Learning curve of i-gel insertion in novices using a cumulative sum analysis.

The i-gel, a popular second-generation supraglottic airway device, has been used in a variety of airway management situations, including as an alternative to tracheal intubation for general anesthesia, rescue in difficult airway settings, and out-of-hospital cardiac arrest resuscitation. We aimed to investigate the number of experiences needed to achieve a rapid, highly successful first attempt i-gel insertion in novices with a cumulative sum analysis. We also looked at how learning affected success rates, insertion time, and bleeding and reflex (limb movement, frowning face, or coughing) incidences.

Low psoas major muscle area as a risk factor for contralateral hip fracture following intertrochanteric fracture.

Objective: This study aimed to investigate the relationship between the psoas major muscle area as a risk factor and subsequent contralateral hip fractures in patients with initial intertrochanteric fractures.

Methods: Of 136 treated for intertrochanteric fractures, 104 female patients had computed tomography done to assess their fractures at initial stage and had been followed up for more than 2 years. These patients were then divided into 2 groups: i.

AutoFlow® versus volume-controlled ventilation for laparoscopic gynecological surgery using LMA® ProSeal™: a randomized controlled trial.

Background: During laparoscopic gynecological surgery, increased peak airway pressure (PAWP) can cause airway leak upon ventilation with the LMA® ProSeal™. We hypothesized that compared with the use of volume-controlled ventilation (VCV), the use of the AutoFlow® mode would decrease PAWP and airway leak during laparoscopic gynecological surgery with LMA ProSeal.

Methods: This single-center, randomized, controlled trial allocated 80 adult women undergoing elective laparoscopic gynecological surgery to one of two groups, namely, the AutoFlow group or the VCV group.

Excessive dynamic airway collapse during general anesthesia: a case report.

Background: Excessive dynamic airway collapse (EDAC) is an uncommon cause of high airway pressure during mechanical ventilation. However, EDAC is not widely recognized by anesthesiologists, and therefore, it is often misdiagnosed as asthma.

Case Presentation: A 70-year-old woman with a history of asthma received anesthesia with sevoflurane for a laparotomic cholecystectomy.

A learning curve of LMA ProSeal™ insertion: a prospective analysis of cumulative sum method.

Purpose: LMA ProSeal™ (pLMA) has been used as an alternative to tracheal tubes. It is unclear how many cases are required to achieve proficiency in performing pLMA insertion among novice residents. Therefore, we analyzed the learning curve of pLMA insertion using a cumulative sum (CUSUM) chart and assessed the effects of learning.

Pectoral nerve II block, transversus thoracic muscle plane block, and dexmedetomidine for breast surgery in a patient with achondroplasia: a case report.

Background: Patients with achondroplasia have various airway deformations and spinal anatomic abnormalities; therefore, performing general anesthesia and neuraxial anesthesia in such patients can be challenging.

Case Presentation: A 56-year-old, 112-cm, 30-kg woman was scheduled to undergo partial mastectomy and sentinel lymph node biopsy for cancer of the right breast. She had short limbs, scoliosis, thorax deformation, and chronic moderate to severe mitral regurgitation of the mitral valve.

Distal radial arterial hypertrophy after transradial intervention: A serial intravascular ultrasound study.

Background: Transradial intervention (TRI) may cause damage to the radial artery (RA). We have demonstrated intima-media thickening and luminal narrowing of the distal RA after TRI using intravascular ultrasound (IVUS). This study aimed to determine the predictors of intima-media thickening of RA after TRI in the same patients using serial IVUS.

Postoperative laryngeal morbidity and intubating conditions using the McGRATH™ MAC videolaryngoscope with or without neuromuscular blockade: a randomised, double-blind, non-inferiority trial.

Tracheal intubation without neuromuscular blockade may be associated with worse intubating conditions and increased laryngeal morbidity. We hypothesised that tracheal intubation using the McGRATH™ MAC videolaryngoscope would not increase postoperative hoarseness, even without neuromuscular blockade. In this prospective, randomised, parallel-group, double-blind, non-inferiority trial, 248 patients were randomly assigned to tracheal intubation with or without neuromuscular blockade using rocuronium.

Monitoring of central venous pressure and stroke volume variation in a case with a ruptured brain arteriovenous malformation and Fontan circulation.

Background: Patients with complex congenital heart disease increasingly undergo noncardiac surgeries because of advancements in surgical techniques and medical management. In Fontan circulation, maintaining an adequate transpulmonary gradient is essential for preserving both pulmonary blood flow and cardiac output. However, intraoperative circulatory monitoring of Fontan patients has not been established.

Intravenous dexmedetomidine for cesarean delivery and its concentration in colostrum.

Background: Dexmedetomidine is a sedative agent with high α-adrenoreceptor selectivity. We investigated intravenous dexmedetomidine administration during scheduled cesarean delivery under neuraxial anesthesia; and its concentration in the colostrum.

Methods: Twenty-seven participants having elective cesarean delivery under combined spinal-epidural anesthesia were enrolled.

Flow cytometric analysis as an additional predictive tool of treatment response in children with chronic-phase chronic myeloid leukemia treated with imatinib.

Bone marrow samples of newly diagnosed children with chronic-phase chronic myeloid leukemia (CML) were obtained at diagnosis and after imatinib initiation and stained with anti-human CD34, CD38, CD123, CD45RA, cMpl, and lineage antibodies. Flow cytometric analysis revealed that granulocyte macrophage progenitor predominance in CML progenitors at diagnosis and elevated cMpl expression in bone marrow progenitors at 3 months may predict poor outcome in children with chronic-phase CML treated with imatinib. We recommend flow cytometric analysis of bone marrow in the early phase of treatment, as it is a convenient tool that may predict treatment response and guide CML management.

Confirmation of optimal guidewire length for central venous catheter placement using transesophageal echocardiography.

Study Objective: Several authors have reported rare, but severe, complications associated with the length of the intravascular guidewire during central venous catheter placement, as the wire tip can cause cardiac arrhythmia or perforation or become trapped within the vessel. Although one report investigated the optimal guidewire length using fluoroscopy, few reports have precisely measured guidewire position using transesophageal echocardiography (TEE). Here, we investigated the appropriate intravascular length of a guidewire for right internal jugular vein approach using TEE during cardiac surgery.

Detection of dexmedetomidine in human breast milk using liquid chromatography-tandem mass spectrometry: Application to a study of drug safety in breastfeeding after Cesarean section.

Several analytical methods for dexmedetomidine (DEX) in human plasma have been published, but quantification of DEX in human breast milk has not been described. In this article, we describe a high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) method suitable for quantification of DEX in human breast milk. DEX and an internal standard were extracted in a single liquid-liquid extraction step with diethyl ether from 200μL of human breast milk.