Comparison of Tracheal Intubation Using the Macintosh Laryngoscope Versus the Disposable Laryngoscope by Inexperienced Personnel: A Manikin Study

PURPOSE: Disposable one piece laryngoscope (DOL), which probably carries a lower risk of infection than conventional reusable ones, is the only device which has received approval by the Korean Ministry of Food and Drug safety. In the current study, we evaluated the effectiveness and usefulness of the conventional Macintosh laryngoscope (MAC) and DOL in inexperienced personnel. METHODS: A randomized crossover trial was designed. Ninety seven participants (Medical students, Paramedic students) were enrolled and performed endotracheal intubation with MAC and DOL in Manikin (SimMan(R) Laedal Medical Corporation, Stravanger; Norway). Cormack-Lehane grade, the number of attempts, time required for intubation, and dental compression were measured to evaluate the effectiveness. The participants were given a questionnaire survey on the usefulness of laryngoscopes (easier to use, lightness, brightness, manageable to use, delivering power, safer for patients, intense to use). RESULTS: Regarding the aspect of effectiveness, a significant difference in dental compression was observed between DOL and MAC (p=0.011). Others showed no significant differences. Regarding the aspect of usefulness, DOL was superior to MAC except in delivering power. CONCLUSION: The DOL appears to be a reasonable device for use in emergency airway management. It should be verified for effectiveness and usefulness of newly developed equipment in emergency airway management because it is directly related to life.

Spinal Cord Stimulation in Management of Intractable Chronic Pain: A 5-Year Experience / 대한마취과학회지

BACKGROUND: We investigated the effect of spinal cord stimulation on intractable chronic pain retrospectively and report our 5-year experience. METHODS: 49 patients with the medical history of trial spinal cord stimulation have been retrospectively analyzed. They consist of 34 men and 15 women, ranging in age from 22 to 89 years. Causes of intractable chronic pain included postherpetic neuralgia, failed back surgery syndrome, complex regional pain syndrome, chronic back and leg pain, cauda equina syndrome, perineal pain, diabetic polyneuropathy, and spinal cord injury. RESULTS: The pain due to failed back surgery syndrome, complex regional pain syndrome, chronic low back and leg pain, and spinal cord injury was well controlled by using spinal cord stimulation system. After a trial period of stimulation, 20 patients had permanent stimulators implanted. Most of them reported satisfactory pain relief for maximum 60 months and minimum 9 months. Noticeable complications included electrode displacement and hemorrhage. CONCLUSIONS: We may suggest that spinal cord stimulation is an effective and safe therapy for chronic intractable pain.

Pulsed Radiofrequency Treatment in Glossopharyngeal Neuralgia: A report of 2 cases / 대한마취과학회지

Glossopharyngeal neuralgia (GPN) is a pain syndrome characterized by unilateral sharp pain in the sensory distribution of the ninth cranial nerve. The first line of treatment for GPN is medical. However, it usually provides only partial relief. Pulsed radiofrequency has been proposed as safe, nondestructive treatment method. We present two cases of secondary GPN that was managed with pulsed radiofrequency by extraoral approach. The results were satisfactory.

Biplane Fluoroscopy Guided Maxillary Nerve Block and Pulsed Radiofrequency Lesioning of the Mandibular Nerve: A report of two cases / 대한통증학회지

Biplane fluoroscopy is usually used in angiography. Biplane fluoroscopy gives a biplane image with high resolution during the performance of operations. Trigeminal nerve blocks are effective treatment modalities for trigeminal neuralgia, and maxillary nerve block is the most dangerous procedure among them. The anatomic structures can change after head and neck surgery, so the trigeminal nerve block procedures cannot be done so easily. We used biplane fluoroscopy in these difficult cases. Our first case was a 60-year-old man who had undergone maxillary nerve block. The second case was of a 64-year-old man who had pulsed radiofrequency lesioning of mandibular nerve performed after head and neck surgery. With biplane fluoroscopy, we got good results without any complications.