Anesthesia and analgesia
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Anesthesia and analgesia · Apr 2010
Randomized Controlled Trial Comparative StudyLaryngeal mask airway or endotracheal tube for percutaneous dilatational tracheostomy: a comparison of visibility of intratracheal structures.
Some severe complications during percutaneous dilatational tracheostomy (PDT) may be related to poor visualization of tracheal structures. Subjectively, the bronchoscopical view obtained via a laryngeal mask airway (LMA) seems to be better than that obtained with an endotracheal tube (ETT). In this prospective, randomized study, we compared LMA and ETT as the ventilatory device during PDT mainly with respect to visualization of tracheal structures. The quality of ventilation and airway-related complications are also reported. ⋯ The LMA technique showed definite advantages regarding visualization of relevant tracheal structures and the dilation process compared with an ETT. This may be especially relevant in the hands of inexperienced intensivists and in cases of difficult patient anatomy where improved structural visualization optimizes operating conditions.
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Anesthesia and analgesia · Apr 2010
Randomized Controlled Trial Comparative StudyTracheal intubation of a difficult airway using Airway Scope, Airtraq, and Macintosh laryngoscope: a comparative manikin study of inexperienced personnel.
The Airway Scope (AWS) (Pentax-AWS, Hoya Corp., Tokyo, Japan) and the Airtraq (ATQ) (Prodol, Vizcaya, Spain) have similarities in the novel structures of their blades. In this study, we evaluated the ease of use of the AWS and ATQ compared with the Macintosh laryngoscope (ML) by inexperienced personnel in a simulated manikin difficult airway. ⋯ Both the AWS and ATQ may be suitable devices for difficult intubation by inexperienced personnel in this manikin simulated scenario. Further studies in a clinical setting are necessary to confirm these findings.
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Anesthesia and analgesia · Apr 2010
ReviewReview article: anesthetic management of patients undergoing deep brain stimulator insertion.
Deep brain stimulation is used for the treatment of patients with neurologic disorders who have an alteration of function, such as movement disorders and other chronic illnesses. The insertion of the deep brain stimulator (DBS) is a minimally invasive procedure that includes the placement of electrodes into deep brain structures for microelectrode recordings and intraoperative clinical testing and connection of the DBS to an implanted pacemaker. ⋯ The challenges and demands for the anesthesiologist in the care of these patients relate to the specific concerns of the patients with functional neurologic disorders, the effects of anesthetic drugs on microelectrode recordings, and the requirements of the surgical procedure, which often include an awake and cooperative patient. The purpose of this review is to familiarize anesthesiologists with deep brain stimulation by discussing the mechanism, the effects of anesthetic drugs, and the surgical procedure of DBS insertion, and the perioperative assessment, preparation, intraoperative anesthetic management, and complications in patients with functional neurologic disorders.