Journal of anesthesia
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Journal of anesthesia · Dec 2015
Randomized Controlled Trial Comparative StudyEvaluation of the efficacy of six supraglottic devices for airway management in dark conditions: a crossover randomized simulation trial.
During out-of-hospital cardiopulmonary resuscitation, several factors can render tracheal intubation more difficult, such as when rescuers must secure the airway in complete darkness or with limited illumination. The purpose of this study was to evaluate the efficacy of six supraglottic devices (SGDs), ProSeal(®) (ProSeal), Classic(®) (Classic), Supreme(®) (Supreme), Laryngeal Tube(®) (LT), air-Q(®) (air-Q), and i-gel(®) (i-gel), for airway management under light and dark conditions using a manikin. ⋯ Compared to ProSeal and Classic, Supreme, i-gel, LT, and air-Q are more effective for airway management in the dark. Our findings suggest that anatomically shaped SGDs may help novice doctors secure the airway under dark conditions.
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Journal of anesthesia · Dec 2015
Randomized Controlled Trial Comparative StudyEffect of glycopyrrolate versus atropine coadministered with neostigmine for reversal of rocuronium on postoperative catheter-related bladder discomfort in patients undergoing transurethral resection of bladder tumor: a prospective randomized study.
Muscarinic receptors are involved in the mechanism of postoperative catheter-related bladder discomfort (CRBD). Glycopyrrolate and atropine as adjuncts to reversal of neuromuscular blockers have differential inhibitory effects on muscarinic receptors. This study was conducted to compare the effect of glycopyrrolate versus atropine on postoperative CRBD in patients undergoing transurethral resection of a bladder tumor (TURBT). ⋯ Glycopyrrolate as an adjunct to reversal of neuromuscular blockers decreased the incidence of early postoperative CRBD and postoperative tramadol requirements in patients undergoing TURBT when compared to atropine.
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Journal of anesthesia · Dec 2015
Randomized Controlled Trial Comparative StudyFace-to-face tracheal intubation in adult patients: a comparison of the Airtraq™, Glidescope™ and Fastrach™ devices.
Airway management in emergency settings can be difficult due to limited access to the patient. The use of video laryngoscopes along with the Fastrach™ device improves tracheal intubation; however, the use of such devices in a face-to-face intubation model has not been evaluated in adult patients. ⋯ The Airtraq™ device provided faster insertion and intubation times and enabled better Cormack-Lehane grades. Additionally, the Airtraq™ device required the minimum number of optimization maneuvers and was associated with fewer complications and fewer intubation attempts than the Glidescope™ and Fastrach™ devices during face-to-face tracheal intubation.
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Journal of anesthesia · Dec 2015
Randomized Controlled Trial Comparative StudyThe effects of intravenous fosaprepitant and ondansetron in the prevention of postoperative nausea and vomiting in patients who underwent lower limb surgery: a prospective, randomized, double-blind study.
Postoperative nausea and vomiting (PONV) is the most common complication after surgery, and opioid administration increases its incidence. We compared the preventive effects of fosaprepitant, a neurokinin-1 (NK1) receptor antagonist, with those of ondansetron on PONV in patients who underwent lower limb surgery with postoperative epidural opioid administration. ⋯ Fosaprepitant was more effective than ondansetron in decreasing the incidence of vomiting after lower limb surgery with postoperative opioid administration. Meanwhile, fosaprepitant was not inferior to ondansetron in decreasing the incidence and severity of PONV.
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Journal of anesthesia · Dec 2015
Randomized Controlled TrialFlurbiprofen axetil increases arterial oxygen partial pressure by decreasing intrapulmonary shunt in patients undergoing one-lung ventilation.
In the present study, we investigated whether flurbiprofen axetil (FA) alleviates hypoxemia during one-lung ventilation (OLV) by reducing the pulmonary shunt/total perfusion (Q s/Q t) ratio, and examined the relationship between the Q s/Q t ratio and the thromboxane B2 (TXB2)/6-keto-prostaglandin F1α (6-K-PGF1α) ratio. ⋯ Treatment with FA reduced the Q s/Q t ratio and further increased the PaO2 level during OLV, possibly due to upregulation of the vasoactive agent TXB2/6-K-PGF1α ratio.