Journal of clinical anesthesia
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Comparative Study
Comparison of the Magill forceps and the Boedeker (curved) intubation forceps for removal of a foreign body in a Manikin.
To compare the straight Magill and the curved Boedeker Intubation Forceps in foreign body removal in a manikin with a difficult airway using the videolaryngoscope. ⋯ The curve of the Boedeker Intubation Forceps allows both the tip of the forceps and the glottic opening to be simultaneously visible in the field of view during videolaryngoscopy, making removal of glottic foreign bodies easier.
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Case Reports
Opioid-free single-incision laparoscopic (SIL) cholecystectomy using bilateral TAP blocks.
A 30 year old woman who was 8 weeks postpartum with a history of cholelithiasis and gallstone pancreatitis, and who was status-post endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy, was treated with a single-incision laparoscopic (SIL) cholecystectomy. A transversus abdominis plane block (TAP) was performed after induction of anesthesia. The patient required no intraoperative or postoperative opioids.
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To determine the sensitivity and specificity of direct laryngoscopy in the conscious patient as a diagnostic test for difficult direct laryngoscopy in the unconscious patient. ⋯ Using remifentanil as the sole analgesic allows evaluation of the larynx with direct laryngoscopy in a conscious patient. A poor Cormack-Lehane grade in a conscious patient may or may not improve with general anesthesia.
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Case Reports
Neurolytic transversus abdominis plane block in the palliative treatment of intractable abdominal wall pain.
A 45 year old man with metastatic colon cancer presented with uncontrollable abdominal wall pain. Transversus abdominis plane (TAP) block with ropivacaine and methylprednisolone was performed with excellent pain relief, which allowed a significant weaning of the patient's opioid requirements. A second TAP block was performed with a 33% ethanol solution (ethanol and ropivacaine) with excellent pain relief. The neurolytic block appeared to offer better pain control for more than 5 days after placement until the patient finally succumbed to his illness.
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In 2010, the American Board of Anesthesiology instituted a new Maintenance of Certification in Anesthesiology (MOCA) Part IV activity requiring diplomates to attend and self-reflect on a simulation-based course in an American Society of Anesthesiologists-endorsed program. Although there are certain course requirements, much of the curriculum and structure of these MOCA activities is left to the discretion of the participating endorsed program. The ideal course would emphasize multimodality simulation-based activities that optimize diplomate education and satisfaction, while economizing faculty requirements. We describe of our course structure and content as a potentially useful template.