725K.P. Mason (ed.), Pediatric Sedation Outside of the Operating Room: A Multispecialty International Collaboration,DOI 10.1007/978-1-4939-1390-9, © Springer Science+Business Media New York 2015

Epilogue

Anthony R. Absalom, M.B.Ch.B., F.R.C.A., F.H.E.A., M.D. Professor of Anesthesia Department of Anesthesiology University Medical Center Groningen Groningen, The Netherlands

Karel Allegaert, M.D., Ph.D. Associate Professor of Anesthesia Department of Growth and Regeneration KU Leuven and Neonatal Intensive Care Unit University Hospitals Leuven Leuven, Belgium

Brian J. Anderson, M.B.Ch.B., Ph.D., F.A.N.Z.C.A., F.J.F.I.C.M. Adjunct Professor of Anesthesiology Department of Anesthesiology University of Auckland School of Medicine Pediatric Intensive Care Unit Auckland Children’s Hospital Auckland, New Zealand

Dean B. Andropoulos, M.D., M.H.C.M. Chief of Anesthesiology Texas Children’s Hospital Professor of Anesthesiology and Pediatrics Baylor College of Medicine Houston, TX, USA

Franz E. Babl, M.D., M.P.H. Associate Professor of Anesthesia University of Melbourne Emergency Department Royal Children’s Hospital Melbourne, VIC, Australia

Douglas W. Carlson, M.D. Professor of Pediatrics Director, Division of Pediatric Hospitalist Medicine Division of Pediatric Hospitalist Medicine Department of Pediatrics St. Louis Children’s Hospital Washington University St. Louis, MO, USA

Xuan Chen, M.Med. Department of Anesthesia Hong Kong University Shenzhen, Guangdong, China

Vincent W. Chiang, M.D. Associate Professor of Pediatrics Harvard Medical School Chief of Inpatient Services Boston Children’s Hospital Associate Program Director Boston Combined Residency Boston, MA, USA

Stewart L. Cohen, Esq. Partner/Shareholder Cohen, Placitella & Roth, P.C. Philadelphia, PA, USA

Luciane Ribeiro de Rezende Sucasas da Costa, D.D.S., M.S., Ph.D. Professor of Pediatric Dentistry Faculty of Dentistry Division of Pediatric Dentistry Federal University of Goiás Goiania, Goias, Brazil

Paulo S é rgio Sucasas da Costa, M.S., Ph.D. Associate Professor of Pediatrics Department of Pediatrics Federal University of Goiás Goiania, Goias, Brazil

Joseph P. Cravero, M.D. Associate Professor of Anesthesia Harvard Medical School Department of Anesthesiology, Perioperative, and Pain Medicine Boston Children’s Hospital Boston, MA, USA

Stuart R. Dalziel, M.B.Ch.B., F.R.A.C.P., Ph.D. Pediatric Emergency Medicine Specialist Children’s Emergency Department

726

Director of Emergency Medicine Research Starship Children’s Hospital Auckland District Health Board Auckland, New Zealand

Andrew J. Davidson, M.B.B.S., M.D., F.A.N.Z.C.A. Associate Professor Department of Pediatrics Senior Staff Anesthetist Director of Clinical Research Department of Anaesthesia and Pain Management The Royal Children’s Hospital Melbourne Murdoch Children’s Research Institute University of Melbourne Melbourne, VIC, Australia

James J. Fehr, M.D. Associate Professor of Anesthesia Department of Anesthesiology and Pediatrics St. Louis Children’s Hospital St. Louis, MO, USA

Lynne R. Ferrari, M.D. Associate Professor of Anesthesia Harvard Medical School Medical Director and Chief, Perioperative Anesthesia Departments of Anesthesiology, Perioperative and Pain Medicine Boston Children’s Hospital Boston, MA, USA

Daniela Hearst, B.Sc. (Hons.), M.Phil. Consultant Clinical Psychologist and Joint Head of Pediatric Psychology Department of Pediatric Psychology, Psychosocial and Family Services Great Ormond Street Hospital for Children NHS Foundation Trust London, UK

Robert S. Holzman, M.D., M.A. (Hon.), F.A.A.P. Professor of Anaesthesia Harvard Medical School Department of Anesthesiology, Perioperative and Pain Medicine Boston Children’s Hospital Boston, MA, USA

Timothy Horeczko, M.D., M.S.C.R. Assistant Professor of Emergency Medicine Department of Emergency Medicine Harbor – UCLA Medical Center Torrance, CA, USA

Marie Therese Hosey, D.D.S., M.Sc. (Med. Sci.), B.D.S., F.D.S.R.C.P.S. (Glas.) Head of Pediatric Dentistry Department of Pediatric Dentistry

Professor of Dentistry King’s College London, Dental Institute London, UK

Michael G. Irwin, M.B.Ch.B., M.D., F.H.K.C.A., F.A.N.Z.C.A., F.R.C.A., F.H.K.A.M. Professor and Head Department of Anesthesiology The University of Hong Kong Chief of Service in Anesthesia Queen Mary Hospital, China Chief of Service in Anesthesia HKU Shenzen Hospital, China President, Society of Anesthetists, Hong Kong President, International Federation of Intravenous Anesthesia Society President, Organizing Committee for World Congress of Anaesthesia 2016

Ian A. Jenkins, M.B.B.S., F.R.C.A., F.R.C.P.E., F.F.I.C.M. Consultant in Pediatric Intensive Care & Anaesthesia Bristol Royal Hospital for Children Bristol, UK Past President of the Pediatric Intensive Care Society Past Chair of the Pediatric Intensive Care Society Sedation Group

Robert M. Kennedy, M.D. Professor of Pediatrics Associate Director, Education Affairs Emergency Services Washington University School of Medicine Department of Pediatrics St. Louis Children’s Hospital St. Louis, MO, USA

Baruch S. Krauss, M.D., Ed.M. Associate Professor of Pediatrics Harvard Medical School Director, Inpatient Sedation Service Division of Emergency Medicine Boston Children’s Hospital Boston, MA, USA

Piet L.J.M. Leroy, M.D., Ph.D. Associate Professor of Pediatrics Department of Pediatrics Division of Pediatric Critical Care Pediatric Procedural Sedation Unit Maastricht University Medical Centre Maastricht, The Netherlands

Bi-lian Li, M.D. Department of Anesthesiology Guangzhou Women and Children’s Medical Centre Guangzhou, Guangdong, China

Epilogue

727

Jenifer R. Lightdale, M.D., M.P.H. Professor of Pediatrics, University of Massachusetts Medical School Division Chief, Pediatric Gastroenterology, Hepatology and Nutrition Chief Quality Offi cer UMass Memorial Children’s Medical Center Division of Pediatric Gastroenterology, Hepatology and Nutrition UMass Memorial Children’s Medical Center Department of Pediatrics University of Massachusetts Medical School Worcester, MA, USA

Yuan-Chi Lin, M.D., M.P.H. Director, Medical Acupuncture Service Department of Anesthesiology, Perioperative and Pain Medicine Boston Children’s Hospital Associate Professor of Anesthesia (Pediatrics) Harvard Medical School

Mohamed Mahmoud, M.D. Associate Professor of Pediatrics and Anesthesiology Director, Radiology Anesthesia and Sedation Department of Anesthesia Cincinnati Children’s Hospital Medical Center Cincinnati, OH, USA

Keira P. Mason, M.D. Associate Professor of Anesthesia Harvard Medical School Director of Radiology Anesthesia and Sedation Department of Anesthesiology, Perioperative and Pain Medicine Boston Children’s Hospital Boston, MA, USA Vice President, World Society of Intravenous Anesthesia (SIVA) Chairman, International Sedation Task Force (ISTF) and Pediatric Committee, World SIVA

Lisa L. Mathis, M.D. Executive Medical Director Department of Global Regulatory Affairs and Safety Maternal and Pediatric Safety and Regulatory Amgen Inc. Thousand Oaks, CA, USA

Ian McKenzie, M.B.B.S., Dip. R.A.C.O.G., F.A.N.Z.C.A. Assistant Professor University of Queensland, Brisbane, Australia Director, Department of Anesthesia and Pain Management The Royal Children’s Hospital Parkville, VIC, Australia

Suzanne Swanson Mendez, M.D. Pediatric Hospitalist Department of Pediatrics Santa Clara Valley Medical Center San Jose, CA, USA

Alan F. Merry, O.N.Z.M., M.B.Ch.B., F.A.N.Z.C.A., F.P.M.A.N.Z.C.A., F.R.C.A. Professor and Head of School of Medicine University of Auckland Department of Anesthesiology Auckland City Hospital Auckland, New Zealand Chairman, Board of the New Zealand Health Quality and Safety Commission

James R. Miner, M.D. Professor of Emergency Medicine University of Minnesota Medical School Department of Emergency Medicine Hennepin County Medical Center Minneapolis, MN, USA

Itai M. Pessach, M.D., Ph.D. Israel Center for Medical Simulation (MSR) Sheba Medical Center Tel-Hashomer, Israel

Randy P. Prescilla, M.D. Instructor in Anesthesia Harvard Medical School Department of Anesthesiology, Perioperative and Pain Medicine Children’s Hospital Boston Boston, MA, USA

Mark G. Roback, M.D. Professor of Pediatrics and Emergency Medicine University of Minnesota Medical School Co-Director, Pediatric Emergency Medicine Department of Pediatrics University of Minnesota Amplatz Children’s Hospital Minneapolis, MN, USA

James A. Roelofse, M.B.Ch.B., M.Med. (Anes.) Professor of Anesthesiology Head of Sedation and Pain Control University of the Western Cape Department of Anesthesiology Tygerberg Hospital Bellville, Cape Province, South Africa Visiting Professor of Anesthesiology Director, Post-Graduate Certifi cate in Sedation and Pain Management University College London Visiting Professor of Anesthesiology

Epilogue

728

Khan University, Nairobi, Kenya President, Society of Sedation Practitioners of South Africa (SOSPOSA)

Joel S. Rosen, Esq. Partner Cohen, Placitella & Roth, P.C. Philadelphia, PA, USA

Cyril Sahyoun, M.D. Assistant Professor of Clinical Pediatrics Department of Pediatric Emergency Medicine Morgan Stanley Children’s Hospital of New York Columbia University Medical Center New York, NY, USA

Steven M. Selbst, M.D. Professor of Pediatrics Thomas Jefferson University Hospital Department of Pediatrics Nemours/Alfred I. duPont Hospital for Children and Jefferson Medical College Wilmington, DE, USA

Wang Ning ShangGuan, M.D., Ph.D. Associate Professor Department of Anesthesiology The 2nd Affi liated Hospital Wenzhou Medical University Wenzhou, Zhejiang, China

Devona J. Slater, C.H.A., C.H.C., C.M.C.P. President and Compliance Auditor Auditing for Compliance and Education, Inc. (ACE) Overland Park, KS, USA

Sulpicio G. Soriano, M.D. Professor and BCH Endowed Chair in Pediatric Neuroanesthesia Harvard Medical School Department of Anesthesiology, Perioperative and Pain Medicine Boston Children’s Hospital Boston, MA, USA

Michael J. Stabile, M.D., M.B.A. Chief, Department of Anesthesia Centennial Medical Center Nashville, TN, USA Cheif of Anesthesia, Operation Smile

Michael R.J. Sury, M.B.B.S., F.R.C.A., Ph.D. Consultant Pediatric Anesthetist Great Ormond Street Hospital for Children Honorary Senior Lecturer in Anaesthesia PORTEX Unit of Pediatric Anesthesia

Institute of Child Health University College of London London, England

Joss J. Thomas, M.B.B.S., M.P.H., F.C.C.P. Clinical Associate Professor of Anesthesia Department of Anesthesia University of Iowa Hospitals and Clinics Iowa City, IA, USA

Joseph D. Tobias, M.D. Chief, Department of Anesthesiology & Pain Medicine Department of Anesthesiology & Pain Medicine Nationwide Children’s Hospital Columbus, OH, USA

Johannes van den Anker, M.D., Ph.D. Professor, Department of Pediatrics, Pharmacology and Physiology Department of Pediatrics, Pharmacology and Physiology Children’s National Medical Center, Washington, DC, USA Intensive Care, Erasmus Medical Center-Sophia Children’s Hospital, Rotterdam, The Netherlands Department of Pediatric Pharmacology, University Children’s Hospital Basel, Switzerland

Gail A. Van Norman, M.D. Professor Anesthesiology and Pain Medicine Adjunct Professor Biomedical Ethics Department of Anesthesiology and Pain Medicine Department of Biomedical Ethics University of Washington Medical Center Seattle, WA, USA

Robert A. Veselis, M.D. Professor of Anesthesiology Weill Cornell Medical College Director, Neuroanesthesiology Research Laboratory Department of Anesthesiology/CCM Memorial Sloan Kettering Cancer Center New York, NY, USA

Pablo O. Sepúlveda Voullième, Dr. Med. Professor of Anesthesia Servicio de Anestesia Clinica Alemana Santiago Chile Santiago, Chile

Laszlo Vutskits, M.D., Ph.D. Staff Anesthesiologist and Senior Lecturer Department of Anesthesiology, Pharmacology and Intensive Care Department of Fundamental Neuroscience Geneva Neuroscience Center University of Geneva Geneva, Switzerland

Epilogue

729

Chunyan Wang, M.Med. Department of Anesthesiology Hong Kong University Shenzhen Hospital Shenzhen, Guangdong, China

Craig S. Webster , B.Sc., M.Sc. (Hon.), Ph.D. Senior Lecturer Centre for Medical and Health Sciences Education School of Medicine University of Auckland Auckland, New Zealand

Graeme S. Wilson Senior Specialist Department of Anaesthesia University of Cape Town, Red Cross War Memorial Children’s Hospital Rondebosch, Western Cape, South Africa

Stephen Wilson, D.M.D., M.A., Ph.D. Professor, University of Cincinnati Department of Pediatrics Medical Director, Division of Pediatric Dentistry Division of Pediatric Dentistry Cincinnati Children’s Hospital Medical Center Cincinnati, OH, USA

Ying Xu, Ph.D., M.D. Associate Professor Department of Anesthesiology Children’s Hospital of Chongqing Medical University Chongqing, Chongqing, China

Lynne P. Yao, M.D. Associate Director Offi ce of New Drugs Pediatric and Maternal Health Staff Center for Drug Evaluation and Research United States Food and Drug Administration (FDA) Silver Spring, MD, USA

