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Abstract

Minimally invasive surgery and interventional medical specialties are replacing conventional surgery, and increasingly these procedures can appropriately be done under sedation rather than general anesthesia (GA). In part, this is due to advances in minimally invasive surgical techniques that do not require full GA. In addition, patients choose sedation techniques, wanting to recover as quickly as possible and avoid the potential side effects of GA.

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References

  1. Philip BK. Monitored anesthesia. In: McGoldrick KE, ed. Ambulatory Anesthesiology: A Problem Oriented Approach. Baltimore, MD: Williams & Wilkins; 1995:387–398.

    Google Scholar 

  2. Bailey PL, Pace NL, Ashburn MA, et al. Frequent hypoxia and apnea after sedation with midazolam and fentanyl. Anesthesiology. 1990;73:826–830.

    Article  CAS  PubMed  Google Scholar 

  3. McNabb TG, Goldwyn RM. Blood Gas and hemodynamic effects of sedatives and analgesics when used as a supplement to local anesthesia in plastic surgery. Plastic Reconstr Surg. 1976;58:37–43.

    Article  CAS  Google Scholar 

  4. Singer R, Thomas PR. Pulse oximeter in the ambulatory aesthetic surgical facility. Plastic Reconst Surg. 1988;82:111–114.

    CAS  Google Scholar 

  5. Greenberg CP, De Soto H. Sedation techniques. In: Twersky RS, ed: The Ambulatory Anesthesia Handbook. St Louis, MO: Mosby; 1995:301–359.

    Google Scholar 

  6. Kallar SK. Conscious sedation in ambulatory surgery. Anesth Rev. 1990;17(suppl 2):45–51.

    Google Scholar 

  7. Natof HE. FASA Special Study 1. Alexandria, VA: Federated Ambulatory Surgery Association; 1986.

    Google Scholar 

  8. Campbell RL. Prevention of complications associated with intravenous sedation and general anesthesia. J Oral Maxillofac Surg. 1986;44:289.

    Article  CAS  PubMed  Google Scholar 

  9. Daneshmend TK, Bell GD, Logan RFA. Sedation for upper gastrointestinal endoscopy: results of a nationwide survey. Gut. 1991;32:12–15.

    Article  CAS  PubMed  Google Scholar 

  10. Mackenzie N, Grant IS. Propofol for intravenous sedation. Anaesthesia. 1987;42: 3–6.

    Article  CAS  PubMed  Google Scholar 

  11. Bhananker SM, Posner KL, Cheney FW, Caplan RA, Lee LA, Domino KB. Injury and liability associated with monitored anesthesia care: a closed claims analysis. Anesthesiology. 2006;104:228–234.

    Article  PubMed  Google Scholar 

  12. Philip BK, Minzter BH. Intravenous sedation and monitored anesthesia care. In: White PF, ed. Ambulatory Anesthesia and Surgery. Philadelphia, PA: W.B. Saunders; 1997:349–367.

    Google Scholar 

  13. Walker JA, McIntyre RD, Schleinitz PF, et al. Nurse-administered propofol sedation without anesthesia specialists in 9152 endoscopic cases in an ambulatory surgery center. Am J Gastroent. 2003;98:1744–1750.

    Article  PubMed  Google Scholar 

  14. Rex DK, Overley C, Kinser K, et al. Safety of propofol administered by registered nurses with gastroenterologist supervision in 2000 endoscopic cases. Am J Gastroent. 2002;97:1159–1163.

    Article  PubMed  Google Scholar 

  15. Vargo JJ, Holub JL, Faigel DO, et al. Risk factors for cardiopulmonary events during propofol-mediated upper endoscopy and colonoscopy. Aliment Pharmacol Ther. 2006;24:955–963.

    Article  CAS  PubMed  Google Scholar 

  16. Green SM, Krauss B. Propofol in emergency medicine: pushing the sedation frontier. Ann Emerg Med. 2003;42:792–797.

    Article  PubMed  Google Scholar 

  17. Yagiela JA. Making patients safe and comfortable for a lifetime of dentistry: frontiers in office-based sedation. J Dent Educ. 2001;65:1348–1356.

    CAS  PubMed  Google Scholar 

  18. Gan TJ, Glass PS, Howell ST, et al. Determination of plasma concentrations of propofol associated with 50% reduction in postoperative nausea. Anesthesiology. 1997;87:779–784.

    Article  CAS  PubMed  Google Scholar 

  19. Baker MT, Naguib M. Propofol: the challenges of formulation. Anesthesiology. 2005;103:860–876.

    Article  CAS  PubMed  Google Scholar 

  20. Rau J, Roizen MF, Doenicke AW, O’Connor MF, Strohschneider U. Propofol in an emulsion of long-and medium-chain triglycerides: the effect on pain. Anesth Analg. 2001;93:382–384.

