Application of the upper lip catch test for airway evaluation in edentulous patients: an observational study

Application of upper lip catch test [ULCT] for airway evaluation in edentulous patients. This research is an evaluation of a clinical diagnostic test in edentulous patients prior to operation. Five hundred eighty eight edentulous patients in a referral university hospital, between March 2008 and June 2011 scheduled for elective surgery under general anesthesia were enrolled. Those unable to open the mouth and those with pharyngo-laryngeal pathology were excluded. ULCT was assessed and compared with Cormack-Lehane grading as a gold standard for airway evaluation. A high negative predictive value of 99.4% was a notable finding for the ULCT. The results also showed a high specificity [89.4%], high sensitivity [75.0%] and a high accuracy [89.3%] in a comparatively higher range for the ULCT. The ULCT proved to be a useful predictor for airway assessment in edentulous patients in this setting. Further studies are needed to reconfirm its validity in other ethnic groups

Comparing the effect of using atracourium and cis-atracourium as adjuvant agents to the local anesthetic substance on peribulbar-induced akinesia

Peribulbar anesthesia is widely applied in cataract surgeries. The aim of this study was comparing the effect of using Atracourium, cis-Atracourium, and placebo as adjuvant agents to the local anesthetic substance on peribulbar-induced akinesia in cataract surgeries. The study was double-blind randomized clinical trial, among the patients candidate for the cataract surgery who were hospitalized in ocular surgery ward in Farabi Hospital between 2006 and 2007. 90 patients were subcategorized into 3 groups randomly. Group I received a mixture [8 ml] containing equal parts of Marcaine 0.5%, Lidocaine 2% and Hyaluronidase 90 IU plus 0.5 ml normal saline; group II received the mixture [8 ml] plus 0.5 ml Atracourium 5 mg, and group III received the mixture [8 ml] plus 0.5 ml cis-Atracurium with the help of peribulbar blockage technique. The score of akinesia were evaluated in the 1st, 3rd, 5th, 10th minutes after administration of the medications. 10 minute after drug administration, 25 [92.6%] reached the total akinesia with Atracourium, 23 [85.2%] with cis-Atracourium, and 23 [85.2%] with the placebo [P>0.05]. Addition of low-dose Atracourium and cis-Atracourium to the anesthetic drug is recommended in order to accelerate the onset of akinesia resulted by the peribulbar block, and in order to enhance the quality of akinesia especially when Hyaloronidaze is not added

Comparing the efficacy of prophylactic P6 acupressure, ondansetron, metoclopramide and placebo in the prevention of vomiting and nausea after strabismus surgery

To compare the efficacy of acupressure wrist bands, ondansetron, metoclopramide and placebo in the prevention of vomiting and nausea after strabismus surgery. Two hundred patients, ASA physical status I or II, aged between 10 and 60 years, undergoing strabismus surgery in Farabi Hospital in 2007-2008 years, were included in this randomized, prospective, double-blind and placebo-controlled study. Group I was the Control, group II received metoclopramide 0.2 mg/kg, group III received ondansetron 0.15 mg/kg iv just before induction, in Group IV acupressure wristbands were applied at the P6 points. Acupressure wrist bands were placed inappropriately in Groups I, II and III. The acupressure wrist bands were applied 30 min prior to the induction of anesthesia and removed six hours after surgery. Postoperative nausea and vomiting [PONV] was evaluated within 0-2 hours and 2-24 hours after surgery by a blinded observer. Results were analyzed by chi-square test. A P value of < 0.05 was taken as significant. The incidence of PONV was not significantly different in acupressure, metoclopramide and ondansetron during the 24 hours. Acupressure at P6 causes a significant reduction in the incidence of PONV 24 hours after strabismus surgery as well as metoclopramide 0.2 mg/kg and ondansetron 0.15 mg/kg iv for patients aged 10 or more

Upper lip bite test as a predictor of difficult mask ventilation: a prospective study

Oxygenation and ventilation by means of bag-mask and ambubag play a significant role in maintaining an optimal oxygen saturation of blood and hence the essence of life itself. Predicting difficulty in mask ventilation is again of paramount importance at the time of induction of anesthesia, and in emergency situations. In this study we aimed at evaluating factors that could help in predicting the difficulty of bag-mask ventilation. In a prospective study, 200 patients were allocated into two groups, 100 each. First group with a ULBT class I, and the other group with ULBT class II and III. Factors such as height, weight, gender, past history of snoring, neck circumference, Mallampati class, sternomental and thyromental distances were then evaluated in each of the patients in the two groups in order to arrive at their impact on the incidence of difficult mask ventilation. Data were analyzed using Chi-square, student t-test and Fisher's exact test depending upon the situation. A p<0.05 was considered to be statistically significant. The results revealed that negative predictive value [NPV] of ULBT class, history of snoring and neck circumference we 86%, 83%, 81%, respectively. A combination of these three predictors had an NPV of 95%. ULBT class alone was of value in predicting difficulty in mask ventilation, but a combination of the three tests significantly improved the predictive value