International Journal of

Anesthetics and AnesthesiologyISSN: 2377-4630

Archive

Research Article Open Access

Time and Motion Study Assessment of Simulated Rapid Sequence Intubation

Trung Du, David Bramley, Justin Nazareth and David T Andrews
Int J Anesthetic Anesthesiol Volume 1, Issue 3

Abstract: We carried out an observational study using a system of time and motion analysis that was developed to critically evaluate work systems by correlating the number and type of hand and equipment movements that were associated with the time taken to perform the stereotypical anaesthetic technique of rapid sequence intubation (RSI). The number and type of hand movements required to complete RSI exhibited significant correlation with, and were linearly related to, the time taken to carry out the RSI procedure.

PDF   | Full Text  DOI: 10.23937/2377-4630/1/3/1018

Case Report Open Access

Robotic Surgery, Hypertrophic Cardiomyopathy and Difficult Airway - A Challenging Combination for the Anesthesiologist! : A Case Report

Uma Hariharan, Shagun Bhatia Shah and Binod Kumar Naithani
Int J Anesthetic Anesthesiol Volume 1, Issue 3

Abstract: The introduction of robotic surgery has heralded new challenges for the anesthesiologists. The daVinci TM robotic system provides a three-dimensional view and better work ergonomics for the surgeon, especially in complex and radical cancer surgeries. Innovation of robotic surgery has opened the doors for newer concerns in patient safety for the anesthesia team. This is of greater importance in patients with concurrent serious conditions like hypertrophic cardiomyopathy. The challenge becomes greater when difficult airway compounds the situation.

PDF   | Full Text  DOI: 10.23937/2377-4630/1/3/1017

Research Article Open Access

Ultrasound Guided Regional Anesthesia Training Simulator Using Microsoft Kinect

Aparajith Sairam, Jian Feng, Norman I. Badler, Jiabin Liu, Kenneth Richman and Nabil Elkassabany
Int J Anesthetic Anesthesiol Volume 1, Issue 3

Abstract: We present a system for the interactive simulation of ultrasound guided peripheral nerve blocks using a Microsoft Kinect. The system performs motion tracking of both the ultrasound probe and the nerve block needle. Software generates synthetic ultrasound images from previously captured ultrasound images. Details of the software elements in the system are described. Some of the current challenges and future work in this research are discussed.

PDF   | Full Text  DOI: 10.23937/2377-4630/1/3/1016

Case Report Open Access

Endotracheal Repair of an Iatrogenic Tracheal Laceration in A 83-Year-Old Critically Ill Woman with Aspiration Pneumonitis and Sepsis

Stefan Welter, Danjouma Cheufou, Thomas Ehmann, Sandra Kampe and Peter Scharmann
Int J Anesthetic Anesthesiol Volume 1, Issue 3

Abstract: Tracheal laceration is a rare complication of emergency intubation. The treatment decision depends on severity of accompanying problems, available resources, condition and perspectives of the patient and experience of the responsible intensivist and surgeon. The life saving application of endotracheal suture in a disastrous situation is demonstrated in this report. We present the case of a 83-year-old woman who presented with an acute abdomen and septicaemia. A heavy aspiration occured during insertion of a central venous line. The emergency intubation led to a 6 cm rupture of the posterior tracheal wall with a consecutive mediastinal and subcutaneous emphysema. During the Hartmann's operation intermittent tube obstruction caused critically impaired ventilation. The tracheal suture was performed in manifest septicaemia and later allowed regular ventilation, extubation, tracheostomy and weaning. The rupture healed primarily. We think that endotracheal suture of iatrogenic lacerations is a valuable treatment option, even in very difficult situations.

PDF   | Full Text  DOI: 10.23937/2377-4630/1/3/1015

Case Report Open Access

Need of Ultrasound in Emergency Department for Suprapubic Catheterization

Prerana N. Shah, Vaishali P Chaskar, Pradeep Rathod, Anand Komawar and Barakha Gadpale
Int J Anesthetic Anesthesiol Volume 1, Issue 3

Abstract: Acute retention of urine is a medical emergency which needs immediate intervention. Urethral catheterization is a common procedure in the emergency department. Repeated unsuccessful attempts for urethral catheterization demand alternative procedure like suprapubic catheterization. Traditionlly, anatomical landmarks are used to achieve suprapubic catheterization. The confirmation of successful catheterization by ultrasound is recommended. Often due to its unavailability, complications like bowel injury, bleeding etc are reported. We report a case of gastric perforation caused by such a blind suprapubic catheter (SPC) insertion procedure.

PDF   | Full Text  DOI: 10.23937/2377-4630/1/3/1014

Original Article Open Access

Allergy to General Anesthetics: Evaluation of Patients Profile

Carla Irani, C. Saade, C. Dagher and P.Yazbeck
Int J Anesthetic Anesthesiol Volume 1, Issue 3

Abstract: 8 millions procedures requiring anesthesia are performed yearly in France with 75% of them being general anesthesia. In 45% of those procedures, a NMBA (neuromuscular blocking agents) is used. Th incidence of allergy to general anesthetics ranges between 1/20000 in Australia and 1/350 in Great-Britain. Th incidence of peranesthestic allergic reactions estimated in 1996 in France was 1/9000, all drugs confounded and the incidence of allergic reactions to NMBA was evaluated to be 1/6500 anesthesia. Allergic reactions can be benign or fatal in some cases (6%), presenting with urticaria /angioedema or systemic manifestations (dyspnea, bronchospam) and a severe anaphylactic shock requiring a cardiopulmonary resuscitation and the administration of adrenaline.

PDF   | Full Text  DOI: 10.23937/2377-4630/1/3/1013

Original Article Open Access

Supplementary Low - Dose Oral Ketamine Provides Better Parental Separation and Face Mask Acceptance

Zeinab Ahmed El Seify and Ahmed Metwally Khattab
Int J Anesthetic Anesthesiol Volume 1, Issue 3

Abstract: Background: Anesthesia is stressful for children and parents. Although anxiolytics can keep children calm, side effects may exist. No single method shows a clear advantage in keeping the child calm and cooperative. This study aimed to test the effiacy and safety of adding a small dose ketamine to midazolam-based oral premedication on child-parents separation and acceptance of face mask. Methods: Eighty preschool children scheduled for elective surgeries were included. Patients were allocated into 2 groups: A control group (group C), patients received oral midazolam 0.5mg/kg, and a study group (group S), patients the same dose of midazolam in addition to ketamine 2mg/kg. Child reaction to parent separation and parent satisfaction was rated according to separation and satisfaction scores. Induction of anesthesia was carried out using Sevoflrane 6 Vol% in 100% oxygen via face mask; child’s acceptance of the mask was reported. Results: Group (S) children were more cooperative regarding parents separation and acceptance of the face mask than group (C) children (P=0.000&0.02) respectively. No child developed deep sedation in both groups and Sedation score was more satisfactory in group (S), with better parent satisfaction in the same group (p=0.008, P=0.03respectively). Conclusion: Adding a small dose oral ketamine to midazolambased premedication in preschool children proved to be a safe and effective technique in improving child -parent separation and pleasant face mask acceptance.

PDF   | Full Text  DOI: 10.23937/2377-4630/1/3/1012

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