Use Of Intravenous Sedation Research Articles

SELF‐EXPANDABLE OESOPHAGEAL STENTS IN THE MANAGEMENT OF BENIGN PEPTIC OESOPHAGEAL STRICTURES IN THE ELDERLY

SUMMARYSelf‐expandable oesophageal stents are being increasingly used in the management of malignant oesophageal strictures. Most benign peptic oesophageal strictures can be successfully managed using endoscopic oesophageal dilatation combined with long‐term Proton pump inhibition therapy. Although endoscopic oesophageal dilatation can be performed on an outpatient basis, it often requires repeated hospital visits. There is a small risk of oesophageal perforation, while cardiorespiratory complications may be encountered during the use of intravenous sedation in an elderly population. The use of self‐expandable Strecker stents in three elderly patients with benign peptic oesophageal strictures is described.

Small bowel biopsy in Swedish paediatric clinics

The capsule technique for small bowel biopsy performed at Swedish paediatric clinics was evaluated using two questionnaires in 1990 and 1993, respectively. Replies were received from all 45 centres which together perform approximately 2300 biopsies per year. Clotting function tests prior to biopsy were carried out in 42% of the centres. The biopsies were performed under intubation anaesthesia in 13% of the centres. The most striking difference between the answers to the two questionnaires was the mode of sedation. The use of intravenous sedatives increased from 40% of the centres in the first questionnaire to 59% in the second one. The use of the oral, rectal and intramuscular routes decreased correspondingly. The most frequently used drugs for intravenous sedation were benzodiazepines, in the first questionnaire diazepam and in the second one midazolam. The failure rate was approximately 5%. In the first questionnaire, no complication was encountered. In the second questionnaire, three cases of intramural duodenal haematoma were reported, one of which led to pancreatitis. We conclude that by focusing on questions of sedation these rather simple questionnaires may have resulted in more effective sedation of children undergoing small bowel biopsy.

Use of a Strecker oesophageal stent in the treatment of benign oesophageal stricture

The use of self-expanding prostheses in the management of malignant oesophageal strictures has become well established. The majority of benign peptic oesophageal strictures can be successfully managed using endoscopic or fluoroscopically guided balloon oesophageal dilatation combined with long-term drug therapy, particularly using proton pumper inhibitors. Although endoscopic oesophageal dilatation can be performed on an outpatient basis, it requires repeated hospital visits. There is a small risk of oesophageal perforation whilst cardio-respiratory complications may be encountered during the use of intravenous sedation in an elderly population. The use of a self-expanding Strecker stent in a 98 year old woman with a benign oesophageal stricture is described.

Use of Intravenous Sedation for Wisdom Tooth Surgery on Aircraft Carriers

Use of Intravenous Sedation for Wisdom Tooth Surgery on Aircraft Carriers

Providing Comfort to Critically Ill Pediatric Patients: Isoflurane

Isoflurane is a fluorinated ether used primarily as an inhalation anesthetic. Rapid titratable effects, limited metabolism, and a reliable mode of administration make isoflurane an appealing alternative to the use of intravenous sedatives and narcotics in critically ill patients requiring prolonged mechanical ventilation. This article, in reviewing this novel approach to management of patient discomfort, focuses on nursing practice issues and provides a critical analysis of isoflurane use in the intensive care unit.

Patients must be monitored

EDITOR,—M Q F Hatton and colleagues suggest that the routine use of intravenous sedation has little part to play when patients undergo a single diagnostic procedure.1 We agree that the blanket administration of intravenous sedatives to all patients undergoing endoscopic procedures is inappropriate, but we believe that these drugs have a useful role in helping a small number of patients to accept an often distressing procedure. …

Use of Intravenous Sedatives in Infants and Children

Use of Intravenous Sedatives in Infants and Children