If mechanical ventilation fails, ECMO should be considered.

Ketamine has bronchodilation properties. The aim of the single-centre, evaluator-blinded, randomised clinical trial study was to evaluate whether continuous infusion of ketamine is associated with improvement in respiratory mechanics correlated with bronchospasm relief, as compared with continuous infusion of fentanyl.

Adult patients submitted to invasive mechanical ventilation were included if they had an acute severe bronchospasm, due to status asthmaticus or COPD exacerbation. They were randomised to ketamine or a standard IV analgesia with fentanyl, both in bolus and continuous infusion. Measurements of respiratory mechanics (airway resistance – R_smax, dynamic compliance – C_dyn and intrinsic PEEP – PEEPi) both at baseline and 3 and 24 h after randomisation were performed. The main outcome of this study was to evaluate the improvement of R_smax in 3 h of continuous infusion of the study drugs.

Ketamine use was not associated with greater reduction in R_smax when compared with fentanyl, either after 3 h (0 cm H₂O L-1 s-1 ± 6 vs. -3 cm H₂O L-1 s-1 ± 7.7, respectively; P = 0.16) or after 24 h (-3 cm H₂O L-1 s-1 ± 17 vs. -3.5 cm H₂O L-1 s-1 ± 13.7, respectively; P = 0.73). Patients randomized to the ketamine group did not have better improvements in delta PEEPi as compared with fentanyl in 3 h (P = 0.77) or in 24 h (P = 0.72).

In this study, ketamine use was not associated with improvement in ventilatory variables associated with bronchospasm.

In this study, ketamine use was not associated with improvement in ventilatory variables associated with bronchospasm.

Preoperative airway assessment plays a key role in the context of difficult airway management. Several scores have been proposed to predict difficult intubation including the el-Ganzouri index (EL.GA). Anatomical parameters such as the opening of the mouth or the circumference of the neck (which currently is not usually evaluated) are used to predict difficult intubation. The nutritional status of super-morbid obesity (body mass index [BMI] > 50 kg m-2) is a recognised risk factor for difficult intubation.

This is a single-centre, retrospective, observational study whose aim is to validate an additional parameter (anatomical plus nutritional) to the El.GA index, hence the choice of the acronym for the definition of the study EL.GA+, in predictivity of airway management; multiple logistic regression analysis was performed to determine the predictive role of BMI, neck circumference and opening of the mouth of intubation difficulty measured with the gold standard.

In total, 240 patients who had an elective surgical procedure under general anaesthesia, requiring endotracheal intubation, were examined. The predictive value of the EL.GA score was confirmed by the values of sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) according to the data reported in the literature. Furthermore, based on the values of the PPV and NPV (0.69 and 0.60 respectively), neck circumference of 42.5 cm can be taken as a cut-off value for which EL.GA+ becomes predictive of difficult intubation in patients with mild obesity (BMI of 30 to 35).

The EL.GA+ score greatly increases the prediction of difficult laryngoscopy in mildly obese patients.

The EL.GA+ score greatly increases the prediction of difficult laryngoscopy in mildly obese patients.

Although postoperative early airway complications are rarely observed, when they do develop, fatal results such as brain damage and cardiac arrest may occur. The Royal College of Anaesthetists and Difficult Airway Society investigated airway complications developing during anaesthesia over a period of 12 months within the context of the Fourth National Audit Project (NAP4) study. Inspired by that multicentre research project, this study aims to identify early airway complications that can develop in relation to anaesthesia induction in our hospital.

After our proposed study received approval from the Ethical Council, adult patients undergoing general anaesthesia at our operating theatres within the period of January-July 2018 were included in it. Demographic data, ventilation, American Society of Anesthesiologists (ASA) grade, Cormack-Lehane scores, tools that are used in airway management, and complications were recorded.

Out of 909 patients in total, 752 were intubated; a laryngeal mask was placed on 157 of these patients. The complication rate was 5%, and the 3 most frequently observed complications were desaturation, bronchospasm and pharyngeal injuries. In the group having complications, the body mass index value, Cormack-Lehane, Mallampati, and ventilation scores were significantly higher than those with no complications.

During routine general anaesthesia induction at our clinic, major or minor airway complications have developed with a frequency of 5%, and it was determined that desaturation was the most frequent reversible cause.

During routine general anaesthesia induction at our clinic, major or minor airway complications have developed with a frequency of 5%, and it was determined that desaturation was the most frequent reversible cause.

Shivering is a common complication of neuraxial anaesthesia. We compared the efficacy of tramadol, clonidine and pregabalin in preventing post-spinal anaes-thesia shivering in hysteroscopic procedures.

A prospective, randomized, triple-blind, controlled clinical trial involving 120 ASA I-II women, aged 18-60 years. The patients were randomly allocated to receive either oral clonidine 0.2 mg (group C), tramadol 100 mg (group T), pregabalin 150 mg (group P) or <i><i><i>placebo</i></i></i> (group O) 90 minutes before spinal anaesthesia. The body tempe-rature was monitored at the forehead and tympanic membrane. The primary outcome was the occurrence of perioperative shivering. selleck compound The secondary outcomes were the side effects and meperidine requirements to treat shivering.

All groups had comparable demographic data. Group C showed the lowest incidence, severity and number of intraoperative and postoperative shivering attacks. The time to the first shivering attack was significantly longer in group C than the other groups and in group T than groups P and O.