Vivian Man-ying Yuen, M.B.B.S., F.A.N.Z.C.A., F.H.K.C.A., F.H.K.A.M. Consultant of University of Hong Kong Shenzhen Hospital Honorary Clinical Associate Professor Department of Anesthesiology University of Hong Kong Honorary Consultant Department of Anesthesiology Queen Mary Hospital Shenzhen, Guangdong, China

Epilogue

731K.P. Mason (ed.), Pediatric Sedation Outside of the Operating Room: A Multispecialty International Collaboration,DOI 10.1007/978-1-4939-1390-9, © Springer Science+Business Media New York 2015

Index

A Aartman, I.H. , 439 Abnormal airway anatomy , 61 Absalom, A.R. , 615–628 Abstral , 130 Accreditation Council for Graduate Medical Education (ACGME) ,

680 ACEP. See American College of Emergency Physicians (ACEP) Acetaminophen , 179, 265–266 Achondroplasia , 54 ACLS. See Advanced Cardiac Life Support (ACLS) Actiq , 130 Acupressure , 636–637, 640 Acupuncture , 502, 636

ear , 637 PC 6 , 638

Acute osteomyelitis , 476 Acute Physiology and Chronic Health Evaluation II (APACHE II) , 339 ADA. See American Dental Association (ADA) ADHD. See Attention defi cit hyperactivity disorder (ADHD) Adults

age-specifi c anxieties , 119 child to, development , 116 CNS physiology , 117–119 developmental changes , 114 drug pharmacokinetics , 122 fetal hemoglobin , 112, 115 heart , 114, 115 hematologic system development , 119 hepatic/gastrointestinal physiology , 120 larynx , 95–96 lung development , 111–112 metabolic needs , 114, 116 pharmacodynamics , 122 pressure–volume curves , 113 renal physiology, and fl uid and electrolytes , 119–120 respiratory physiology , 111–114 temperature regulation , 120–121

Advanced Cardiac Life Support (ACLS) , 20, 425 Advanced sedation , 28 Advanced trauma life support (ATLS) , 62 Adverse drug reaction , 52 Adverse effects , 186 Adverse Event Reporting Tool , 564, 565 Adverse events , 126, 127

anesthesia , 561 best practice guideline , 561 clinical parameters , 562 evidence-based practice guidelines , 562 intervention-based defi nition , 563 ISTF , 564 making sense of uncommon , 591–592

multicenter investigations ketamine , 564 propofol administration , 563 PSRC , 563

oxygen desaturation , 562 Quebec guidelines , 563, 564 rates , 561–562

estimation , 588 respiratory , 589 safety , 560–561 sedation , 560 stratifi cation , 560

AEP. See Auditory evoked potentials (AEP) Africa

certifi cation of sedation training , 525–526 child behavioral management , 530–531

protocol , 530 chronic shortage of anesthesiologists in , 525 demand for sedation , 524–525 ED procedural sedation , 529 health care practitioners , 525 health care professionals , 524, 526 ketamine usage , 524 mobile sedation practitioners, guidelines for , 527, 530 multimodal analgesia

with opioids , 534–535 without opioids , 535

pediatric dental model , 526 provision of sedation , 528 recovery and discharge , 528

protocol , 528 safe pediatric sedation, guidelines , 528 sedation models

combined , 527 dedicated sedationist model , 527 mobile sedationist model , 527 mobile sedation model , 527 operator-sedationist model , 527 sedation unit model , 526–527

sedation strategies intravenous route: single agent , 532–533 multimodal routes: drug combinations , 534 nasal route: drug combinations , 534 nasal route: single agent , 532 non-opioid analgesic combinations , 535 oral route: sedative and analgesic combination , 533–534 oral route: single agent , 531–532 rectal route: single agent , 532

selection, assessment, and preparation of patients , 528 survey on anesthesia services , 524

Agudelo, S.C. , 491 AHI. See Apnea-hypopnea index (AHI)

732

Airway anatomical differences , 111 management , 63 refl exes, protective NMDA antagonists , 397 resistance , 112

Alanto-occipital joint abnormalities , 61 Albanese, J. , 332 Albumen concentrations , 176 Alcohol , 3, 4 Alcohol abuse, psychiatric and behavioral disorders , 59 Aldrete scale , 501 Aldrete score , 79, 80, 500

characteristics , 81 as sedation scales , 76

Alfenta , 128 Alfentanil , 128, 719

dosing schedule , 534 response surface methodology , 187

Algil , 132 Allegaert, K. , 243–269 Allergy , 52 Allometry , 177, 178 Alodan , 132 Alpha-1 acid glycoprotein (AAG) concentrations , 176 Alpha 2 -adrenergic agonists , 513, 514

clonidine , 298 dexmedetomidine

effects , 299 loading dose , 300 mechanical ventilation , 299 pharmacokinetic profi le , 298–299 retrospective case series, infants , 300

physiologic effects , 298 Alpha-2 receptor agonists, PICU, Europe

benefi ts , 334 clonidine and dexmedetomidine , 333–334 dose escalation pharmacokinetic and pharmacodynamic study , 335

Alveolar, pharmacokinetics , 174–175 AMA. See American Medical Association (AMA) American Academy of Pediatric Dentistry (AAPD) , 18, 425

Frankl behavioral rating scale , 427 guidelines , 24 patient assessment tools , 426 sedation record consistent guidelines , 428

American Academy of Pediatrics and American Academy of Pediatric Dentistry (AAPAAPD) guidelines , 428–429

American Academy of Pediatrics (AAP) guidelines , 18–19, 227, 248 Committee on Drugs , 127 conscious sedation , 33 goals , 125–128 pediatric sedation defi nitions , 72 procedural sedation , 83 sedation record consistent guidelines , 428

American College of Emergency Physicians (ACEP) guidelines , 18, 21–24, 395, 560

Clinical Policy on Sedation , 43 NPO considerations , 23 procedural sedation , 83

American College of Gastroenterologists , 228 American Dental Association (ADA) guidelines , 24–25

CODA , 425 pediatric dentistry , 425

American Gastroenterological Association (AGA) , 359 American Medical Association (AMA) guidelines

CPT-4 reference book , 196 palliative sedation , 707

American Society of Anesthesiologists (ASA) guidelines , 18–20, 353, 371, 561

Current Year Relative Value Guide , 200 deep sedation , 199 fasting recommendations , 119–120 pediatric sedation defi nitions , 72, 73 procedural sedation , 83 training program in sedation , 126

American Society of Anesthesiology (ASA) guidelines , 56–57 Task Force on Fasting , 43

American Society of Gastroenterologists (ASG) , 25–26 American Society of Gastrointestinal Endoscopy (ASGE) , 359 Amethocaine. See Tetracaine Amidate , 130 Amling, J. , 305 Amnesia , 151–152

building block of , 158 drug-induced , 158–159

Analgesia , 36, 498, 715 services , 13–14

Analgesics, sedatives and alfentanil , 128 chloral hydrate , 128–129 codeine , 129 dexmedetomidine , 129 diazepam , 129–130 etomidate , 130 etomidate analogs , 130 fentanyl , 130 fospropofol , 130–131 ketamine , 131 ketofol , 131–132 lorazepam , 132 meperidine , 132 methohexital , 133 midazolam , 133 morphine , 133–134 nitrous oxide , 134 pentobarbital , 134–135 propofol , 135 remifentanil , 135–136 S-ketamine , 136 sufentanil , 136

Analgo-sedation , 330 chronic morphine exposure , 244 drug dosing , 245–246 effective management of pain , 246 epidemiological study , 244–245 inadequate analgesia , 244 inadequate management of pain , 246 morbidity and mortality , 245 neonatal analgo-sedation ( see Neonatal analgo-sedation) pain management , 244 verbalization , 245

Anand, K.J. , 244, 266, 340 Ancora, G. , 29 Ander, B.J. , 587–608 Anderson, B.J. , 173–188, 262 Andragogy , 676 Andropoulos, D.B. , 71–82, 111–122 Anestfusor simulator , 486, 489 Anesthesia , 3–4, 12–13

general, regional, and monitored , 199–200 induction of , 175 sedation vs. , 152–155

Index

733

Anesthesia assistant (AA) , 196 Anesthesia-directed sedation service

case studies burn injury , 239 multiple procedures sedation , 239 pulmonary function testing, infant , 238

non-anesthesia sedation providers airway skills training , 229 anesthesiology assistants , 228–229 ASA guidelines, statements, and education modules , 231 computer-assisted personalized sedation , 230–231 CRNAs , 229 objective risk assessment tool for sedation , 230, 231 sedation delivery , 228 Texas children’s hospital , 229–230

protocols development dexmedetomidine , 234–235 ketamine , 232–234 pentobarbital , 234 propofol , 235–236

United States , 227–228 University of Iowa

nursing-administered sedation program , 236–238 nursing-delivered propofol , 236

Anesthesiology assistants (AA) , 25, 228–229 Anesthetic conserving device (AnaConDa ® ) , 333 Anesthetic-induced developmental neurotoxicity (AIDN) , 554 Anexate , 136–137 Anghelescu, D.L. , 312 Anodyne imagery technique , 636 Antenex , 129–130 Anterior mediastinal mass , 101–102, 107 Anticipation , 378 Anticoagulants, CHD , 48 Antiemetics , 138–140 Anxiety

assessment , 657 levels , 657 during transport, case study , 640

Anxiolysis , 36, 84, 700 ANZCA guidelines. See Australian and New Zealand College

of Anaesthetists (ANZCA) guidelines Apnea , 57, 101, 104 Apnea-hypopnea index (AHI) , 55 Apoptosis , 514 Arderne, J. , 9, 10 Arenas-Lopez, S. , 298 Arginine vasopressin (AVP) , 50 Arnold, J.H. , 283, 302 Artifi cial somnambulism , 11 ASD. See Autism spectrum disorders (ASD) ASG. See American Society of Gastroenterologists (ASG) Aspiration, pre-sedation screening , 42 Association of Paediatric Anaesthetists (APA) , 467 Asthma, pre-sedation screening , 45–46 Ativan , 132 ATLS. See Advanced trauma life support (ATLS) Atomizers , 500 Atopic wheezers , 45 Atropine , 47, 401 Attention defi cit hyperactivity disorder (ADHD) , 59, 536–537 Auditory evoked potentials (AEP) , 77 Augmentative and alternative communication (AAC) , 669 Auricular acupressure , 637, 640 Australasian College for Emergency Medicine (ACEM) , 26, 505

Australia ANCA guidelines ( see Australian and New Zealand College

of Anaesthetists (ANZCA) guidelines) dental sedation , 515–516 emergency departments , 514–515 NICU

non-pharmacological management , 514 PAT , 514

non-pharmacological management , 517–518 PICU

common issues , 513 “KIDS SAFE” checklist , 513 management techniques and strategies , 513

RACP guidelines ( see Royal Australasian College of Physicians (RACP) guidelines)

Royal Children’s Hospital, Melbourne ( see Royal Children’s Hospital, Melbourne)

sedation of children with burns , 516–517 medical imaging , 516 oncologic procedures , 517 program development , 511–512

Australian and New Zealand College of Anaesthetists (ANZCA) guidelines

levels of sedation , 506 limitations , 508–509 safe procedural sedation and analgesia , 508 staffi ng requirements , 506, 507

Austrian Society of Gastroenterology and Hepatology (OGGH) , 28

Autism, case study , 221–222, 502–503 Autism spectrum disorders (ASD)

pre-sedation screening , 46–47 social communication , 668 social imagination , 668 social interaction , 668

Avicenna , 8 Avinza , 133–134 AVP. See Arginine vasopressin (AVP) Axelin, A. , 251

B Babl, F.E. , 505–520, 677, 718 Barbiturates , 387

pentobarbital infusion , 294 short-acting agents , 294 thiopental , 293–294 ultrashort-acting barbiturates , 294

Barton, W.P.C. , 12–13 Baseline cardiac evaluation , 62 Basic life support (BLS) , 425 Bayer, C.L. , 166 Beachamp, T. , 692 Becker , 53 Beddoes, T. , 11 Beers , 5 Beery, K.E. , 556 Behavioral disorders, pre-sedation screening , 59–60 Behavioral management

Africa , 530–531 case studies ,670–672

Bell, C. , 11 Belleville, J.P. , 300 Benadryl , 139

Index

734

Benzodiazepines , 25, 27, 332, 388, 498 diazepam , 284 effects on memory , 162–163 GABA receptor , 261 intranasal and sublingual administration , 285 lorazepam , 286 midazolam , 284–285

bioavailability , 261–262 opioid analgesia with , 513 pediatric GI , 355, 356 PICU, Europe

immunity , 336 prevention and treatment , 339 withdrawal , 340

prolonged and cumulative doses , 262 The Berlin Papyrus , 5 Best Pharmaceuticals for Children Act (BPCA) , 127, 545, 719 Billing and reimbursement, for sedation , 195–197

deep sedation , 199 evaluation and management services , 198–199 fee for services , 200 incorrect coding/documentation , 201–202 medical decision-making , 199 minimal sedation , 197 moderate sedation , 197–198 monitored anesthesia care , 199–200 patient history , 198 physical examination , 198–199 physician quality measure reporting , 200–201

Bioavailability, pharmacokinetics , 175 Bispectral Index (BIS) , 76–77, 247, 466, 645, 713

characteristics , 81 monitoring, pediatric GI , 359 physiological monitoring , 89–91 PICU, Europe , 338

Blood–brain barrier, pharmacokinetics , 176–177 Blood pressure ranges, different ages , 116–119 Blount, R.L. , 660 Blundell, J. , 10 Body composition, pharmacokinetics , 175–176 Body mass index (BMI), pediatric GI , 354 Body surface area (BSA), metabolism maturation , 177 Borland, L.M. , 61, 373 Bourgoin, A. , 290 Boyd, J. , 310 Boyle, R. , 10 BPCA. See Best Pharmaceuticals for Children Act (BPCA) BPD. See Bronchopulmonary dysplasia (BPD) Bradycardia , 61 Bradypneic hypoventilation , 88 Brain death , 704 Bray, R.J. , 292 Breach , 583 Brecelj, J. , 356 Brevital. See Methohexital British Society of Gastroenterology , 27 British Society of Paediatric Dentistry (BSPD) sedation

guideline , 436 Bronchial hyperreactivity, pre-sedation screening , 45 Bronchopulmonary dysplasia (BPD) , 47, 112 Brown-McDermott, N. , 280 Bruera, E. , 296 Brunow de Carvalho, W. , 490 Buktenica, N.A. , 556 Bunke, V. , 660 Bupivacaine , 176

Burns anesthesia-directed sedation service , 239 daily dressing change, case study , 538–539, 639 management , 516–517, 519–520

