Anaesthesia
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This prospective, observational volunteer study aimed to describe the appearance of the great auricular nerve using ultrasound and its blockade under ultrasound guidance. An in-plane needle guidance technique was used for blockade of the great auricular nerve with 0.1 ml mepivacaine 1%. ⋯ The great auricular nerve was successfully seen in all volunteers and the tail of the helix, antitragus, lobula and mandibular angle were blocked in all cases whereas the antihelix and concha were never blocked. Ultrasound imaging of the great auricular nerve can be reliably achieved and successful blockade with minimal volumes of local anaesthetic is another example of the benefits of ultrasound-guided peripheral nerve blocks.
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We studied the effect of pilot balloon design on the ability of experienced anaesthetists to assess and inflate tracheal tube cuffs to safe pressures. A model trachea was designed, incorporating a degree of compliance and an air leak, to evaluate six different pilot balloons grafted onto identical tracheal tubes. Pilot balloons were inflated to one of four pressures and anaesthetists were asked to estimate whether the pressure was acceptable, too low or too high. ⋯ Pressures generated by anaesthetists inflating tracheal tube cuffs were very variable. Median (IQR [range]) pressures for each pilot balloon ranged from 29 (17-43 [9-56]) cmH(2)O to 74 (49-114 [4-140]) cmH(2)O (p < 0.001). The design of the pilot balloon significantly affects anaesthetists' ability to inflate tracheal tube cuffs to safe pressures.
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While previous studies have investigated the country of origin of anaesthetic publications, they have generally used a medline computer search to identify original articles and have often excluded non-English language articles. We undertook a hand-search of journals in the Journal Citation Reports using the subject category of Anesthesiology. We quantified the number of original articles, editorials, review articles, case reports and correspondence attributed to each country. ⋯ High-income countries published 89.2% of original articles, middle-income countries 10.5%, and low-income countries just 0.3%. There were more articles published by middle-income countries during the study period than a decade earlier, notably from Turkey, China and India. We discuss barriers to publications from low-income countries.
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Letter Multicenter Study
Tracheal tube introducers: choose and use with care.