scholarly journals A comparison between the Disposcope endoscope and fiberoptic bronchoscope for nasotracheal intubation-A randomized controlled trial

2019 ◽  
Author(s):  
Junma Yu ◽  
Rui Hu ◽  
Lining Wu ◽  
Peng Sun ◽  
Zhi Zhang
Keyword(s):  
Adverse Reactions ◽  
Controlled Trial ◽  
Nasotracheal Intubation ◽  
Fiberoptic Bronchoscopy ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Severe Epistaxis ◽  
Nasal Bleeding ◽  
Severe Adverse Reactions ◽  
Time Point

Abstract Background Nasotracheal intubation (NTI) is frequently performed in oral and maxillofacial surgeries. This study evaluated whether NTI is easier when guided by Disposcope endoscopy or fiberoptic bronchoscopy. Methods Sixty patients (30 per group) requiring NTI were randomly assigned to undergo fiberoptic bronchoscopy-guided (fibreoptic group) or Disposcope endoscope-guided (Disposcope group) NTI. Then, the NTI time were recorded. Epistaxis was recorded using direct laryngoscopy five minutes after completing NTI. Results The time to complete NTI was significantly longer in the fiberoptic group than the Disposcope group (38.4 sec vs 24.1 sec; mean difference, 14.2 sec; 95% CI, 10.4 to 18.1). In addition, Mild epistaxis (nasal bleeding) was observed in 8 patients in the fiberoptic group and 7 patients in the Disposcope group (26.7% vs 23.3%, respectively; relative risk, 1.2; 95% CI, 0.4 to 3.9). No moderate or severe epistaxis occurred in either group. Furthermore, there was no obvious nasal pain at any time point after extubation in the Disposcope group, and there was no significant difference between the two groups. Conclusion NTI can be completed successfully using either fiberoptic bronchoscopy or a Disposcope endoscope as a guide without any severe adverse reactions. However, compared to fiberoptic bronchoscopy, the Disposcope endoscope requires less transaction time.

scholarly journals A comparison between the Disposcope endoscope and fiberoptic bronchoscope for nasotracheal intubation-A randomized controlled trial

2019 ◽  
Author(s):  
Junma Yu ◽  
Rui Hu ◽  
Lining Wu ◽  
Peng Sun ◽  
Zhi Zhang
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Nasotracheal Intubation ◽  
Fibreoptic Bronchoscope ◽  
Fibreoptic Bronchoscopy ◽  
Suction Catheter ◽  
Fiberoptic Bronchoscope ◽  
Randomized Controlled ◽  
Severe Epistaxis ◽  
Time Point

Abstract Background: Nasotracheal intubation (NTI) is frequently performed in oral and maxillofacial surgeries. This study evaluated whether NTI is easier when guided by Disposcope endoscopy or fibreoptic bronchoscopy. Methods: Sixty patients (30 per group) requiring NTI were randomly assigned to undergo fibreoptic bronchoscopy-guided (fibreoptic group) or Disposcope endoscope-guided (Disposcope group) NTI. Then, the NTI time, which was defined as the time from when the fibreoptic bronchoscope or aseptic suction catheter was inserted into the nasal cavity to the time at which the tracheal tube was correctly inserted through the glottis, was recorded. Epistaxis was recorded using direct laryngoscopy five minutes after completing NTI and was scored as one of four grades according to the following modified criteria: no epistaxis, mild epistaxis, moderate epistaxis, and severe epistaxis. Results: The time to complete NTI was significantly longer in the fibreoptic group than that in the Disposcope group (38.4 sec vs 24.1 sec; mean difference, 14.2 sec; 95% confidence interval (CI), 10.4 to 18.1). In addition, mild epistaxis was observed in 8 patients in the fibreoptic group and in 7 patients in the Disposcope group (26.7% vs 23.3%, respectively; relative risk, 1.2; 95% CI, 0.4 to 3.9). No moderate or severe epistaxis occurred in either group. Furthermore, no obvious nasal pain was reported at any time point after extubation in the two groups (P = 0.74). Conclusion: NTI can be completed successfully using either fibreoptic bronchoscopy or a Disposcope endoscope as a guide without any severe complications. However, compared to fibreoptic bronchoscopy, the Disposcope endoscope requires less execution time (the NTI time).

scholarly journals A comparison between the Disposcope endoscope and fiberoptic bronchoscope for nasotracheal intubation-A randomized controlled trial

