Skip to main content Accessibility help
×
Hostname: page-component-848d4c4894-wg55d Total loading time: 0 Render date: 2024-06-04T02:38:58.576Z Has data issue: false hasContentIssue false

9 - Personalized Sedation and Analgesia

from Section 2 - Targeting Effects

Published online by Cambridge University Press:  03 December 2019

Pedro L. Gambús
Affiliation:
Hospital Clinic de Barcelona, Spain
Jan F. A. Hendrickx
Affiliation:
Aalst General Hospital, Belgium
Get access

Summary

The practice of medicine often requires procedures that cause pain and anxiety. With the advent of modern anaesthesia these procedures have become commonplace and tolerable. Procedures with the greatest degree of pain are frequently accomplished during a state of general anaesthesia. Many procedures, however, are performed under sedation and analgesia. In contrast to general anaesthesia, sedation and analgesia use short acting medications to alleviate pain and anxiety while leaving patients capable of maintaining their airway and basic physiological functions.

Type
Chapter
Information
Personalized Anaesthesia
Targeting Physiological Systems for Optimal Effect
, pp. 128 - 145
Publisher: Cambridge University Press
Print publication year: 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Society of Anesthesiologists Task Force on S, Analgesia by N-A. Practice guidelines for sedation and analgesia by non-anesthesiologists. Anesthesiology. 2002; 96 (4): 1004–17. PubMed PMID: 11964611.Google Scholar
Cohen, LB, Wecsler, JS, Gaetano, JN, Benson, AA, Miller, KM, Durkalski, V, Aisenberg, J: Endoscopic sedation in the United States: results from a nationwide survey. Am.J.Gastroenterol. 2006; 101 (5): 967–74. doi:10.1111/j.1572-0241.2006.00500.x. PubMed PMID: 16573781.Google Scholar
Krauss, B, Green, SM: Sedation and analgesia for procedures in children. N.Engl.J.Med. 2000; 342 (13): 938–45. doi:10.1056/NEJM200003303421306. PubMed PMID: 10738053.CrossRefGoogle ScholarPubMed
Shah, A, Shelley, KH: Is pulse oximetry an essential tool or just another distraction? The role of the pulse oximeter in modern anesthesia care. J.Clin.Monit.Comput. 2013; 27 (3): 235–42. doi:10.1007/s10877-013-9428-7. PubMed PMID: 23314807.Google Scholar
Moller, JT, Johannessen, NW, Espersen, K, Ravlo, O, Pedersen, BD, Jensen, PF, Rasmussen, NH, Rasmussen, LS, Pedersen, T, Cooper, JB, et al: Randomized evaluation of pulse oximetry in 20,802 patients: II. Perioperative events and postoperative complications. Anesthesiology. 1993; 78 (3): 445–53. PubMed PMID: 8457045.Google Scholar
Moller, JT, Pedersen, T, Rasmussen, LS, Jensen, PF, Pedersen, BD, Ravlo, O, Rasmussen, NH, Espersen, K, Johannessen, NW, Cooper, JB, et al: Randomized evaluation of pulse oximetry in 20,802 patients: I. Design, demography, pulse oximetry failure rate, and overall complication rate. Anesthesiology. 1993; 78 (3): 436–44. PubMed PMID: 8457044.Google Scholar
Mehta, P, Kochhar, G, Albeldawi, M, Kirsh, B, Rizk, M, Putka, B, John, B, Wang, Y, Breslaw, N, Vargo, JJ: Capnographic monitoring does not improve detection of hypoxemia in colonoscopy with moderate sedation. A randomized, controlled trial. American College of Gastroenterology; Philadelphia, 2014.Google Scholar
Waugh, JB, Epps, CA, Khodneva, YA: Capnography enhances surveillance of respiratory events during procedural sedation: a meta-analysis. J.Clin.Anesth. 2011; 23 (3): 189–96. doi:10.1016/j.jclinane.2010.08.012. PubMed PMID: 21497076.Google Scholar
Van de Velde, M, Roofthooft, E, Kuypers, M: Risk and safety of anaesthesia outside the operating room. Curr.Opin.Anaesthesiol. 2008; 21 (4): 486–7. doi:10.1097/ACO.0b013e328304d95e. PubMed PMID: 18660658.CrossRefGoogle ScholarPubMed
Tanaka, PP, Tanaka, M, Drover, DR: Detection of respiratory compromise by acoustic monitoring, capnography, and brain function monitoring during monitored anesthesia care. J.Clin.Monit.Comput. 2014; 28 (6): 561–6. doi:10.1007/s10877-014-9556-8. PubMed PMID: 24420342.Google Scholar
Vargo, JJ, Zuccaro, G Jr., Dumot, JA, Conwell, DL, Morrow, JB, Shay, SS: Automated graphic assessment of respiratory activity is superior to pulse oximetry and visual assessment for the detection of early respiratory depression during therapeutic upper endoscopy. Gastrointest.Endosc. 2002; 55 (7): 826–31. PubMed PMID: 12024135.CrossRefGoogle ScholarPubMed
Cohen, S, Lhuillier, F, Mouloua, Y, Vignal, B, Favetta, P, Guitton, J: Quantitative measurement of propofol and main glucuroconjugate metabolites in human plasma using solid phase extraction-liquid chromatography-tandem mass spectrometry. J.Chromatogr.B.Analyt.Technol.Biomed.Life.Sci. 2007; 854 (1–2): 165–72. doi:10.1016/j.jchromb.2007.04.021. PubMed PMID: 17485254.Google Scholar
