The American journal of gastroenterology
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Am. J. Gastroenterol. · Sep 2006
Randomized Controlled TrialEfficacy of bispectral monitoring as an adjunct to nurse-administered propofol sedation for colonoscopy: a randomized controlled trial.
Bispectral (BIS) monitoring provides an objective, non-invasive measure of the level of consciousness in sedated patients. BIS has been shown to lag behind the level of sedation during induction and emergence of sedation with propofol. In this study, we sought to determine whether BIS is a useful adjunctive maneuver to registered nurse-administered propofol sedation (NAPS) as measured by reductions in recovery time and doses of propofol administered. ⋯ BIS did not lead to reductions in mean propofol dose or recovery time when used as an adjunct to NAPS for colonoscopy, or when used as the primary target for sedation. No clinically important role for BIS monitoring as an adjunct to NAPS has yet been established.
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Am. J. Gastroenterol. · Sep 2006
Comparative StudyAssociation between achalasia and nitric oxide synthase gene polymorphisms.
Our group previously reported the absence of nitric oxide synthase (NOS) in the gastroesophageal junction of patients with achalasia. NOS exists in three distinct isoforms: neuronal NOS (nNOS), endothelial NOS (eNOS), and inducible isoform (iNOS). Some studies have shown that NO production is regulated by NOS polymorphisms. ⋯ Our data suggest that NOS gene polymorphisms are not involved in the susceptibility to and nature of the clinical course of sporadic achalasia. However, studies in a greater number of patients are required to analyze the tendency toward a higher prevalence of genotypes iNOS22*A/A and eNOS*4a4a.
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Am. J. Gastroenterol. · Sep 2006
Editorial Comment Comparative StudySedation for endoscopic procedures: not as simple as it seems.
The Bispectral Index (BIS) is a processed electroencephalogram, which has been evaluated as an automated monitoring technique for patients receiving sedation for endoscopic procedures. BIS monitoring has not been shown to be of significant clinical benefit, but the need for an objective quantitative measure of the depth of sedation in patients undergoing endoscopy remains.