{"title":"Predictors of paediatric difficult intubation according to the experience of a university hospital in a low- and middle-income country: A prospective observational study.","authors":"Anouar Jarraya, Manel Kammoun, Hind Ketata, Hasna Bouchaira, Saloua Ammar, Riadh Mhiri","doi":"10.1177/17504589241264404","DOIUrl":"10.1177/17504589241264404","url":null,"abstract":"<p><strong>Background: </strong>Difficult airway management is one of the main challenges in paediatric anaesthesia, particularly in low- and middle-income countries.</p><p><strong>Aims: </strong>The aim of this study was to investigate the main predictors of difficult paediatric intubation.</p><p><strong>Methods: </strong>In this observational study, we included all children aged less than five years undergoing intra-abdominal surgery with endotracheal intubation. Patients were divided into two groups according to the incidence of difficult intubation. Then, we investigated predictors for difficult paediatric intubation.</p><p><strong>Results: </strong>We included 217 children, and difficult intubation was observed in 10% of them. Predictors were as follows: Mallampati III-IV class (adjusted odds ratio = 2.21; 95% confidence interval = 1.1-6.4), limited mouth opening (adjusted odds ratio = 2.4; 95% confidence interval = 1.8-3.5), facial dysmorphia (adjusted odds ratio = 2.6; 95% confidence interval = 1.32-7.4) and anaesthesia without muscle relaxant (adjusted odds ratio = 1.8; 95% confidence interval = 1.0-5.1) or without opioids during crash inductions (adjusted odds ratio = 1.7; 95% confidence interval = 1.01-4.8).</p><p><strong>Conclusion: </strong>Facial dysmorphia and limited mouth opening were predictors of difficult intubation in children. Furthermore, it seems that Mallampati class and anaesthesia technique may also predict challenging intubation, which may guide us to change our perioperative practice.</p>","PeriodicalId":35481,"journal":{"name":"Journal of perioperative practice","volume":" ","pages":"136-142"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141907836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"It's all about the visuals.","authors":"Jasper Joseph Carag Ballecer","doi":"10.1177/17504589251318505","DOIUrl":"https://doi.org/10.1177/17504589251318505","url":null,"abstract":"","PeriodicalId":35481,"journal":{"name":"Journal of perioperative practice","volume":"35 4","pages":"95"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A critical appraisal of perioperative sleep apnoea management after nasal surgery: A review of up-to-date literature supplemented by findings of a retrospective observational study.","authors":"Anne Duvekot, Markus Klimek, Frank R Datema","doi":"10.1177/17504589231215941","DOIUrl":"10.1177/17504589231215941","url":null,"abstract":"<p><strong>Objective: </strong>To review the current recommendations on postoperative precautions for obstructive sleep apnoea patients undergoing elective nasal surgery.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Department of Otorhinolaryngology and Anesthesiology/Intensive Care, University Teaching Hospital, Rotterdam, the Netherlands.</p><p><strong>Participants: </strong>The medical charts of 61 patients with sleep apnoea who were admitted to the post-anaesthesia care unit between 2016 and 2020, following nasal surgery were reviewed.</p><p><strong>Main outcome measures: </strong>Number of respiratory events during post-anaesthesia care unit admission that required medical intervention.</p><p><strong>Results: </strong>In all 61 patients, continuous positive airway pressure could not be used. In 13 patients (8%), decreased oxygen saturation levels were registered during the first postoperative night, and in five of these patients, supplemental oxygen was needed. No other respiratory incidents of medical interventions were registered.</p><p><strong>Conclusions: </strong>The number of clinically relevant respiratory events of obstructive sleep apnoea patients with bilateral nasal packing following nasal surgery is low. We suggest that the safety of less expensive and less scarce alternatives of postoperative observation should be explored.</p>","PeriodicalId":35481,"journal":{"name":"Journal of perioperative practice","volume":" ","pages":"96-101"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139418235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The effect of oral clonidine and intravenous dexmedetomidine administration on the quality of functional endoscopic sinus surgery.","authors":"Shahram Samadi, Zahra Ghahremaniyeh, Shima Khanahmadi, Somayeh Ghavipanjeh Rezaiy, Shalaleh Bagheri, Ajay Prakash Pasupulla, Shayan Khalilollah, Marius Fassbinder, Behzad Kazemi Haki, Shahriar Khanahmadi, Saghar Mohtashami","doi":"10.1177/17504589241268620","DOIUrl":"10.1177/17504589241268620","url":null,"abstract":"<p><strong>Background: </strong>Clonidine and dexmedetomidine are alpha-2 receptor blockers administered for haemorrhage control during surgery in limited settings. Functional endoscopic sinus surgery (FESS) may be associated with bleeding, thus making it challenging. This study aims to evaluate the effect of dexmedetomidine and clonidine on haemorrhage control during FESS and surgical outcomes.