J. O. Ruiz-Villa, L. Echeverri-Cataño, J. C. Tocora-Rodríguez
Introduction: Postoperative nausea and vomiting (PONV) are common complications in surgical patients undergoing general anesthesia, and multiple strategies have been suggested to prevent them. Objective: To describe the available evidence on the effectiveness of pharmacological and non-pharmacological strategies for preventing PONV in adults undergoing surgery under general anesthesia, as reported in previous meta-analyses and systematic reviews. Methodology: An overview of systematic reviews and meta-analyses was conducted. Searches were performed in PubMed, EBSCO, EMBASE, Cochrane Database, Science Direct, and Scopus, without restrictions as to gender, clinical condition, or date of publication, including articles in Spanish, French, and English only. Two reviewers independently and in duplicate did the screening, data extraction, quality evaluation, and risk of bias assessment according to AMSTAR-2. The PRISMA and PRIOR statements were followed for reporting. PROSPERO registration number CRD42021251999. Results: Out of 80 candidate articles, three were viable for meta-analysis. 1.5 mg to 18 mg doses of Dexamethasone showed a significant reduction in the risk of PONV, with a RR of 0.48 (95 % CI 0.41-0.57; p<0.001), I2=63 % (p=0.07), and a NNTc of 5 and 7. Other effective strategies included the use of acoustic stimulation/acupuncture/acupressure, 5HT3 antagonists, NK1 antagonists, gabapentinoids, haloperidol, droperidol, metoclopramide, midazolam, mirtazapine, among others. The risk of publication bias was low. Conclusion: Different strategies are effective for PONV prophylaxis in surgeries under general anesthesia. Dexamethasone shows the best available evidence at the moment. The documented methodological quality suggests the need for better studies to establish the effectiveness of the strategies.
{"title":"Post-operative nausea and vomiting prophylaxis: A meta-review on systematic reviews and meta-analyses","authors":"J. O. Ruiz-Villa, L. Echeverri-Cataño, J. C. Tocora-Rodríguez","doi":"10.5554/22562087.e1086","DOIUrl":"https://doi.org/10.5554/22562087.e1086","url":null,"abstract":"Introduction: Postoperative nausea and vomiting (PONV) are common complications in surgical patients undergoing general anesthesia, and multiple strategies have been suggested to prevent them. Objective: To describe the available evidence on the effectiveness of pharmacological and non-pharmacological strategies for preventing PONV in adults undergoing surgery under general anesthesia, as reported in previous meta-analyses and systematic reviews. Methodology: An overview of systematic reviews and meta-analyses was conducted. Searches were performed in PubMed, EBSCO, EMBASE, Cochrane Database, Science Direct, and Scopus, without restrictions as to gender, clinical condition, or date of publication, including articles in Spanish, French, and English only. Two reviewers independently and in duplicate did the screening, data extraction, quality evaluation, and risk of bias assessment according to AMSTAR-2. The PRISMA and PRIOR statements were followed for reporting. PROSPERO registration number CRD42021251999. Results: Out of 80 candidate articles, three were viable for meta-analysis. 1.5 mg to 18 mg doses of Dexamethasone showed a significant reduction in the risk of PONV, with a RR of 0.48 (95 % CI 0.41-0.57; p<0.001), I2=63 % (p=0.07), and a NNTc of 5 and 7. Other effective strategies included the use of acoustic stimulation/acupuncture/acupressure, 5HT3 antagonists, NK1 antagonists, gabapentinoids, haloperidol, droperidol, metoclopramide, midazolam, mirtazapine, among others. The risk of publication bias was low. Conclusion: Different strategies are effective for PONV prophylaxis in surgeries under general anesthesia. Dexamethasone shows the best available evidence at the moment. The documented methodological quality suggests the need for better studies to establish the effectiveness of the strategies.","PeriodicalId":36529,"journal":{"name":"Colombian Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139340976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Diego Andrés Díaz-Guio, Julián Henao, Andy Pantoja, María Alejandra Arango, Ana Sofía Díaz-Gómez, Aida Camps Gómez
The rapid advancement of Artificial Intelligence (AI) has taken the world by “surprise” due to the lack of regulation over this technological innovation which, while promising application opportunities in different fields of knowledge, including education, simultaneously generates concern, rejection and even fear. In the field of Health Sciences Education, clinical simulation has transformed educational practice; however, its formal insertion is still heterogeneous, and we are now facing a new technological revolution where AI has the potential to transform the way we conceive its application.
