A broken laryngoscope

Is the pain of intravenous catheter insertion associated with hemodynamic changes?

“…All the parts were accounted for, and a postoperative chest x-ray showed no foreign bodies. Similar breakages have been reported before [1][2][3][4][5][6] but either age or chemical sterilization, or improperly made blade were implicated. Our blades are sterilized only with steam and are not old.…”

“…However, bacteriostatic normal saline containing benzyl alcohol as a preservative (NS-BA) may be as effective as lidocaine and cause less pain on injection. [1][2][3] We electively studied 60 adult patients. Patients randomly received, in a double-blind fashion, either NS-BA or lidocaine 1% via a 25g needle, or no drug, before inserting an 18g iv catheter.…”

“…1 L'analyse bispectrale (BIS) est une valeur dérivée de l'EEG et semble un outil fiable pour prédire le niveau de sédation, la perte de conscience 2 ou la profondeur de l'anesthésie. 3 Nous décrivons le cas d'un patient de 64 ans, sans antécédent, proposé pour une chirurgie réglée d'une névralgie faciale invalidante par la technique de Gardner. L'anesthésie générale a été réalisée par l'association propofol (concentration cible: 3 µg•mL -1 ), rémifentanil (0.25 µg•kg -1 •min -1 ).…”

Unexpected laryngoscope failure

“…3 Metal fatigue from chronic use can result in sudden and unexpected breakage. [3][4][5] The Welch Allyn laryngoscope handle and Macintosh #3 blade ( Figure) were checked prior to the induction of anesthesia for the first patient of the day. It functioned normally during the first intubation.…”

“…3 Not only should the electrical integrity of the laryngoscope be checked but routine stress testing of the blade and handle as well as a careful visual inspection of older laryngoscope handles and blades are necessary. 1,5 During a rapid sequence induction, neglecting these precautions could be disastrous. Both a back up laryngoscope handle and blade should always be immediately available.…”