Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Randomized Controlled Trial Comparative Study Clinical Trial
The McCoy straight blade does not improve laryngoscopy and intubation in normal infants.
The McCoy curved blade laryngoscope has been demonstrated to improve view at laryngoscopy in adults. A straight-bladed version of this laryngoscope has recently been introduced into pediatric practice. The objective of this prospective, randomized study was to compare the intubating conditions afforded by the McCoy (#1) straight blade laryngoscope with the conventional Miller (#1) blade in neonates and infants. ⋯ Our data indicate that the McCoy blade has no advantage over the conventional pediatric Miller blade in normal infants.
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Comparative Study Clinical Trial Controlled Clinical Trial
Comparison of phonomyography with balloon pressure mechanomyography to measure contractile force at the corrugator supercilii muscle.
Phonomyography is based on the creation of low frequency sounds during muscle contraction, which can be recorded and used for neuromuscular monitoring. In this study, balloon pressure mechanomyography, a novel method to measure the force of contraction via pressure changes in an air-filled balloon, was compared with phonomyography to determine neuromuscular blockade at the corrugator supercilii muscle. ⋯ We applied a balloon pressure method to measure the force at the corrugator supercilii. Phonomyography at the corrugator supercilii shows good agreement with this modified version of mechanomyography.
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Randomized Controlled Trial Clinical Trial
Drinking 300 mL of clear fluid two hours before surgery has no effect on gastric fluid volume and pH in fasting and non-fasting obese patients.
To determine whether, in obese [body mass index (BMI) > 30 kg.m(2)] patients, oral intake of 300 mL clear liquid two hours before elective surgery affects the volume and pH of gastric contents at induction of anesthesia. ⋯ Obese patients without comorbid conditions should follow the same fasting guidelines as non-obese patients and be allowed to drink clear liquid until two hours before elective surgery, inasmuch as obesity per se is not considered a risk factor for pulmonary aspiration.
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The responsibility of acute airway management often falls into the hands of non-anesthesiologists. Emergency physicians now routinely use neuromuscular blockade to facilitate intubation. The literature in support of this practice has almost exclusively been published in emergency medicine (EM) journals. This body of literature is presented and issues of educational support are discussed. ⋯ The role of non-anesthesiologists in acute airway management is significant. Despite shortcomings in methodology, current evidence and practice supports the use of RSI by trained emergency physicians. Constructive collaborative efforts between anesthesiology and EM need to occur to ensure that educational needs are met and that competent airway management is provided.