{"title":"Artificial intelligence, applications and challenges in simulation-based education","authors":"Diego Andrés Díaz-Guio, Julián Henao, Andy Pantoja, María Alejandra Arango, Ana Sofía Díaz-Gómez, Aida Camps Gómez","doi":"10.5554/22562087.e1085","DOIUrl":"https://doi.org/10.5554/22562087.e1085","url":null,"abstract":"The rapid advancement of Artificial Intelligence (AI) has taken the world by “surprise” due to the lack of regulation over this technological innovation which, while promising application opportunities in different fields of knowledge, including education, simultaneously generates concern, rejection and even fear. In the field of Health Sciences Education, clinical simulation has transformed educational practice; however, its formal insertion is still heterogeneous, and we are now facing a new technological revolution where AI has the potential to transform the way we conceive its application.","PeriodicalId":36529,"journal":{"name":"Colombian Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139342672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
During the past two decades, the videolaryngoscope (VDL) has become a valuable and effective tool for the management of the airway, not just in the realm of anesthesiology, but also in other medical specialties in clinical scenarios requiring tracheal intubation. In countries such as the United States, this represents over 15 million cases in the operating room and 650,000 outside the OR. The overall accumulated incidence of difficult airway is 6.8% events in routine practice and between 0.1 and 0.3 % of failed intubations, both associated with complications such as desaturation, airway injury, hemodynamic instability and death. Notwithstanding the fact that the VDL has proven advantages such as improved visualization of the glottis, higher first attempt success rates, and a shortened learning curve, most of the time its use is limited to rescue attempts or as a secondary option. The objective of this article is to review the advantages and limitations of the VDL vs. the direct laryngoscope in a wide range of clinical settings, including the operating room, intensive care units, emergency departments, pediatrics, obstetrics, and Covid-19 to consider its routine use.
{"title":"Should videolaryngoscopy be routinely used for airway management? An approach from different scenarios in medical practice","authors":"Cristian Camilo Becerra Gómez, Miguel Ángel Rojas","doi":"10.5554/22562087.e1084","DOIUrl":"https://doi.org/10.5554/22562087.e1084","url":null,"abstract":"During the past two decades, the videolaryngoscope (VDL) has become a valuable and effective tool for the management of the airway, not just in the realm of anesthesiology, but also in other medical specialties in clinical scenarios requiring tracheal intubation. In countries such as the United States, this represents over 15 million cases in the operating room and 650,000 outside the OR. The overall accumulated incidence of difficult airway is 6.8% events in routine practice and between 0.1 and 0.3 % of failed intubations, both associated with complications such as desaturation, airway injury, hemodynamic instability and death. Notwithstanding the fact that the VDL has proven advantages such as improved visualization of the glottis, higher first attempt success rates, and a shortened learning curve, most of the time its use is limited to rescue attempts or as a secondary option. The objective of this article is to review the advantages and limitations of the VDL vs. the direct laryngoscope in a wide range of clinical settings, including the operating room, intensive care units, emergency departments, pediatrics, obstetrics, and Covid-19 to consider its routine use.","PeriodicalId":36529,"journal":{"name":"Colombian Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139349299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
William Jaramillo-Garzón, Gustavo Andrade, H. Khoury
Introduction: Anesthetists play an important role during interventional radiology procedures. Like the main operator, anesthetists may also be subject to significant radiation levels in the fluoroscopy suite. Due to its complexity, hepatic chemoembolization procedures demand high fluoroscopic times and digital subtraction angiography images, exposing patients and medical staff to high radiation doses. Objetive: To assess and quantify the radiation to which one anesthetist was exposed over the course of seven consecutive hepatic chemoembolization procedures, and compare it to the exposure received by the main operator. Methods: Medical staff dosimetry was evaluated during seven consecutive hepatic chemoembolization procedures conducted in a private hospital in Recife (Brazil), using thermoluminiscent dosimeters placed in regions of the head and torso. Results: For the seven procedures evaluated in this study, the anesthetist received, on average, absorbed doses to the glabella, left eyebrow, right eyebrow and effective dose of 142.4 ± 72 µSv, 117.3 ± 66 µSv, 137.8 ± 71 µSv and 12.4 ± 8.4 µSv, respectively. Conclusions: In some cases, ocular dose and effective dose received by the anesthetist may be 4 and 4.7 times greater, respectively, when compared to the main operator. According to the results of this study, the current occupational annual dose limit to the lens of the eye of 20 mSv can be exceeded with only two hepatic chemoembolization procedures per week if adequate radiation protection conditions are not guaranteed.
