A comparative study on adequate anesthesia depth: clinical judgement and the Narcotrend® measurement.

Purpose: To compare the clinical judgement of electroencephalogram (EEG)-naïve anesthesiologists with an EEG-based measurement of anesthetic depth (AD) using the Narcotrend® monitor.

Methods: In this prospective cohort study including 600 patients, AD during stable anesthesia was assessed by clinical judgement of the attending, EEG-blinded anesthesiologist (using a scale staging the AD as mid-adequate, adequate but fairly deep, or adequate but fairly light) and by simultaneously recorded Narcotrend measurements.

Results: In 42% of patients (n = 250), the anesthesiologist's clinical judgement was in agreement with anesthetic levels as measured by the Narcotrend monitor.

Indirect versus direct laryngoscopy for routine nasotracheal intubation.

Study Objective: To compare the effectiveness of the indirect laryngoscopes, Airtraq (A) and GlideScope (G), with the Macintosh (M) laryngoscope in routine nasotracheal intubation.

Design: Randomized, single-blinded study.

Setting: University-affiliated, tertiary-care hospital.

Use of remifentanil for awake fiberoptic intubation in a morbidly obese patient with severe inflammation of the neck.

Impending upper airway obstruction due to odontogenic facial and cervical spreading infection is a potential fatal situation that requires urgent treatment. In particular, securing the threatened airway is a priority and a precondition to the pressing need for surgery. The best approach to establish the difficult airway is awake fiberoptic intubation or scheduled tracheotomy under local anesthesia.

Evaluation of remifentanil as single drug for awake fiberoptic intubation.

Background: Awake fiberoptic intubation is the standard of care for difficult airway management. Quality and success of this technique depend on the experience of the intubating physician and the proper preparation of the patient. The aim of this study was to compare remifentanil (R) as single agent to the combination of fentanyl (F) and midazolam (M), which have been the drugs for analgesia and sedation for this procedure.