Journal of anaesthesiology, clinical pharmacology
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J Anaesthesiol Clin Pharmacol · Jul 2019
Emergency front of neck airway: What do trainers in the UK teach? A national survey.
Front of neck airway (FONA) is the final step to deliver oxygen in the difficult airway management algorithms. The Difficult Airway Society 2015 guidelines have recommended a standardized scalpel cricothyroidotomy technique for an emergency FONA. There is a wide variability in the FONA techniques with disparate approaches and training. We conducted a national postal survey to evaluate current teaching, availability of equipment, experienced surgical help and prevalent attitudes in the face of a can't intubate, can't oxygenate situation. ⋯ The survey has demonstrated that a majority of the airway trainers in the UK would prefer scalpel cricothyroidotomy as emergency FONA. There is a significant variation and deficiency in the current levels of FONA training. Hence, it is important that emergency FONA training is standardized and imparted at a multidisciplinary level.
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J Anaesthesiol Clin Pharmacol · Jul 2019
Advanced airway training in the UK: A national survey of senior anesthetic trainees.
High-quality training in advanced airway skills is imperative to ensure safe anesthetic care and develop future airway specialists. Modern airway management skills are continually evolving in response to advancing technology and developing research. Therefore, it is of concern that training provisions and trainee competencies remain current and effective. ⋯ This national survey identified numerous deficiencies in airway competencies and training amongst senior anesthetic trainees (residents) in the UK. Restructuring of the airway training program and improvements in access to training facilities are essential to ensure effective airway training and the capability to produce future airway specialists.
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J Anaesthesiol Clin Pharmacol · Jul 2019
A comparison between ProSeal laryngeal mask airway and Air-Q Blocker in patients undergoing elective laparoscopic cholecystectomy.
ProSeal laryngeal mask airway (PLMA) is an established device for airway management, while Air-Q Blocker (AQB) is a relatively new supraglottic device. The aim of this study is to compare AQB against PLMA in adults undergoing laparoscopic cholecystectomy under general anesthesia. ⋯ Both PLMA and AQB show similar efficacy in maintaining ventilation and oxygenation, during laparoscopic surgery. However, proper positioning and functioning of the blocker tube of AQB is a limiting factor, and needs further evaluation.
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J Anaesthesiol Clin Pharmacol · Jul 2019
Ambu AuraGain versus intubating laryngeal tube suction as a conduit for endotracheal intubation.
Newly developed supraglottic airway devices (SGAs) are designed to be used both for ventilation and as conduits for endotracheal intubation with standard endotracheal tubes (ETTs). We compared the efficacy of the Ambu AuraGain (AAG) and the newly developed intubating laryngeal tube suction disposable (ILTS-D) as conduits for blind and fiber-optically guided endotracheal intubation in an airway mannequin. ⋯ The ILTS-D successfully performs in an airway mannequin with higher success rate and shorter time for blindly establishing an airway with an ETT using the SGA as a conduit, compared with AAG. Further clinical trials are warranted.
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J Anaesthesiol Clin Pharmacol · Jul 2019
Comparison of thyromental height test with ratio of height to thyromental distance, thyromental distance, and modified Mallampati test in predicting difficult laryngoscopy: A prospective study.
Preoperative airway assessment to predict patients with difficult laryngoscopy is always crucial for anesthesiologists. Several predictive tests have been studied by various authors in quest of finding the best airway predictor. Recently, a new airway predictor, thyromental height test (TMHT) has been reported to have good predictive value in assessing difficult airway. We conducted this study with primary aim to evaluate the diagnostic accuracy of TMHT and to compare it with other established airway predictors, such as ratio of height to thyromental distance (RHTMD), thyromental distance (TMD), and modified Mallampati test (MMT) for predicting difficult laryngoscopy. ⋯ TMHT is the best predictive test with highest accuracy and odds ratio for predicting difficult airway out of all predictive tests evaluated.