{"title":"Occupational radiation exposure in anesthesia for hepatic chemoembolization: a prospective study","authors":"William Jaramillo-Garzón, Gustavo Andrade, H. Khoury","doi":"10.5554/22562087.e1083","DOIUrl":"https://doi.org/10.5554/22562087.e1083","url":null,"abstract":"Introduction: Anesthetists play an important role during interventional radiology procedures. Like the main operator, anesthetists may also be subject to significant radiation levels in the fluoroscopy suite. Due to its complexity, hepatic chemoembolization procedures demand high fluoroscopic times and digital subtraction angiography images, exposing patients and medical staff to high radiation doses. Objetive: To assess and quantify the radiation to which one anesthetist was exposed over the course of seven consecutive hepatic chemoembolization procedures, and compare it to the exposure received by the main operator. Methods: Medical staff dosimetry was evaluated during seven consecutive hepatic chemoembolization procedures conducted in a private hospital in Recife (Brazil), using thermoluminiscent dosimeters placed in regions of the head and torso. Results: For the seven procedures evaluated in this study, the anesthetist received, on average, absorbed doses to the glabella, left eyebrow, right eyebrow and effective dose of 142.4 ± 72 µSv, 117.3 ± 66 µSv, 137.8 ± 71 µSv and 12.4 ± 8.4 µSv, respectively. Conclusions: In some cases, ocular dose and effective dose received by the anesthetist may be 4 and 4.7 times greater, respectively, when compared to the main operator. According to the results of this study, the current occupational annual dose limit to the lens of the eye of 20 mSv can be exceeded with only two hepatic chemoembolization procedures per week if adequate radiation protection conditions are not guaranteed.","PeriodicalId":36529,"journal":{"name":"Colombian Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139350336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jossman Javier Carvajal Roa, Diego Ferney Victoria Cuéllar, Akemi Arango Sakamoto, Gustavo Adolfo Cruz Suárez, Einar Sten Billefals Vallejo, Mabel Moreno, Iván Fernando Quintero Cifuentes
Introduction: Hip fracture is one of the main causes of morbidity and mortality among the elderly population. In Colombia there is a shortage of scientific literature on the perioperative management of this population of patients. Objective: To describe the perioperative management of hip fracture patients at a tertiary university hospital in Cali, Colombia. Methods: An observational study was conducted with relational scope of a historical cohort of patients with hip fracture who underwent surgical management between January 2018 and June 2022. A non-probability sampling method was used and contingency tables were designed aimed at describing the relationship between the patients’ characteristics and the postoperative outcomes. Results: 235 patients were included, of which 57 % were males. The mean age was 79 years and 49.8 % were classified as ASA III or higher. Spinal anesthesia was the most commonly used technique in 63.4 % of the cases. The most frequent outcomes were delirium in 17.9 %, and acute kidney failure in 6.8 %. 83.4 % of the patients underwent surgery within 48 hours of admission to the emergency department and intra-hospital mortality was 2.6 %. Conclusion: The results of this study provide relevant information to identify opportunities for improvement and their implementation, such as the reduction in the time elapsed until surgical management and the development of care protocols in the region.