</p><p><strong>Methods: </strong>This three-blinded prospective study included 102 patients who underwent FESS at the Imam Khomeini public referral hospital at the Imam Khomeini public referral hospital, in Urmia, Iran. It was either American Society of Anaesthesiologists (ASA) class I or II. They were divided into three groups (clonidine, dexmedetomidine, and placebo). The volume of blood loss, mean arterial pressure, surgical field visualisation, and surgeon satisfaction were assessed in the three groups. Data analysis was performed using SPSS version 23.0.</p><p><strong>Results: </strong>Dexmedetomidine and clonidine decreased mean arterial pressure, heart rate, and blood loss volume while improving surgical field visualisation. The effect of dexmedetomidine was associated significantly statistically with surgeon satisfaction (p < 0.0001). Furthermore, dexmedetomidine improved the surgical field and reduced operating times in the dexmedetomidine group (p < 0.0001).</p><p><strong>Conclusion: </strong>The present clinical trial findings indicated that the administration of dexmedetomidine during FESS decreased mean arterial pressure, provided balanced anaesthesia and appropriate analgesia, and improved the visibility of the surgical field and increased surgeon satisfaction.</p>","PeriodicalId":35481,"journal":{"name":"Journal of perioperative practice","volume":" ","pages":"129-135"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Brendon K Warner, C Cooper Munhall, Shaun A Nguyen, Rodney J Schlosser, George J Guldan, Ted A Meyer
{"title":"Dexmedetomidine and surgical field visibility in nasal surgery: A systematic review and meta-analysis.","authors":"Brendon K Warner, C Cooper Munhall, Shaun A Nguyen, Rodney J Schlosser, George J Guldan, Ted A Meyer","doi":"10.1177/17504589241252107","DOIUrl":"10.1177/17504589241252107","url":null,"abstract":"<p><strong>Introduction: </strong>Nasal and sinus surgery, especially using endoscopy, relies upon adequate haemostasis to be safe and effective. Often other haemostatic methods, such as cautery are not viable, and other methods must be employed. This study examines the effectiveness of dexmedetomidine in controlled hypotension and for surgical field visibility in endoscopic sinus surgery and other nasal surgeries.</p><p><strong>Review methods: </strong>A literature search was conducted in PubMed, Scopus, CINAHL and Central for randomised controlled trials using dexmedetomidine for controlled hypotension in adult patients undergoing endoscopic sinus surgery or other nasal surgery. Meta-analysis of mean differences and single means were performed.</p><p><strong>Results: </strong>Of 935 identified studies, 31 met the inclusion criteria. A statistically significant difference in Fromme-Boezaart surgical field visibility scores was found comparing dexmedetomidine to placebo (p < 0.00001) and propofol (p < 0.0001), but not other agents. A significant difference in intraoperative blood loss volume was found compared with placebo (51.5mL, p < 0.00001) and propofol (13.6mL, p < 0.0001), but not other agents.</p><p><strong>Conclusion: </strong>Dexmedetomidine demonstrated significantly improved surgical field visibility and blood loss volume compared with placebo and propofol, but not other agents. Dexmedetomidine is viable and useful for controlled hypotension in nasal surgery. Choice of controlled hypotension agent should follow patient and procedure-specific considerations.</p>","PeriodicalId":35481,"journal":{"name":"Journal of perioperative practice","volume":" ","pages":"112-126"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141238332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Postoperative lingual nerve injury following airway management: A literature review.","authors":"Mohamed Aly, Rohan Dadak, Cheng Lin, Kamal Kumar","doi":"10.1177/17504589241270238","DOIUrl":"10.1177/17504589241270238","url":null,"abstract":"<p><p>Postoperative lingual nerve injury is a rare but serious complication following airway management and can lead to significant discomfort and disability. This literature review explores the aetiology, clinical presentation, management strategies and potential preventive measures for lingual nerve injuries associated with airway management during surgery. A search of PubMed, MEDLINE, EMBASE Science Direct, Cochrane library and Web of Science databases was done since inception to January 2024, including any observational studies and clinical trials describing patients diagnosed with lingual nerve injury following airway instrumentation. Multiple risk factors for lingual nerve injury were identified. Anaesthesia factors include difficulty with intubation and use of laryngeal mask airway. Surgical factors are long duration of operation and surgery of the head and neck. Patient factor includes female sex. Anaesthetists should proactively inform patients about the potential for this nerve injury and control modifiable risk factors to mitigate the risk of injury.