Purpose Of Review: There has been a significant increase in the number and types of procedures performed outside of the operating room with nonanesthesia providers administering sedation. This review describes current recommendations for training nonanesthesiologists involved in administering deep sedation, summarizes best practices and highlights select patient outcomes.
Recent Findings: There are numerous guidelines and standards related to the administration of deep sedation. However, there are no universally accepted guidelines regarding the necessary educational and skill competencies needed for nonanesthesiologists to provide deep sedation. The American Society of Anesthesiologists has published a position statement and guidelines on these educational requirements, yet the extent to which these are adhered to remains unknown. As evidence-based guidelines continue to evolve, more research is needed to describe how current practices affect patient outcomes.
Summary: The American Society of Anesthesiologists publishes recommendations regarding the essential educational components for nonanesthesiologist providers who administer deep sedation. The available data support the need for formal educational programmes to prevent adverse events associated with deep sedation. Competencies should include preprocedural evaluation, understanding sedation levels, airway management, documentation, emergency life support skills, teamwork and quality improvement.
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http://dx.doi.org/10.1097/ACO.0000000000000342 | DOI Listing |
Heart Rhythm O2
December 2024
Department of Electrophysiology, North Mississippi Medical Center, Tupelo, Mississippi.
Background: Historically, percutaneous transcatheter left atrial appendage closure (LAAC) has been performed under general anesthesia (GA) with transesophageal echocardiographic images obtained by a noninvasive cardiologist and usually requires an overnight hospital stay. Alternatively, we present our single-center experience performing LAACs under deep sedation (DS), employing an echocardiographic technician instead of a noninvasive cardiologist, and expediting same-day discharge. Mid- to long-term outcomes were also evaluated with follow-up imaging at a 45-day visit.
View Article and Find Full Text PDFNat Sci Sleep
January 2025
Department of Anesthesiology, Hospital for Skin Diseases (Institute of Dermatology), Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, 210042, People's Republic of China.
Purpose: The aim of this study was to investigate the effect of general anesthesia combined with transversus abdominis plane block on postoperative sleep disorders in elderly patients undergoing gastrointestinal tumor surgery.
Methods: For elderly patients with gastrointestinal malignant tumors, we recruited 94 patients, aged 65-80, who were scheduled for radical laparoscopic surgery. Using the random number table method, the patients were randomly divided into two groups, the general anesthesia group (group GA) and the general anesthesia combined with transversus abdominis plane block group (group GT).
Acta Anaesthesiol Scand
February 2025
Department of Brain and Spinal Cord Injury, Neuroscience Centre, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.
Background: The harm-benefit balance for early out-of-bed mobilisation of patients with severe acquired brain injury (ABI) in neurointensive care units (neuro-ICUs) is unclear, and there are no clinical guidelines. This study aimed to survey the current clinical practice and perceptions among clinicians involved in first out-of-bed mobilisation in Scandinavian neuro-ICUs.
Methods: This was a cross-sectional, anonymous, web-based survey; the reporting follows the recommended CROSS checklist.
Anaesthesia
January 2025
The Christie NHS Foundation Trust, Manchester, UK.
Introduction: Radiotherapy is currently used in approximately one-third of children with cancer. Treatments are typically received as weekday outpatient appointments over 3-6 weeks. The treatment is painless but requires a still, co-operative patient who can lie alone in set positions, facilitated by the use of immobilisation devices, for up to 1 h.
View Article and Find Full Text PDFJ Clin Med
December 2024
Department of Plastic and Reconstructive Surgery, Tokyo Medical University, Tokyo 160-0023, Japan.
: We treated deep partial-thickness burns of the hands and feet in four cases using a combination of NexoBrid and ReCell autologous cell regeneration techniques, without conventional split-thickness skin graft, with good results following debridement of the eschar. : We report cases of patients treated with a combination of the NexoBrid and ReCell techniques between 1 August 2023 and 31 July 2024. The degree of debridement and the time to complete wound closure were evaluated.
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