Background/aims: This study aimed to determine whether the anxiety levels of pediatric patients who undergo endoscopy are reduced after receiving preparatory information about the endoscopic procedure by monitoring their salivary cortisol (s-cortisol) levels.
Patients And Methods: A total of 184 children undergoing gastroscopy under sedoanalgesia were included in the study. All the patients received a brief explanation of the endoscopic procedure. Patients were divided into two groups; Group Unexplained did not receive any further information other than a brief explanation of the procedure, Group Explained received more detailed explanation of the procedure. To determine anxiety levels, saliva specimens were taken on the day before the procedure to examine cortisol levels before and after endoscopy. Anxiety scores before endoscopy were calculated by the modified Yale Preoperative Anxiety Scale. Patients were monitored throughout sedoanalgesia, including during the endoscopy, sedation and recovery, and total propofol dosages were recorded.
Results: Eighty-nine children undergoing gastroscopy (age 11.55 ± 2.52 years; 50.5% girls) constituted Group Explained and 95 children undergoing gastroscopy (age 11.44 ± 2.66 years; 56.8% male) constituted Group Unexplained. The anxiety score, duration of sedation, endoscopy and recovery, propofol dose, pre- and post-endoscopy s-cortisol levels were significantly reduced in Group Explained.
Conclusions: We demonstrated that when endoscopic procedure is explained broadly to a child, the procedural stress is significantly less, as measured by the s-cortisol levels and the anxiety questionnaire. It is important for the attending physician to explain all aspects of examination carefully.
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http://dx.doi.org/10.4103/sjg.SJG_493_18 | DOI Listing |
Cureus
January 2025
Anesthesiology and Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, NLD.
When a difficult airway is anticipated, awake tracheal intubation can be considered. Usually, low doses of sedatives are administered during this procedure for minimal sedation and anxiolysis, such as midazolam and remifentanil. The newly developed ultra-short-acting benzodiazepine remimazolam has a pharmacokinetic profile that is more suitable for titration during awake tracheal intubation than the long-acting midazolam.
View Article and Find Full Text PDFClin Interv Aging
January 2025
Department of Orthopedics, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200072, People's Republic of China.
Purpose: Shoulder arthroscopic repair of rotator cuff tears with simultaneous treatment of lesions of the long head of the biceps tendon has become increasingly accepted. However, the clinical outcomes between tenotomy and tenodesis remain unclear. This study aimed to compare the efficacy of tenotomy and tenodesis combined with rotator cuff repair in elderly patients with medium-to-massive rotator cuff tears.
View Article and Find Full Text PDFWorld J Gastrointest Oncol
January 2025
Department of Anatomy, Division of Human Biology, School of Medicine, IMU University, Kuala Lumpur 57000, Kuala Lumpur, Malaysia.
Gallbladder carcinoma (GBC) is the most common malignant tumor of biliary tract, with poor prognosis due to its aggressive nature and limited therapeutic options. Early detection of GBC is a major challenge, with most GBCs being detected accidentally during cholecystectomy procedures for gallbladder stones. This letter comments on the recent article by Deqing in the , which summarized the various current methods used in early diagnosis of GBC, including endoscopic ultrasound (EUS) examination of the gallbladder for high-risk GBC patients, and the use of EUS-guided elastography, contrast-enhanced EUS, trans-papillary biopsy, natural orifice transluminal endoscopic surgery, magnifying endoscopy, choledochoscopy, and confocal laser endomicroscopy when necessary for early diagnosis of GBC.
View Article and Find Full Text PDFLaryngoscope Investig Otolaryngol
February 2025
Objective: The primary aim of this study was to investigate the accuracy of a semi-automatic algorithm in assessing the feasibility and complexity of endoscopic stapes surgery preoperatively.
Methods: A semi-automatic algorithm was developed to simulate endoscopic stapes surgery in 3D. To test the accuracy of the algorithm, five fresh-frozen cadaveric heads (ten ears) were used.
J Spine Surg
December 2024
Department of Orthopedic Surgery, Chung Shan Hospital, Taipei, Taiwan.
Background: Prone lateral spinal surgery for simultaneous lateral and posterior approaches has recently been proposed to facilitate surgical room efficiency. The purpose of this study is to evaluate the feasibility and outcomes of minimally invasive prone lateral spinal surgery using a rotatable radiolucent Jackson table.
Methods: From July 2021 to June 2023, a consecutive series of patients who received minimally invasive prone lateral spinal surgery for various etiologies by the same surgical team were reviewed.
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