Anesthesiology and pain medicine
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One of the main challenges in anesthesiology is difficult intubation. There are many anatomical parameters for evaluating the feasibility of tracheal intubation; one that can reliably predict a difficult intubation is the Cormack-Lehane classification obtained during direct laryngoscopy. This is an invasive procedure that cannot be performed in an awake patient or for pre-anesthetic airway assessments in patients with no prior history of tracheal intubation. Recently, ultrasound has been successfully used for several airway-related applications. ⋯ Our study revealed weak correlation between PE/E-VC and Cormack-Lehane grade, with 87% sensitivity and 30% specificity. Therefore, we concluded that sonographic measurement criteria are not accurate in airway evaluations before anesthesia.
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The goal of this study was to evaluate the impact of intubation skill training involving the use of mannequins on novice anesthesiology residents in a knowledge, attitudes, and practices designed study in which three different types of evaluation were implemented. ⋯ Our results suggest that the personnel in the five participating faculties were highly satisfied with the practical performance of the residents, who were found to hold good attitudes towards the program as a whole.
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Chronic knee pain from osteoarthritis (OA) is common in the aging and the obese population. Radiofrequency ablation of the genicular nerves has been introduced as a potential surgery-sparing treatment for chronic knee pain from OA, yet only two outcome studies have been published and optimal patient selection for this procedure has not been established. ⋯ The accompanying case series suggests that this protocol is deserving of randomized, prospective study.
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Case Reports
Unexpected Collection of Pulmonary Venous Blood from a Pulmonary Artery Catheter: A Case Report.
Pressure and waveform at the catheter tip are continuously monitored during catheterization of pulmonary artery to ensure accurate catheter placement. We present a case in which pulmonary venous blood was unexpectedly collected from the pulmonary artery catheter despite pulmonary artery pressure and waveform detection at the catheter tip, and describe the measures taken to correct the catheter placement. ⋯ Our case highlights the fact that the tip of the pulmonary artery catheter can easily advance into a peripheral branch of the pulmonary artery and cause pulmonary venous blood to be sampled instead of pulmonary arterial blood. A variety of monitoring techniques are needed to confirm accurate catheter placement.