A randomized clinical trial comparing different combination of peripheral nerve blocks for intraoperative analgesia in patients on antithrombotic drugs undergoing hip fracture surgery: pericapsular nerve group (PENG) block versus femoral and obturator nerve block.

Background: Locoregional anesthesia is commonly used in orthopedic trauma surgery, particularly in elderly patients. We conducted a prospective, monocentric, randomized controlled trial to evaluate the anesthetic and analgesic efficacy of pericapsular nerve group (PENG) block in patients on antithrombotic drugs undergoing hip fracture surgery, comparing it with femoral and obturator nerve block (FNB+ONB).

Methods: Forty patients were randomly allocated to receive a PENG block or FNB and ONB, both combined with wound infiltration (WI).

Hemodynamic Stability of Midazolam versus Remimazolam During Outpatient Genitourinary Interventional Radiology Procedures in a Patient With Aortic Stenosis: A Case Report.

Patients with aortic stenosis (AS) and other significant cardiopulmonary comorbidities are vulnerable to hemodynamic instability during anesthesia. This case report compares the use of remimazolam and midazolam in a 71-year-old man with symptomatic AS, chronic kidney disease, and ischemic cardiomyopathy. The patient underwent multiple short ambulatory interventional radiology procedures.

Increased sound levels in the cardiac ICU are associated with an increase in heart rate, blood pressure, and sedation.

Background: Several organizations including the Environmental Protection Agency, World Health Organization and American Academy of Pediatrics recommend that hospital sound levels not exceed 45 decibels. Yet, several studies across multiple age groups have observed higher than recommended levels in the intensive care setting. Elevated sound levels in hospitals have been associated with disturbances in sleep, patient discomfort, delayed recovery, and delirium.

Protocol for Comparing Benzodiazepine-Ketamine and Benzodiazepine-Fentanyl Sedation in Phacoemulsification (BEKEF): A Double-Blind Crossover Non-Inferiority Clinical Trial Study.

Background: Cataract surgery, particularly phacoemulsification, often requires sedation alongside topical anesthesia to manage patient anxiety and discomfort. This protocol proposes a study comparing the efficacy of ketamine and fentanyl, both combined with benzodiazepine, as sedation options for patients undergoing bilateral phacoemulsification.

Methods: In a randomized, double-blind, crossover clinical trial, at least 48 patients scheduled for bilateral cataract surgery will receive fentanyl with midazolam for one eye and ketamine with midazolam for the other.

Incorporating Patient and Family Perspectives into ICU Environmental Design: A Systematic Review and Narrative Synthesis of Existing Literature.

Objective: This review aims to assess the incorporation of patient and family input into intensive care unit (ICU) design processes. It aims to highlight the importance of prioritising patient and family perspectives in ICU design to improve patient experiences and clinical outcomes.

Background: Traditionally, ICU design has focused on clinical efficiency at the expense of patient-centered needs, leading to heavily sedated patients and neglected holistic care delivery.

Management of pain and sedation in the intensive care unit.

Advances in our approach to treating pain and sedation when caring for patients in the intensive care unit (ICU) have been propelled by decades of robust trial data, knowledge gained from patient experiences, and our evolving understanding of how pain and sedation strategies affect patient survival and long term outcomes. These data contribute to current practice guidelines prioritizing analgesia-first sedation strategies (analgosedation) that target light sedation when possible, use of short acting sedatives, and avoidance of benzodiazepines. Together, these strategies allow the patient to be more awake and able to participate in early mobilization and family interactions.

Introduction of a LAT gel and low-dose midazolam sedo-analgesia protocol for pediatric skin suture in the emergency department: simpler is better.

Background: skin lacerations are one of the main causes of children's referral to the emergency department (ED). We introduced in our general ED a pediatric sedo-analgesia protocol (SAP) for suturing skin wounds using LAT gel, a local anesthetic solution of lidocaine, adrenaline and tetracaine, with or without low-dose oral midazolam according to patient's age, to improve the experience of laceration repair.

Methods: Primary outcomes were improvement of suturing experience for ED operators (as a reduction in the desire to avoid the procedure) and of the adequacy of sedo-analgesia provided, investigated through two different surveys administered to the ED staff before and after the introduction of the SAP.

Combination of Silver Diamine Fluoride and Hall Technique for Caries Management in Primary Molars: A Randomized Controlled Trial.

Aims And Background: Combination of different noninvasive caries arresting approaches may improve the effectiveness and success rate of individual procedures for caries management. The purpose of this study was to evaluate clinical and radiographic success rate of a combination of 38% silver diamine fluoride (SDF) application and Hall technique (HT) for the management of dentinal caries in primary molars and compare it with conventional stainless steel crown (SSC) restoration.

Materials And Methods: Children aged 4-8 years, having carious primary molars with the International Caries Detection and Assessment System (ICDAS) score of 5 or 6, were randomly assigned to treatment group A or B.

