[Comparison of difficulty in airway intubation with aging. Study on 71 subjects who had an airway intubation 20-or-more years earlier].

BACKGROUND: Although there are reports targeting children with micrognathia, there is no report how orotracheal intubation difficulty of normal adult patients changes with aging. We surveyed orotracheal intubation episodes after more than 20 years from the initial surgery. METHODS: Seventy one patients underwent general anesthesia again after 23 years in average. Change of orotracheal intubation difficulty was checked retrospectively. The same anesthesiologist assessed 73.2% of cases. RESULTS: Intubation of 4 patients became more difficult, in one patient it became easier, and in the remainder did not change. There was no relation between the change in difficulty and presence or absence of maxillary incisor. Restricted neck mobility or opening of mouth caused by progressive musculoskeletal diseases made orotracheal intubation more difficult CONCLUSIONS: We conclude that in adult patients, if there are no changes in the degree of opening mouth and neck mobility, almost all patients remained in the same situation regarding orotracheal intubation after 23 years in average.

Local infusion analgesia using intra-articular double lumen catheter after total knee arthroplasty: a double blinded randomized control study.

PURPOSE: Although intra-operative local infiltration analgesia has gained increasing popularity in joint replacement surgery, it is not clear whether postoperative local infusion analgesia using an indwelling catheter provides clinically important additional effects. We, therefore, conducted a randomized controlled trial to clarify the efficacy of the originally developed local infusion analgesia technique in total knee arthroplasty. METHODS: Forty patients were randomly allocated to the local infusion analgesia or control group. Patients in the local infusion analgesia group received intermittent bolus intra-articular injection of analgesics consisting of ropivacaine, dexamethasone, and isepamicin until postoperative 48 h. Primary outcome was pain severity at rest using 100-mm visual analogue scale. RESULTS: Pain severity in patients of the local infusion analgesia group was lower than control group, and there were significant differences between groups at POD1 (p = 0.025) and POD3 (p = 0.007). Reduction of postoperative pain was associated with a decrease in C-reactive protein level and earlier achievement of straight leg raise. In addition, postoperative drain volume was reduced in the local infusion analgesia group. CONCLUSION: Although larger studies are needed to examine its safety, the local infusion analgesia alone provided clinically significant analgesic effects and rapid recovery in total knee arthroplasty.