<p>This thesis covered the fast track assessment of the referred dental patient for conscious sedation in a day clinic. The assessment took in consideration patient information, medical history, anatomical observations, treatment required, phobic aspects and patient expectations.</p>

<p>The purpose of this research project was to assess the safety and efficacy of a combination of drugs for conscious sedation in patients undergoing office-based plastic and reconstructive surgery. A pilot study was done to determine the safety of the co-administration of the drugs used in the sedation technique.</p>

Magister Scientiae Dentium - MSc(Dent) / This study was designed to evaluate the efficacy and safety of intranasal sufentanil/midazolam [S/M] and ketamine/madazolam [K/M] for sedation and analgesia in preschool children that require dental surgery [extractions]. Fifty children [ASA 1] aged 5 – 7 years, requiring six or more dental extractions under general anaesthesia, were allocated to two groups of 25 children to receive either ketamine 5 mg/kg or sufentanil 20μg intranasally, 20 minutes before induction of surgery in this randomised double-blind study. All the children in both groups in addition concurrently received nasal midazolam 0,3 mg/kg. For induction of anaesthesia, sevoflurane in nitrous oxide and oxygen, was used. S/M was accepted significantly better as a nasal pre-medication [p<0.05]. Both groups were equally sedated and a smooth mask induction of anaesthesia was experienced in the majority of children. Recovery of children in both groups were similar; 82% of the S/M group were fully recovered 120 minutes post-operatively versus 80% in the K/M group [p>0,05]. Effective postoperative analgesia for multiple extractions was provided. For pain evaluation, children were divided into two groups, a non-responder group where all pain values over time were more than 40 and a responder group where pain values were equal to, or less than 40. Seventy two percent of children in the S/M group were responders as to fifty two percent in the K/M group [p>0,05]. No adverse respiratory, cardiovascular or other effects were recorded. This study showed that intranasal administration of sufentanil /midazolam or ketamine/midazolam, provides safe and effective sedation and analgesia in children aged 5–7 years undergoing multiple dental extractions.

This thesis covered the fast track assessment of the referred dental patient for conscious sedation in a day clinic. The assessment took in consideration patient information, medical history, anatomical observations, treatment required, phobic aspects and patient expectations.

Bakgrund Djup sedering är associerat med förlängd vårdtid och ett flertal komplikationer för intensivvårdspatienten. Även för ytlig sedering medför komplikationer, stress och lidande. Studier visar på vikten av adekvat sedering, samt att skalor och protokoll används. Syftet med denna studie var att beskriva sederingsnivå, andel optimalt, över- och undersederade patienter, vårdtid i ventilator och vårdtid inom intensivvården för patienter på en svensk intensivvårdsavdelning. Metod Studien, med deskriptiv design, inkluderade konsekutivt sederade, ventilatorbehandlade patienter, 18 år och äldre, på en svensk intensivvårdsavdelning under nio månader. Primära utfallsvariabler var sederingsnivå, utifrån Motor Activity Assessment Scale och andel optimalt, över- och undersederade patienter. Sekundära variabler var vårdtid i ventilator och vårdtid på intensivvårdsavdelningen. Resultat Studien omfattade 34 patienter. Under vårdtid i ventilator med endotrackealtub hade 28  patienterna optimal sedering mer än två tredjedelar av vårdtiden. Medianvärdet för sederingsnivå under vårdtid med endotrackealtub var MAAS 2 (kvartilavstånd 2-2,25) jämfört med medianvärdet för sederingsnivån med trackealkanyl som var MAAS 3 (kvartilavstånd 2-3) (P &lt; 0,001). Trettio patienter (88,2 %) var optimalt sederade med ett MAAS-värde på 2-3 (md) sett till hela vårdtiden. Fyra patienter (11.8 %) var översederade med ett MAAS-värde på 0-1,5 (md). Ingen patient var undersederad sett till hela vårdtiden. Konklusion Studien visar att majoriteten av intensivvårdspatienterna var optimalt sederade under större delen av vårdtiden i ventilator. Endast ett fåtal patienter var översederade och ingen patient var undersederad större delen av vårdtiden. Patienter vårdade med trackealkanyl var ytligare sederade än de med endotrackealtub.

Thesis (Ph. D.)--University of Washington, 2007. / Vita. Includes bibliographical references (leaves 38-41).

No description available.

Thesis (Ph. D.)--Virginia Commonwealth University, 2010. / Prepared for: School of Nursing. Title from title-page of electronic thesis. Bibliography: leaves 80-85.

Magister Scientiae Dentium - MSc(Dent) / This study was done to show that sedation is a safe and a viable option in young children. Dental procedures were done on children aged two to ten years. Two hundred children were included in the study. In all of these children the procedures were completed. Only two children were excluded, because an intravenous line could not be placed on the one child, and the other child was unmanageable under sedation. The safety of sedation was evaluated looking at the incidence of adverse events and complications. No serious adverse effects or complications occurred. The complications that occurred were all corrected with minimal or non-invasive interventions. Only six of the two hundred children required oxygen to correct a drop in oxygen saturation.

Agitated patients are common in the prehospital environment and pose a significant danger to themselves, the public, law enforcement and prehospital medical providers. Pharmacologic and non-pharmacologic options exist for managing agitation in the prehospital setting. Severe agitation is best managed with pharmacologic methods, but the optimal drug or drug combination is unclear. Intramuscular (IM) ketamine has been shown to be very effective at obtaining fast and safe control of severely agitated patient. However, current research on this subject is limited to retrospective studies and case series. This proposal is a 2 year, single-center, double-blind randomized controlled trial which will measure the potential superiority of ketamine compared to a commonly used standard-of-care medication (IM haloperidol) for the rapid sedation of acutely agitated patients in the prehospital environment. It will be the first randomized, controlled, double blind study investigating the use of ketamine compared to haloperidol in the prehospital setting for agitation and will impact prehospital protocols for the treatment and management of agitation. It will potentially aid in the future reduction of harm to medical and law enforcement personnel by violent patients as well as decrease morbidity and mortality to the acutely agitated patients.