Anesthesia and analgesia
-
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.
-
Anesthesia and analgesia · Apr 2020
ReviewA Narrative Review of Oxygenation During Pediatric Intubation and Airway Procedures.
Hypoxemia is a common complication in the pediatric operating room during endotracheal intubation and airway procedures and is a precursor to serious adverse events. Small children and infants are at greater risk of hypoxemia due to their high metabolic requirements and propensity to alveolar collapse during general anesthesia. To improve the care and safety of this vulnerable population, continued efforts must be directed to mitigate hypoxemia and the risk of subsequent serious adverse events. ⋯ Humidified, high-flow nasal oxygenation systems have been shown to provide excellent conditions for effective apneic oxygenation in adults and children and have the added benefit of providing some carbon dioxide clearance in adults; although, this latter benefit has not been shown in children. Humidified, high-flow nasal oxygenation systems may also be useful during spontaneous ventilation for airway procedures in children by minimizing room air entrainment and maintaining adequate oxygenation allowing for a deeper anesthetic. The use of apneic oxygenation and humidified, high-flow nasal oxygenation systems in the pediatric operating room reduces the incidence of hypoxemia and may be effective in decreasing related complications.
-
Anesthesia and analgesia · Apr 2020
Randomized Controlled TrialEffects of Perioperative Administration of Acetaminophen on Postoperative Shivering: A Randomized, Triple-Blind, Placebo-Controlled Trial.
In this randomized, triple-blind, placebo-controlled trial, we tested the hypothesis that perioperative acetaminophen administration has a prophylactic effect on postoperative shivering. ⋯ Our findings in patients undergoing gynecological laparotomy suggest that perioperative acetaminophen administration can prevent postoperative severe shivering. This prophylactic effect might be due to suppressing the postoperative increase in the BT set point, rather than lowering the threshold for shivering, as observed with clonidine.
-
Anesthesia and analgesia · Apr 2020
Multicenter Study Observational StudyA Multinational Observational Study Exploring Adherence With the Kidney Disease: Improving Global Outcomes Recommendations for Prevention of Acute Kidney Injury After Cardiac Surgery.
The Kidney Disease: Improving Global Outcomes (KDIGO) guidelines recommend a bundle of different measures for patients at increased risk of acute kidney injury (AKI). Prospective, single-center, randomized controlled trials (RCTs) have shown that management in accordance with the KDIGO recommendations was associated with a significant reduction in the incidence of postoperative AKI in high-risk patients. However, compliance with the KDIGO bundle in routine clinical practice is unknown. ⋯ In patients after cardiac surgery, compliance with the KDIGO recommendations was low in routine clinical practice.
-
Anesthesia and analgesia · Apr 2020
Multicenter StudyAwake Volunteer Pain Scores During Neuromuscular Monitoring.
There is a need for easy to use, reliable neuromuscular monitors (NMMs). This multicenter, prospective, unblinded study compared the discomfort associated with neurostimulation in unmedicated healthy volunteers when using the new electromyography (EMG)-based TetraGraph and acceleromyography (AMG)-based TOF-Watch NMMs. The secondary aim was to compare the repeatability of the train-of-four (TOF) ratios (TOFRs) obtained with the 2 devices. ⋯ Despite the different size and design of the stimulating electrodes, the 2 NMMs caused the same level of discomfort in unmedicated healthy volunteers.