Comparison of Different Ultrasound Parameters for Airway Assessment in Patients Undergoing Surgery under General Anaesthesia

2021 ◽  
Vol 49 (5) ◽  
pp. 394-399
Author(s):  
Saru Singh ◽  
◽  
Ruchi Ohri ◽  
Kulvinder Singh ◽  
Meena Singh ◽  
...  
Keyword(s):  
General Anaesthesia ◽  
Airway Assessment ◽  
Ultrasound Parameters

Comparison of Upper Lip Bite Test and Ratio of Height to Thyromental Distance in Predicting Difficult Tracheal Intubation in South Indian Population – A Descriptive Study

2021 ◽  
Vol 8 (27) ◽  
pp. 2412-2416
Author(s):  
Baseema Thayyil ◽  
Neetha Thattaparambil Chandran ◽  
Asish Karthik ◽  
Maya Gomathy Amma
Keyword(s):  
Tracheal Intubation ◽  
General Anaesthesia ◽  
Difficult Intubation ◽  
Descriptive Study ◽  
Kappa Statistics ◽  
Fisher Exact Test ◽  
South Indian Population ◽  
Upper Lip ◽  
Airway Assessment ◽  
South Indian

BACKGROUND Failure in managing the airway is the most important cause of death in patients undergoing general anaesthesia (GA). For effectively preventing airway catastrophe it is essential to have a meticulous airway assessment pre-operatively. Many methods are in use to predict difficult airway like Mallampati, Wilson’s scoring, percentage of glottic opening (POGO) scoring, Cormack - Lehane classification, thyromental distance, mandibular hyoid distance, atlantooccipital joint extension etc. In this study, we compared between two popular methods of airway assessment, upper lip bite test (ULBT) and height to thyromental distance ratio (RHTMD) to predict the difficulty in tracheal intubation. METHODS This descriptive study was conducted at Government Medical college, Thrissur, over a period of one year , on 76 patients of American society of Anaesthesiologist (ASA) - PS l - lll, requiring general anaesthesia. ULBT and RHTMD were used to assess the patient’s airway. It was correlated with Cormack - Lehane classification during direct laryngoscopy. The data was analysed using Fisher exact test (P < 0.05) and Kappa statistics. RESULTS Out of the 76 patients, 41 (53.9%) were women 35 were men (46.1 %). ULBT predicted 89.6 % [25 + 43] belonging to class 1 and 2 as easy, while 10.5 % [8] of class 3 as difficult. RHTMD predicted 35 patients (46 %) as easy (grade 1) and 41 patients (54 %) as grade 2. Using ULBT, of the 8 patients predicted to have difficult intubation (Class 3), 2 were found practically difficult and 6 were easy. In remaining 68 patients, 23 patients had difficult view and 45 had easy view. According to Cormac and Lehane, among 41 patients who predicted difficult by RHTMD, 19 patients were practically difficult and 22 were easy. Of 35 patients, 6 patients were difficult and 29 were easy. CONCLUSIONS The RHTMD is more sensitive compared to ULBT in predicting difficult intubation. As assessed by Cormack - Lehane classification. KEYWORDS Difficult Intubation, Ratio of Height to Thyromental Distance, Upper Lip Bite Test

Anaesthesia for Caesarean section: General anaesthesia

2020 ◽  
pp. 325-354
Author(s):  
Stephen Morris ◽  
Rhidian Jones
Keyword(s):  
Caesarean Section ◽  
Difficult Airway ◽  
General Anaesthesia ◽  
Current Evidence ◽  
Failed Intubation ◽  
Airway Assessment ◽  
Obstetric Anaesthetist ◽  
Obstetric Surgery

There will always be the need to give GA to pregnant womrn, and it is paramount that the obstetric anaesthetist is well prepared to perform a GA quickly and safely. This chapter reviews the current evidence, drugs, and conduct of GA for CS, with emphasis on exemplary communication within the delivery suite team and meticulous airway assessment to identify features suggestive of additional anticipated difficulty. A helpful ‘pre-induction’ checklist illustrates the need for team-based communication in preparation and planning to mitigate against complications following induction. The latest guidelines from the Obstetric Anaesthetists' Association and Difficult Airway Society on the management of failed intubation and ventilation have been included. The chapter also includes up-to-date information on accidental awareness in obstetric surgery from NAP4, and the steps to avoid and manage aspiration if it occurs.

