By Peter B. Cotton
Crucial new identify within the complex Digestive Endoscopy seriesAdvanced Digestive Endoscopy: perform & security offers a pragmatic guide on tips on how to practice concepts accurately and successfully with the intention to maximise worth, and to lessen hazards. basically based, it covers education, endoscopy and imaging gear, an infection keep an eye on, sufferer coaching and tracking, issues and the way to prevent and care for them. increasing at the content material of Peter Cotton’s best-selling functional Gastrointestinal Endoscopy, this instructive quantity includes info and directions on all facets of the perform of endoscopy, and is a perfect better half for either the trainee and the skilled endoscopist.Key good points include:Written by way of the major foreign names in endoscopy textual content has been expertly edited through Peter Cotton right into a succinct and instructive layout offered briefly paragraphs established with headings, subheadings and bullet issues Richly illustrated all through with full-color images
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Extra resources for Advanced Digestive Endoscopy: Practice and Safety
Am J Gastroenerol 2005; 100: 2689–95. qxd 22/01/2008 09:40 AM Page 41 SEDATION, ANALGESIA, AND MONITORING FOR ENDOSCOPY 4 Nelson DB, Freeman ML, Silvis SE et al. A randomized, controlled trial of transcutaneous carbon dioxide monitoring during ERCP. Gastrointest Endosc 2000; 51: 288–95. 5 Vargo JJ, Zuccaro G, Dumot JA, Conwell DL, Morrow JB, Shay SS. Automated assessment of respiratory activity is superior to pulse oximetry and visual assessment for the detection of early respiratory depression during therapeutic upper endoscopy.
The development of modern flexible gastrointestinal endoscopes followed the development of fiber optics and subsequently the chargecoupled device (CCD). Modern endoscopes continue to use fiber optic light guides to transmit light to the endoscope tip. However, fiber-optic image guides have largely been replaced by copper wire that transmits digital information, from a CCD at the endoscope tip to a video processor for display. A variety of endoscope models from several manufacturers are commercially available.
Hemodynamic parameters and levels of sedation were determined at 3-minute intervals utilizing the Modified Observer’s Assessment of Alertness and Sedation. Deep sedation occurred in 68% of the patients. The procedures with the highest percentage of deep sedation assessments were EUS (29%) and ERCP (35%). Multivariate analysis showed that only ERCP and EUS were independent risk factors for deep sedation and not Body Mass Index, sedation dose or procedure duration. 33 Purposeful response after repeated/painful stimulation Intervention may be required May be inadequate Usually maintained No repsonse, event with painful stimulation Intervention often required Intervention often required May require intervention General anesthesia Adapted from Gross JB, Bailey PL, Caplan RA et al.
Advanced Digestive Endoscopy: Practice and Safety by Peter B. Cotton