Risk factors and comorbidities associated with cardiac arrests and medical emergencies in interventional radiology patients.

Purpose: To investigate the incidence, predictors, and outcomes of medical emergencies in patients undergoing IR procedures at a tertiary care center.

Materials And Methods: Seven-year retrospective review of all medical emergencies in patients undergoing IR procedures at King Abdulaziz Medical City, Riyadh, Saudi Arabia. Medical emergencies included Cardiopulmonary arrest (CPA), or emergencies that required activation of the critical care response team (CCRT).

A single 1-min brain MRI scan for generating multiple synthetic image contrasts in awake children from quantitative relaxometry maps.

Background: Diagnostically adequate contrast and spatial resolution in brain MRI require prolonged scan times, leading to motion artifacts and image degradation in awake children. Rapid multi-parametric techniques can produce diagnostic images in awake children, which could help to avoid the need for sedation.

Objective: To evaluate the utility of a rapid echo-planar imaging (EPI)-based multi-inversion spin and gradient echo (MI-SAGE) technique for generating multi-parametric quantitative brain maps and synthetic contrast images in awake pediatric participants.

Selective coronary arteriography via transradial access in young children.

Background: Transradial access (TRA) is not a common vascular access in children. We have been performing TRA actively to reduce puncture complications, and the purpose of this study was to investigate the safety and efficacy of TRA in young children.

Methods: The study included 29 patients aged 5-12 years who underwent diagnostic catheterization at Kurume University Hospital.

The Efficacy and Safety Profile of Balanced Propofol Sedation for Bronchoscopy.

Purpose: We conducted a prospective, real-world study to evaluate the efficacy and safety of balanced propofol sedation (BPS) in bronchoscopy and identify an advantageous sedation regimen for such procedures.

Patients And Methods: The participants were placed in four groups based on their sedation regimen (exposure factor): the M-S group (midazolam + sufentanil for traditional sedation), R-S group (remimazolam + sufentanil for traditional sedation), M-S-P group (midazolam + sufentanil + propofol for BPS), and R-S-P group (remimazolam + sufentanil + propofol for BPS). The primary outcomes included satisfaction metrics (satisfaction of the patients, endoscopic physicians, and nurses) and follow-up questionnaires.

An unusual surgical complication: Slipped molar lodged in vocal cords and its anesthetic management.

Background: Extraction of wisdom tooth is one of the most common surgical interventions, as it is more prone for impaction. Due to the pain and anxiety associated with the procedure, it is common to do this procedure under conscious sedation. However unexpected events do occur during the procedure and one such complication along with the prompt management is discussed here.

Spinal anesthesia for endoscopic submucosal dissection of large rectosigmoid lesions: Feasibility study.

Colorectal endoscopic submucosal dissection (ESD) is often challenging and time-consuming. Prolonged sedation and general anesthesia are associated with a relevant risk of anesthesia-related adverse events (ARAEs), especially in elderly and frail patients. Spinal anesthesia (SA), a simple technique providing analgesia and motor block without systemic drug administration, has never been described in gastrointestinal endoscopy.

Effect of Music Therapy on Anxiety, Stress and Sedative Requirements in Patients Undergoing Lower Limb Orthopedic Surgery Under Spinal Anesthesia: A Randomized Controlled Study.

Background Music therapy is a safe, non-pharmacological way to help reduce anxiety, especially before surgery. It helps to calm the nervous system, promotes relaxation, and offers comfort by blocking outside noise and distracting from pain. This can be helpful in managing preoperative anxiety and symptoms like hypertension and tachycardia.

Correlation of Preoperative Hippocampal Volume Measured with Magnetic Resonance Imaging and Emergence from General Anaesthesia in Elective Neurosurgical Patients: An Observational Study.

Background And Objectives: The electrophysiological process of emergence from general anesthesia (GA) commences from deeper structures of the brain rather than the cortex. The phylogenetically old parts of the brain (hippocampus) are the first to recover during emergence. Study objectives were to evaluate and predict the effect of preoperative hippocampal volume (HV) measured using MRI with emergence from GA and delayed extubation in patients undergoing elective neurosurgical procedures.

The sedative effect of intravenous butorphanol in dogs with intracranial space occupying lesions or indicators of intracranial hypertension.

