Comparison of effectiveness of the piston-pump method versus the pressure-infusor method for rapid infusion of crystalloids: A bench study.

Background And Aims: The piston-pump method is a simple method for rapid administration of fluids but some problems are unsolved. We compared the effectiveness of using the piston-pump method with that of the pressure-infusor method.

Methods: Twelve anaesthetists were classified randomly into the piston-pump and pressure-infusor groups.

Unexpected Obstruction of a Parker Flex-Tip Endotracheal Tube Caused by Outward Bending of Its Tip: A Case Report.

We report a case of Parker Flex-Tip endotracheal tube obstruction caused by its tip bending outward against the tube lumen. The Parker Flex-Tip tube tip is designed to bend inward to prevent damage to airway structures during intubation. However, when its tip is bent outward, the tube aperture is distorted, shifts against the tracheal wall, and is occluded.

Bougies as an aid for endotracheal intubation with the Airway Scope: bench and manikin comparison studies.

Background: When encountering a difficult airway with an Airway Scope (AWS) a bougie can be inserted into the endotracheal tube in the AWS channel. The angulated tip of the bougie can be guided toward the glottis by rotating it. We tested the ease of rotating bougies (Venn reusable, Boussignac, Portex single-use, and Frova) in an endotracheal tube when placed in the AWS channel.

Prevention of aspiration of gastric contents during attempt in tracheal intubation in the semi-lateral and lateral positions.

Background: Pulmonary aspiration of gastric contents during tracheal intubation is a life-threatening complication in emergency patients. Rapid sequence intubation is commonly performed to prevent aspiration but is not associated with low risk of intubation related complications. Although it has been considered that aspiration can be prevented in the lateral position, few studies have evaluated the ability to prevent aspiration.

[Airway Obstruction Caused by Heat and Moisture Exchange Filter Used during General Anesthesia: A Case Report and an In Vitro Study].

Background: A previously healthy 54-year-old woman underwent a resection of the acoustic tumor. Following induction of general anesthesia and tracheal intubation, volume-controlled ventilation was started and the patient was placed in the left park bench position. The heat and moisture exchange filter (HMEF) was placed within the ventilatory circuit and positioned below the patient's head to avoid unintentional extubation.

[Monitoring of Somatosensory Evoked Potentials during Foramen Magnum Decompression of Chiari Malformation Type I Complicated with Syringomyelia: A Report of Two Cases].

Few reports exist on anesthetic management for foramen magnum decompression (FMD) of Chiari malformation type I (CM I) complicated with syringomyelia. In two such cases we monitored somatosensory evoked potentials (SEP). Case 1 : A 40-year-old woman presented with occipital headache and nuchal pain for 2 months; numbness and muscular weakness of bilateral upper limbs for a month.

[Head extension during laryngoscopy for obtaining a best glottic view: comparison of the McGrath and Macintosh laryngoscopes].

Background: Camera eye in the McGrath video-laryngoscope blade is located closer to the larynx, which may allow reduction of the head-neck movement during laryngoscopy compared with a conventional laryngoscope. We compared the degree of head extension during laryngoscopy with McGrath laryngoscope and that with Macintosh laryngoscope.

Methods: Fifty patients without cervical spine abnormality were randomized into two groups: laryngoscopies with Macintosh laryngoscope and that with McGrath laryngoscope.

Combining head-neck position and head-down tilt to prevent pulmonary aspiration of gastric contents during induction of anaesthesia: a volunteer and manikin study.

Context: Although a life-threatening complication, pulmonary aspiration of gastric contents caused by vomiting or regurgitation during induction of anaesthesia cannot be prevented. It may be prevented if the mouth is placed more inferiorly than the larynx and tracheal bifurcation by the use of head-down tilt and head-neck positioning.

Objective: We aimed to determine the head-down tilt required to prevent aspiration in the neutral, simple extension, sniffing and full cervical spine extension (Sellick) positions and to investigate the relationship between pulmonary aspiration and the vertical height of the mouth, larynx and tracheal bifurcation.

Efficacy of the Airway Scope on tracheal intubation in the lateral position: comparison with the Macintosh laryngoscope.

Background: The Airway Scope (AWS) may become a rescue airway device to secure the airway in the lateral position. We evaluated the efficacy of the AWS on tracheal intubation in patients in this position in comparison with the Macintosh laryngoscope.

Methods: Seventy patients scheduled for surgery in the lateral position under general anaesthesia with tracheal intubation were randomised into two groups: intubation with the Macintosh laryngoscope and that with the AWS.

[Efficacy of bougie in difficult intubation with the Airway Scope caused by inability to lift the epiglottis directly].

Background: There are some disadvantages of the Airway Scope (AWS), and the most crucial one is that the AWS has only one fixed-size AWS blade. When the blade is too short to reach beneath the epiglottis and to lift it directly, an endotracheal tube hits the epiglottis and cannot be advanced into the glottic aperture even when it is visible. A bougie may solve this difficulty because its angulated tip can be controlled in a desired direction.

Approach combining the airway scope and the bougie for minimizing movement of the cervical spine during endotracheal intubation.

Background: The Airway Scope (AWS, AWS-S100; Hoya-Pentax, Tokyo, Japan), a recently introduced video laryngoscope, has been reported to reduce movement of the cervical spine during intubation attempts in comparison with conventional laryngoscopes. Use of the bougie as an aid for the AWS may cause further reduction. The authors compared cervical spine movement during intubation with the AWS with and without a bougie.

Combination of Airway Scope and bougie for a full-stomach patient with difficult intubation caused by unanticipated anatomical factors and cricoid pressure.

The Airway Scope, one of the newest video-laryngoscopes, provides an excellent view of the larynx on a built-in monitor screen. Difficulty in introducing an endotracheal tube into the laryngeal aperture may occur, even though the aperture is visible. The bougie may solve this difficulty because its angulated tip can be controlled in a desired direction.

Malposition of the epiglottis associated with fiberoptic intubation.

A case in which the epiglottis was tucked into the laryngeal inlet by advancement of an endotracheal tube (ETT) during fiberoptic intubation, is presented. In this case, pulling the fibroscope, which was advanced under the displaced epiglottis, was effective for restoration.

The sniffing position provides greater occipito-atlanto-axial angulation than simple head extension: a radiological study.

Purpose: While the anatomic sniffing position has traditionally been considered the standard head and neck position for laryngoscopy, recent evidence suggests that the sniffing position provides no significant advantage over simple head extension. To establish if the sniffing position provides an anatomic advantage, we compared the occipito-atlanto-axial extension angle, a key determinant for obtaining a good laryngeal view during laryngoscopy, in simple head extension and sniffing positions.

Methods: Thirty volunteers with normal cervical spines were studied.

Preoperative evaluation of extension capacity of the occipitoatlantoaxial complex in patients with rheumatoid arthritis: comparison between the Bellhouse test and a new method, hyomental distance ratio.

Background: The authors devised a new method, the hyomental distance ratio (HMDR), for preoperatively identifying patients with a reduced occipitoatlantoaxial extension capacity, which was defined as the ratio of the hyomental distance in head extension position to that in the neutral position. They compared the accuracy of the HMDR with that of the Bellhouse test in 40 patients with rheumatoid arthritis.

Methods: Each patient wearing goggles on which a goniometer was mounted sat upright with the head in the neutral position and then extended the head maximally.