Best evidence in anesthetic practice
2
Citation
7
Reference
10
Related Paper
Citation Trend
This study aimed to evaluate the efficacy of i-gel blind intubation (IGI) as a rescue device for definitive airway management in ground intubation for pre-hospital trauma patients.A prospective randomized crossover study was conducted with 18 paramedics to examine intubation performance of two blind intubation techniques through a supraglottic airway devices (IGI and laryngeal mask airway Fastrach), compared with use of a Macintosh laryngoscope (MCL). Each intubation was conducted at two levels of patient positions (ground- and stretcher-level). Primary outcomes were the intubation time and the success rate for intubation.The intubation time (sec) of each intubation technique was not significantly different between the two positions. In both patient positions, the intubation time of IGI was shortest among the three intubation techniques (17.9±5.2 at the ground-level and 16.9±3.8 at the stretcher-level). In the analysis of cumulative success rate and intubation time, IGI was the fastest to reach 100% success among the three intubation techniques regardless of patient position (all P<0.017). The success of intubation was only affected by the intubation technique, and IGI achieved more success than MCL (odds ratio, 3.6; 95% confidence interval, 1.1 to 11.6; P=0.03).The patient position did not affect intubation performance. Additionally, the intubation time with blind intubation through supraglottic airway devices, especially with IGI, was significantly shorter than that with MCL.
Cite
Citations (9)
Stylet
Gold standard (test)
Cite
Citations (36)
In this paper, we compare logistic regression and 2 other classification methods in predicting hypertension given the genotype information. We use logistic regression analysis in the first step to detect significant single-nucleotide polymorphisms (SNPs). In the second step, we use the significant SNPs with logistic regression, support vector machines (SVMs), and a newly developed permanental classification method for prediction purposes. We also detect rare variants and investigate their impact on prediction. Our results show that SVMs and permanental classification both outperform logistic regression, and they are comparable in predicting hypertension status.
Logistic model tree
Cite
Citations (28)
We compared heart rate and blood pressure changes to intubation produced by conventional laryngoscopic-guided intubation to those produced by blind intubation through the intubating laryngeal mask (ILM) in normotensive adults with normal airways. Forty paralysed, anaesthetised adults undergoing elective surgery were randomly assigned to one of two groups: 1. Blind intubation through the ILM using a straight silicone tracheal tube manufactured for specific use with the ILM; 2. Intubation with a size 3 macintosh laryngoscope using a polyvinyl chloride tube. Intubation success rate, number of intubation attempts, time to intubation were recorded. Heart rate and non-invasive blood pressure preinduction, preintubation and at one minute intervals after intubation until ten minutes post intubation were recorded. The intubation success rate was 90%(68% first attempt)for the ILM group and 100%(all first attempt) for the laryngoscopic group. Time to successful intubation was longer (50 vs 22s) and more intubation attempts were required in the ILM group (p<0.0001). Changes from pre-intubation values showed a significantly lower heart rate response in the ILM group at 4 to 10 minutes post intubation (p<0.05). The ILM may have a role in managing the intubation response in patients where an increase in heart rate is associated with an increased risk, such as in patients with ischaemic heart disease.
Elective surgery
Cite
Citations (1)
We tested the hypothesis that haemodynamic changes to intubation and postoperative pharyngolaryngeal morbidity are similar for blind intubating laryngeal mask (ILM)-guided compared with laryngoscope-guided tracheal intubation in adults with normal airways. We also compared intubation success rates and airway complications. One-hundred and fifty paralysed, anaesthetized adult patients undergoing elective surgery were randomly assigned to one of three equal-sized groups: 1. blind intubation via the ILM using a straight, silicone tube; 2. intubation with a Macintosh laryngoscope using a straight silicone tube and 3. intubation with a Macintosh laryngoscope using a polyvinyl chloride tube (controls). A standard sequence of adjusting manoeuvres was followed if intubation was difficult. The number of adjusting manoeuvres and intubation attempts, time to intubation, intubation success rate (first attempt and within 3 min), haemodynamic changes (pre-induction, post-induction, post-intubation), oesophageal intubation, mucosal trauma (blood detected), hypoxia (SpO2 < 95%) and postoperative pharyngolaryngeal morbidity (double-blinded) were documented. Time to successful intubation was longer (57 vs 35 s), and more intubation attempts were required in the ILM group (P < 0.0001). The intubation success rate was 100% (all first attempt) for the laryngoscope groups and 94% (56% first attempt) for the ILM group. There were no significant differences in heart rate or blood pressure among groups. Oesophageal intubation (26 v 0%) and mucosal trauma (19 v 2%) were more common in the ILM group. Hypoxia and postoperative pharyngolaryngeal morbidity were similar among groups. Blind intubation through the ILM offers no advantages over the Macintosh laryngoscope for adult patients requiring intubation for elective surgery with normal airways, but it is a feasible alternative.
