Haider Abbas, M. Kohli, Murali., Sarita Singh, V. Singh
The plexus is formed (in part) by the greater and lesser splanchnic nerves of both sides, and also parts of the right vagus nerve. The celiac plexus proper consists of the celiac ganglia with a network of interconnecting fibers. The aorticorenal ganglia are often considered to be part of the celiac ganglia, and thus, part of the plexus. Celiac ganglia vary from 1 to 5 in number, and also located from T12 to L2. The celiac plexus innervates most of the abdominal viscera, including stomach, liver, biliary tract, pancreas, spleen, kidneys, adrenals, omentum, small bowel, and large bowel to the level of the splenic flexure. Coeliac Plexus block can be performed for pain palliation in patients who have chronic abdominal pain related malignancy. Many ways are available for performing the block; blocks which are performed under image guidance has less complication and good success rate.
{"title":"Celiac Plexus Block – A Palliative Care For Pancretic Malignancy","authors":"Haider Abbas, M. Kohli, Murali., Sarita Singh, V. Singh","doi":"10.5580/60e","DOIUrl":"https://doi.org/10.5580/60e","url":null,"abstract":"The plexus is formed (in part) by the greater and lesser splanchnic nerves of both sides, and also parts of the right vagus nerve. The celiac plexus proper consists of the celiac ganglia with a network of interconnecting fibers. The aorticorenal ganglia are often considered to be part of the celiac ganglia, and thus, part of the plexus. Celiac ganglia vary from 1 to 5 in number, and also located from T12 to L2. The celiac plexus innervates most of the abdominal viscera, including stomach, liver, biliary tract, pancreas, spleen, kidneys, adrenals, omentum, small bowel, and large bowel to the level of the splenic flexure. Coeliac Plexus block can be performed for pain palliation in patients who have chronic abdominal pain related malignancy. Many ways are available for performing the block; blocks which are performed under image guidance has less complication and good success rate.","PeriodicalId":396781,"journal":{"name":"The Internet Journal of Anesthesiology","volume":"117 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127294415","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}
We describe the case of a 32 year old primiparous woman with syringomyelia and Arnold-Chiari type I malformation who presented in early labour at 37 weeks gestation. She was delivered by caesarean section performed under general anaesthesia with a remifentanil infusion. There was no intra-operative complication or neurological deterioration post-operatively. We discuss the anaesthetic implications of this disease in pregnancy and focus on the advantages of using a remifentanil infusion as part of a general anaesthetic technique
{"title":"Anaesthetic Management Of Caesarean Section In A Patient With Syringomyelia.","authors":"Y. Nawaz, D. Mcatamney","doi":"10.5580/215d","DOIUrl":"https://doi.org/10.5580/215d","url":null,"abstract":"We describe the case of a 32 year old primiparous woman with syringomyelia and Arnold-Chiari type I malformation who presented in early labour at 37 weeks gestation. She was delivered by caesarean section performed under general anaesthesia with a remifentanil infusion. There was no intra-operative complication or neurological deterioration post-operatively. We discuss the anaesthetic implications of this disease in pregnancy and focus on the advantages of using a remifentanil infusion as part of a general anaesthetic technique","PeriodicalId":396781,"journal":{"name":"The Internet Journal of Anesthesiology","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128971038","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}
S. Rana, Arif Ahmed, Seema Mishra, S. Bhatnagar, H. Chado
We investigated cervical epidural steroid injection effects on Current Perception Threshold (CPT) measures in a patient with neuropathic pain using the NeurometerAE CPT/C device (Neurotron, Inc Baltimore MD, USA). CPT measures pre injection revealed a significant hypoesthesia in A�¥ and C fibers with normal A�≤ fiber function. CPT testing 24 hours after a cervical epidural injection at the C7-T1 interspace using methylprednisolone and lignocaine revealed normal measures indicating a reversal of
