scholarly journals Is Duration of Endotracheal Tube Intubation Using a Video Laryngoscope Different with a Direct Laryngoscope in Elective Surgery Patients During Pandemic Covid-19?

2021 ◽  
Vol 2 (1) ◽  
pp. 103-114
Author(s):  
Zaky Hasan ◽  
Zulkifli ◽  
Agustina Br Haloho ◽  
Irfannuddin
Keyword(s):  
Experimental Study ◽  
Endotracheal Tube ◽  
Sore Throat ◽  
Primary Outcome ◽  
Elective Surgery ◽  
Video Laryngoscope ◽  
Secondary Outcome ◽  
Direct Laryngoscope ◽  
Quasi Experimental ◽  
Post Intubation

Introduction: Aerosol box is a usefull tools to prevent aerosol and droplet contaminations during laryngoscopy and intubation in COVID-19 pandemic. Video laryngoscope is recommended during this era to increase the operator and patient’s distance during the procedure. However, many anesthesiologists still use direct laryngoscopes due to their availability and familiarity. This study aims to compare endotracheal tube intubation with video laryngoscope compared to direct laryngoscope in elective surgery patients. Methods: This study was a quasi-experimental study. The sample size in each group (video and direct laryngoscope) was 35 subjects. The primary outcome of this study was to compare the duration of intubation between video laryngoscope and direct laryngoscope, while the secondary outcome was to evaluate complications such as broken teeth and sore throat 24 hours post intubation. Results: Direct laryngoscope had shorter intubation duration than video laryngoscope [12.3 (8.9-21.0) vs 13.3 (11.4 – 21.6; p =0.07) respectively. Two complication reported on video laryngoscope groups. Conclusion: Duration of ETT intubation using a direct laryngoscope was shorter during intubation with aerosol box compared to video laryngoscope in elective surgery patients. The box which was being used may limit the space of movement making it difficult to intubate.

scholarly journals First attempt success of video versus direct laryngoscopy for endotracheal intubation by ambulance nurses: a prospective observational study

2020 ◽  
Vol 46 (5) ◽  
pp. 1039-1045 ◽  
Author(s):  
Wim Breeman ◽  
Mark G. Van Vledder ◽  
Michael H. J. Verhofstad ◽  
Albert Visser ◽  
Esther M. M. Van Lieshout
Keyword(s):  
Success Rate ◽  
Endotracheal Intubation ◽  
Direct Laryngoscopy ◽  
Prospective Observational Study ◽  
Primary Outcome ◽  
Spontaneous Circulation ◽  
Video Laryngoscope ◽  
Video Laryngoscopy ◽  
Direct Laryngoscope ◽  
Positive Effect

Abstract Purpose The aim of this study was to compare the rate of first attempt success of endotracheal intubation performed by ambulance nurses in patients with a Glasgow Coma Scale (GCS)  of 3 using video laryngoscopy versus direct laryngoscopy. Methods A prospective cohort study was conducted in a single, independent ambulance service. Twenty of a total of 65 nurse-staffed ambulances were equipped with a video laryngoscope; a classic direct laryngoscope (Macintosh) was available on all 65 ambulances. The primary outcome was first attempt success of the intubation. Secondary outcomes were overall success, time needed for intubation, adverse events, technical or environmental issues encountered, and return of spontaneous circulation (ROSC). Ambulance nurses were asked if the intubation device had affected the outcome of the intubation. Results The first attempt success rate in the video laryngoscopy group [53 of 93 attempts (57%)] did not differ from that in the direct laryngoscopy group [61 of 126 (48%); p = 0.221]. However, the second attempt success rate was higher in the video laryngoscopy group [77/93 (83%) versus 80/126 (63%), p = 0.002]. The median time needed for the intubation (53 versus 56 s) was similar in both groups. Ambulance nurses more often expected a positive effect when performing endotracheal intubation with a video laryngoscope (n = 72, 81%) compared with a direct laryngoscope (n = 49, 52%; p < 0.001). Conclusion Although no significant effect on the first attempt success was found, video laryngoscopy did increase the overall success rate. Ambulance nurses had a more positive valuation of the video laryngoscope with respect to success chances.

scholarly journals Tablet Hisap Dan Relaksasi Nafas Dalam Untuk Mengurangi Nyeri Tenggorok Pada Pasien Post Operasi Dengan General Anesthesia (GA)

