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At least 973 records · Page 54Linked to original sources
PubMed1982

Is lumbar epidural analgesia an alternative in patients who have incomplete colonoscopy with standard premedication?

Total colonoscopy is unsuccessful in about 10% of attempts. In three fourths of the cases, failure is due to the patient's inability to tolerate the procedure and difficulty in negotiating the sigmoid colon. Lumbar epidural analgesia has been used in a series of 29 patients referred for total colonoscopy which had been unsuccessful using intravenous analgesia. The cecum was reached in 27 of 29 examinations. Mean time required to perform total colonoscopy was 10 min and took less than 5 min in one third of the cases. Complete visceral analgesia was responsible for one case of perforation.

Adolescent↗
PubMed1984

The effect of upper gastrointestinal endoscopy on arterial O2 tension in smokers and nonsmokers with and without premedication.

Fiberoptic upper gastrointestinal endoscopy has become an accepted procedure with recognized and acceptable complication rates. Recently, significant hypoxemia during upper gastrointestinal endoscopy has been identified. This report evaluates changes in arterial blood gases and investigates the effects of drugs, smoking, and length of procedure. Upper gastrointestinal endoscopy was performed on 60 patients--15 patients in four different groups. Group I and II were smokers and nonsmokers who received sedation; groups III and IV were smokers and nonsmokers who received no sedation. A significant drop in PaO2 was noted in each group. Sedation, length of procedure, or smoking did not affect the PaO2 levels significantly. No significant change in PaCO2 was noted in any of the four groups. A V/Q mismatch related to vasospasm and/or bronchospasm is proposed as the main reason for the hypoxemia.

Adolescent↗
PubMed1986

Premedication with meperidine and diazepam for upper gastrointestinal endoscopy precludes the need for topical anesthesia.

The authors conducted a prospective study in 90 patients undergoing upper endoscopic examination under sedation to determine whether there was any beneficial effect in anesthetizing the pharynx with topical anesthesia. These patients were divided into three groups of 30 patients. Group A received 39 ml of viscous lidocaine gargle (2%) diluted with 15 ml of tap water. Group B received the placebo. Group C received neither viscous lidocaine nor placebo. All patients received intravenous meperidine and diazepam titrated to produce adequate sedation for upper endoscopy. It was demonstrated that the undesirable effects of upper endoscopy, that is, gagging, sore throat, and dysphagia, did not differ significantly in any of the three study groups as evaluated by either the patients or the endoscopist. Only two patients complained that the procedure was mildly unpleasant. The authors conclude that the practice of anesthetizing the pharynx in patients receiving sedation for upper endoscopy should be abandoned since anesthesia of the pharynx is not exempt from morbidity and mortality as well as being time-consuming and expensive.

Adult↗
PubMed1996

Antihistamine premedication in specific cluster immunotherapy: a double-blind, placebo-controlled study.

BACKGROUND: Specific immunotherapy treatment in allergic diseases involves a risk of systemic side effects. A double-blind, placebo-controlled study was performed in 45 patients allergic to pollen to determine whether pretreatment with loratadine could reduce the number and severity of systemic reactions during the dose-increase phase of cluster immunotherapy. METHODS: The patients received cluster immunotherapy with a standardized birch (Betula verrucosa) or grass (Phleum pratense) pollen extract adsorbed to aluminum hydroxide. The immunotherapy schedule involved seven visits and 14 injections to reach a maintenance dose of 100,000 standardized quality units. Loratadine, 10 mg, or placebo tablets were administered 2 hours before the first injection at each visit. RESULTS: A total of 720 injections were given (309 injections in 21 patients receiving loratadine and 411 injections in 24 patients receiving placebo). The median numbers of injections to reach maintenance dose were 15 (range, 14 to 18) in the loratadine group and 16 (range, 14 to 23) in the placebo group (p = 0.037). The numbers of patients with systemic reactions were seven (33%) and 19 (79%) in the loratadine and placebo groups, respectively (p = 0.002). Twenty-five reductions caused by systemic reactions were observed in the placebo group in contrast to nine in the loratadine group (p = 0.047). No life-threatening systemic reactions were observed in either group. Systemic reactions were, however, more severe in the placebo group, mainly because of a significantly higher incidence of urticaria (10 vs 1, p = 0.022). CONCLUSION: Pretreatment with loratadine seems to reduce both the number and severity of systemic reactions in specific cluster immunotherapy.

Adult↗