Use of Sugammadex in "Cannot Intubate, Cannot Ventilate" Scenarios: A Systematic Review of Case Reports.

After an induction dose of rocuronium, sugammadex in a dose of 16 mg.kg-1 has been shown to provide early reversal of the neuromuscular blockade. However, the use of sugammadex to rescue a "cannot intubate, cannot ventilate" (CICV) scenario remains controversial.

The effect of the addition of nefopam to intraoperative ketoprofen and acetaminophen on postoperative morphine requirements after laparoscopic cholecystectomy: a randomized controlled trial.

Background: Few studies investigated the use of nefopam for pain control after laparoscopic cholecystectomy in the context of multimodal analgesia. The aim of this study was to evaluate the effect of adding nefopam to ketoprofen and acetaminophen given before the end of laparoscopic cholecystectomy.

Methods: In this double-blind, controlled study, 90 patients undergoing laparoscopic cholecystectomy during sevoflurane-dexmedetomidine-based anesthesia were randomized to receive either ketoprofen and acetaminophen or nefopam, ketoprofen, and acetaminophen for postoperative pain control before the end of surgery.

An ergonomic assessment of using laterally-tilting operating room tables and friction reducing devices for patient lateral transfers.

Patient lateral transfers between two adjacent surfaces pose high musculoskeletal disorder risks for nurses and patient handlers. The purpose of this research was to examine the ergonomic benefits of utilizing the laterally-tilting function of operating room (OR) tables during such transfers - along with different friction-reducing devices (FRD). This method allows the patient to slide down to the adjacent surface as one nurse guides the transfer and another controls the OR table angle with a remote control.

Propofol use in children: updates and controversies.

Advantages of propofol use in children may include less airway complications, less emergence agitation, and less postoperative behavioral changes. However, needle phobia and the complexity of total intravenous anesthesia set-up, as well as the pharmacokinetic and pharmacodynamic restrictions may limit the wide use of propofol-based anesthesia in the form of total intravenous anesthesia. Furthermore, pediatric infusion models and monitoring techniques are not fully validated yet.

Half dose sugammadex combined with neostigmine is non-inferior to full dose sugammadex for reversal of rocuronium-induced deep neuromuscular blockade: a cost-saving strategy.

Background: Sugammadex reverses the effect of rocuronium more rapidly and effectively than neostigmine, at all levels of neuromuscular blockade (NMB). However, its cost is prohibitive. The combination of half dose sugammadex with neostigmine would be non-inferior to full dose sugammadex for the reversal of deep NMB.

Femoral arterial cannulation performed by residents: a comparison between ultrasound-guided and palpation technique in infants and children undergoing cardiac surgery.

Background: Percutaneous cannulation of the femoral artery in the pediatric age group can be technically challenging, especially when performed by residents in training.

Objective: We examined whether the use of real-time ultrasound guidance is superior to a palpation landmark technique for femoral artery catheterization in children undergoing heart surgery.

Methods: Patients were prospectively randomized into two groups.

Predictors of postoperative pain and analgesic requirements following abdominal hysterectomy: an observational study.

Purpose: A prospective observational study is conducted to identify independent predictors of pain and morphine consumption following abdominal hysterectomy.

Methods: Preoperative State Trait Anxiety Inventory (STAI), Numerical Rating Scales (NRS) for anxiety and pain expectations, thermal pain thresholds and pain scores at forearm and incision site, and pain scores generated from the insertion of an intravenous catheter were measured in female patients undergoing abdominal hysterectomy. Pearson correlations between the predictors and the two outcome measures postoperative pain scores and morphine consumption were studied and multiple regression analysis was conducted to identify independent predictors (primary outcome).

ESOPHAGEAL PERFORATION FOLLOWING OROGASTRIC SUCTION CATHETER INSERTION IN AN ELDERLY PATIENT.

Esophageal rupture has been described following iatrogenic manipulation. In this report, we present an elderly lady admitted to the operative theater for laparoscopic cholecystectomy. Multiple intra-operative attempts to place a flexible orogastric tube were unsuccessful because of failure to advance.

The effects of propofol on cerebral perfusion MRI in children.

