Anesthesiology
-
Randomized Controlled Trial Comparative Study
Intubation Biomechanics: Laryngoscope Force and Cervical Spine Motion during Intubation with Macintosh and Airtraq Laryngoscopes.
Laryngoscopy and endotracheal intubation in the presence of cervical spine instability may put patients at risk of cervical cord injury. Nevertheless, the biomechanics of intubation (cervical spine motion as a function of applied force) have not been characterized. This study characterized and compared the relationship between laryngoscope force and cervical spine motion using two laryngoscopes hypothesized to differ in force. ⋯ The relationship between laryngoscope force and cervical spine motion is: (1) nonlinear and (2) differs between laryngoscopes. Differences between laryngoscopes in motion/force relationships are likely due to: (1) laryngoscope-specific cervical extension needed for intubation, (2) laryngoscope-specific airway displacement/deformation needed for intubation, and (3) cervical spine and airway tissue viscoelastic properties. Cervical spine motion during endotracheal intubation is not directly proportional to force. Low-force laryngoscopes cannot be assumed to result in proportionally low cervical spine motion.
-
Randomized Controlled Trial Comparative Study
Intraperitoneal Local Anesthetics Have Predominant Local Analgesic Effect: A Randomized, Double-blind Study.
Intermittent intraperitoneal lidocaine at 50 mg/h reduces post-operative morphine consumption by almost 50% after open abdominal hysterectomy.
pearl -
Randomized Controlled Trial
Limb Remote Ischemic Preconditioning Attenuates Lung Injury after Pulmonary Resection under Propofol-Remifentanil Anesthesia: A Randomized Controlled Study.
Remote ischaemic preconditioning was induced using a BP cuff on one arm with three 5-min-ON / 5-min-OFF cycles before surgical start. Patients receiving RIPC before elective thoracotomy and pulmonary resection experienced less acute lung injury (indicated by PaO2/FiO2) and a 30% shorter hospital stay compared to those who did not receive RIPC.
summary -
Randomized Controlled Trial
Cyclosporine Protects the Heart during Aortic Valve Surgery.
Cyclosporine administered at the time of cardiac reperfusion may reduce reperfusion injury from CPB, although with uncertain clinical benefit.
pearl -
Randomized Controlled Trial Comparative Study
Comparison of Three Techniques for Ultrasound-guided Femoral Nerve Catheter Insertion: A Randomized, Blinded Trial.
Ultrasound guidance for continuous femoral perineural catheters may be supplemented by electrical stimulation through a needle or through a stimulating catheter. The authors tested the primary hypothesis that ultrasound guidance alone is noninferior on both postoperative pain scores and opioid requirement and superior on at least one of the two. Second, the authors compared all interventions on insertion time and incremental cost. ⋯ Ultrasound guidance alone without adding either stimulating needle or needle/catheter combination thus seems to be the best approach to femoral perineural catheters.