scholarly journals Inter-center comparison of EasyTube and endotracheal tube during general anesthesia in minor elective surgery

PLoS ONE ◽  
2017 ◽  
Vol 12 (6) ◽  
pp. e0178756 ◽  
Author(s):  
Oliver Robak ◽  
Sonia Vaida ◽  
Mostafa Somri ◽  
Luis Gaitini ◽  
Lisa Füreder ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Endotracheal Tube ◽  
Elective Surgery

scholarly journals Comparison of endotracheal tube cuff inflation techniques by stethoscope and “just seal” method in patients undergoing surgeries under general anesthesia

2019 ◽  
Vol 5 (1) ◽  
pp. 16-21
Author(s):  
Mona Rajbhandari ◽  
Nagendra Bahadur KC ◽  
Bhuban Raj Kunwar ◽  
Bindu Laxmi Shah
Keyword(s):  
General Anesthesia ◽  
Endotracheal Tube ◽  
Sore Throat ◽  
Elective Surgery ◽  
Cuff Pressure ◽  
Thyroid Cartilage ◽  
Cuff Inflation ◽  
Endotracheal Tube Cuff ◽  
Tube Cuff ◽  
Tracheal Cuff

Background: Overinflation of the endotracheal tube cuff affects tracheal mucosa blood supply that causes postoperative complications like cough, sore throat and hoarseness. There is no standard cuff inflation technique that produces appropriate cuff pressure. The aim of this study was to find out better technique of cuff inflation that will produce adequate pressure with limited complication using stethoscope guided and “just seal”. Methods: This was prospective, randomized single blinded study of 100 American Society of Anesthesiologists Physical Status (ASA PS) I and II patients of 18-65 years undergoing elective surgery under general anesthesia requiring endotracheal intubation. Group J (n=50) received ‘just seal’ method of tracheal cuff inflation where air was introduced into cuff until audible leak at mouth disappeared and Group S (n=50) received stethoscope-guided tracheal cuff inflation where air was introduced into cuff until harsh breath sound changed to soft while listening with stethoscope bell over the thyroid cartilage. Volume of air in endotracheal tube cuff, cuff pressure following inflation and post-operative sore throat, hoarseness and cough at 24 hour were assessed. Results: Demographic details, mean volume of air in cuff, mean cuff pressure and incidence of postoperative adverse effects like sore throat, hoarseness and cough at 24 hours between the groups were comparable. Conclusion: Both the stethoscope guided and “just seal” cuff inflation techniques were equally effective in producing adequate cuff pressure of 20-30 cmH2O with limited complication.

scholarly journals Utilization of apnea-hypopnea index as a novel predictive factor for difficult mask ventilation in the Chinese population under general anesthesia

2020 ◽  
Author(s):  
Jia-Yi Wang ◽  
Jing-Jie Li ◽  
Peng-Cheng Zhao ◽  
Jia-Li Peng ◽  
Rong Hu ◽  
...  
Keyword(s):  
Risk Factors ◽  
General Anesthesia ◽  
Elective Surgery ◽  
Chinese Patients ◽  
Apnea Hypopnea Index ◽  
Mask Ventilation ◽  
Clinical Trial Registry ◽  
Difficult Mask Ventilation ◽  
Physical Status Classification ◽  
Obstructive Sleep

Abstract Background: Difficult Mask Ventilation (DMV) is a potentially life-threatening situation that can arise during anesthesia. Accordingly, the majority of current airway management guidelines include risk assessments for DMV. Although Obstructive Sleep Apnea (OSA) is among the most important risk factors associated with DMV, other measurements such as the Apnea-Hypopnea Index (AHI) may play an important role in determining patient risk.This study investigated the relationship between DMV and AHI, and determined preoperative risk factors for DMV in Chinese patients.Methods: A prospective cohort trial enrolled patients scheduled for elective surgery. After obtaining informed consent, patient demographic information was collected, and patients were tested with pre-operative polysomnography. Inclusion criteria: Patients >18 years of age, American Society of Anesthesiologists Physical Status Classification (ASA) I-III, and planned elective surgery with general anesthesia. Exclusion criteria: malformations of the airway, patients undergoing regional anesthesia, and patients with contraindications to mask ventilation (i.e. planned awake intubation). A logistic regression model was used to analyze the association between AHI and DMV. Results: A total of 159 patients were analyzed. For both primary and secondary outcomes, the unadjusted and adjusted odds ratio for DMV showed significant increases of 5 AHI units. AHI, age, and the Mallampati classification were found to be independent predictive factors for DMV.Conclusions AHI is associated with DMV as a novel independent risk factor in Chinese patients. Along with age and Mallampati classification, AHI should be included in establishing a superior predictive strategy DMV screening.Trial registration: Chinese Clinical Trial Registry (Registration number # ChiCTR17013076; Date of Registration on October 22nd, 2017).