</p>","PeriodicalId":35481,"journal":{"name":"Journal of perioperative practice","volume":" ","pages":"143-152"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ravi Patel, Radhika Acharya, Saumil Shah, Chaitya Desai, Dimit Raveshia, Harrypal Panesar, Neil Patel, Greg Mcconaghie, David Charles Cain, Dilen Parmar, Robin Banerjee, Rohit Singh
{"title":"Five historical innovations that have shaped modern otolaryngological surgery.","authors":"Ravi Patel, Radhika Acharya, Saumil Shah, Chaitya Desai, Dimit Raveshia, Harrypal Panesar, Neil Patel, Greg Mcconaghie, David Charles Cain, Dilen Parmar, Robin Banerjee, Rohit Singh","doi":"10.1177/17504589241244996","DOIUrl":"10.1177/17504589241244996","url":null,"abstract":"<p><p>Throughout history, many innovations have contributed to the development of modern otolaryngological surgery, improving patient outcomes and expanding the range of treatment options available to patients. This article explores five key historical innovations that have shaped modern otolaryngological surgery: Operative Microscope, Hopkins Rigid Endoscope, Laryngeal Nerve monitoring, Cochlear implants and Laser surgery. The selection of innovations for inclusion in this article was meticulously determined through expert consensus and an extensive literature review. We will review the development, impact and significance of each innovation, highlighting their contributions to the field of otolaryngological surgery and their ongoing relevance in contemporary and perioperative practice.</p>","PeriodicalId":35481,"journal":{"name":"Journal of perioperative practice","volume":" ","pages":"102-111"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141198902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Amanda McClanahan, Amanda Hantouli, Leeza Struwe, Kelly Gonzales
{"title":"Capnography in the Post Anaesthesia Care Unit: A quality improvement study.","authors":"Amanda McClanahan, Amanda Hantouli, Leeza Struwe, Kelly Gonzales","doi":"10.1177/17504589251330599","DOIUrl":"https://doi.org/10.1177/17504589251330599","url":null,"abstract":"<p><p>Best practice supports continuous capnography for early detection of impaired respiratory and ventilatory status in postoperative settings. The current standard of care in a United States private hospital's postoperative unit does not include continuous capnography. This quality improvement study used a quantitative descriptive design to (1) compare capnography to the current standard of care for early detection of respiratory and/or ventilatory decline and (2) increase Post Anaesthesia Care Unit (PACU) practitioners' knowledge and confidence about capnography. A total of 92 retrospective electronic health records were analysed, and 15 nurses participated in the study. Results revealed earlier detection of adverse respiratory and ventilatory status, and this monitoring was accurately and safely performed by PACU nurses.</p>","PeriodicalId":35481,"journal":{"name":"Journal of perioperative practice","volume":" ","pages":"17504589251330599"},"PeriodicalIF":1.2,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Catarina Espírito Santo Ferros, Rita Reis Aguiar, Manuela Casal
{"title":"Anaesthetic management of deep brain stimulation in obesity treatment: A case report.","authors":"Catarina Espírito Santo Ferros, Rita Reis Aguiar, Manuela Casal","doi":"10.1177/17504589251328529","DOIUrl":"https://doi.org/10.1177/17504589251328529","url":null,"abstract":"<p><strong>Introduction: </strong>Obesity is a 21st-century epidemic, recognised as an independent risk factor for all-cause mortality, often accompanied by numerous conditions that exacerbate morbidity and mortality. Deep brain stimulation shows promise in reducing body mass index.</p><p><strong>Case report: </strong>We present the successful anaesthetic management of a patient with refractory morbid obesity who was submitted to deep brain stimulation of the nucleus accumbens, the first described in Portugal and the second in Europe.</p><p><strong>Conclusion: </strong>Optimised anaesthetic management is crucial for a successful outcome. Given the limited literature on this issue, case series and further observational studies are needed to support the value of the anaesthetic approach.</p>","PeriodicalId":35481,"journal":{"name":"Journal of perioperative practice","volume":" ","pages":"17504589251328529"},"PeriodicalIF":1.2,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}