Craniotomy for acute monitoring of pial vessels in the rodent brain.

A growing awareness for vascular contribution to pathogenesis of brain diseases increases the need for techniques that allow high-resolution imaging and quantification of changes in function and structure of cerebral microvessels. Cerebral vessels are very sensitive structures, making them vulnerable for injury. In addition, they are uniquely characterized with the blood-brain barrier, and an extra caution is required during procedures that involve engagement of cerebral vessels (i.e., craniotomy). Using state of the art facilities, including 3D intravital microscope, we describe here in details:•The steps and equipment required for drilling a craniotomy and removing of the dura, while keeping brain parenchyma and vessels intact. This enables long duration of live and direct monitoring of pial vessels and imaging of BBB permeability.•We present the craniotomy procedure that relevant and compatible with imaging pial vessels and monitoring the blood-brain barrier in small rodents.

Correction to: Incidence and severity of postoperative sore throat: a randomized comparison of Glidescope with Macintosh laryngoscope.

We are thankful to Dr. Deepak Gupta (Clinical Assistant Professor Anesthesiology, Wayne State University/Detroit Medical Center) for bringing to our attention a typographical error in our manuscript [1].

Incidence and severity of postoperative sore throat: a randomized comparison of Glidescope with Macintosh laryngoscope.

BACKGROUND: Postoperative sore throat (POST) is a common problem following endotracheal (ET) intubation during general anesthesia. The objective was to compare the incidence and severity of POST during routine intubation with Glidescope (GL) and Macintosh laryngoscope (MCL). METHODS: One hundred forty adult patients ASA I and II with normal airway, scheduled to undergo elective surgery under GA requiring ET intubation were enrolled in this prospective randomized study and were randomly divided in two groups, GL and MCL. Incidence and severity of POST was evaluated at 0, 6, 12 and 24 h after surgery. RESULTS: At 0 h, the incidence of POST was more in MCL than GL (n = 41 v.s n = 22, P = 0.001), and also at 6 h after surgery (n = 37 v.s n = 23, P = 0.017). Severity of POST was more at 0, 6 and 12 h after surgery in MCL (P < 0.001, P = 0.001, P = 0.004 respectively). CONCLUSIONS: Routine use of GL for ET tube placement results in reduction in the incidence and severity of POST compared to MCL. TRIAL REGISRATION: ClinicalTrials.gov NCT02848365 . Retrospectively Registered (Date of registration: July, 2016).

Spatial relationship of i-gel® and Ambu® AuraOnceTM on pediatric airway: a randomized comparison based on three dimensional magnetic resonance imaging.

BACKGROUND: Gross morphological differences exist among different brands of pediatric supraglottic devices (SGDs). The aim of this study is to compare the spatial relationship of i-gel® and Ambu® AuraOnce (AO)TM on pediatric airway based on three dimensional (3-D) magnetic resonance imaging (MRI) measurements. METHODS: Sixty patients up to 12 years of age were enrolled and assigned in two groups, i-gel® or Ambu® AOTM. After confirmation of proper placement of these SGDs, 3-D MRI scans of head and neck were performed. Another native scan was also obtained after removal of the SGD for comparison. RESULTS: i-gel® produced significant degree of compression of the tongue (P<0.001) while Ambu® AOTM significantly reduced the axial diameter of glottis (P=0.033) compared to their native values. Both i-gel® and Ambu® AOTM significantly reduced the area of the glottic opening (P<0.001 for each device) and the distance between the arytenoids (P<0.001 and P=0.007 respectively); and increased the distance between the hyoid bone and cervical spine (P<0.001 and P=0.001 respectively) in comparison to their corresponding native values. Bowl of i-gel® produced greater dilation of the upper esophageal sphincter at all levels of measurement- upper (P<0.001), middle (P=0.001) and lower (P=0.015) in comparison to Ambu® AOTM. CONCLUSIONS: Based on 3-D MRI measurements done on living patients, both SGDs distorted the anatomy of pediatric airway compared to their respective native values to variable extent. The relevance of these effects needs further studies on larger patient group in order to reduce morbidity on pediatric airway.

Routine Use of Glidescope and Macintosh Laryngoscope by Trainee Anesthetists.

OBJECTIVE: To compare intubating conditions, success rate, and ease of intubation by anesthesia trainees using Glidescope Videolaryngoscope (GVL) compared to Macintosh laryngoscope (MCL). STUDY DESIGN: Comparative study. PLACE AND DURATION OF STUDY: King Khalid University Hospital, Riyadh, Saudi Arabia, from January 2012 to February 2015. METHODOLOGY: Eighty adult patients ASAI and II with normal airway, scheduled to undergo elective surgery requiring endotracheal (ET) intubation were enrolled. Patients were randomly divided into 2 groups: GVL and MCL. All intubations were performed by trainee residents having experience of more than 1 year and who had successfully performed more than 50 tracheal intubations with each device. Glottic view based on Cormack and Lehane&#039;s (C&amp;L&#039;s) score and percentage of glottis opening (POGO) score, time to successful intubation, need of external pressure, and overall difficulty scores were compared using either GVL or MCL. RESULTS: View of glottis based on C&amp;L&#039;s classification was better (p &lt; 0.001) and POGO score was higher (88.25 &plusmn;22.06 vs. 57.25 &plusmn;29.26, p &lt; 0.001) with GVL compared to MCL. Time to intubate in seconds was (32.90 &plusmn;8.69 vs. 41.33 &plusmn;15.29, p = 0.004) and overall difficulty score was less 2.78 &plusmn;1.39 vs. 4.85 &plusmn;1.75 (p &lt; 0.001) using GVL compared to MCL. CONCLUSION: Residents found ET intubation to be faster and easier with superior glottic view using GVL compared to MCL in patients with normal airway.