Journal of clinical anesthesia
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Randomized Controlled Trial Comparative Study
Evaluation of double-lumen endotracheal tube extubation force by extraction angle: a prospective randomized clinical trial.
Gentle and noninvasive double-lumen tracheal tube (DLT) extubation is important for both airway and circulatory management, especially after lung resection. We performed a prospective randomized clinical trial comparing DLT extubation force based on 2 different extraction angles. ⋯ Our findings suggest that DLT extubation at 60° requires less force than at 90° and was accompanied by a smaller increase in blood pressure. Thus, extraction at 60° may be less invasive and beneficial for patients undergoing DLT extubation.
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Randomized Controlled Trial
A pilot study of upper airway management using a remote-controlled artificial muscle device during propofol anesthesia.
To test the hypothesis that the jaw closure using a pneumatic actuator device affect airway collapsibility and resistance during propofol anesthesia. ⋯ We demonstrated that jaw closure using an air-inflatable pneumatic actuator device can produce substantial decreases in upper airway collapsibility and maintain upper airway patency during propofol anesthesia.
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Patient characteristics may affect patients' response to insulin. We examined the impact of body weight and presence of diabetes on the response to insulin during noncardiac surgery. We studied 202 patients who were enrolled in the DeLiT Trial and received intraoperative intravenous insulin. ⋯ The response to insulin was similar in patients with or without diabetes (adjusted mean difference [97.5% confidence interval], 0.2 [-3.9, 4.2] mg/dL, 0.01 [-0.22, 0.24] mmol/L; P = .93). No relationship was found between insulin response and body weight (P=0.38). Our results suggest that adjustment for body weight and the presence of diabetes may not improve intraoperative insulin treatment algorithms.
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Observational Study
Effect of laryngotracheal topical anesthesia on recurrent laryngeal nerve monitoring during thyroid Surgery.
Intraoperative neuromonitoring of the recurrent laryngeal nerve (RLN) is often used as an adjunct for RLN identification and preservation during thyroidectomies. Laryngotracheal anesthesia (LTA) with topical lidocaine reduces coughing upon emergence from anesthesia and in the immediate postoperative period; however, its use is prohibited with concerns that it could decrease the sensitivity of the intraoperative neuromonitoring. We hypothesize that there is no difference in measurements of nerve conduction made before and after LTA administration. ⋯ Laryngotracheal anesthesia had no significant effect on RLN nerve conduction in the period assessed.