Gastrointestinal endoscopy
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Gastrointest. Endosc. · Aug 2000
Comparative Study Clinical TrialBispectral index monitoring of sedation during endoscopy.
No objective measure of the level of sedation is universally accepted. However, bispectral index monitoring is currently used to objectively measure sedation levels in several clinical settings. This study compares the temporal relationship of bispectral index levels versus the Observer's Assessment of Alertness/Sedation (OAA/S) scale for sedation during endoscopy and proposes a functional bispectral index range for endoscopic procedures. ⋯ Bispectral index monitoring temporally correlates with the OAA/S scale and therefore provides an objective measure of sedation during endoscopy. This preliminary, observational study suggests that a bispectral index level near 82 corresponds with sufficient and functional sedation levels for endoscopy.
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Gastrointest. Endosc. · Jul 2000
Randomized Controlled Trial Comparative Study Clinical TrialConscious sedation and cardiorespiratory safety during colonoscopy.
Cardiorespiratory events during colonoscopy are common. The effect of sedative premedication on cardiorespiratory parameters during colonoscopy has not been studied in controlled, prospective trials. ⋯ Premedication with midazolam induced a statistically significant decrease in arterial oxygen saturation and increased the risk for hypotension. However, colonoscopy proved to be a safe procedure both with and without sedation.
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Gastrointest. Endosc. · May 2000
Randomized Controlled Trial Comparative Study Clinical TrialA randomized, double-blind study of the use of droperidol for conscious sedation during therapeutic endoscopy in difficult to sedate patients.
Droperidol has been used in combination with narcotics and benzodiazepines to achieve conscious sedation. We performed a randomized, double-blind, study of droperidol in patients at risk for difficult sedation scheduled for therapeutic endoscopy. ⋯ Droperidol is a useful adjunct to conscious sedation in patients who are difficult to sedate. Its use results in significantly fewer interruptions due to poor sedation and improved sedation ratings compared with sedation using midazolam and meperidine alone.
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Gastrointest. Endosc. · Apr 2000
Palliation of hilar biliary obstruction from colorectal metastases by endoscopic stent insertion.
In patients with hepatic metastases from colorectal carcinoma there is a distinct subgroup in whom jaundice is not due to hepatic replacement but rather biliary obstruction. We reviewed our experience with stent insertion in patients with malignant proximal biliary obstruction from metastatic colorectal carcinoma. ⋯ Endoscopic stent placement offers effective palliation in most patients with hilar obstruction from colorectal metastases. A subset of patients with type III strictures and greater than 3 intrahepatic metastases often do not benefit from stent insertion.