Objective: To determine whether dogs with magnetic resonance imaging (MRI)-determined intracranial space occupying lesions (MRI-iSOLs) or intracranial hypertension (MRI-ICH) had greater sedation scores and quicker onset of recumbency following premedication with intravenous (IV) butorphanol in comparison with dogs which had normal MRI findings.

Study Design: Prospective, observational study.

Animals: A total of 53 dogs presenting for brain MRI were included.

Clinical Decision-Making and Process Complications During Anticipated Difficult Airway Management for Elective Surgery.

Background: Difficult airway management (DAM) is a challenging aspect of anesthetic care. Although nearly all DAM episodes result in successful intubation, complications are common and clinical decision-making may be complex. In adults with anticipated DAM scheduled for nonemergent surgery, we prospectively observed clinical decisions made during DAM such as awake/sedated versus anesthetized, choice of initial and subsequent devices, case cancellation/postponement, conversions between awake and anesthetized approaches, and process complications such as multiple intubation/supraglottic airway (SGA) insertion attempts, difficult bag-mask ventilation (BMV), hypoxemia, and cardiovascular destabilization.

Enhancing Pediatric Magnetic Resonance Imaging Preparation: A Qualitative Study of Current Practices and the Role of Virtual Reality Tools.

Background And Objectives: How children prepare for magnetic resonance imaging (MRI) can help reduce the need for sedation and improve access to pediatric health care. Embedding virtual reality (VR) tools within routine preparation for MRI may support this process. The aim of this study was to qualitatively describe the process of preparing a child for MRI in a tertiary health care setting.

Challenges in Transitioning from Controlled to Assisted Ventilation in Acute Respiratory Distress Syndrome (ARDS) Management.

Acute respiratory distress syndrome (ARDS) presents significant challenges in critical care, primarily due to its inflammatory nature, which leads to impaired gas exchange and respiratory mechanics. While mechanical ventilation (MV) is essential for patient support, the transition from controlled to assisted ventilation is complex and may be associated with intensive care unit-acquired weakness, ventilator-induced diaphragmatic dysfunction and patient self-inflicted lung injury. This paper explores the multifaceted challenges encountered during this transition, with a focus on respiratory effort, sedation management, and monitoring techniques, and investigates innovative approaches to enhance patient outcomes.

Ganglioside GM1 Alleviates Propofol-Induced Pyroptosis in the Hippocampus of Developing Rats via the PI3K/AKT/NF-κB Signaling Cascade.

In pediatric and intensive care units, propofol is widely used for general anesthesia and sedation procedures as a short-acting anesthetic. Multiple studies have revealed that propofol causes hippocampal injury and cognitive dysfunction in developing animals. As is known, GM1, a type of ganglioside, plays a crucial role in promoting nervous system development.

Ameliorating Effect of Fermented on Sleep Deprivation-Induced Cognitive Impairment Through Antioxidant and BDNF Signaling in Mice.

Adequate sleep is essential for maintaining cognitive function, as evidenced by literature. var. (PF) is a traditional medicinal herb reported to improve vascular cognitive impairment and induce sedation.

Occurrence of Opioid Related Neurocognitive Symptoms Associated with long-term Opioid Therapy.

Objective: Neurocognitive symptoms (NCS) may be early indicators of opioid-related harm. We aimed to evaluate the incidence and potential attribution of opioid-related NCS among patients on long-term opioid therapy (LTOT) by using natural language processing (NLP) to extract data from the electronic health records (EHR) within the Veterans Health Administration.

Methods: We conducted a retrospective cohort study of patients prescribed LTOT in 2018.

Behavioral symptoms and treatment challenges for patients living with dementia: Hospice clinician and caregiver perspectives.

Introduction: Dementia affects one in three older adults over age 85 and individuals with dementia constitute the fastest growing population of patients entering hospice care. While cognitive impairment is the hallmark of dementia, behavioral symptoms are reported in nearly all patients with advanced dementia, contributing to both the complexity of end-of-life care and caregiver burden.

Methods: This qualitative study involved semi-structured interviews with prescribing hospice clinicians and caregivers of patients living with dementia who previously received hospice services.

Pharmacokinetics, pharmacodynamics and bioavailability of dexmedetomidine nasal spray in healthy Chinese adults: A phase I clinical trial.

Background: Intranasal administration is a convenient route for drug delivery that can be applied for procedural sedation. However, there is currently limited exploration into fixed dosing regimens. This study was to investigate the pharmacokinetics (PK), pharmacodynamics (PD), bioavailability (BA) and safety of dexmedetomidine after fixed doses of intranasal and intravenous administration in healthy male and female subjects.

