Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Randomized Controlled Trial Comparative Study
A comparison between left molar direct laryngoscopy and the use of a Bonfils intubation fibrescope for tracheal intubation in a simulated difficult airway.
Tracheal intubation in patients with an immobilized cervical spine can be difficult because of a restricted mouth opening and limited neck movements. Use of the Bonfils intubation fibrescope (BIF) or left molar (LM) laryngoscopy may be suitable options for tracheal intubation in such patients. Intubation adjuncts, such as an endotracheal tube introducer, may improve the overall intubation success rate with the LM approach. Formal studies are currently lacking on the use of LM laryngoscopy with a tube introducer. ⋯ The tube introducer-assisted LM approach to intubation may be a good alternative to the BIF approach in patients with anticipated and unanticipated difficult airway scenarios.
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Randomized Controlled Trial Comparative Study
A randomized comparison between the i-gel™ and the air-Q™ supraglottic airways when used by anesthesiology trainees as conduits for tracheal intubation in children.
Supraglottic airways are commonly used as conduits for fibreoptic bronchoscopy (FOB)-guided intubation in pediatric patients. We hypothesized that anesthesiology trainees with limited prior experience with FOB-guided intubation through a supraglottic airway in children would intubate the trachea faster through the air-Q™ supraglottic airway than through the i-gel™. ⋯ Contrary to our hypothesis, both the air-Q and i-gel supraglottic airways served as effective conduits for FOB-guided tracheal intubation in children when performed by trainees with limited prior experience. The i-gel, however, was associated with more problems during device removal following tracheal intubation. This study was registered at http://clinicaltrials.gov/show/NCT02189590 .
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Randomized Controlled Trial
Randomized controlled trial of gabapentin as an adjunct to perioperative analgesia in total hip arthroplasty patients.
Gabapentin was investigated as a single-dose adjunct to morphine for postoperative pain management. The primary objective was to determine if gabapentin given preoperatively and for two days postoperatively as part of multimodal analgesia would decrease postoperative morphine consumption in patients undergoing primary total hip arthroplasty (THA). ⋯ This trial indicated that gabapentin treatment had no clinically important reduction in postoperative morphine consumption at 72 hr in patients undergoing THA. Multimodal analgesia may account for the similar primary and secondary outcomes found in the groups. This trial was registered at ClinicalTrials.gov, number: NCT01307202.
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Randomized Controlled Trial
Cricothyrotomy training increases adherence to the ASA difficult airway algorithm in a simulated crisis: a randomized controlled trial.
Non-adherence to airway guidelines in a 'cannot intubate-cannot oxygenate' (CICO) crisis situation is associated with adverse patient outcomes. This study investigated the effects of hands-on training in cricothyrotomy on adherence to the American Society of Anesthesiologists difficult airway algorithm (ASA-DAA) during a simulated CICO scenario. ⋯ Hands-on training in cricothyrotomy resulted in fewer major ASA-DAA deviations in a simulated CICO scenario. Training in cricothyrotomy may play an important role in complying with the ASA-DAA in a CICO situation but does not appear to affect non-technical behaviours such as decision-making.