scholarly journals Observer’s Assessment of Alertness/Sedation-based titration reduces propofol consumption and incidence of hypotension during general anesthesia induction: A randomized controlled trial

2021 ◽  
Vol 104 (4) ◽  
pp. 003685042110523
Author(s):  
Lihong Chen ◽  
Kun Lu ◽  
Tongfeng Luo ◽  
Huiming Liang ◽  
Yuqin Gui ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
General Anesthesia ◽  
Diastolic Blood Pressure ◽  
Elective Surgery ◽  
Controlled Trial ◽  
Mean Blood Pressure ◽  
Conventional Group ◽  
Anesthesia Induction ◽  
Post Intubation

Administration of a single propofol bolus dose for anesthesia induction causes hypotension. We included 160 patients (74 males and 86 females; mean age, 42.4 ± 10.7 [range: 18–60] years) with the American Society of Anesthesiologists status I–II undergoing elective surgery under general anesthesia. Using simple randomization, the patients were divided into a conventional group ( n = 80; received 2 mg/kg propofol at a rate of 250 mg/min) and titrated group ( n = 80; received propofol at a rate of 1 mg/kg/min until the Observer's Assessment of Alertness/Sedation scale score reached 1 point). Fentanyl (4 µg/kg) and cisatracurium (0.2 mg/kg) were administered, as appropriate. Systolic blood pressure, diastolic blood pressure, mean blood pressure, and heart rate were recorded at different time points. Propofol consumption, hypotension, and other adverse events were recorded. All the patients were intubated without awareness. Compared with the conventional group, the titrated group showed more stable blood pressure ( p < 0.05), as well as a lower decrease in systolic blood pressure, mean blood pressure at 1 and 3 min, and diastolic blood pressure at 1 min after propofol administration ( p < 0.01). Moreover, compared with the conventional group, the titrated group showed a lower post-intubation hypotension incidence (9 vs. 19 cases; p = 0.04), as well as lower total propofol dosage and propofol dose per kilogram of body weight (93.57 ± 14.40 mg vs. 116.80 ± 22.37 mg and 1.73 ± 0.27 mg/kg vs. 2.02 ± 0.08 mg/kg, respectively, p < 0.01). Compared with conventional propofol usage, titrated propofol administration can reduce the incidence of hypotension and propofol consumption during anesthesia induction.

scholarly journals Factors affecting general or regional anesthesia preference in patients with elective surgery

2020 ◽  
Vol 7 (7) ◽  
pp. 570-574
Author(s):  
Esra Adıyeke ◽  
Levent Adıyeke
Keyword(s):  
General Anesthesia ◽  
Regional Anesthesia ◽  
Significant Positive Correlation ◽  
Elective Surgery ◽  
Education Level ◽  
Foot Surgery ◽  
Factors Affecting ◽  
Positive Correlation ◽  
The Mean ◽  
To Receive

Objective: This study aimed to investigate the factors that affect the preference of the anesthesia method in patients who were indicated for general or regional anesthesia. Material and Methods: A descriptive questionnaire was used to evaluate the opinions of 123 patients who were planned to undergo elective surgery in the orthopedics and traumatology outpatient clinic between January 2018 and June 2019. Results: 73 women (%59) and 50 men (%41) participated in the study. The mean age was 58.62±11 years. General anesthesia was preferred in 58% of the patients. The most common reason for rejection was that the patients who preferred general anesthesia did not want to receive visual and auditory stimuli during the surgical procedure. There was a significant positive correlation between education level and regional anesthesia preference rate. There was a significant positive correlation between the regional anesthesia preference rate of patients receiving hand and foot surgery indications. Conclusion: The preference of the majority of patients was found to be general anesthesia method. Additionally, the type of surgery and education level of the patients was found to be effective in preference of the anesthesia method.

