Sternomental distance and view at laryngoscopy were documented in 523 parturients undergoing elective or emergency Caesarean section under general anaesthesia. Eighteen (3.5%) had a grade III or IV laryngoscopic view (Cormack and Lehane's classification) and were classified as potentially difficult tracheal intubations. There was a significant difference between sternomental distance in those patients with a grade III or IV laryngoscopic view compared with those with a grade I or II (13.17 (SD 1.54) cm vs 14.3 (1.49) cm; P = 0.0013). A sternomental distance of 13.5 cm or less with the head fully extended on the neck and the mouth closed provided, using discriminant analysis, the best cut-off point for predicting subsequent difficult laryngoscopy. A sternomental distance of 13.5 cm or less had a sensitivity, specificity, positive and negative predictive values of 66.7%, 71.1%, 7.6% and 98.4%, respectively. While there was no association between sternomental distance and age, weight, height or body mass index (BMI), there was a significant association between grade of laryngoscopy (III and IV) and older (P = 0.049) and heavier (P = 0.0495) mothers. The results suggest that while sternomental distance on its own may not be an adequate sole predictor of subsequent difficult laryngoscopy the measurement should be incorporated into a series of quick and simple preoperative tests.
Cervico-facial cellulitis can cause serious complications including neuro-meningeal infections. Among these neuro-meningeal infections are intracranial empyemas, which are rarer than brain abscesses. We report the case of a young patient of 25 years, immunocompetent, having presented a cerebral empyema secondary to diffuse cervicofacial cellulitis of dental origin. The diagnosis was suspected in the presence of cervicofacial cellulitis, febrile meningeal syndrome and consciousness disorder, confirmation was reported by brain MRI. The evolution was favorable after the recourse to the surgical treatment.
Chondronecrosis is a rare life-threatening complication of endotracheal intubation. This case is a patient with a history of severe brain injury, who developed a cricoid chondronecrosis after prolonged intubation. The complication was suspected when decannulation led to upper airway obstruction and was confirmed by laryngoscopy and computed tomography. We discuss the diagnosis of the condition, the causative factors, treatment through a literature review.
Post-operative sore throat (POST) represents a real discomfort for patients. In short duration surgeries, sore throat complain can replace the post-operative pain. Many studies intended to reduce its incidence using multiples medications.
ObjectiveAssess the efficiency of extra cuff lidocaine jelly 2% associated with intra cuff liquid lidocaine 2% on the post extubation syndrome.
Materials and methodProspective study lead during 3 months in Otorhinolaryngology operating rooms. Inclusion criteria: Every intubation (naso or orotracheal) performed during this period. Exclusion criteria: upper airways surgery, tonsillectomy and patient's refusal. Patients were randomized in 3 groups: First (G1): Control group (inflated cuff with air), Second (G2): liquid lidocaine 2% injected intra cuff, Third (G3): Lidocaine 2% jelly applied on the external surface of the cuff associated with liquid lidocaine intra cuff. Patients were assessed for post-operative sore throat, cough, and hoarseness at 1, 6, and 24 hours after surgery.
ResultsNinety-nine patients were randomized (G1 n=30, G2 n=34, G3 n=35). The association of liquid and jelly lidocaine reduced POST at H1, H6, and H24 after patient's discharge (p respectively at 0.0001; 0.002; 0.003 and 0.004). There was no significant difference in blunting coughing (p=0.053) and post-operative nausea and vomiting (p=0.198)
ConclusionThe association of liquid and jelly lidocaine was efficient in reducing the POST. This result needs to be supported by a larger study including an important number of patients.
Copyright 2018 by Reda H. This is an open-access article distributed under Creative Commons Attribution 4.0 International License (CC BY 4.0), which allows to copy, redistribute, remix, transform, and reproduce in any medium or format, even commercially, provided the original work is properly cited.
IntroductionPost-operative sore throat (POST) represents a real discomfort for patients. In short duration surgeries, sore throat complain can replace the post-operative pain. Many studies intended to reduce its incidence using multiples medications.
ObjectiveAssess the efficiency of extra cuff lidocaine jelly 2% associated with intra cuff liquid lidocaine 2% on the post extubation syndrome.
Materials and methodProspective study lead during 3 months in Otorhinolaryngology operating rooms. Inclusion criteria: Every intubation (naso or orotracheal) performed during this period. Exclusion criteria: upper airways surgery, tonsillectomy and patient's refusal. Patients were randomized in 3 groups: First (G1): Control group (inflated cuff with air), Second (G2): liquid lidocaine 2% injected intra cuff, Third (G3): Lidocaine 2% jelly applied on the external surface of the cuff associated with liquid lidocaine intra cuff. Patients were assessed for post-operative sore throat, cough, and hoarseness at 1, 6, and 24 hours after surgery.
ResultsNinety-nine patients were randomized (G1 n=30, G2 n=34, G3 n=35). The association of liquid and jelly lidocaine reduced POST at H1, H6, and H24 after patient's discharge (p respectively at 0.0001; 0.002; 0.003 and 0.004). There was no significant difference in blunting coughing (p=0.053) and post-operative nausea and vomiting (p=0.198)
ConclusionThe association of liquid and jelly lidocaine was efficient in reducing the POST. This result needs to be supported by a larger study including an important number of patients.
Brief Research ReportBrief Research Report | Volume 3 | Number 1|
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