Journal of clinical anesthesia
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Randomized Controlled Trial
Do mask aperture bars of extraglottic airway devices prevent prolapse of epiglottis causing airway obstruction? A randomized crossover trial in anesthetized adult patients.
The study objective is to determine whether extraglottic airway devices (EADs) with or without mask aperture bars (MABs) result in similar anatomical positions in patients undergoing surgery. ⋯ This study demonstrated that the anatomical position of the four tested single-use EADs is similar with or without mask aperture bars. We therefore question whether MABs have a protective role in prevention of airway occlusion and whether MABs are essential components. In the overall majority of EADs with MABs, the latter did not prevent contact with the epiglottis. Contact and herniation of the laryngeal structures are seen more frequently when more than two MABs are present.
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Multicenter Study
Major complications of regional anesthesia in 11 teaching hospitals of China: a prospective survey of 106,569 cases.
To determine the incidence of major complications in patients undergoing regional anesthesia (RA) in China. ⋯ This large, multicenter, prospective survey revealed the incidence of major complications after RA in China's hospitals. Although severe complication like cardiac arrest is rare, it is distressing and challenging. Hence, there is still a room to improve on daily basis to further reduce complications related to RA.
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As the patient population with deep brain stimulators grows, medical personnel need to be comfortable managing these patients because they will likely encounter them in practice. Caring for a patient with a deep brain stimulator during surgery or a procedure requires technical knowledge of the device and its possible interactions in order to take the correct precautionary measures. Here we discuss the key issues and questions that should be covered in every preanesthetic evaluation visit of a patient with a deep brain stimulator along with an evaluation checklist.
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Randomized Controlled Trial
Two methods for teaching basic upper airway sonography.
The purpose of this study was to evaluate and compare hands-on gel phantom versus instructional video teaching methods to improve anesthesia residents and staff members' ability to correctly identify airway structures using ultrasound on a human volunteer. ⋯ Use of either a low cost, airway gel phantom training model for hands-on training or a simple instructional teaching video can be used in a single training session to improve staff anesthesiologist and anesthesia resident knowledge and skills for ultrasound identification of upper airway anatomy.
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We describe a very rare case of an indwelling central venous catheter (CVC) through the left internal jugular vein that perforated the superior vena cava (SVC) wall postoperatively, although the CVC was placed in the appropriate position preoperatively. Three days after CVC insertion, a chest radiograph showed that the CVC tip had moved from the lower SVC to the upper SVC. ⋯ In cases of CVC insertion through the left side, the CVC tip should not be placed in the upper SVC (zone B). Considering individual clinical factors and the indwelling period for the CVC, the left innominate vein (zone C) may be a suitable site for the left-sided CVC tip to reduce the risk of SVC perforation.