Anaesthesia
-
Randomized Controlled Trial Comparative Study
GlideScope® vs flexible fibreoptic scope for elective intubation in obese patients.
We hypothesised that in obese patients, tracheal intubation with the GlideScope® would be advantageous compared with flexible fibreoptic intubation. Seventy-five anaesthetised obese patients were randomly assigned to oral intubation by either GlideScope or flexible fibreoptic bronchoscope. ⋯ Median (IQR [range]) time to intubation was 37 (25-48 [19-81]) s and 95% of the first attempts were successful with the GlideScope, vs 43 (35-58 [26-96]) s and an 86% first-attempt success rate with the flexible fibreoptic bronchoscope. For experienced users, the time required to intubate the trachea in anaesthetised obese patients is similar with the GlideScope and a flexible bronchoscope.
-
After the anaesthetist has induced anaesthesia, it is desirable that the surgeon is present and ready to start surgery, otherwise the team needs to wait for the surgeon. From another perspective, however, the surgeon does not necessarily wish to be present from the start of induction, since that process can take a variable time and the surgeon might be otherwise occupied in productive activity rather than waiting for the patient to be ready. ⋯ In this prospective study we used the data from 718 first cases of the day, during a 4-week study period at two university hospitals, to develop a simple spreadsheet-based method to analyse the interaction of anaesthesia and surgical start time, anaesthesia technique and the probability of waiting time for anaesthetist or surgeon, respectively. This method can be used to determine the best surgical or anaesthesia start time for each case, so that the waiting time for anaesthetists and surgeons can be minimised.