European journal of anaesthesiology
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Randomized Controlled Trial Comparative Study
Comparison of three modes of positive pressure mask ventilation during induction of anaesthesia: a prospective, randomized, crossover study.
Mask ventilation of apnoeic patients may be associated with alveolar hypoventilation, hyperventilation and gastric insufflation, which may be affected by the mode of ventilation during induction of anaesthesia. This study is to compare the effect of three modes of positive pressure mask ventilation during induction of anaesthesia regarding ventilatory variables and gastric insufflation. ⋯ We concluded that in this model of apnoeic patients with an unprotected airway, PCV was associated with lower peak airway pressure which may provide additional patient safety.
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Mathematical coupling may explain in part why cardiac filling volumes obtained by transpulmonary thermodilution may better predict and monitor responses of cardiac output to fluid loading than pressures obtained by pulmonary artery catheters (PACs). ⋯ After coronary surgery, fluid responses can be similarly assessed by intermittent transpulmonary and continuous pulmonary thermodilution methods, in spite of overestimation of CCIp by CItp. Filling pressures are poor monitors of fluid responses and superiority of GEDVI can be caused, at least in part, by mathematical coupling when cardiac volume and output are derived from the same thermodilution curve.
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Letter Case Reports
Cranial nerve injuries from a laryngeal mask airway.
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Randomized Controlled Trial Comparative Study
A comparison of the Laryngopharyngeal Examination blade and the English Macintosh laryngoscope blade using an intubating manikin: a prospective randomized crossover study.
To compare the new design laryngoscope blade, Laryngopharyngeal Examination blade, with the English Macintosh blade for examination of the laryngopharynx and placement of a nasogastric tube in the presence of a tracheal tube, time taken to insert the nasogastric tube and for tracheal intubation in an adult intubation manikin. ⋯ We conclude that, in a manikin, the new design blade can make nasogastric tube insertion easier when compared with the Macintosh blade and it can be used to facilitate laryngoscopy and tracheal intubation. Further studies are needed to evaluate its use in patients.
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Awake craniotomy has become an increasingly frequent procedure. In this paper, the principles of its anaesthetic management are reviewed. The means allowing achievement of anaesthetic objectives are described, with emphasis on points that determine success of the procedure. ⋯ The main challenge of intraoperative anaesthetic management relies on the ability of rapidly adjusting the level of sedation and analgesia according to the sequence of surgical events, while ensuring haemodynamic stability, adequate ventilation, and minimal interference with eventual electrophysiological recordings. Throughout the procedure, complications must be anticipated and managed according to predefined guidelines. More prospective randomized clinical trials are still needed to improve safety and efficacy of awake craniotomies, as well as to validate this technique in comparison with more conventional anaesthetic management.