Journal of clinical anesthesia
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Observational Study
Evaluation of pH on removed tracheal tubes after general anesthesia: a prospective observational study.
Aspiration pneumonia is a complication of tracheal intubation and mechanical ventilation. We hypothesized that tracheal tubes removed after anesthesia that have an acidic pH may reflect latent regurgitation of gastric fluid. ⋯ Acidic pH was found on about 2.5% of removed tracheal tubes. These tubes were used in patients who were in the prone or head-down position during general anesthesia, although they did not exhibit significant aspiration symptom. Anesthesiologists should be aware of the inherent risk of gastric fluid regurgitation when their patients undergo general anesthesia in these positions.
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To assess the stability of pharmaceutical suxamethonium (succinylcholine) solution for injection by validated stability-indicating chromatographic method in vials stored at room temperature. ⋯ Storage of suxamethonium solution for injection vials at ambient temperature (22°C-26°C) for 17 days demonstrated that at least 95% of original suxamethonium concentration remained stable.
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Randomized Controlled Trial Comparative Study
Fascia iliaca block vs intravenous fentanyl as an analgesic technique before positioning for spinal anesthesia in patients undergoing surgery for femur fractures-a randomized trial.
Pain arising from femur fractures is of severe nature. Surgery for fixation of femoral fractures may be done under spinal anesthesia. We conducted this study to compare the analgesic efficacy of fascia iliaca compartment block (FICB) and intravenous fentanyl (IVF) before positioning for spinal anesthesia. ⋯ Fascia iliaca block offers superior analgesia compared to IVF in patients with femur fracture before positioning for spinal anesthesia.
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Randomized Controlled Trial Comparative Study
A comparison of King Vision video laryngoscopy and direct laryngoscopy as performed by residents: a randomized controlled trial.
For more than 40 years, direct laryngoscopy (DL) has been used to assure the airway during endotracheal intubation. The King Vision video laryngoscope is one of the latest devices introduced for endotracheal intubation. We hypothesize that, relative to direct laryngoscopy, it improves the intubation success rate with fewer intubation attempts and no difference in intubation time or complications. ⋯ The use of KVVL by residents with less than 1 year of training (considered nonexperts) significantly improves visualization of the glottis in patients without predictors of difficult airway. The incidence of complications was too low to draw conclusions.
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Observational Study
Preoperative depressed mood and perioperative heart rate variability in patients with hepatic cancer.
How perioperative heart rate variability (HRV) indices differ according to the anxiety or depressed mood of patients scheduled to undergo a major surgical procedure for cancer. ⋯ HRV decreased significantly immediately before anesthesia and recovered to baseline with anesthetic induction. Preoperative, more depressed patients showed increased sympathetic tone at baseline and blunted response to impending anesthesia on the HRV measurements.