scholarly journals Observational Analysis of Changes in Endotracheal Tube Cuff Pressure During Laparoscopic Surgery

2020 ◽  
Vol 3 (2) ◽  
pp. 46-49
Author(s):  
Hunsehalli Revanasiddappa Narendra ◽  
Aparna Nerurkar ◽  
Shibu Sasidharan
Keyword(s):  
Laparoscopic Surgery ◽  
General Anesthesia ◽  
Endotracheal Tube ◽  
Airway Pressure ◽  
Cuff Pressure ◽  
Pressure Gauge ◽  
Endotracheal Tube Cuff ◽  
Tube Cuff ◽  
Observational Analysis ◽  
Endotracheal Tube Cuff Pressure

ABSTRACT Background Laparoscopic surgery is performed under general anesthesia with mechanical ventilation, and a high-volume, low-pressure endotracheal tube (ETT) with a sealing cuff pressure about 20–30 cm of H2O is commonly used for a proper seal and avoidance of overinflation. Nitrous oxide (N2O) is an inhalational anesthetic that is used with oxygen in the ratio 50:50 for the maintenance of anesthesia if there is no facility of medical air. However, N2O increases the intracuff pressure of the tracheal tube due to diffusion of N2O in to cuff during general anesthesia. The present research was done to study the cuff pressure changes during laparoscopic surgeries with N2O anesthesia and to assess its variation during the various stages of surgery and also its correlation with position of the patient. Materials and methods A study was done in a tertiary-level hospital over a period of 1 year in 70 patients undergoing laparoscopic surgery. Endotracheal tube was inflated with incremental doses of 0.5 mL of air to a point where no leak on auscultation on the suprasternal area was noted. Cuff pressure measurement using cuff pressure monitor (Hand pressure gauge) was done at the time of first inflation of cuff up to 20–30 cm of H2O and airway pressure, along with total amount of air inflated was noted as “zero” reading. Thereafter, cuff pressure was measured at regular interval of 5 minutes. Cuff pressures and airway pressures were taken just prior to insufflation, 2 minutes after abdominal insufflation, thereafter every 15 minutes throughout surgery, and 2 minutes after desufflation and prior to extubation. Results Out of 70 patients, maximum patients were of the age-group of 20–50 years (78.5%). There was no statistically significant difference between the groups. Cuff pressure at the induction was kept in range of 20–30 cm of H2O. In this study, mean tracheal cuff pressure at baseline was 21.10 + 6.16 (p value of 0.207) and prior to insufflation was 21 + 7.13 (p value of 0.733). The cuff pressures at 2 minutes post insufflation (P2), P15, P30, P45, and P60 were 31.40 ± 12.54 cm of H2O, 25.79 ± 8.68 cm of H2O, 24.61 ± 7.37 cm of H2O, 23.83 ± 9.43 cm of H2O, and 24.63 ± 4.77 cm of H2O, respectively. p value was strongly significant showing a positive correlation between pneumo-peritoneum and cuff pressures. We could see the cuff pressure continuously increasing in successive readings. Post desufflation and prior to extubation, there was a fall in cuff pressure with mean cuff pressure being 17.24 + 5.32 cm of H2O and 15.27 + 4.00 cm of H2O, respectively, which also suggests that cuff pressures increased with pneumoperitoneum. Conclusion Use of N2O increases the cuff pressure (31.4 + 12.54 cm of H2O), especially immediately post-insufflation (35.54 + 12.06 cm of H2O), more so in head low position (36.28 + 12.13 cm of H2O). Mean airway pressure (Ppeak) also increased with pneumoperitoneum (22.60 + 4.38 cm of H2O). The regular monitoring of endotracheal tube cuff pressure should be a part of regular safe practice of anesthesia, and use of handy device like hand pressure gauge should be implemented in regular practice where N2O is used. How to cite this article Narendra HR, Nerurkar A, Sasidharan S. Observational Analysis of Changes in Endotracheal Tube Cuff Pressure During Laparoscopic Surgery. J Med Acad 2020;3(2):46–49.

