2022 American Society of Anesthesiologists Practice Guidelines for Management of the Difficult Airway.

The American Society of Anesthesiologists; All India Difficult Airway Association; European Airway Management Society; European Society of Anaesthesiology and Intensive Care; Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care; Learning, Teaching and Investigation Difficult Airway Group; Society for Airway Management; Society for Ambulatory Anesthesia; Society for Head and Neck Anesthesia; Society for Pediatric Anesthesia; Society of Critical Care Anesthesiologists; and the Trauma Anesthesiology Society present an updated report of the Practice Guidelines for Management of the Difficult Airway.

Airway management.

In this article, recent literature related to airway management in the ambulatory surgery setting is reviewed. Practical pointers to improve clinical success and avoid complications of newer airway management techniques are provided.

[Caring for newborns in a NICU: dealing with the fragility of living/surviving in the light of complexity].

The objective of this study was to understand the meaning of being a nurse and providing care in the Neonatal Intensive Care Unit (NICU) of a general hospital in Southern Brazil, developing an explanatory theoretical model. The Grounded Theory and the Complexity Paradigm were used to develop the Theoretical Model: Caring for newborns in the NICU: Dealing with the fragility of living/surviving in the light of complexity. Data was collected from 11 subjects through an open interview, and organized using NVIVO software.

Evolution of the extraglottic airway: a review of its history, applications, and practical tips for success.

The development of the laryngeal mask airway in 1981 was an important first step toward widespread use and acceptance of the extraglottic airway (EGA). The term extraglottic is used in this review to encompass those airways that do not violate the larynx, in addition to those with a supraglottic position. Although the term extraglottic may be broad and include airways such as tracheostomy tubes, the term supraglottic does not describe a large number of devices with subglottic components and is too narrow for a discussion of modern devices.

Practices for caring in nursing: Brazilian research groups.

Background: The present study considers the production of knowledge and the interactions in the environment of research and their relationships in the system of caring in nursing and health.

Aim: To elaborate a theoretical model of the organization of the practices used for caring, based on the experiences made by the research groups of administration and management in nursing, in Brazil.

Methods: The study is based on grounded theory.

[What do the users think and say about the Brazilian Health System (SUS)? An analysis of meanings based on the users' rights booklet].

This study is the result of an expanded research-action project aimed at presenting and discussing the main thematic units that emerged from discussions conducted with a group of users about booklet regarding users' rights from the SUS (Brazilian Health System). Between May and July 2007, weekly meetings were held, recorded and followed by qualitative research data analysis until reaching the thematic units. The results show that granting access to the public health system is not enough.

Poor inter-rater reliability on mock anesthesia oral examinations.

Purpose: Inter-rater reliability (IRR) and communication skills are both important factors that have been shown to affect oral examination scores. This study was designed to test: 1) IRR of a group of American Board of Anesthesiology (ABA) and the Royal College of Physicians and Surgeons of Canada (RCPSC) graders who graded in true isolation; 2) the effect of teaching residents examination techniques.

Methods: This was a randomized, pretest-posttest trial.

Mapping cognitive work: the way out of healthcare IT system failures.

The failure of automation to improve clinical performance is likely rooted in the design concepts on which IT systems are based. Current systems provide clinicians with specific direction about how to care for individual patients. This is much like the specific, detailed, complicated, and narrow trip route driving directions that can be obtained from various web sites.

Low-dose intrathecal morphine does not delay early extubation after cardiac surgery.

Purpose: This study was designed to examine the efficacy of low-dose intrathecal morphine (ITM) on extubation times and pain control after cardiac surgery.

Methods: 43 patients undergoing elective cardiac surgery were enrolled in this prospective, randomized, double-blind placebo controlled trial. Patients were given a pre-induction dose of ITM (6 microg x kg(-1) per ideal body weight in 5 mL normal saline, group ITM) or 5 mL of intrathecal normal saline (group ITS).

Getting to the point: developing IT for the sharp end of healthcare.

Healthcare demonstrates the same properties of risk, complexity, uncertainty, dynamic change, and time-pressure as other high hazard sectors including aviation, nuclear power generation, the military, and transportation. Unlike those sectors, healthcare has particular traits that make it unique such as wide variability, ad hoc configuration, evanescence, resource constraints, and governmental and professional regulation. While healthcare's blunt (management) end is more easily understood, the sharp (operator) end is more difficult to research the closer one gets to the sharp end's point.

Clarification of anesthesia standards and guidelines.

Understanding and complying with the guidelines of the American Society of Anesthesiologists will help ensure high-quality patient care, increase levels of patient safety, and minimize medico-legal risk. The author discusses important standards and guidelines for the administration of general anesthesia and sedation/analgesia in the office-based setting and compares the requirements of the different accrediting organizations. (Aesthetic Surg J 2001;21:573-575.