    Article  CAS  PubMed  Google Scholar 

  21. Sneyd JR. Recent advances in intravenous anaesthesia. Br J Anaesth. 2004;93: 725–736.

    Article  CAS  PubMed  Google Scholar 

  22. Gan TJ, Glass PS. Pharmacokinetic and pharmacodynamic aspects of intravenous anesthesia. Anesthetic Pharmacology Review. 1995;3:28–36.

    Google Scholar 

  23. Glass PS, Gan TJ, Howell S, Ginsberg B. Drug interactions: volatile anesthetics and opioids. J Clin Anesth. 1997;9:18S–22S.

    Article  CAS  PubMed  Google Scholar 

  24. Horn E, Nesbit SA. Pharmacology and pharmacokinetics of sedatives and analgesics. Gastrointest Endosc Clin N Am. 2004;14:247–268.

    Article  PubMed  Google Scholar 

  25. Philip BK. Flumazenil: the benzodiazepine antagonist. Anesthesiol Clin North Am. 1993;11:799–814.

    Google Scholar 

  26. Weinbroum AA. A single small dose of postoperative ketamine provides rapid and sustained improvement in morphine analgesia in the presence of morphine-resistant pain. Anesth Analg. 2003;96:789–795.

    Article  CAS  PubMed  Google Scholar 

  27. Badrinath S, Avramov MN, Shadrick M, et al. The use of a ketamine-propofol combination during monitored anesthesia care. Anesth Analg. 2000;90:858–862.

    Article  CAS  PubMed  Google Scholar 

  28. Hwang J, Jeon Y, Park HP, et al. Comparison of alfetanil and ketamine in combination with propofol for patient-controlled sedation during fiberoptic bronchoscopy. Acta Anaesthesiol Scand. 2005;49:1334–1338.

    Article  CAS  PubMed  Google Scholar 

  29. Sun R, Watcha MF, White PF, et al. A cost comparison of methohexital and propofol for ambulatory anesthesia. Anesth Analg. 1999;89:311–316.

    Article  CAS  PubMed  Google Scholar 

  30. Hamid SK, McCann N, McArdle L, Asbury AJ. Comparison of patient-controlled sedation with either methohexitone or propofol. Br J Anaesth. 1996;77:727–730.

    CAS  PubMed  Google Scholar 

  31. Arain SR, Ebert TJ. The efficacy, side effects, and recovery characteristics of dexmedetomidine versus propofol when used for intraoperative sedation. Anesth Analg. 2002;95:461–466.

    Article  CAS  PubMed  Google Scholar 

  32. Alhashemi JA, Kaki AM. Dexmedetomidine in combination with morphine PCA provides superior analgesia for shockwave lithotripsy. Can J Anaesth. 2004;51: 342–347.

    Article  PubMed  Google Scholar 

  33. Scher CS, Gitlin MC. Dexmedetomidine and low-dose ketamine provide adequate sedation for awake fibreoptic intubation. Can J Anaesth. 2003;50:607–610.

    Article  PubMed  Google Scholar 

  34. Jalowiecki P, Rudner R, Gonciarz M, et al. Sole use of dexmedetomidine has limited utility for conscious sedation during outpatient colonoscopy. Anesthesiology. 2005;103:269–273.

    Article  CAS  PubMed  Google Scholar 

  35. White PF, Negus JB. Sedative infusions during local and regional anesthesia: a comparison of midazolam and propofol. J Clin Anesth. 1991;3:32–39.

    Article  CAS  PubMed  Google Scholar 

  36. Sherry E. Admixture of propofol and alfentanil. Anaesthesia. 1992;47:477–479.

    Article  CAS  PubMed  Google Scholar 

  37. Monk TG, Boure B, White PF, et al. Comparison of intravenous sedative-analgesic techniques for outpatient immersion lithotripsy. Anesth Analg. 1991;72:616–621.

    Article  CAS  PubMed  Google Scholar 

  38. Monk TG, Rater JM, White PF. Comparison of alfentanil and ketamine infusions in combination with midazolam for outpatient lithotripsy. Anesth Analg. 1991;74: 1023–1028.

    CAS  Google Scholar 

  39. Sa Rego MM, Inagaki Y, White PF. The cost-effectiveness of methohexital versus propofol for sedation during monitored anesthesia care. Anesth Analg. 1999;88:723–728.

    Article  CAS  PubMed  Google Scholar 

  40. Patel SS, Goa KL. Sevoflurane. A review of its pharmacodynamic and pharmacokinetic properties and its clinical use in general anesthesia. Drugs. 1996;51:658–700.

    Article  CAS  PubMed  Google Scholar 

  41. Goa KL, Noble S, Spencer CM. Sevoflurane in paediatric anaesthesia: a review. Paediatr Drugs. 1999;1:127–153.

    Article  CAS  PubMed  Google Scholar 

  42. Ibrahim AE, Ghoneim MM, Kharasch ED, et al. Speed of recovery and side-effect profile of sevoflurane sedation compared with midazolam. Anesthesiology. 2001;94: 87–94.

