scholarly journals BLIND NASOTRACHEAL INTUBATION

2006 ◽  
Vol 13 (04) ◽  
pp. 669-675
Author(s):  
ZAHID MEHMOOD CHEEMA ◽  
MANZAR ZAKARIA ◽  
NOMAN ALI MALIK
Keyword(s):  
Patient Safety ◽  
Adverse Events ◽  
Endotracheal Tube ◽  
Elective Surgery ◽  
Randomized Study ◽  
Nasotracheal Intubation ◽  
Mouth Opening ◽  
Inhalational Anesthesia ◽  
Significant Difference ◽  
Group 2

Objective: Blind Nasotracheal Intubation (BNI) can be undertaken aftermuscle relaxation with Inj. Succinylcholine or under deep inhalational anesthesia. The objective of study was todetermine the preferred one of these 2 techniques of BNI. Design: Prospective, randomized study. Place andDuration of Study: PNS SHIFA, Karachi and AFID, Rawalpindi from May 2002 to April 2005. Subjects and Methods:Sixty patients between 10 - 40 years of age presenting for elective surgery in whom BNI was required due to limitedor no mouth opening were enrolled through convenient sampling. Patients were randomly divided into two groups:WMR (n=30) or NMR (n=30) to undergo BNI after relaxation with Succinylcholine or under inhalational anesthesia with2% Halothane, respectively. A red rubber nasal endotracheal tube (cuffed and un cuffed in adults and childrenrespectively) was used. Results: The frequency of successful BNI in WMR group was 100% and significantly higher(P=0.03) than in the NMR group (86%). Time to succeed was significantly less in the WMR group 2±0.9 minutes versus3.4±2.0 in the NMR group. There was no statistically significant difference of occurrence of adverse events in the twogroups. Conclusion: BNI with Succinylcholine produced a higher success rate. This technique can decrease failureto intubate, we speculate that it may, therefore, increase patient safety.

scholarly journals The Comparison of Duration Endotracheal Tube Insertion Using Aerosol Box And without Aerosol Box in Elective Surgery Patients in the Covid-19 Pandemic

2022 ◽  
Vol 2 (2) ◽  
pp. 212-221
Author(s):  
Zulkifli ◽  
Agustina Br Haloho ◽  
Legiran ◽  
Muhammad Ikhsan Kartawinata
Keyword(s):  
Endotracheal Tube ◽  
Elective Surgery ◽  
Mouth Opening ◽  
Tube Insertion ◽  
Operating Theater ◽  
Limited Mouth Opening ◽  
Mallampati Score ◽  
Significant Difference ◽  
Post Test ◽  
Mouth Movement

Introduction. The aerosol box can reduce the risk of droplet and aerosol transmission from the patient to the operator when performing intubation, but in practice, an aerosol box makes the glottis visualization less evident, and the operator moves less space with less space the aerosol box. This study aimed to compare ETT duration using an aerosol box and without an aerosol box using a video laryngoscope. Methods: This study was a clinical trial with a post-test-only control design. The study was carried out from February 2021 to May 2021 at the Central Operating Theater of dr. Mohammad Hoesin General Hospital Palembang. The sample in this study was all patients who underwent elective surgery under general anesthesia using intubation at the Central Surgical Installation of dr. Mohammad Hoesin Palembang. After the data is collected, it is analyzed using the SPSS 22.0 program with the appropriate test. Results. There were no differences in subject characteristics (age, sex, BMI, Mallampati score, TMD, Cormack Lehane, limited mouth opening, short neck, limited mouth movement) between the group using the aerosol box and the group without the aerosol box. The duration of intubation without an aerosol box is 30.67 + 2.63 seconds, and using an aerosol box is 44.53 + 2.89 seconds. There was a significant difference between the two groups in the duration of patient intubation (p < 0.001). However, there was no significant difference in complications in the two groups (p >0.05). Conclusion. The duration of the endotracheal tube insertion using an aerosol box is more extended than without an aerosol box in elective surgery patients.

