Anaesthesia
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Review
Peripartum general anasthesia without tracheal intubation: incidence of aspiration pneumonia.
This study estimated the incidence of pulmonary aspiration during general anasthesia for obstetric procedures performed in the peripartum period (Caesarean sections were not studied). The records of 1870 patients anasthetised without tracheal intubation were reviewed retrospectively. The diagnosis of aspiration was based on the anasthetist's written remarks and the postoperative course. ⋯ No cricoid pressure or tracheal intubation was performed. A single case of mild aspiration was detected in a woman anasthetised with methohexital (an incidence of 0.053%). These results suggest that the risk of aspiration during general anasthesia without tracheal intubation, during and immediately after delivery, may not be higher in obstetric patients in the peripartum period, as has been reported previously.
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The gum elastic bougie is a simple device that is used to assist in the management of the difficult intubation. It is not uncommon for a bougie to be re-used many times. ⋯ Potentially pathogenic organisms were identified both on the bougies and in their storage containers. This has implications for their cleaning and maintenance, and raises the question as to whether we should replace them with single-use, disposable devices.
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We describe a modification to the Guedel airway that improves suction and oxygenation during fibreoptic bronchoscopy. The entire roof of a Guedel airway was removed. ⋯ During the procedure there were no problems with either fogging of the lens or secretions in the pharynx. In addition, oxyhaemoglobin saturation, as monitored continuously by pulse oximetry, was >/= 97% in all patients.
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The bacterial and viral filtration performance of 12 breathing system filters was determined using test methods specified in the draft European standard for breathing system filters, BS EN 13328-1. All the filters were of two types, either pleated hydrophobic or electrostatic, and these two types differed in their filtration performance. ⋯ In general, there was little change in the microbial penetration values following 24 h simulated use. It is concluded that results from the tests specified in the draft standard will allow comparisons to be made between different manufacturers' products enabling an informed choice to be made.