FDA Warning For Sedation in Kids Under 3 Years and Pregnant Women

On 12/14/16, the FDA published a warning that prolonged or repeated sedation in kids under 3 years old and women who are pregnant during their third trimester may adversely affect childhood brain development. However, a single short exposure to a general anesthetic and sedation drugs in infants or toddlers is UNLIKELY to have any negative effects on the brain. Such short time exposure with minimal risk would apply to ear tube placements as well as tonsillectomy and adenoidectomy . This r…

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Esophagoscopy without Sedation [VIDEO]

Here is a video demonstrating how esophagoscopy can be performed in the office without any sedation. The esophagus is the tube that connects the mouth to the stomach. The exam, called trans-nasal esophagoscopy (TNE), can be performed in any patient as long as the nose is large enough to accommodate the endoscope and lack a severe gag reflex. A very thin disposable sheath (like a condom) is used to protect endoscope and maintain sterility between patient use.

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Ear Tube Placement in Kids WITHOUT Sedation (Starting at 12 Months of Age)

A recent report describes how using a relatively old technology, ear tube placement can now be performed in children starting at 12 months of age with chronic ear infections or hearing loss due to fluid buildup without the need for sedation of any kind nor aggressive restraints (ie papoose). Historically,  ear tube placement in the office without sedation is typically performed starting at around 12 years of age using standard local anesthesia techniques. Any younger, a child could not …

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New Video on Awake Tonsil Cryptolysis to Address Tonsil Stones

A  new video  has been uploaded describing a minimally invasive technique to address tonsil stones called  tonsil cryptolysis . This technique accomplishes the same thing as laser cryptolysis but at lower cost and increased safety. Just like laser cryptolysis, this procedure can be done awake without any sedation using only local anesthesia (the caveat being that the patient must have minimal/no gag reflex with easy visualization of the tonsils). Watch the video below or on  YouTube . Read…

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In-Office Sinus Surgery Without General Anesthesia

There has been tremendous advances in sinus surgery over the past decade. From the elimination of nasal packing after most routine sinus surgery to the more recent use of balloons to open the sinus cavities, patient comfort has improved greatly after this particular operation. What used to be a several week recovery may now only be a few days. Balloon sinuplasty in particular has been revolutionary in the surgical treatment of chronic sinusitis . Though sinus surgery normally is performe…

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Tonsillectomy Circa 1940s [video]

I encountered this interesting video of tonsillectomy being performed in a child with sedation (but NO intubation) performed circa 1940s. Of course, nowadays, tonsillectomy is performed under general anesthesia with intubation for airway protection. Below is a video of the way it is now done. That is, unless, you practice in other parts of the world where modern medicine is not up to United States standards. In those nations, tonsillectomy is STILL being performed WITHOUT general ane…

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