{"title":"Measuring the Influence of Cervical Epidural Steroids on Current Perception Threshold Measures Using a Neurometer®CPT/C - A Case Report","authors":"S. Rana, Arif Ahmed, Seema Mishra, S. Bhatnagar, H. Chado","doi":"10.5580/314","DOIUrl":"https://doi.org/10.5580/314","url":null,"abstract":"We investigated cervical epidural steroid injection effects on Current Perception Threshold (CPT) measures in a patient with neuropathic pain using the NeurometerAE CPT/C device (Neurotron, Inc Baltimore MD, USA). CPT measures pre injection revealed a significant hypoesthesia in A�¥ and C fibers with normal A�≤ fiber function. CPT testing 24 hours after a cervical epidural injection at the C7-T1 interspace using methylprednisolone and lignocaine revealed normal measures indicating a reversal of","PeriodicalId":396781,"journal":{"name":"The Internet Journal of Anesthesiology","volume":"207 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115272166","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}
In a prospective randomized study the Bispectral index (BIS) was used to titrate propofol infusion during cardiopulmonary bypass (CPB) (between 40-50) and in the postoperative period in the ICU ( between 60-70) until extubation. We studied a total of 40 patients undergoing cardiac surgery under CPB. They were randomized to 20 patients each in the BIS and standard therapy group (STG). In the STG group the propofol infusion was titrated to mean arterial pressures (MAPS) of 55 to 65 mm Hg during CPB and to a sedation score of zero on the Sedation-Agitation Scale (SAS). Patients in both groups had similar demographic characteristics, duration of CPB and surgery. The total amount of propofol used (BIS 1662mg, STG 1729 mg)] showed no statistical difference despite BIS monitoring. The time to the average time to eye opening (190 min), time to wean (210 min) and extubation (BIS 352 minutes, STG 380 minutes) were comparable in the both groups. Monitoring of hypnotic component with BIS during cardiac surgery failed to demonstrate an earlier time to recovery and extubation.
在一项前瞻性随机研究中，双谱指数(BIS)用于体外循环(CPB)期间(40-50之间)和ICU术后期间(60-70之间)滴定异丙酚输注直至拔管。我们总共研究了40例在CPB下接受心脏手术的患者。他们被随机分为BIS组和标准治疗组(STG)各20例。在STG组，异丙酚输注滴定至CPB期间平均动脉压(MAPS)为55至65 mm Hg，镇静-躁动量表(SAS)镇静评分为零。两组患者的人口学特征、CPB持续时间和手术时间相似。异丙酚总用量(BIS 1662mg, STG 1729 mg)]经BIS监测无统计学差异。两组的平均睁眼时间(190分钟)、断奶时间(210分钟)和拔管时间(BIS 352分钟，STG 380分钟)具有可比性。在心脏手术期间用BIS监测催眠成分未能证明较早的恢复和拔管时间。
{"title":"Does Perioperative Bispectral Index Monitoring Decrease Time To Extubation In Patients Undergoing Coronary Artery Bypass Graft Procedures","authors":"J. Mukherji, W. Jellish, Pierre Levan","doi":"10.5580/16f8","DOIUrl":"https://doi.org/10.5580/16f8","url":null,"abstract":"In a prospective randomized study the Bispectral index (BIS) was used to titrate propofol infusion during cardiopulmonary bypass (CPB) (between 40-50) and in the postoperative period in the ICU ( between 60-70) until extubation. We studied a total of 40 patients undergoing cardiac surgery under CPB. They were randomized to 20 patients each in the BIS and standard therapy group (STG). In the STG group the propofol infusion was titrated to mean arterial pressures (MAPS) of 55 to 65 mm Hg during CPB and to a sedation score of zero on the Sedation-Agitation Scale (SAS). Patients in both groups had similar demographic characteristics, duration of CPB and surgery. The total amount of propofol used (BIS 1662mg, STG 1729 mg)] showed no statistical difference despite BIS monitoring. The time to the average time to eye opening (190 min), time to wean (210 min) and extubation (BIS 352 minutes, STG 380 minutes) were comparable in the both groups. Monitoring of hypnotic component with BIS during cardiac surgery failed to demonstrate an earlier time to recovery and extubation.","PeriodicalId":396781,"journal":{"name":"The Internet Journal of Anesthesiology","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124863101","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}
Spontaneous rupture of liver hydatid cyst causes an acute abdomen and leakage of a cyst contents into the blood circulation is a triggering factor for anaphylaxis. Abdominal ultrasonography and computed tomography are the first-line imaging studies in cases of suspected rupture of hydatid cyst. Urgent treatment should be initiated, relying first on emergency management of anaphylactic shock and later on surgical treatment of the cysts.We report a case of a anaphylaxis due to a spontaneously ruptured hydatid cyst
