Anesthesia and analgesia
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Anesthesia and analgesia · Nov 2013
Randomized Controlled Trial Comparative StudyA Comparison Between the Bonfils Intubation Fiberscope and McCoy Laryngoscope for Tracheal Intubation in Patients with a Simulated Difficult Airway.
The Bonfils Intubation Fibrescope (Bonfils) and the McCoy laryngoscope (McCoy) are airway devices designed to assist tracheal intubation in difficult cases. Individually, both the Bonfils and McCoy have demonstrated superiority to the Macintosh laryngoscope in a simulated difficult airway. In this study, we compared the Bonfils with the McCoy laryngoscope in patients whose tracheal intubation had been intentionally hindered. Our primary hypothesis was that there is a significant difference in the rate of success for tracheal intubation when using the Bonfils or McCoy laryngoscope in patients with an intentionally hindered airway. ⋯ In the hands of trained operators, there appears to be no clinically significant difference in success, time to intubation, or adverse outcomes, when comparing the Bonfils with the McCoy laryngoscope, in the setting of a simulated difficult airway. The choice to use either device should remain based on appropriate patient selection, available aids, individual operator's experience, and economic circumstances.
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Anesthesia and analgesia · Nov 2013
Randomized Controlled Trial Comparative StudyA Comparison of Quincke and Whitacre Needles with Respect to Risk of Intravascular Uptake in S1 Transforaminal Epidural Steroid Injections: A Randomized Trial of 1376 Cases.
Transforaminal epidural steroid injection (TFESI) is a useful treatment modality for pain management. Most complications of TFESI are minor and transient. However, there is a risk of serious complications such as nerve injury, spinal cord infarct, or paraplegia. Some of the risks are related to direct injury to the vessel or intravascular injection of the particulate steroid. We prospectively tested the hypothesis that the intravascular injection rate of the Whitacre needle is lower than that of the Quincke needle during TFESI. ⋯ To reduce the risk of intravascular injection, the use of Whitacre needles without intrasacral bone contact may be a safer and more effective approach.
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Anesthesia and analgesia · Nov 2013
Closed-Loop Fluid Resuscitation: Robustness Against Weight and Cardiac Contractility Variations.
Surgical patients present with a wide variety of body sizes and blood volumes, have large differences in baseline volume status, and may exhibit significant differences in cardiac function. Any closed-loop fluid administration system must be robust against these differences. In the current study, we tested the stability and robustness of the closed-loop fluid administration system against the confounders of body size, starting volume status, and cardiac contractility using control engineering methodology. ⋯ The results indicate that the controller is highly effective in targeting optimal blood and stroke volumes, regardless of weight, contractility or starting blood volume.