Journal of clinical anesthesia
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Randomized Controlled Trial
Do mask aperture bars of extraglottic airway devices prevent prolapse of epiglottis causing airway obstruction? A randomized crossover trial in anesthetized adult patients.
The study objective is to determine whether extraglottic airway devices (EADs) with or without mask aperture bars (MABs) result in similar anatomical positions in patients undergoing surgery. ⋯ This study demonstrated that the anatomical position of the four tested single-use EADs is similar with or without mask aperture bars. We therefore question whether MABs have a protective role in prevention of airway occlusion and whether MABs are essential components. In the overall majority of EADs with MABs, the latter did not prevent contact with the epiglottis. Contact and herniation of the laryngeal structures are seen more frequently when more than two MABs are present.
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Randomized Controlled Trial Comparative Study
Comparison of three video laryngoscopy devices to direct laryngoscopy for intubating obese patients: a randomized controlled trial.
To compare three different video laryngoscope devices (VL) to standard direct laryngoscopy (DL) for tracheal intubation of obese patients undergoing bariatric surgery. ⋯ Video-Mac and GlideScope required fewer intubation attempts than standard DL and the McGrath device. The Video-Mac also significantly reduced the time needed to secure the airway and improved the glottic view compared to standard DL.
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Randomized Controlled Trial
A randomized placebo-controlled study of preoperative pregabalin for postoperative analgesia in patients with spinal surgery.
To determine whether single preoperative administration of 2 different doses of pregabalin (75 and 150 mg) could decrease postoperative pain intensity and opioid consumption following posterior lumbar interbody fusion surgery. ⋯ Single preoperative administration of 150 mg of pregabalin 2 hours prior to surgery reduced postoperative pain intensity and morphine consumption compared with 5 mg diazepam in patients who underwent posterior lumbar interbody fusion.
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Randomized Controlled Trial Comparative Study
Comparison of the C-MAC video laryngoscope to a flexible fiberoptic scope for intubation with cervical spine immobilization.
To compare the C-MAC video laryngoscope to the standard flexible fiberoptic scope (FFS) with an eye piece (but without a camera or a video screen) for intubation of patients undergoing cervical spine surgery with manual inline stabilization. The primary end point was the time to achieve successful tracheal intubation. Secondary end points included glottic view at intubation and number of intubation attempts. ⋯ The C-MAC may offer an advantage over the FFS with respect to the time required to obtain glottic view and successful placement of the tracheal tube in patients requiring cervical spine immobilization.
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We describe a very rare case of an indwelling central venous catheter (CVC) through the left internal jugular vein that perforated the superior vena cava (SVC) wall postoperatively, although the CVC was placed in the appropriate position preoperatively. Three days after CVC insertion, a chest radiograph showed that the CVC tip had moved from the lower SVC to the upper SVC. ⋯ In cases of CVC insertion through the left side, the CVC tip should not be placed in the upper SVC (zone B). Considering individual clinical factors and the indwelling period for the CVC, the left innominate vein (zone C) may be a suitable site for the left-sided CVC tip to reduce the risk of SVC perforation.