2020 ◽  
Vol 7 (2) ◽  
pp. 409-414
Author(s):  
Arip Susianto ◽  
Hikmi Muharromah Pratiwi ◽  
Evi Komala Simamora
Keyword(s):  
Visual Analogue Scale ◽  
General Anesthesia ◽  
Endotracheal Tube ◽  
Sore Throat ◽  
Analogue Scale ◽  
Intervention Group ◽  
Control Group ◽  
Deep Breath ◽  
Vas Score ◽  
Quasi Experimental

Latar belakang: Standar prosedur penanganan pada pasien paska bedah di RSUP Dr Kariadi belum cukup efektif untuk mengurangi nyeri tenggorok paska operasi dengan pamasangan endotrakeal tube pada General Anesthesia (GA). Penggunaan tablet hisap terbukti mampu menurunkan nyeri tenggorok, akan tetapi bukti penelitian masih terbatas. Penelitian ini untuk menguji keefektivitasan pemberian tablet hisap dan relaksasi napas dalam untuk mengurangi derajat nyeri tenggorok paska operasi. Metode: Penelitian dilakukan dengan desain quasi experimental pre-posttest pada 11 Juli – 30 Oktober 2019. Subyek penelitian berjumlah 60 pasien paska operasi dengan general anesthesia yang dikelompokan menjadi 30 kelompok intervensi dan 30 kelompok kontrol. Nyeri tenggorok paska operasi diukur dengan menggunakan Visual Analogue Scale (VAS) pada 6 jam paska operasi dan dievaluasi tiap 12 jam selama 48 jam. Hasil: Perbedaan rerata skor VAS antara kelompok kontrol dan kelompok intervensi secara signifikan terjadi pada penilaian nyeri 36 jam paska operasi (t = -3,70, p = 0,002) dan 48 jam paska operasi ( t = -4,28, p = 0,000). Skor VAS pada kelompok intervensi lebih rendah secara signifikan dibandingan dengan skor VAS pada kelompok kontrol. Simpulan: Pemberian tablet hisap dan relaksasi napas dalam secara signifikan menurunkan tingkat nyeri tenggorak paska operasi. Pemberian tablet hisap dapat dijadikan sebagai intervensi alternatif untuk penangangan pasien dengan komplikasi nyeri tenggorok paska operasi. Key words: Nyeri tenggorok, Endotracheal Tube, Tablet hisap, Relaksasi napas dalam, Visual Analogue Scale (VAS)   Background: The standard procedures of post operative patients at RSUP Dr Kariadi Semarang was ineffective to reduce post operative sore throat with Endotracheal Tube insertion in General Anesthesia. Lozenges was proven may reduce sore throat while the evidences were still limited. Methods: The research design was quasi experimental pre-post test on 11 july - 30 october 2019. The study subjects were 60 post operative patients with General Anesthesia grouped into 30 intervention grups and 30 control groups. Post operative sore throat was measured using Visual Analogue Scale (VAS) at 6 hours after surgery then evaluated every 12 hours for 48 hours. Results: Mean difference VAS score between intervention group and control group significantly in the assessment of pain 36 hours (t = -3,70, p = 0,002) and 48 hours ( t = -4,28, p = 0,000) post operatively. VAS score in intervention group was significantly lower than VAS score in control group. Conclusion: Lozenges and deep breath relaxation reduce significantly post operative sore throat. Lozenges could be used as an alternative intervention to treat patients with post operative sore throat. Keywords: Sore Throat, Endotracheal Tube, Lozenges, Deep Breath Relaxation, Visual Analogue Scale.

scholarly journals Effect of mHealth tool on knowledge regarding reproductive health of school going adolescent girls: a before-after quasi-experimental study

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e036656
Author(s):  
Tanima Ahmed
Keyword(s):  
Experimental Study ◽  
Reproductive Health ◽  
Adolescent Girls ◽  
Knowledge Score ◽  
Secondary Outcome ◽  
Message Service ◽  
Before And After ◽  
Sms Intervention ◽  
Quasi Experimental ◽  
Linear Slope