Factors influencing agitation during anesthesia recovery after laparoscopic hernia repair under total inhalation combined with caudal block anesthesia.

Background: Laparoscopic hernia repair is a minimally invasive surgery, but patients may experience emergence agitation (EA) during the post-anesthesia recovery period, which can increase pain and lead to complications such as wound reopening and bleeding. There is limited research on the risk factors for this agitation, and few effective tools exist to predict it. Therefore, by integrating clinical data, we have developed nomograms and random forest predictive models to help clinicians predict and potentially prevent EA.

Perioperative Stroke Following Implantation of Left Ventricular Assist Device: A Retrospective Cohort Study.

Objectives: Stroke is common following left ventricular assist device (LVAD) implantation, although comprehensive data on perioperative strokes in this uncommon population is lacking. The current study aim was to characterize the presentation, features, and outcomes of perioperative cerebrovascular ischemia post-LVAD implantation at the authors' institution.

Design: Single-center retrospective cohort.

Clinical experience and video description of minimally invasive surgery for benign prostatic obstruction using the Schelin Catheter®.

Although designed for in-office use, water vapor thermal therapy (Rezum™) remains a painful procedure, and oral±intravenous sedation is often required. Schelin Catheter® (ProstaLund AB, Lund, Sweden) is an innovative bladder catheter that delivers local anesthesia to the prostate in a sterile transurethral way. We aimed to evaluate the safety and feasibility of Rezum™ for male lower urinary tract symptoms due to benign prostatic obstruction (LUTS/BPO) with local anesthesia delivered with Schelin® catheter, and to report its first step-by-step video description.

Total Aortic Arch Repair With Double-Fenestrated Physician-Modified Endograft Under Local Anesthesia And Sedation: A Prospective Study.

The outcomes of local anesthesia and sedation (also referred to as monitored anesthesia care) in endovascular aortic arch repair are not well-studied or widely reported. This study aims to demonstrate the feasibility and safety of this approach using physician-modified endografts for total aortic arch repair and showing it is a promising alternative to general anesthesia. Only a few exclusion criteria necessitate performing the procedure under general anesthesia and no conversions to general anesthesia were required.

Rescue Sedation after 5 mg or 10 mg of Droperidol as the Initial Treatment for Acute Agitation in the Emergency Department.

Background: Droperidol is used commonly to treat agitation in the emergency department (ED), however, data comparing doses are lacking.

Objective: The aim of this study was to compare the effectiveness of 5 mg vs. 10 mg as initial droperidol dose for acute agitation in the ED.

Physicochemical and Microbiological Stability of Extemporaneously Compounded Chloral Hydrate Oral Liquid Dosage Forms in PCCA Base, SuspendIt®.

Chloral hydrate is a hypnotic, sedative and anxiolytic (non-benzodiazepine) drug that is commonly administered to children prior to procedures such as dental sedation. It is also indicated for nocturnal sedation in all types of patients and especially for the ill, the young, and the elderly patients. A review of the therapeutic uses of chloral hydrate reveals the need for flexibility in dosing, especially in children.

Palliative sedation at the end of life: prevalence, characteristics and possible determinants.

Background: Palliative Sedation (PS) at the end of life is practiced and perceived differently by health professionals depending on the geographical location in which they provide their health care. Taking into account this heterogeneity, it is necessary to expand knowledge and provide data on this clinical practice in different contexts and countries. On the other hand, the identification of factors associated with PS could help healthcare professionals, at an early stage, to identify patients more likely to require sedation.

The Effect of Dexmedetomidine on Inflammatory Factors and Clinical Outcomes in Patients With Septic Shock: A Randomized Clinical Trial.

Purpose: Dexmedetomidine is a sedative-analgesic that is widely used in sepsis. However, its effect on septic shock remains unclear. This study aimed to investigate dexmedetomidine's effect on inflammatory biomarkers in septic shock.

Association of anaesthesia-directed sedation with unplanned discharge to a nursing home following non-ambulatory interventional radiology and endoscopic procedures: a retrospective cohort study.

Introduction: Interventional radiology procedures and endoscopies are performed commonly worldwide, often necessitating pharmacological sedation to optimise patient comfort. It is unclear to what extent non-anaesthetists should provide procedural sedation.

Methods: We studied adult patients who previously lived independently and underwent a non-ambulatory interventional radiology or gastroenterology procedure under anaesthetist-directed or non-anaesthetist-directed sedation at a large healthcare network.

[The reality of bronchoscopy care in Germany: a survey by the German Respiratory Society].

Unlabelled: Bronchoscopy has changed considerably in recent years as a result of technical innovations and health economic pressure. There is little current information available on the reality of bronchoscopy care in Germany.

Methodology: In September 2022, sites where bronchoscopy was carried out were systematically surveyed regarding structural and process quality features in an anonymized DGP survey with 33 questions.