Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: EC:2.3.1.177 (BIS)
 957 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Patient-controlled sedation (PCS) allows patients to match their sedation requirement to perceived discomfort. The significant delay in onset of sedation may be overcome with effect-site steered target controlled infusion, but previously only trials in volunteers have been carried out. We therefore conducted a randomised, double-blind controlled trial comparing effect-site steered propofol PCS with anaesthetist-administered propofol sedation in 40 patients presenting for colonoscopy. The initial effect-site target in the PCS group was 0.8 microg.ml(-1), increment was 0.1 microg.ml(-1) and lockout was 3 min. Patient and endoscopist satisfaction and operating conditions were similar between the two groups. PCS patients were sedated more slowly (13 [7.1] vs. 3 [1.1] min; p < 0.0001) and less deeply (minimum BIS value: 71 [16] vs. 58 [15]; p = 0.13) than anaesthetist-administered propofol sedation patients. More of the latter patients were hypotensive, but all patients had similar recollection of events during the procedure and similar quality of recovery.
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PMID:Effect-site targeted patient-controlled sedation with propofol: comparison with anaesthetist administration for colonoscopy. 1648 Mar 48

In this paper the effect of uterine artery embolization (UAE) on sexual functioning and body image is investigated in a randomized comparison to hysterectomy for symptomatic uterine fibroids. The EMbolization versus hysterectoMY (EMMY) trial is a randomized controlled study, conducted at 28 Dutch hospitals. Patients were allocated hysterectomy (n = 89) or UAE (n = 88). Two validated questionnaires (the Sexual Activity Questionnaire [SAQ] and the Body Image Scale [BIS]) were completed by all patients at baseline, 6 weeks, and 6, 12, 18, and 24 months after treatment. Repeated measurements on SAQ scores revealed no differences between the groups. There was a trend toward improved sexual function in both groups at 2 years, although this failed to reach statistical significance except for the dimensions discomfort and habit in the UAE arm. Overall quality of sexual life deteriorated in a minority of cases at all time points, with no significant differences between the groups (at 24 months: UAE, 29.3%, versus hysterectomy, 23.5%; p = 0.32). At 24 months the BIS score had improved in both groups compared to baseline, but the change was only significant in the UAE group (p = 0.009). In conclusion, at 24 months no differences in sexuality and body image were observed between the UAE and the hysterectomy group. On average, both after UAE and hysterectomy sexual functioning and body image scores improved, but significantly so only after UAE.
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PMID:Sexuality and body image after uterine artery embolization and hysterectomy in the treatment of uterine fibroids: a randomized comparison. 1767 9

Almost all children in the pediatric intensive care (PICU) need analgesia and/or sedation. Analgesics drugs are used to control pain from surgical incisions, drainages, vascular access or endotracheal suctioning. Sedatives are used to facilitate the delivery of nursing care, to facilitate mechanical ventilation, prevent self-extubation and to minimize patient discomfort. A therapeutic plan for analgesia and sedation should be established for each patient and regularly reviewed. The most often used sedation agents in PICU patients are Morphine or Fentanyl alone or in combination with Midazolam. Several other drugs should be helpful to manage PICU patients therefore techniques like regional anesthesia and patient controlled analgesia to decrease the use of intravenous analgesia and sedation and to reduce the incidence of withdrawal syndrome. The therapeutic plan for analgesia and sedation should be established for each patient and regularly reviewed. Doses of sedative agents should be titrated to produce the desired level of sedation. The level of sedation should be regularly assessed and documented using few validated sedation assessment tool. However, behavioral evaluation tools based on patient responsiveness, cannot be used during the administration of neuromuscular blocking agents. Under this conditions it could be difficult to interpret the degree of sedation. EEG derived Monitoring devices may represents an useful tools of assessing the level of sedation, but there is insufficient evidence to support the routine use of the BIS monitor in PICU.
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PMID:Sedation and analgesia in pediatric intensive care. 2251 93

Sedation or anesthesia is necessary in most of the patients undergoing catheter ablation of atrial fibrillation (AF) because of longer procedure time and interventions causing pain and discomfort such as cardioversion, administration of adenosine or RF applications to the posterior left atrium. In the United States, AF ablation is performed under general anesthesia by anesthesiologists or anesthesia nurses in half of the patients and other half is under conscious sedation by cardiologists or nurses. In Japan, however, a nationwide survey revealed more than 95% of patients underwent AF ablation under conscious or deep sedation and most of them are performed by cardiologists who also have other responsibility. Current problems include a difficulty in management of respiration in patients with sleep apnea that often coincide with AF. Continuous positive airway pressure combined with nasal or oral airway and jaw elevation device is often used. Frequencies of monitoring of SP(O2), arterial blood pressure, BIS, and Et(CO)2 were 99%, 79%, 13.2% and 2% of patients, respectively, which suggests monitoring of consciousness level and ventilation may be insufficient Japanese Heart Rhythm Society started educational activities for safe sedation by themselves.
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PMID:[Current Status and Issues of Sedation and Anesthesia in Cardiovascular Medicine]. 2612 86