ObjectiveThis study was executed to (1) assess the effect of mHealth (mobile health) tool on knowledge regarding reproductive health (RH) of adolescent girls and (2) determine the utilisation of mHealth tool among school girls.DesignBefore-after type of quasi-experimental study.SettingDhaka North City Corporation in Bangladesh.Participants400 adolescent girls aged 14–19 years were selected based on defined criteria.InterventionsShort message service (SMS) intervention on RH was delivered through a mobile phone.Primary and secondary outcome measures8 schools out of 61 were randomly selected in the study area. A total of 400 girls were selected randomly on permission from those schools and parents. SMS interventions were delivered for 8 weeks. The data were collected using a self-administered questionnaire before and after SMS intervention to evaluate the effect. The number of responses to weekly SMS determined mHealth usage or practice.ResultsPostintervention knowledge score (mean 70.8%±9.7%) on RH was significantly higher (paired t=69.721, p<0.001) than preintervention knowledge score (mean 44.71%±9.13%) with a large effect size (cohen’s d=3.6). The knowledge score on RH was (p<0.001) correlated (+0.636) with SMS response. Multiple linear regression indicated that increase response to one SMS intervention there was an increase of knowledge score by 2.661% (linear slope 2.66, at 95% CI, p<0.001) after controlling the confounder. The mean knowledge score in all five knowledge segments of RH increased significantly (p<0.001) after SMS intervention.ConclusionThe result indicated that the SMS tool of the mHealth approach is an easy and effective way to improve RH knowledge for adolescent girls. SMS intervention was well accepted by the girls. Thereby this mHealth tool can be chosen to provide health information for a mass approach.

scholarly journals A Meta-Analysis on the Effect of Dexamethasone on the Sugammadex Reversal of Rocuronium-Induced Neuromuscular Block

2020 ◽  
Vol 9 (4) ◽  
pp. 1240
Author(s):  
Chang-Hoon Koo ◽  
Jin-Young Hwang ◽  
Seong-Won Min ◽  
Jung-Hee Ryu
Keyword(s):  
General Anesthesia ◽  
Neuromuscular Blockade ◽  
Primary Outcome ◽  
Elective Surgery ◽  
Neuromuscular Block ◽  
Meta Analysis ◽  
Secondary Outcome ◽  
Continuous Variables ◽  
Train Of Four ◽  
The Mean

Sugammadex reverses the rocuronium-induced neuromuscular block by trapping the cyclopentanoperhydrophenanthrene ring of rocuronium. Dexamethasone shares the same steroidal structure with rocuronium. The purpose of this study was to evaluate the influence of dexamethasone on neuromuscular reversal of sugammadex after general anesthesia. Electronic databases were searched to identify all trials investigating the effect of dexamethasone on neuromuscular reversal of sugammadex after general anesthesia. The primary outcome was time for neuromuscular reversal, defined as the time to reach a Train-of-Four (TOF) ratio of 0.9 after sugammadex administration. The secondary outcome was the time to extubation after sugammadex administration. The mean difference (MD) and 95% CI were used for these continuous variables. Six trials were identified; a total of 329 patients were included. The analyses indicated that dexamethasone did not influence the time for neuromuscular reversal of sugammadex (MD −3.28, 95% CI −36.56 to 29.99, p = 0.847) and time to extubation (MD 25.99, 95% CI −4.32 to 56.31, p = 0.093) after general anesthesia. The results indicate that dexamethasone did not influence the neuromuscular reversal of sugammadex in patients after general anesthesia. Therefore, the dexamethasone does not appear to interfere with reversal of neuromuscular blockade with sugammadex in patients undergoing general anesthesia for elective surgery.

scholarly journals Re-intubation frequency in paediatric surgical patients: a randomised controlled trial

2020 ◽  
pp. 230-234
Author(s):  
AMA Elshazly ◽  
EAA Motlb ◽  
NAA Ghaffar
Keyword(s):  
Endotracheal Tube ◽  
Elective Surgery ◽  
Controlled Trial ◽  
Group Versus ◽  
Secondary Outcome ◽  
Outer Diameter ◽  
Transverse Diameter ◽  
Blinded Study ◽  
Randomised Controlled ◽  
Surgical Operations

Background: Paediatric tracheal intubation represents a challenge to many anaesthesiologists and requires considerable expertise. We assessed re-intubation frequency and the time needed for intubation in children undergoing elective surgical operations. Methods: A prospective randomised single blinded study was conducted in Mansoura University Children’s Hospital, Egypt from April 2016 till April 2017. We enrolled 50 children scheduled for elective surgery not exceeding 90 minutes with general anaesthesia using an uncuffed endotracheal tube. They were randomly allocated into one of two groups (age-based group versus ultrasoundbased group). Primary outcome variables were re-intubation frequency and the time taken for intubation. Secondary outcome variables were optimum tube selection and complications after extubation. Results: In the ultrasound-based group, the frequency of re-intubation frequency was decreased due to an endotracheal tube which was too large (p = 0.047). The optimum tube selection was higher (p = 0.034) and the time taken for intubation was longer (p = 0.004). A significant correlation was found between the outer diameter of the endotracheal tube and the transverse diameter of the subglottic airway (r = 0.988, p < 0.001). No significant differences were detected between groups regarding complications after extubation (p > 0.05). Conclusion: Ultrasonography was superior to the use of an age-based formula in reducing re-intubation frequency but intubation was slower.

