Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · May 2012
Assessment of pain in sedated and mechanically ventilated patients: an observational study.
Critically ill patients often undergo unpleasant procedures. We quantified the effects of an unpleasant stimulus on physiological and behavioral parameters and evaluated how they are modified by sedation and analgesia. ⋯ Intratracheal suctioning evoked significant changes in some physiological and behavioral parameters. Some physiological changes were suppressed by analgesia, but at our ICU's standard doses, neither analgesia nor sedation attenuated changes in behavioral parameters at the intensity tested.
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Acta Anaesthesiol Scand · May 2012
Comparative StudyVerification of endotracheal intubation in obese patients - temporal comparison of ultrasound vs. auscultation and capnography.
Ultrasound (US) may have an emerging role as an adjunct in verification of endotracheal intubation. Obtaining optimal US images in obese patients is generally regarded more difficult than for other patients. This study compared the time consumption of bilateral lung US with auscultation and capnography for verifying endotracheal intubation in obese patients. ⋯ In obese patients, verification of endotracheal tube placement with US is as fast as auscultation alone and faster than the standard method of auscultation and capnography.
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Acta Anaesthesiol Scand · May 2012
A cost analysis of reusable and disposable flexible optical scopes for intubation.
Intubation using a flexible optical scope (FOS) is a cornerstone technique for managing the predicted and unpredicted difficult airway. The term FOS covers both fibre-optic scopes and videoscopes. The total costs of using flexible scopes for intubation are unknown. The recent introduction of a disposable flexible scope for intubation merits closer scrutiny of the total costs associated with both modalities. ⋯ At our institution, the total cost of an intubation is greater when using disposable compared with reusable equipment (€204.4 vs. €177.7). If video equipment with an external monitor is considered mandatory, the expenses are of equal magnitude. The cost analysis is particularly sensitive to the actual number of flexible optic intubations performed; with fewer intubations, the total cost will begin to favour disposable equipment.
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Acta Anaesthesiol Scand · May 2012
A clinical assessment tool for ultrasound-guided axillary brachial plexus block.
Competency in anesthesia traditionally has been determined subjectively in practice. Optimal training in procedural skills requires valid and reliable forms of assessment. The objective was to examine a procedure-specific clinical assessment tool for ultrasound-guided axillary brachial plexus block for inter-rater reliability and construct validity in a clinical setting. ⋯ The objective of task-specific checklist and global rating scale are reliable and valid measures of axillary block performance between different levels of expertise.