    Article  CAS  PubMed  Google Scholar 

  43. Ibrahim AE, Taraday JK, Kharasch ED. Bispectral index monitoring during sedation with sevoflurane, midazolam, and propofol. Anesthesiology. 2001;95:1151–1159.

    Article  CAS  PubMed  Google Scholar 

  44. Glass PS, Gan TJ, Howell S. A review of the pharmacokinetics and pharmacodynamics of remifentanil. Anesth Analg. 1999;89:S7–S14.

    Article  CAS  PubMed  Google Scholar 

  45. Sator-Katzenschlager SM, Oehmke MJ, Deusch E, Dolezal S, Heinze G, Wedrich A. Effects of remifentanil and fentanyl on intraocular pressure during the maintenance and recovery of anaesthesia in patients undergoing non-ophthalmic surgery. Eur J Anaesthesiol. 2004;21:95–100.

    CAS  PubMed  Google Scholar 

  46. Philip BK, Scuderi PE, Chung F, et al. Remifentanil compared with alfentanil for ambulatory surgery using total intravenous anesthesia. The Remifentanil/Alfentanil Outpatient TIVA Group. Anesth Analg. 1997;84:515–521.

    Article  CAS  PubMed  Google Scholar 

  47. Shafer SL, Varvel JR, Aziz N, et al. Pharmacokinetics of fentanyl administered by computer-controlled infusion pump. Anesthesiology. 1990;73:1091–1102.

    Article  CAS  PubMed  Google Scholar 

  48. Dogru K, Madenoglu H, Yildiz K, Boyaci A. Sedation for outpatient endometrial biopsy: comparison of remifentanil-propofol and alfentanil-propofol. J Int Med Res. 2003;31:31–35.

    CAS  PubMed  Google Scholar 

  49. Fechner J, Ihmsen H, Hatterscheid D, et al. Pharmacokinetics and clinical pharmacodynamics of the new propofol prodrug GPI 15715 in volunteers. Anesthesiology. 2003;99:303–313.

    Article  CAS  PubMed  Google Scholar 

  50. Struys MM, Vanluchene AL, Gibiansky E, et al. FOSPROPOFOL injection, a watersoluble prodrug of propofol, as a bolus injection: a phase I dose-escalation comparison with DIPRIVAN (part 2): pharmacodynamics and safety. Anesthesiology. 2005;103: 730–743.

    Article  CAS  PubMed  Google Scholar 

  51. Rodrigo MR, Irwin mg, Tong CK, et al. A randomised crossover comparison of patient-controlled sedation and patient-maintained sedation using propofol. Anaesthesia. 2003;58:333–338.

    Article  CAS  PubMed  Google Scholar 

  52. Gillham MJ, Hutchinson RC, Carter R, Kenny GN. Patient-maintained sedation for ERCP with a target-controlled infusion of propofol: a pilot study. Gastrointest Endosc. 2001;54:14–17.

    Article  CAS  PubMed  Google Scholar 

  53. LeBlanc JM, Dasta JF, Kane-Gill SL. Role of the bispectral index in sedation monitoring in the ICU. Ann Pharmacother. 2006;40:490–500.

    Article  PubMed  Google Scholar 

  54. Bower AL, Ripepi A, Dilger J, Boparai N, Brody FJ, Ponsky JL. Bispectral index monitoring of sedation during endoscopy. Gastrointest Endosc. 2000;52:192–196.

    Article  CAS  PubMed  Google Scholar 

  55. Schneider G, Heglmeier S, Schneider J, Templ G, Kochs EF. Patient State Index (PSI) measures depth of sedation in ICU patients. Intensive Care Med. 2004:30;213–216.

    Article  PubMed  Google Scholar 

  56. Chen X, Tang J, White PF, et al. A comparison of patient state index and bispectral index values during the perioperative period. Anesth Analg. 2002;95:1669–1674.

    Article  PubMed  Google Scholar 

  57. Kreuer S, Bruhn J, Larsen R, Hoepstein M, Wilhelm W. Comparison of Alaris AEP index and bispectral index during propofol-remifentanil anaesthesia. Br J Anaesth. 2003;91:336–340.

    Article  CAS  PubMed  Google Scholar 

  58. Standards for Basic Anesthetic Monitoring. Park Ridge, IL: American Society of Anesthesiologists; October 25, 2005.

    Google Scholar 

  59. Egan TD. Target-controlled drug delivery: progress toward an intravenous “vaporizer” and automated anesthetic administration. Anesthesiology. 2003;99:1214–1219.

    Article  PubMed  Google Scholar 

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Gan, T.J., Philip, B.K. (2008). Sedation techniques. In: Twersky, R.S., Philip, B.K. (eds) Handbook of Ambulatory Anesthesia. Springer, New York, NY. https://doi.org/10.1007/978-0-387-73329-6_7

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  • DOI: https://doi.org/10.1007/978-0-387-73329-6_7

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