Butkovic, D. , 638 Butyrophenones , 297–298

C CAM. See Complementary and alternative medicine (CAM) CAMPIS-SF. See Child-adult medical procedure interaction

scale-short form (CAMPIS-SF) Canadian Consensus Guidelines , 27 Cannabinoid hyperemesis syndrome , 59 Cannabis , 6

C. indica , 4, 5 C. sativa , 6 inhalation of , 7

Capnography , 19, 81, 359, 714–715 Europe , 465–466 exceptions to , 20 level B recommendation , 22, 24 for procedural sedation , 78, 79 for prolonged cases , 25 United Kingdom National Audit Project , 465 ventilation monitoring , 86–89

Capp, P.L. , 491 CAPS. See Computer-assisted personalized sedation device (CAPS) Carbajal, R. , 244 Carboxyhemoglobin (COHb) , 85–86 Cardiology , 469–470 Cardiovascular physiology

child to adult , 116 heart rate and blood pressure , 116–117 innervation of heart , 115 neonate to older infant and child , 114–115

Carlson, D.W. , 207–224 Cassiodorus , 8 Cavaliere, F. , 295 CBT. See Cognitive behavioral therapy (CBT) CD. See Conduct disorder (CD) Ceelie, I. , 248, 265 Celiac disease, pediatric GI , 360–361 Center for Medicare and Medicaid Services (CMS) , 20, 195–196,

198, 229 Central DI , 50–51 Centralgin , 132 Central sleep apnea , 55 Central venous catheters (CVC) , 463 Centre for Resuscitation Education and Simulation Training (CREST)

course , 515 Cerebral oximetry, physiological monitoring , 91 Cerebral palsy (CP), pre-sedation screening , 47–48 Certifi cate of merit , 583 Certifi ed registered nurse anesthetist (CRNA) , 196, 229 Cerucal , 138–139 CF. See Cystic fi brosis (CF) Chang Chung-Ching , 4 Charaka Samhita , 4 Charles X (King of France) , 11 Chauliac, Guy de , 9 CHD. See Congenital heart disease (CHD) Chemistry, manufacturing, and control (CMC) , 548 Chen, M.I. , 680 Chen, X. , 497–503 CHEOPS. See Children’s Hospital of East Ontario Pain Scale (CHEOPS)

Index

735

Chernik, D.A. , 74 The Chester Beatty Papyrus , 5 Cheung, Y.M. , 77 Chiang, V.W. , 33–38 Child

to adult, development , 116 age-specifi c anxieties , 119 EEG during , 117 neonate to , 114–115

Child-adult medical procedure interaction scale-short form (CAMPIS-SF) , 660

Children’s Fear Survey Schedule-Dental Subscale (CFSS-DS) , 426, 439

Children’s Hospital of East Ontario Pain Scale (CHEOPS) , 658 Children’s Medical Center, sedation service in , 500–501 Childress, J.F , 692 China

pediatric sedation service Children’s Medical Center , 500–501 Chongqing Medical University , 499 Guangzhou Women Center , 500–501 survey , 498–499

publications on pediatric sedation in , 501–502 Chinese drug lore , 4 Chloral hydrate , 128–129, 258–260, 301, 386, 463, 500, 501, 511

dentistry , 431 neurotoxicity , 554–555 oral route , 531–532

Chongqing Medical University, sedation service in , 499 Choong, K. , 257 Chorney, J.M. , 657 Chrysostomou, C. , 301 Chung, F. , 55 Cignacco, E.L. , 251 Circulatory effects, NMDA antagonists , 396 Circumcision , 269 Civil Action , 578 Civil lawsuit , 583, 697 Clarke, W.E. , 13 Claro, M.C. , 490 Clinical application

alfentanil , 128 chloral hydrate , 129 dexamethasone , 140 dexmedetomidine , 129 diazepam , 130 diphenhydramine , 139 etomidate , 130 fentanyl , 130 fl umazenil , 137 fospropofol , 131 ketamine , 131 lidocaine , 137 lorazepam , 132 meperidine , 132 methohexital , 133 metoclopramide , 138 midazolam , 133 morphine , 134 naloxone , 137 nitrous oxide , 134 ondansetron , 138 pentobarbital , 134 propofol , 135 remifentanil , 136 scopolamine , 139

S-ketamine , 136 sufentanil , 136

Clinical microsystem , 590–591 Clinical monitoring , 27 “Clinical Policy: Procedural Sedation and Analgesia in the Emergency

Department,” 21 , 22 Clinical scoring systems

methadone , 306–307 OBWS , 304 opioids administration , 306 sedation withdrawal score , 303–304 weaning process , 306 Withdrawal Assessment Tool Version 1 , 304–305

Clonidine, PICU (Europe) context-sensitive half-lives effects , 334 dose-response , 334

Closed Claims Project , 561 Clysmatica nova (Elsholtz) , 10, 11 CMS. See Center for Medicaid and Medicare Services

(CMS); Center for Medicare and Medicaid Services (CMS)

CNS physiology , 117–119 Cocaine, psychiatric and behavioral disorders , 59 Cochrane meta-analysis , 262 Codeine , 129, 395 Coding

incorrect , 201–202 of moderate sedation services , 198

Cognitive behavioral therapy (CBT) , 666 Cognitive development

of child , 35 stages of , 36

COHb. See Carboxyhemoglobin (COHb) Cohen, L.L. , 660, 666 Cohen, S.L. , 571–584 Coleman, A. , 13 Colton, G.Q. , 13 COMFORT

scale , 74, 75, 81, 182 score , 248, 337–338

Comfort Assessment Tool for Sedation (CATS) , 713 Commission on Dental Accreditation (CODA) , 425 Complaint , 578 Complementary and alternative medicine (CAM) , 633

acupressure , 636–637 auricular , 637

acupuncture , 636 ear , 637 PC 6 , 638

anodyne imagery technique , 636 guided imagery , 635–636 hypnotherapy , 635 mind-body medicine , 633 music , 634 sucrose sucking , 639 types , 634

Complex forehead laceration , 411–412 Computer-assisted personalized sedation (CAPS) device , 230–231,

360, 720, 721 Computerized provider order entry (CPOE) , 606, 718 Computerized tomography (CT), oral contrast for , 43 Conduct disorder (CD) , 59 Confederation of Latin American Societies of Anesthesiologists

(CLASA) , 485–486 Confl icts of Interest , 578 Confusion assessment method (CAM) , 339

Index

736

Congenital heart disease (CHD) pre-sedation screening , 48–49 staging for infants and children , 48

Conscious memory , 155 building block of , 156–158

Conscious sedation , 18, 25, 84 defi nition , 27, 437–439, 467 dentistry , 434–435 elimination , 72 guidelines for , 33

Containment , 250–251 Context-sensitive half-time (CSHT) , 184–185, 330–331, 621–622 Continual monitoring , 20 Continuous positive airway pressure (CPAP) , 103, 245, 255 Contraindications

alfentanil , 128 chloral hydrate , 129 dexamethasone , 139 dexmedetomidine , 129 diazepam , 129–130 diphenhydramine , 139 etomidate , 130 fentanyl , 130 fl umazenil , 137 fospropofol , 131 ketamine , 131 lidocaine , 137 lorazepam , 132 meperidine , 132 methohexital , 133 metoclopramide , 138 midazolam , 133 morphine , 134 naloxone , 137 nitrous oxide , 134 ondansetron , 138 pentobarbital , 134 propofol , 135 remifentanil , 135 scopolamine , 139 S-ketamine , 136 sufentanil , 136

Cooper, J.B. , 603 Corah’s dental anxiety scale , 439 Cordero, L. , 249 Cordus, V. , 9 Corff, K.E. , 251 Costa, L.R. , 423–453, 491 Costantini, M. , 700 Cote, C.J. , 35, 55 Cote, G.A. , 354 Courville, C.B. , 13 CP. See Cerebral palsy (CP) CPAP. See Continuous positive airway pressure (CPAP) CPOE. See Computerized provider order entry (CPOE) Craniofacial morphology , 103 Cravero, J.P. , 17–30, 76 Cravero’s model, of pediatric sedation , 71, 72 Credentialing , 21

hospitalists , 209–210 national standards for , 212

CREST course. See Centre for Resuscitation Education and Simulation Training (CREST) course

Crew resource management (CRM) , 596 Criminal negligence , 583, 697 Crisis Resource Management (CRM) , 676

CRNA. See Certifi ed registered nurse anesthetist (CRNA) Cunliffe, M. , 340 Cunnington, P.M.D. , 657, 668 Curley, M. , 305 Current Procedural Terminology (CPT ® )

CPT-4 reference book , 196, 197 procedure code , 200

Cutaneous, pharmacokinetics , 174 CVC. See Central venous catheters (CVC) Cystic fi brosis (CF) , 112

pre-sedation screening , 48–49

D da Costa, P.S.S. , 485–494 da Silva, L.P.S. , 490 da Silva, P.S. , 491 Daedalon , 139 Dalziel, S.R. , 505–520 Darnell, C. , 335 Dartmouth , 81 Dartmouth Operative Conditions Scale , 75–76 Davidson, A. , 643–653 Davy, H. , 11, 12 Dawson, D. , 595 de Benedetto, M.A.C. , 703 de Kock, M. , 530, 532–535 de Laguna, A. , 9, 10 de Puysegur, M. , 11 Decadron , 139–140 Dedicated sedationist model , 527 Deep continuous sedation (DCS)

AMA guidelines , 707 defi ning death , 704–705 epidemiology , 701–702 euthanasia , 703–704 existential suffering and transcendence , 702–703 initiation, recommendations , 707–708 KNMG sedation scale , 708 legal precedents and physician attitudes , 706 palliative sedation therapy , 707, 708 principle of double effect and , 705 professional societies and opinions , 706–707 proponents of , 704 RASS , 708 symptom-specifi c therapy , 707 time to death after institution of , 706 for treatment of existential suffering , 708 and withdrawal of hydration and nutrition , 706

Deep sedation , 18–19, 84 billing and reimbursement , 199 defi nition , 72, 438–439, 467, 473 ED, staffi ng , 376 ketamine dosing schedules , 400 ketamine + midazolam

fentanyl technique , 405 ketamine technique , 405–406 patient safety , 405 pre-sedation assessment and preparation , 405

monitoring and equipment , 377 requirements , 24 training hospitalists for , 208 in United States , 209–210 vital signs , 85

Defendant , 580 Defense , 583, 697

Index

737

Deformation , 60 Degan , 138–139 Deitch, K. , 714 Delirium

PICU, Europe characteristics , 340 critically ill patient , 339 haloperidol and benzodiazepines , 339 incidence , 340 neurotransmitters role , 339

PICU, United States CAM-ICU , 308–309 classifi cation , 307 diagnosis , 308 intensive care delirium screening checklist , 308 pathophysiology , 309–310 pediatric confusion assessment method , 308, 310 prevention and treatment , 310–311 risk factors , 308–309

della Porta, Giambattista , 9 Demerol. See Meperidine Denson, J.S. , 675 Dental sedation

in Australia and New Zealand , 515–516 Europe , 471

Deontology , 693 Department of Anesthesiology , 21 Designer drugs, psychiatric and behavioral disorders , 59 Developmental delay, pre-sedation screening , 46–47 Dexamethasone , 139–140 Dexdor , 129 Dexmedetomidine , 90, 127, 129, 174, 179, 263–264, 500, 502

anesthesia-directed sedation service , 234–235 cardiovascular effects of , 513 case study , 166–167 clearance , 179 effects on memory , 163 FDA , 548 intravenous route , 532 neurotoxicity , 556 OSA , 56 pediatric GI , 358 pediatric hospital medicine service , 219 pharmacodynamics , 618 PICU, Europe

context-sensitive half-lives effects , 334 dose fi nding study , 334–335 international multicenter study , 334 licensing processes , 334 rescue treatment , 335

PICU, United States , 312 DHM , 139 Diabetes insipidus (DI) , 49 Diabetes mellitus (DM), pre-sedation screening, 49Diaz, S.M. , 298 Diazepam , 129–130, 174, 389, 498

pediatric GI , 355 rectal route , 532

Dimedrol , 139 Dioscorides , 8 Diphenhydramine , 139 Diprifusor ® , 626 Diprivan , 135 Discharge scales , 78–81 Discharge scores, sedation scales and , 80–81 Discharge/transfer criteria , 214 Dispadol , 132

Displaced metaphyseal fractures fasting status , 407 pain relief

fentanyl intranasally , 407 nitrous oxide , 407 opioids intravenously , 407 oxycodone orally , 406–407

PSA techniques anesthesia reduction , 409 fentanyl + midazolam , 409 ketamine IV , 408 nitrous oxide plus lidocaine fracture hematoma block , 407

Disruption , 60 Dissociative effects, NMDA antagonists , 397 Dissociative sedation , 28, 84, 468, 473 Distal forearm fracture, case study , 475–476 Distal radius fracture

pain relief , 409 PSA technique options , 409

Distress and interactions assessment , 658, 660 Dixon, W.J. , 185 DM. See Diabetes mellitus (DM) DMD , 53 Dolantin , 132 Dolestine , 132 Dolosal , 132 Dolsin , 132 Dormicum , 133 Dose selection , 182 Douleur Aiguë du Nouveau-né (DAN/EDIN) score , 247–248 Down syndrome , 60, 62, 477–479 DPH , 139 Drug

additional pharmacologic effects , 127 alternate sites of administration , 127–128 allergy , 52 off-label use , 127 psychotropic , 128 reversal agents , 128 for sedation , 126–127 selection and administration , 126 stacking , 126

Drug development, FDA application , 544–545 chemistry, manufacturing, and controls , 548 clinical trials , 549 ethics , 549 extrapolation , 550 nonclinical studies , 548–549 “off-label” use , 545 pharmacokinetics and pharmacodynamics , 549–550 phases , 544

safety and effi cacy studies , 550–552 Drug-induced amnesia, mechanistic implications , 158–159 Drug-induced hypoventilation , 88 Drug interactions , 186–187 Drug intolerance , 52 Drug metabolism, pharmacokinetics , 177 Drug pharmacokinetics , 122 Duchenne and Becker MDs , 53 Duhigg, C. , 329 Dunbar, A.E. , 267 Duragesic , 130 Durogesic , 130 Duthie, D.J.R. , 287 Dysplasia , 60