Introduction: The effects of anesthesia are infrequently considered when interpreting pediatric perfusion magnetic resonance imaging (MRI). The objectives of this study were to test for measurable differences in MR measures of cerebral blood flow (CBF) and cerebral blood volume (CBV) between non-sedated and propofol-sedated children, and to identify influential factors.

Methods: Supratentorial cortical CBF and CBV measured by dynamic susceptibility contrast perfusion MRI in 37 children (1.

A randomized controlled trial comparing the AccuVein AV300 device to standard insertion technique for intravenous cannulation of anesthetized children.

Objectives And Aims: To evaluate the efficacy of the AccuVein AV300 device in improving the first-time success rate of intravenous cannulation of anesthetized pediatric patients.

Background: The AccuVein AV300 device was developed to assist venepuncture and intravenous cannulation by enhancing the visibility of superficial veins. It uses infrared light to highlight hemoglobin so that blood vessels are darkly delineated against a red background.

The effect of adjuvant drugs on the quality of tracheal intubation without muscle relaxants in children: a systematic review of randomized trials.

Intubation without prior administration of muscle relaxants is a common practice in children. However, succinylcholine may be considered as the golden standard for optimizing intubating conditions. We conducted a systematic review of the literature to identify drug combinations that included induction of anesthesia with sevoflurane or propofol.

Phantom limb pain in young cancer-related amputees: recent experience at St Jude children's research hospital.

Objectives: This study in children and young adults having cancer-related amputation aimed to examine the incidence of phantom limb pain (PLP) in the first year after amputation and also the proportion of patients who had preamputation pain.

Methods: A retrospective review of medical records was undertaken. The proportion of patients with PLP was reported.

Guidelines for elective pediatric fiberoptic intubation.

Fiberoptic intubation in pediatric patients is often required especially in difficult airways of syndromic patients i.e. Pierre Robin Syndrome.

Complications of anesthesia for children with malignant infantile osteopetrosis before and after hematopoietic stem cell transplantation.

Objectives And Aims: The primary aim was to determine the frequency of anesthetic-related complications for patients with malignant infantile osteopetrosis (MIOP) before and after hematopoietic stem cell transplant (HSCT). The secondary aims were to describe the types of complications that occurred, to determine whether the risk of anesthetic complications was altered by HSCT, and to determine the frequency of difficult intubation.

Background: Patients with MIOP undergo HSCT, often in infancy, and anesthesia is frequently required for investigations and procedures associated with transplantation.

Anesthesia management of a Jehovah's Witness patient with pheochromocytoma undergoing off pump coronary artery bypass graft surgery--acase report.

Concomitant coronary artery disease (CAD) and pheochromocytoma are rare. Patients with advanced CAD requiring coronary artery bypass graft (CABG) surgery and clinically active pheochromocytoma present a challenge to anesthesiologists. The risk is much higher if the patient is an anemic Jehovah's Witness because these patients refuse to receive blood or blood products, even when faced with a life-threatening hemorrhage.

Electrocautery-induced fire during adenotonsillectomy: report of two cases.

We describe two cases of flash fires in the oropharynx, secondary to electrocautery during adenotonsillectomies. We believe that in both cases, the leak around the uncuffed endotracheal tubes raised the oxygen concentration in the oropharynx. Cuffed endotracheal tubes provide many advantages, and their use should strongly be considered during adenotonsillectomy in children when electrocautery is to be used.

Prophylactic methylene blue in a patient with congenital methemoglobinemia.

Purpose: To report the beneficial effect of prophylactic methylene blue administration before induction of anesthesia in a patient with congenital methemoglobinemia.

Clinical Features: A 26-yr-old male patient known to have congenital methemoglobinemia was scheduled for turbinectomy under general anesthesia. The patient was clinically cyanotic with a pulse oximetry of 91%.

End-tidal CO2 for prediction of cardiac output following weaning from cardiopulmonary bypass.

This prospective study included 32 patients undergoing cardiopulmonary bypass (CPB) for elective coronary artery bypass grafting correlates the respiratory end-tidal CO2 (ETCO2) during partial separation from CPB with cardiac output (CO) following weaning from CPB. After induction of general anesthesia, a pulmonary artery catheter was inserted for measurement of cardiac output by thermodilution. Patients were monitored using a 5-lead ECG, pulse oximeter, invasive blood pressure monitoring, rectal temperature probe, and end-tidal capnography.