Comparison of a Colorimetric End-Tidal CO2 Detector and an Esophageal Aspiration Device for Verifying Endotracheal Tube Placement in the Prehospital Setting: A Six-Month Experience

1997 ◽  
Vol 12 (1) ◽  
pp. 57-63 ◽  
Author(s):  
Richard J. Schaller ◽  
J. Stephen Huff ◽  
Allan Zahn
Keyword(s):  
Cardiac Arrest ◽  
Endotracheal Tube ◽  
Sensitivity And Specificity ◽  
Nasotracheal Intubation ◽  
Prehospital Setting ◽  
Tube Placement ◽  
Emergency Department Physician ◽  
Significant Difference ◽  
End Tidal ◽  
Chi Square Analysis

AbstractIntroduction:Hand held, colorimetric, end-tidal CO2 detector devices are being used to verify correct endotracheal tube (ETT) placement. The accuracy of these devices has been questioned in situations of cardiac arrest. The use of the esophageal detector device (EDD) is an easy alternative for detection of ETT placement, and may be more accurate in situations of cardiac arrest.Hypothesis:The use of the esophageal aspiration device in comparison with a colorimetric end-tidal CO2 detector is more accurate in detecting proper ETT placement and easier to use in the prehospital setting than is the colorimetric end-tidal CO2 detection device.Methods:This was a prospective alternating weeks, 6-month study in a prehospital setting. Participants included all patients older than 18 years who were intubated by the Portsmouth, Virginia Emergency Medical Services (EMS) personnel from 01 July 1993 through 31 December 1993. The aspiration device used, also known as an esophageal detector device (EDD), was a 60 ml, luer-lock syringe attached to a 15 mm ETT adapter. Its efficacy was compared with an already accepted method of ETT position detection, the colorimetric endtidal CO2 detector. Each device was used on alternating weeks, and correct ETT placement was determined by the receiving emergency department physician using standard techniques. Chi-square analysis and Fisher's Exact test were used to compare parameters, time of device use, and ease of use. Sensitivity and specificity were calculated, and provider preference was assessed using a survey instrument administered following completion of the study.Results:There were 49 patients who met the inclusion criteria, but six were excluded because of situational circumstances rendering use of the device a possible compromise of patient care. Twenty-five patients were in the EDD group, and 18 were in the endtidal CO2 detector group. There was no statistically significant difference detected between groups for the gender ratio, underlying condition, CPR in progress, perceived difficulty of intubation, or percentage of nasotracheal intubation. The EDD was significantly easier to use (p<0.005). There was no statistically significant difference in time required for use of end-tidal CO2 detector device versus the EDD. The sensitivity and specificity for correct tracheal placement using the EDD was 100%, and the sensitivity for correct tracheal placement using the end-tidal CO2 detector device was 78%. Use of the EDD was preferred over use of the end-tidal CO2 detector device by 75% of participating EMS providers. One case of nasotracheal intubation with an ETT placement above the cords raised the question of accuracy of this device in situations where direct visualization is not utilized.Conclusion:The EDD was accurate in all cases of orotracheal intubation, and was easier to use than was end-tidal CO2 detector device. It was preferred by 75% of participating EMS providers. In cases in which the ETT may be above the vocal cords, caution must be used with interpreting the results obtained by use of the EDD.

scholarly journals Outcomes of coaxial microincision cataract surgery versus conventional phacoemulsification surgery

2019 ◽  
Vol 16 (3) ◽  
pp. 168-178
Author(s):  
Anu Malik ◽  
Smruti Ranjan Dethi ◽  
Yogesh Kumar Gupta ◽  
Alka Gupta
Keyword(s):  
Cataract Surgery ◽  
Randomized Study ◽  
Corrected Visual Acuity ◽  
Age Related ◽  
Significant Difference ◽  
Induced Astigmatism ◽  
The Mean ◽  
Group 2 ◽  
Surgically Induced ◽  
Group 1