{"title":"Experience in the perioperative management of patients with hip fracture in southwestern Colombia. Retrospective cohort study","authors":"Jossman Javier Carvajal Roa, Diego Ferney Victoria Cuéllar, Akemi Arango Sakamoto, Gustavo Adolfo Cruz Suárez, Einar Sten Billefals Vallejo, Mabel Moreno, Iván Fernando Quintero Cifuentes","doi":"10.5554/22562087.e1080","DOIUrl":"https://doi.org/10.5554/22562087.e1080","url":null,"abstract":"Introduction: Hip fracture is one of the main causes of morbidity and mortality among the elderly population. In Colombia there is a shortage of scientific literature on the perioperative management of this population of patients. Objective: To describe the perioperative management of hip fracture patients at a tertiary university hospital in Cali, Colombia. Methods: An observational study was conducted with relational scope of a historical cohort of patients with hip fracture who underwent surgical management between January 2018 and June 2022. A non-probability sampling method was used and contingency tables were designed aimed at describing the relationship between the patients’ characteristics and the postoperative outcomes. Results: 235 patients were included, of which 57 % were males. The mean age was 79 years and 49.8 % were classified as ASA III or higher. Spinal anesthesia was the most commonly used technique in 63.4 % of the cases. The most frequent outcomes were delirium in 17.9 %, and acute kidney failure in 6.8 %. 83.4 % of the patients underwent surgery within 48 hours of admission to the emergency department and intra-hospital mortality was 2.6 %. Conclusion: The results of this study provide relevant information to identify opportunities for improvement and their implementation, such as the reduction in the time elapsed until surgical management and the development of care protocols in the region.","PeriodicalId":36529,"journal":{"name":"Colombian Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139370656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Controversies in one-lung ventilation: One way or the other?","authors":"A. Zorrilla-Vaca","doi":"10.5554/22562087.e1067","DOIUrl":"https://doi.org/10.5554/22562087.e1067","url":null,"abstract":"","PeriodicalId":36529,"journal":{"name":"Colombian Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47789076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. D. López-Ponce de León, J. Mejia-Mantilla, Camilo Andrés Calderón-Miranda, Leidy Johanna López-Erazo, Akemi Arango, G. A. Cruz-Suárez
The effects of hypertension on the outcomes during the perioperative period are still unclear. No specific systolic or diastolic blood pressure measurement has been determined as the cutoff point to continue with the surgical plan or adjourn.This study is designed as a narrative review of the available scientific evidence on the perioperative management of hypertension. A non-systematic review was conducted in Pubmed considering the title and abstract; 120 articles were pre-selected of which 55 papers were selected for full-text eligibility and 16 were excluded for a total of 39 articles including ACCF/AHA 2009 and ACC/AHA 2014 on perioperative cardiovascular care; 2013 ESH/ESC, 8 JNC, and the 2017 ACC/AHA/AAPA/ABC Guideline for the Prevention, detection, and management of hypertension in adults. Blood pressure values, target organ damage, and type of surgery should be considered for decision-making in the perioperative period. If surgery is an option, blood pressure fluctuations should be avoided and actively treat any potential causes. A patient with mild hypertension with values below SBP 160 and DBP 110 mmHg may be managed in the ambulatory setting during the postoperative period, as long as the clinical conditions are favorable.
{"title":"Perioperative hypertension","authors":"J. D. López-Ponce de León, J. Mejia-Mantilla, Camilo Andrés Calderón-Miranda, Leidy Johanna López-Erazo, Akemi Arango, G. A. Cruz-Suárez","doi":"10.5554/22562087.e1066","DOIUrl":"https://doi.org/10.5554/22562087.e1066","url":null,"abstract":"The effects of hypertension on the outcomes during the perioperative period are still unclear. No specific systolic or diastolic blood pressure measurement has been determined as the cutoff point to continue with the surgical plan or adjourn.This study is designed as a narrative review of the available scientific evidence on the perioperative management of hypertension. A non-systematic review was conducted in Pubmed considering the title and abstract; 120 articles were pre-selected of which 55 papers were selected for full-text eligibility and 16 were excluded for a total of 39 articles including ACCF/AHA 2009 and ACC/AHA 2014 on perioperative cardiovascular care; 2013 ESH/ESC, 8 JNC, and the 2017 ACC/AHA/AAPA/ABC Guideline for the Prevention, detection, and management of hypertension in adults. Blood pressure values, target organ damage, and type of surgery should be considered for decision-making in the perioperative period. If surgery is an option, blood pressure fluctuations should be avoided and actively treat any potential causes. A patient with mild hypertension with values below SBP 160 and DBP 110 mmHg may be managed in the ambulatory setting during the postoperative period, as long as the clinical conditions are favorable.","PeriodicalId":36529,"journal":{"name":"Colombian Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43074266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Medication errors are the cause of severe lesions and complications, particularly with regards to injectable medications. During anesthesia, several drugs are administered simultaneously and quite easily the wrong medication may be administered, leading to morbidity and mortality. Different strategies have been devised to reduce error, including the use of color and letters to facilitate the identification of the various medications and improving safety in anesthesia.