Index

738

E Ear acupuncture , 637 EAS. See Emotionality, activity and sociability scale (EAS) Ebbinghaus, H. , 158 Ebers medical papyrus , 5 ECF. See Extracellular fl uid (ECF) Echelle Douleur Inconfort Nouveau-Né (EDIN) , 261 Echocardiogram , 53 ECMO. See Extracorporeal membrane oxygenation (ECMO) Edwin smith papyrus , 5 EEG. See Electroencephalography (EEG) Egyptian medicine , 5–7 Ekbom, K. , 469 Elam, J. , 675 Electrical velocimetry measurements , 91 Electrocardiogram (ECG)

mitochondrial disease , 52 monitoring, continuous , 89

Electroencephalography (EEG) , 182 Europe , 466 procedural sedation , 89, 91 sedation scale , 71

Electrolytes , 119–120 Electronic medical records (EMR) , 578 Electronic monitoring , 85 Elitsur, Y. , 357 Elliotson, J. , 11 Elsholtz, J.S. , 10 Ely, E.W. , 308 Emergency department (ED)

in Australia and New Zealand , 514–515 Europe , 463, 464, 470 PSA ( see Procedural sedation and analgesia (PSA))

Emergency medical care, Europe , 470 Emergency Medical Service (EMS) , 573

nonhospital facilities , 34–35 Emergency Medical Systems (EMS) , 19 Emesis , 383 EMLA. See Eutectic mixture of local anesthetics (EMLA) Emotionality, activity and sociability scale (EAS) , 660, 661 EMS. See Emergency Medical Systems (EMS) Endocrinopathies, pre-sedation screening , 49–50 End-of-life care , 700 Endoscopic mucosal resection (EMR) , 352 Endoscopic procedures, GI

bispectral index monitoring , 359 capnography , 359 CAPS system , 360 patient-controlled sedation and analgesia , 359–360 pulse oximetry , 359 SEDASYS ® system , 360

Endoscopic retrograde cholangio-pancreatography (ERCP) , 352, 359 Endotracheal intubation

non-pharmacological interventions , 268 pharmacological interventions , 269

Endotracheal suctioning , 249 End-tidal CO 2 capnography , 377 Enteral administration, pharmacokinetics , 174 Entropy monitoring , 89, 90 Enzyme maturation , 179 The Erman Document , 5 Esdaile, J. , 11 Ether , 9 Etomidate , 130, 431

CNS dynamics and myocardial function , 288 CORTICUS trial , 287–288

dose-dependent depressant effect , 287 effects on memory , 164–165 HYPOLYTE study , 288 intravenous infusions , 617 myocardial function , 287 non-analgesic sedative agents , 391–392 pediatric-aged patients , 287 thrombophlebitis development , 288

Etomidate analogs , 130 Europe

anesthesia services , 464–465 challenges and setbacks , 465 cultural aspects, diversities, and inconsistencies within , 462–464 demand for PSA , 462 health-care providers , 462 health-care settings , 462 high-quality service , 462 monitoring practices

capnography , 465–466 EEG , 466

NICE guideline , 466, 471, 472 nitrous oxide usage , 463–464 non-anesthesia practitioners , 465 OEL , 464 practice standards implementation , 468 sedation

algorithm and pathway procedures , 472 care, ethical and legal aspects , 467 delivery, fi nancial aspects , 468–469

sedation defi nitions conscious sedation , 467 deep sedation , 467 dissociative sedation , 468 moderate sedation , 467 relative analgesia , 468

sedation practice procedure dentistry , 471 emergency medical care , 470 gastroenterology , 470 interventional radiology and cardiology , 469–470 oncology , 470 painless imaging , 469

SIGN , 466 training and credentialing, inconsistency , 468

European Academy of Pediatric Dentistry (EAPD) guidelines, dendistry , 438

European Pediatric Association (EPA) , 467 European Society for Pediatric Anesthesiology (ESPA) , 466 European Society for Pediatric Research (ESPR) , 467 European Society of Anesthesiology (ESA) guidelines , 29, 466 European Society of Gastroenterology and Endoscopy Nurses

and Associates , 29 European Society of Gastrointestinal Endoscopy , 29 Eutectic Mixture of Local Anesthetics (EMLA) , 253–254, 469, 514 Euthanasia , 703–704 Evidence-based guidelines, ACEP , 22 Extracellular fl uid (ECF) , 175 Extracorporeal membrane oxygenation (ECMO) , 513 Extrapolation, Food and Drug Administration , 550 Ezfusor , 486

F Face, legs, activity, cry, and consolability scale (FLACC) , 658, 659, 661 Facial image scale , 440 Failed sedation , 28

Index

739

Failure mode and effect analysis (FMEA), sedation safety , 601 Faraday, M. , 13 Farnsworth, S.T. , 677 Fassoulaki, A. , 293 “Fasting and Emergency Department Procedural Sedation and Analgesia:

A Consensus Based Clinical Practice Advisory,” 22 Fasting guidelines, and sedation , 43–45 FDA. See Food and Drug Administration (FDA) Fearon, I. , 251 Federal Aviation Authority (FAA) , 718 Feed-and-scan approach , 259 Feed-and-wrap strategy , 259 Fee for services , 200 Fehr, J.J. , 675–683 Fentanil , 130 Fentanyl , 130, 260, 430, 511

airway complications , 511 high-dose , 514 intranasal , 509, 515 intravenous infusions , 617 pediatric GI , 355 pediatric hospital medicine service , 215 sedative-analgesic agents

contraindications/cautions/adverse effects , 393 deep sedation , 405 dosages , 393 fentanyl plus midazolam , 393–394 indications , 392–393 mechanism of action , 394 metabolization , 394

Fentora , 130 Ferrari, L.R. , 95–108 Finn, M. , 13 Fischer, E. , 12 FLACC. See Face, Legs, Activity, Cry, and Consolability Scale

(FLACC) Fluid requirements , 119–120 Flumazenil , 136–137, 380 Fonsmark, L. , 302 Food and Drug Administration (FDA)

drug development application , 544–545 chemistry, manufacturing, and controls , 548 clinical trials , 549 ethics , 549 extrapolation , 550 nonclinical studies , 548–549 “off-label” use , 545 pharmacokinetics and pharmacodynamics , 549–550 phases , 544 safety and effi cacy studies , 550–552

FD&C Act , 543 off-label use , 127 pediatric GI , 360 pediatric legislation

common sedatives and use , 546–547 dexmedetomidine , 548 FDAMA , 545 lorazepam and ketamine , 548 Pediatric Research Equity Act , 545, 548

pharmaceutical pregnancy categories , 57, 58 Food and Drug Modernization Act of 1997 (FDAMA) , 545 Food, Drug, and Cosmetic (FD&C) Act , 543 Forbes, C. , 660 Forbes, G.M. , 356 Formulary , 128 Fospropofol , 130–131, 719

Fractal geometry , 177 Franck, L.S. , 304, 305 Frankl behavioral rating scale , 427, 439 FRC. See Functional residual capacity (FRC) Frobenius, W.G. , 9 Froom S.R. , 338 Frugardi, R. , 9 Fuchs, D.C. , 310 Functional residual capacity (FRC) , 112, 174

G GA. See General anesthesia (GA) Gaba, D.M. , 676 Gabriel, M.A. , 251 Galen , 8 Gallardo, F. , 490 Gamma amino butyric acid (GABA) , 152–153, 163–165, 554, 555 Gana A.J.C. , 490 Garetti, E. , 29 Gaskell, S. , 668 Gastric emptying , 174 Gastric fl uid volume (GFV) , 43 Gastroenterology

Europe , 470 pediatric gastrointestinal (GI) procedures , 362

Gastrointestinal endoscopy, in anxious child , 479–480 Gastrointestinal physiology , 120 Gastrointestinal (GI) procedures

gastroenterology , 362 sedation recommendations for , 474

Gauss, C.F. , 13, 14 Gawande, A. , 595 GCP. See Good clinical practice (GCP) GEMS. See Generic error-modeling system (GEMS) General anesthesia (GA) , 26, 84

administration of , 197 conscious sedation and , 436 defi nition , 72, 468 for dentistry , 436 premedication prior to , 436–437

General Dental Council (GDC), dentists authority , 435 Generic error-modeling system (GEMS) , 593 Gerard , 9 German Society for Digestive and Metabolic Diseases , 29 Gersdorff, H. von , 9 GFR. See Glomerular fi ltration rate (GFR) GFV. See Gastric fl uid volume (GFV) Ghanta, S. , 255 Ghoneim, M.M. , 635 Gill, M. , 280 Glomerular fi ltration rate (GFR) , 179–180 Glover, R. , 13 Glucocorticoids , 50 Glycopyrrolate , 47

NMDA antagonists , 401 Godoy, L.M. , 492 Gómez, L.M.B. , 492 Good clinical practice (GCP) , 651, 652 Gray, R. , 530, 532–535 Greek medicine , 6–8 Green, G.M. , 564 Green, S.M. , 78, 230, 468, 561, 713 Grunting , 100 Guangzhou Women Center, sedation service in , 500–501 Guide for Sedation of the Royal Dutch Medical Association (KNMG)

sedation scale , 708

Index

740

H Haberland, C.M. , 76 Hallucination , 3–4 Halothane , 180 Harrison A.M. , 297 Harris, S. , 305 Hartwig scale , 338 Hawthorne effect , 645 Health Insurance Portability and Accountability Act of 1996 (HIPAA) ,

195 Hearing impairment, case study , 503 Hearst, D. , 655–672 Hearst medical papyrus , 5 Heart, innervation of , 115 Heart rate , 247–248, 263

at different ages , 116–119 Hebb, D.O. , 156 Hebbian learning , 156 Heel lancing , 253 Heinrich, H.W. , 600 HELPinKIDS program , 268 Hematologic system development , 119 Hemodynamic monitoring , 89 Hemorrhagic shock classifi cation , 62 Henderson, K. , 35 Hepatic elimination, pharmacokinetics , 179 Hepatic physiology , 120 Herodotus , 7 Hess, D.R. , 87 Hickman, H.H. , 11, 12 Hilary , 8 Hill, S. , 251 Hindu drugs , 4–5 Hippocampus , 156 Hippocrates , 6, 8 Hoffman, G.M. , 528, 604, 606 Holzman, R.S. , 3–14 Homicide , 583, 688, 697 Hopkins, J. , 14 Horeczko, T. , 41–66 Hosey, M.T. , 423–453 Hospitalist-run sedation service

medical evaluations , 211–212 staffi ng , 210–211 triaging patients , 211

Hua Tuo , 4, 5 Hugh of Lucca , 9 Hull, C.J. , 186 Hume-Smith, J. , 257 Hydronephrosis , 223 Hydroxyzine , 430, 431 Hyoscine , 139 Hyoscyamus , 5 Hyperextension, of neck , 54 Hyperthermia, prevention , 120–121 Hyperthyroidism , 50 Hyperventilation , 87–88 Hypnosis , 11, 633, 666–667 Hypnotherapy , 635 Hypnotic trance , 635 Hypnovel , 133 Hypoglycemia, mitochondrial disease , 51 Hypoplastic left heart syndrome , 66 Hypopnea , 104 Hypopneic hypoventilation , 88–89 Hypothyroidism, adverse effects of , 50

Hypoventilation/apnea , 259 Hypoxemia , 100 Hypoxia , 471, 714

I ICC. See Induction compliance checklist (ICC) Idiopathic scoliosis , 54 ILCOR. See International Liaison Committee on Resuscitation

(ILCOR) Immunity , 336–337 Ince, I. , 262 Indemnity , 583 Induction compliance checklist (ICC) , 660, 661 Inebriation , 3–4 Infancy, EEG during , 117 Infant

age-specifi c anxieties , 119 brain growth and development , 117–118 cerebral autoregulation , 117 developmental changes , 114 fetal hemoglobin , 112, 115 glucose requirement , 120 larynx , 95–97, 100, 101, 111 lung and chest , 112 neonate to , 114–115 pressure–volume curves , 113 respiratory physiology , 111–114 tongue , 111 upper respiratory infections , 113

Infant-Centered Care index (ICC) , 266 Infant Pain Management index (IPM) , 266 Informed consent , 583–584, 697

medicolegal risks , 576–577 Inhalational anesthetic agents , 165–166, 264

advantages , 283–284 AnaConDa ® , 284 desfl urane , 283 halothane , 282 hepatitis , 283 intracranial pressure , 283 isofl urane , 283 metabolism , 283

Inhalational sedation , 333 Inhalation sedation , 27 Inouye, S.K. , 310 Insomnia , 692 Instanyl , 130 Institutional Review Board (IRB), off-label use , 127 Intellectual disability, pre-sedation screening , 46–47 International Association of Paediatric Dentistry (IAPD) , 434 International guidelines, for sedation , 26–30 International Liaison Committee on Resuscitation

(ILCOR) , 535 International Sedation Task Force (ISTF) , 564, 718–719 Interpretative Guidelines , 196 Interventional radiology, Europe , 469–470 Intoxication , 3–4 Intramuscular route, pharmacokinetics , 174 Intravenous infusions

fentanyl , 617 half-life , 619 intravenous route of administration , 615–616 pharmacodynamics , 616, 617

dexmedetomidine , 618 propofol , 617–618

Index

741

pharmacokinetic models for propofol Kataria and Paedfusor models , 622 Marsh model , 622 Paedfusor model , 623

pharmacokinetics , 616, 617 compartmental model , 618, 619 fi rst-order process , 619 rate of change , 619

propofol infusion deep sedation regimen , 624 infusion regimens for dexmedetomidine , 624–625 PK models for dexmedetomidine , 624 repeated boluses , 623

target controlled infusions blood-targeted TCI systems , 627–628 closed loop control system , 628 defi nition , 625 drug interactions , 627 open TCI initiative , 627 PMS system , 628 predictive performance , 626–627 principles , 625–626 propofol target concentration , 626 rationale for , 625

time and rate constant , 619 volume of distribution

CSHT , 621–622 single compartment pharmacokinetic model , 620 three compartment models , 620–621

Intravenous sedation , 27, 590 Intubation-surfactant-extubation (INSURE) , 258, 266 Investigational new drug (IND) application , 544 Involuntary manslaughter , 583, 697 IRB. See Institutional Review Board (IRB) Irwin, M.G. , 497–503 Islamic medicine , 8 Isofl urane , 333 Isonipecaine , 132 Ista, E. , 278, 303, 304, 340 ISTF. See International Sedation Task Force (ISTF)

J Jackson, M. , 685–697 Jain, A. , 254 James, R. , 592 Jefferson, T. , 13 Jeleazcov, C. , 186 Jenkins, I.A. , 329–344 Jewish medicine , 5 Johnston, C. , 251 Joint Commission guidelines , 19, 21

defi nitions of pediatric sedation , 72 medicolegal risks , 574, 575 moderate and deep sedation , 209 physiological monitoring , 84

