Journal of anesthesia
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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 TrialElectrostimulation with or without ultrasound-guidance in interscalene brachial plexus block for shoulder surgery.
In a prospective controlled trial to compare conventional interscalene brachial plexus block (ISBPB) using anatomic landmarks and electro-stimulation with a combined technique of ultrasound guidance followed by nerve stimulation, 60 patients were randomized into 2 matched equal groups: Group A using nerve stimulation (NS) alone and Group B using the combination of ultrasound and NS. The time to detect the plexus (3.9 ± 4 min in Group A and 3.3 ± 1.4 min in Group B) was not significantly different. We needed to reposition the needle once (n = 13) or twice (n = 4) in Group B. ⋯ None of the patients needed general anaesthesia. There were no significant differences between postoperative pain, motor power, or patient's satisfaction. ISBPB seems similarly effective using electro-stimulation and ultrasound if performed by experienced anesthesiologists.
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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
Case ReportsCervical impalement injury to a child by a chopstick diagnosed with computed tomography and ultrasonography.
Injuries penetrating into the floor of the mouth in the oral cavity caused by chopsticks are rare. We report a case of neck impalement injury caused by a wooden chopstick fragment penetrating all the way through the base of the tongue. An 18-month-old boy fell off his chair when he was biting on a wooden chopstick. ⋯ Postoperative progress was satisfactory and without complications. Of particular interest is the sensitivity of US in outlining the broken chopstick fragment lodged in the neck. It is noteworthy that the contrast of the chopstick greatly varied between CT and US.
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Journal of anesthesia · Aug 2012
Case ReportsIncidence and neurological outcomes of aneurysm rupture during interventional neuroradiology procedures in a hybrid operating suite.
A hybrid operating suite, where craniotomy, brain CT scanning, fluoroscopy, and angiography can be performed on the same operating table, is becoming popular among neurosurgeons. However, whether use of a hybrid operating suite can improve neurological outcome has not been studied. ⋯ Despite emergency neurosurgical intervention within 2 h of rupture of the aneurysms, two of these five patients died and one patient had permanent neurological deficit postsurgery. Whether use of a hybrid operating suite improves neurological outcome remains uncertain.