Aim: To compare surgical parameters and visual outcomes of coaxial microincision cataract surgery (MICS) with standard phacoemulsification. Methods: A prospective randomized study was conducted on 60 eyes of 60 patients with age-related uncomplicated cataract who underwent: standard phacoemulsification surgery (30 eyes) i.e., Group 1, or coaxial MICS (30 eyes) i.e., Group 2. Intraoperative parameters were mean effective phacoemulsification power (EPP), effective phacoemulsification time (EPT), and total volume of balanced salt solution (BSS) used. Best-corrected visual acuity (BCVA) and surgically induced astigmatism (SIA) were evaluated pre- and postoperatively. Results: Mean BCVA at 6 weeks was 0.04 ± 0.07 in Group 1 and 0.05 ± 0.08 in Group 2. No significant difference was observed in SIA between the two groups. Mean EPT was 29.80 ± 3.67 seconds in Group 1 and 31.93 ± 4.08 seconds in Group 2. The mean total EPP in Group 1 was 35.77 ± 5.17%, whereas it was 33.70 ± 3.05% in Group 2. There was a significant statistical difference between mean EPP and EPT in the two groups. Mean total BSS volume used in Group 1 was 128.83 ± 19.81 ml, whereas it was 139.33 ± 13.57 ml in Group 2. Conclusion: Although EPT and BSS volume used were significantly higher in coaxial MICS, the postoperative results of the two techniques were comparable.

scholarly journals Renal access in PNL under sonographic guidance: Do we really need to insert an open end ureteral catheter in dilated renal systems? A prospective randomized study

2017 ◽  
Vol 89 (3) ◽  
pp. 226
Author(s):  
Bilal Eryildirim ◽  
Murat Tuncer ◽  
Emre Camur ◽  
Fatih Ustun ◽  
Fatih Tarhan ◽  
...  
Keyword(s):  
Randomized Study ◽  
Total Duration ◽  
Renal Stones ◽  
Complication Rates ◽  
Nephrostomy Tube ◽  
Ureteral Catheter ◽  
Sonographic Guidance ◽  
Hospitalization Period ◽  
Significant Difference ◽  
Group 2

Purpose: To evaluate the true necessity of open end ureteral catheter insertion in patients with moderate to severe pelvicalyceal system dilation treated with percutaneous nephrolithotomy (PNL) under sonographic guidance. Patients and methods: 50 cases treated with PNL under sonographic guidance in prone position for solitary obstructing renal stones were evaluated. Patients were randomly divided into two groups; Group 1: Patients in whom a open end ureteral catheter was inserted prior to the procedure; Group 2: Patients receiving no catheter before PNL. In addition to the duration of the procedure as a whole and also all relevant stages as well, radiation exposure time, hospitalization period, mean nephrostomy tube duration, mean drop in Hb levels and all intra and postoperative complications have been evaluated. Results: Mean size of the stones was 308.5 ± 133.2 mm2. Mean total duration of the PNL procedure in cases with open end ureteral catheter was significantly longer than the other cases (p < 0.001). Evaluation of the outcomes of the PNL procedures revealed no statistically significant difference between two groups regarding the stone-free rates (86% vs 84%). Additionally, there was no significant difference with respect to the duration of nephrostomy tube, hospitalization period and secondary procedures needed, complication rates as well as the post-operative Hb drop levels in both groups (p = 0.6830). Conclusions: Our results indicate that the placement of an open end ureteral catheter prior to a PNL procedure performed under sonographic access may not be indicated in selected cases presenting with solitary obstructing renal pelvic and/or calyceal stones.