scholarly journals Homeopathic Arnica for Prevention of Pain and Bruising: Randomized Placebo-Controlled Trial in Hand Surgery

2003 ◽  
Vol 96 (2) ◽  
pp. 60-65 ◽  
Author(s):  
C Stevinson ◽  
V S Devaraj ◽  
A Fountain-Barber ◽  
S Hawkins ◽  
E Ernst
Keyword(s):  
Outcome Measures ◽  
Primary Outcome ◽  
Elective Surgery ◽  
Short Form ◽  
Controlled Trial ◽  
Hand Surgery ◽  
Secondary Outcome ◽  
Mcgill Pain Questionnaire ◽  
Double Blind ◽  
Analgesic Medication

Homeopathic arnica is widely believed to control bruising, reduce swelling and promote recovery after local trauma; many patients therefore take it perioperatively. To determine whether this treatment has any effect, we conducted a double-blind, placebo-controlled, randomized trial with three parallel arms. 64 adults undergoing elective surgery for carpal tunnel syndrome were randomized to take three tablets daily of homeopathic arnica 30C or 6C or placebo for seven days before surgery and fourteen days after surgery. Primary outcome measures were pain (short form McGill Pain Questionnaire) and bruising (colour separation analysis) at four days after surgery. Secondary outcome measures were swelling (wrist circumference) and use of analgesic medication (patient diary). 62 patients could be included in the intention-to-treat analysis. There were no group differences on the primary outcome measures of pain ( P=0.79) and bruising ( P=0.45) at day four. Swelling and use of analgesic medication also did not differ between arnica and placebo groups. Adverse events were reported by 2 patients in the arnica 6C group, 3 in the placebo group and 4 in the arnica 30C group. The results of this trial do not suggest that homeopathic arnica has an advantage over placebo in reducing postoperative pain, bruising and swelling in patients undergoing elective hand surgery.

scholarly journals Comparison of endotracheal tube cuff inflation techniques by stethoscope and “just seal” method in patients undergoing surgeries under general anesthesia

2019 ◽  
Vol 5 (1) ◽  
pp. 16-21
Author(s):  
Mona Rajbhandari ◽  
Nagendra Bahadur KC ◽  
Bhuban Raj Kunwar ◽  
Bindu Laxmi Shah
Keyword(s):  
General Anesthesia ◽  
Endotracheal Tube ◽  
Sore Throat ◽  
Elective Surgery ◽  
Cuff Pressure ◽  
Thyroid Cartilage ◽  
Cuff Inflation ◽  
Endotracheal Tube Cuff ◽  
Tube Cuff ◽  
Tracheal Cuff

Background: Overinflation of the endotracheal tube cuff affects tracheal mucosa blood supply that causes postoperative complications like cough, sore throat and hoarseness. There is no standard cuff inflation technique that produces appropriate cuff pressure. The aim of this study was to find out better technique of cuff inflation that will produce adequate pressure with limited complication using stethoscope guided and “just seal”. Methods: This was prospective, randomized single blinded study of 100 American Society of Anesthesiologists Physical Status (ASA PS) I and II patients of 18-65 years undergoing elective surgery under general anesthesia requiring endotracheal intubation. Group J (n=50) received ‘just seal’ method of tracheal cuff inflation where air was introduced into cuff until audible leak at mouth disappeared and Group S (n=50) received stethoscope-guided tracheal cuff inflation where air was introduced into cuff until harsh breath sound changed to soft while listening with stethoscope bell over the thyroid cartilage. Volume of air in endotracheal tube cuff, cuff pressure following inflation and post-operative sore throat, hoarseness and cough at 24 hour were assessed. Results: Demographic details, mean volume of air in cuff, mean cuff pressure and incidence of postoperative adverse effects like sore throat, hoarseness and cough at 24 hours between the groups were comparable. Conclusion: Both the stethoscope guided and “just seal” cuff inflation techniques were equally effective in producing adequate cuff pressure of 20-30 cmH2O with limited complication.

scholarly journals Registration and publication of emergency and elective randomised controlled trials in surgery: a cohort study from trial registries

