Randomized crossover study assessing oropharyngeal leak pressure and fiber optic positioning

2016 ◽  
Vol 65 (8) ◽  
pp. 585-589 ◽  
Author(s):  
L. Gasteiger ◽  
S. Ofner ◽  
B. Stögermüller ◽  
B. Ziegler ◽  
J. Brimacombe ◽  
...  
Keyword(s):  
Crossover Study ◽  
Fiber Optic ◽  
Leak Pressure ◽  
Oropharyngeal Leak Pressure ◽  
Randomized Crossover Study

scholarly journals Appropriate Size of Laryngeal Mask Airway for Children

2002 ◽  
Vol 30 (6) ◽  
pp. 771-774 ◽  
Author(s):  
G. P. Y. Loke ◽  
S. M. Tan ◽  
A. S. B. Ng
Keyword(s):  
Laryngeal Mask Airway ◽  
Crossover Study ◽  
Airway Pressure ◽  
Fibreoptic Bronchoscope ◽  
Laryngeal Mask ◽  
Intracuff Pressure ◽  
Optimal Size ◽  
Leak Pressure ◽  
Gastric Insufflation ◽  
Oropharyngeal Leak Pressure

The aim of this crossover study was to determine the optimal size of laryngeal mask airway in children weighing 10 to 20 kg. In each of 67 apnoeic anaesthetized children, the size 2 and size 2½ laryngeal mask airways were inserted consecutively by a skilled user and the cuff inflated to 60 cmH 2 O. Each LMA was assessed for the ease of insertion (by the number of attempts), oropharyngeal leak pressure, anatomical position (assessed fibreoptically) and the volume of air required to achieve intracuff pressure of 60 cmH 2 O. During the measurement of oropharyngeal leak pressure, the airway pressure was not allowed to exceed 30 cmH 2 O. There was no failed attempt at insertion with any size. The oropharyngeal leak pressure was significantly less for the size 2 LMA compared to the size 2½ LMA (P<0.001). The oesophagus was visible on three occasions, all with the size 2 LMA. Gastric insufflation occurred in three patients, all with the size 2 LMA. The incidence of low oropharyngeal leak pressure (<10 cmH 2 O) was low (9.0%) and all occurred with the size 2 LMA. The fibreoptic bronchoscope scores were not significantly different between the two sizes of LMAs. The volume of air to achieve intracuff pressure of 60 cmH 2 O was much lower than the maximum recommended volume (5.1 ml for size 2 and 6.2 ml for size 2½ ). We conclude that the size 2½ LMA provides a better fit than size 2 in children 10 to 20 kg.

755-P: A Plant-Based Meal Stimulates Incretin and Insulin Secretion More than an Energy- and Macronutrient-Matched Standard Meal in Type 2 Diabetes: A Randomized Crossover Study

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 755-P
Author(s):  
HANA KAHLEOVA ◽  
ANDREA TURA ◽  
MARTA KLEMENTOVA ◽  
LENKA BELINOVA ◽  
MARTIN HALUZIK ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Insulin Secretion ◽  
Crossover Study ◽  
Standard Meal ◽  
Randomized Crossover Study

scholarly journals Robotic-assisted cholecystectomy is superior to laparoscopic cholecystectomy in the initial training for surgical novices in an ex vivo porcine model: a randomized crossover study

2021 ◽  
Author(s):  
E. Willuth ◽  
S. F. Hardon ◽  
F. Lang ◽  
C. M. Haney ◽  
E. A. Felinska ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Crossover Study ◽  
Porcine Model ◽  
Haptic Feedback ◽  
Ex Vivo ◽  
Operating Time ◽  
Surgical Performance ◽  
Robotic Assisted ◽  
Subjective Workload ◽  
Randomized Crossover Study

Abstract Background Robotic-assisted surgery (RAS) potentially reduces workload and shortens the surgical learning curve compared to conventional laparoscopy (CL). The present study aimed to compare robotic-assisted cholecystectomy (RAC) to laparoscopic cholecystectomy (LC) in the initial learning phase for novices. Methods In a randomized crossover study, medical students (n = 40) in their clinical years performed both LC and RAC on a cadaveric porcine model. After standardized instructions and basic skill training, group 1 started with RAC and then performed LC, while group 2 started with LC and then performed RAC. The primary endpoint was surgical performance measured with Objective Structured Assessment of Technical Skills (OSATS) score, secondary endpoints included operating time, complications (liver damage, gallbladder perforations, vessel damage), force applied to tissue, and subjective workload assessment. Results Surgical performance was better for RAC than for LC for total OSATS (RAC = 77.4 ± 7.9 vs. LC = 73.8 ± 9.4; p = 0.025, global OSATS (RAC = 27.2 ± 1.0 vs. LC = 26.5 ± 1.6; p = 0.012, and task specific OSATS score (RAC = 50.5 ± 7.5 vs. LC = 47.1 ± 8.5; p = 0.037). There were less complications with RAC than with LC (10 (25.6%) vs. 26 (65.0%), p = 0.006) but no difference in operating times (RAC = 77.0 ± 15.3 vs. LC = 75.5 ± 15.3 min; p = 0.517). Force applied to tissue was similar. Students found RAC less physical demanding and less frustrating than LC. Conclusions Novices performed their first cholecystectomies with better performance and less complications with RAS than with CL, while operating time showed no differences. Students perceived less subjective workload for RAS than for CL. Unlike our expectations, the lack of haptic feedback on the robotic system did not lead to higher force application during RAC than LC and did not increase tissue damage. These results show potential advantages for RAS over CL for surgical novices while performing their first RAC and LC using an ex vivo cadaveric porcine model. Registration number researchregistry6029 Graphic abstract

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