Efficacy of Phenazone in the Treatment of Acute Migraine Attacks: A Double-Blind, Placebo-Controlled, Randomized Study

Cephalalgia ◽  
2004 ◽  
Vol 24 (10) ◽  
pp. 888-893 ◽  
Author(s):  
H Göbel ◽  
A Heinze ◽  
U Niederberger ◽  
T Witt ◽  
V Zumbroich
Keyword(s):  
Adverse Events ◽  
Randomized Study ◽  
Controlled Study ◽  
Acute Migraine ◽  
Serious Adverse Events ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Number Of Patients ◽  
Significant Difference ◽  
Main Target

In this study we compared the efficacy of 1000 mg phenazone with that of placebo in the treatment of acute migraine attacks in a randomized double-blind, placebo-controlled study of 208 patients. The main target criterion was the number of patients with a pain reduction from severe or moderate to slight or no pain 2 h after taking the pain medication. The percentage of patients satisfying the main target criterion was 48.6% for phenazone and 27.2% ( P < 0.05) for placebo. Freedom from pain after 2 h was reported by 27.6% with phenazone treatment and 13.6% ( P < 0.05) with placebo. Compared with placebo, the phenazone treatment also resulted in a significant improvement in the associated migraine symptoms of nausea, phonophobia and photophobia. Of patients treated with phenazone 11.4%, and 5.8% of those treated with placebo reported adverse events. There was no significant difference between the groups with regard to numbers of patients with adverse events. No serious adverse events occurred. The results show that phenazone at a dosage of 1000 mg is effective and well tolerated in the treatment of acute migraine attacks.

scholarly journals Early Oncological and Functional Outcomes of Prostate Capsule Sparing Cystectomy Compared with Standard Radical Cystectomy

2019 ◽  
Vol 13 (1) ◽  
pp. 37-45 ◽  
Author(s):  
Ahmed Y. Abdelaziz ◽  
Hossam Shaker ◽  
Mohamed Seifelnasr ◽  
Hossam Elfol ◽  
Mohamed Nazim ◽  
...  
Keyword(s):  
Radical Cystectomy ◽  
Randomized Study ◽  
Transitional Cell ◽  
Specific Antigen ◽  
Urinary Continence ◽  
Oncological Outcomes ◽  
Significant Difference ◽  
Group 2 ◽  
Prostate Capsule ◽  
Group 1

Introduction and Objectives: A comparative study of standard radical cystectomy and prostate capsule sparing radical cystectomy regarding functional and oncological outcomes. Materials and Methods: A randomized study of 96 patients with transitional cell carcinoma of the bladder (December 2014 - June 2016) was done. We excluded cases with preoperative T4 staging, lymphadenopathy, prostatic specific antigen > 4 ng/dl, and cases with positive biopsies from the bladder neck, trigone, and/or prostatic urethra. Patients were divided into 2 groups, Group 1: standard radical cystectomy with orthotopic diversion (n = 51), Group 2: prostate capsule sparing cystectomy with orthotopic diversion (n = 45). Preoperative transrectal ultrasound and prostatic biopsies were done in Group 2 to exclude prostate cancer. We compared the urinary continence and erectile function in both groups after 6 months, 1, and 2 years. Results: There was no significant difference between the groups regarding preoperative demographic data, tumor stage, grade, site by cystoscopy, and biopsy. Intraoperative monitoring showed no significant differences regarding blood loss, surgical complications, or operative time (2.5 ± 0.48 vs. 2.4 ± 0.45 h). There was a significantly higher percentage of continence and potency in Group 2 than in Group 1. Sixteen cases (35.6%) in Group 2 but only 4 cases (7.8%) in Group 1 developed large post-voiding residual urine and needed intermittent self-catheterization cleaning (p = 0.001). The tumor recurrence rate was not significantly different between the groups after 2 years (p = 0.3). Conclusion: Prostate capsule sparing cystectomy is a good option in selected cases with better continence and potency and without compromising oncological outcomes after 2 years.

scholarly journals A Comparative Evaluation of Closed and Open Treatment in the Management of Unilateral Displaced Mandibular Subcondylar Fractures: A Prospective Randomized Study