Joint Commission International (JCI) , 500 Jury verdict , 584

K Kabalak, K.K. , 638 Kaddu, R. , 357 Kadian , 133–134 Kahun papyrus , 5 Kain, Z.N. , 163, 469 Kalra, S. , 354

Kangaroo care , 252 Kanmaz, H.G. , 269 Kantovitz, K.R. , 491 Kapanol , 133–134 Kataria, B.K. , 622, 623, 626–628 Kataria model , 532 Katz, R. , 303 Keidan, I. , 259, 677 Kellehear, A. , 702 Kennedy, R.M. , 367–413 Ketadex, NMDA antagonists , 402 Ketalar , 131, 136 Ketamine , 131–132, 174, 256, 332–333, 508

adverse events , 564 anesthesia-directed sedation service

contraindications , 232 intravenous ketamine protocol , 232, 233 propofol vs. propofol-ketamine , 232

benefi cial properties , 289 bolus dosing , 290 case study , 167 CNS effects , 290 deep sedation , 405–406 dissociative anesthesia , 288 dosing schedule , 533 effects on memory , 163–164, 166 in emergency department , 22, 24 Food and Drug Administration , 548 interventional radiology , 469 intravenous route , 532 metabolism , 288–289 NMDA antagonists , 395–396 opioid and NMDA receptor , 289 oral route , 533 OSA , 56 PaCO 2 control , 289 pediatric GI , 355–356 pediatric hospital medicine service , 214–215 PICU, United States , 312 rectal route , 532 sedation , 90

Ketanest , 131, 136 Ketaset , 131, 136 Ketofol , 131–132, 187

dosing schedule , 534–535 NMDA antagonists , 401–402

Knape, J. , 473, 474 Kochhar, G. , 354 Koroglu, A. , 299, 624 Kraemer, F.W. , 61 Krauss, B. , 468 Krauss, B.S. , 83–92 Kress, J.P. , 331 Kronig, B. , 13, 14 Kruger-Thiemer, E. , 625 Kuhnle, G.E. , 92 Kulling, D. , 359 Kurth, C.D. , 58

L Labial abscess, case study , 222–223 Lago, P. , 29 Laguna, Andres de , 9, 10 The Lancet (Hickman) , 11 Lanexat , 136–137 LaPierre, C.D. , 676

Index

742

Largus, Scribonius , 8 Larsson, B.A. , 249 Larsson, P. , 262 Laryngeal mask airway (LMA) , 47, 104–106 Laryngomalacia , 100 Laryngospasm , 215

low-dose succinylcholine , 382–383 recognition , 381 risk factors , 381 treatment algorithm , 381–382

Larynx, infant/adult , 95–97, 100, 101 Le Guen, M. , 381, 720 Lebovic, S. , 289 Legal consequences, of incorrect coding/documentation ,

201–202 Leg pain, case study , 518–519 Lemyre, B. , 254 Lerman, J. , 339 Leroy, P.L.J.M. , 461–480 LES. See Lower esophageal sphincter (LES) Leukemia, case study , 477–478 Levo-duboisine , 139 Li, B.-L. , 497–503 Liaw, J.J. , 251 Lidocaine , 137–138

buffering injected , 368–369 Lidol , 132 Liebreich, M. , 13 Light anesthesia , 468 Lightdale, J.R. , 78, 351–362 Light sedation/anxiolysis , 473 Lignocaine , 137–138 Lima, A.R. , 490 Lin, Y.-C. , 633–640 Lind, B. , 674 Link, E. , 674 Liquors , 4 Litman, R.S. , 259 Liu, N. , 628 LMA. See Laryngeal mask airway (LMA) Local anesthesia

for dentistry , 435 EMLA , 253–254 heel lancing , 253 hepatic metabolism , 253 lumbar puncture , 253 procedural sedation and analgesia

buffering injected lidocaine , 368–369 distress, psychological interventions , 369 goal of pediatric , 369–370 postponement , 369 topical anesthetics , 368

tetracaine effects , 254 venipuncture , 253

Local anesthetics , 137–138, 498 Locock, C. , 13 Locus ceruleus , 152, 153, 163 Logistic regression model , 185 The London Papyrus , 5 Long, C.W. , 13 Long-term memory , 158–159 López, M.E.B. , 490 Lorazepam , 132, 548 Lower esophageal sphincter (LES) , 43 Lugo, R.A. , 306 Lullus, R. , 9

Lumbar puncture , 253 Lungs, respiratory physiology , 111–113 Lusedra , 130–131 Lymphangioma, parotid cystic , 503

M MAC. See Minimal alveolar concentration (MAC); Monitored

anesthesia care (MAC) Mace, S.E. , 386 Magendie, F. , 11 Magnetic resonance enterography (MRE) , 352 Magnetic resonance imaging (MRI)

dexmedetomidine sedation , 166–167 in 10-month-old baby , 476–477

Magnetoencephalography (MEG) scan , 64–65 Mahmoud, M. , 41–66 Maintenance of Certifi cation in Anesthesia (MOCA) program , 680 Maintenance of Wakefulness Test , 79 Malformation , 60 Mallampati classifi cation

of pharyngeal structures , 60, 61, 98 pre-sedation patient assessment , 371–372

Malpractice , 584, 697 Malviya, S. , 74, 76, 80, 280 Marijuana, psychiatric and behavioral disorders , 59 Marsh, B. , 622 Martinbiancho, J.K. , 491 Mason, K.P. , 76, 230, 300, 561, 624, 713 Mathis, L.L. , 543–552 Matínez, C.R. , 490 Maturation, metabolism , 177–179 Maurer, W. , 354 Maxeran , 138–139 Maxolon , 138–139 Mayberg, T.S. , 290 Mazicon , 136–137 Mcculloch, A. , 356 MCDAS. See Modifi ed child dental anxiety scale (MCDAS) McKenzie, I. , 505–520 McMurtry, C.M. , 657 MCUs. See Micturating cystourethrograms (MCUs) MDAS. See Multiple drug allergy syndrome (MDAS) MDIS. See Multiple drug intolerance syndrome (MDIS) Medical ethics

Michael Jackson death case benzodiazepine effect , 687 cardiac arrest , 685–686 criminal negligence , 688–690 deontologic ethical theory , 693 ethical principles in medical care , 692 involuntary manslaughter , 686, 688, 689, 694 legal vs. professional standards and ethics , 686 medication and medical equipment , 687 Murray, Conrad, Dr. , 686–688, 691–692 Murray–Jackson relationship , 692 nonmalefi cence , 693–694 practice of medicine , 691–692 principle of benefi cence , 693 professionalism and , 690–691 propofol effect , 690, 692 prosecution , 688, 689 respect for autonomy , 692–693 standard of care , 689–690 voluntary manslaughter , 688

The People v. Stanley Burroughs , 688, 689, 695

Index

743

routine screening colonoscopy case , 694 legal analysis , 695 professionalism and ethics , 695–696

Medical simulation, for sedation , 677–678 advanced training , 679 andragogy , 676 CRM , 676 education , 676, 677 equipment , 681 future trends , 679–680 history , 675–676 initial training , 678–679 mannequin , 675, 678 onsite simulation setup , 681 patient safety , 679 safety and training , 676–677 scenario , 680–681

actions, template , 682 completion checklist , 682 participant assessment scale , 683

Medicare program , 195–196, 198 Medicare RBRVS , 200 Medications, pediatric hospital medicine service , 214 Medicolegal risks

adverse outcomes , 572, 573 clinician’s communication , 576, 577 contact an attorney , 578–579 documentation , 577 illinois emergency department , 579 informed consent , 576–577 litigation , 579

prevention , 572 medical records , 578 quality improvement , 579 sedation process

clinical guideline , 575–576 complication , 578 medication error , 574 policies and protocols , 575 post-sedation/discharge , 574 pre-sedation evaluation/decisions , 573–574

standard of care , 572 time-based record , 577

Medieval medicine , 8–9 Mefedina , 132 MEG scan. See Magnetoencephalography (MEG) scan Mehler, K. , 602 Mehta, P.P. , 354 Memory , 151–152

conscious ( see Conscious memory) decay curves , 160, 161 defi nition , 155–156 impairment , 163 regions of brain , 157 unconscious mind , 159

Mencken, H.L. , 341 Mendez, S.S. , 207–224 Meperidine , 60, 132

dentistry , 430, 431 sedative-analgesic agents , 394

Merazzi, D. , 29 Merry, A.F. , 587–608 Mesmer, F.A. , 11, 12 Mesmerism , 11 Metabolism maturation, pharmacokinetics , 177–179 Metabolites, pharmacokinetics , 180

Methemoglobin (MetHb) , 85–86 Methohexital , 133, 387 Methohexitone , 133 Methoxyfl urane , 508, 519 Metoclopramide , 138–139 Mialgin , 132 Michigan Sedation Scale , 338 Micky Finn , 13 Micturating cystourethrograms (MCUs) , 516 Midazolam , 133, 162–163, 331, 388–389, 498, 512

case study , 167–168 dentistry , 431 dosing schedule , 532 immunity , 336 intravenous route , 532 memory decay , 158 oral route , 532 pediatric GI , 355 pediatric hospital medicine service , 215 rectal route , 532

Midface abnormalities , 61 Mid-latency auditory-evoked potentials (MLAEPs) , 714 Milner, B. , 156 Mind-body medicine , 633 Miner, J.R. , 711–721 Minimal alveolar concentration (MAC) , 181, 185 Minimal anesthesia , 468 Minimal sedation , 84

billing and reimbursement , 197 defi nition , 72, 438

Minto, C.F. , 186 Mitochondrial disease (MD) , 50–52 MLAEPs. See Mid-latency auditory-evoked potentials (MLAEPs) MMWT. See Modifi ed Maintenance of Wakefulness Test (MMWT) MOAA/S. See Modifi ed Observer Assessment Sedation Score

(MOAA/S) Mobile sedationist model , 527 Mobile sedation model , 527 Mobile sedation practitioners , 530 Moderate sedation , 25, 84

billing and reimbursement , 197–198 defi nition , 72, 438, 467, 473 monitoring and equipment , 377 staffi ng , 376 training hospitalists for , 208 in United States , 209–210

“Modifi cations in Endoscopic Practice for Pediatric Patients” , 25 Modifi ed Aldrete score , 79, 80

characteristics , 81 as sedation scales , 76

The Modifi ed Behavioral Pain Scale (MBPS) , 264 Modifi ed child dental anxiety scale (MCDAS) , 439, 440 Modifi ed Maintenance of Wakefulness Test (MMWT) , 79, 81 Modifi ed Observer Assessment Sedation Score (MOAA/S) , 74, 81 Modifi ed yale preoperative anxiety scale (m-YPAS) , 660, 661 Monitored anesthesia care (MAC) , 20, 196, 228

deep sedation , 199 informational modifi ers , 200

Monitoring, pediatric hospital medicine service , 213–214 Moreira, T.A. , 491 Morphine , 133–134, 179

pharmacokinetic observations , 260 PICU, Europe , 331 postoperative analgesia , 260–261 routine use , 261 sedative-analgesic agents , 394

Index

744

Morton, W.T.G. , 13 Motas, D. , 280, 468 MRI. See Magnetic resonance imaging (MRI) MS Contin , 133–134 MSIR , 133–134 Multimodal analgesia

with opioids , 534–535 without opioids , 535

Multiple afebrile seizures, case study , 219–221 Multiple allergies

predictable reactions , 52 pre-sedation screening , 52–53 unpredictable reactions , 52

Multiple drug allergy syndrome (MDAS) , 52 Multiple drug intolerance syndrome (MDIS) , 53 Multisensorial stimulation , 252 Muñoz, H.R. , 490 Murray, C., Dr. , 685–695 Muscular dystrophies (MD), pre-sedation screening , 53–54 Musculoskeletal disorders , 54 Music therapy , 634 Myopathy, PICU (Europe) , 337 m-YPAS. See Modifi ed yale preoperative anxiety scale (m-YPAS)

N Nalone , 137 Naloxone , 137, 379–380 Narcan. See Naloxone Narcanti , 137 Narcotics , 9

pediatric GI , 357 Nasal diamorphine, pharmacokinetics , 174 National Institute for Clinical Excellence (NICE) guidelines , 26, 437

EEG , 466 sedation algorithm and pathway procedures , 471, 472 sedation defi nitions , 438–439

Nauta, M. , 255 NCCPC. See Non-communicating children’s pain checklist (NCCPC) Near-infrared spectroscopy (NIRS) , 247 Negligence , 583, 697 Nembutal. See Pentobarbital Neonatal Abstinence Score , 340 Neonatal analgo-sedation

adequate pain management , 266 clinical syndromes , 266–267 effective management of pain , 266 improve pain management , 267 INSURE approach , 266 Neofax, dosing guidelines , 267

Neonatal Facial Coding Score (NFCS) , 249 Neonatal Intensive Care Unit (NICU)

analgo-sedation chronic morphine exposure , 244 drug dosing , 245–246 effective management of pain , 246 epidemiological study , 244–245 inadequate analgesia , 244 inadequate management of pain , 246 morbidity and mortality , 245 pain management , 244 verbalization , 245

case studies circumcision , 269 endotracheal intubation , 268–269 immunization-related pain , 268

complementary interventions facilitated tucking , 252 multisensorial stimulation and sensorial saturation , 252 nonnutritive sucking, sucrose, glucose, and human milk , 250 non-pharmacological , 249–250 swaddling and containment procedures , 250–252

distress and pain assessment bispectral index , 247 facial expression , 246–247 implementation , 248 limb movement , 248 multidimensional pain scales , 247, 248

non-pharmacological management , 514 PAT , 514 pharmacological interventions

acetaminophen , 265–266 benzodiazepines , 261–263 chloral hydrate , 258–260 dexmedetomidine , 263–264 inhalational agents , 264 ketamine , 256 morphine and fentanyl , 260–261 pharmacodynamics , 256–257 pharmacokinetics , 256 propofol , 254–256 remifentanil , 257–258 topical and local anesthesia , 253–254

preventive strategies , 249 Neonatal period, pain management , 514 Neonate

blood volume of , 119 CNS physiology , 117–119 congenital heart defects in , 113 drug pharmacokinetics , 122 glucose requirement , 120 heart , 114, 115 hematologic system development , 119 hepatic/gastrointestinal physiology , 120 lung volume of , 112 metabolic needs , 114, 116 myocardium , 114 to older infant and child , 114–115 pharmacodynamics , 122 renal physiology, and fl uid and electrolytes , 119–120 temperature regulation , 120–121

