physicians themselves that cause the gloomy situation he experienced in his intensive care unit (ICU). As more evidence supporting his theory has emerged, Petty’s editorial seems even more...

SUBSTANTIAL efforts have been made over the past decade to focus more attention on sedation and analgesia management in critically ill patients. Although evidence is accumulating of painful and unpleasant experiences suffered during length of stay in the intensive care unit (ICU) that can affect quality of life, even after discharge, more is also known about the impact of excessive use of sedat...