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        Recent Developments in Devices Used for Gastrointestinal Endoscopy Sedation

        Basavana Goudra,Gowri Gouda,Preet Mohinder Singh 대한소화기내시경학회 2021 Clinical Endoscopy Vol.54 No.2

        Hypoxemia is a frequent and potentially fatal complication occurring in patients during gastrointestinal endoscopy. Theadministration of propofol sedation increases the risk of most complications, especially hypoxemia. Nevertheless, propofol has beenincreasingly used in the United States, and the trend is likely to increase in the years to come. Patient satisfaction and endoscopistsatisfaction along with rapid turnover are some of the touted reasons for this trend. However, propofol sedation generally impliesdeep sedation or general anesthesia. As a result, hypopnea and apnea frequently occur. Inadequate sedation and presence of irritableairway often cause coughing and laryngospasm, both leading to hypoxemia and potential cardiac arrest. Hence, prevention ofhypoxemia is of paramount importance. Traditionally, standard nasal cannula is used to administer supplement oxygen. However, itcannot sufficiently provide continuous positive airway pressure (CPAP) or positive pressure ventilation. Device manufacturers havestepped in to fill this void and created many types of cannulas that provide apneic insufflation of oxygen and CPAP and eliminatedead space. Such measures decrease the incidence of hypoxemia. This review aimed to provide essential information of some of thesedevices.

      • KCI등재

        Association between Type of Sedation and the Adverse Events Associated with Gastrointestinal Endoscopy: An Analysis of 5 Years’ Data from a Tertiary Center in the USA

        Basavana Goudra,Ahmad Nuzat,Preet Mohinder Singh,Anuradha Borle,Augustus Carlin,Gowri Gouda 대한소화기내시경학회 2017 Clinical Endoscopy Vol.50 No.2

        Background/Aims: The landscape of sedation for gastrointestinal (GI) endoscopic procedures and the nature of the procedures themselves have changed over the last decade. In this study, an attempt is made to analyze the frequency and etiology of all major adverse events associated with GI endoscopy. Methods: All adverse events extracted from the electronic database and local registry were analyzed. Although the data analysis was retrospective, the adverse events themselves were documented prospectively. These events were evaluated after subdivision into propofol-based anesthesia and intravenous conscious sedation groups. Results: Cardiorespiratory events, including cardiac arrest, were the most common adverse events during esophagogastroduodenoscopy, while bleeding was more frequent in patients undergoing colonoscopy. Pancreatitis was the most frequent adverse event in patients undergoing endoscopic retrograde cholangiopancreatography. The frequencies of most adverse events were significantly higher in patients anesthetized with propofol. Automatic regression modeling showed that the type of sedation, the American Society of Anesthesiologists physical status classification, and the procedure type were some of the predictors of immediate life-threatening complications. Conclusions: Clearly, our regression modeling suggests a strong association between the type of sedation as well as various patient factors and the frequency of adverse events. The possible reasons for our results are the changing demographics, the worsening comorbidities of the patient population, and the increasing technical complexity of these procedures. Although extensive use of propofol has increased patient satisfaction and procedure acceptability, its use is also associated with more frequent adverse events.

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        Preparation, structure and adsorption properties of synthesized multiwall carbon nanotubes for highly effective removal of maxilon blue dye

        Ayad Fadhil Alkaim,Zainab Sadik,Dunia Kamil Mahdi,Saif Mohammed Alshrefi,Abdulkareem Mohammed Al-Sammarraie,Faisal Muhammad Alamgir,Preet Mohinder Singh,Aseel Mushtaq Aljeboree 한국화학공학회 2015 Korean Journal of Chemical Engineering Vol.32 No.12

        Multiwall carbon nanotubes (MWCNTs) have been hydrothermally prepared using polyethylene glycol as the carbon source. Herein, new MWCNTs composites with high adsorption capacity were prepared and applied as efficient adsorbents for adsorption of maxilon blue dye (GRL) from aqueous solution. The morphologies of the MWCNTs were characterized by X-ray diffraction (XRD), Raman spectroscopy, scanning electron microscopy (SEM), transmission electron microscopy (TEM) and Fourier transform-infrared (FT-IR) spectroscopy. The adsorption property of maxilon blue (GRL) from aqueous solution onto MWCNTs was studied as a function of mass dosage, pH of solution, initial dye concentration and temperature. The adsorption of GRL depends on the initial pH of the solution with maximum uptake occurring at about pH 10. The maximum adsorption capacity of prepared MWCNTs was 260.7mg/g. Langmuir, Freundlich and Temkin isotherms were applied to fit the experimental data. The Freundlich equilibrium isotherm fitted well the experimental data indicating the homogeneity of the adsorbent surface sites. Thermodynamics parameters were studied the changes in free energy (ΔG0), enthalpy (ΔH0) and entropy (ΔS0) during adsorption. It is noticeable that the adsorption of GRL dye onto MWCNTs was a spontaneous and endothermic process and indicates that the adsorption is favored at high temperature.

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