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Purpose Education in airway management is a fundamental component of anesthesiology training programs. There has been a shift towards the use of simulation models of higher fidelity for education in airway management. The goal of this study was to create a novel cadaveric model of a simulated parapharyngeal abscess with features of a difficult airway such as distorted anatomy and narrow airway passages presenting as stridor. The model was further assessed for its suitability for enhanced experiential learning in the management of difficult airways. Methods Cadaver heads were modified surgically to simulate parapharyngeal abscess. Airtight torso of the cadaver was connected to an Oxylog ventilator to simulate respiratory movements—the opening and closing of air channels with breaths in a patient with parapharyngeal abscess. Advanced airway workshop facilitators conducted directed one-to-one learning, and provided feedback to participants. A paper-based feedback was obtained from 72 participants on their confidence level, and the realism, attractiveness, beneficial, and difficulty levels of the simulated cadaveric models. Results The modified cadavers were reliable in simulating difficult airways. The majority of participants (91%) reported an increase in confidence level for management of the difficult airway after the experience with the modified cadavers and found the models realistic (93%), attractive (92%), beneficial (93%), and difficult (85%). Conclusions Surgical modifications of cadavers to simulate difficult airways such as parapharyngeal abscess with edema and stridor can be incorporated into advanced airway management courses to enhance experiential learning in airway management by awake fibreoptic intubation, and promote patient safety. Supplementary Information The online version contains supplementary material available at 10.1007/s00540-021-02904-0.

The bilateral use of bispectral index (BIS) monitoring in a 68-year-old male who underwent right carotid endarterectomy (CEA) under general anesthesia (GA) is described. During three episodes of right internal carotid artery cross-clamping intraoperatively, the right BIS value rose relative to the left within 1 min of clamping, followed by a return to baseline within 1–2 min of clamp release. Since unilateral BIS values can decrease or increase in response to cross-clamping, a significant difference in left and right BIS values may provide a simple and easily available method to detect cerebral hypoperfusion during CEA under GA.

The paper addresses the assessment of the steam-side oxidation behavior of alloy TP347H tubes in supercritical boilers.The high temperature heating surface of supercritical boiler can easily form the oxide scale on the inside surfaces of steam tubes after a period of operation. When accumulated to a certain amount, the oxide scale would exfoliate. It could influence the actuating medium flowing and heat transferring, cause overheating or even the explosion of heating surface. The oxide scale sampled on heat-absorbing surface of alloy TP347H tubes was examined. The oxide exfoliation sampled was studied experimentally by energy dispersive spectrometer and the X-ray diffractometer. The constituent elements and structural features of oxide scale in TP347H tubes were emphatically analyzed. The mechanism of steam-side oxidation and scale exfoliation in the TP347H tubes, as well as its influence factor, were described. It is found that the temperature is one of the most important influences. The measures that controlled the oxide exfoliation on a large scale were brought forward so as to provide a scientific guidance for reducing the oxide scale formation and avoiding tube bursting for over-temperature.

In recent years, the use of magnetic resonance imaging (MRI) has extended into the operating theatre, especially in the field of neurosurgery. By providing real-time images during surgery, intra-operative MRI (iMRI) facilitates safer and more complete brain tumour resection. However, the iMRI environment poses additional challenges to the anaesthetist when managing intra-operative cardiovascular events. Through three case examples, this article will discuss the issues of cardiovascular resuscitation, cardiac pacing and cardiovascular monitoring in the iMRI environment.