Gahart, BL, Nazzareno, AR, Qrtega, MQ: Intravenous Medications: A Handbook for Nurses and Health Professionals. Amsterdam: Elsevier, 2019.Google Scholar
Pambianco, DJ, Whitten, CJ, Moerman, A, Struys, MM, Martin, JF: An assessment of computer-assisted personalized sedation: a sedation delivery system to administer propofol for gastrointestinal endoscopy. Gastrointest.Endosc. 2008; 68 (3): 542–7. doi:10.1016/j.gie.2008.02.011. PubMed PMID: 18511048.Google Scholar
Gambus, PL, Jensen, EW, Jospin, M, Borrat, X, Martinez Palli, G, Fernandez-Candil, J, Valencia, JF, Barba, X, Caminal, P, Troconiz, IF: Modeling the effect of propofol and remifentanil combinations for sedation-analgesia in endoscopic procedures using an Adaptive Neuro Fuzzy Inference System (ANFIS). Anaesth.Analg. 2011; 112 (2): 331–9. doi:10.1213/ANE.0b013e3182025a70. PubMed PMID: 21131550.Google Scholar
Borrat, X, Valencia, JF, Magrans, R, Gimenez-Mila, M, Mellado, R, Sendino, O, Perez, M, Nunez, M, Jospin, M, Jensen, EW, Troconiz, I, Gambus, PL: Sedation-analgesia with propofol and remifentanil: concentrations required to avoid gag reflex in upper gastrointestinal endoscopy. Anaesth.Analg. 2015; 121 (1): 90–6. doi:10.1213/ANE.0000000000000756. PubMed PMID: 25902320.CrossRefGoogle ScholarPubMed
Ng, JM, Kong, CF, Nyam, D: Patient-controlled sedation with propofol for colonoscopy. Gastrointest.Endosc. 2001; 54 (1): 813. doi:10.1067/mge.2001.116110. PubMed PMID: 11427834.CrossRefGoogle ScholarPubMed
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 (1): 1417. doi:10.1067/mge.2001.116358. PubMed PMID: 11427835.Google Scholar
Syroid, ND, Agutter, J, Drews, FA, Westenskow, DR, Albert, RW, Bermudez, JC, Strayer, DL, Prenzel, H, Loeb, RG, Weinger, MB: Development and evaluation of a graphical anesthesia drug display. Anesthesiology. 2002; 96 (3): 565–75. PubMed PMID: 11873029.CrossRefGoogle ScholarPubMed
Shafer, SL, Varvel, JR, Aziz, N, Scott, JC: Pharmacokinetics of fentanyl administered by computer-controlled infusion pump. Anesthesiology. 1990; 73 (6): 1091–102. PubMed PMID: 2248388.Google Scholar
Albrecht, S, Ihmsen, H, Hering, W, Geisslinger, G, Dingemanse, J, Schwilden, H, Schuttler, J: The effect of age on the pharmacokinetics and pharmacodynamics of midazolam. Clin.Pharmacol.Ther. 1999; 65 (6): 630–9. Epub 1999/ 07/03. doi:S0009923699000727 [pii] 10.1016/S0009-9236(99)90084-X. PubMed PMID: 10391668.Google Scholar
Schnider, TW, Minto, CF, Gambus, PL, Andresen, C, Goodale, DB, Shafer, SL, Youngs, EJ: The influence of method of administration and covariates on the pharmacokinetics of propofol in adult volunteers. Anesthesiology. 1998; 88 (5): 1170–82. PubMed PMID: 9605675.CrossRefGoogle ScholarPubMed
Schnider, TW, Minto, CF, Shafer, SL, Gambus, PL, Andresen, C, Goodale, DB, Youngs, EJ: The influence of age on propofol pharmacodynamics. Anesthesiology. 1999; 90 (6): 1502–16. PubMed PMID: 10360845.Google Scholar
Minto, CF, Schnider, TW, Egan, TD, Youngs, E, Lemmens, HJ, Gambus, PL, Billard, V, Hoke, JF, Moore, KH, Hermann, DJ, Muir, KT, Mandema, JW, Shafer, SL: Influence of age and gender on the pharmacokinetics and pharmacodynamics of remifentanil. I. Model development. Anesthesiology. 1997; 86 (1): 1023. PubMed PMID: 9009935.Google Scholar
Minto, CF, Schnider, TW, Shafer, SL: Pharmacokinetics and pharmacodynamics of remifentanil. II. Model application. Anesthesiology. 1997; 86 (1): 2433. PubMed PMID: 9009936.CrossRefGoogle ScholarPubMed
Kern, SE, Xie, G, White, JL, Egan, TD: A response surface analysis of propofol-remifentanil pharmacodynamic interaction in volunteers. Anesthesiology. 2004; 100 (6): 1373–81. PubMed PMID: 15166554.CrossRefGoogle ScholarPubMed
LaPierre, CD, Johnson, KB, Randall, BR, White, JL, Egan, TD: An exploration of remifentanil-propofol combinations that lead to a loss of response to esophageal instrumentation, a loss of responsiveness, and/or onset of intolerable ventilatory depression. Anesth.Analg. 2011; 113 (3): 490–9. doi:10.1213/ANE.0b013e318210fc45. PubMed PMID: 21415430.Google Scholar
Johnson, KB, Syroid, ND, Gupta, DK, Manyam, SC, Egan, TD, Huntington, J, White, JL, Tyler, D, Westenskow, DR: An evaluation of remifentanil propofol response surfaces for loss of responsiveness, loss of response to surrogates of painful stimuli and laryngoscopy in patients undergoing elective surgery. Anesth.Analg. 2008; 106 (2): 471–9. doi:10.1213/ane.0b013e3181606c62. PubMed PMID: 18227302; PMCID: 3050649.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×