European journal of anaesthesiology
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Comparative Study Clinical Trial
Videolaryngoscopy in the management of the difficult airway: a comparison with the Macintosh blade.
Several studies have shown that videolaryngoscopes can provide better laryngeal exposure than conventional laryngoscopy. These studies, however, did not exclusively focus on patients with an anticipated difficult intubation. The aim of the present study was to assess whether a videolaryngoscope would provide better laryngeal exposure than conventional laryngoscopy and therefore facilitate intubation in cases of difficult laryngoscopy. ⋯ In patients with an anticipated difficult airway, videolaryngoscopy significantly improved the laryngeal exposure thus facilitating endotracheal intubation.
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Randomized Controlled Trial Comparative Study
Tracheal intubating conditions using propofol and remifentanil target-controlled infusion: a comparison of remifentanil EC50 for Glidescope and Macintosh.
The combination remifentanil-propofol was used for tracheal intubation without muscle relaxant in patients with anticipated difficult airway. Using a target-controlled infusion, we compared the remifentanil concentrations required for intubation with the Macintosh laryngoscope and the Glidescope, at a constant plasma concentration of propofol without muscle relaxant. ⋯ There is no strong evidence that the target remifentanil concentrations required for adequate intubating conditions differed according to the technique used for intubation in the nonparalysed patient. We did not detect any major complications using this technique for either method.
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The last 25 years have seen changes in the management of epidural analgesia for labour, including the advent of low-dose epidural analgesia, the development of new local anaesthetic agents, various regimes for maintaining epidural analgesia and the practice of combined spinal-epidural analgesia. We conducted a survey of Irish obstetric anaesthetists to obtain information regarding the conduct and management of obstetric epidural analgesia in Ireland in 2005. The specific objective of this survey was to discover whether new developments in obstetric anaesthesia have been incorporated into clinical practice. ⋯ It appears that Irish obstetric anaesthetists have adopted the low-dose epidural analgesia trend for the maintenance of labour analgesia. This practice is not as widespread, however, for test dosing, the induction of analgesia dose or in the administration of intermittent epidural boluses to maintain analgesia when higher concentrations are used. Since its introduction in 2000, levobupivacaine has become the most popular local anaesthetic agent.
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An endotracheal cuff pressure of 20-30 cmH(2)O is recommended. Underinflation and overinflation are associated with complications such as aspiration and tracheal wall damage. The aim of this study was to identify prevalence of, and risk factors for, endotracheal cuff underinflation and overinflation. ⋯ Variations in endotracheal cuff pressure are common in ICU patients. Duration of prior intubation and absence of sedation are independently associated with increased risk for cuff underinflation.