Comment on Varghese and Kundu, does the Miller blade truly provide a better laryngoscopic view and intubating conditions than the Macintosh blade in small children?

2014 ◽  
Vol 24 (11) ◽  
pp. 1197-1198 ◽  
Author(s):  
Paul A. Baker ◽  
Jeanette Scott
Author(s):  
Kadirehally Bheemanna Nalini ◽  
Anupama Gopal ◽  
Sadasivan Shankar Iyer ◽  
Nagaraj Mungasuvalli Chanappa

Background: Although several types of laryngoscope blades of different sizes and shapes are present, Miller (MIL) blade is the most preferable blade among paediatric population. However, there is dearth in the literature regarding the use of these blades in the adult population. This study aimed to compare the laryngoscopic view and ease of intubation using MIL and Macintosh (MAC) blade among adults. Methods: A total of 172 patients who were >18 years age, with ASA grades I and II, undergoing elective surgeries with general anaesthesia were included. Patients were distributed in two groups (MAC/MIL and MIL/MAC), where laryngoscopy was first done with MAC blade, followed by MIL blade in the MAC/MIL group and vice-versa in the MIL/MAC group. Grading of laryngoscopic views, number of attempts, ease of intubation and use of backward, upward, rightward pressure (BURP) were noted. R v 3.6.0 was used for statistical analysis and P values≤0.05 were considered as statistically significant. Results: MIL blade showed better laryngoscopic view compared to MAC blade (32.6% vs. 15.1%; P< 0.002). BURP application helped improve the laryngoscopic views with MAC blade. Intubation with MIL blade was easier with regards to ease of intubation and number of attempts 19 (P value<0.05). Conclusion: Glottis visualization is better with the MIL blade as compared to the MAC blade. Therefore, the MIL blade might be helpful in securing the airway among adult patients.


2019 ◽  
Vol 6 (3) ◽  
pp. 463-467
Author(s):  
Malavika Kulkarni ◽  
◽  
Nisha Sara L Jacob ◽  
Muralidhar Kulkarni ◽  
Laxmi Shenoy ◽  
...  

Anaesthesia ◽  
2000 ◽  
Vol 55 (10) ◽  
pp. 1029-1030 ◽  
Author(s):  
T. M. Cook
Keyword(s):  

Author(s):  
Henry James

A young, inexperienced governess is charged with the care of Miles and Flora, two small children abandoned by their uncle at his grand country house. She sees the figure of an unknown man on the tower and his face at the window. It is Peter Quint, the master's dissolute valet, and he has come for little Miles. But Peter Quint is dead. Like the other tales collected here – ‘Sir Edmund Orme’, ‘Owen Wingrave’, and ‘The Friends of the Friends’ – ‘The Turn of the Screw’ is to all immediate appearances a ghost story. But are the appearances what they seem? Is what appears to the governess a ghost or a hallucination? Who else sees what she sees? The reader may wonder whether the children are victims of corruption from beyond the grave, or victims of the governess's ‘infernal imagination’, which torments but also entrals her? ‘The Turn of the Screw’ is probably the most famous, certainly the most eerily equivocal, of all ghostly tales. Is it a subtle, self-conscious exploration of the haunted house of Victorian culture, filled with echoes of sexual and social unease? Or is it simply, ‘the most hopelessly evil story that we have ever read’? The texts are those of the New York Edition, with a new Introduction and Notes.


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