Minerva anestesiologica
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Minerva anestesiologica · Aug 2017
Randomized Controlled TrialRetromolar laryngoscopy: a randomised cross-over vocal cords visualisation study.
Vocal cords visualization is a major determinant for successful tracheal intubation. The aim of our study was to compare vocal cord visualization by using conventional direct laryngoscopy with retromolar direct laryngoscopy in patients with an existing retromolar gap at the right mandible. ⋯ In summary, laryngoscopy via the retromolar method by using a Miller blade #4 lead to a significantly better vocal cord visualization compared to the conventional method performed with a Macintosh blade #3 in patients with an existing retromolar gap on the right side.
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Minerva anestesiologica · Aug 2017
Randomized Controlled Trial Clinical TrialNeuromuscular effect of dexmedetomidine on sevoflurane: an open-label, dose-escalation clinical trial.
Sevoflurane presents reliable central neuromuscular effects. However, little knowledge is available regarding the interaction between sevoflurane and demedetomidine. We evaluated the neuromuscular effect of dexmedetomidine on sevoflurane in patients with normal neuromuscular transmission and calculated the 50% effective concentration (EC50). ⋯ Sevoflurane has a concentration-dependent central neuromuscular effect in patients with normal neuromuscular transmission. Intravenous dexmedetomidine dose-dependently decreases the neuromuscular EC50 of sevoflurane.
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Minerva anestesiologica · Aug 2017
Randomized Controlled Trial Comparative StudyComparative study of fiberoptic guided versus intubating laryngeal mask airway assisted awake orotracheal intubation in patients with unstable cervical spine: a randomized controlled trial.
A safe airway technique minimizes intubation-associated cervical-spine movement and consequent neurological injury in patients with unstable cervical spine (UCS). Awake fiberoptic-guided intubation (FGI) is preferred in patients with UCS. Alternatively, intubating laryngeal mask airway assisted intubation (ILMA-AI) can be performed both during elective and emergency, requires less expertise and is cost-effective. This study evaluated cervical-spine movement during FGI and ILMA-AI in patients with UCS. ⋯ Similar degree of angulations was observed at various time-points during awake FGI and awake ILMA-AI at C1/2 and C2/3 spinal levels in patients with UCS. No patient developed new-onset motor deficits. ILMA can serve as a suitable alternative to fiberoptic-scope for awake intubation in cervical-spine instability.