Journal of anesthesia
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Journal of anesthesia · Oct 2015
Current status of anesthesia residency in Taiwan: a questionnaire survey.
There are 26 teaching hospitals in Taiwan that provide anesthesia residency training programs (one program per hospital), and only an average of 40 medical graduates are accepted for residency training per year. The aim of this study is to understand how this situation affects the learning and working conditions of anesthesia residents in Taiwan. ⋯ Anesthesia residents in Taiwan are treated as an integral part of hospital manpower. This may limit the effectiveness of their learning and cause dissatisfaction with their training environment. To improve the current status, anesthesia residents should perform anesthesia in one operating room at a time and some of the anesthesia training hospitals should be suggested for removal.
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Journal of anesthesia · Oct 2015
Emergency endotracheal intubation-related adverse events in bronchial asthma exacerbation: can anesthesiologists attenuate the risk?
Airway management in severe bronchial asthma exacerbation (BAE) carries very high risk and should be performed by experienced providers. However, no objective data are available on the association between the laryngoscopist's specialty and endotracheal intubation (ETI)-related adverse events in patients with severe bronchial asthma. In this paper, we compare emergency ETI-related adverse events in patients with severe BAE between anesthesiologists and other specialists. ⋯ Anesthesiologist as first exposure was independently associated with attenuated risk of ETI-related adverse events in patients with severe BAE. The skill and knowledge of anesthesiologists should be applied to high-risk airway management whenever possible.
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Levobupivacaine has been developed as a safer alternative to bupivacaine because of its reduced systemic toxicity. However, the effect of directly delivering levobupivacaine into tracheal smooth muscle has not been adequately explored. We performed this study to determine the in vitro effects of levobupivacaine on isolated rat tracheal smooth muscle. ⋯ Contraction inhibition was statistically significant when 10(-5) and 10(-4) M levobupivacaine were applied, compared with the contraction inhibition that occurred in the control groups (p < 0.01). A high dose of levobupivacaine also decreased the spike contraction induced by electrical field stimulation. This study indicated that high concentrations of levobupivacaine might antagonize the cholinergic receptors and inhibit parasympathetic function of the trachea.
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Journal of anesthesia · Oct 2015
The use of a needle guide kit improves the stability of ultrasound-guided techniques.
A needle guide kit will be able to improve visibility on ultrasonic images. We examined the degree of stability using a SIVA guide. The SIVA guide is a needle guide kit in which the angle is not restricted, allowing the puncture to be made at any angle. ⋯ Six anesthesiologists with >7 years experience performed two punctures-one case was punctured with a SIVA guide and the other was punctured without a SIVA guide. Some significant differences were noted in the results between the two punctures at depths of 1.0, 1.5, and 2.0 cm. We were able to prove that the use of a needle guide kit could improve visibility on ultrasonic images.