Journal of clinical anesthesia
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Randomized Controlled Trial Comparative Study
Parker Flex-It intubation stylet versus a 90-degree curved stylet during intubation with the McGrath videolaryngoscope performed by novices: a manikin study with 5 airway scenarios.
To compare the Parker Flex-It intubation stylet with a 90-degree curved stylet using the McGrath videolaryngoscope in 5 airway scenarios (from easy to difficult) in a manikin. ⋯ Intubation of the manikin with the McGrath videolaryngoscope had more success with the Parker Flex-It intubation stylet than a 90° curved stylet.
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Randomized Controlled Trial Comparative Study
Desflurane/fentanyl compared with sevoflurane/fentanyl on awakening and quality of recovery in outpatient surgery using a laryngeal Mask Airway: a randomized, double-blinded controlled trial.
To compare time to awakening and upper airway morbidity between desflurane and sevoflurane using a Laryngeal Mask Airway (LMA) and a balanced anesthetic regimen inclusive of opioids. ⋯ Desflurane retains faster awakening properties than does sevoflurane when used in combination with fentanyl as part of anesthetic maintenance in outpatient surgery with a LMA. The balanced anesthetic maintenance regimen seems to reduce the potential airway reactivity properties of desflurane.
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Multicenter Study Observational Study
Coronary artery disease and its risk factors in patients presenting for liver transplantation.
To determine the distribution of coronary artery disease (CAD) and its risk factors across the various etiologies of end-stage liver disease, and to elucidate the relationship between severe alcohol consumption and CAD. ⋯ Prevalence of CAD and the distribution of CAD risk factors in patients with severe alcohol consumption were similar to patients with viral hepatitis. CAD was most prevalent in patients with hepatic steatosis. This study argues against the notion of decreased expression and progression of CAD in patients with alcoholic cirrhosis presenting for liver transplantation.
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Tracheobronchopathia osteochondroplastica is a rare disorder characterized by cartilaginous or ossified submucosal nodules that project into the tracheobronchial lumen. It is typically discovered in the evaluation of chronic upper respiratory symptoms. A case of a completely asymptomatic man diagnosed with extensive disease throughout his upper airway after unanticipated difficult endotracheal intubation for elective surgery, is presented.
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Serotonin syndrome is gaining attention in perioperative and chronic pain settings due to the growing prevalence of multimodal therapies that increase serotonin levels and thereby heighten patient risk. A patient's genetic make-up may further increase the risk of serotonin syndrome. ⋯ A subsequent cytochrome P4502D6 genetic test result suggested a potential alteration in metabolism. For this patient, who was taking combination antidepressant medications and receiving common perioperative medicines, additive pharmacodynamic effects converged with a pharmacogenetic predisposition, resulting in serotonin syndrome.