2018 ◽  
Vol 11 (3) ◽  
pp. 205-210 ◽  
Author(s):  
Virendra Singh ◽  
Neeraj Kumar ◽  
Amrish Bhagol ◽  
Neha Jajodia
Keyword(s):  
Treatment Options ◽  
Randomized Study ◽  
Mouth Opening ◽  
Treatment Results ◽  
Treatment Groups ◽  
Advantages And Disadvantages ◽  
Closed Treatment ◽  
Significant Difference ◽  
Open Treatment

The aim of the study is to evaluate closed and open treatment in the management of unilateral displaced mandibular subcondylar fractures. Twenty patients with unilateral subcondylar fractures of the mandible were evaluated with degree of displacement of more than 20 degrees and ramal height shortening of more than 10 mm. They were informed of the need for 6-month follow-up. Patients were thoroughly informed, explaining the possible advantages and disadvantages of the open and closed treatment options. Radiographic parameters included the level of fracture, deviation of fragment, and ramal height shortening. Correct anatomical reduction is achieved by open treatment as compared with closed treatment. Regarding pain, mouth opening, and lateral excursion movement, statistically significant difference was found in both groups ( p < 0.01). In radiographic assessment of ramal height shortening and fracture displacement, statistically significant difference was found ( p < 0.01). And no significant complication is found in both treatment groups. The results of this study favor the open treatment for the management of displaced subcondylar fractures. However, the treatment results are also acceptable for closed group.

scholarly journals Effect of Preoperative Colonic Drainage for Obstructing Colorectal Cancer

2015 ◽  
Vol 100 (5) ◽  
pp. 790-796
Author(s):  
Mitsugu Kochi ◽  
Masashi Fujii ◽  
Ken Hagiwara ◽  
Hidenori Tamegai ◽  
Megumu Watanabe ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Elective Surgery ◽  
Long Term Results ◽  
Morbidity Rate ◽  
Term Survival ◽  
Significant Difference ◽  
Colonic Decompression ◽  
Group 2 ◽  
Nasointestinal Tube

Obstructing colorectal cancer (OCRC) is believed to indicate poorer long-term survival. The purpose of this study was to compare retrospectively perioperative safety and long-term results in patients undergoing surgery for OCRC following preoperative colonic decompression with that in those undergoing elective surgery alone for nonobstructing colorectal cancer (CRC). A total of 656 consecutive CRC patients undergoing colectomy between 2001 and 2011 at our institute were eligible for inclusion in the study. The patients were divided into an OCRC group, which included 104 patients undergoing colectomy with preoperative colonic decompression, and a CRC group, which included 552 patients undergoing colectomy alone. Morbidity, mortality, and prognosis were assessed. In the OCRC group, decompression was performed by nasointestinal tube in 42 patients (40.4%), transanal tube in 15 (14.4%), and colostomy in 47 (45.2%). The mortality rate was 0% in the OCRC group and 0.4% in the CRC group (2 of 552 patients). The morbidity rate was 44.8% in the OCRC group (48 of 104 patients) and 36.6% in the CRC group (202 of 552 patients). The 5-year overall survival rate was 69.5% in the OCRC group and 72.9% in the CRC group [hazard ratio 0.76; 95% confidence interval, 0.35 to 1.16; P = 0.48)]. No statistically significant difference in survival was observed between the 2 groups in stage II, III, or IV, or overall. No difference was observed in safety or survival between advanced OCRC patients undergoing preoperative colonic decompression and advanced non-obstructing CRC patients undergoing surgery alone.

