Early clinical experience with a new video laryngoscope (SANYAR®) for tracheal intubation in adults: a comparison clinical study

Objective: SANYAR® video laryngoscope (S-VL) is a new video laryngoscope. We conducted a comparative clinical study to assess its ability to provide laryngeal exposure and facilitate endotrachetal intubation (ETI) in adult patients. Methods: This comparison clinical study was conducted on adult patients undergoing elective general anesthesia. The patients were randomly divided into two groups of direct laryngoscopy (DL) or S-VL. The primary outcome was the time required for performing ETI. The glottic view and successful ETI on the first attempt was also compared between the two groups. Results: Full and partial glottic visualization was achieved in 100% of the patients in the S-VL group, while the corresponding figure in the DL group was 90%. Cormack-Lehane III was observed in 5 patients of the DL group, and ETI was successfully carried out with S-VL. The first-pass success rate of ETI was significantly higher in S-VL group compared to the DL group (94% vs. 78%; P = 0.034). The mean times to ETI were 38.32±6.4 and 35.31±8.4 seconds in DL and S-VL groups, respectively (P = 0.650). Conclusions: During ETI for general anesthesia, SANYAR® video laryngoscope compared with direct laryngoscopy improved glottic visualization and first-pass ETI rate

The Efficacy of Intraoperative Ketamine-Haloperidol for Prevention of Catheter-related Bladder Discomfort After Lumbar Spinal Stenosis Surgery

Objectives: Catheterization of urinary bladder during surgery frequently leads to agitation of the patient in the recovery room, especially in those patients who remain catheterized after gaining consciousness. We hypothesized that administration of a combination of ketamine-haloperidol (KH) before urinary catheterization would reduce the incidence of catheter-related bladder discomfort (CRBD) while reducing some adverse effects of ketamine in the postoperative period. Methods: A total of 119 male patients who underwent lumbar spinal stenosis surgery were randomized into three groups. The KH group consisted of 39 patients who received KH just before urinary catheterization. The second arm of the study including 40 patients who received pethidine-haloperidol (PH). The control (C) group consisted of 40 patients who received normal saline as a placebo. We sought to determine the incidence and severity of CRBD at arrival in recovery and one, six, and 24 hours after. Results: The incidence of CRBD upon arrival in the recovery room was 17.9% in the KH group, and 52.5% and 55% in the PH and C groups, respectively. The incidence of CRBD was significantly lower in the KH group at arrival in the recovery room. The severity of CRBD was lower in the KH group at one and six hours of surgery (p < 0.007). There was no significant difference 24 hours after surgery. Conclusions: Intravenous administration of KH before urinary catheterization effectively decreases the incidence and severity of postoperative CRBD while reducing adverse effects attributed to ketamine

A Non-Inferiority Study of the Speed and Success of Nasotracheal Intubation in Maxillofacial Surgeries Using Macintosh Direct Laryngoscope versus Sanyar® Video Laryngoscope

Background: The recently developed blade design of the Sanyar® video laryngoscope yields an exceptionally precise visualization of the larynx, thereby easing the process of tracheal intubation. Objectives: A non-inferiority clinical investigation, to assess the efficacy of the Sanyar® as compared to the Macintosh® direct laryngoscope for nasotracheal intubation in the context of maxillofacial surgeries. Methods: 78 patients for maxillofacial surgery were divided randomly into two groups and intubated through the nose using either the Sanyar® or Macintosh® laryngoscope after anesthesia was induced. The study measured intubation time and secondary objectives included success rate, attempts, and hemodynamic changes in two groups. Results: 40 eligible patients in the Sanyar® and 38 in the Macintosh® group were involved. Of all, 42(53.8%) were men and 36(46.2%) were women. The average age of patients in the Sanyar® and Mackintosh groups was (31.62±13.41) and (30.81±10.89), respectively. 39(98%) of the Sanyar® group and 33(86%) of the Macintosh® group had successful laryngoscopy and intubation, with a P-value<0.034. Sanyar® group had a significantly shorter intubation time than Macintosh® (P-value<0.001). Hemodynamic changes before and after laryngoscopy and intubation had no significant differences between the two groups. Conclusion: The Sanyar® video laryngoscope reduced the time of nasal tracheal intubation in maxillofacial surgery compared to direct laryngoscopy and improved the success rate of the first intubation attempt

The Effect of Mannitol and Hypertonic Sodium Administration on Hemodynamic Parameters Under LiDCO Monitoring in Patients Undergoing Elective Craniotomy