2019 ◽  
Author(s):  
Junma Yu ◽  
Rui Hu ◽  
Lining Wu ◽  
Peng Sun ◽  
Zhi Zhang
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Nasotracheal Intubation ◽  
Fibreoptic Bronchoscope ◽  
Fibreoptic Bronchoscopy ◽  
Suction Catheter ◽  
Fiberoptic Bronchoscope ◽  
Randomized Controlled ◽  
Severe Epistaxis ◽  
Time Point

Abstract Background: Nasotracheal intubation (NTI) is frequently performed in oral and maxillofacial surgeries. This study evaluated whether NTI is easier when guided by Disposcope endoscopy or fibreoptic bronchoscopy. Methods: Sixty patients (30 per group) requiring NTI were randomly assigned to undergo fibreoptic bronchoscopy-guided (fibreoptic group) or Disposcope endoscope-guided (Disposcope group) NTI. Then, the NTI time, which was defined as the time from when the fibreoptic bronchoscope or aseptic suction catheter was inserted into the nasal cavity to the time at which the tracheal tube was correctly inserted through the glottis, was recorded. Epistaxis was recorded using direct laryngoscopy five minutes after completing NTI and was scored as one of four grades according to the following modified criteria: no epistaxis, mild epistaxis, moderate epistaxis, and severe epistaxis. Results: The time to complete NTI was significantly longer in the fibreoptic group than that in the Disposcope group (38.4 sec vs 24.1 sec; mean difference, 14.2 sec; 95% confidence interval (CI), 10.4 to 18.1). In addition, mild epistaxis was observed in 8 patients in the fibreoptic group and in 7 patients in the Disposcope group (26.7% vs 23.3%, respectively; relative risk, 1.2; 95% CI, 0.4 to 3.9). No moderate or severe epistaxis occurred in either group. Furthermore, no obvious nasal pain was reported at any time point after extubation in the two groups (P = 0.74). Conclusion: NTI can be completed successfully using either fibreoptic bronchoscopy or a Disposcope endoscope as a guide without any severe complications. However, compared to fibreoptic bronchoscopy, the Disposcope endoscope requires less execution time (the NTI time).

Intravenous versus Oral iron for Iron-Deficiency Anemia in Pregnancy (IVIDA): A Randomized Controlled Trial

2021 ◽  
Author(s):  
Adam K. Lewkowitz ◽  
Molly J. Stout ◽  
Emily Cooke ◽  
Seon C. Deoni ◽  
Viren D'Sa ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Adverse Reactions ◽  
Controlled Trial ◽  
Oral Iron ◽  
Deficiency Anemia ◽  
Randomized Controlled ◽  
Iv Iron ◽  
Severe Adverse Reactions

Objective Iron-deficiency anemia (IDA) can have serious consequences for mothers and babies. Iron supplementation is recommended, but the administration route is controversial. We sought to conduct a randomized controlled trial (RCT) testing the effectiveness and safety of intravenous (IV) iron compared with oral iron on perinatal outcomes in pregnant women with IDA. Study Design This open-label RCT randomized patients with IDA (hemoglobin [hgb] <10 g/dL and ferritin <30 ng/mL) at 24 to 34 weeks' to oral iron or single 1,000-mg dose of IV low-molecular weight iron dextran over one hour. The primary outcome was maternal anemia at delivery (hgb < 11 g/dL). Secondary outcomes were mild/moderate or severe adverse reactions, maternal hgb and ferritin at delivery, blood transfusion, gestational age at delivery, birth weight, neonatal hgb and ferritin, and composite neonatal morbidity. Analysis was as per protocol. Results The trial was stopped early for logistical reasons, and the data analyzed as preliminary data to inform a larger, potentially externally funded, definitive trial. Of 55 patients approached, 38 consented. Of these, 15 were withdrawn: 5 received IV iron from their primary obstetrician after being randomized to oral iron and 10 declined to receive IV iron. Of the remaining 23 patients, who were included in the analytic population, 13 received oral iron and 10 received IV iron. The rate of maternal anemia at delivery (hgb < 11 g/dL) was high overall but significantly reduced with IV iron (40 vs. 85%, p = 0.039). Rates of maternal hgb < 10 g/dL were significantly lower in the IV iron group (10 vs. 54%, p = 0.029). There were no severe adverse reactions and similar rates of mild/moderate reactions between groups. Conclusion IV iron reduces rates of anemia at the time of admission for delivery, supporting a larger RCT comparing IV versus oral iron for the treatment of IDA of pregnancy powered for definitive clinical outcomes. However, issues uncovered in this RCT suggest that patient, clinician, and systems-level barriers associated with different IDA treatment modalities must be considered prior to conducting a larger RCT. This study is registered with clinicaltrials.gov with identifier no.: NCT03438227. Key Points

scholarly journals Comparison with Tube Core and Magill forceps for Nasotracheal Intubation: A Randomized Controlled Trial

