Journal of clinical anesthesia
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Randomized Controlled Trial Clinical Trial
The laryngeal lift: a method to facilitate endotracheal intubation.
To assess the efficacy of the "laryngeal lift" maneuver in improving laryngoscopic visualization to facilitate endotracheal intubation. ⋯ The laryngeal lift should be part of the anesthesiologists' armamentarium in helping the laryngoscopist who is faced with Grades II, III, IV, and V laryngoscopic views to enhance visualization of the larynx and thus facilitate endotracheal intubation.
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Pregnancy carries substantial maternal and fetal risks in patients with uncorrected or palliatively corrected cyanotic congenital heart disease (CHD). In tricuspid valve Ebstein's anomaly, pregnancy is well tolerated. Maternal mortality in tetralogy of Fallot seems to be less than 10%, but it exceeds 50% in Eisenmenger's syndrome and primary pulmonary hypertension (PPH). ⋯ Prevention of excessive erythrocytosis, volume and blood loss substitution, cardiocirculatory pharmacologic support, prophylaxis of infective endocarditis, and judicious use of anticoagulant drugs should be applied as indicated by the type and presentation of CHD. Poor outcome of pregnancy in PPH requires an early consideration of heart-lung or lung transplantation. Multidisciplinary team effort and prolonged monitoring in the intensive care unit are mandatory to ensure a favorable outcome for cyanotic CHD and PPH parturients.
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To estimate the frequency of successful conduction blockade of the femoral, lateral femoral cutaneous, and obturator nerves following a femoral 3-in-1 block. ⋯ The femoral 3-in-1 nerve block does not block the parent trunk of the obturator nerve.
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Comparative Study
Computerized patient anesthesia records: less time and better quality than manually produced anesthesia records.
To compare manual and computerized anesthesia information management systems (AIMS's) with respect to time demands on the anesthetist and record quality. ⋯ The concern that the introduction of computerized AIMS's may complicate the anesthesia working environment by requiring more time than manual AIMS's and thus detracting from direct patient care is not supported by this study. In fact, this computer approach not only required less time but also produced a more complete and higher-quality record than did the manual AIMS.
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Although the use of a gum-elastic bougie to secure an airway is well described, its use during extubation is not well documented. A bougie was passed through the endotracheal tube (ETT) prior to extubation in anticipation of possible reintubation of a patient with a difficult airway. Once the bougie was in place, the ETT was removed over it. Later, when the patient's airway did become compromised, the trachea was rapidly reintubated using the bougie, without the need for direct laryngoscopy, fiberoptic bronchoscopy, or, worse, emergency tracheostomy.