Tracheal tube
Rapid sequence induction
Cite
Citations (57)
Cite
Citations (21)
Objectives: To compare Dacryocystorhinostomy ( DCR) with and without intubation and see, their success rate, surgical duration, cost and postoperative complications. Design: Prospective, randomized, hospital based study. Place and duration: D.H.Q Hospital Lakki Marwat from January 2000 to September 2002. Methods: Eighty traditional external DCR procedures with and without intubation were performed. Patients were randomly divided into two groups of 40 cases in each group. Group “A” was labeled as DCR with intubation and Group “B” as DCR without intubation. All the patients were followed for 1 year. Surgical duration, postoperative complications and the success rates were compared. Results: The success rates at one year after surgery was 97.5 % for DCR with intubation and 95 % for DCR without intubation ( not significant). The surgical duration for DCR without intubation was 45 minutes (shorter) and that for DCR with intubation 55 minutes (longer). DCR with intubation was more costly as compared to that without intubation. Conclusions: External DCR without intubation yielded equally good results as DCR with intubation. Both procedures were associated with minimal complications. DCR without intubation costs an extra amount of rupees 1800.
Cite
Citations (14)
We compared heart rate and blood pressure changes to intubation produced by conventional laryngoscopic-guided intubation to those
produced by blind intubation through the intubating laryngeal mask (ILM) in normotensive adults with normal airways. Forty
paralysed, anaesthetised adults undergoing elective surgery were randomly assigned to one of two groups : 1. Blind intubation through
the ILM using a straight silicone tracheal tube manufactured for specific use with the ILM; 2. Intubation with a size 3 macintosh
laryngoscope using a polyvinyl chloride tube. Intubation success rate, number of intubation attempts, time to intubation were recorded.
Heart rate and non-invasive blood pressure preinduction, preintubation and at one minute intervals after intubation until ten minutes
post intubation were recorded. The intubation success rate was 90% (68% first attempt) for the ILM group and 100% (all first attempt) for the laryngoscopic group. Time to successful intubation was longer (50 vs 22s) and more intubation attempts were required in the
ILM group (p<0.0001). Changes from pre-intubation values showed a significantly lower heart rate response in the ILM group at 4 to
10 minutes post intubation (p<0.05). The ILM may have a role in managing the intubation response in patients where an increase in
heart rate is associated with an increased risk, such as in patients with ischaemic heart disease.
Elective surgery
Tracheal tube
Cite
Citations (0)
ve To study the risk factors in the occurrence of cleft lip and palate (CLP). Methods 189 CLP mothers and 60 normal mothers were studied in a case-control study. The investigation included the risk factors which may cause CLP. Nonconditional stepwise logistic model to simple factor and multivariate analysis was used. Results According to simple factor analysis, 8 factors were significantly related with cleft lip with or without palate (CL ± P)and 4 factors related with cleft palate (CP) . In the multiple logistic regression model, only family history, blood type(O), birth season (May -July ) and mother occupation were related with CL ± P and only number of pregnance, birth season (November - January) and occupation related with CP, Conclusion Hereditary and environmental factors may be the risk factors for occurrence of CL ± P, but only environmental factor is the risk factor for occurrence of CP.
Stepwise regression
Cite
Citations (0)
Summary Background Cleft palate anesthesia is challenging due to difficult airway. Left paraglossal intubation moves resting point of laryngoscope laterally but associated with narrower laryngoscopic view and possible trauma, and we invented the use of hard gum shield as a bridge over defective palate to facilitate intubation with possible wider window and defective tissue protection. Methods Eighty bilateral cleft palate children, ASA physical status I – II aged 9 months to 6 years scheduled for plastic surgery had general anesthesia, were involved in prospective, controlled, randomized study, and were randomly divided by closed envelope method into two groups: group I (40 patients): intubated by hard gum shield–aided intubation and group II (40 patients): intubated by left paraglossal intubation. Both techniques compared as regards (i) intubation time; (ii) C ormack and L ehane score; (iii) need for external laryngeal manipulation; (iv) easiness of intubation: easy, modest, or difficult intubation; and (v) complications: desaturation and failed intubation. Results Intubation time was shorter in group I (28.47 ± 3.78 vs. 37.63 ± 6.64 s, P = 0.001). C ormack and L ehane score was better in group I ( P = 0.003). Need for external laryngeal manipulation was less in group I ( P = 0.015). Easiness of intubation was better in group I ( P = 0.022). No difference was found in complications between groups. Conclusion Hard gum shield–aided intubation facilitated intubation more than left paraglossal in bilateral cleft palate children with shorter intubation time, better glottic view, easier intubation, less need for laryngeal manipulation than left paraglossal intubation with no difference in complications.
Elective surgery
Hard palate
Cite
Citations (8)