{"title":"Labeling of medications in anesthesia: colors and letters that save lives","authors":"Alex Castro-Gómez","doi":"10.5554/22562087.e1065","DOIUrl":"https://doi.org/10.5554/22562087.e1065","url":null,"abstract":"Medication errors are the cause of severe lesions and complications, particularly with regards to injectable medications. \u0000During anesthesia, several drugs are administered simultaneously and quite easily the wrong medication may be administered, leading to morbidity and mortality. Different strategies have been devised to reduce error, including the use of color and letters to facilitate the identification of the various medications and improving safety in anesthesia.","PeriodicalId":36529,"journal":{"name":"Colombian Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46777021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The social determinants of health are the social characteristics in which people's lives and work develop, giving them the capacity to act in specific contexts and are responsible for the health conditions of individuals and populations. Recent World Bank data show that Colombia has made modest progress in terms of social equity. These data reveal that neonatal mortality in remote areas of the country is similar to that found in Sub-Saharan Africa. In these regions, there is no access to specialized neonatal health services. As for anesthesia services, this age group has the highest mortality and perioperative complication rates related to prematurity, the quality of health services and, especially, the expertise of the anesthesiologist. In Colombia, efforts to implement formal university programs for sub-specialization in pediatric anesthesiology have not received governmental support. Meanwhile, the Colombian Society of Anesthesiology, through its Committee of Pediatric Anesthesiology, has created ongoing education opportunities, which, although important, are insufficient to meet the needs of the country. For this reason, a State policy is required, aimed at meeting its social debt and that considers the specialized training of human resources as a pillar for the promotion of equity in health, so that the surgical neonate does not have to travel in the procurement of services, but rather have the State bring those services to them.
{"title":"Social determinants for health and neonatal anesthesia in Colombia","authors":"Alexander Trujillo","doi":"10.5554/22562087.e1063","DOIUrl":"https://doi.org/10.5554/22562087.e1063","url":null,"abstract":"The social determinants of health are the social characteristics in which people's lives and work develop, giving them the capacity to act in specific contexts and are responsible for the health conditions of individuals and populations. \u0000Recent World Bank data show that Colombia has made modest progress in terms of social equity. These data reveal that neonatal mortality in remote areas of the country is similar to that found in Sub-Saharan Africa. In these regions, there is no access to specialized neonatal health services. As for anesthesia services, this age group has the highest mortality and perioperative complication rates related to prematurity, the quality of health services and, especially, the expertise of the anesthesiologist. \u0000In Colombia, efforts to implement formal university programs for sub-specialization in pediatric anesthesiology have not received governmental support. Meanwhile, the Colombian Society of Anesthesiology, through its Committee of Pediatric Anesthesiology, has created ongoing education opportunities, which, although important, are insufficient to meet the needs of the country. \u0000For this reason, a State policy is required, aimed at meeting its social debt and that considers the specialized training of human resources as a pillar for the promotion of equity in health, so that the surgical neonate does not have to travel in the procurement of services, but rather have the State bring those services to them.","PeriodicalId":36529,"journal":{"name":"Colombian Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47187803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: The C-MAC D-blade was designed for difficult airway intubation scenarios. To facilitate easier and faster endotracheal intubation in the laryngoscopy paradox, an introducer is preferred. Hence, we decided to conduct a study to compare the 60˚ angled C-MAC stylet and the gum elastic bougie as aids to intubation while using the C-MAC D-blade laryngoscope in a simulated difficult airway setting. Objective: To compare the ease of oral intubation with the use of the C-MAC stylet (60˚ angled stylet) versus intubation performed over a bougie inserted using the C-MAC D-blade guidance in patients with simulated restricted cervical mobility. Methods: Prospective, randomized controlled single-center study. Intubation using the C-MAC D-blade laryngoscope was performed in 48 surgical patients randomly assigned to 2 groups of 24 each: Stylet group, Group S (using 60˚ angled stylet) and Bougie group, Group B (using bougie) after providing manual in-line stabilization to restrict cervical mobility. The Mann-Whitney U test and the Chi square test were used as applicable. Results: The use of stylet resulted in easier (Group S 75% vs. Group B 16.7%) and faster (Group S 26.83 ± 8.61s vs. Group B 47.18 ± 16.46s) intubation with fewer attempts compared to group B. Both groups experienced a similar hemodynamic stress response to intubation. Conclusions: The 60˚ angled C-MAC Stylet is a more effective and time-saving intubation aid with C-MAC D-blade compared to bougie.
