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https://www.readbyqxmd.com/read/28658880/ultrasonographic-estimation-of-endotracheal-tube-size-in-paediatric-patients-and-its-comparison-with-physical-indices-based-formulae-a-prospective-study
#1
Jagadish G Sutagatti, Ranjana Raja, Madhuri S Kurdi
INTRODUCTION: Choosing the correct Endotracheal Tube (ETT) size is important in paediatric anaesthesia. The subglottic diameter being the narrowest diameter of the paediatric upper airway plays an important role in appropriate ETT size selection. AIM: This study was planned to determine the accuracy of Ultrasonography (USG) to assess the appropriate ETT size and compare it with physical indices based formulae. The secondary outcome was to assess the number of times the tube was changed based on air leak test for USG estimated tube size...
May 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28251606/a-randomised-trial-of-peri-operative-positive-airway-pressure-for-postoperative-delirium-in-patients-at-risk-for-obstructive-sleep-apnoea-after-regional-anaesthesia-with-sedation-or-general-anaesthesia-for-joint-arthroplasty
#2
J W Nadler, J L Evans, E Fang, X A Preud'Homme, R L Daughtry, J B Chapman, M P Bolognesi, D E Attarian, S S Wellman, A D Krystal
Previous pilot work has established an association between obstructive sleep apnoea and the development of acute postoperative delirium , but it remains unclear to what extent this risk factor is modifiable in the 'real world' peri-operative setting. In a single-blind randomised controlled trial, 135 elderly surgical patients at risk for obstructive sleep apnoea were randomly assigned to receive peri-operative continuous positive airway pressure (CPAP) or routine care. Of the 114 patients who completed the study, 21 (18...
March 2, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28237681/assessment-of-distribution-of-ventilation-and-regional-lung-compliance-by-electrical-impedance-tomography-in-anaesthetized-horses-undergoing-alveolar-recruitment-manoeuvres
#3
Tamas D Ambrisko, Johannes Schramel, Klaus Hopster, Sabine Kästner, Yves Moens
OBJECTIVE: To examine changes in the distribution of ventilation and regional lung compliances in anaesthetized horses during the alveolar recruitment manoeuvre (ARM). STUDY DESIGN: Experimental study in which a series of treatments were administered in a fixed order on one occasion. ANIMALS: Five adult Warmblood horses. METHODS: Animals were anaesthetized (xylazine, midazolam-ketamine, isoflurane), placed in dorsal recumbency and ventilated with 100% oxygen using peak inspiratory pressure (PIP) and positive end-expiratory pressure (PEEP) of 20 cmH2O and 0 cmH2O, respectively...
March 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28219323/a-preliminary-assessment-of-the-lma-protector%C3%A2-in-non-paralysed-patients
#4
Ban Leong Sng, Farida Binte Ithnin, Deepak Mathur, Eileen Lew, Nian-Lin Reena Han, Alex Tiong-Heng Sia
BACKGROUND: The LMA Protector™ is the latest CE marked single use supraglottic airway device. This airway device provides access and functional separation of the respiratory and digestive tracts. There are two ports (male, female ports) to provide suction in the laryngeal region and insertion of the gastric tube. The aim of our study is to assess the ease of use, airway quality, device positioning, airway leak and complications associated with initial clinical experience in LMA Protector™ usage...
February 20, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28108038/the-effect-of-endotracheal-tubes-versus-laryngeal-mask-airways-on-perioperative-respiratory-adverse-events-in-infants-a-randomised-controlled-trial
#5
Thomas F E Drake-Brockman, Anoop Ramgolam, Guicheng Zhang, Graham L Hall, Britta S von Ungern-Sternberg
BACKGROUND: Perioperative respiratory adverse events (PRAE) are the most common critical incidents in paediatric anaesthesia and occur more often in infants. Use of laryngeal mask airways (LMAs) is associated with reduced PRAE compared with endotracheal tubes in older children (>1 year). We aimed to evaluate the effect of these devices on the incidence of PRAE in infants. METHODS: We did a randomised controlled trial at the Princess Margaret Hospital for Children in Perth (WA, Australia) by recruiting infants (aged 0-12 months) undergoing general (with or without regional or local) anaesthesia with anticipated fentanyl dose 1 μg/kg or lower for minor elective surgery...
February 18, 2017: Lancet
https://www.readbyqxmd.com/read/27697130/lack-of-national-consensus-in-preoperative-airway-assessment
#6
MULTICENTER STUDY
Anders K Nørskov, Charlotte V Rosenstock, Lars H Lundstrøm
INTRODUCTION: Difficult airway management is associated with an increased risk of morbidity and mortality. Several preoperative risk factors associated with airway management difficulties have been proposed; however, no clear guideline for airway assessments exists. We therefore hypothesised that Danish airway assessment was lacking uniformity. We aimed to examine whether multivariable risk assessment tools and predictors for difficult intubation and mask ventilation were used systematically...
