BMC anesthesiology
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Orogastric tube placement is a common procedure routinely used in clinical anesthesiology and intensive care medicine. Nevertheless high failure rates and severe complications have been reported. We conducted this study to evaluate if the usage of the new gastric tube guide would speed up the placement of orogastric tubes and ease the procedure. ⋯ Our results show that using the gastric tube guide to place orogastric tubes in a manikin led to a significant shorter placement time and a higher overall success rate.
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Preoperative airway assessment help anticipate a difficult airway. We hypothesized that a close association existed between difficult laryngoscopy and the neck circumference/inter-incisor gap ratio (RNIIG). Our aim was to determine its utility in predicting difficult laryngoscopy in cervical spondylosis patients. ⋯ RNIIG is a new and simple predictor with a higher level of efficacy, and could help anesthetists plan for difficult laryngoscopy management in cervical spondylosis patients.
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Small nasotracheal tubes (NTTs) and intranasal compression of the NTT in the nasal cavity may contribute to increasing airway resistance. Since the effects of size, shape, and partial compression of the NTT on airway resistance have not been investigated, values of airway resistance with partial compression of preformed NTTs of various sizes were determined. ⋯ Pressure losses through NTTs are in inverse proportion to the tubes' IDs; greater pressure losses due to slip joints, acute bending, and partial compression of the NTT were obvious in small NTTs. Pressure losses through NTTs, especially in small NTTs, could increase the work of breathing to a greater extent than that through standard tubes; intranasal compression further increases the pressure loss.
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Case Reports
Case report: perioperative management of caesarean section for a parturient with mitochondrial myopathy.
Mitochondrial myopathies represent a group of disorders caused by mitochondrial defects that disrupt energy production. Most patients have issues from infancy to early childhood. Pregnancy in women with mitochondrial myopathy is uncommon and the management for these parturients is full of challenges. ⋯ It is important that patients with mitochondrial diseases are comprehensively assessed and monitored perioperatively.
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Clinical Trial Observational Study
The optimum sevoflurane concentration for supraglottic airway device Blockbuster™ insertion with spontaneous breathing in obese patients: a prospective observational study.
Airway management of the obese patient presenting for surgery is more likely to be a challenging problem. Supraglottic airway device has been adopted as a bridge to connect ventilation and tracheal intubation in obese patients who would be suffered with difficult intubation. The optimum sevoflurane concentration for supraglottic airway device insertion allowing spontaneous breathing in 50% of obese patients (ED50) is not known. The purpose of this study was to determine the ED50 of sevoflurane for supraglottic airway device Blockbuster™ insertion with spontaneous breathing in obese patients requiring general anesthesia. ⋯ We conclude that the optimum end-tidal sevoflurane concentration required for the supraglottic airway device Blockbuster™ insertion allowing spontaneous breathing in 50% of obese patients (ED50) is 2.5 ± 0.6%.