ABSTRACT
The objective of this study is to evaluate the efficacy and safety of sealing pressure as an inflation technique of the Microcuff pediatric tracheal cuffed tube. A total of 60 children were enrolled in this study. After induction of anesthesia and intubation with Microcuff pediatric tracheal tube, patients were randomly assigned, to one of the three groups. Control group [n = 20] the cuff was inflated to a cuff pressure of 20 cm H 2 O; sealing group [n = 20] the cuff was inflated to prevent the air leak at peak airway pressure of 20 cm H 2 O and the finger group [n = 20] the cuff was inflated to a suitable pressure using the finger estimation. Tracheal leak, incidence and severity of post-extubation cough, stridor, sore throat and hoarseness were recorded. The cuff pressure as well as the volume of air to fill the cuff was significantly low in the sealing group when compared with the control group [P < 0.001]; however, their values were significantly high in the finger group compared with both the control and the sealing group [P < 0.001]. The incidence and severity of sore throat were significantly high in the finger group compared with both the control and the sealing group [P = 0.0009 and P = 0.0026]. Three patients in the control group developed air leak around the endotracheal tube cuff. The incidence and severity of other complications were similar in the three groups. In pediatric N 2 O, free general anesthesia using Microcuff pediatric tracheal tub, sealing cuff pressure is safer than finger palpation technique regarding post-extubation morbidities and more reliable than recommended safe pressure in prevention of the air leak
ABSTRACT
The present study was conducted to compare the effect of pump injection versus manual injection on the venous pressure, during forearm intravenous regional anesthesia [IVRA] and the incidence and the magnitude of lidocaine leak,. A crossover randomized study of IVRA with a forearm tourniquet was conducted on 14 male healthy volunteers. This study was performed, once using manual injection of local anesthetic and once using automatic pump injection, on two separate sessions. In both techniques, 0.3 ml/kg lidocaine 0.5% was injected over 90 seconds. The occlusion pressure, continuous venous pressure and the serum lidocaine two minutes at end of injection, were recorded. The mean occlusion pressure 161.6 [17.2] mmHg was always higher than the mean initial arm systolic blood pressure 131.7[11]. The maximum venous pressure was significantly higher in the manual technique 176.7 [15.4] mmHg than in the pump technique 161.3 [12.3] mmHg [p = 0.04]. The incidence of lidocaine leak was significantly lower [35.71%] in the pump technique compared to [78.5%] in the manual technique [p = 0.02]. Moreover; the mean lidocaine plasma concentrations was significantly higher [0.86 [0.5] microg.ml[-1]] in the manual technique compared to [0.32 [0.4] microg.ml[-1]] the pump technique [p = 0.04]. The use of pump injection for forearm IVRA could significantly decrease the maximum venous pressure, and decrease the incidence and the magnitude of lidocaine leak past the tourniquet