October 2016: Danish Medical Journal
https://www.readbyqxmd.com/read/27245925/-a-germany-wide-survey-on-anaesthesia-in-thoracic-surgery
#7
J Defosse, M Schieren, A Böhmer, V von Dossow, T Loop, F Wappler, M U Gerbershagen
BACKGROUND/OBJECTIVE: This study's objective was to evaluate current thoracic anaesthesia practice in Germany and to quantify potential differences depending on the hospital's level of care. MATERIALS AND METHODS: A four-part online survey containing 28 questions was mailed to all anaesthesiology department chairs (n = 777) registered with the German Society of Anaesthesiology and Intensive Care Medicine. RESULTS: The general response rate was 31...
June 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27190963/an-interesting-case-of-penetrating-craniofacial-trauma-involving-a-wooden-stick
#8
Ambadas Kulkarni, Soumithran Chandrasala, Basavaraj Nimbeni, Praveesh Vishnudas, Arul Dev
Penetrating craniofacial trauma, although uncommon, has a high potential for death or catastrophic consequences from head injury or vital neurovascular injuries. The foreign body may cause significant challenge, especially when it is a large one. Airway obstruction, vascular injuries, intracranial communication, ocular injury and injuries to any other adjacent vital structures when involved may change the treatment objectives from simple foreign body retrieval to a comprehensive multidisciplinary approach to stabilize the patient...
April 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27053783/effects-of-irrigation-fluid-in-shoulder-arthroscopy
#9
Surbhi Gupta, M Manjuladevi, K S Vasudeva Upadhyaya, A M Kutappa, Rajkumar Amaravathi, J Arpana
BACKGROUND AND AIMS: Extravasation of irrigation fluid used in shoulder arthroscopy can lead to life-threatening airway and systemic complications. This study was conducted to assess the effect of irrigation fluid absorption on measurable anthropometric parameters and to identify whether these parameters predict airway/respiratory compromise. METHODS: Thirty six American Society of Anaesthesiologists physical status one or two patients aged 15-60 years undergoing shoulder arthroscopy under general anaesthesia were recruited...
March 2016: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/26917912/anaesthesia-for-laparoscopic-surgery-general-vs-regional-anaesthesia
#10
REVIEW
Sukhminder Jit Singh Bajwa, Ashish Kulshrestha
The use of laparoscopy has revolutionised the surgical field with its advantages of reduced morbidity with early recovery. Laparoscopic procedures have been traditionally performed under general anaesthesia (GA) due to the respiratory changes caused by pneumoperitoneum, which is an integral part of laparoscopy. The precise control of ventilation under controlled conditions in GA has proven it to be ideal for such procedures. However, recently the use of regional anaesthesia (RA) has emerged as an alternative choice for laparoscopy...
January 2016: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/26636511/effects-of-end-tidal-co2-and-venous-co2-levels-on-postoperative-nausea-and-vomiting-in-paediatric-patients
#11
RANDOMIZED CONTROLLED TRIAL
N Altay, S Yalçın, H Aydoğan, A Küçük, H H Yüce
OBJECTIVE: Postoperative nausea and vomiting (PONV) is a common complaint of paediatric surgical patients. The aim of this prospective study was to compare the effects of end tidal CO2 (PeCO2) and venous CO2 (PvCO2) in laryngeal mask (LMA) and face mask (FM) ventilation on the occurrence of PONV in paediatric patients with surgical interventions in the inguinal region. To date, no data regarding these parameters on PONV are available. PATIENTS AND METHODS: Ninety children were randomized using the sealed-envelope method...
November 2015: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/26556919/post-operative-pulmonary-complications-after-non-cardiothoracic-surgery
#12
REVIEW
Kalpana Vinod Kelkar
Post-operative pulmonary complications (PPCs) occur in 5-10% of patients undergoing non-thoracic surgery and in 22% of high risk patients. PPCs are broadly defined as conditions affecting the respiratory tract that can adversely influence clinical course of the patient after surgery. Prior risk stratification, risk reduction strategies, performing short duration and/or minimally invasive surgery and use of anaesthetic technique of combined regional with general anaesthesia can reduce the incidence of PPCs. Atelectasis is the main cause of PPCs...
September 2015: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/26556917/anaesthesia-for-children-with-bronchial-asthma-and-respiratory-infections
#13
REVIEW
M C Rajesh
Asthma represents one of the most common chronic diseases in children with an increasing incidence reported worldwide. The key to successful anaesthetic outcome involves thorough pre-operative assessment and optimisation of the child's pulmonary status. Judicious application of proper anti-inflammatory and bronchodilatory regimes should be instituted as part of pre-operative preparation. Bronchospasm triggering agents should be carefully probed and meticulously avoided. A calm and properly sedated child at the time of induction is ideal, so also is extubation in a deep plane with an unobstructed airway...
September 2015: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/26556916/anaesthesia-for-patient-with-chronic-obstructive-pulmonary-disease
#14
REVIEW
Devika Rani Duggappa, G Venkateswara Rao, Sudheesh Kannan
The chronic obstructive pulmonary disease has become a disease of public health importance. Among the various risk factors, smoking remains the main culprit. In addition to airway obstruction, the presence of intrinsic positive end expiratory pressure, respiratory muscle dysfunction contributes to the symptoms of the patient. Perioperative management of these patients includes identification of modifiable risk factors and their optimisation. Use of regional anaesthesia alone or in combination with general anaesthesia improves pulmonary functions and reduces the incidence of post-operative pulmonary complications...