C-MAC D-blade是为困难气道插管场景设计的。在喉镜检查悖论中，为了使气管插管更容易和更快，推荐引入器。因此，我们决定在模拟困难气道环境下使用C-MAC d -刀片喉镜，比较60˚角C-MAC型腔和牙龈弹性伸缩器作为辅助插管的效果。目的:比较C-MAC型(60˚角型)与C-MAC d型刀片引导下的弓支插管在模拟颈椎活动受限患者中的易用性。方法:前瞻性、随机对照、单中心研究。采用C-MAC d刀片喉镜对48例手术患者进行插管，随机分为2组，每组24例:Stylet组，S组(使用60˚角Stylet)和Bougie组，B组(使用Bougie)，给予手动在线稳定以限制颈椎活动。适用时采用Mann-Whitney U检验和卡方检验。结果:与B组相比，使用stylet插管更容易(S组75% vs B组16.7%)，插管速度更快(S组26.83±8.61s vs B组47.18±16.46s)，插管次数较少。两组的血流动力学应激反应相似。结论:60˚角C-MAC Stylet与bougie相比，C-MAC D-blade是一种更有效、更省时的插管辅助工具。
{"title":"Comparison between stylet and bougie with the C-MAC D-blade in cervical simulated immobility. A prospective randomized controlled trial","authors":"Nirenjen Sadamaaya Thevar Manoharan, Nita Varghese, Rama Rani Krishna Bhat","doi":"10.5554/22562087.e1061","DOIUrl":"https://doi.org/10.5554/22562087.e1061","url":null,"abstract":"Introduction: The C-MAC D-blade was designed for difficult airway intubation scenarios. To facilitate easier and faster endotracheal intubation in the laryngoscopy paradox, an introducer is preferred. Hence, we decided to conduct a study to compare the 60˚ angled C-MAC stylet and the gum elastic bougie as aids to intubation while using the C-MAC D-blade laryngoscope in a simulated difficult airway setting.\u0000Objective: To compare the ease of oral intubation with the use of the C-MAC stylet (60˚ angled stylet) versus intubation performed over a bougie inserted using the C-MAC D-blade guidance in patients with simulated restricted cervical mobility.\u0000Methods: Prospective, randomized controlled single-center study. Intubation using the C-MAC D-blade laryngoscope was performed in 48 surgical patients randomly assigned to 2 groups of 24 each: Stylet group, Group S (using 60˚ angled stylet) and Bougie group, Group B (using bougie) after providing manual in-line stabilization to restrict cervical mobility. The Mann-Whitney U test and the Chi square test were used as applicable. \u0000Results: The use of stylet resulted in easier (Group S 75% vs. Group B 16.7%) and faster (Group S 26.83 ± 8.61s vs. Group B 47.18 ± 16.46s) intubation with fewer attempts compared to group B. Both groups experienced a similar hemodynamic stress response to intubation.\u0000Conclusions: The 60˚ angled C-MAC Stylet is a more effective and time-saving intubation aid with C-MAC D-blade compared to bougie.","PeriodicalId":36529,"journal":{"name":"Colombian Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48754855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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