Contribution of the nasal passage to face mask ventilation: a prospective blinded randomized crossover trial
AbstractBackgroundPrevious studies have shown that the nasal passage plays an important role in manual face mask ventilation, but this has yet to be quantitatively assessed. We conducted a prospective randomized crossover clinical trial to compare the change in pressure-controlled face mask tidal volume with and without nasal airway occlusion.MethodFemale patients undergoing elective surgery under general anesthesia served as study subjects. Patients were randomly assigned to face mask ventilation beginning either with or without nasal passage occlusion (achieved with a swimmer ’s nose clip), followed by removal or application of the nose clip, respectively. After standardized induction of general anesthesia and muscle paralysis, a tight-fitting face mask was applied to each patient, and tidal volume was measured by the anesthesia machine during pressure-controlled venti lation (10, 15, 20 cm H2O; 8 breaths ·min−1; inspiratory:expiratory ratio 1:2).ResultsThe median [interquartile range] tidal volume was lower withvs without nasal passage occlusion at 10 cm H2O inspiratory pressure (100 [55-134] mLvs 300 [230-328] mL, respectively; median difference (MD), 200 mL; 95% confidence interval (CI), 157 to 229;P
The authors describe how a comprehensive perioperative pain service can be integrated into a Perioperative Surgical Home model, with the aim of improving outcomes and reducing costs.Anesthesia &Analgesia
Are there disadvantages to fasting prior to elective surgery? This paper reviews the physiological changes from fasting and the potential benefits of pre-operative carb loading.BJA Education
Here is a true story of a decision made by the patient and his opthalmologist to allow a terminally ill patient who is expected to die soon and who has cataracts in both eyes to have cataract surgery to be able to see his family before he dies. The story is described at the National Public Radio websitehttps://www.npr.org/sections/health-shots/2017/12/03/565683105/should-eye-surgeons-fulfill-a-dying-mans-wish-to-see-his-family Should this decision be subjected to debate as an ethical issue? For example, the opthalmologist involved, who wrote the article, stated:Our anesthesiologist and others on the operating roo...
ConclusionEight milligrams of intravenous ondansetron given 5 min before spinal anesthesia attenuated but did not prevent spinal anesthesia-induced hypotension in parturients undergoing elective cesarean delivery.
PMID: 29226530 [PubMed - in process]
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What can we learn (or not) from in vitro airway studies for clinical applications in children? Paediatr Anaesth. 2018 Jan;28(1):4-5 Authors: Jagannathan N, von Ungern-Sternberg BS PMID: 29226527 [PubMed - in process]
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In response to "Interventions designed using quality improvement methods reduce the incidence of serious airway events and airway cardiac arrests during pediatric anesthesia". Paediatr Anaesth. 2018 Jan;28(1):73 Authors: Cloyd BH PMID: 29226525 [PubMed - in process]