scholarly journals Prospective randomized double blind study for determining the efficacy of Sellick’s maneuver for preventing gastric distension during mask ventilation

2020 ◽  
Vol 11 (SPL4) ◽  
pp. 2735-2740
Author(s):  
Arun Prasad T ◽  
Yachendra V S G
Keyword(s):  
Elective Surgery ◽  
Cricoid Cartilage ◽  
Gastric Volume ◽  
Gastric Distension ◽  
Anesthesia Induction ◽  
Double Blind Study ◽  
Mask Ventilation ◽  
Double Blind ◽  
Cross Sectional ◽  
Post Intubation

Sellick’s maneuver is a technique in which pressure is applied over the cricoid cartilage to occlude the upper part of esophagus which passes behind it. It is used to prevent regurgitation of gastric and esophageal contents and gastric distension during intubation and mask ventilation. This research is conducted to determine the efficacy of Sellick's maneuver in preventing gastric distension during mask ventilation using ultrasound. Sixty patients posted for elective surgery were selected and randomly allocated to a group receiving Sellick's Maneuver (SM) or No Sellick's Maneuver (NSM). Patients of both groups had their gastric antral cross sectional area (CSA) measured using ultrasound before induction of anesthesia and after intubation and mask ventilation. The SM group was intubated after application of Sellick's maneuver. Gastric volume was then calculated from the gastric antral CSA. Changes in gastric volume among SM and NSM group were assessed to determine whether Sellick's maneuver is effective in preventing gastric distension. Changes in gastric antral CSA and gastric volume before anesthesia induction and post-intubation is lower in the SM group as compared to the NSM group. Sellick's Maneuver is effective in preventing gastric distension.

scholarly journals A randomized, double-blind study of the ultrasound assessment of the effect of pharyngeal packing on perioperative gastric volume in nasal surgery

2019 ◽  
Author(s):  
Mehmet Emrah Temel ◽  
Tolga TOTOZ ◽  
KEREM ERKALP ◽  
Gulen Safiye TEMEL ◽  
Aysin SELCAN
Keyword(s):  
Pearson Correlation ◽  
Postoperative Nausea And Vomiting ◽  
Gastric Volume ◽  
Sinus Surgery ◽  
Double Blind Study ◽  
Nasal Surgery ◽  
Double Blind ◽  
Cross Sectional ◽  
Ultrasound Assessment ◽  
Pharyngeal Packing

Abstract Background: Pharyngeal packing (PP) is commonly performed to reduce the incidence of perioperative blood ingestion (PBI) in nasal surgery (NS), and thus the incidence and severity of postoperative nausea and vomiting (PONV). This study examined the effects of PP on the perioperative gastric volume (GV) and PONV in patients undergoing NS, by ultrasound assessment. Methods: Patients undergoing elective NS [septoplasty, septo-rhinoplasty (SRP) and functional endoscopic sinus surgery (FESS)] were randomised to receive or not receive PP. In the PP group, pharyngeal packs were placed after the orotracheal intubation. Ultrasound assessments were performed for all patients preoperatively (before the anaesthesia induction) and postoperatively (before the extubation). The antero-posterior (AP) and cranio-caudal (CC) antral diameters, antral cross-sectional area (ACSA), and total GV were calculated. PONV incidence and severity were rated. These variables were compared between timepoints and groups, and in the subgroup analyses according to the surgery type. Pearson correlation analysis was performed to assess correlations between the variables. Results: AP and CC diameters and ACSAs were greater postoperatively than preoperatively in the PP and non-PP groups (n = 44 each; all p < 0.05). Postoperative AP and CC diameters and the ACSA were greater in the non-PP than in the PP group (all p < 0.05). Postoperative AP diameters were greater than preoperatively in patients undergoing SRP and FESS, and the postoperative CC diameter and ACSA were greater than preoperatively in patients undergoing SRP (all p < 0.05). Surgery duration was correlated positively with postoperative AP diameter (r = 0.380, p < 0.05), CC diameter (r = 0.291, p < 0.05), and ACSA (r = 0.369, p < 0.05). Patients who underwent septoplasty surgery, PP was decreased PONV incidence and severity at the first four hours, postoperatively (p < 0.05). Conclusions: The study findings indicate that PP reduces the increase in the perioperative GV due to PBI in an elective NS. It is therefore a useful and safe means of reducing the risk of perioperative pulmonary aspiration in such surgeries.