2020 ◽  
Author(s):  
Rui Hu ◽  
Jingyi Niu ◽  
Lining Wu ◽  
Hao Sun ◽  
Peng Sun ◽  
...  
Keyword(s):  
Tracheal Tube ◽  
Controlled Trial ◽  
Liquid Paraffin ◽  
Demographic Data ◽  
Nasotracheal Intubation ◽  
Clinical Trial Registry ◽  
Magill Forceps ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Oral Tissue

Abstract Background: Magill forceps are frequently used to complete the process of nasotracheal intubation (NTI). We aimed to identify a tube core that could facilitate the NTI process conveniently without Magill forceps. Methods: Sixty patients with no differences between the two groups (30 per group) with regard to demographic data were enrolled in our study. In Group M, the wire-reinforced tracheal tube was inserted into the trachea using Magill forceps. However, in Group T, a tube core bent to the physiological curve of the nasal cavity lubricated with aseptic liquid paraffin was inserted into the tracheal tube, and the tube core was then withdrawn after the tracheal tube was advanced through the glottis under direct vision. Results: All NTIs were completed successfully, and no Magill forceps were used in Group T. There was a significant difference in total NTI time between the two groups (Group M, 59.7 (5.1) sec vs Group T, 52.4 (3.1) sec). Mild epistaxis was observed in 6 patients in Group M and 5 patients in Group T (6/30 vs 5/30, respectively). There was no presence of damaged oral tissue or damage to the teeth in either group. Conclusion: We conclude that using the tube core, which is a disposable sterilised stylet, for NTI is a convenient choice. Trial registrations: This clinical research was registered at the Chinese Clinical Trial Registry (www.Chictr.org.cn, ChiCTR1900027387).

scholarly journals Comparison with tube core and Magill forceps for nasotracheal intubation: a randomized controlled trial

2020 ◽  
Author(s):  
Rui Hu ◽  
Jingyi Niu ◽  
Lining Wu ◽  
Hao Sun ◽  
Peng Sun ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Nasal Cavity ◽  
Controlled Trial ◽  
Demographic Data ◽  
Nasotracheal Intubation ◽  
Magill Forceps ◽  
Randomized Controlled ◽  
Paraffin Oil ◽  
Significant Difference ◽  
Oral Tissue

Objective: Magill forceps are frequently used to complete the process of nasotracheal intubation (NTI). We aimed to identify a tube core that could facilitate the NTI process conveniently without Magill forceps. Methods: Sixty patients scheduled for oral and maxillofacial surgeries with no differences between the two groups (30 per group) with regard to demographic data were enrolled in our study. In Group M, the wire-reinforced endotracheal catheter was inserted into the trachea using Magill forceps. However, in Group T, a tube core bent to the physiological curve of the nasal cavity lubricated with aseptic paraffin oil was inserted into the endotracheal catheter, and it was then withdrawn after the endotracheal catheter was advanced through the glottis under direct vision. Results: All NTIs were completed successfully, and no Magill forceps were used in Group T. There was a significant difference in total NTI time between the two groups (Group M, 59.7 (5.1) sec vs Group T, 52.4 (3.1) sec). Mild epistaxis was observed in 6 patients in Group M and 5 patients in Group T (6/30 vs 5/30, respectively). There was no presence of damaged oral tissue or damage to the teeth in either group. Conclusion: We conclude that using the tube core, which is a disposable sterilised stylet, for NTI is a convenient choice.

scholarly journals Comparison with tube core and Magill forceps for nasotracheal intubation: a randomized controlled trial

2020 ◽  
Author(s):  
Rui Hu ◽  
Jingyi Niu ◽  
Lining Wu ◽  
Hao Sun ◽  
Peng Sun ◽  
...  
Keyword(s):  
Tracheal Tube ◽  
Controlled Trial ◽  
Liquid Paraffin ◽  
Demographic Data ◽  
Nasotracheal Intubation ◽  
Clinical Trial Registry ◽  
Magill Forceps ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Oral Tissue

