Journal of clinical anesthesia
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Randomized Controlled Trial Comparative Study
A comparison of classic laryngeal mask airway insertion between lightwand- and standard index finger-guided techniques.
To compare the efficacy of lightwand-guided classic laryngeal mask airway (cLMA) real-time insertion technique with the standard recommended index finger-guided insertion technique. ⋯ Lightwand-guided cLMA insertion technique can provide a more objective indicator for correct cLMA positioning, higher first attempt success rates, better glottic views, and less damage to oropharyngeal or esophagus tissues than standard index finger-guided cLMA insertion technique.
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Randomized Controlled Trial
Randomized study of postcesarean analgesia with intrathecal morphine alone or combined with clonidine.
To investigate the efficacy of the combination of intrathecal morphine with clonidine in comparison with 2 doses of intrathecal morphine alone for postcesarean analgesia. ⋯ At these doses, there was no benefit of associating clonidine with morphine to improve postcesarean analgesia. Considering that higher doses of morphine were associated with more side effects, 50 μg of intrathecal morphine alone seems to be a better option for analgesia. The use of clonidine to reduce postoperative shivering must be balanced against the potential risks of hypotension, bradycardia, dizziness, and sedation.
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Randomized Controlled Trial Comparative Study
Ultrashort acting remifentanil is not superior to long-acting sufentanil in preserving cognitive function-a randomized study.
Postoperative cognitive dysfunction (POCD) is a well-known complication after cardiac surgery and may cause permanent disabilities with severe consequences for quality of life. The objectives of this study were, first, to estimate the frequency of POCD after on-pump cardiac surgery in patients randomized to remifentanil- or sufentanil-based anesthesia and, second, to evaluate the association between POCD and quality of recovery and perioperative hemodynamics, respectively. ⋯ We could not demonstrate differences in POCD between remifentanil and sufentanil based anaesthesia, but in general, the fraction of patients with POCD seemed smaller than previously reported. We found an association between POCD and both perioperative low Svo2 and postoperative ventilation time, underlining the importance of perioperative stable hemodynamics and possible fast-track protocols with short ventilation times to attenuate POCD.
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Randomized Controlled Trial
Muscle relaxant facilitates i-gel insertion by novice doctors: A prospective randomized controlled trial.
This study aimed to determine whether muscle relaxants facilitates insertion efficacy of the i-gel supraglottic device (i-gel) by novice doctors in anesthetized patients. ⋯ Our randomized clinical trial suggests that muscle relaxation facilitates i-gel insertion efficacy in anesthetized patients, as assessed by successful insertion rate, sealing pressure, and subjective difficulty of insertion.
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Observational Study
Recovery of laryngeal nerve function with sugammadex after rocuronium-induced profound neuromuscular block.
The aim of this study was to evaluate the efficacy of sugammadex in reversing profound rocuronium-induced neuromuscular block at the laryngeal adductor muscles using motor-evoked potentials (mMEPs). ⋯ Recovery from profound rocuronium-induced block on the larynx is fast and complete with sugammadex. In urgent scenarios, "early" extubation can be performed, even with a TOF ratio ≤0.9. However, all procedures to prevent postoperative residual curarization should still be immediately undertaken.