Anesthesia and analgesia
-
Anesthesia and analgesia · Mar 2014
Randomized Controlled Trial Observational StudyThe effectiveness of cricoid pressure for occluding the esophageal entrance in anesthetized and paralyzed patients: an experimental and observational glidescope study.
Cricoid pressure of 30N prevented the passage of both small and large gastric tubes into the oesophageal entrance, which the authors believe supports the utility of cricoid pressure in successfully occluding the oesophagus.
summary -
Anesthesia and analgesia · Mar 2014
ReviewGastric Tubes and Airway Management in Patients at Risk of Aspiration: History, Current Concepts, and Proposal of an Algorithm.
Rapid sequence induction and intubation (RSII) and awake tracheal intubation are commonly used anesthetic techniques in patients at risk of pulmonary aspiration of gastric or esophageal contents. Some of these patients may have a gastric tube (GT) placed preoperatively. Currently, there are no guidelines regarding which patient should have a GT placed before anesthetic induction. ⋯ In the latter cases, the success of placement will indicate whether to use RSII or awake intubation. The GT should not be withdrawn and should be connected to suction during induction. Airway management and the use of GTs in the surgical correction of certain gastrointestinal anomalies in infants and children are discussed.
-
Anesthesia and analgesia · Mar 2014
Randomized Controlled TrialBronchial blocker lung collapse technique: nitrous oxide for facilitating lung collapse during one-lung ventilation with a bronchial blocker.
Effective lung collapse of the nonventilated lung can facilitate thoracic surgery. Previous studies showed that using a bronchial blocker could delay the time of lung collapse compared with using a double-lumen endotracheal tube. We hypothesized that the use of nitrous oxide (N2O) in the inspired gas mixture during 2-lung ventilation would lead to clinically relevant improvement of lung collapse during subsequent 1-lung ventilation with a bronchial blocker. ⋯ Filling the lung with 50% N2O before 1-lung ventilation facilitated lung collapse 5 minutes after opening the chest compared with 100% oxygen when a bronchial blocker was used. The N2O/O2 mixture (FIO2 = 0.5) did not have a harmful effect on subsequent arterial oxygenation during 1-lung ventilation.