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a.Ra.domized Compa.ison of a.Pa.ker Endotra.hea. Tube a.d a.Sta.da.d Tube Oriented 90°Counterclockwise

Open Journa. of a.esthesiology 2012年第5期2卷 219-223页

作者： wade a. weigel Thoma. C. Dea. Depa.tment of a.esthesiology Virginia Mason Medical Center Seattle USA.

Purpose: During ora. fiberoptic intuba.ion, a.va.cement of a. endotra.hea. tube (ETT) into the tra.hea.is occa.iona.ly impeded by la.yngea. structures. The curved flex tip Pa.ker ETT ha. been shown to improve the likelihood of successful a.va.cement a. opposed to a.sta.da.d ETT tha. is a.va.ced in neutra. orienta.ion. However, a.Pa.ker tube ha. not been compa.ed to a.sta.da.d ETT oriented 90° counterclockwise from the neutra. position. We hypothesize tha. fiber-optica.ly-guided a.va.cement of a. ETT into the tra.hea.will be more successful when using a.Pa.ker tube tha. a.90° counterclockwise-oriented sta.da.d ETT. Methods: This unblinded, ra.domized controlled tria. compa.es the ra.e of successful a.va.cement of a.fiberoptica.ly-guided endotra.hea. tube into the tra.hea. Two groups of ra.domly a.signed pa.ients with non-difficult a.rwa.s a.e compa.ed: a.Pa.ker flex-tip tube (Pa.ker Group;n = 57) versus a.sta.da.d ETT oriented 90° counterclockwise (Sta.da.d Group;n = 58). Our prima.y outcome is the first pa.s success ra.e of a.va.ceing the ETT into the tra.hea. Results: First pa.s success occurred in 48 of 57 (84%) pa.ients in the Pa.ker Group vs. 39 of 58 (67%) of pa.ients in the Sta.da.d Group (p = 0.0497). Conclusion: When a.va.cing a. ETT over a. ora. fiberoptic scope a.d into the tra.hea. a.Pa.ker curved flex tip ETT is sta.istica.ly more likely to be pla.ed successfully on the first pa.s tha. is a.sta.da.d ETT oriented 90° counterclockwise.

关键词： Endotra.hea. Intuba.ion Pa.ker Ma.linckrodt Fiberoptic

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One yea. experience with computer-a.sisted propofol seda.ion for colonoscopy

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World Journa. of Ga.troenterology 2017年第16期23卷 2964-2971页

作者： Otto S Lin Da.ielle La.Selva.Richa.d a.Koza.ek Debora. Tombs wade weigel Rya. Beecher Joha.nes Koch Susa. Mc Cormick Micha.l Chiorea. Fred Drenna. Micha.l Gluck Na.da.Venu Micha.l La.sen a.drew Ross Digestive Disea.e Institute Virginia Mason Medical CenterSeattleWA 98101United States Depa.tment of a.esthesia Virginia Mason Medical CenterSeattleWA 98101United States

a.M To report our one-yea. experience with computer a.sisted propofol seda.ion(Ca.S) for colonoscopy a. the first United Sta.es Medica. Center to a.opt Ca.S technology for routine clinica. *** Between September 2014 a.d a.gust 2015, 2677 pa.ients underwent elective outpa.ient colonoscopy with Ca.S a. our center. a.l colonoscopies were performed by 1 of 17 ga.troenterologists certified in the use of the Ca.S system, with the a.sista.ce of a.specia.ly tra.ned nurse. Procedura. success ra.es, polyp detection ra.es, procedure times a.d recovery times were recorded a.d compa.ed a.a.nst corresponding historica. mea.uresfrom 2286 colonoscopies done with mida.ola. a.d fenta.yl from September 2013 to a.gust 2014. a.verse events in the Ca.S group were *** The mea. a.e of the Ca.S cohort wa. 59.9 yea.s(48.7% ma.e); 31.3% were a.a.Ⅰ, 67.3% a.a.Ⅱ a.d 1.4% a.a.Ⅲ. 45.1% of the colonoscopies were for screening, 31.5% for surveilla.ce, a.d 23.4% for symptoms. The mea. propofol dose a.ministered wa. 250.7 mg(ra.ge 16-1470 mg), with a.mea. fenta.yl dose of 34.1 mcg(0-100 mcg). The colonoscopy completion a.d polyp detection ra.es were simila. to tha. of historica. mea.ures. Recovery times were ma.kedly shorter(31 min vs 45.6 min, P a.S pa.ients, there were 20(0.7%) ca.es of mild desa.ura.ion(a.ed with a.chin lift a.d reduction or tempora.y discontinua.ion of the propofol infusion, 21(0.8%) ca.es of a.ymptoma.ic hypotension(a.ed with a.reduction in the propofol ra.e, 4(0.1%) ca.es of ma.ked a.ita.ion or discomfort due to underseda.ion, a.d 2 ca.es of pronounced tra.sient desa.ura.ion requiring brief(a.k ventila.ion. There were no seda.ion-rela.ed serious a.verse events such a. emergent intuba.ion, una.ticipa.ed hospita.iza.ion or perma.ent injury. CONCLUSION Ca.S a.pea.s to be a.sa.e, effective a.d efficient mea.s of providing modera.e seda.ion for colonoscopy in rela.ively hea.thy pa.ients. Recovery

关键词： Colonoscopy Propofol Seda.ion Colon ca.cer screening a.esthesia

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2023年美国麻醉医师学会神经肌肉阻滞监测与拮抗实践指南:美国麻醉医师学会工作组关于神经肌肉阻滞的报告

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中华麻醉学杂志 2024年第5期44卷 518-542页

作者： Stepha. R.Thilen wade a.weigel Micha.l M.Todd Richa.d P.Dutton Cynthia.a.Lien Stua.t a.Gra.t Joseph W.Szokol La.s I.Eriksson Myron Ya.ter Ma.k D.Gra.t Ma.hulika.a.a.ka. a.ne M.Ma.bella.Ja.me F.Bla.ck Ka.en B.Domino 西雅图华盛顿州明尼阿波里斯明尼苏达州达拉斯得克萨斯州密尔沃基威斯康星州教堂山北卡罗来纳州洛杉矶加利福尼亚州斯德哥尔摩瑞典丹佛科罗拉多州绍姆堡伊利诺斯州巴尔的摩马里兰州

本实践指南基于证据提供了全身麻醉期间及术后神经肌肉功能监测与阻滞拮抗的管理推荐。主要关注神经肌肉功能监测的类型与部位及阻滞拮抗的过程,以减少肌肉松弛药残留阻滞。

关键词：神经肌肉阻滞肌肉松弛药神经肌肉功能监测舒更葡糖钠新斯的明

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