Gastrointestinal endoscopy
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Gastrointest. Endosc. · Apr 2008
Randomized Controlled Trial Comparative StudyClinical efficacy of dexmedetomidine alone is less than propofol for conscious sedation during ERCP.
Propofol is an accepted method of sedation for an ERCP and generally achieves deep sedation rather than conscious sedation, and dexmedetomidine has sedative properties of equivalent efficacy. ⋯ Dexmedetomidine alone was not as effective as propofol combined with fentanyl for providing conscious sedation during an ERCP. Furthermore, dexmedetomidine was associated with greater hemodynamic instability and a prolonged recovery.
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Gastrointest. Endosc. · Oct 2007
Randomized Controlled TrialSublingual L-hyoscyamine for duodenal antimotility during ERCP: a prospective randomized double-blinded study.
ERCP is often made difficult by duodenal motility. Glucagon is typically used to inhibit this motility. L-hyoscyamine is an antimuscarinic, anticholinergic agent shown to be a feasible intravenous alternative to glucagon. ⋯ Preprocedure administration of sublingual L-hyoscyamine did not reduce the amount of glucagon required to complete ERCP.
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Gastrointest. Endosc. · Oct 2007
Randomized Controlled TrialLidocaine lollipop as single-agent anesthesia in upper GI endoscopy.
Conscious sedation is usually achieved during EGD by a combination of intravenous benzodiazepines and opiates; however, these have potential serious adverse effects. The addition of topical oropharyngeal anesthetics such as lidocaine may be useful. Recent data suggest that the administration of topical lidocaine by means of a lollipop is effective for endotracheal intubation and bronchoscopy. ⋯ Lidocaine lollipop is a promising form of local oropharyngeal anesthesia for EGD. Its use resulted in sparing the use of intravenous sedation. It is well tolerated and safe and may be particularly important in the elderly, patients with comorbidities, and office-based endoscopy.
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Gastrointest. Endosc. · Sep 2007
Randomized Controlled TrialPremedication with orally administered lorazepam in adults undergoing ERCP: a randomized double-blind study.
Restlessness often complicates ERCP and may be a reason for premature termination of the procedure. ⋯ The trial failed to show an advantage of an oral premedication with lorazepam. The amount of sedatives administered in the lorazepam group even tended to be higher. A premedication with lorazepam may be counterproductive when followed by sedation containing another benzodiazepine.
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Gastrointest. Endosc. · Mar 2007
Randomized Controlled TrialUse of a variable-stiffness colonoscope decreases the dose of patient-controlled sedation during colonoscopy: a randomized comparison of 3 colonoscopes.
The variable-stiffness colonoscope incorporates different degrees of stiffness of the insertion tube, which can be adjusted during the examination. Whether its use can lead to reduced procedure-related pain and sedative use is unknown. ⋯ The use of the new variable-stiffness adult-size colonoscope significantly reduced procedure-related pain and doses of sedative medications during colonoscopy.