Effect of Remimazolam vs Midazolam on Early Postoperative Cognitive Recovery in Elderly Patients Undergoing Dental Extraction: A Prospective Randomized Controlled Study.

Purpose: Elderly patients undergoing dental extraction are particularly susceptible to delayed cognitive recovery after sedation. This study aimed to compare the effects of remimazolam and midazolam on early postoperative cognitive recovery in elderly patients undergoing dental extraction.

Patients And Methods: This was a single-centre randomized controlled study with elderly patients scheduled for receiving dental extraction under sedation of remimazolam (Group R) or midazolam (Group M).

Parenting Styles and Sedation Efficacy in Pediatric Dental Care; A Study in Uncooperative Children Aged 4 to 6 Years: Structural Equation Modeling Approach.

Background: Behavioral problems in children contribute significantly to non-compliance and lack of cooperation with dentists.This study aimed to assess the impact of parenting styles on the success of conscious sedation with midazolam in uncooperative children aged 4 to 6 years.

Methods: This short-term longitudinal study included ninety-six children aged 4-6 years who were classified as uncooperative according to the Frankl Behavior Rating Scale (Frankl I, II), requiring pulp treatment and Stainless-Steel Crown (SSC) restoration.

Comparison of the anesthetic effect of sufentanil versus fentanyl in pediatric surgical patients: a meta-analysis.

Objective: To evaluate the anesthetic effects of sufentanil and fentanyl in pediatric surgery.

Methods: We conducted a comprehensive search across multiple databases, including Wanfang, CNKI, Chinese Biomedical Literature, VIP, Embase, PubMed, Cochrane Library, and Web of Science. Studies were retrieved to screen randomized controlled trials (RCTs) comparing sufentanil and fentanyl use in children during surgery.

Dexmedetomidine as an Adjunctive Sedative in Patients Undergoing Endoscopic Submucosal Dissection: A Systematic Review and Meta-Analysis.

Introduction: Endoscopic submucosal dissection (ESD) allows for curative en-bloc resection of dysplastic gastrointestinal (GI) tract lesions. However, it is associated with postoperative adverse events (AEs) such as pain, bleeding, and perforation. Dexmedetomidine, an α2-receptor agonist, has emerged as a promising adjunct sedative for ESD under moderate sedation, offering anxiolysis and analgesia.

Transdermal Ketoprofen Versus Fentanyl Patches for Pain Management Post-cesarean Section: A Comparative, Randomized, Double-Blind Study.

Introduction: Postoperative pain management after a cesarean section is essential to promote mother-infant bonding and ease of breastfeeding. Transdermal patches present a viable alternative to oral medications, offering controlled drug delivery and better bioavailability while avoiding first-pass metabolism, all of which can facilitate smoother recovery and rehabilitation.

Methods: This comparative, randomized, double-blind study was conducted on 70 parturients scheduled for cesarean section under spinal anesthesia, classified as ASA II.

Procedural sedation performed by pediatric critical care physicians for children undergoing daily radiation therapy is effective and safe.

Radiation therapy targets tumor tissue and requires children to lay still, often necessitating sedation. Historically anesthesiologists provided procedural sedation, but pediatric critical care physicians now regularly administer sedation outside the operating room. Procedural sedation for radiation poses unique challenges.

A randomized controlled trial investigating the impact of early goal-directed sedation dominated by dexmedetomidine on cerebral oxygen metabolism and inflammatory mediators in patients with severe brain injury.

Objective: The aim of this study is to assess the neuroprotective efficacy of early goal-directed sedation (EGDS) primarily governed by dexmedetomidine in patients experiencing severe traumatic brain injury, and to elucidate its potential underlying mechanisms.

Data And Methods: All participants were randomly allocated into two groups: the experimental group-dexmedetomidine-dominated EGDS group (group D, n = 30) and the control group-the standard propofol sedation group (group P, n = 30). Patients in the experimental group received sedation primarily with dexmedetomidine, while those in the control group received propofol sedation.

The effect of intramuscular atipamezole on head height and sedation scores in detomidine-sedated horses.

Objective: To assess the effect of two different doses of intramuscular atipamezole on head height (HH) in horses after sedation with detomidine.

Study Design: Randomized, blinded, triple crossover study.

Animals: Eight healthy adult horses.