{"title":"Anaphylaxis Due To A Spontaneously Ruptured Hydatid Cyst:A Case Report","authors":"S. Devrim, M. Gura, E. N. Koltka, Serdar Yuzer","doi":"10.5580/1ac4","DOIUrl":"https://doi.org/10.5580/1ac4","url":null,"abstract":"Spontaneous rupture of liver hydatid cyst causes an acute abdomen and leakage of a cyst contents into the blood circulation is a triggering factor for anaphylaxis. Abdominal ultrasonography and computed tomography are the first-line imaging studies in cases of suspected rupture of hydatid cyst. Urgent treatment should be initiated, relying first on emergency management of anaphylactic shock and later on surgical treatment of the cysts.We report a case of a anaphylaxis due to a spontaneously ruptured hydatid cyst","PeriodicalId":396781,"journal":{"name":"The Internet Journal of Anesthesiology","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115393871","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}
Nina Dimitrova Shachiri, D. Karadimov, D. Tonev, M. Shishenkov
Aim: The aim of this article was to present an overview of the hemostaseologic changes in patients with obstructive jaundice undergoing bile duct and hepatic surgery, with respect to the risk assessment for developing postoperative liver insufficiency, intraoperative and postoperative hemorrhage or thrombembolism. Source: Relevant articles from the MEDLINE databases (1976-2010) were extracted and reviewed, using the following key words: “obstructive jaundice”, “liver resections”, “hemostasis”, “perioperative hemostaseologic changes”, “perioperative bleeding”, “liver insufficiency”, and “perioperative thromboembolism”.Main findings: The development of intraand postoperative hemorrhages and the occurrence of thromboembolic incidents in patients with obstructive jaundice are due to changes in coagulation and fibrinolysis. They depend on the etiopathogenesis of the main disease and inflammatory changes in the biliary system, as well as on the duration of mechanical obstruction and the scope of surgical intervention. The occurrence of perioperative hemostatic complications does not always correlate with the extent of abnormalities in the analyzed perioperative laboratory hemostaseologic parameters. Conclusion: Further research of the association between perioperative hemostaseologic changes in patients with obstructive jaundice of malignant and benign origin would contribute to the risk assessment of possible intraand postoperative hemostatic complications and liver insufficiency, as well as to the prophylaxis of these complications.
{"title":"Hemostasiologic Changes during Hepatobiliary Surgery in Patients with Obstructive Jaundice: Pathophysiology and Clinical Considerations","authors":"Nina Dimitrova Shachiri, D. Karadimov, D. Tonev, M. Shishenkov","doi":"10.5580/22c9","DOIUrl":"https://doi.org/10.5580/22c9","url":null,"abstract":"Aim: The aim of this article was to present an overview of the hemostaseologic changes in patients with obstructive jaundice undergoing bile duct and hepatic surgery, with respect to the risk assessment for developing postoperative liver insufficiency, intraoperative and postoperative hemorrhage or thrombembolism. Source: Relevant articles from the MEDLINE databases (1976-2010) were extracted and reviewed, using the following key words: “obstructive jaundice”, “liver resections”, “hemostasis”, “perioperative hemostaseologic changes”, “perioperative bleeding”, “liver insufficiency”, and “perioperative thromboembolism”.Main findings: The development of intraand postoperative hemorrhages and the occurrence of thromboembolic incidents in patients with obstructive jaundice are due to changes in coagulation and fibrinolysis. They depend on the etiopathogenesis of the main disease and inflammatory changes in the biliary system, as well as on the duration of mechanical obstruction and the scope of surgical intervention. The occurrence of perioperative hemostatic complications does not always correlate with the extent of abnormalities in the analyzed perioperative laboratory hemostaseologic parameters. Conclusion: Further research of the association between perioperative hemostaseologic changes in patients with obstructive jaundice of malignant and benign origin would contribute to the risk assessment of possible intraand postoperative hemostatic complications and liver insufficiency, as well as to the prophylaxis of these complications.","PeriodicalId":396781,"journal":{"name":"The Internet Journal of Anesthesiology","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114068942","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}
