Anaesthesia
-
Randomized Controlled Trial Comparative Study
The circulatory responses to fibreoptic intubation: a comparison of oral and nasal routes.
The circulatory responses to fibreoptic intubation under general anaesthesia were studied in 60 adult female patients who were randomly assigned to receive either the oral or nasal route for insertion. Non-invasive blood pressure and heart rate were recorded before anaesthesia induction (baseline values), immediately after anaesthesia induction (post-induction values), at intubation and every minute for a further 5 min. The product of heart rate and systolic blood pressure (rate pressure product) at every time point was also calculated. ⋯ There were no significant differences between the two groups in blood pressure, heart rate and rate pressure product at any measuring point, or in the maximum values during observation. The time required for recovery of systolic blood pressure to the post-induction value was not significantly different between the two groups, but the time required for recovery of heart rate to post-induction value was significantly longer in the fibreoptic orotracheal intubation group than in the fibreoptic nasotracheal intubation group. It was concluded that both fibreoptic orotracheal and fibreoptic nasotracheal intubations could cause a similar magnitude of circulatory responses in general anaesthetised, female adults, but the tachycardic response to fibreoptic orotracheal intubation lasted longer than that to fibreoptic nasotracheal intubation.
-
Randomized Controlled Trial Multicenter Study
Does the efficacy of supplemental oxygen for the prevention of postoperative nausea and vomiting depend on the measured outcome, observational period or site of surgery?
High intra-operative oxygen concentration reportedly reduces postoperative nausea and vomiting (PONV), but recent data are conflicting. Therefore, we tested whether the effectiveness of supplemental oxygen depends on the endpoint (nausea vs. vomiting), observation interval (early vs. late) or surgical field (abdominal vs. non-abdominal). We randomly assigned 560 adult patients undergoing various elective procedures with a PONV risk of at least 40% to intra-operative 80% (supplemental) or 30% oxygen (control). ⋯ Incidences of nausea were similar in the groups during early (12% (supplemental) vs. 10% (control), p = 0.43) and late intervals, 26%vs. 20%, p = 0.09, as were the incidences of vomiting (early: 2%vs. 3%, p = 0.40; late: 8%vs. 9%, p = 0.75). Supplemental oxygen was no more effective at reducing PONV in abdominal (40%vs. 31%, p = 0.37) than in non-abdominal surgery (25%vs. 21%, p = 0.368). Thus, supplemental oxygen was unable to reduce PONV independent of the endpoint, observational period or site of surgery.
-
Randomized Controlled Trial Comparative Study
Tracheal intubation using the ILMA, C-Trach or McCoy laryngoscope in patients with simulated cervical spine injury.
A study of 90 patients was undertaken to compare intubation success rates of using either ILMA, C-Trach or McCoy laryngoscope in patients with simulated cervical spine injury. Insertion and intubation success rates, time taken to achieve intubation, airway complications and haemodynamic parameters were recorded. ⋯ Total intubation time was significantly longer in the ILMA (63 s, SD 36.5) group than in the C-Trach (41 s, SD 15.8) and McCoy (30 s, SD 7.4) groups (p < 0.05, p < 0.05, respectively). There were no significant differences in haemodynamic parameters among the groups at any time.
-
Comparative Study
Comparison of the Berman Intubating Airway and the Williams Airway Intubator for fibreoptic orotracheal intubation in anaesthetised patients.
Sixty patients with no clinical indicators of a difficult airway were selected to undergo a fibreoptic assessment after induction of general anaesthesia using both the Berman Intubating Airway and the Williams Airway Intubator. The bronchoscopic view and ease of railroading a tracheal tube during fibreoptic orotracheal intubation were studied. ⋯ The estimated odds ratio of obtaining an obstructed path was 3.06 times higher for the Berman than the Williams Airway. However, if the glottis could be reached with the bronchoscope, there was no significant difference in the degree of ease of intubation between the two airways.