scholarly journals A randomized, double-blind study of the ultrasound assessment of the effect of pharyngeal packing on perioperative gastric volume in nasal surgery

2019 ◽  
Author(s):  
Mehmet Emrah Temel ◽  
Tolga TOTOZ ◽  
KEREM ERKALP ◽  
Gulen Safiye TEMEL ◽  
Aysin SELCAN
Keyword(s):  
Pearson Correlation ◽  
Postoperative Nausea And Vomiting ◽  
Gastric Volume ◽  
Sinus Surgery ◽  
Double Blind Study ◽  
Nasal Surgery ◽  
Double Blind ◽  
Cross Sectional ◽  
Ultrasound Assessment ◽  
Pharyngeal Packing

Abstract Background: Pharyngeal packing (PP) is commonly performed to reduce the incidence of perioperative blood ingestion (PBI) in nasal surgery (NS), and thus the incidence and severity of postoperative nausea and vomiting (PONV). This study examined the effects of PP on the perioperative gastric volume (GV) and PONV in patients undergoing NS, by ultrasound assessment. Methods: Patients undergoing elective NS [septoplasty, septo-rhinoplasty (SRP) and functional endoscopic sinus surgery (FESS)] were randomised to receive or not receive PP. In the PP group, pharyngeal packs were placed after the orotracheal intubation. Ultrasound assessments were performed for all patients preoperatively (before the anaesthesia induction) and postoperatively (before the extubation). The antero-posterior (AP) and cranio-caudal (CC) antral diameters, antral cross-sectional area (ACSA), and total GV were calculated. PONV incidence and severity were rated. These variables were compared between timepoints and groups, and in the subgroup analyses according to the surgery type. Pearson correlation analysis was performed to assess correlations between the variables. Results: AP and CC diameters and ACSAs were greater postoperatively than preoperatively in the PP and non-PP groups (n = 44 each; all p < 0.05). Postoperative AP and CC diameters and the ACSA were greater in the non-PP than in the PP group (all p < 0.05). Postoperative AP diameters were greater than preoperatively in patients undergoing SRP and FESS, and the postoperative CC diameter and ACSA were greater than preoperatively in patients undergoing SRP (all p < 0.05). Surgery duration was correlated positively with postoperative AP diameter (r = 0.380, p < 0.05), CC diameter (r = 0.291, p < 0.05), and ACSA (r = 0.369, p < 0.05). Patients who underwent septoplasty surgery, PP was decreased PONV incidence and severity at the first four hours, postoperatively (p < 0.05). Conclusions: The study findings indicate that PP reduces the increase in the perioperative GV due to PBI in an elective NS. It is therefore a useful and safe means of reducing the risk of perioperative pulmonary aspiration in such surgeries.

scholarly journals Observer’s Assessment of Alertness/Sedation-based titration reduces propofol consumption and incidence of hypotension during general anesthesia induction: A randomized controlled trial

2021 ◽  
Vol 104 (4) ◽  
pp. 003685042110523
Author(s):  
Lihong Chen ◽  
Kun Lu ◽  
Tongfeng Luo ◽  
Huiming Liang ◽  
Yuqin Gui ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
General Anesthesia ◽  
Diastolic Blood Pressure ◽  
Elective Surgery ◽  
Controlled Trial ◽  
Mean Blood Pressure ◽  
Conventional Group ◽  
Anesthesia Induction ◽  
Post Intubation

