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Sedation: Clinical Challenges and New Insights
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Sedation: Clinical Challenges and New Insights

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Anesthesiology".

Deadline for manuscript submissions: closed (20 July 2024) | Viewed by 2510

Special Issue Editor

Dr. Basavana Goudra

E-Mail Website
Guest Editor
Department of Anesthesiology and Critical Care Medicine, Honickman Center, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
Interests: sedation; airway management; anesthesia

Special Issue Information

Dear Colleagues,

Surgical procedures are constantly evolving, and many are being replaced with safer non-surgical interventions. Additionally, patients who are not candidates for aggressive surgical procedures benefit from less invasive options. Several such interventions have moved out of operating rooms to, unfortunately, lesser-equipped procedure rooms. Even though the field of gastroenterology leads in this area, other disciplines such as respiratory medicine, cardiology, radiology, and reproductive healthcare are making steady progress too.

The drug and device industry has responded to this uniquely dynamic landscape. Newer sedative agents such as remimazolam and opioids such as oliceridine are some of the tools currently available. The device market has evolved to address the oxygenation and ventilation issues faced by anesthesia providers tasked with providing sedation and anesthesia in unfamiliar areas.

In this Special Issue, we aim to publish articles that uniquely assist anesthesia providers, provide an overview of challenges, and suggest solutions.

Dr. Basavana Goudra
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • anesthesia
  • oxygenation
  • sedative agents
  • ventilation
  • airway management

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Further information on MDPI's Special Issue polices can be found here.

Published Papers (2 papers)

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Research

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10 pages, 1812 KiB  
Article
Predictors for Dexmedetomidine Requirement for Sedation under Regional Anesthesia
by Jun Ho Lee, Taehyeon Jung, Seonghoon Ko and Aram Doo
J. Clin. Med. 2024, 13(5), 1435; https://doi.org/10.3390/jcm13051435 - 1 Mar 2024
Viewed by 997
Abstract
(1) Background: This prospective observational study aimed to investigate the predictors affecting DMT requirements for sedation during regional anesthesia. (2) Method: A total of 108 patients who received regional anesthesia with intravenous DMT administration for orthopedic upper- or lower-extremity surgery were [...] Read more.
(1) Background: This prospective observational study aimed to investigate the predictors affecting DMT requirements for sedation during regional anesthesia. (2) Method: A total of 108 patients who received regional anesthesia with intravenous DMT administration for orthopedic upper- or lower-extremity surgery were enrolled. Following successful regional anesthesia, DMT was administered at a rate of 4 µg/kg/h until reaching loss of consciousness (LOC). The administered dose of DMT per body weight until LOC (DMTLOC; µg/kg) was evaluated. The infusion was maintained at a rate of 0.2–0.7 µg/kg/h during the surgery. At the end of surgery, the elapsed time to a BIS value of 90 (TBIS90; s) was recorded. Linear regression models were used to identify potential predictors of DMTLOC and TBIS90. (3) Results: One hundred patients were analyzed. There were negative relationships between DMTLOC and age (r = −0.297, p = 0.003) and DMTLOC and body mass index (BMI) (r = −0.425, p < 0.001), respectively. Multiple linear regression models revealed that both increasing age and BMI were significantly related to DMTLOC (r2 = 0.259, p < 0.001), but those variables showed no association with TBIS90. (4) Conclusions: The results of this study suggest that initial loading of DMT should be carefully titrated to minimize risk in elderly and obese surgical populations. Full article
(This article belongs to the Special Issue Sedation: Clinical Challenges and New Insights)
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Review

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19 pages, 2920 KiB  
Review
Setting Up an Ambulatory GI Endoscopy Suite in the USA—Anesthesia and Sedation Challenges
by Basavana Goudra
J. Clin. Med. 2024, 13(15), 4335; https://doi.org/10.3390/jcm13154335 - 25 Jul 2024
Viewed by 980
Abstract
Gastrointestinal endoscopy units, both freestanding and associated with ambulatory surgical centers, are on the increase, and the trend is likely to continue. The concept is relatively new, and there are insufficient guidelines and a general dearth of information for prospective planners and physicians. [...] Read more.
Gastrointestinal endoscopy units, both freestanding and associated with ambulatory surgical centers, are on the increase, and the trend is likely to continue. The concept is relatively new, and there are insufficient guidelines and a general dearth of information for prospective planners and physicians. Debate continues in areas such as the selection of patients, appropriateness of procedures, and access to tertiary care. Leaders often scramble to address both critical and non-critical issues, often after the center has opened to the public. They often encounter issues which were not anticipated. In this review, we have provided comprehensive and concise information on the various aspects of starting and running an endoscopy unit. Some of the areas considered are referral and recruitment systems, determination of the need and site selection, layout and regulations, aspects related to drugs, equipment, medical emergencies, and emergency room transfers, discharge criteria, post-discharge follow-up, and finally, we have addressed issues related to avoiding and managing cancelations. It is assumed that a majority of the procedures are performed with predominantly propofol-induced deep sedation. Full article
(This article belongs to the Special Issue Sedation: Clinical Challenges and New Insights)
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