ABSTRACT
Abstract Purpose: In this study, we evaluated the effectiveness of intubations by way of "Gum Elastic Bougie" and "Intubating Laryngeal Mask Airway" in endotracheal intubation of patients with simulated cervical trauma. Method: 134 patients were included in the study. All patients were placed cervical collar for a simulated cervical trauma. Patients were allocated randomly into three groups: Group NI (n = 45) intubation with Macintosh laryngoscopy, Group GEB (n = 45) intubation with Gum Elastic Bougie, and Group ILMA (n = 44) intubation with Intubating Laryngeal Mask Airway. The number of intubation attempts, success of intubation, duration of complete visualization of the larynx, duration of intubation, user's performance score, hemodynamic changes and the observed complications were recorded. Results: Success of intubation in the first attempt was highest in Group GEB while it was lowest in Group ILMA. Regarding the intubation success, rates of successful intubation were 95.6%, 84.4% and 65.9% in Groups GEB, NI, and ILMA, respectively. Durations of visualization of larynx and intubation were shorter in Groups NI and GEB than in Group ILMA. This difference was statistically significant (p < 0.05) while there was no significant difference between Groups NI and GEB. The number of patients with "good" intubation performance was significantly higher in Group GEB while the number of patients with "poor" intubation performance was significantly higher in Group ILMA (p < 0.05). Conclusions: We conclude that GEB, which is cheap and easily accessible, should be an advantageous choice in cervical trauma patients for both the easeness of intubation and patient morbidity and mortality.
Resumo Objetivo: Neste estudo avaliamos a eficácia de intubações por meio de guia introdutor Bougie e máscara laríngea em intubação endotraqueal de pacientes com trauma cervical simulado. Método: Foram incluídos no estudo 134 pacientes. Colar cervical foi colocado em todos os pacientes para um trauma cervical simulado. Os pacientes foram alocados aleatoriamente em três grupos: Grupo NI (n = 45) foi submetido à intubação com laringoscópio Macintosh; Grupo ITE (n = 45) foi submetido à intubação com guia introdutor de tubo endotraqueal e Grupo ML (n = 44) foi submetido à intubação com máscara laríngea. Número de tentativas de intubação, sucesso de intubação, tempo de visualização completa da laringe, tempo de intubação, escore de desempenho do usuário, alterações hemodinâmicas e complicações observadas foram registrados. Resultados: O sucesso da intubação na primeira tentativa foi maior no Grupo ITE e menor no grupo ML. Ainda em relação ao sucesso da intubação, as taxas de sucesso foram 95,6%, 84,4% e 65,9% nos grupos ITE, NI e ML, respectivamente. Os tempos de visualização da laringe e de intubação foram menores nos grupos NI e ITE do que no Grupo ML. Essa diferença foi estatisticamente significativa (p < 0,05), enquanto não houve diferença significativa entre os Grupos NI e ITE. O número de pacientes com bom desempenho na intubação foi significativamente maior no grupo ITE, enquanto o número de pacientes com mau desempenho na intubação foi significativamente maior no grupo ML (p < 0,05). Conclusões: Concluímos que o ITE, que é barato e facilmente acessível, deve ser uma opção vantajosa em pacientes com trauma cervical, tanto pela facilidade de intubação quanto devido à taxa de morbidade e mortalidade dos pacientes.
Subject(s)
Humans , Male , Female , Neck Injuries/therapy , Intubation, Intratracheal/instrumentation , Prospective Studies , Treatment Outcome , Patient Simulation , Laryngeal Masks , Equipment Design , Middle AgedABSTRACT
PURPOSE: The purpose of this study was to evaluate and compare the effects of different surface pretreatment techniques on the surface roughness and shear bond strength of a new self-adhering flowable composite resin for use with lithium disilicate-reinforced CAD/CAM ceramic material. MATERIALS AND METHODS: A total of one hundred thirty lithium disilicate CAD/CAM ceramic plates with dimensions of 6 mm x 4 mm and 3 mm thick were prepared. Specimens were then assigned into five groups (n=26) as follows: untreated control, coating with 30 microm silica oxide particles (Cojet(TM) Sand), 9.6% hydrofluoric acid etching, Er:YAG laser irradiation, and grinding with a high-speed fine diamond bur. A self-adhering flowable composite resin (Vertise Flow) was applied onto the pre-treated ceramic plates using the Ultradent shear bond Teflon mold system. Surface roughness was measured by atomic force microscopy. Shear bond strength test were performed using a universal testing machine at a crosshead speed of 1 mm/min. Surface roughness data were analyzed by one-way ANOVA and the Tukey HSD tests. Shear bond strength test values were analyzed by Kruskal-Wallis and Mann-Whitney U tests at alpha=.05. RESULTS: Hydrofluoric acid etching and grinding with high-speed fine diamond bur produced significantly higher surface roughness than the other pretreatment groups (P<.05). Hydrofluoric acid etching and silica coating yielded the highest shear bond strength values (P<.001). CONCLUSION: Self-adhering flowable composite resin used as repair composite resin exhibited very low bond strength irrespective of the surface pretreatments used.