Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Randomized Controlled Trial Comparative Study
A comparison between left molar direct laryngoscopy and the use of a Bonfils intubation fibrescope for tracheal intubation in a simulated difficult airway.
Tracheal intubation in patients with an immobilized cervical spine can be difficult because of a restricted mouth opening and limited neck movements. Use of the Bonfils intubation fibrescope (BIF) or left molar (LM) laryngoscopy may be suitable options for tracheal intubation in such patients. Intubation adjuncts, such as an endotracheal tube introducer, may improve the overall intubation success rate with the LM approach. Formal studies are currently lacking on the use of LM laryngoscopy with a tube introducer. ⋯ The tube introducer-assisted LM approach to intubation may be a good alternative to the BIF approach in patients with anticipated and unanticipated difficult airway scenarios.
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Observational Study
[Evaluating the learning curve for the transversus abdominal plane block: a prospective observational study.]
Anesthesia is a medical specialty where a large number of technical skills need to be mastered with the learning curve for these skills depending on both the technique and the individual involved. The transversus abdominis plane (TAP) block has demonstrated its effectiveness especially in postoperative analgesia following midline laparotomy. It is usually described as a simple technique even though little is known about the learning curve for this block. The purpose of this study was to determine the learning curve for ultrasound-guided TAP block in anesthesiologists who had no prior experience performing the block. ⋯ This study demonstrates that the TAP block can be rapidly mastered even if the learning curve varies due to inter-individual differences in dexterity and in the ease of obtaining the ultrasound images.
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Preoperative cognitive impairment is a major risk factor for postoperative delirium. We therefore investigated the prognostic significance and feasibility of administering a brief cognitive screen before surgery. ⋯ The AFT is a potentially useful brief cognitive screen for identifying patients at risk of developing postoperative delirium. Limited participation by eligible participants in this study, however, raises questions about how useful and feasible systematic administration of the test is. Large studies using prospective measurement of postoperative delirium are indicated to validate our results.
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Erratum to: Can J Anesth/J Can Anesth DOI 10.1007/s12630-015-0327-x. In the published version, the first name of the third author is incorrect and should read Naoaki Yamada as given in this erratum. The publisher apologizes most sincerely for this error.