Airway management in the patients who receive transmaxillary approach for resection of giant pituitary tumor presents a clinical challenge to the anesthesiologists. Oral or nasal route for tracheal intubation can inte...Airway management in the patients who receive transmaxillary approach for resection of giant pituitary tumor presents a clinical challenge to the anesthesiologists. Oral or nasal route for tracheal intubation can interfere with surgical procedures. This report describes submental tracheal intubation for airway management in a patient who underwent resection of recurrent giant pituitary tumor via transmaxillary approach. Submental tracheal intubation is an adaptable and safe alternative technology for airway management during operation.展开更多
Objective：To describe the use of the GlideScope in comparison with direct laryngoscopy for elective surgical patients requiring tracheal intubation. Methods：Two hundred patients, ASA Ⅰ - Ⅱ scheduled for elective s...Objective：To describe the use of the GlideScope in comparison with direct laryngoscopy for elective surgical patients requiring tracheal intubation. Methods：Two hundred patients, ASA Ⅰ - Ⅱ scheduled for elective surgery under general anesthesia requiring orotracheal intubation were selected. Information was collected identifying the patient demographics and airway assessment features （Mallampati oropharyngeal scale, thyromenta distance and mouth opening）. In a random crossover design, after induction of anesthesia and neuromuscular block, the laryngoscopes were inserted in turn, and the views of the glottis at laryngoscopy （Cormack and Lehane scores） were compared. The tracchea was intubated using either the standard Macintosh laryngoscope or GlideScope after the second grading at laryngoscopy was done. Complications associated with intubating were recorded. Results： There were 200 patients including 107 males and 93 females, with mean age being 52±13 years, height 164.8±11.3 cm, weight 64.0±11. 5 kg, thyromental distance 6. 9± 1.1 cm, and mouth opening 5.7±0.5 cm. There was a significant association between the preoperative view of the oropharynx （Mallampati score） and the view of the glottis at laryngoscopy for both the direct Macintosh laryngoscope （P〈0. 001） and the GlideScope （P〈0. 001）. Among 200 patients, 106 patients had the same C＆L grade, 91 of remaining patients showed improvement in the C＆L grade （P〈0. 001 ） obtained with GlideScope compared with the direct Macintosh laryngoscope. 3 of remaining patients showed better view of the glottis（C＆L grade） with the direct Macintosh laryngoscope （grade 1） than with GlideScope （grade 2）. There were no cases of failure to be intubated. There were no cases of dental or mucosal injury in all patients. Conclusion： GlideScope videolaryngoscope yielded comparable or superior laryngeal view compared with Macintosh laryngoscope. The new type of laryngoscope may have potential advantages for managing the difficult airway.展开更多
Objective: In this study, we evaluated the effect of preemptive analgesia of flurbiprofen axetil (FA) and tramadol on immune response in patients undergoing radical mastectomy. Methods: In this prospective randomized,...Objective: In this study, we evaluated the effect of preemptive analgesia of flurbiprofen axetil (FA) and tramadol on immune response in patients undergoing radical mastectomy. Methods: In this prospective randomized, double-blind, placebo-controlled study, 80 patients were randomly assigned to one of four groups (n = 20). The FA group (group A) patients received FA before tracheal intubation and at the end of surgery. The tramadol group (group B) patients received tramadol before tracheal intubation and at the end of surgery. The control group (group C) patients received saline before tracheal intubation and at the end of surgery. The combination group (group D) patients received FA and tramadol before tracheal intubation and at the end of surgery. Cluster of differentiation and lymphocytes were measured. Results: The CD3, CD4, CD8 and lymphocytes decreased postoperatively of all groups except of group A and D at 0.5 h postoperatively (P < 0.05). The CD3, CD4, CD8 and lymphocytes of group D were higher than those of group C at 0.5 h and 4 h postoperatively (P < 0.05). Conclusion: Preemptive analgesia using flurbiprofen axetil (FA) and tramadol may protect the immune system. The immune protective effect of FA may be better than that of tramadol. The combination of FA and tramadol may be the most effective among all the strategies.展开更多
文摘Airway management in the patients who receive transmaxillary approach for resection of giant pituitary tumor presents a clinical challenge to the anesthesiologists. Oral or nasal route for tracheal intubation can interfere with surgical procedures. This report describes submental tracheal intubation for airway management in a patient who underwent resection of recurrent giant pituitary tumor via transmaxillary approach. Submental tracheal intubation is an adaptable and safe alternative technology for airway management during operation.
文摘Objective：To describe the use of the GlideScope in comparison with direct laryngoscopy for elective surgical patients requiring tracheal intubation. Methods：Two hundred patients, ASA Ⅰ - Ⅱ scheduled for elective surgery under general anesthesia requiring orotracheal intubation were selected. Information was collected identifying the patient demographics and airway assessment features （Mallampati oropharyngeal scale, thyromenta distance and mouth opening）. In a random crossover design, after induction of anesthesia and neuromuscular block, the laryngoscopes were inserted in turn, and the views of the glottis at laryngoscopy （Cormack and Lehane scores） were compared. The tracchea was intubated using either the standard Macintosh laryngoscope or GlideScope after the second grading at laryngoscopy was done. Complications associated with intubating were recorded. Results： There were 200 patients including 107 males and 93 females, with mean age being 52±13 years, height 164.8±11.3 cm, weight 64.0±11. 5 kg, thyromental distance 6. 9± 1.1 cm, and mouth opening 5.7±0.5 cm. There was a significant association between the preoperative view of the oropharynx （Mallampati score） and the view of the glottis at laryngoscopy for both the direct Macintosh laryngoscope （P〈0. 001） and the GlideScope （P〈0. 001）. Among 200 patients, 106 patients had the same C＆L grade, 91 of remaining patients showed improvement in the C＆L grade （P〈0. 001 ） obtained with GlideScope compared with the direct Macintosh laryngoscope. 3 of remaining patients showed better view of the glottis（C＆L grade） with the direct Macintosh laryngoscope （grade 1） than with GlideScope （grade 2）. There were no cases of failure to be intubated. There were no cases of dental or mucosal injury in all patients. Conclusion： GlideScope videolaryngoscope yielded comparable or superior laryngeal view compared with Macintosh laryngoscope. The new type of laryngoscope may have potential advantages for managing the difficult airway.
文摘Objective: In this study, we evaluated the effect of preemptive analgesia of flurbiprofen axetil (FA) and tramadol on immune response in patients undergoing radical mastectomy. Methods: In this prospective randomized, double-blind, placebo-controlled study, 80 patients were randomly assigned to one of four groups (n = 20). The FA group (group A) patients received FA before tracheal intubation and at the end of surgery. The tramadol group (group B) patients received tramadol before tracheal intubation and at the end of surgery. The control group (group C) patients received saline before tracheal intubation and at the end of surgery. The combination group (group D) patients received FA and tramadol before tracheal intubation and at the end of surgery. Cluster of differentiation and lymphocytes were measured. Results: The CD3, CD4, CD8 and lymphocytes decreased postoperatively of all groups except of group A and D at 0.5 h postoperatively (P < 0.05). The CD3, CD4, CD8 and lymphocytes of group D were higher than those of group C at 0.5 h and 4 h postoperatively (P < 0.05). Conclusion: Preemptive analgesia using flurbiprofen axetil (FA) and tramadol may protect the immune system. The immune protective effect of FA may be better than that of tramadol. The combination of FA and tramadol may be the most effective among all the strategies.