Nephrogenic DI , 50 Neuromuscular blocking drugs (NMBDs) , 175–176 Neuromuscular scoliosis , 54 Neuropathologic effects , 337 Neurotoxicity

aberrant neuronal development neuronal apoptosis , 554–555 peak synaptogenesis , 554 propofol impairs , 555

anesthesia , 553, 555 clinical investigations , 556 NMDA antagonists , 398 preclinical investigations , 556 sedation , 553, 555 sedative-induced neurological sequelae

AIDN , 554 dexmedetomidine , 556 neuroapoptosis , 553–554 retrospective reports , 555, 556 risk factors , 555 VMI scores , 556

Index

745

New Drug Application (NDA) , 544 New York Heart Association (NYHA) , 48 New Zealand

ANCA guidelines ( see Australian and New Zealand College of Anaesthetists (ANZCA) guidelines)

dental sedation , 515–516 emergency departments , 514–515 NICU

non-pharmacological management , 514 PAT , 514

non-pharmacological management , 517–518 PICU

common issues , 513 “KIDS SAFE” checklist , 513 management techniques and strategies , 513

sedation of children with burns , 516–517 for medical imaging , 516 for oncologic procedures , 517 program development , 511–512

Ng, J.M. , 359 NIBP measurement. See Noninvasive blood pressure (NIBP)

measurement Nicholl, J. , 13 NICU. See Neonatal Intensive Care Unit (NICU) Nil per os (NPO) guidelines , 18, 19

ACEP , 22–23 liquid intake , 119 pre-sedation screening , 42

Nitrous oxide , 11–14, 134, 509–512, 720 children with MD , 54 dentistry , 431–432 NMDA antagonists

adverse effects , 404 contraindications/cautions , 404 delivery system , 403–404 dosages , 405 indications , 402–403 mechanism of action , 405 metabolization , 405 monitoring , 404 technique , 403

pediatric GI , 356 pediatric hospital medicine service , 215, 218 RA , 471 usage, inconsistent over Europe , 463–464

NMBDs. See Neuromuscular blocking drugs (NMBDs) N -methyl- D -aspartate (NMDA) , 166, 554, 555

antagonists, PSA atropine , 401 circulatory effects , 396 contraindications/cautions/adverse effects , 399 dissociative effects , 397 glycopyrrolate , 401 ketadex , 402 ketamine , 395–396 ketofol , 341–402 neurotoxicity , 398 nitrous oxide , 402–405 pharmacokinetics , 399–401 prolonged analgesic effects , 397–398 protective airway refl exes , 397 psychotomimetic effects , 398 sedative-analgesic effects , 397 ventilatory effects , 396

Non-anesthesia practitioners, Europe , 465

Nonanesthesiologist , 20 Non-anesthesiologist-administered propofol sedation (NAAPS) ,

357–358 Non-atopic wheezers , 45 Non-communicating children’s pain checklist (NCCPC) , 660–662 Noninvasive blood pressure (NIBP) measurement , 89 Noninvasive cardiovascular monitoring , 91 Nonnutritive sucking , 250 Non-pharmacological distraction techniques , 657 Non-tertiary care centers , 514 Norman, E. , 257 North American Society of Pediatric Gastroenterology, Hepatology

and Nutrition (NASPGHAN) , 352 Nothing by mouth (NPO) , 575 Noxious stimulation , 635 NPO guidelines. See Nil per os (NPO) guidelines Nuclear power industry safety development, TMI-2 nuclear power

plant accident , 601–602 Numeric Rating Scales (NRS) , 248 Nurse-administered propofol sedation (NAPS) , 357, 359 Nurse-assisted propofol sedation (NAPS) , 228 Nursing-administered sedation program , 236–238 Nursing-delivered propofol , 236, 237 NYHA. See New York Heart Association (NYHA)

O OAA/S. See Observer’s Assessment of Alertness/Sedation Scale

(OAA/S) Objective physiologic monitoring, sedation scales , 78 Objective risk assessment tool for sedation (ORATS) , 79, 230, 231,

561, 713 Observational monitoring , 84–85 Observer’s Assessment of Alertness/Sedation Scale (OAA/S) , 74, 78

and BIS , 91 characteristics , 81

Obstructive sleep apnea (OSA) , 102–103 pediatric airway , 106–107 predisposing factors for , 60 pre-sedation screening , 54–57 risk factor for , 104 snoring , 65

Occupational exposure limits (OEL) , 464 ODD. See Oppositional defi ant disorder (ODD) OF. See Organ function (OF) Off-label

alternate sites of administration , 127–128 drug , 127

Ogawa, S. , 249 OI. See Osteogenesis imperfecta (OI) Olesen A.S. , 288 Oliveira, C.A. , 491 Oncology , 470, 517 Ondansetron , 138, 383 Onsolis , 130 Operating room time , 208 Operator-sedationist model , 527 Opiates , 25, 26 Opioid abuse, psychiatric and behavioral disorders , 59 Opioids , 392, 508

analgesia, with benzodiazepine , 513 anecdotal , 296 DCS , 707 fentanyl and sufentanil , 295 morphine infusions , 296 multimodal analgesia with , 534–535

Index

746

Opioids (cont.) multimodal analgesia without , 535 PICU, Europe , 332 remifentanil , 295–296 short acting , 719–720 subcutaneous fentanyl infusions , 297

Opium , 7, 8 Oppositional defi ant disorder (ODD) , 59 Optimal level of sedation

adverse event identifi cation/documentation , 712 consciousness monitoring , 713–714 depth of sedation , 712–713

Oral bioavailability, pharmacokinetics , 175 Oramorph , 133–134 ORATS. See Objective risk assessment tool for sedation (ORATS) Oré, Pierre-Cyprien , 12 Organ function (OF) , 178 OSA. See Obstructive sleep apnea (OSA) Osteogenesis imperfecta (OI) , 54 Ouimet, S. , 307, 308 Overly, F.L. , 90 Ovid , 7 Oxycodone , 395 Oxygenation assessment , 714 Oxygenation monitoring , 85–86 Oxygen desaturation , 259 Oxygen saturation , 104, 247, 264 Oxyhemoglobin dissociation curve , 85

P PACSA. See Pediatric Anesthesia Congress of South Africa (PACSA) Pain assessment tool (PAT) , 514 Pain assessment

CAMPIS-SF , 660, 663, 664 CHEOPS , 658 EAS , 660, 661, 664 FLACC , 658, 659, 661, 663, 664 ICC , 660, 661, 664 m-YPAS , 660, 661, 664 NCCPC , 660–662, 664 PBCL , 658, 659, 664 PBRS , 658, 673 PHBQ , 660, 662, 664

Painful stimulus , 666, 702 Painless imaging

Europe , 469 sevofl urane , 468, 469

Palliative care , 311–312, 702, 708 PALS. See Pediatric Advanced Life Support (PALS) Pambianco, D.J. , 360 Papoff, P. , 255 Paracelsus , 9 Paracetamol. See Acetaminophen Paradoxical agitation , 533 Paradoxical reactions , 388 Parekh, M. , 229 Parke, T.J. , 292 Parotid cystic lymphangioma , 503 PAT. See Pain assessment tool (PAT) Patient-controlled sedation and analgesia (PCS) , 359 Patient-maintained sedation (PMS) system , 628 PBCL. See Pediatric behavior checklist (PBCL) PBPK model. See Physiologically based pharmacokinetic (PBPK) model PBRS. See Procedure behavioral rating scale (PBRS) Peak synaptogenesis , 554

Peden, C.J. , 300 Pediatric Advanced Life Support (PALS) , 20, 105, 209, 678 Pediatric airway

adverse events , 104–106 anatomic imbalance , 100 anatomy of , 95–97 anterior mediastinal mass , 101–102, 107 assessment for sedation , 97–99 case studies , 106–108 cold , 107–108 obstructive sleep apnea , 106–107 risk factors for , 99–102 sleep-disordered breathing , 102–104

Pediatric Anesthesia Association in China , 498 Pediatric Anesthesia Congress of South Africa (PACSA) , 525 Pediatric behavior checklist (PBCL) , 658, 659 Pediatric dentistry

BSPD guidelines , 436, 438 case studies

dark spot in molar , 450–451 dental anxiety , 452–453 dental treatment , 445–447 “gum boil,” 451–452 odontogenic pain , 447–448 sensitivity to cold , 449

children’s behavior Frankl behavioral rating scale , 427 Houpt sedation rating scale , 427 parent assessment , 426

conscious sedation Cochrane review , 434–437 and GA , 436

Corah’s dental anxiety scale , 439 dental caries, extent and treatment , 424–425 EAPD guidelines , 438 facial image scale , 440 future of sedation , 433–434 guidelines, training, and protocols , 425–426 intravenous midazolam sedation , 437–438 local anesthesia, UK , 435 MCDAS , 439, 440 model , 526 NICE guidelines , 437–439 oral sedation , 438 patients in UK and Europe , 434 pharmacological interventions , 432–433 premedication prior to GA , 436–437 propofol , 441 sedation

and anesthesia, reimbursement , 432 appointment protocols , 427, 429–430 in dental offi ce, South America , 442–443 effectiveness, measuring , 439 and general anesthesia, UK , 436 guidelines , 433, 443 morbidity and mortality , 432 record, AAPAAPD guidelines , 428–429 regimens, South America , 442–444 training, UK , 435–436

sedative agents , 442 chloral hydrate , 431 hydroxyzine , 430, 431 meperidine , 430, 431 midazolam , 431 nitrous oxide , 431–432

titrated nitrous oxide inhalation sedation , 437

Index

747

Pediatric exclusivity , 545 Pediatric gastrointestinal (GI) procedures

case studies celiac disease , 360–361 gastroenterology , 362 ulcerative colitis , 361–362

endoscopic procedures bispectral index monitoring , 359 capnography , 359 CAPS system , 360 patient-controlled sedation and analgesia , 359–360 pulse oximetry , 359 SEDASYS ® system , 360

goals and optimal levels , 352–353 IV sedation regimens

dexmedetomidine , 358 drugs dosages , 355 fentanyl , 355 ketamine , 355–356 midazolam , 355 NAAPS , 357–358 narcotics and benzodiazepines , 355 nitrous oxide , 356 propofol , 356–357

moderate sedation , 352 patient positioning , 354 pre-procedure preparation/patient assessment

Mallampati score , 353–354 STOP-BANG scoring model , 354

sedation administration training , 358 Pediatric hospital medicine service , 207–208

administered sedation drugs , 214–219 credentialing hospitalists , 209–210 dexmedetomidine , 219 fentanyl , 215 funding , 212 hospitalist-run sedation service , 210–212 ketamine , 214–215 midazolam , 215 national standards for training and credentialing , 212 nitrous oxide , 215, 218 ongoing competency , 209 on-the-job training , 208 operating room time , 208 PALS , 209 pentobarbital , 218 planning, monitoring, and recovering , 213–214 pre-sedation evaluation , 213 propofol , 218 residency training , 208 simulation time , 208–209 training hospitalists , 208 training under direct supervision , 208

Pediatricians primary care , 37 procedural sedation , 33–34 sedation provided by , 498, 499

Pediatric intensive care unit (PICU), Australia and New Zealand , 513 Pediatric intensive care unit (PICU), Europe

alpha-2 receptor agonists , 333–335 benzodiazepines , 332 clinical case studies

context-sensitive half-life , 344 delirium , 343 leukemia , 342–343 neuromyopathy , 343

Norwood surgical operation, hypoplastic left heart , 343–344 septic arthritis , 342 sleep cycle , 343

delirium , 339–340 immunity , 336–337 inhalational sedation , 333 ketamine , 332–333 measuring sedation , 337–338 neuropathologic effects , 337 opioids , 332 pharmacologic aspects

automation effects , 331 context-sensitive half-times , 330–331 midazolam and morphine , 331 NEOPAIN group , 330 post-conceptual age , 331 RESTORE group , 330 vecuronium , 331

propofol , 335–336 sedation and analgesia , 329–330 staff , 341 tolerance and withdrawal , 340–341

Pediatric intensive care unit (PICU), United States ASA classifi cation , 277 case study

aortic stenosis , 315–316 congenital heart disease , 316–317 direct laryngoscopy and airway laser , 317

choice of agent and route of delivery alpha2-adrenergic agonists , 298–301 barbiturates , 292–295 benzodiazepines , 284–286 chloral hydrate , 301 etomidate , 286–288 inhalational anesthetic agents , 282–284 ketamine , 288–291 opioids , 295–297 phenothiazines and butyrophenones , 297–298 propofol , 291–293

delirium classifi cation , 307 diagnosis , 308 pathophysiology , 309–310 prevention and treatment , 310–311 risk factors , 308–309

depth of sedation assessment BIS monitoring , 280–281 COMFORT-B scale , 278–279 COMFORT scale , 278, 279 OAAS scale , 279–280 Ramsay scale , 278 sedation-agitation scale , 278, 280 UMSS , 280

distress cause , 281 drug holidays , 281–282 end of life

dexmedetomidine , 312 ketamine , 312 propofol , 312, 313

ETCO 2 monitoring , 278 guidelines, sedative and analgesic agents , 314, 315 Mallampati grading system , 277 nil per os , 278 pharmacogenetic factors , 281 pharmacokinetic studies , 281 physiologic stress response , 282

Index

748

Pediatric intensive care unit (PICU), United States (cont.) pre-procedure preparation , 276 presedation assessment , 276–277 tolerance, physical dependency, and withdrawal

clinical scoring systems , 303–307 clinical signs and symptoms , 302–303

Pediatric research clinical research , 644

analysis plan , 651–652 big trials , 652 ethical approval , 650–651 funding , 652 pilot studies , 650 protocol development , 650 regulatory issues , 651 reporting results , 652 research question , 649–650 running the project , 652 statistical help , 652

health service delivery research , 647 implementation science , 647 observational research , 644

bias and confounding , 645–646 causality and association , 646

qualitative research , 644–645 quality improvement , 647–648 quantitative research

data types , 645 study designs , 645

theory of research hypotheses , 648–649 mechanistic and empiric research , 648

translation , 647 trials

effi cacy and effectiveness , 646 phases , 646

Pediatric Research Equity Act (PREA) , 127, 545, 548, 719 Pediatric Research in Inpatient Settings (PRIS) Network , 207 Pediatric Sedation Research Consortium (PSRC) , 563 Pediatric sedation, South American approach

