Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists
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Most of the potent analgesics currently in use act through the mu opioid receptor. Although they are classified as mu opioids, clinical experience suggests differences among them. The relative potencies of the agents can vary from patient to patient, as well as the side-effect profiles. ⋯ The explosion in molecular biology has led to the identification of a single gene encoding mu opioid receptors. It now appears that this gene undergoes extensive splicing, in which a single gene can generate multiple proteins. Evidence now suggests that these splice variants may help explain the clinical variability in responses among patients.
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Acta Anaesthesiol Taiwan · Mar 2011
Forces applied to the maxillary incisors during tracheal intubation and dental injury risks of intubation by beginners: a manikin study.
We wished to determine whether dental injuries during intubation would occur more frequently when performed by inexperienced beginners. We measured the laryngoscopic force exerted on maxillary teeth of a modified manikin by experienced anesthesiologists and unexperienced medical students and estimated the injury risk. ⋯ Our results suggest that the experience levels of the laryngoscopists are not a major determinant of dental injuries in patients with healthy dentition.
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Acta Anaesthesiol Taiwan · Mar 2011
Randomized Controlled Trial Comparative StudyComparison of the performance of 'Intubating LMA' and 'Cobra PLA' as an aid to blind endotracheal tube insertion in patients scheduled for elective surgery under general anesthesia.
Supraglottic airways (SGA) through which blind endotracheal intubation is made possible is an area of considerable interest. Our study aimed at comparing the Cobra Perilaryngeal Airway (CPLA) with the Intubating Laryngeal Mask Airway (ILMA) with regard to the performance of the former as a conduit for facilitating blind endotracheal intubation. ⋯ We conclude that CPLA can be used as an effective conduit for blind endotracheal intubation with cuffed PVC tube and has comparable efficacy in tracheal intubation as that with ILMA.
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Acta Anaesthesiol Taiwan · Mar 2011
Case ReportsUse of a video fiberoptic bronchoscope to assist double-lumen endobronchial tube intubation in a patient with a difficult airway.
In clinical scenarios, the insertion of double-lumen endobronchial tubes (DLTs) is usually employed as a technique of separation of lungs for treatment purposes inclusive of one-lung ventilation for the ease of thoracic surgery. However, in patients with difficult airways, the DLT intubation can be challenging, even with the aid of a fiberoptic bronchoscope (FOB). Insertion of the FOB itself into the trachea may be relatively simple, but the advancement of the DLT with the FOB enclosed in the lumen may be hindered by the abnormal or diseased laryngeal aperture. Herein, we present an alternative approach by using a 5.5-mm video FOB to monitor the DLT rather than using it to act as an introducer to overcome the difficulties often met in DLT intubation in oral cancer patients.