Administration of a single propofol bolus dose for anesthesia induction causes hypotension. We included 160 patients (74 males and 86 females; mean age, 42.4 ± 10.7 [range: 18–60] years) with the American Society of Anesthesiologists status I–II undergoing elective surgery under general anesthesia. Using simple randomization, the patients were divided into a conventional group ( n = 80; received 2 mg/kg propofol at a rate of 250 mg/min) and titrated group ( n = 80; received propofol at a rate of 1 mg/kg/min until the Observer's Assessment of Alertness/Sedation scale score reached 1 point). Fentanyl (4 µg/kg) and cisatracurium (0.2 mg/kg) were administered, as appropriate. Systolic blood pressure, diastolic blood pressure, mean blood pressure, and heart rate were recorded at different time points. Propofol consumption, hypotension, and other adverse events were recorded. All the patients were intubated without awareness. Compared with the conventional group, the titrated group showed more stable blood pressure ( p < 0.05), as well as a lower decrease in systolic blood pressure, mean blood pressure at 1 and 3 min, and diastolic blood pressure at 1 min after propofol administration ( p < 0.01). Moreover, compared with the conventional group, the titrated group showed a lower post-intubation hypotension incidence (9 vs. 19 cases; p = 0.04), as well as lower total propofol dosage and propofol dose per kilogram of body weight (93.57 ± 14.40 mg vs. 116.80 ± 22.37 mg and 1.73 ± 0.27 mg/kg vs. 2.02 ± 0.08 mg/kg, respectively, p < 0.01). Compared with conventional propofol usage, titrated propofol administration can reduce the incidence of hypotension and propofol consumption during anesthesia induction.

scholarly journals Analysis of the presence and location of mast cells in periapical cysts and periapical granulomas

2016 ◽  
Vol 64 (4) ◽  
pp. 376-381 ◽  
Author(s):  
Emerson Filipe de Carvalho NOGUEIRA ◽  
Elder Gyress Feitosa FARIAS ◽  
Luciano Barreto SILVA ◽  
Alexandrino Pereira dos SANTOS NETO ◽  
Emanuel Sávio de Souza ANDRADE ◽  
...  
Keyword(s):  
Mast Cells ◽  
Granulation Tissue ◽  
Blue Staining ◽  
Double Blind Study ◽  
Double Blind ◽  
Cross Sectional ◽  
Periapical Granuloma ◽  
Staining Methods ◽  
Periapical Cyst ◽  
Quantitative Descriptive

ABSTRACT Objective: The aim of the present study was to locate mast cells in chronic periapical lesions (granulomas and cysts) by using histochemical techniques and toluidine blue staining. Methods: A quantitative, descriptive, cross-sectional and retrospective research was performed. The sample was obtained from histopathological reports in the archives of the laboratory of surgical pathology of the University of Pernambuco between November 2014 and May 2015. Results: Sixteen cases of granuloma and 21 cases of periapical cysts were selected. The stained slides were analyzed by two examiners at different times, in a double-blind study. Mast cells were found in 13 (61.9%) of the periapical cyst cases, located in the capsule of the lesion. In the periapical granuloma cases, mast cells were found in eight cases (50%), located in the granulation tissue. Conclusion: Mast cells were detected in both cysts and periapical granuloma, located in the capsule and granulation tissue, respectively. Mast cells were more prevalent in periapical cysts than in periapical granuloma.

scholarly journals Comparison of analgesic effect of intrathecal morphine alone or in combination with bupivacaine and fentanyl in patients undergoing total gastrectomy: A prospective randomised, double blind clinical trial

2013 ◽  
Vol 70 (6) ◽  
pp. 541-547 ◽  
Author(s):  
Zoran Slavkovic ◽  
Dusica Stamenkovic ◽  
Veselin Geric ◽  
Milic Veljovic ◽  
Nebojsa Ivanovic ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Epidural Catheter ◽  
Total Gastrectomy ◽  
Analgesic Effect ◽  
Catheter Removal ◽  
Anesthesia Induction ◽  
Double Blind Study ◽  
Double Blind ◽  
Combined Spinal Epidural ◽  
Spinal Epidural

