Patient factors associated with difficult flexible bronchoscopic intubation under general anesthesia: a prospective observational study.

Purpose: Patient characteristics associated with difficult tracheal intubation using a flexible bronchoscope (FB) under general anesthesia have not been prospectively evaluated. This observational study aimed to identify demographic and morphologic factors associated with difficult FB intubation.

Methods: We recruited 420 adult elective surgery patients undergoing tracheal intubation during general anesthesia.

Effect of Intravenous Dexamethasone on the Regression of Isobaric Bupivacaine Spinal Anesthesia: A Randomized Controlled Trial.

The effect of intravenous dexamethasone on the regression of sensory and motor block after isobaric bupivacaine spinal anesthesia is unknown. We conducted a prospective, double-blind, randomized controlled trial on 60 patients who received intravenously either placebo (group P) or 8-mg dexamethasone (group D) during the intrathecal injection of 12-mg isobaric bupivacaine 0.5%.

The Effect of Adductor Canal Block on Knee Extensor Muscle Strength 6 Weeks After Total Knee Arthroplasty: A Randomized, Controlled Trial.

Background: Total knee arthroplasty (TKA) reduces knee extensor muscle strength (KES) in the operated limb for several months after the surgery. Immediately after TKA, compared to either inguinal femoral nerve block or placebo, adductor canal block (ACB) better preserves KES. Whether this short-term increase in KES is maintained several weeks after surgery remains unknown.

Impact of thoracic epidural catheter threading distance on analgesia during the first 24 hours following thoracotomy: a randomized controlled trial.

Purpose: The purpose of this prospective randomized controlled trial was to determine the impact of thoracic epidural catheter threading distance on analgesia quality after thoracotomy.

Methods: We randomly assigned 120 elective thoracotomy patients to a thoracic epidural catheter threading distance of 3, 5, or 7 cm (groups 3CM, 5CM, and 7CM, respectively). Epidural bupivacaine 0.

A comparison of cervical spine motion during orotracheal intubation with the trachlight(r) or the flexible fiberoptic bronchoscope.

Background: Tracheal intubation of an unstable cervical spine (c-spine) patient with the flexible fiberoptic bronchoscope (FOB) is thought to minimize c-spine movement but may be technically difficult in certain patients. Intubation using a luminous stylet, such as the Trachlight(R) (TL), also produces minimal motion of the c-spine and may be an interesting alternative technique for patients with an unstable c-spine. In this study, we compared the cervical motion caused by the TL and the FOB during intubation.

Perioperative interscalene block versus intra-articular injection of local anesthetics for postoperative analgesia in shoulder surgery.

Background And Objectives: Up to 70% of patients report moderate to severe pain after shoulder surgery, which can compromise early rehabilitation and functional recuperation. Postoperative shoulder pain control is improved with both interscalene block and intra-articular local anesthetic injection. The present study hypothesized that perioperative interscalene analgesia would offer pain control superior to perioperative intra-articular local anesthetics over the first 24 hours after surgery.

Cervical spine motion during tracheal intubation with manual in-line stabilization: direct laryngoscopy versus GlideScope videolaryngoscopy.

Background: The optimal tracheal intubation technique for patients with potential cervical (C) spine injury remains controversial. Using continuous cinefluoroscopy, we conducted a prospective study comparing C-spine movement during intubation using direct laryngoscopy (DL) or GlideScope videolaryngoscopy (GVL), with uninterrupted manual in-line stabilization of the head by an assistant.

Methods: Twenty patients without C-spine pathology were studied.

Preliminary evaluation of infraclavicular catheters inserted using ultrasound guidance: through-the-catheter anesthesia is not inferior to through-the-needle blocks.

Background And Objectives: This prospective study compared the initial block quality and surgical anesthesia rates of ultrasound-guided infraclavicular blocks with local-anesthetic injected through a catheter versus through a needle. We hypothesized that positioning of the catheter immediately posterior to the axillary artery would produce through-the-catheter (TTC) anesthesia with rates of complete block not inferior to through-the-needle (TTN) injection.

Methods: Eighty patients undergoing hand or forearm surgery extensive enough to require regional anesthesia were randomized into 2 groups of 40.

Neurostimulation in ultrasound-guided infraclavicular block: a prospective randomized trial.

Ultrasound guidance (USG) for infraclavicular blocks provides real time visualization of the advancing needle and local anesthetic distribution. Whether visualization of local anesthetic spread can supplant neurostimulation as the end point for local anesthetic injection during USG block has never been formally evaluated. Therefore, for this prospective randomized study, we recruited 72 patients scheduled for hand or forearm surgery and compared the speed of execution and quality of USG infraclavicular block with either USG alone (Group U) or USG combined with neurostimulation (Group S).

Ultrasound-guided infraclavicular versus supraclavicular block.

In this prospective study we compared ultrasound-guided (USG) infraclavicular and supraclavicular blocks for performance time and quality of block. We hypothesized that the infraclavicular approach would result in shorter performance times with a quality of block similar to that of the supraclavicular approach. Eighty patients were randomized into two equal groups: Group I (infraclavicular) and Group S (supraclavicular).

Vasopressin for treatment of shock following aprotinin administration.

Purpose: To describe the utility of vasopressin in the treatment of acute distributive shock clinically compatible with the diagnosis of aprotinin anaphylaxis.

Clinical Features: A 57-yr-old female patient underwent repeat cardiac surgery to treat prosthetic valve endocarditis. She had received aprotinin during her first surgery 60 days ago.

Ultrasound guidance speeds execution and improves the quality of supraclavicular block.

Unlabelled: In this prospective study, we assessed the quality, safety, and execution time of supraclavicular block of the brachial plexus using ultrasonic guidance and neurostimulation compared with a supraclavicular technique that used anatomical landmarks and neurostimulation. It was hypothesized that ultrasonic guidance would increase the proportion of successful blocks, decrease block execution time, and reduce the incidence of complications such as pneumothorax and neuropathy. Eighty patients were randomized into two groups of 40, Group US (supraclavicular block guided in real time by a two-dimensional ultrasonic image, with neurostimulator confirmation of correct needle position) and Group NS (supraclavicular block using the subclavian perivascular approach, also with neurostimulator confirmation).

Time course and magnitude of movement-related gating of tactile detection in humans. III. Effect of motor tasks.

This study investigated the relative importance of central and peripheral signals for movement-related gating by comparing the time course and magnitude of movement-related decreases in tactile detection during a reference motor task, active isotonic digit 2 (D2) abduction, with that seen during three test tasks: a comparison with active isometric D2 abduction (movement vs. no movement) evaluated the contribution of peripheral reafference generated by the movement to gating; a comparison with passive D2 abduction (motor command vs. no motor command; movement generated by an external agent) allowed us to evaluate the contribution of the central motor command to tactile gating; and finally, the inclusion of an active "no apparatus," or freehand, D2 abduction task allowed us to evaluate the potential contribution of incidental peripheral reafference generated by the position detecting apparatus to the results (apparatus vs.