Endotracheal Tube Obstruction due to Mucous Crust after General Anesthesia

1987 ◽  
Vol 20 (6) ◽  
pp. 901
Author(s):  
Yun Mo Im ◽  
Young Ryong Choi ◽  
Jong Dal Joung
Keyword(s):  
General Anesthesia ◽  
Endotracheal Tube ◽  
Tube Obstruction

scholarly journals A Comparative Study of Oral Dexmedetomidine versus Oral Midazolam As preanesthesia Medication in Pediatric Patients to Reduce anxiety

2019 ◽  
Vol 4 (2) ◽  
pp. 724-728
Author(s):  
Sabin Gauchan ◽  
Chitra Thapa ◽  
Abha Prasai
Keyword(s):  
General Anesthesia ◽  
Separation Anxiety ◽  
Elective Surgery ◽  
Sedation Score ◽  
Preoperative Anxiety ◽  
Parental Separation ◽  
Emergence Agitation ◽  
Oral Midazolam ◽  
Significant Difference ◽  
Group D

Introduction: Preoperative period is a stressful period. In children the preoperative anxiety is expressed as difficult separation from parents and difficult mask induction. The level of preoperative anxiety also affects postoperative outcomes. To overcome anxiety premedication is often used by pediatric anesthesiologist. Objective: The objective of this study was to compare the effect of oral midazolam 0.5mg/kg and oral dexmedetomidine 4μg/kg on parental separation, mask induction and postoperative emergence agitation in children undergoing elective surgery under general anesthesia. Methodology: 120 children aged 2-8years undergoing elective surgery under general anesthesia were divided into two groups: Group M and Group D. Patients in group M received oral midazolam 0.5mg/kg and patients in group D received oral dexmedetomidine 4μg/kg. After 45min of premedication sedation score was assessed in both the groups. Ease of parental separation and mask acceptance was compared in both the groups. In the postoperative period occurrence of emergence agitation was compared in both the groups. Results: There was no statistically significant difference in preoperative sedation score in both the groups. Parent separation anxiety score and mask acceptance score were statistically similar in both the groups. But emergence agitation was significantly lesser in patients who received dexmedetomidine premedication. Conclusions: Premedication with oral midazolam as well as oral dexmedetomidine effectively reduces parental separation anxiety and produces satisfactory mask induction in pediatric age group. However, dexmedetomidine is more effective in reducing emergence delirium in comparison to midazolam.

scholarly journals Role of β-type natriuretic peptide as predictor of early post-operative outcomes in Chinese patients undergoing anesthesia

2017 ◽  
Vol 12 (4) ◽  
pp. 393
Author(s):  
Chun Chen ◽  
Lei Lin
Keyword(s):  
Hospital Stay ◽  
General Anesthesia ◽  
Natriuretic Peptide ◽  
Elective Surgery ◽  
Chinese Patients ◽  
Operative Outcomes ◽  
Study Results ◽  
Before And After ◽  
Prolonged Hospital ◽  
Relationship Of

<p class="Abstract">The purpose of the present study was to assess whether pre-operative and post-operative B-type natriuretic peptide (BNP) levels could be used as the predictor of post-operative complications in Chinese patients undergoing elective surgery under general anesthesia. A total of 80 adult patients were analyzed. Blood sample to measure BNP was collected from each patient before and after surgery to assess the relationship of pre-operative BNP with all possible clinical outcomes. Elevated BNP levels were associated with prolonged hospital stay and mortality. Our study results suggested that the high levels of BNP predict the prolong hospital stay, increased mortality, and increased usage of balloon pump. Also results suggested that the BNP is one of the key predictors of early post-operative outcomes in Chinese patients undergoing elective surgery under general anesthesia.</p>

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