Anesthesia and analgesia
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Anesthesia and analgesia · Apr 2020
Nasolaryngeal Distances in the Adult Population and an Evaluation of Commercially Available Nasotracheal Tubes.
Nasolaryngeal distance can be reliably predicted using:
NLD (mm) = 1.1 × body height (cm) – 13.2
pearl -
Anesthesia and analgesia · Apr 2020
Anesthesia Capacity of District-Level Hospitals in Malawi, Tanzania, and Zambia: A Mixed-Methods Study.
District-level hospitals (DLHs) are the main providers of surgical services for rural populations in Sub-Saharan Africa (SSA). Skilled teams are essential for surgical care, and gaps in anesthesia impact negatively on surgical capacity and outcomes. This study, from a baseline of a project scaling-up access to safe surgical and anesthesia care in Malawi, Tanzania, and Zambia, illustrates the deficit of anesthesia care in DLHs. ⋯ Tanzania, Malawi, and Zambia are falling far short of ensuring universal access to safe and affordable surgical and anesthesia care for district and rural populations. Mixed-methods situation analyses, undertaken in collaboration with anesthesia specialists-measuring and understanding deficits in district hospital anesthetic staff, equipment, and supplies-are needed to address the critical neglect of anesthesia that is essential to providing surgical responses to the needs of rural populations in SSA.
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Anesthesia and analgesia · Apr 2020
Randomized Controlled Trial Comparative StudyMcGrath MAC Videolaryngoscope Versus Optiscope Video Stylet for Tracheal Intubation in Patients With Manual Inline Cervical Stabilization: A Randomized Trial.
Manual inline stabilization of the head and neck is a recommended maneuver for tracheal intubation in patients with a suspected cervical injury. However, because applying this maneuver inevitably restricts neck flexion and head extension, indirect intubating devices such as a videolaryngoscope or a video stylet could be required for successful tracheal intubation. In this study, we compared the clinical performance of the McGrath MAC videolaryngoscope versus the Optiscope video stylet in patients with manual inline cervical stabilization during tracheal intubation. ⋯ The McGrath MAC videolaryngoscope showed a higher first-attempt success rate for tracheal intubation and a shorter intubation time than the Optiscope video stylet in cervical spine patients with manual inline stabilization during tracheal intubation. These results suggest that the McGrath MAC videolaryngoscope may be a better option for tracheal intubation in such patients.
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Anesthesia and analgesia · Apr 2020
Dexmedetomidine-Mediated Prevention of Renal Ischemia-Reperfusion Injury Depends in Part on Cholinergic Anti-Inflammatory Mechanisms.
Organ ischemia-reperfusion injury often induces local and systemic inflammatory responses, which in turn worsen organ injury. These inflammatory responses can be regulated by the central nervous system, particularly by the vagal nerve and nicotinic acetylcholine receptors, which are the key components of cholinergic anti-inflammatory pathway. Activation of the cholinergic anti-inflammatory pathway can suppress excessive inflammatory responses and be a potential strategy for prevention of ischemia-reperfusion injury of organs including the kidney. ⋯ Our findings suggest that Dex provides renoprotection, at least in part, through anti-inflammatory effects of the parasympathetic nervous system activation in addition to its direct actions on α2-adrenergic receptors.