Ketamine for Emergency Sedation of Agitated Patients: A Systematic Review and Meta-Analysis
Prior studies suggest that ketamine is effective for acute agitation in the emergency department (ED) and prehospital settings. This systematic review and meta-analysis aims to evaluate the rate of sedation and need for airway management in patients given ketamine for management of acute agitation. Methods: We performed a systematic review of publications describing the use of ketamine to control agitation in the ED and prehospital settings. Studies were included if they included agitated patients, used ketamine to control agitation, occurred in the ED and prehospital setting and measured sedation status or need for airway management.
ConclusionSubstantial agreement exists among experts regarding many strong recommendations for the improvement of practice concerning the use of muscle relaxants and reversal agents during anaesthesia. In particular, the French Society of Anaesthesia and Intensive Care (SFAR) recommends the use of a device to monitor neuromuscular blockade throughout anaesthesia.
AbstractPurpose of ReviewPoint-of-care ultrasound (POCUS) has been widely adopted in the management of trauma patients by emergency and surgical specialists. Advances in technology, portability, and affordability have contributed to its exponential growth, particularly in the field of trauma anesthesia where ultrasound usage has steadfastly blossomed in recent years.Recent FindingsStudies and protocols have expanded beyond the oft-used focused assessment with sonography for trauma examination to include focused cardiac and lung examinations. POCUS may also be useful as an adjunct for airway management, vascular access, and...
What is the optimal airway management for patients undergoing interventional pulmonary procedures under general anesthesia?BMC Anesthesiology
Authors: De Cassai A, Boscolo A, Rose K, Carron M, Navalesi P Abstract BACKGROUND: Airway management is a fundamental goal for the anesthesiologist. The rate of difficult laryngoscopy in patients undergoing thyroid surgery ranges from 6.8% to 9.6%. An accurate and detailed preoperative evaluation of the airway seems to be a promising tool to predict a potentially difficult airway management. We aimed to identify possible risk factors and physical findings that predict difficult intubation in thyroid surgery. METHODS: MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL) were analysed,...
ConclusionThere is no anatomical relation between otolaryngologic surgery, the hypoglossal nerve and recurrent laryngeal branch of the vagus nerve. This Tapia’s syndrome case is possibly caused by nerve compression of the two nerves due to anaesthesia cannula. Ginkgo leaf extract, methylcobalamin and mouse nerve growth factor could be used as an alternative treatment plan in case of steroid contraindications.
CONCLUSION TFEL is a useful tool in predicting difficult intubation, improving predictability of routine bedside evaluation. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT02671877.
BACKGROUND Tracheal intubation using a double-lumen endobronchial tube (DLT) causes postoperative sore throat. OBJECTIVE To determine the effect of two-handed jaw thrust on postoperative sore throat in patients requiring insertion of a DLT. DESIGN A randomised study. SETTING A tertiary teaching hospital from December 2017 to May 2018. PATIENTS One-hundred and six patients undergoing one-lung anaesthesia. INTERVENTIONS Patients were allocated to one of two groups (n=53 each). In the jaw thrust group, the two-handed jaw thrust manoeuvre was applied at intubation and advancement of the DLT. In the control gro...
Authors: Surani S, Varon J PMID: 31908688 [PubMed]
Conclusion. Substantial agreement exists among experts regarding many strong recommendations for the improvement of practice concerning the use of muscle relaxants and reversal agents during anaesthesia. In particular, the French Society of Anaesthesia and Intensive Care (SFAR) recommends the use of a device to monitor neuromuscular blockade throughout anaesthesia.
Publication date: Available online 3 January 2020Source: Trends in Anaesthesia and Critical CareAuthor(s): Michael Seltz Kristensen