Objective: Cuffs inflated to inappropriately high pressures cause ischemia, reducing tracheal mucosal blood flow, while cuffs inflated at lower pressure than necessary give rise to inadequate ventilation, aspiration of gastric contents, or extubation due to air leakage. In this study, we aimed to investigate the effect of the experience of anaesthesia staff on endotracheal tube and laryngeal mask airway cuff inflation.
Methods:The study included 348 elective patients scheduled to undergo surgery under general anaesthesia, with 34 anaesthesia technicians, 16 anaesthesia residents, and 12 anaesthesiologists with different years of professional experience. The participants were told to inflate the cuff balloon with air to the level of the pressure that was appropriate for them. No information was provided to the participants about the values of the cuff pressure pending the completion of all measurements. After placement of the laryngeal mask airway and endotracheal tube, the success of the procedure was checked by monitoring square-wave capnograph tracing and thoracoabdominal motion. Each participant performed the procedures on three patients, and the mean cuff pressures were measured.
Results:There was no significant correlation between duration of experience of technicians, residents, and experts in using laryngeal mask airway pressure (r=-0.192/p=0.278, r=0.225/p=0.402, r=-0.476/p=0.118, respectively) and endotracheal tube (r=-0.306/ p=0.079, r=-0.060/p=0.826, r=-0.478/0.116, respectively).
Conclusion:It has been concluded that professional experience does not contribute to achieving normal cuff pressure without monitoring. Introduction of the cuff manometer into routine anaesthesia practice will be useful, irrespective of anaesthesiologists' experience.
We concluded that 2 mg kg(-1) esmolol infusion before extubation can prevent hypertension and tachycardia caused by extubation in patients undergoing elective craniotomy.
As there was no significant difference in oropharyngeal leak pressure and fibreoptic view, we concluded that the I-gel device may be used safely in both the supine and lateral positions.
Breast cancer is the most prevalent malignant tumor among women in the world, accounting for almost 30% of all cancers in the female sex, with nearly 1.7 million new cases diagnosed in 2012. Breast cancer is the most common malignancy in United States, accounting for more than 40.000 female deaths each year (1, 2). Mammography is the gold standard to detect breast cancer at an early stage and, when followed up with appropriate diagnosis and treatment, reduces mortality from breast cancer (3). However, meta-analysis of studies has revealed contradicting results (4). Screening decisions should take into account an individual woman's risks of breast cancer and her values and preferences, weighing the potential benefits and harms of screening (5). The characteristics of each country is important to identify the initial screening time and frequency. The majority of breast cancers in the United States are diagnosed as a result of an abnormal screening study, although a significant number cases are first brought to attention by a patient (6). In Turkey, breast cancer awareness programs conducted by the Ministry of Health has been ongoing for almost 30 years and screening mammography for women 40-69 years of age, every two years, is recommended (7, 8). However, screening programs are far from perfect.
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