Journal of anesthesia
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Journal of anesthesia · Aug 2012
Randomized Controlled Trial Comparative StudyEfficacy of Coopdech videolaryngoscope: comparisons with a Macintosh laryngoscope and the Airway Scope in a manikin with difficult airways.
We studied the efficacy of the Coopdech videolaryngoscope Portable VLP-100, by comparing it with a Macintosh laryngoscope, and another videolaryngoscope, the Airway Scope (AWS), in a manikin with four simulated difficult airways. In a randomized, crossover design, each of 50 residents inserted the three devices, in turn, and graded the view of the glottis at laryngoscopy. Time to see the glottis, time to intubate the trachea, and the success rate of tracheal intubation (within 120 s) were recorded. ⋯ In a manikin with cervical spine rigidity or pharyngeal obstruction, the AWS and the VLP-100 provided significantly higher success rates of intubation than the Macintosh laryngoscope (P < 0.05). In a manikin with laryngospasm, no one could intubate the trachea using any device. Our results indicate that, in patients with difficult airways, the videolaryngoscopes (VLP-100 and AWS) would provide higher success rates of tracheal intubation than the Macintosh laryngoscope, but the VLP-100 may be inferior to the AWS.
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Journal of anesthesia · Aug 2012
Review Meta AnalysisA comprehensive appraisal of meta-analyses focusing on nonsurgical treatments aimed at decreasing perioperative mortality or major cardiac complications.
Millions of patients worldwide who undergo surgical procedures face significant morbidity and mortality risks. Several systematic reviews have been performed on ancillary treatments aimed at improving surgical outcomes, but their features and scholarly impact are unclear. We describe characteristics of meta-analyses on ancillary treatments aimed at improving surgical outcomes and explore factors associated with scholarly citations. ⋯ Systematic reviews currently represent a key element in defining state of the art ancillary treatments of patients undergoing surgery. However, the citation success of available meta-analyses is not significantly associated with prognostically relevant findings or quality features.
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Journal of anesthesia · Aug 2012
Randomized Controlled TrialKetofol in electroconvulsive therapy anesthesia: two stones for one bird.
Propofol and ketamine have become progressively popular in electroconvulsive therapy (ECT) anesthesia, although propofol shortened seizure duration and ketamine might cause cardiotoxicity, psychotic episodes, and delayed recovery. Ketofol is a combination of ketamine and propofol, and the current study was designed to evaluate the effect of ketamine, propofol, and ketofol on hemodynamic profile, duration of seizure activity, and recovery times in patients undergoing ECT. ⋯ The ketofol 1:1 mixture is associated with longer mean seizure time than propofol, and shorter mean recovery times than ketamine, with better hemodynamic stability, without any important side effects in ECT anesthesia.
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Journal of anesthesia · Aug 2012
Randomized Controlled TrialThe application of dexmedetomidine in children undergoing vitreoretinal surgery.
Dexmedetomidine is a highly selective alpha-2 adrenergic agonist that has a sedative effect and has been shown to reduce anesthetic requirements. It also has a sympatholytic effect, which may prove useful when used to blunt the sympathetic surge during intubation and extubation. However, its effects on intraocular pressure, hemodynamic stability, attenuation of extubation response, and emergence agitation remain unclear for pediatric patients undergoing vitreoretinal surgery. We focused on these effects in this study. ⋯ Dexmedetomidine 0.5 µg/kg had no effect on intraoperative hemodynamics or intraocular pressure, but attenuated the hemodynamic response to extubation and diminished emergence agitation in pediatric patients undergoing vitreoretinal surgery.
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Journal of anesthesia · Aug 2012
Randomized Controlled TrialAvailability of a 5% lidocaine patch used prophylactically for venipuncture- or injection-related pain in children.
Venipuncture- or injection-related pain is still major problem during anesthetic induction in children. This study was designed to determine the availability of a 5% lidocaine patch used prophylactically for venipuncture- or injection-related pain during the induction of anesthesia. ⋯ Although pretreatment with a 5% lidocaine patch was found to be a safe, effective, and simple method of preventing venipuncture pain in children, this method did not reduce drug injection pain during the induction of anesthesia.