Journal of neurosurgical anesthesiology
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J Neurosurg Anesthesiol · Jul 2020
Randomized Controlled TrialHigh-fidelity Training Model for Measurement of Dynamic Optic Nerve Sheath Diameter Using Transorbital Ultrasonography.
Transorbital ultrasonographic measurement of optic nerve sheath diameter (ONSD) is an important technique for bedside assessment of raised intracranial pressure (ICP). However, developing competency for this clinical skill requires practice scans on both normal subjects and patients with raised ICP. The aim of this study is to develop a high-fidelity training model capable of measuring dynamic changes in ONSD and to test the reliability and reproducibility of the model at different simulated ICP values. ⋯ We have developed a clinically relevant model capable of simulating changes in ONSD in patients with normal and raised ICP. This model could be a valuable training tool to gain scanning experience in optic nerve ultrasonography, and improve operators' technical abilities.
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J Neurosurg Anesthesiol · Jul 2020
Randomized Controlled Trial Comparative StudyIntubating Laryngeal Mask Airway-assisted Flexible Bronchoscopic Intubation is Associated With Reduced Cervical Spine Motion When Compared With C-MAC Video Laryngoscopy-guided Intubation: A Prospective Randomized Cross Over Trial.
In the evolving research into cervical spine mechanics during airway intervention, new devices are being constantly added to the armamentarium of anesthesiologists. In this study we compared cervical spine movement during orotracheal intubation using an intubating laryngeal mask airway (LMA Fastrach) assisted flexible bronchoscope or video laryngoscope. ⋯ There was significantly less movement in the craniocervical and upper cervical spine during LMA Fastrach assisted flexible bronchoscopic intubation compared to video laryngoscopic intubation.
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J Neurosurg Anesthesiol · Jul 2020
Randomized Controlled TrialCervical Spine Movement During Awake Orotracheal Intubation With Fiberoptic Scope and McGrath Videolaryngoscope in Patients Undergoing Surgery for Cervical Spine Instability: A Randomized Control Trial.
Cervical spine movement during intubation with direct laryngoscopy can predispose to new-onset neurological deficits in patients with cervical spine instability. While fiberoptic-guided intubation (FGI) is mostly preferred in such patients, this is not always possible. Videolaryngoscopy results in less cervical spine movement than direct laryngoscopy and may be an alternative to FGI in patients with cervical spine instability. The objective of this study was to compare cervical spine movement during awake FGI with those during awake McGrath videolaryngoscope-guided intubation (VGI) in patients undergoing surgery for cervical spine instability. ⋯ Compared with FGI, VGI results in a greater degree of cervical spine movement at C1/C2 but not at C3.