Esophageal atresia (EA), with or without trachea-esophageal fistula, is a fairly common congenital disorder with an incidence of 18000 per year in India. In Western countries, associated congenital anomaly is the main factor which affects the prognosis. But in India the preoperative condition, intraoperative and postoperative condition and socioeconomic status along with congenital anomaly affects the prognosis. 55 neonates after evaluation for congenital anomalies and routine investigation were operated for TEF and were classified on the basis of Age, Sex, Birth weight, Maturity; presence of pneumonitis, and other associated congenital anomalies. Epidural catheter was passed through L3-L4 interspace in 24 patients after giving GA to provide postoperative analgesia. 3ml of 0.0625% bupivacaine was given for introperative and postoperative analgesia. It was noted the best survival was in babies who were operated in the first two days. Infants weighing greater than 2.5 kg showed 76% survival. Both sexes had the similar results. Patients with severe chest infection showed only survival of 16.6%. Infants with epidural showed 100 % survival. 33.33% of neonates survived after postoperative ventilation, and there is 77.50% survival in neonates who did not require postoperative ventilation. 17 cases had reported congenital anomalies, which showed 41.17% survival and 76.31% survival was noted in neonates who don’t have congenital anomalies. Neonates with preoperative saturation >95% had 86.36% survival but neonates with <85% saturation showed only 33.33% survival. We observed that epidural analgesia would provide got postoperative outcome in TEF neonates, by reducing mortality in these infants.
{"title":"Factors Affecting Anaesthetic Management And Early Post-Operative Outcome In Patients With Esophageal Atresia And Tracheo-Esophageal Fistula – A Prospective Study","authors":"M. Kohli, T. Murali, A. Malik, Sateendra Singh","doi":"10.5580/21aa","DOIUrl":"https://doi.org/10.5580/21aa","url":null,"abstract":"Esophageal atresia (EA), with or without trachea-esophageal fistula, is a fairly common congenital disorder with an incidence of 18000 per year in India. In Western countries, associated congenital anomaly is the main factor which affects the prognosis. But in India the preoperative condition, intraoperative and postoperative condition and socioeconomic status along with congenital anomaly affects the prognosis. 55 neonates after evaluation for congenital anomalies and routine investigation were operated for TEF and were classified on the basis of Age, Sex, Birth weight, Maturity; presence of pneumonitis, and other associated congenital anomalies. Epidural catheter was passed through L3-L4 interspace in 24 patients after giving GA to provide postoperative analgesia. 3ml of 0.0625% bupivacaine was given for introperative and postoperative analgesia. It was noted the best survival was in babies who were operated in the first two days. Infants weighing greater than 2.5 kg showed 76% survival. Both sexes had the similar results. Patients with severe chest infection showed only survival of 16.6%. Infants with epidural showed 100 % survival. 33.33% of neonates survived after postoperative ventilation, and there is 77.50% survival in neonates who did not require postoperative ventilation. 17 cases had reported congenital anomalies, which showed 41.17% survival and 76.31% survival was noted in neonates who don’t have congenital anomalies. Neonates with preoperative saturation >95% had 86.36% survival but neonates with <85% saturation showed only 33.33% survival. We observed that epidural analgesia would provide got postoperative outcome in TEF neonates, by reducing mortality in these infants.","PeriodicalId":396781,"journal":{"name":"The Internet Journal of Anesthesiology","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130067694","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}
Due to increasing financial burden on the penal systems to keep offenders in the prisons, there have been increasing uses of electronic home monitoring devices to place “less risky” offenders under house arrest. These devices on several occasions have malfunctioned and caused electrical harm to wearers in cases of power surges and lightning strikes. Due to its relative novelty, there is no consensus or guidelines in the literature on how to manage patients with electronic home monitoring devices in surgical cases using monopolar electrocautery which can deliver charges that could potentially cause harm or malfunction of the monitoring system. Recently, we encountered a patient who needed bilateral cranioplasty procedures but had been placed on house arrest unbeknownst to us. During the surgery, we packed several gauzes in between the patient and the device and placed the electrocautery pad on the contralateral leg with power set at 20 MHz. The surgery was performed without any adverse outcome and the patient did well after surgery.