scholarly journals Huge adult cystic hygroma: anaesthesia challenge

2015 ◽  
Vol 1 (1) ◽  
pp. 52
Author(s):  
Rachana Chabaria
Keyword(s):  
General Anaesthesia ◽  
Orotracheal Intubation ◽  
Cystic Hygroma ◽  
Neck Swelling ◽  
Airway Assessment

Cystic hygroma is a rare lymphatic tumor, uncommonly seen in adults. We report a case of woman aged 55 years, who presented with a huge cystic swelling causing difficulty in neck movements. Huge neck swelling distorting the anatomy poses a challenge for securing the airway. The airway was secured with orotracheal intubation with help of a bougie after general anaesthesia, shifting the swelling off the midline by an experienced anaesthesiologist. Appropriate preoperative airway assessment, meticulous planning anticipating difficulty and simple manoeuvres, can ease intubation.

scholarly journals Noninvasive Ultrasound Stimulation of Ventral Tegmental Area Induces Reanimation from General Anaesthesia in Mice

Research ◽  
2021 ◽  
Vol 2021 ◽  
pp. 1-13
Author(s):  
Tianyuan Bian ◽  
Wen Meng ◽  
Meihong Qiu ◽  
Zhigang Zhong ◽  
Zhengrong Lin ◽  
...  
Keyword(s):  
Ventral Tegmental Area ◽  
General Anaesthesia ◽  
Sham Group ◽  
Maximal Effect ◽  
Ultrasound Stimulation ◽  
Righting Reflex ◽  
Ventral Tegmental ◽  
Ultrasound Parameters ◽  
Deep Brain ◽  
Stimulation Of

Evidence in animals suggests that deep brain stimulation or optogenetics can be used for recovery from disorders of consciousness (DOC). However, these treatments require invasive procedures. This report presents a noninvasive strategy to stimulate central nervous system neurons selectively for recovery from DOC in mice. Through the delivery of ultrasound energy to the ventral tegmental area, mice were aroused from an unconscious, anaesthetized state in this study, and this process was controlled by adjusting the ultrasound parameters. The mice in the sham group under isoflurane-induced, continuous, steady-state general anaesthesia did not regain their righting reflex. On insonation, the emergence time from inhaled isoflurane anaesthesia decreased (sham: 13.63±0.53 min, ultrasound: 1.5±0.19 min, p<0.001). Further, the induction time (sham: 12.0±0.6 min, ultrasound: 17.88±0.64 min, p<0.001) and the concentration for 50% of the maximal effect (EC50) of isoflurane (sham: 0.6%, ultrasound: 0.7%) increased. In addition, ultrasound stimulation reduced the recovery time in mice with traumatic brain injury (sham: 30.38±1.9 min, ultrasound: 7.38±1.02 min, p<0.01). This noninvasive strategy could be used on demand to promote emergence from DOC and may be a potential treatment for such disorders.

Is general anaesthesia for orthodontic extractions in children necessary?

BDJ ◽  
1996 ◽  
Vol 181 (5) ◽  
pp. 165-165
Author(s):  
W A Jack ◽  
J Wad
Keyword(s):  
General Anaesthesia

Kirschner-Ehmer Device Alone to Stabilize Caudal Lumbar Fractures in Small Dogs

1991 ◽  
Vol 4 (04) ◽  
pp. 112-115 ◽  
Author(s):  
Julia Blackmore ◽  
Lesley Phillips
Keyword(s):  
General Anaesthesia ◽  
Broad Spectrum ◽  
Healing Process ◽  
Postoperative Management ◽  
Lumbar Fractures ◽  
Systemic Antibiotics

SummaryA Kirschner-Ehmer device was used to stabilize caudal lumbar fractures/luxations in three dogs weighing 12 kg or less. A through and through Kirschner-Ehmer device maintained alignment during the healing process using the appropriate sized rods and clamps. Postoperative management included strict cage confinement and oral broad spectrum systemic antibiotics for up to two weeks after removal of the Kirschner-Ehmer device. In all three cases, the fractures/luxations were healed within six to eight weeks. The Kirschner-Ehmer device could then be removed with sedation or general anaesthesia.

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