Masui. The Japanese journal of anesthesiology
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Randomized Controlled Trial Clinical Trial
[Evaluation of a pressure and volume-relief instrument (modified Brandt's rediffusion system) to prevent increase in endotracheal tube cuff pressure].
Nitrous oxide diffuses into the endotracheal tube cuff and then overexpand the cuff. This causes upper airway obstruction and trauma in intubated patient during general anesthesia. We evaluated the efficacy and a safety of a pressure and volume-relief instrument (modified Brandt's rediffusion system), which can easily be made by ourselves, to prevent increases in endotracheal tube cuff pressure. ⋯ Pressure of endotracheal tube cuffs was monitored and recorded until the extubation. Time interval until the pressure of tube cuffs increased more than 23 mmHg, which inhibit the local circulation on the tracheal cartilage, in rediffusion group (274.7 +/- 95.9 min) was significantly longer than the duration in control group (64.7 +/- 23.5 min). We conclude that the rediffusion instrument is effective and safe to prevent the rise in the pressure of an endotracheal tube cuff.
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Randomized Controlled Trial Comparative Study Clinical Trial
[A better method to attach an endotracheal tube to the stylet of the Bullard laryngoscope].
The Bullard laryngoscope with its introducing stylet is useful in a variety of patients with airway problems, but it poses difficulties in some cases where an endotracheal tube (ETT) catches on the ary-epiglottic fold and cannot be advanced into the trachea. This difficult may be avoided by slightly angulating the tip of the ETT so that it is directed in a better alignment toward the rima glottis. The efficacy of the two methods of angulation was studied. ⋯ Intubation on the first attempt was successful in 56% of group 1, 83% in group 2 and 100% in group 3. The patients in groups 1 & 2 in whom first attempt failed were all successfully intubated on the second trial with the method used in group 3. This method (180 degrees rotation of the ETT on the stylet), is applicable to any ETT with or without the Murphy eye.