September 2015: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/26075167/correlation-between-retropalatal-collapse-as-observed-during-muller-s-maneuver-to-severity-of-osa
#15
Raghavendra K Suresh, Arun B Nair, V Sreenivas, C Shilpa, Shiju Abraham, Ravi C Nayar
Objective of the study was to evaluate the reliability of Muller's maneuver (MM) with the severity of obstructive sleep apnea (OSA) at the retropalatal level. Case series of 58 adult patients diagnosed to have OSA. Sleep apnoea clinic in a tertiary referral center in south India. Fifty-eight adult OSA patients underwent outpatient based MM under local anaesthesia. Collapse of hypopharynx and the retroglossal regions were assessed during a maximal inspiratory effort against the closed mouth and sealed nose (reverse valsalva)...
June 2015: Indian Journal of Otolaryngology and Head and Neck Surgery
https://www.readbyqxmd.com/read/26023625/intraoperative-bipap-in-osa-patients
#16
Bhavna P Singh, Kodandaram Ns
Obstructive sleep apnea syndrome (OSA) is characterized by recurrent episodes of partial or complete upper airway obstructions during sleep. Severe OSA presents with a number of challenges to the anesthesiologist, the most life threatening being loss of the airway. We are reporting a case where we successfully used intraoperative bi level positive pressure ventilation (BiPAP) with moderate sedation and a regional technique in a patient with severe OSA posted for total knee replacement (TKR). A 55-year-old lady with osteoarthritis of right knee joint was posted for total knee replacement...
April 2015: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/25937647/effect-of-positive-airway-pressure-during-pre-oxygenation-and-induction-of-anaesthesia-upon-safe-duration-of-apnoea
#17
Melveetil S Sreejit, Venkateswaran Ramkumar
BACKGROUND AND AIMS: Induction of general anaesthesia per se as also the use of 100% oxygen during induction of anaesthesia, results in the development of atelectasis in dependent lung regions within minutes of anaesthetic induction. We aimed to assess the effect of application of a continuous positive airway pressure (CPAP) of 5 cm H2O during pre-oxygenation and induction of anaesthesia on the period of apnoea before the occurrence of clinically significant desaturation. METHODS: In this prospective, randomised, and double-blind study, 40 patients posted for elective surgery were enrolled...
April 2015: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/25683737/laryngeal-advancement-surgery-improves-swallowing-function-in-a-reversible-equine-dysphagia-model
#18
J E Virgin, S J Holcombe, J P Caron, J Cheetham, K A Kurtz, H A Roessner, N G Ducharme, J G Hauptman, N C Nelson
REASONS FOR PERFORMING STUDY: Pharyngeal dysphagia is a debilitating, sometimes fatal condition in horses, with multiple aetiologies. The pathophysiology is complex and not fully understood. Treatment is largely supportive. Laryngeal advancement surgery may diminish symptoms of dysphagia and improve swallowing in affected horses. OBJECTIVES: 1) to induce reversible moderate and marked pharyngeal dysphagia by regional anaesthesia of branches of the glossopharyngeal (IX), vagus (X) and hypoglossal (XII) nerves; 2) to characterise the dysphagia produced by each model; and 3) to determine whether laryngeal advancement surgery improves swallowing in these models...
May 2016: Equine Veterinary Journal
https://www.readbyqxmd.com/read/25233181/difficult-airway-equipment-a-survey-of-standards-across-metropolitan-perth
#19
N Alakeson, T Flett, V Hunt, A Ramgolam, W Reynolds, K Hartley, M Hegarty, B S von Ungern-Sternberg
The importance of appropriate equipment to manage the difficult airway has been highlighted by the publication of the Australian and New Zealand College of Anaesthetists (ANZCA) guidelines in 2012. We set out to audit compliance with these guidelines in all public and private sites providing general anaesthesia in metropolitan Perth. Public and private health care websites identified 39 sites of which 37 were studied. Institutional and ethics approval was obtained. A tick-box design audit tool, based on the ANZCA guidelines, was used to collect information regarding the dedicated difficult airway container (DDAC) at each site...
September 2014: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/24980427/anaesthesia-considerations-in-penetrating-trauma
#20
REVIEW
N Sheffy, R V Chemsian, A Grabinsky
Trauma and penetrating injury, mostly in the form of assault and self-inflicted gunshot and stab wounds, is a major contributor to mortality and morbidity in the modern world, specifically among younger populations. While the prevalence of this form of injury is drastically lower in the UK and Europe in comparison with the USA, it is still common enough to necessitate practising anaesthetists to have a good understanding and working knowledge of the principles in treating victims with penetrating injury. This review article aims to cover basic principles of attending to penetrating trauma victims starting at the pre-hospital level and continuing into the emergency department (ED) and the operating theatre...
August 2014: British Journal of Anaesthesia
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