{"title":"Safety of Electronic Home Monitoring Devices in the Operating Room","authors":"Y. Sarpong, A. Dagal, S. Sharar, A. Avellino","doi":"10.5580/24c8","DOIUrl":"https://doi.org/10.5580/24c8","url":null,"abstract":"Due to increasing financial burden on the penal systems to keep offenders in the prisons, there have been increasing uses of electronic home monitoring devices to place “less risky” offenders under house arrest. These devices on several occasions have malfunctioned and caused electrical harm to wearers in cases of power surges and lightning strikes. Due to its relative novelty, there is no consensus or guidelines in the literature on how to manage patients with electronic home monitoring devices in surgical cases using monopolar electrocautery which can deliver charges that could potentially cause harm or malfunction of the monitoring system. Recently, we encountered a patient who needed bilateral cranioplasty procedures but had been placed on house arrest unbeknownst to us. During the surgery, we packed several gauzes in between the patient and the device and placed the electrocautery pad on the contralateral leg with power set at 20 MHz. The surgery was performed without any adverse outcome and the patient did well after surgery.","PeriodicalId":396781,"journal":{"name":"The Internet Journal of Anesthesiology","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127017523","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}
K. Kahveci, Gözde Bumin Ayd n, D. Ornek, Hande Çelik, Cihan Do er, M.Naz m Elmasl, G. Özgün
Background. In a prospective, randomized, double-blind study we tested whether local anaesthetic administered i.m. potentiates the hypnotic effect of propofol. Methods. Sixty patients (two groups, n=30) undergoing lower abdominal surgery with total i.v. propofol anaesthesia were investigated. Patients in Group Lidocaine (Group L) received i.m. 100 mg and patients in Group Control (Group C) received i.m. saline 5 ml before the operation. Hypnosis was measured with responses to verbal commands. Results. In Group L, the time required for failure to open the eyes in response to verbal command, and the time and dose for achieving hypnosis were significantly shorter than Group C. The induction, and the maintenance doses of propofol were significantly less in Group L compared with the control group. Induction doses were 1.52 and 2.05 mg kg respectively; p<.0001. Maintenance doses were 7.28 and 9.93 mg kg respectively in the first hour; p<.0001. Conclusion. I.M. administered local anaesthetics are associated with a decrease in both the induction and maintenance doses of propofol during total i.v. anaesthesia and a reduction in haemodynamic responses.
{"title":"Effects Of Intramuscular Administration Of Lidocaine In Hynotic Effect And On Induction And Maintenance Doses Of Propofol","authors":"K. Kahveci, Gözde Bumin Ayd n, D. Ornek, Hande Çelik, Cihan Do er, M.Naz m Elmasl, G. Özgün","doi":"10.5580/1ee5","DOIUrl":"https://doi.org/10.5580/1ee5","url":null,"abstract":"Background. In a prospective, randomized, double-blind study we tested whether local anaesthetic administered i.m. potentiates the hypnotic effect of propofol. Methods. Sixty patients (two groups, n=30) undergoing lower abdominal surgery with total i.v. propofol anaesthesia were investigated. Patients in Group Lidocaine (Group L) received i.m. 100 mg and patients in Group Control (Group C) received i.m. saline 5 ml before the operation. Hypnosis was measured with responses to verbal commands. Results. In Group L, the time required for failure to open the eyes in response to verbal command, and the time and dose for achieving hypnosis were significantly shorter than Group C. The induction, and the maintenance doses of propofol were significantly less in Group L compared with the control group. Induction doses were 1.52 and 2.05 mg kg respectively; p<.0001. Maintenance doses were 7.28 and 9.93 mg kg respectively in the first hour; p<.0001. Conclusion. I.M. administered local anaesthetics are associated with a decrease in both the induction and maintenance doses of propofol during total i.v. anaesthesia and a reduction in haemodynamic responses.","PeriodicalId":396781,"journal":{"name":"The Internet Journal of Anesthesiology","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127564000","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}
