Background: To compare the effects of thermal softening of double-lumen endotracheal tubes (DLT) at different temperatures during fiberoptic bronchoscopy (FOB)-guided intubation.
Methods: We randomly divided 144 patients undergoing thoracic surgery into 4 groups as follows: T1 (T = 24 ± 1°C, n = 36), T2 (T = 36 ± 1°C, n = 36), T3 (T = 40 ± 1°C, n = 36), and T4 (T = 48 ± 1°C, n = 36). All groups underwent FOB-guided double-lumen endotracheal intubation and positioning. We recorded the duration of positioning and intubation using DLT, intubation resistance (IR), the success rate of the first attempt at endotracheal intubation, and the incidence of postoperative vocal cord injury and hoarseness.
Results: The time to intubation was longer in the T1 group than that in the T2, T3, and T4 groups (P < .05). The time for positioning was longer in the T4 group than that in the T1, T2, and T3 groups (P < .05). IR was lower in the T3 and T4 groups than those in T1 and T2 groups (P < .05). The success rate of the first attempt at endotracheal intubation was higher in the T2, T3, and T4 groups than that in the T1 group (P < .05). Postoperative glottic injury and hoarseness were higher in the T1 and T2 groups than those in the T3 and T4 groups (P < .05).
Conclusion: A thermally softened DLT shortened the time to intubation, reduced the IR, improved the success rate of the first attempt at endotracheal intubation, and lowered the incidence of postoperative glottic injury and hoarseness. The optimal tube temperature for FOB-guided intubation of thermally softened DLT was 40 ± 1°C.
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http://dx.doi.org/10.1097/MD.0000000000029999 | DOI Listing |
Natl J Maxillofac Surg
November 2024
Department of Family Dentistry, University of Benin Teaching Hospital, Benin-city, Edo State, Nigeria.
Background: Postoperative throat complications (POTCs) are common and distressing to patients; consensus on their optimum treatment is unclear.
Aim: The aim of the study was to determine the efficacy of a steroid-soaked throat pack on POTCs following oral and maxillofacial surgery.
Materials And Methods: This was a randomized, triple-blinded, controlled clinical study design on all consecutive patients who had endotracheal intubation and pharyngeal throat packs following major oral and maxillofacial surgery.
BMC Anesthesiol
January 2025
Department of Anaesthesiology, West China Hospital, Sichuan University & The Research Units of West China (2018RU012), Chinese Academy of Medical Sciences, Chengdu, 610041, China.
Background: Given the prevalence of cardiovascular disease, encountering difficult airways in this patient population is quite common. The challenge for anesthesiologists lies not only in establishing the airway but also in managing the hemodynamic instability caused by sympathetic activation during intubation. The purpose of this report is to describe the anesthetic experience of this patient with severe mitral and tricuspid regurgitation, atrial fibrillation with rapid ventricular response, and moderate pulmonary hypertension with an anticipated difficult airway.
View Article and Find Full Text PDFIntroduction: Simulation has become an integral part of health care education curricula that is used to teach a variety of topics, from emergency situations to physical diagnoses. Without further reinforcement, the skills learned through the simulation are subject to deterioration over time. Rapid Cycle Deliberate Practice (RCDP) is a teaching method that was developed to resist this deterioration and achieve mastery of skills.
View Article and Find Full Text PDFJ Craniofac Surg
November 2024
State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Sichuan University.
Objective: To describe the cases of oral and maxillofacial tumors (OMFT) resection and defects reconstruction under submandibular intubation (SMI) performed in our institution; secondly, to systematically review and analyze the characteristics of studies about SMI in oral and maxillofacial surgery to estimate the incidence rate of complication.
Method: Data related to all 6 patients included in this study were prospectively collected from November 2016 to November 2023. The tract for endotracheal tube was created by bluntly dissection from the submandibular area to the floor of mouth.
World J Surg Oncol
January 2025
Department of Thoracic Surgery, University Hospitals Birmingham, Birmingham, UK.
A 34-year-old male patient with recently diagnosed with medullary thyroid carcinoma underwent total thyroidectomy and radical neck dissection, requiring sharp dissection to separate the tumour from the trachea. He required post operative intubation due to bilateral vocal cord paralysis. He developed ischaemic necrosis of the upper two thirds of the trachea presenting with marked surgical emphysema and an infective wound.
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