Abstract Background: Magill forceps are frequently used to complete the process of nasotracheal intubation (NTI). We aimed to identify a tube core that could facilitate the NTI process conveniently without Magill forceps. Methods: Sixty patients with no differences between the two groups (30 per group) with regard to demographic data were enrolled in our study. In Group M, the wire-reinforced tracheal tube was inserted into the trachea using Magill forceps. However, in Group T, a tube core bent to the physiological curve of the nasal cavity lubricated with aseptic liquid paraffin was inserted into the tracheal tube, and the tube core was then withdrawn after the tracheal tube was advanced through the glottis under direct vision. Results: All NTIs were completed successfully, and no Magill forceps were used in Group T. There was a significant difference in total NTI time between the two groups (Group M, 59.7 (5.1) sec vs Group T, 52.4 (3.1) sec). Mild epistaxis was observed in 6 patients in Group M and 5 patients in Group T (6/30 vs 5/30, respectively). There was no presence of damaged oral tissue or damage to the teeth in either group. Conclusion: We conclude that using the tube core, which is a disposable sterilised stylet, for NTI is a convenient choice. Trial registrations: This clinical research was registered at the Chinese Clinical Trial Registry (www.Chictr.org.cn, ChiCTR1900027387).

scholarly journals Mivacurium Compared with Three Different Doses of Suxamethonium for Nasotracheal Intubation

1998 ◽  
Vol 26 (5) ◽  
pp. 521-525 ◽  
Author(s):  
R. Hodgson ◽  
P. Harvey ◽  
R. Burrows
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Nasotracheal Intubation ◽  
Maxillofacial Surgery ◽  
Double Blind ◽  
Randomized Controlled ◽  
Intubating Conditions ◽  
Significant Difference ◽  
Rectal Indomethacin ◽  
Different Doses

Suxamethonium in the doses of 1.0, 0.5 and 0.25 mg/kg was compared with mivacurium 0.15 mg/kg in 80 patients requiring nasotracheal intubation for maxillofacial surgery in a double-blind randomized controlled trial. Anaesthesia was induced with thiopentone 5 mg/kg and alfentanil 15 μg/kg. Patients were randomly allocated to one of the four relaxant groups. Anaesthesia was maintained with enflurane in 70% nitrous oxide and 30% oxygen and analgesia provided with intravenous pethidine 0.5 to 1.5 mg/kg and rectal indomethacin 100mg. All patients given mivacurium or suxamethonium 1mg/kg had acceptable intubating conditions. Significantly fewer patients given suxamethonium 0.5 mg or 0.25 mg/kg had acceptable intubating conditions (90% and 70% respectively) (P=0.003). Poor intubating conditions requiring additional relaxation were seen in two patients given suxamethonium 0.25 mg/kg and two given 0.5 mg/kg, while no patients given suxamethonium 1.0 mg/kg or mivacurium 0.15 mg/kg required additional relaxation (P=0.004). Only four patients had postoperative myalgia, all of whom were given suxamethonium 0.5 mg/kg or more but no significant difference between groups could be demonstrated.

scholarly journals The The Effectiveness of Early Mobilization Time on Balance and Functional Ability after Ischemic Stroke

2019 ◽  
Vol 7 (7) ◽  
pp. 1088-1092
Author(s):  
Umi Budi Rahayu ◽  
Samekto Wibowo ◽  
Ismail Setyopranoto
Keyword(s):  
Randomized Controlled Trial ◽  
Ischemic Stroke ◽  
Functional Ability ◽  
Controlled Trial ◽  
Early Mobilization ◽  
Berg Balance Scale ◽  
Early Mobilisation ◽  
Inclusion Criteria ◽  
Randomized Controlled ◽  
Significant Difference

