Sublingual ultrasound as an assessment method for predicting difficult intubation: a pilot study.

Current methods to assess the airway before tracheal intubation are variable in their ability to predict a difficult airway accurately. We hypothesised that sublingual ultrasound could provide additional information to predict a difficult airway with greater success than current methods. We recruited 110 patients to perform sublingual ultrasound on themselves following brief instruction.

Estimation of equivalent threshold currents using different pulse widths for the epidural stimulation test in a porcine model.

Background: The epidural stimulation test can help detect if a catheter is correctly positioned in the epidural space. Previous studies showed that a current of up to 16 mA was required to elicit a motor response, but few peripheral nerve stimulators can produce a current this high. Manipulating pulse width can produce a positive response at a lower current.

ED placement of perineural catheters for femoral fracture pain management.

Regional nerve blocks provide superior analgesia over opioid-based pain management regimens for traumatic injuries such as femur fractures. An ultrasound-guided regional nerve block is placed either as a single-shot injection or via a perineural catheter that is left in place. Although perineural catheters are commonplace in the perioperative setting, their use by emergency physicians (EPs) for emergency pain management in adults has not been previously described.

Impact of anesthesia for cancer surgery: Continuing professional development.

Purpose: A number of original publications and review articles have addressed the issue of perioperative immune modulation and cancer outcome. The objective of this module is to review current understanding surrounding the pathways involved and the evidence implicating commonly used anesthetic agents.

Principal Findings: Drugs commonly used in anesthetic practice have been shown to affect various components of the immune system in laboratory animal and human in vitro models.

Modeling of the renal kinetics of the AT1 receptor specific PET radioligand [11C]KR31173.

Purpose: The radioligand [(11)C]KR31173 has been introduced for PET imaging of the angiotensin II subtype 1 receptor (AT1R). The purpose of the present project was to employ and validate a compartmental model for quantification of the kinetics of this radioligand in a porcine model of renal ischemia followed by reperfusion (IR).

Procedures: Ten domestic pigs were included in the study: five controls and five experimental animals with IR of the left kidney.

Quantifying the Importance of the Statistical Assumption in Statistical X-ray CT Image Reconstruction.

Statistical image reconstruction (SIR) is a promising approach to reducing radiation dose in clinical computerized tomography (CT) scans. Clinical CT scanners use energy-integrating detectors. The CT signal follows a compound Poisson distribution, its probability density function (PDF) does not have an analytical form hence cannot be used in an SIR method.

Detection and localization of carcinoma within the prostate using high resolution transrectal gamma imaging (TRGI) of monoclonal antibody directed at prostate specific membrane antigen (PSMA)--proof of concept and initial imaging results.

Purpose: Molecular imaging methods may identify primary prostate cancer foci and potentially guide biopsy and optimal management approaches. In this exploratory study, safety and first human imaging experience of a novel solid state endocavity transrectal gamma-imaging (TRGI) device was evaluated.

Methods: Twelve patients received 5 ± 0.

An analytical geometric calibration method for circular cone-beam geometry.

This work is a continuation of our previous work on geometric calibration in the circular cone-beam geometry. It is well known that seven parameters completely describe such a geometry in either flat-panel X-ray computed tomography or single pinhole SPECT imaging. Previously we developed a graphical procedure to determine the detector in-plane rotation angle independently of the other six parameters.

Airway sonography in live models and cadavers.

Sonography using cadavers is beneficial in teaching and learning sonoanatomy, which is particularly important because imaging of the airway can be challenging due to the cartilaginous landmarks and air artifacts. In this exploratory study, we have attempted to compare the airway sonoanatomy of cadavers and live models. Our observations support the use of cadavers as teaching tools for learning airway sonoanatomy and practicing procedures involving airway structures, such as superior laryngeal nerve blocks, transtracheal injections, and needle cricothyroidotomy, before performance on patients in clinical situations.

Reproducibility of current perception threshold with the Neurometer(®) vs the Stimpod NMS450 peripheral nerve stimulator in healthy volunteers: an observational study.

Purpose: Current methods of assessing nerve blocks, such as loss of perception to cold sensation, are subjective at best. Transcutaneous nerve stimulation is an alternative method that has previously been used to measure the current perception threshold (CPT) in individuals with neuropathic conditions, and various devices to measure CPT are commercially available. Nevertheless, the device must provide reproducible results to be used as an objective tool for assessing nerve blocks.

Comparison of blind and electrically guided tracheal needle insertion in human cadavers.

The purpose of this study was to investigate whether an electrically guided needle insertion technique would enable greater success at intratracheal needle tip insertion than the traditional, aspiration-of-air technique. Twenty-seven anaesthesiology residents were assessed in their ability to place a needle tip in the trachea of cadavers using the two methods. Success of needle placement, time to placement and confidence in placement were recorded.

The catheter-over-needle assembly facilitates delivery of a second local anesthetic bolus to prolong supraclavicular brachial plexus block without time-consuming catheterization steps: a randomized controlled study.

Background: Single-shot delivery of a supraclavicular brachial plexus block is effective for providing outpatient surgical anesthesia; however, patients generally must use oral analgesics to control pain shortly after discharge from the hospital. Catheterized delivery of supraclavicular blocks can be challenging to perform. We aimed to show that administering a second postoperative bolus of local anesthetic through a catheter placed by a catheter-over-needle assembly not only avoids time-consuming steps but also provides an extended analgesic effect compared with the traditional single-shot approach.

A simple approach to measure computed tomography (CT) modulation transfer function (MTF) and noise-power spectrum (NPS) using the American College of Radiology (ACR) accreditation phantom.

Purpose: To develop an easily-implemented technique with free publicly-available analysis software to measure the modulation transfer function (MTF) and noise-power spectrum (NPS) of a clinical computed tomography (CT) system from images acquired using a widely-available and standardized American College of Radiology (ACR) CT accreditation phantom.

Methods: Images of the ACR phantom were acquired on a Siemens SOMATOM Definition Flash system using a standard adult head protocol: 120 kVp, 300 mAs, and reconstructed voxel size of 0.49 mm × 0.

Color flow Doppler ultrasonography can distinguish caudal epidural injection from intrathecal injection.

Background: Color flow Doppler ultrasonography has been used to confirm caudal epidural injection, but its ability to detect accidental intrathecal injection is unknown. We hypothesized that, when using color flow Doppler, the injection of fluid into the epidural space would result in turbulent flow which would appear as a burst of color while intrathecal injection would show an absence of a color flow Doppler signal.

Methods: Two groups of pediatric patients (up to 6 years of age) were prospectively enrolled for this observational study during a 2-month period.