RESUMO
This study used a patient simulator to study the ease of use and efficacy of four currently available cricothyroidotomy sets. We assessed the success of insertion of each piece of equipment and measured the subsequent adequacy of oxygenation and ventilation. We also examined the complications encountered using each set. We found that there was a 100% success rate of achieving an adequate airway within acceptable time limits using the 'Quiktrach' and 'Melker' sets, with good airway patency and ease of ventilation. There was an unacceptably high failure rate in achieving a patent airway when using the 'Transtracheal airway catheter with ENK-flow modulator' and 'Patil's airway'. The pre-assembled and user-friendly 'Quiktrach' set provided the fastest and most effective means of oxygenation in the simulated patient requiring an emergency surgical airway.
Assuntos
Traqueotomia/instrumentação , Adulto , Competência Clínica , Cartilagem Cricoide/cirurgia , Emergências , Humanos , Manequins , Consumo de Oxigênio , Respiração Artificial , Fatores de Tempo , Traqueotomia/efeitos adversos , Traqueotomia/métodosRESUMO
In a randomised, double-blinded, two-centre trial we evaluated the effect of a microbiological filter (Supor, Pall Life Sciences) on propofol injection pain. We studied 336 unpremedicated adult patients, who graded pain experienced during induction of anaesthesia with propofol on a 4-point verbal rating scale. Use of the microfilter reduced both the incidence and severity of propofol injection pain (p < 0.001). Incidence of severe pain in the filter group was 2.4% compared with 16.6% in the control group. Overall, 33.7% in the filter group experienced pain compared with 62.1% in the control group. A microbiological filter may provide a non-pharmacological alternative to a lidocaine/propofol mixture for reducing injection pain. It would also reduce the risk of any glass and bacterial contamination.
Assuntos
Anestésicos Intravenosos/efeitos adversos , Filtros Microporos , Dor/prevenção & controle , Propofol/efeitos adversos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Distribuição de Qui-Quadrado , Método Duplo-Cego , Feminino , Vidro , Humanos , Injeções Intravenosas , Irritantes , Masculino , Pessoa de Meia-Idade , Dor/induzido quimicamente , Medição da Dor , SiliconesRESUMO
The use of a newly developed aid to jet ventilation of the lungs, a modified Ben-Jet tube (the Hunsaker Monjet tube), is described in a patient with partial upper airway obstruction. This report highlights an unusual use of this device. The Monjet is a fluoroplastic, monitored, self-centring, fine bore tube that can be inserted from the mouth through to the subglottic region. It was originally developed to anaesthetize healthy patients without airway obstruction who were undergoing suspension microlaryngoscopy.
Assuntos
Obstrução das Vias Respiratórias/etiologia , Anestesia Geral/métodos , Intubação/instrumentação , Neoplasias Laríngeas/cirurgia , Pólipos/cirurgia , Idoso , Anestesia Geral/instrumentação , Feminino , Humanos , Intubação/métodos , Neoplasias Laríngeas/complicações , Laringoscopia , Pólipos/complicações , Respiração Artificial/instrumentação , Prega VocalRESUMO
Although biologically more or less inert, a white patch is a social taboo in India. When a white patch is localized and remains static in spite of conservative treatment, it can be dealt with by tattooing as a camouflage procedure. Inert pigments of skin color match are impregnated into the intradermal plane. The procedure is simpler than melanocyte transfer and serves the purpose of hiding a white patch. In the present study, histology of the tattooed skin was studied to confirm the retention of the pigments into the intradermal plane. The patient remains pain-free in the postoperative period. The procedure does not keep the patient away from work, nor does it require hospitalization or general anaesthesia. It can be dealt with as an office procedure, making it relatively inexpensive.