The effect of sevoflurane and desflurane on upper airway reactivity.

Background: Although bronchial reactivity can be assessed by changes in airway resistance, there is no well-accepted measure of upper airway reactivity during anesthesia. The authors used the stimulus of endotracheal tube cuff inflation and deflation to assess changes in airway reactivity in patients anesthetized with sevoflurane and desflurane.

Methods: Sixty-four patients classified as American Society of Anesthesiologists physical status I or II participated in this randomized, double-blind study.

Use of electronic mail for postoperative follow-up after ambulatory surgery.

The authors report on a patient who used electronic mail to report satisfactory recovery from ambulatory surgery and anesthesia. The potential benefits and pitfalls of using electronic mail for patient follow-up and communication, as well as research purposes, are reviewed. Potential benefits include cost savings, ease in collecting quality improvement data, and the potential for increased reporting of unpleasant events.

The effects of subanesthetic concentrations of sevoflurane and nitrous oxide, alone and in combination, on analgesia, mood, and psychomotor performance in healthy volunteers.

Unlabelled: We studied the effects of subanesthetic concentrations of sevoflurane and nitrous oxide, alone and in combination, on analgesia, mood, and psychomotor performance in human volunteers. We hypothesized that nitrous oxide and sevoflurane would produce both opposing and potentiating effects within the same study. Over the course of three sessions, 20 subjects inhaled 0%, 0.

Improving the efficiency of survey research in postoperative patients.

Study Objective: To increase the contact rate with eligible patients for quality assurance/improvement surveys by modifying survey rounds to accommodate the schedules of individual nursing units.

Design: Two-phase, interventional time series study.

Setting: Postoperative inpatients at a university hospital.

Assessment of satisfaction with treatment for chronic pain.

The purpose of this study was to develop an instrument to assess satisfaction with treatment of chronic pain, evaluate the reliability and validity of this instrument, and then examine predictors and consequences of satisfaction. The Pain Service Satisfaction Test (PSST) is the result of this effort. Fifty adult patients receiving services for chronic pain in a university pain clinic completed the PSST as part of a survey mailed to their homes.

Subjective, psychomotor, cognitive, and analgesic effects of subanesthetic concentrations of sevoflurane and nitrous oxide.

Background: Sevoflurane is a volatile general anesthetic that differs in chemical nature from the gaseous anesthetic nitrous oxide. In a controlled laboratory setting, the authors characterized the subjective, psychomotor, and analgesic effects of sevoflurane and nitrous oxide at two equal minimum alveolar subanesthetic concentrations.

Methods: A crossover design was used to test the effects of two end-tidal concentrations of sevoflurane (0.

Effects of information on the reinforcing, subjective, and psychomotor effects of nitrous oxide in healthy volunteers.

The purpose of this study was to characterize the reinforcing, subjective, and psychomotor effects of nitrous oxide (N2O) in healthy volunteers who were given different amounts of information regarding the drugs they were being administered in the experiment. A choice procedure was used in which subjects first sampled a placebo and a given concentration of N2O and then chose between the two. N2O concentration varied across the four-session experiment from 10-40%.

Analgesic and psychomotor effects of thiopental at subanesthetic concentrations in human volunteers.

Background: Studies of the effects of barbiturates on the modulation of pain have produced mixed results. In a prospective, double-blind, randomized, placebo-controlled trial, we studied the effects of thiopental at presumed steady-state, "conscious sedation" levels on cold-pressor-induced pain in 12 healthy volunteers.

Methods: Five drug conditions were used, each condition consisting of an injection (either drug or placebo) with a 20-min infusion and a 160-min recovery period.

The effects of alcohol history on the reinforcing, subjective and psychomotor effects of nitrous oxide in healthy volunteers.

The purpose of this study was to characterize the reinforcing, subjective and psychomotor effects of nitrous oxide in healthy volunteers with different alcohol histories. Subjects were divided into two groups: light drinkers (n = 9) and moderate drinkers (n = 10). A choice procedure was used in which subjects first sampled placebo and a given concentration of nitrous oxide, and then chose between the two.

The reinforcing effects of brief exposures to nitrous oxide in healthy volunteers.

The reinforcing and subjective effects of brief (about 1.5 min) exposures to nitrous oxide, ranging from inspired concentrations of 20-80% in oxygen, were examined in 11 healthy volunteers. A choice procedure was used in which during each of four sessions, subjects first sampled a given concentration of nitrous oxide and placebo oxygen, and then chose between the two.