This case demonstrates a novel preoxygenation technique in a patient with difficult access to the airway after a traumatic facial injury. To find a solution, a fusion of oxygenation equipment was trialed by altering and combining a tracheostomy mask and the tubing of an Optiflow circuit from which the nasal cannula component had been removed. This novel combination delivered high-flow humidified oxygen (60 L/min) orally, avoided further facial injury, and was well tolerated by the patient.
View Article and Find Full Text PDFBackground: Atrial fibrillation (AF) affects 1.5-2% of the population and is associated with a five-fold increased lifetime risk of stroke [1]. The left atrial appendage (LAA) is the source of embolic strokes in up to 90% of patients with non-valvular AF with clots in the left atrium [2].
View Article and Find Full Text PDFThe brain anaesthesia response (BAR) monitor uses a method of EEG analysis, based on a model of brain electrical activity, to monitor the cerebral response to anaesthetic and sedative agents via two indices, composite cortical state (CCS) and cortical input (CI). It was hypothesised that CCS would respond to the hypnotic component of anaesthesia and CI would differentiate between two groups of patients receiving different doses of fentanyl. Twenty-five patients scheduled to undergo elective first-time coronary artery bypass graft surgery were randomised to receive a total fentanyl dose of either 12 μg/kg (fentanyl low dose, FLD) or 24 μg/kg (fentanyl moderate dose, FMD), both administered in two divided doses.
View Article and Find Full Text PDFIntroduction: ELECTROPHYSIOLOGICAL AND HEMODYNAMIC ASSESSMENT.
Dormant-af Study: The significance of adenosine induced dormant pulmonary vein (PV) conduction in atrial fibrillation (AF) ablation remains controversial. The optimal dose of adenosine to determine dormant PV conduction is yet to be systematically explored.
Background: Multiple approaches to the paravertebral space have been described to produce analgesia after thoracic surgery. Ultrasound-guided regional anesthesia has the potential to improve efficacy and reduce complications via real-time visualization of the paravertebral space, surrounding structures, and the approaching needle. We compared a single- versus dual-injection technique for ultrasound-guided paravertebral blockade in a cadaver model, evaluating the spread of contrast dye and location of a catheter.
View Article and Find Full Text PDFBackground: Collapse of the ipsilateral lung facilitates surgical exposure during thoracic procedures. The use of different gas mixtures during two-lung ventilation (2LV) may improve or impede surgical conditions during subsequent one-lung ventilation (OLV) by increasing or delaying lung collapse. We investigated the effects of three different gas mixtures during 2LV on lung collapse and oxygenation during subsequent OLV: Air/Oxygen (fraction of inspired oxygen [FIO(2)] = 0.
View Article and Find Full Text PDFThe properties of dexmedetomidine (DEX) that result in titratable sedation and sympathetic modulation suggest that it would be suitable for use during carotid endarterectomy (CEA) performed under regional anesthesia. We performed a randomized, double-blind study in 56 patients having CEA under regional anesthesia and compared hemodynamic control using DEX versus a conventional sedation technique using midazolam and fentanyl standard (STD). Sedation was titrated to a Ramsay Sedation Score of 2-4 in both groups.
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