Turkish journal of anaesthesiology and reanimation
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Turk J Anaesthesiol Reanim · Apr 2018
Comparison of Different Cuff Pressure Use with the Supreme Laryngeal Mask Airway on Haemodynamic Response, Seal Pressure and Postoperative Adverse Events: A Prospective Randomized Study.
The Supreme™ laryngeal mask airway (SLMA) is a supra glottic airway (SGA) device that is used as an alternative to endotracheal tubes. In the present study, we aimed to compare the use of the SLMA with normal cuff pressure and low cuff pressure, primarily for haemodynamic response. ⋯ SLMA use with a cuff pressure of 45 cm H2O significantly decreases haemodynamic response and post-operative side effects compared with a normal cuff pressure. Therefore, except for some specific surgeries that require higher seal pressures, we recommend the use of the SLMA with cuff pressures as low as 45 cm H2O.
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Turk J Anaesthesiol Reanim · Apr 2018
Reliability of Passive Leg Raising, Stroke Volume Variation and Pulse Pressure Variation to Predict Fluid Responsiveness During Weaning From Mechanical Ventilation After Cardiac Surgery: A Prospective, Observational Study.
During assisted ventilation and spontaneous breathing, functional haemodynamic parameters, including stroke volume variation (SVV) and pulse pressure variation (PPV), are of limited value to predict fluid responsiveness, and the passive leg raising (PLR) manoeuvre has been advocated as a surrogate method. We aimed to study the predictive value of SVV, PPV and PLR for fluid responsiveness during weaning from mechanical ventilation after cardiac surgery. ⋯ During mechanical ventilation, adequate prediction of fluid responsiveness using SVV and PPV was observed. However, during spontaneous breathing, the reliability of SVV and PPV was poor. In this period, PLR as a surrogate was able to predict fluid responsiveness better than SVV or PPV but was less reliable than previously reported.
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Turk J Anaesthesiol Reanim · Apr 2018
Hypobaric Unilateral Spinal Anaesthesia versus General Anaesthesia in Elderly Patients Undergoing Hip Fracture Surgical Repair: A Prospective Randomised Open Trial.
Intraoperative hypotension during hip fracture surgery is frequent in the elderly. No study has compared the haemodynamic effect of hypobaric unilateral spinal anaesthesia (HUSA) and standardised general anaesthesia (GA) in elderly patients undergoing hip fracture surgical repair. ⋯ This study shows that HUSA provides better haemodynamic stability than GA, with lower consumption of ephedrine and similar operating conditions. This new approach of spinal anaesthesia seems to be safe and effective in elderly patients undergoing hip fracture surgery.
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Turk J Anaesthesiol Reanim · Apr 2018
Effect of Bougie-Guided Nasal Intubations upon Bleeding: A Randomised Controlled Trial.
Bleeding due to inadvertent trauma is a troublesome complication of nasal intubations. A lot of methods have been suggested to minimise this problem. A flexible bougie can be passed atraumatically via the nasal route to the trachea and an appropriate-sized endotracheal tube can be railroaded over it to avoid this problem. The primary objective of the study was to compare the severity of bleeding with bougie-guided and conventional nasotracheal intubations on a subjective scale. The time taken for successful intubations and the number of attempts required were also noted. ⋯ Using a bougie routinely for nasal intubations might minimise trauma during nasal intubations but increase the time taken for intubation marginally. The success rates for intubations may also be better.