Turkish journal of anaesthesiology and reanimation
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Turk J Anaesthesiol Reanim · Aug 2018
ReviewLumbar Ultrasonography for Obstetric Neuraxial Blocks: Sonoanatomy and Literature Review.
Ultrasonography has gained popularity in recent years among anaesthesiologists and being used widely for regional blocks and central venous catheterization. Ultrasonography for neuraxial blocks was found beneficial especially for determining the correct needle insertion site and estimating the needle insertion depth of epidural space. In many recent studies, ultrasound guided epidural and spinal blocks have been evaluated among obstetric patients. ⋯ We aimed to evaluate lumbar ultrasonography for obstetric neuraxial blocks. We describe the principles of lumbar ultrasound scanning techniques and present a practical review of lumbar sonoanatomy. We discuss the potential impact and benefits of the ultrasound-guided technique in improving obstetric neuraxial blocks and limitations of its use in clinical practice, based on previous studies.
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Turk J Anaesthesiol Reanim · Aug 2018
Case ReportsSelecting an Appropriate Cuffed Endotracheal Tube Using Ultrasound of the Cricoid in a Child with Down Syndrome.
A 7-year-old girl (height, 94 cm; weight, 15.1 kg) with Down syndrome was scheduled for right patellar dislocation repositioning. The ultrasonographically measured internal transverse width of the cricoid before intubation was 7.8 mm. Attempted insertion of a cuffed Mallinckrodt® endotracheal tube (ETT) (internal diameter, 5.0 mm; deflated cuff portion, 8.4 mm diameter) failed. ⋯ It is becoming standard to use the ultrasonographically measured internal width of the cricoid when choosing cuffed paediatric ETTs, and this approach may be suitable for patients with Down syndrome as well. In these children, approximately 20% of uncuffed ETTs inserted were one or two sizes smaller in diameter than those predicted for the same age. We may choose the ETT size in reference to an ultrasonographically obtained internal transverse width of the cricoid, stated outer diameter (OD) by the producer, and the actual OD depending on the cuff bulk instead of a tube size calculation in patients with growth retardation.
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Turk J Anaesthesiol Reanim · Aug 2018
Quadratus Lumborum Block III for Postoperative Pain After Percutaneous Nephrolithotomy.
An effective pain control is important in early mobilization and returning to normal daily life following percutaneous nephrolithotomy (PCNL) operations. The use of an intraoperative local anaesthetic or postoperative analgesic has been reported for pain control in PCNL. Transmuscular quadratus block (QLB III) is a regional anaesthetic technique applied under ultrasound guidance. The aim of this study was to investigate the effectiveness of QLB III on postoperative pain in PCNL. ⋯ The QLB III was observed to be effective in pain control and reducing morphine consumption during the postoperative 48 hours follow-up after PCNL.
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Turk J Anaesthesiol Reanim · Aug 2018
Effect of Two Techniques of Parental Interaction on Children's Anxiety at Induction of General Anaesthesia-A Randomized Trial.
Several non-pharmacological techniques, such as parental presence and behavioral preparation, are used to decrease children's anxiety at anaesthesia induction. We compared the mean anxiety score in children at the time of anaesthesia induction with two different physical techniques of parental interaction and a control group with no parent present. The secondary objective was to determine the face mask acceptance during induction. ⋯ Parental presence during induction did not prevent children's anxiety, but it reduced it, irrespective of the physical technique used. The face mask acceptance was better in Gp PH.
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Turk J Anaesthesiol Reanim · Aug 2018
Creatinine Excretion as a Determinant of Accelerated Skeletal Muscle Loss with Critical Illness.
The 24-h urinary creatinine excretion rate has been used as an approximation of the skeletal muscle (SM) mass in non-intensive care unit (ICU) settings. The study goal or aim was to determine reductions in SM mass in patients with recurrent critical illness who are admitted to a medical ICU. ⋯ Patients with chronic critical illness admitted to the medical ICU, who become bed bound, can experience up to 50% reduction in SM mass as gleaned from creatinine excretion within 4 months. Low SM mass may predispose patients to increased mortality. Measurement of 24-h urinary creatinine excretion may be a useful ICU biomarker to determine SM mass for diagnostic and prognostic purposes.