Masui. The Japanese journal of anesthesiology
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Comparative Study
[McGRATH MAC Videolaryngoscope: clinical assessment of its performance in 50 surgical patients].
The aim of this study was to evaluate the utility of McGRATH MAC Videolaryngoscope in tracheal intubation of surgical patients. ⋯ McGRATH MAC Videolaryngoscope facilitates tracheal intubation in surgical patients.
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Ultrasound-guided neuraxial block has provided safe and accurate analgesia. Although the classic anatomical landmark technique is still standard for completing epidural or subarachnoid puncture, it is difficult to identify the anatomical structure in some cases such as pregnant women, obese patients and patients with spinal deformity. Preparatory ultrasound scanning enables to identify the midline and determine the point of insertion, which reduces the number of puncture attempts and failure rate of procedure. ⋯ Cerebrospinal puncture is an important procedure for diagnosis of some critical conditions such as subarachnoid hemorrhage and central nervous system infections. Ultrasound imaging contributes to smooth procedure and fewer complications. This review summarizes the basic ultrasound-guided technique for expected difficult neuraxial block patients, presenting recent findings.
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Ultrasound guidance for regional anesthesia has gained enormous popularity in the past decade. The usage of ultrasound guidance has reawaken many block techniques in daily clinical practice. In this review, the author described how the ultrasound guidance has changed the manner of intraoperative and postoperative analgesic methods. ⋯ Those success rates increased using sonography, whereas the complications decreased. Advanced sonography shows the clear images of the detailed nerve tissues, so that we can perform the more pin-pointed nerve block considering postoperative benefits of patients. However, it must never be forgotten that both the pre-scan examination before a needle insertion and the continuous watching of an advancing needle tip are essential to perform safer regional anesthesia techniques.
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We report a successful awake tracheal intubation in an emergency patient with acute exacerbation of aortic stenosis using the Pentax-AWS Airwayscope (AWS). An 83-year-old woman was admitted to our emergency department for severe dyspnea due to exacerbation of aortic stenosis. Her Sp(O2) was 92-93% even after administration of 10 l x min(-1) oxygen through a reservoir-attached face mask. ⋯ The AWS allowed for visualization of the glottis and safe placement of the tracheal tube. Sufficient spontaneous ventilation was maintained during interventions with minimum vital sign changes. Awake intubation in the sitting position with the AWS may be helpful in resolving cardiovascular crisis in patients unable to maintain the supine position.
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We report on the development of a simulation-based sedation training course (SEDTC). Participants were doctors and medical staff, such as operating room nurses. During the course, we identified issues that medical staff confront in the operating room (OR). ⋯ At the end of the course, participants discussed problems associated with sedation and provided input regarding sedation safety. Participants commented not only on changes in their views regarding sedation, but also on general medical safety in the OR. Our findings suggest that the SEDTC may serve as a vehicle to promote safety with respect to sedation and analgesia.