BMJ Open ◽  
2018 ◽  
Vol 8 (7) ◽  
pp. e021700 ◽  
Author(s):  
Rachael L Morley ◽  
Matthew J Edmondson ◽  
Ceri Rowlands ◽  
Jane M Blazeby ◽  
Robert J Hinchliffe
Keyword(s):  
Outcome Measures ◽  
Emergency Surgery ◽  
Randomised Controlled Trials ◽  
Primary Outcome ◽  
Elective Surgery ◽  
Secondary Outcome ◽  
Controlled Trials ◽  
Surgical Trials ◽  
Surgical Interventions ◽  
Randomised Controlled

ObjectivesEmergency surgical practice constitutes 50% of the workload for surgeons, but there is a lack of high quality randomised controlled trials (RCTs) in emergency surgery. This study aims to establish the differences between the registration, completion and publication of emergency and elective surgical trials.DesignThe clinicaltrials.gov and ISRCTN.com trials registry databases were searched for RCTs between 12 July 2010 and 12 July 2012 using the keyword ‘surgery’. Publications were systematically searched for in Pubmed, MEDLINE and EMBASE.ParticipantsResults with no surgical interventions were excluded. The remaining results were manually categorised into ‘emergency’ or ‘elective’ and ‘surgical’ or ‘adjunct’ by two reviewers.Primary outcome measuresNumber of RCTs registered in emergency versus elective surgery.Secondary outcome measuresNumber of RCTs published in emergency versus elective surgery; reasons why trials remain unpublished; funding, sponsorship and impact of published articles; number of adjunct trials registered in emergency and elective surgery.Results2700 randomised trials were registered. 1173 trials were on a surgical population and of these, 414 trials were studying surgery. Only 9.4% (39/414) of surgical trials were in emergency surgery. The proportion of trials successfully published did not significantly differ between emergency and elective surgery (0.46 vs 0.52; mean difference (MD) −0.06, 95% CI −0.24 to 0.12). Unpublished emergency surgical trials were statistically equally likely to be terminated early compared with elective trials (0.33 vs 0.16; MD −0.18, 95% CI −0.06 to 0.41). Low accrual accounted for a similar majority in both groups (0.43 vs 0.46; MD −0.04, 95% CI −0.48 to 0.41). Unpublished trials in both groups were statistically equally likely to still be planning publication (0.52 vs 0.71; MD −0.18, 95% CI −0.43 to 0.07).ConclusionFewer RCTs are registered in emergency than elective surgery. Once trials are registered both groups are equally likely to be published.

scholarly journals Effectiveness of an intervention to optimise the use of mirabegron for overactive bladder: a quasi-experimental study in primary care

2018 ◽  
Vol 68 (677) ◽  
pp. e852-e859
Author(s):  
Eladio Fernández-Liz ◽  
Pere Vivó Tristante ◽  
Antonio Aranzana Martínez ◽  
Maria Estrella Barceló Colomer ◽  
Josep Ossó Rebull ◽  
...  
Keyword(s):  
Experimental Study ◽  
Overactive Bladder ◽  
Primary Outcome ◽  
Intervention Group ◽  
Discontinuation Of Treatment ◽  
Quasi Experimental ◽  
Structured Intervention ◽  
New Treatments ◽  
Lower Urinary

BackgroundOveractive bladder is a composite of lower urinary tract storage symptoms. Pharmacological treatment is widely employed despite markedly modest efficacy data, adverse effects, and costs for the health system.AimTo determine the 12-month efficacy of an intervention delivered by GPs on mirabegron revision and, if appropriate, discontinuation of treatment.Design and settingMulticentre, quasi-experimental study in Barcelona (Catalonia), Spain.MethodTwo groups composed of 17 intervention and 34 control practices were formed. The follow-up period was 12 months, from 1 January to 31 December 2017. A structured intervention was designed consisting of initiatives with GPs and urology/gynaecology specialists. The primary outcome was mirabegron use at 12 months.ResultsOf the 1932 patients, a significant discontinuation in treatment was observed at 12 months’ follow-up in the intervention group (IG) (n = 433 out of 762, 56.8%), in contrast with the control one (CG) (n = 484 out of 1170, 41.4%) (P<0.001). There was also a reduced incorporation of new treatments in the IG (n = 214 out of 762, 28.1%) compared with the CG (n = 595 out of 1170, 50.9%) (P<0.001). In relation to patients with treatment at the beginning and end of the period, there was a decrease of 219 (28.7%) patients in the IG and an increase of 111 (9.5%) in the CG (P<0.001).ConclusionThe structured intervention showed optimisation in the use of mirabegron. When considering discontinuation it is necessary to provide clear data on the benefits and/or risks for patients and their caregivers, as such information is a precondition for shared decision making.

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