Replacing a double-lumen tube with a single-lumen tube or a laryngeal mask airway device to reduce coughing at emergence after thoracic surgery: a randomized controlled single-blind trial

Tanoubi, Issam; Sun, Joanna Ng Man; Drolet, Pierre; Fortier, Louis‐Philippe; Donati, François

doi:10.1007/s12630-015-0403-2

Cited by 12 publications

(11 citation statements)

References 22 publications

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“…Furthermore, compared with the results of earlier studies, the time to recovery and time to extubation were decreased for the patients in the treatment group compared to those in the control group ( 15 ). The incidences of throat pain for patients in the treatment group were inferior to those of the control group, which was consistent with previously reported studies ( 16 ). These results may be attributed to the fact that indwelling of SLIPA LMA requires no air inflation and may not produce overcompression to the throat cavity wall ( 4 , 17 ).…”

Section: Discussionsupporting

confidence: 92%

Laryngeal mask airway without muscle relaxant in femoral head replacement in elderly patients

Kong

Tian

2015

Experimental and Therapeutic Medicine

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The number of elderly patients undergoing femoral head replacement surgeries is on the increase. These patients often suffer from comorbidity such as cardiovascular and cerebrovascular complications, which limits the ability of medical teams to employ anesthesia. Thus, alternative methods are required. The aim of this study was to examine the advantage of laryngeal mask airway (LMA) in the absence of muscle relaxant in elderly patients undergoing femoral head replacement operations. Fifty patients (27 males and 23 females) undergoing femoral head replacements were selected for the study between March 2013 and May 2014. The mean value for the age in this group was 74.6±12.5 years. The patients were randomly distributed into two groups of 25. One group was designated as the treatment group and the second group as the control group. For the treatment group, LMA without muscle relaxant was used, and the control group received routine anesthesia. Variations in heart rate (HR), mean arterial pressure (MAP) and oxygen saturation (SPO2) in the two groups were monitored at different times. Clinical efficacy and muscle relaxation effects were also analyzed. For the treatment group, the HR, MAP and SPO2 measurements did not reveal any significant variation while these values in the control group demonstrated important dissimilarities. Time to recovery, time to extubation and incidence of throat pain in the treatment group were all markedly decreased as compared to those in control group. The operation time in the treatment group was not significantly different to that of control group. The satisfaction of the muscle relaxation effect in the treatment group was significantly higher than that in the control group while the incidence of adverse reactions was not considerably different. In conclusion, the use of LMA without using muscle relaxant in femoral head replacement surgeries performed on elderly patients showed to be effective and safe.

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Section: Discussionsupporting

confidence: 92%

Laryngeal mask airway without muscle relaxant in femoral head replacement in elderly patients

Kong

Tian

2015

Experimental and Therapeutic Medicine

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“…The larger areas of contact with the airway are reported to cause more coughing than with a regular ETT. 33 Some of the current guidelines recommend transferring an intubated patient to a single-occupancy negative-pressure room for emergence and extubation. 3 Because of significant logistical difficulties, such as the availability of negative-pressure rooms and the need for nursing staff trained in the management of patients in the immediate perioperative period, this recommendation is reserved for confirmed COVID-19 patients or those requiring postoperative intensive care unit (ICU) or high-dependency (HDU) care.…”

Section: Extubationmentioning

confidence: 99%

“…Intravenous lidocaine, propofol, opioids, or dexmedetomidine may be given to attenuate cough reflex, yet these agents may slow down the emergence and delay extubation and so should be timed appropriately. [33][34][35] One study from Canada described the exchange of a DLT for a supraglottic airway device at the end of surgery. For spontaneously breathing patients, a significant reduction in coughing on emergence and extubation was reported.…”

Section: Extubationmentioning

confidence: 99%

“…For spontaneously breathing patients, a significant reduction in coughing on emergence and extubation was reported. 33 Another method reported to prevent an excessive spillage of secretions on extubation is to cover the head and torso of a patient with a transparent plastic sheet. 36 PPE with airborne protection capabilities should be worn by any staff member in the room at the time of extubation.…”

Section: Extubationmentioning

confidence: 99%

“…The larger areas of contact with the airway are reported to cause more coughing than with a regular ETT. 33 …”

Section: Extubationmentioning

confidence: 99%

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Anesthesia for Patients Undergoing Anesthesia for Elective Thoracic Surgery During the COVID-19 Pandemic: A Consensus Statement From the Israeli Society of Anesthesiologists

Shaylor

Verenkin

Matot

2020

Journal of Cardiothoracic and Vascular Anesthesia

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Anesthesia for thoracic surgery requires specialist intervention to provide adequate operating conditions and one-lung ventilation. The pandemic caused by severe acute respiratory syndromeÀassociated coronavirus 2 (SARS-CoV-2) is transmitted by aerosol and droplet spread. Because of its virulence, there is a risk of transmission to healthcare workers if appropriate preventive measures are not taken. Coronavirus disease 2019 (COVID-19) patients may show no clinical signs at the early stages of the disease or even remain asymptomatic for the whole course of the disease. Despite the lack of symptoms, they may be able to transfer the virus. Unfortunately, during current COVID-19 testing procedures, about 30% of tests are associated with a false-negative result. For these reasons, standard practice is to assume all patients are COVID-19 positive regardless of swab results. Here, the authors present the recommendations produced by the Israeli Society of Anesthesiologists for use in thoracic anesthesia for elective surgery during the COVID-19 pandemic for both the general population and COVID-19Àconfirmed patients. The objective of these recommendations is to make changes to some routine techniques in thoracic anesthesia to augment patients' and the medical staff's safety.

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The case for a 3rd generation supraglottic airway device facilitating direct vision placement

Zundert

Kumar

Zundert

et al. 2020

J Clin Monit Comput

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Although 1st and 2nd generation supraglottic airway devices (SADs) have many desirable features, they are nevertheless inserted in a similar 'blind' way as their 1st generation predecessors. Clinicians mostly still rely entirely on subjective indirect assessments to estimate correct placement which supposedly ensures a tight seal. Malpositioning and potential airway compromise occurs in more than half of placements. Vision-guided insertion can improve placement. In this article we propose the development of a 3rd generation supraglottic airway device, equipped with cameras and fiberoptic illumination, to visualise insertion of the device, enable immediate manoeuvres to optimise SAD position, verify whether correct 1st and 2nd seals are achieved and check whether size selected is appropriate. We do not provide technical details of such a '3rd generation' device, but rather present a theoretical analysis of its desirable properties, which are essential to overcome the remaining limitations of current 1st and 2nd generation devices. We also recommend that this further milestone improvement, i.e. ability to place the SAD accurately under direct vision, be eligible for the moniker '3rd generation'. Blind insertion of SADs should become the exception and we anticipate, as in other domains such as central venous cannulation and nerve block insertions, vision-guided placement becoming the gold standard.

show abstract

Replacing a double-lumen tube with a single-lumen tube or a laryngeal mask airway device to reduce coughing at emergence after thoracic surgery: a randomized controlled single-blind trial

Cited by 12 publications

References 22 publications

Laryngeal mask airway without muscle relaxant in femoral head replacement in elderly patients

Laryngeal mask airway without muscle relaxant in femoral head replacement in elderly patients

Anesthesia for Patients Undergoing Anesthesia for Elective Thoracic Surgery During the COVID-19 Pandemic: A Consensus Statement From the Israeli Society of Anesthesiologists

The case for a 3rd generation supraglottic airway device facilitating direct vision placement

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