Background/Aim. Combined spinal-epidural-general anesthesia has several advantages over general anesthesia alone. This study was designed to compare the efficacy of intrathecal (IT) morphine alone, or in combination with bupivacaine and fentanyl, as part of a combined spinal-epidural (CSE) analgesia, in patients undergoing elective total gastrectomy. Methods. This prospective, randomized double-blind study included 60 patients undergoing total gastrectomy under general anesthesia and CSE. We compared the analgesic effect of lumbar IT morphine 300 ?g (the group M, n = 20) vs morphine 300 ?g + bupivacaine 2 mg (the group MB, n = 20) vs morphine 300 ?g + bupivacaine 2 mg + fentanyl 25 ?g (the group MBF, n = 20) given after thoracic epidural catheter placement (T6-7) but before general anesthesia induction. Pain visual analogue scale (VAS) at rest (R), with movement (M) and with cough (C), and the number of analgesia requests were assessed for 72 h and after epidural catheter removal. Results. Compared to other groups, the MBF group required significantly fewer additional intra-operative epidural bupivacaine doses (p < 0.001), whereas the M group required significantly more supplemental intraoperative intravenous fentanyl, compared with the MBF (p = 0.022) and MB groups (p = 0.005). Postoperative pain relief was satisfactory in all the groups at all the time. VAS-R and VAS-M did not differ significantly among the groups. Compared to the M group, VAS-C scores 30 min postoperatively were significantly lower in the MBF (p = 0.029) and MB groups (p = 0.002). Duration of analgesia was longer in the MBF and MB groups, but the difference reached no significance. The number of supplemental analgesia requests was similar in all the groups in the first 12 h and during 72 h. Additional analgesia requests after epidural catheter removal were similar in all the groups, and side effects were infrequent. Conclusion. Compared to IT morphine alone, triple IT combination administered as part of CSE provided better intraoperative analgesia, but conferred no benefit with regards to postoperative analgesia.

Corticosteroids for Prophylaxis of Post-intubation Inflammation: A Double-Blind Study

1966 ◽  
Vol 27 (2) ◽  
pp. 215-216
Author(s):  
James E. Goddard ◽  
Otto C. Phillips ◽  
Joseph H. Marcy
Keyword(s):  
Blind Study ◽  
Double Blind Study ◽  
Double Blind ◽  
Post Intubation

scholarly journals EFFICACY OF TAP BLOCK AND PLACEBO FOR PAIN IN PATIENTS UNDERGOING CSECTION SURGERY

2021 ◽  
Vol 71 (1) ◽  
pp. 266-69
Author(s):  
Usman Khalid ◽  
Kaukab Majeed ◽  
Maihmoona Yasmeen ◽  
Khalid Mehmood ◽  
Muhammad Ali Muazzam ◽  
...  
Keyword(s):  
Transversus Abdominis Plane Block ◽  
Transversus Abdominis ◽  
Military Hospital ◽  
P Value ◽  
Double Blind Study ◽  
Transversus Abdominis Plane ◽  
Double Blind ◽  
Cross Sectional ◽  
Group A ◽  
Group B

Objective: To compare efficacy of transversus abdominis plane block and placebo for pain in patients undergoing C-section surgery. Study Design: Comparative cross-sectional study. Place and Duration of Study: Department of Anaesthesiology, Combined Military Hospital Quetta, from Apr toOct 2018. Methodology: A sample size of 200 patients calculated by WHO calculator undergoing Elective C-section andof age 20-40 year were randomized in a double blind study to undergo transversus abdominis plane block orplacebo group in two equal groups. Group A received block as placebo and group B with Bupivacaine. Resultsrecorded and analysed there-after for conclusion. Results: The mean age of patients in group A was 29.98 ± 5.18 years and in group B was 29.68 ± 5.43 years (pvalue ≤0.01). Majority of the patients 141 (70.50%) were between 31 to 40 years of age. Out of 200 patients, 108 (54.0%) were ASA I and 92 (46.0%) were ASA II (p-value ≤0.01). Mean body mass index was 25.20 ± 2.28 kg/m2 (p-value ≤0.01). Meantime for the first analgesia in the patients undergoing elective C-section in group A (placebo group) was 4.96 ± 1.44 hours while in group B (transversus abdominis plane block group) was 11.24 ± 1.83 hours (p-value ≤0.01). Conclusion: This study concluded that meantime for the first analgesia was found longer in TransversusAbdominis plane block for post-operative pain management in patients undergoing elective C-section.

scholarly journals A small dose of remifentanil pretreatment suppresses sufentanil-induced cough during general anesthesia induction: a randomized, double-blind, placebo-controlled trial

2019 ◽  
Author(s):  
Wendong Lin ◽  
Jiehao Sun ◽  
Shuying Fu
Keyword(s):  
General Anesthesia ◽  
Small Dose ◽  
Elective Surgery ◽  
Controlled Trial ◽  
Inhibitory Effect ◽  
Control Group ◽  
Anesthesia Induction ◽  
Double Blind ◽  
Prospective Randomized Controlled Trial ◽  
Size Groups