BACKGROUND: Early mobilisation (EM) after-ischemic stroke is a motor learning intervention aimed to restore nerve cells and to improve balance and functional ability. Unfortunately, the study of when this intervention began has not been widely studied. AIM: On this study was compared the effect of EM started at 24 hours and 48 hours after an ischemic stroke on balance and functional ability. MATERIAL AND METHODS: Randomized controlled trial involving 40 patients on 2 groups meeting predefined inclusion criteria. The levels of balance were measured using the Berg Balance Scale, and the functional ability was measured using the Barthel Index, at 5th and 7th day. RESULTS: A significant difference was observed in both balance (p = 0.038) and functional ability (p = 0.021) obtained on the 7th day of assessment between both groups. A significant difference on the 5th day was observed only in the functional ability (p = 0.002) and not in the balance (p = 0.147), between the groups. CONCLUSION: EM started at 24 hours after the ischemic stroke has been found to have a better impact on balance and functional ability compared to that at 48 hours.

scholarly journals Effect of leg wrapping technique on prevention of spinal induced hypotension and fetal acidosis during cesarean section: Randomized controlled trial

2019 ◽  
Vol 10 (2) ◽  
pp. 70
Author(s):  
Samah Nasser Abd El-Aziz El-Shora ◽  
Amina Mohamed Rashad El-Nemer
Keyword(s):  
Randomized Controlled Trial ◽  
Cesarean Section ◽  
Controlled Trial ◽  
Intervention Group ◽  
Cost Effective ◽  
Control Group ◽  
Induced Hypotension ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Wrapping Technique

Background and aim: Hypotension during cesarean section (CS) under spinal anesthesia has been a subject of scientific study for more than 50 years and the search for the most effective strategy to achieve hemodynamic stability remains challenging. Aim: The study was carried out to apply leg wrapping technique for the prevention of spinal-induced hypotension (SIH) during CS.Methods: Randomized Controlled Trial design was utilized at cesarean delivery operating room Mansoura General Hospital in El-Mansoura City during the period from May 2018 to November 2018. A purposive sample of 88 pregnant women, assigned randomly to an intervention group (n = 44) in which their legs wrapped with elastic crepe bandage and control group (n = 44) in which no wrapping was done. Data collected for maternal, neonatal hemodynamic and signs of hypotension, the feasibility of application and cost analysis.Results: There was a statistically significant difference in the incidence of SIH and Ephedrine use among both groups (18.20% in leg wrapping group whereas 75% in control group). In addition, neonatal acidosis and NICU admission were less among leg wrapping group (11.40%, 9.10% respectively). Economically, leg wrapping technique was cost effective compared to the cost of the hospital regimen for treating SIH and admission to (NICU).Conclusion and recommendations: Leg wrapping technique was cost effective and an efficient method for decreasing SIH, neonatal acidosis and Ephedrine administration. It is recommended to apply leg wrapping technique in maternal hospitals' protocol of care for decreasing SIH during CS.

scholarly journals Interest of a standardized hypnotic message for the reduction of pain and anxiety in cancer patients treated by capsaicin patch for neuropathic pain: a randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rémi Etienne ◽  
Myriam Laurent ◽  
Aline Henry ◽  
Antoine Bioy ◽  
Julia Salleron ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Neuropathic Pain ◽  
Rating Scales ◽  
Controlled Trial ◽  
Standard Group ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Numerical Rating ◽  
Reduction Of Pain ◽  
The Impact

Abstract Background Neuropathic pain is characterized by spontaneous painful symptoms. Medical therapies include the use of a capsaicin 8% patch (Qutenza®, Grünenthal Gmbh, Germany), and patients may experience a sharp burning sensation at application and removal of the patch. This study aimed to evaluate the impact of playing a standardized hypnosis recording during application, on the pain and anxiety induced by capsaicin treatment. Methods In a randomized, controlled trial, we assessed the benefits of the intervention firstly on pain and secondly on anxiety, as measured using numerical rating scales. All patients had application of the capsaicin patch, including the possibility for the patient to apply a cold patch. Participants were randomly assigned to one of 3 groups, namely the “Standard group” (no intervention), “Hypnosis group”, in which a standardized hypnotic message was played during application, or the “Music group” in which relaxing music was played during application of the patch. Results Sixty-nine patients were included. Overall, there was no significant difference in pain scores between groups (p = 0.355). Compared to standard application, anxiety was significantly lower in the hypnosis group after application (p = 0.007), with no significant difference between the standard and music arms (p = 0.271), or between the hypnosis and music arms (p = 0.423). Conclusions Listening to a standardized hypnotic message during application of a capsaicin patch was found to significantly lower anxiety. These findings indicate that the use of a hypnotic message can reduce discomfort and warrant its evaluation in other indications of pain or anxiety during treatment procedures. Trial registration NCT02822625.

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