Argentina , 486 Bolivia , 488 Brazil , 486–487 case studies

AOC, 5-month infant , 493–494 IBS , 492 JBC, oral surgery , 492, 493

Chile , 487 CLASA , 486 Colombia , 488 data publications, past 20 years , 492, 493 vs. North America , 486 Peru , 488 sedation literature , 489–492 sedation techniques , 488–489 TCI systems , 486

Penido, M.G. , 255 Pennsylvania law, informed consent , 576 Pentobarbital , 134–135, 387–388

anesthesia-directed sedation service , 234 pediatric hospital medicine service , 218

Pen Tsao , 4 Pereira e Silva, Y. , 257 Peripherally inserted central catheter (PICC) , 106 Peri-procedural stress dosing , 50

Peritonsillar abscess , 412 Perrow, C. , 598, 599, 601 Persistent vegetative states (PVSs) , 155 Pessach, I.M. , 675–683 Peterson, J.F. , 307 Pethanol , 132 Petidin Dolargan , 132 PG. See Pharmacogenomics (PG) Pharmacodynamics (PD) , 122, 256–257

endpoint, measurement , 182 Food and Drug Administration , 549–550 intravenous infusions , 616–617

dexmedetomidine , 618 propofol , 617–618

PK with , 185–186 population modeling , 182 target concentration approach , 182–183

Pharmacogenomics (PG) , 181–182 Pharmacokinetics (PK) , 256

absorption , 173 alfentanil , 128 alveolar , 174–175 bioavailability , 175 blood–brain barrier , 176–177 body composition , 175–176 chloral hydrate , 129 cutaneous , 174 dexamethasone , 139 dexmedetomidine , 129 diphenhydramine , 139 distribution , 175 drug metabolism , 177 enteral , 174 etomidate , 130 fentanyl , 130 fl umazenil , 137 Food and Drug Administration , 549–550 fospropofol , 131 hepatic elimination , 179 intramuscular , 174 intravenous infusions , 616–617

compartmental model , 618, 619 dexmedetomidine , 624 fi rst-order proces , 619 rate of change , 619

ketamine , 131 lidocaine , 137 lorazepam , 132 medications , 384–385 meperidine , 132 metabolism maturation , 177–179 metabolites , 180 methohexital , 133 metoclopramide , 138 midazolam , 133 models , 183–185 morphine , 133–134 naloxone , 137 nasal , 174 nitrous oxide , 134 NMDA antagonists

age-specifi c ketamine pharmacokinetic profi le , 399–400 indications , 400 ketamine dosing schedules , 400 pregnancy category B , 400–401

Index

749

non-analgesic sedative agents , 390–391 ondansetron , 138 with PD , 185–186 pentobarbital , 134 plasma proteins , 176 population modeling , 182 propofol , 135, 184 pulmonary elimination , 180 regional blood fl ows , 176 remifentanil , 135 renal elimination , 179–180 scopolamine , 139 S-ketamine , 136 sufentanil , 136

Pharmacologic effects , 127 Pharmacopuloi , 6 Pharyngeal anatomy

alignment , 105 Mallampati classifi cation , 98 muscle contraction , 100, 103

PHBQ. See Post-hospital behavioral questionnaire (PHBQ) Phenothiazines , 297–298 Phenylpiperidines , 534 Physical restraint , 463 Physician-assisted suicide (PAS) , 700 Physician quality measure reporting , 200–201 Physiologically based pharmacokinetic (PBPK) model , 178, 183 Physiological monitoring, for procedural sedation

bispectral index , 89–91 cerebral oximetry , 91 depth of sedation monitoring , 89 electronic monitoring , 85 guidelines and standards , 83–84 hemodynamic monitoring , 89 noninvasive cardiovascular monitoring , 91 observational monitoring , 84–85 oxygenation monitoring , 85–86 sedation guidelines , 84 ventilation monitoring , 86–89

PICC. See Peripherally inserted central catheter (PICC) Pieragostini, L. , 29 Piercy, J. , 530, 532–535 Pilot study

clinical research project , 650 midazolam , 262 of PCS , 359

Pirelli, A. , 29 Piridosal , 132 Pizov, R. , 291 PK. See Pharmacokinetics (PK) Plasma proteins, pharmacokinetics , 176, 256 Pliny the Elder , 8 Polyneuropathy , 337 Polysomnography (PSG) , 55, 79, 103, 104 Poppy

power of , 7 seed , 6 in Sumerian life , 5

Population modeling , 182 Postanesthesia recovery

after surgical procedure , 78 score , 76

Postanesthetic apnea , 101 Post-hospital behavioral questionnaire (PHBQ) , 660, 662 Postmenstrual age (PMA) , 254–255, 331 Postnatal age (PNA) , 254–255

Potts, A.L. , 179, 299 Practice Guidelines for Sedation and Analgesia by

Nonanesthesiologists , 19 Pramin , 138–139 PREA. See Pediatric Research Equity Act (PREA) Precedex , 129 Pregnancy

anatomic and physiologic changes , 57 FDA pharmaceutical pregnancy categories , 58 pre-sedation screening , 57

Premature infant body mass indices , 354 pre-sedation screening , 57–59

Premature Infant Pain Profi le (PIPP) , 247, 258, 261, 264 Prescilla, R.P. , 125–140 Pre-sedation evaluation

anticipation , 378 CT imaging , 502 and decisions , 573–574 mild hypotonia , 224 pediatric hospital medicine service , 213

Pre-sedation patient assessment airway assessment , 371–372 ASA physical status-E classifi cation , 371 history and physical examination , 371 pulmonary aspiration risk , 372–373

Pre-sedation screening , 42 aspiration , 43 asthma , 45–46 autism spectrum disorders , 46–47 behavioral disorders , 59 bronchial hyperreactivity , 45 bronchopulmonary dysplasia , 47 case studies , 64–66 cerebral palsy , 47–48 congenital heart disease , 47–48 cystic fi brosis , 48 developmental delay , 46–47 diabetes mellitus , 49 ED procedural sedation , 44 endocrinopathies , 49–50 fasting guidelines and sedation , 43–45 intellectual disability , 46–47 mitochondrial disease , 50–52 multiple allergies , 52–53 muscular dystrophies , 53–54 musculoskeletal disorders , 54 obstructive sleep apnea , 54–57 pain control , 47 physical examination , 42 pregnancy , 57 premature infant , 57–59 psychiatric and behavioral disorders , 59–60 reactive airway disease , 45–46 sickle cell disease , 60 STOP-BANG questionnaire , 55, 56 syndromes , 60–62 telephone screening , 42 trauma , 62 tuberous sclerosis , 62–63 upper respiratory tract infection , 63

Prilocaine , 514 Primperan , 138–139 PRIS Network. See Pediatric Research in Inpatient Settings (PRIS)

Network Privileging programs , 21

Index

750

Procedural anxiety AAC , 669 anxiety assessment

CAMPIS-SF , 660, 663, 664 CHEOPS , 658 EAS , 660, 661, 664 FLACC , 658, 659, 661, 663, 664 ICC , 660, 661, 664 m-YPAS , 660, 661, 664 NCCPC , 660–662, 664 PBCL , 658, 659, 664 PBRS , 658, 663 PHBQ , 660, 662, 664

ASD , 668–669 behavioral intervention , 664 behavioral management , 671–672 behavior and distress , 660 context of treatment , 657 developmental stages and understanding of illness

adolescence , 668 from infant to toddler , 667 from primary school to early adolescence , 667

distress and interactions , 649, 660 fear , 654 good practice for procedures , 665–666 parental protection and support , 662, 664 preparation , 664–666 psychological interventions

distraction , 666 hypnosis , 666–667 relaxation with guided imagery , 666

stress , 656 uncooperative/resistant children dealing , 669–670 using restraint during , 670

Procedural pain breastfeeding for , 248 consensus documents for , 639 dental caries , 424 in neonatal period , 514 in newborn, guidelines , 29 Wisconsin Sedation Scale , 182

Procedural sedation advances in , 37 capnographic airway assessment for , 87 case studies , 38 childhood developmental considerations , 36 child life therapists , 37 content , 36 equipment requirement , 34, 35 format , 36 language , 36 monitoring , 34 patients , 35–36 personnel , 34 phlebotomy , 38 physiological monitoring ( see Physiological monitoring, for

procedural sedation) practice of , 33–34 preprocedure health assessment , 35 procedures , 36–37 protocols , 34–35 questions to consider , 34 risk assessment , 715 setting , 34 small-gauge needle , 37 subungual hematoma , 38

time-based record , 35 timing , 35–36 vapocoolant spray , 37

Procedural sedation and analgesia (PSA) adverse events management

airway and ventilation maintenance , 379 anticipation , 378 respiratory depression and apnea , 378–379

anxiolytic-amnestic-sedative agents benzodiazepines , 388 diazepam , 389 midazolam , 388–389 paradoxical reactions , 388

barbiturates methohexital , 387 pentobarbital , 387–388

case studies buttock abscess , 412 complex forehead laceration , 411–412 displaced metaphyseal fractures , 406–409 distal radius fracture , 409 hematoma , 412–413 hot water burns , 410–411 peritonsillar abscess , 412

chloral hydrate , 386 clinical policies , 370 demand for, Europe , 460 dosing

hub, intravenous administration , 386 intramuscular administration , 386 titration , 385–386

emesis , 383 goals of , 370 informed consent , 373–374 intravenous access , 378 ketamine + midazolam, deep sedation , 405–406 laryngospasm , 381–383 long-term negative impact , 368 medications

biphasic redistribution , 384 drug’s therapeutic window , 384–385 one arm-brain kinetics , 384 plasma drug and CNS concentration , 384, 385

NMDA antagonists atropine , 401 circulatory effects , 396 contraindications/cautions/adverse effects , 399 dissociative effects , 397 glycopyrrolate , 401 ketadex , 402 ketamine , 395–396 ketofol , 401–402 neurotoxicity , 398 nitrous oxide , 402–405 pharmacokinetics , 399–401 prolonged analgesic effects , 397–398 protective airway refl exes , 397 psychotomimetic effects , 398 sedative-analgesic effects , 397 ventilatory effects , 396

non-analgesic sedative agents etomidate , 391–392 pharmacokinetics , 390–391 propofol , 389–390

painless local anesthesia buffering injected lidocaine , 368–369

Index

751

distress, psychological interventions , 369 goal of pediatric , 369–370 postponement , 369 topical anesthetics , 368

planning analgesia, hypnosis, anxiolysis , 374 depth of sedation , 374–376 indications and strategies , 374, 375 intravenous access , 378 monitoring and equipment , 376–377 resuscitation equipment , 378 sedative-analgesic medications effects , 374, 375 staffi ng , 376

pre-sedation patient assessment airway assessment , 371–372 ASA physical status-E classifi cation , 371 fasting status and aspiration risk , 372–373 history and physical examination , 371

pulmonary aspiration , 383–384 resuscitation equipment , 378 safe and effective management , 368 sedative-analgesic agents

codeine , 395 fentanyl , 392–394 meperidine , 394 morphine , 394 opioid medications , 392 oxycodone , 395

sedative-hypnotic agents , 386 treatment

rapid succession , 379 respiratory depression and apnea , 379–380

upper airway obstruction , 380–381 Procedure behavioral rating scale (PBRS) , 658 Prolonged analgesic effects , 397–398 Prophylaxis

and avoiding conditioned behaviors , 715 for bacterial endocarditis , 48–49

Propofol administration of , 693 adverse events , 562 airway complications , 511 airway reactivity , 291 analgesics , 131–132, 135 anesthesia-directed sedation service , 235–236 anesthetic induction , 291 cardiovascular effects , 291 death (Michael Jackson) , 690, 692 dendistry , 441 distribution volume , 50 effects on memory , 160–162 in emergency department , 22, 24 GABA system , 291 immunity , 336 integrated PK-PD models , 255 in intensive care , 335–336 intravenous infusions , 616 intravenous route , 532 lipid component , 292 memory decay , 158, 160, 161 mitochondrial disease , 52 non-analgesic sedative agents , 389–390 non-painful procedures , 500 opisthotonic posturing , 291–292 pediatric GI , 356–357 pediatric hospital medicine service , 218

pharmacodynamics , 255, 617–618 pharmacokinetic characteristics , 254 PICU, United States , 312, 314 PK , 184 propofol infusion syndrome , 292 recommendations , 474 response surface methodology , 187 role of , 25 short-term administration , 292 soy allergy , 293 TCI of , 532 ventilation , 292–293

Propofol infusion syndrome (PRIS) , 335–336, 441 Prosecution , 584, 697 PSA. See Procedural sedation and analgesia (PSA) Pseudo-allergy , 52 PSG. See Polysomnography (PSG) Psychiatric disorders , 59–60 Psychomotor vigilance task (PVT) , 595 Psychotomimetic effects , 398 Psychotropic drugs , 128 Pulmonary aspiration

clinical symptoms , 380 incidence , 373 risk factors , 372–373 treatment , 384 US FDA pharmaceutical pregnancy categories , 373–374 vomiting , 373

Pulmonary elimination , 180 Pulmonary hypertension

for infant , 314 OSA , 55 preexisting , 333

Pulse oximetry , 359, 377, 714 oxygenation monitoring , 85–86 recommendation , 18, 22 respiratory physiology , 112

Puysegur, Marquis de , 11 PVSs. See Persistent vegetative states (PVSs) PVT. See Psychomotor vigilance task (PVT) Pylomid , 138–139

Q Quantal effect model , 185 Quebec Guidelines , 563, 564

R RA. See Relative analgesia (RA) RACP guidelines. See Royal Australasian College of Physicians

(RACP) guidelines Ramsay, M.A. , 73, 187, 624, 625 Ramsay Sedation Scale (RSS) , 73, 78, 81 RANZCR guidelines , 516 Rapifen , 128 Rasmussen, J. , 592 RBRVS. See Resource Based Relative Value System (RBRVS) RDI. See Respiratory disturbance index (RDI) Reactive airway disease , 45–46 Recent-onset ataxia, case study , 519 Recovery scales

monitoring of , 214 sedation scales , 78–81

Recurrent cystitis, case study , 536 Reed, A. , 530, 532–535

Index

752

Reeves, S.T. , 72, 293 Regional blood fl ows , 176 Reglan , 138–139 Relative analgesia (RA)

defi nition , 468 nitrous oxide , 471

Remifentanil , 719 advantage , 258 analgesic and procedural effi cacy , 258 analgesics , 135–136 anesthesiologists , 534 drug interactions , 187 endotracheal intubation , 257 infusion rates , 177, 178 RAPIP trial , 258

