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929 results on '"Sessler D"'

232. GlideScope.

Author

Abdelmalak, B. B., Bernstein, E., Egan, C., Abdallah, R., You, J., Sessler, D. I., and Doyle, D. J.

Subjects
TRACHEA intubation, INTUBATION, OVERWEIGHT persons, BRONCHOSCOPES, HEMORRHAGE, AIRWAY (Anatomy)
Abstract

We hypothesised that in obese patients, tracheal intubation with the GlideScope would be advantageous compared with flexible fibreoptic intubation. Seventy-five anaesthetised obese patients were randomly assigned to oral intubation by either GlideScope or flexible fibreoptic bronchoscope. We compared the two devices for time to intubate (p = 0.19), difficulty of intubation (p = 0.58), successful intubation on first attempt (p = 0.29), number of attempts (p = 0.24), incidence of hypoxaemia (p = 0.57), amount of post-intubation bleeding (p = 0.79) and sore throat (p = 0.82). None differed significantly. Median (IQR [range]) time to intubation was 37 (25-48 [19-81]) s and 95% of the first attempts were successful with the GlideScope, vs 43 (35-58 [26-96]) s and an 86% first-attempt success rate with the flexible fibreoptic bronchoscope. For experienced users, the time required to intubate the trachea in anaesthetised obese patients is similar with the GlideScope and a flexible bronchoscope. [ABSTRACT FROM AUTHOR]

Published
2011
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233. A comparison of the Airway Scope® and McCoy laryngoscope in patients with simulated restricted neck mobility.

Author

Komatsu, R., Kamata, K., Sessler, D. I., and Ozaki, M.

Subjects
MEDICAL research, AIRWAY (Anatomy), LARYNGOSCOPES, ANESTHESIA, INTUBATION, ESOPHAGEAL perforation
Abstract

We compared the efficacy of the Airway Scope® and McCoy laryngoscope as intubation tools with the neck stabilised by a rigid cervical collar. After induction of anaesthesia and neck stabilisation, 100 patients were randomly assigned to tracheal intubation with an Airway Scope or McCoy laryngoscope. Overall intubation success rate, time required for intubation, number of intubation attempts required for successful intubation, and airway complications related to intubation were recorded. Overall intubation success rates were 100% with both devices and a similar number of intubation attempts were required. However, the mean (SD) time required for successful intubation was shorter with the Airway Scope (30 (7) s) than with the McCoy laryngoscope (40 (14) s; p < 0.0001). The incidences of intubation complications were similar, but oesophageal intubation (in six cases) occurred only with McCoy laryngoscope. [ABSTRACT FROM AUTHOR]

Published
2010
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241. The use of patient-controlled epidural fentanyl in elderly patients.

Author

Ishiyama, T., Iijima, T., Sugawara, T., Shibuya, K., Sato, H., Terada, Y., Ichikawa, M., Sessler, D. I., and Matsukawa, T.

Subjects
POSTOPERATIVE care, ANALGESIA, EPIDURAL analgesia, SURGERY, FENTANYL
Abstract

We studied whether delivering postoperative analgesia, using a patient-controlled epidural analgesia (PCEA) device was effective and safe in elderly patients. We enrolled 40 patients aged > 65 years (elderly group) and 40 patients aged 20–64 years (young group) scheduled for elective major abdominal surgery. PCEA infusion was started following completion of surgery. Mean (SD) fentanyl consumption (10.7 (3.7) compared with 10.5 (2.7) μg.kg−1, p = 0.76) and number of times patients pressed the bolus switch (32 (36) compared with 44 (38), p = 0.16) during the first 24 h postoperatively were similar in the two groups. Pain scores, which were similar in both groups at rest, were significantly lower in the elderly on coughing (at 24 h, p < 0.05). In addition, average pain scores were similar at the time of PCEA bolus demands in the two groups. Elderly and young adult patients therefore required similar amounts of patient-controlled epidural fentanyl to produce satisfactory pain relief. [ABSTRACT FROM AUTHOR]

Published
2007
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242. Selected new antithrombotic agents and neuraxial anaesthesia for major orthopaedic surgery: management strategies.

Author

Rosencher, N., Bonnet, M.-P., and Sessler, D. I.

Subjects
ANTICOAGULANTS, ANESTHESIA, ORTHOPEDIC surgery, PHARMACOKINETICS, CATHETERS, HEMATOLOGIC agents
Abstract

We propose recommendations to reduce the risk of haemorrhagic events associated with regional anaesthesia in patients treated with newer anticoagulants after orthopaedic surgery. The risk/benefit ratio should be individualised for each patient according to the type and dose of anticoagulant, the type of regional anaesthesia and patient risk factors. Neuraxial anaesthetic management strategy can be based on the pharmacokinetic properties of specific anticoagulants, including the time required to reach maximal concentration, half-life, and dose regimen. Central neuraxial blocks should not be performed and epidural catheters should not be removed until at least two half-lives after the last injection of anticoagulant, the half-life depending on renal function. After removing a catheter or after a haemorrhagic puncture, the timing of the next anticoagulant injection should be based on the time required for an anticoagulant dose to reach maximum activity. Vigilance remains paramount during the initial days after removal of a neuraxial catheter. [ABSTRACT FROM AUTHOR]

Published
2007
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