Anaesthesia
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Sciatic nerve block was performed in two groups of patients using a low power peripheral nerve stimulator to aid nerve location. In group A 1% prilocaine with felypressin was used as the local anaesthetic agent in a volume of 0.25 ml/kg body weight. ⋯ Use of the 3% solution resulted in highly significant reductions in the mean latency for analgesia of the nerve block and in the latency and degree of motor block achieved (p less than 0.005 in each case). The clinical value of high concentration, low volume nerve block is discussed.
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Randomized Controlled Trial Clinical Trial
The oesophageal detector device. Assessment of a new method to distinguish oesophageal from tracheal intubation.
A new method to distinguish oesophageal from tracheal intubation using the oesophageal detector device was evaluated. In 100 healthy adults, observers of differing experience reliably and rapidly detected 51 oesophageal and 49 tracheal intubations in a randomised, single-blind trial. ⋯ This method can be used in patients with bronchospasm to detect correct tracheal placement when auscultation and decreased compliance of the chest may make clinical confirmation difficult. It can be concluded from this study that the oesophageal detector device is a reliable, rapid, inexpensive and easy to use method for the detection of oesophageal intubation and its very low cost should make it readily available in all situations where tracheal intubation is carried out.
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A patient with Klippel-Feil syndrome who underwent abdominal surgery is presented and the anomaly reviewed. The anatomical abnormality and potentially unstable neck provide a potentially difficult tracheal intubation which was undertaken using an awake fibreoptic technique. The role of the fiberscope and the advantage of pre-operative assessment of the difficult airway are discussed.