Remimazolam , 720 Renal elimination , 179–180 Renal function , 63 Renal physiology , 119–120 Renz, M. , 703 Resource Based Relative Value System (RBRVS) , 200 Respiratory adverse events , 589 Respiratory depression , 127

at-risk periods , 379 avoiding respiratory depression , 379 ineffective ventilation recognition , 379 treatment

opioids and benzodiazepines , 379–380 rapid succession , 379

Respiratory disturbance index (RDI) , 55, 104 Respiratory physiology , 111–114 Respiratory tract infections (RTIs) , 63 Retrograde amnesia , 156, 162 Reversal agents , 128, 136–137 Revised Hospital Anesthesia Services Interpretive Guidelines , 196 Rhabdomyomas , 62 Rhazes , 8 Rhizotomoi , 6 Richard , 672 Richmond Agitation-Sedation Scale (RASS) , 78, 338, 708 Riera, F.C. , 491 Rigouzzo, A. , 624, 626–627 Riker, R.R. , 297 Riva, J. , 490 Roback, M.G. , 559–567 Robinson, B.R. , 78 Roediger, H.L. , 676 Roelofse, J.A. , 523–539 Roman medicine , 8 Romazicon. See Flumazenil Ronco, R.M. , 490 Root cause analysis (RCA), sedation safety , 601 Rosen, J.S. , 685–697 Rosenberg, D.R. , 676 Route of administration

alfentanil , 128 chloral hydrate , 129 dexamethasone , 139 dexmedetomidine , 129 diphenhydramine , 139 etomidate , 130 fentanyl , 130 fl umazenil , 137 fospropofol , 131 ketamine , 131 lidocaine , 137 lorazepam , 132

meperidine , 132 methohexital , 133 metoclopramide , 138 midazolam , 133 morphine , 133 naloxone , 137 nitrous oxide , 134 ondansetron , 138 pentobarbital , 134 propofol , 135 remifentanil , 135 scopolamine , 139 S-ketamine , 136 sufentanil , 136

Routsi, C. , 339 Roxanol , 133–134 Royal Australasian College of Physicians (RACP) guidelines

addressing issues , 509 distraction ideas for children , 518 limitations , 511 minimizing pain and suffering in procedures , 509 resuscitation equipment , 510 sedation lists , 509–510 sedative agents , 511 total procedure process , 510

Royal Children’s Hospital, Melbourne contentious issue , 512–513 inpatient wards , 512–513 sedation program development , 511–512

RSS. See Ramsay Sedation Scale (RSS) RTIs. See Respiratory tract infections (RTIs) Runciman, W.B. , 594

S SAAD. See Society for the Advancement of Anesthesia in Dentistry

(SAAD) Safar, P. , 675 Sahyoun, C. , 83–92 Saitua, F. , 490 Salas, E. , 597 Sammartino, M. , 255, 258 Sanborn, P.A. , 43 SCD. See Sickle cell disease (SCD) Schieveld, J.N. , 340 Schieveld, J.N.M. , 311 Schinasi, D.A. , 677 Schipper, D. , 473, 474 Schlager, A. , 638 Schmidt, A.P. , 491 Schneeweiss, S. , 677 Scolville, W.B. , 156 Scopolamine , 139 Scottish Intercollegiate Guidelines Network (SIGN) ,

26–27, 466 Scottish National Guidelines of 2004 , 29 SDB. See Sleep-disordered breathing (SDB) SEDASYS ® system , 360, 628, 720–721 Sedation , 151–152

agents , 159 benzodiazepine , 162–163 case studies , 166–168 dexmedetomidine , 163 etomidate , 164–165 inhalational and miscellaneous , 165–166 ketamine , 163–164 propofol , 160–162

Index

753

ancient history , 4 anesthesia , 12–13, 152–155 Chinese drug lore , 4 continuum , 3–4 depth, consciousness monitoring , 713–714 Egyptian medicine , 5–7 ether , 9 fi nal checklist , 214 future of , 14 Greek medicine , 6–8 Hindu drugs , 4–5 Islamic medicine , 8 Jewish medicine , 5 location of , 208 medieval medicine , 8–9 modern , 13–14 monitoring , 89 planning

analgesia, hypnosis, anxiolysis , 374 depth of sedation , 374–376 indications and strategies , 374, 375 intravenous access , 378 monitoring and equipment , 376–377 resuscitation equipment , 378 sedative-analgesic medications effects , 374, 375 staffi ng , 376

practice procedure, Europe dentistry , 471 emergency medical care , 470 gastroenterology , 470 interventional radiology and cardiology , 469–470 oncology , 470 painless imaging , 469

practice, safety culture development , 718 program development , 511–512 providers , 528, 531

demand for , 525 operator-sedationist model , 527 training and credentialing , 716–718 training of , 535

Roman medicine , 8 scientifi c/modern epoch , 9–12 simple , 28 Sumerian drugs , 5 training , 208 training certifi cation, Africa , 525–526 unit model , 526–527 varying potencies , 9

Sedation and anesthesia providers (SAP) , 229 Sedation models, Africa , 526

combined , 527 dedicated sedationist model , 527 mobile sedationist model , 527 operator-sedationist model , 527 unit model , 526–527

Sedation-related adverse events (SRAE) , 104, 718–719 Sedation safety improvement

adverse events making sense of uncommon , 591–592 rates, estimation , 588

Boeing Model 299 , 596 clinical microsystem , 590–591 closed claims settlements for cases , 603–605 CPOE , 606 CRM , 596 dosage errors , 589

effects of fatigue , 595–596 error-prone environments , 591 exhortation and protocols , 595 FMEA , 601 GEMS , 603 human-centered approach , 592 human errors , 592

knowledge-based errors , 593 rule-based errors , 593–594 skill-based errors , 594

human factors and culture of safety , 596 incident reporting, new approaches , 607 interaction vs. coupling space , 599 medication errors , 599–590 multiple defenses in preventing system failure , 599 nature of system failures , 595

barriers , 599–600 safe and unsafe systems characteristics , 598

Normal Accidents Theory (Perrow) , 598, 601 paradigm shift , 588–589 practical suggestions , 606 practice guidelines in procedural sedation , 604, 606 RCA , 601 risk factors , 589 safety monitoring, new approaches , 607 simulation and safety , 596–597 state-space approach

incident-based recovery pathways value , 603 role of incident reporting , 602–603

teamwork and communication , 597–598 technical errors , 594–595 WHO safe surgery checklist , 598 World SIVA tool , 607

Sedation scales , 72–73 auditory evoked potentials , 77 Bispectral Index , 76–77 COMFORT Scale , 74, 75 Dartmouth Operative Conditions Scale , 75–76 and discharge scores , 80–81 modifi ed Aldrete score as , 76 OAA/S and MOAA/S , 74 objective physiologic monitoring , 78 recovery and discharge scales , 78–81 RSS , 73 simplifi ed postanesthetic recovery score , 80 UMSS , 74–75

Sedative-analgesic effects , 397 Sedatives

and analgesics ( see Analgesics, sedatives and) contraindications for , 26 modes of delivery , 719–721 respiratory depression , 55–56

Sedo-analgesia , 330 Selbst, S.M. , 571–584 Sensorial saturation , 252 Sepulveda, P. , 491 Serturner, F.W.A. , 10 Sevofl urane , 333, 468, 469 Sfoggia, A. , 490 Shah, P.S. , 255 Shah, V.S. , 254, 265 ShangGuan, W.N. , 497–503 Sheiner, L.B. , 186 Shukry, M. , 263 SIAARTI-SARNePI Guidelines , 27 Sickle cell disease (SCD) , 60

Index

754

Sigmoid E max model , 185 SIGN. See Scottish Intercollegiate Guidelines Network (SIGN) Sikich, N. , 339 Simons, S.H. , 245 Singh, G. , 354 Single-drug technique , 527 Single nuclear polymorphism (SNP) , 181 S-Ketamine , 136 Slater, D.J. , 195–202 Slater, R. , 247, 250 SLCH. See St. Louis Children’s Hospital (SLCH) Sleep

effects on memory , 151–152 pathways , 152, 153, 163 physiology , 152–155

Sleep-disordered breathing (SDB) , 102–104 Sleep-related breathing disorders , 54 Small bowel, transit time , 45 Smith, H.A.B. , 310, 311 Smith, W. , 13 SNP. See Single nuclear polymorphism (SNP) Society for the Advancement of Anesthesia in Dentistry (SAAD) , 27 Soetenga, D. , 305 Sophia Observation Score (SOS) , 340–341 Soriano, S.G. , 553–556 SOSPOSA. See South African Society of Sedation Practitioners

(SOSPOSA) Sossa, M.P. , 490 South African Society of Anesthesiologists (SASA) ,

28, 525 South African Society of Sedation Practitioners (SOSPOSA) , 525 SRAE. See Sedation-related adverse events (SRAE) Stabile, M.J. , 587–608 Standard of care , 572, 584 Standards for Basic Anesthesia Monitoring , 20, 34 State Behavioral Scale (SBS) , 338 “Statement on Safe Use of Propofol,” 20 Steward, D.J. , 80 Steward Scale

characteristics , 81 simplifi ed postanesthetic recovery score , 80

St. Louis Children’s Hospital (SLCH) anesthesiologist consult , 211 moderate and deep sedation , 209–210

STOP-BANG questionnaire , 55, 56, 104 Stridor , 99, 100 Sublimaze , 130 Submucosal dissection (ESD) , 352 Subungual hematoma , 38 Succinylcholine , 382–383 Sucrose sucking , 639 Suction, Oxygen, Airway, Pharmacy, Monitors, Equipment

(SOAPME) , 574 Su, F. , 299 Sufenta , 136 Sufentanil , 136, 500, 535, 719, 720 Sumerian drugs , 5 Sundaram, B. , 251 Supplemental oxygen , 13 Sury, M.R.J. , 80, 461–480 Suspended animation , 11 Susruta , 4, 5 Swaddling , 250–251 Sweetening agents , 639

Syndromes, pre-sedation screening , 60–62 Systolic blood pressures , 117

T Taddio, A. , 253 Talke, P. , 300 Target concentration

approach , 182–183 defi ning , 187

Target controlled infusion (TCI) , 486, 616, 720 blood-targeted , 627–628 closed loop control system , 628 defi nition , 625 delivery system , 432 drug interactions , 627 open TCI initiative , 627 PMS system , 628 predictive performance , 626–627 principles , 625–626 of propofol , 532 propofol target concentration , 626 pumps , 178, 183, 187 rationale for , 625

Temesta , 132 Temperature regulation , 120–121 Terminal illness , 699, 706 Tetracaine , 254 Tetzlaff, J. , 354 Texas children’s hospital , 229–230 Theodoric of Cervia , 9 Theophrastus , 7 Therapeutic orphans , 644 Thomas, J. , 227–239, 530, 532–535 Three Mile Island nuclear power plant accident , 601–602, 604 Thyroid hormones , 50 Titration , 385–386 TIVA. See Total intravenous anesthesia (TIVA) Tobias, J.D. , 275–317 Tobin, C.D. , 677, 717 Tonsillar hyperplasia , 98, 99, 101 Topical anesthesia. See Local anesthesia Total intravenous anesthesia (TIVA) , 617, 644 Trachea , 95 Transient wheezers , 45 Trauma, pre-sedation screening , 62 Triage, medical evaluations , 211–212 Tuberous sclerosis (TS) , 62–63 “Twilight Sleep” , 13–14

U Ulcerative colitis , 361–362 Ultiva , 135–136 UMSS. See University of Michigan Sedation Scale (UMSS) Unconscious mind , 159 United States Medical Licensing Examination (USMLE) , 680 University of Iowa

nursing-administered sedation program , 236–238 nursing-delivered propofol , 236

University of Michigan Sedation Scale (UMSS) , 74–75, 338, 503 and BIS , 76 characteristics , 81 modifi ed wakefulness test , 80

Index

755

Upper airway obstruction , 112 recognition , 380 risk factors , 380 treatment , 381

Upper respiratory tract infection (URI) CHD , 48 child with cold , 108 clinical algorithm , 64 infant , 113 pre-procedure , 63 pre-sedation screening , 63–66

V VAD. See Ventricular assist devices (VAD) Vagbhata , 4 Valium , 129–130 van den Anker, J. , 243–269 Van Lingen, R.A. , 265 Van Norman, G.A. , 685–697, 699–709 Van Sleuwen, B.E. , 250 Vancouver Scale , 78 Vargo, J. , 353 Vecuronium , 331 Venipuncture , 253 Venous blood sampling , 249 Venous puncture/lumbar puncture , 475–476 Ventilation monitoring , 86–89 Ventilation-perfusion (V-Q) mismatch , 87 Ventilatory effects, NMDA antagonists , 396 Ventricular assist devices (VAD) , 513 Ventrolateral preoptic nucleus (VLPO) , 152, 153, 618 Verbalization , 245 Versed (midazolam) , 133 Veselis, R.A. , 151–168 Virgil , 7 Visual Analogue Scale (VAS) , 248 Visual motor integration (VMI) scores , 556 Vital signs, deep sedation , 85 VLPO. See Ventrolateral preoptic nucleus (VLPO) Volume of distribution, pharmacokinetics , 175 von Baeyer, C.L. , 293 Voullième, P.S. , 485–494 V-Q mismatch. See Ventilation-perfusion (V-Q) mismatch Vutskits, L. , 553–556

W Walker, S.M. , 244 Wang, C. , 497–503 Ward-Larson, C. , 251 Warner, M.A. , 373 Washington University (WU), moderate and deep sedation , 209–210 Waters, R. , 13, 14 Webster, C.S. , 587–608 Wells, H. , 13 Welzing, L. , 255, 257 Wepfer, J.J. , 9–10 What a Blessing She Had Chloroform (Caton) , 14 Wheezing, during inspiration/exhalation , 100 Williams, G.D. , 289 William T.G.M. , 13 Wilm’s tumor, case study , 537–538 Wilson, G.S. , 523–539 Wilson, S. , 423–453 Winemaking , 3–4 Wisconsin Sedation Scale , 182 Withdrawal Assessment Tool-1 (WAT-1) , 340–341, 513 Wolf, A. , 335 Womack, W. , 35 World Society of Intravenous Anesthesia (World SIVA) , 564, 607, 718 Wormwood , 4 Wren, C. , 10

X Xenon , 333 X-ray

airway of child , 97 tuberous sclerosis , 63

Xu, Y. , 497–503

Y Yanay, O. , 294 Yao, L.P. , 543–552 Yu, L. , 92, 714 Yuen, V.M. , 497–503

Z Zofran , 138

Index