The Effect of a Charcoal-based Powder for Enamel Dental Bleaching

2020 ◽  
Vol 45 (6) ◽  
pp. 618-623 ◽  
Author(s):  
MC Franco ◽  
JLS Uehara ◽  
BM Meroni ◽  
GS Zuttion ◽  
MS Cenci
Keyword(s):  
Surface Roughness ◽  
Randomized Study ◽  
Dental Enamel ◽  
Control Group ◽  
Dental Bleaching ◽  
Significance Level ◽  
Significant Difference ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Clinical Relevance Charcoal based-powders are not effective for dental bleaching. SUMMARY Charcoal-based dentifrices for dental whitening are a novelty in the market. Manufacturers claim that such charcoal-based products have whitening, remineralization, antimicrobial, and antifungal properties of charcoal in such products. However, there is no substantial scientific evidence for these claims. This laboratory randomized study was designed to evaluate the whitening properties of a charcoal-based toothpowder. A total of 45 bovine dental enamel discs were randomly distributed into three groups (n=15): group 1, mechanical brushing with a 1450-ppm F toothpaste (control group); group 2, mechanical brushing with an activated charcoal-based powder; group 3, bleaching per the standard protocol using 10% carbamide peroxide. The surface roughness and color of each specimen were analyzed at baseline and after 14 days of experiment. The surface of one randomly selected specimen from each group was examined using a scanning electron microscope (SEM). The Kruskal-Wallis test was used to compare groups at a significance level of 5%. Only group 3 promoted a statistically significant effect on ΔE compared with groups 1 and 2 (p&lt;0.001 and p=0.003, respectively). No statistically significant difference was found between groups for surface roughness (p&gt;0.05). SEM revealed a more irregular surface in group 1 specimens compared with group 2 and 3 specimens. The charcoal-based powder did not seem to have any bleaching effect.

scholarly journals To describe minimally invasive esophagectomy with a focus on peri-esophageal lacuna anatomy

2020 ◽  
Author(s):  
Nanzheng Chen ◽  
Xiaomei Yang ◽  
Haiqi He ◽  
Guangjian Zhang ◽  
Qifei Wu ◽  
...  
Keyword(s):  
Endotracheal Tube ◽  
Minimally Invasive Esophagectomy ◽  
Left Lung ◽  
Lung Ventilation ◽  
Invasive Esophagectomy ◽  
Double Lumen Endotracheal Tube ◽  
Single Lumen ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

Abstract Background: Lacuna anatomy has been studied widely in various organs to improve the operative approach and surgical procedure. However, there are few studies about the peri-esophageal lacuna (PEL). The aim of this study was to describe minimally invasive esophagectomy (MIE) with a focus on PEL anatomy.Methods: From August 2012 to December 2015, patients with esophageal carcinoma underwent MIE by the same group of surgeons at our institution. A double lumen endotracheal tube was used with left lung ventilation without pneumothorax for patients in group 1. A single lumen endotracheal tube was used with two-lung ventilation and right artificial pneumothorax for patients in group 2. The methods that we used for thoracic esophagus mobilization and modularized lymph node dissection, based on the American joint committee on cancer (AJCC) staging manual, in the peri-esophageal space are described. We evaluated the surgical effect, postoperative complications and follow-up results.Results: A total of 147 patients (107 men; mean ± standard deviation age 63.1 ± 7.7 years) were enrolled. Among them, 67 were placed in group 1 and 80 in group 2. There was no significant difference between the two groups in terms of age, gender, tumor location, T stage, N stage or comorbidities. The mean operation duration (283±46 vs 307±69 minutes; p=0.007) and blood loss (129±84 vs 260±225 mL; p=0.000) was less in group 2 than group 1. Group 2 also yielded a larger number of lymph nodes compared with group 1 (22.5 ± 11.1 vs 16.4 ± 7.4; p=0.007). Complication rates were similar between the two groups, with hoarseness developing in a significantly smaller number of patients in group 1 than group 2 (1% vs 21%; p=0.000). There was no significant difference between the two groups in one-year (78.3% vs 84.2%; p=0.345) and three-year (52.1% vs 62.7%; p=0.210) survival rates for group 1 (a double lumen endotracheal tube with left lung ventilation without pneumothorax) versus group 2 (a single lumen endotracheal tube with two-lung ventilation and right artificial pneumothorax).Conclusion: Esophageal mobilization based on PEL and the modularized lymph node dissection based on the AJCC cancer staging manual improves surgical outcomes.

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