Comparison of the GlideScope and the McGrath method using vascular forceps and a tube exchanger in cases of simulated difficult airway intubation / 대한마취과학회지

BACKGROUND: A "difficult airway" can be simulated with an extrication collar, which restricts cervical motion and mouth opening. The purpose of this study is to compare the efficacy of the GlideScope and the McGrath in difficult airway simulation. METHODS: Patients were randomized using computer-generated numbers and were placed into the GlideScope group or the McGrath group. The total intubation time was defined as the time measured from when the anesthesiologist picks up the device to the time at which three successive end-tidal CO2 values are acquired after intubation. RESULTS: There was no significant difference in total intubation time between the two groups (73.0 ± 25.3 sec vs. 72.3 ± 20.9 sec, P = 0.92). The success rates of the first intubation attempt did not differ between the two groups (82.8% vs. 83.3%, P = 0.95). CONCLUSIONS: Our results suggest that there are no significant differences in the intubations with GlideScope and McGrath using vascular forceps and tube exchangers in difficult intubation scenarios.

End-tidal concentration of sevoflurane for reducing rocuronium-induced withdrawal reactions in adult patients: a comparison between male and female patients / 대한마취과학회지

BACKGROUND: In this study, we assessed the 50% effective concentration (EC50) of sevoflurane for reducing a rocuronium-induced reaction, based on the Dixon's up-and-down method. We also assessed the 50 and 95% effective end-tidal concentration of sevoflurane (ETsev), based on the probit regression curve of the probability of nonwithdrawal reaction. METHODS: We conducted a prospective, double-blind study in 23 males and 24 females. After using 2.5% thiopental sodium (4 mg/kg), anesthesia was induced in the patients. The patients then inhaled sevoflurane with 5 vol% in 6 L/min of oxygen. When the target ETsev was achieved, a nurse injected the intubating dose of rocuronium (0.6 mg/kg) for 5-10 s under the free flow of intravenous fluid. After the nurse evaluated the response, the nurse recorded the maximum heart rate during 30 s and the mean arterial pressure after rocuronium injection. RESULTS: Based on Dixon's up-and-down method, the EC50 of sevoflurane was 2.5 alpha 0.5 vol% in males and 2.5 alpha 0.3 vol% in females. The probit regression curve of the probability of nonwithdrawal reaction showed that in males the 50% effective ETsev was 2.4 vol% (95% confidence interval [CI], 1.5-3.1 vol%) and the 95% effective ETsev was 3.5 vol% (95% CI, 2.9-11.0 vol%); in females, the 50% effective ETsev was 2.4 vol% (95% CI, 2.1-2.7 vol%) and the 95% effective ETsev was 3.0 vol% (95% CI, 2.7-4.5 vol%). CONCLUSIONS: The inhalation of sevoflurane during the induction period may provide a simple and reliable means of reducing rocuronium-induced reactions without adverse hemodynamic changes. There was no significant difference between males and females.