Abstract Background: Intravenous use of sufentanil can elicit cough. This study aimed to evaluate the inhibitory effect of pre-injection of a mall dose of remifentanil on sufentanil-induced cough during the induction of general anesthesia. Methods: This prospective, randomized, controlled trial was conducted from January 10, 2019 to March 01, 2019. A total of 100 patients undergoing elective surgery under general anesthesia were enrolled, and at last 84 patients were included and randomly allocated into two equal size groups (n=42): Patients in the Remifentanil group (R group) received an intravenous infusion of remifentanil 0.3 µg/kg (diluted to 2 ml) 1 minute before sufentanil injection; patients in the Control group (C group) received 2 ml of normal saline (NS) at the same time point. Injections of patients in both groups were completed within 5 seconds. Then, sufentanil 0.5 µg/kg was injected within 5 seconds and the number of coughs that occurred within 1 minute after sufentanil injection were recorded. One minute after sufentanil injection, etomidate 0.3 mg/kg and cisatracurium 0.15 mg/kg were given for general anesthesia induction irrespective of the presence or absence of cough. The mean arterial pressure (MAP) and heart rate (HR) at time points just before remifentanil pretreatment administration (T0), 3 minutes after administration (T1), 1 minute after intubation (T2), and 3 minutes after intubation (T3) were recorded. Results: The incidence of cough in patients in the R group and C group was 4.8% and 31%, respectively. Compared with group C, the incidence and severity of cough in group R was significantly lower (P <0.01). No significant differences were observed in MAP and HR at the time of general anesthesia induction between the two groups (P> 0.05). Conclusion: Pretreatment with a small dose of remifentanil effectively and safely reduced the incidence and severity of cough induced by sufentanil during anesthesia induction and can be used as an alternative treatment to inhibit coughing caused by sufentanil.

Rhinoplasty—Do Patients and Surgeons See the Same? A Double-Blind Study with 100 Randomized Patients

2018 ◽  
Vol 34 (04) ◽  
pp. 356-362 ◽  
Author(s):  
Mariline Santos ◽  
Diogo Carmo ◽  
José Neves ◽  
Cecília Sousa ◽  
Frank Datema ◽  
...  
Keyword(s):  
Subjective Evaluation ◽  
Cross Sectional Study ◽  
Clear Understanding ◽  
Double Blind Study ◽  
Double Blind ◽  
Cross Sectional ◽  
The North ◽  
Key Points ◽  
South Portugal ◽  
Level Of Agreement

AbstractOne of the key points of a successful rhinoplasty is communication between the patient and surgeon. The surgeon needs to get a clear understanding of the patient's motivation for surgery and expectations of the procedure. This information is mandatory in formulating an optimal surgical plan and managing realistic expectations of the procedures. Ideally, surgeons and patients see, discuss, and quantify the same nasal defects. In reality, the subjective nature of perceiving aesthetics can cause variability of inter-rating nasal appearance. Therefore, one might question how well surgeons understand their patients. Do they see what patients see? The aim of this study is to assess the level of agreement on the evaluation of nasal appearance between patients, surgeons, and nonphysicians observers, and try to find predictive factors that cause high interobserver variability. This prospective, observational, and cross-sectional study was performed on a total of 100 randomized patients undergoing rhinoplasty. All patients were photographed before surgery and asked to rate the appearance of their nose on a 10 cm visual analogue scale (VAS) with 0 indicating very ugly and 10 indicating very nice. Subsequently, the photographs of each patient were, independently, rated by two panels: one constituted by two rhinoplasty surgeons and the other by four nonmedical raters. Both panels included European raters from the north (The Netherlands) and south (Portugal). Data regarding age, gender, skin type, and major nasal deformity were also collected. The authors found that there is no statistical agreement between the aesthetical evaluation of the nose between patients and surgeons or patients and nonmedical raters. Based exclusively on the VAS for subjective evaluation of nasal appearance, the authors' findings show that surgeons and patients do not “see the same” and generally, the score attributed by the surgeon is more favorable (almost 1 point higher) than the auto-assessment's score. This is important to realize when communicating about nasal appearance before rhinoplasty.

Sign in / Sign up

Export Citation Format

Share Document