Journal of clinical anesthesia
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Mowat-Wilson syndrome is a rare congenital syndrome involving multiple system abnormalities. The most consistently present components include facial deformity, mental retardation, and Hirschsprung disease. We report the anesthetic management of a case of Mowat-Wilson syndrome, with a difficult airway, who underwent Duhamel's procedure and colostomy closure.
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Randomized Controlled Trial Comparative Study
Impact of pillow height on double-lumen endotracheal tube intubation with McGRATH MAC: a prospective randomized clinical trial.
This study aimed to compare the impact of pillow height on double-lumen tracheal tube (DLT) intubation with McGRATH MAC (McG) in patients undergoing elective surgery. ⋯ Intubation with an HP was associated with a better DLT intubation profile than with an LP with McG, possibly due to smoother tracheal tube progression through the glottis.
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Recent health care policy changes promote objective measurements of patient satisfaction with care provided during hospitalization. Acute postsurgical pain is a significant medical problem and strongly impacts patient experience and patient satisfaction. Multimodal analgesic pathways are used for acute pain management, but opioid medications remain a mainstay of treatment. Opioid use is increasing in the outpatient setting, but opioid use trends in the inpatient postsurgical setting are not well known. We hypothesized that use of opioid medications has increased over time along with decrease in postoperative pain scores and increase in pain-related patient satisfaction. ⋯ In this retrospective cohort study, opioid use and pain-related patient satisfaction scores were stable over time. Pain-related patient satisfaction scores were negatively associated with both pain score and opioid dose. The associations we report should not be considered evidence of a causal relationship.
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Randomized Controlled Trial Comparative Study
Nerve stimulator-guided pudendal nerve block vs general anesthesia for postoperative pain management after anterior and posterior vaginal wall repair: a prospective randomized trial.
Compare the effectiveness of nerve stimulator-guided pudendal nerve block (PNB) vs general anesthesia (GA) for anterior and posterior (AP) colporrhaphy in terms of pain relief and analgesic consumption within 24 and 48 hours postoperatively. ⋯ This randomized controlled trial demonstrated that nerve stimulator-guided PNB could be used as an alternative to GA for AP repair of stages I and II prolapse because it is associated with less postoperative pain and analgesic consumption, in addition to shorter duration of recovery.
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Comparative Study
Comparing 3 ventilation modalities by measuring several respiratory parameters using the ProSeal laryngeal mask airway in children.
To determine quantitative differences in several routinely measured ventilation parameters using a standardized anesthetic technique and 3 different ventilation modalities in pediatric patients with a ProSeal laryngeal mask airway (PLMA). ⋯ All 3 modes of ventilation using a PLMA were safely used. Our SV group was noted to have a significantly higher Etco2 when compared with PSV and PCV with a mean Etco2 over time in excess of 55 mm Hg. PSV and PCV were found to be more appropriate ventilation strategies to more optimally control Etco2 over time in these patients.