Journal of clinical anesthesia
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Review Meta Analysis Comparative Study
Commonly-used versus less commonly-used methods in the loss of resistance technique for identification of the epidural space: A systematic review and meta-analysis of randomized controlled trials.
To summarize the efficacy of less-commonly used modern methods (e.g. epidrum, lidocaine, acoustic device, Macintosh balloon) compared to more commonly-used methods (i.e. air, saline, both) in the loss of resistance technique for identification of the epidural space. ⋯ Moderate-quality evidence shows that less commonly-used modern methods such as epidrum, lidocaine and acoustic devices, are more efficacious compared to more commonly-used methods (i.e. air, saline, both) in terms of the loss of resistance technique for identification of the epidural space. These findings should be explored further in the context of the clinical practice among anaesthesiologists.
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Randomized Controlled Trial Comparative Study
Randomized trial of a novel double lumen nasopharyngeal catheter versus traditional nasal cannula during total intravenous anesthesia for gastrointestinal procedures.
Patients undergoing general anesthesia routinely experience episodes of hypoxemia. There are multiple causes of procedural oxygen desaturation including upper airway obstruction and central hypoventilation. We hypothesize that oxygen supplementation via nasopharyngeal catheter (NPC) will decrease the number of episodes of hypoxemia as compared to traditional NC oxygen supplementation in patients undergoing general anesthesia provided by an anesthesia provider for gastrointestinal endoscopy procedures. ⋯ Oxygen supplementation via a nasopharyngeal catheter during intravenous general anesthesia resulted in significantly fewer episodes of hypoxemia and number of airway assist maneuvers. Future studies are needed to assess the utility of NPC in other clinical environments where supplemental oxygen is required in the setting of potential airway obstruction.
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Review Meta Analysis Comparative Study
The sedative effects of the intranasal administration of dexmedetomidine in children undergoing surgeries compared to other sedation methods: A systematic review and meta-analysis.
Administration of intranasal dexmedetomidine for sedation is comfortable and effective in children who are afraid of needles, and it offers efficient sedation similar to that of intravenous administration. We performed a systematic review and meta-analysis to evaluate the clinical effects of the pre-procedural administration of intranasal dexmedetomidine. ⋯ This review suggests that intranasal dexmedetomidine is associated with better sedative effects than oral benzodiazepines without producing respiratory depression, but it had a significantly delayed onset of effects.
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Randomized Controlled Trial Comparative Study
Effect of propofol, sevoflurane, and isoflurane on postoperative cognitive dysfunction following laparoscopic cholecystectomy in elderly patients: A randomized controlled trial.
To compare the incidence of postoperative cognitive dysfunction (POCD) in elderly surgical patients (>60years) receiving different anesthetics (propofol, sevoflurane, or isoflurane) and to identify potential biomarkers of POCD in this patient population. ⋯ Propofol anesthesia may be an option for elderly surgical patients.
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Randomized Controlled Trial
Airborne bacterial contamination during orthopedic surgery: A randomized controlled pilot trial.
Several factors such as lack of unidirectional, turbulent free laminar airflow, duration of surgery, patient warming system, or the number of health professionals in the OR have been shown or suspected to increase the number of airborne bacteria. The objective of this study was to perform a multivariate analysis of bacterial counts in the OR in patients during minor orthopedic surgery. ⋯ ORs with unidirectional turbulent free laminar airflow, and a reduction of surgery time decreased the number of viable airborne bacteria. These factors may be particularly important in critical patients with a high risk for the development of surgical site infections.