A. Joffe, Hernando P. Olivar, A. Dagal, R. Raver, A. Grabinsky
Purpose: To describe intubation success and the device manipulations needed to obtain adequate glottic views to facilitate successful first attempt tracheal tube passage with the Airtraq.Methods: Retrospective audit of anonymously collected prospective data from a departmental equipment purchasing committee sponsored device trial. Descriptive data is provided. The odds of successful passage of the tracheal tube on the first attempt without repositioning when the posterior arytenoids cleft was in the left lower quadrant of the view from the Airtraq was compared to its location in any of the other quadrants using a contingency table and presented as OR (95% CI).Results: All patients were successfully intubated with the Airtraq (median time 28 seconds). Device repositioning to attain adequate view of the glottis occurred in 30-48% of insertions depending on whether it was a back-up or rotational motion. The odds of successful intubation on first attempt was thirty times higher when the posterior interarytenoid cleft was in the lower left quadrant of the operators view (95% CI [4-300], p<.0001.Conclusions: Our results support the ease of use and attainment of skills of the Airtraq in inexperienced users. More importantly, our results suggest that maneuvering the device to obtain a view of the glottic structures in the lower left quadrant of operator’s view leads to the highest likelihood of first attempt intubations success.
目的:描述插管成功和设备操作需要获得足够的声门视图，以促进成功的首次尝试气管插管与Airtraq。方法:回顾性审计匿名收集的前瞻性数据来自部门设备采购委员会赞助的器械试验。提供了描述性数据。当后杓骨裂位于Airtraq视野的左下象限时，气管插管首次成功通过而不重新定位的几率与其位于任何其他象限的位置使用列联表进行比较，并以OR (95% CI)表示。结果:所有患者均成功插管(中位时间28秒)。器械重新定位以获得足够的声门视野发生在30-48%的插入中，这取决于它是备份还是旋转运动。当后肌腱间裂位于操作者视野的左下象限时，首次插管成功的几率高出30倍(95% CI [4-300]， p< 0.0001)。结论:我们的研究结果支持在经验不足的用户中易于使用和获得Airtraq的技能。更重要的是，我们的结果表明，操作设备以获得声门结构在操作者视野的左下象限的视图，导致首次插管成功的可能性最高。
{"title":"The Airtraqtm Optical Laryngoscope: A Retrospective Audit Of Optimal Usage Characteristics In Clinical Practice","authors":"A. Joffe, Hernando P. Olivar, A. Dagal, R. Raver, A. Grabinsky","doi":"10.5580/1562","DOIUrl":"https://doi.org/10.5580/1562","url":null,"abstract":"Purpose: To describe intubation success and the device manipulations needed to obtain adequate glottic views to facilitate successful first attempt tracheal tube passage with the Airtraq.Methods: Retrospective audit of anonymously collected prospective data from a departmental equipment purchasing committee sponsored device trial. Descriptive data is provided. The odds of successful passage of the tracheal tube on the first attempt without repositioning when the posterior arytenoids cleft was in the left lower quadrant of the view from the Airtraq was compared to its location in any of the other quadrants using a contingency table and presented as OR (95% CI).Results: All patients were successfully intubated with the Airtraq (median time 28 seconds). Device repositioning to attain adequate view of the glottis occurred in 30-48% of insertions depending on whether it was a back-up or rotational motion. The odds of successful intubation on first attempt was thirty times higher when the posterior interarytenoid cleft was in the lower left quadrant of the operators view (95% CI [4-300], p<.0001.Conclusions: Our results support the ease of use and attainment of skills of the Airtraq in inexperienced users. More importantly, our results suggest that maneuvering the device to obtain a view of the glottic structures in the lower left quadrant of operator’s view leads to the highest likelihood of first attempt intubations success.","PeriodicalId":396781,"journal":{"name":"The Internet Journal of Anesthesiology","volume":"51 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128798796","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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