In craniotomy surgery, it is important to maintain hemodynamics and prevent the increase of intracranial pressure. Using semi-invasive methods such as LiDCO monitoring is a good option in this situation. This study aimed to evaluate the effectiveness of mannitol and hypertonic sodium on hemodynamic parameters in patients undergoing elective craniotomy. This randomized clinical trial was done on 40 patients of both genders. Patients whose ages were between 18-65 years, who had American Society of Anesthesiologists (ASA) score I and II, and who underwent craniotomy surgery were eligible for this study. Participants were divided into two groups receiving hypertonic sodium and mannitol. Hemodynamic parameters were evaluated before surgery, 20 minutes, and 60 minutes after surgery in both groups, under Lithium dilution cardiac output (LiDCO) monitoring. The results showed that there was no difference between groups in terms of the average fluid intake, the duration of the operation, the amount of urinary output, and the primary hemodynamic characteristics. Significant differences were recorded in the evaluation of hemodynamic parameters. The results demonstrated a reduction in systolic, diastolic, and mean arterial blood pressure during 20 to 60 minutes after mannitol injection compared to hypertonic sodium injection. Additionally, the effectiveness of both therapies on maintaining cardiac function was similar, but the use of mannitol led to a greater decrease in arterial and peripheral vascular resistance. It can be concluded that mannitol may be more effective than hypertonic sodium during craniotomy procedures in terms of reducing blood pressure monitored with LiDCO

Evaluation of the Role of Hemoperfusion on Mortality and Morbidity in Patients with Severe Coronavirus Disease 2019 (COVID- 19)

Background: Cytokine storm in severe Covid-19 disease is one of the leading causes of death in these patients. Hemoperfusion is a method used to purify the blood from toxins and inflammatory factors. The aim of this study was to evaluate the effect of hemoperfusion on mortality and morbidity in patients with severe Covid - 19 disease. Methods: This was a retrospective study which performed by reviewing the files of 30 patients with severe Covid-19 disease referred to Sina Hospital affiliated to Tehran University of Medical Sciences in 2020. Thirty patients with severe covid-19 disease and positive PCR participated in the study. All patients received routine treatment protocol for covid-19. Hemoperfusion was used for 15 patients in addition to receiving routine care. The remaining 15 patients were included in the control group. Patients in the hemoperfusion group underwent four sessions of hemoperfusion using continuous renal replacement therapy with continuous venovenous hemofiltration. Results: the ICU length of stay in the control and hemoperfusion groups was 3.40 ± 11.40 and 9.65 ± 16.33 days, respectively (P= 0.075). 8 patients died and 7 patients were discharged in the control group, but 11 patients died and 4 patients were discharged in the hemoperfusion group (P= 0.256). The respiratory rate of patients in the control and hemoperfusion groups decreased from 7.43 ± 29.40 to 4.03 ± 24.60 and from 6.11 ± 31.60 to 5.04 ± 24.46, respectively (P < 0.001). The percentage of arterial blood oxygen saturation in the control and hemoperfusion groups increased from 90.86 ± 5.61 to 93.06 30 4.30 and from 92.33 26 3.26 to 92.06 31 5.31, respectively (P= 0.456). Conclusion: Hemoperfusion could not prevent the mortality of patients and finally out of 15 patients, 11 patients died and 4 patients were discharged. Also, no significant difference was observed between the two groups in terms of arterial blood oxygen saturation

Comparative Analysis of Patient Satisfaction and Sedation Outcomes in Bronchoscopy: Fentanyl/Chlorpheniramine vs. Ketamine/Chlorpheniramine

This randomized clinical trial aimed to assess and compare patient satisfaction and sedation outcomes in bronchoscopy procedures using two distinct sedation protocols: fentanyl/chlorpheniramine (FC) and ketamine/chlorpheniramine (KC). Ninety patients undergoing simple bronchoscopy and bronchoalveolar lavage were randomly assigned to receive either FC (1 µg/kg fentanyl and 10 mg chlorpheniramine) or KC (0.5 mg/kg ketamine and 10 mg chlorpheniramine). Lidocaine was also administered during bronchoscopy. Primary outcomes included patient satisfaction scores, while secondary outcomes encompassed sedation levels, bronchoscopist satisfaction, cough rates, lidocaine usage, and physiological parameters. Patients in the FC group exhibited significantly higher satisfaction levels compared to the KC group (P=0.002). Bronchoscopist satisfaction was also superior in the FC group (P=0.001). Although cough rates did not differ significantly, severe persistent coughs were more prevalent in the KC group. Physiological parameters such as oxygen saturation were comparable, but the KC group demonstrated higher increases in systolic blood pressure and heart rate. The use of fentanyl/chlorpheniramine resulted in higher patient and bronchoscopist satisfaction during simple bronchoscopy and bronchoalveolar lavage compared to ketamine/chlorpheniramine. This study suggests that the combination of fentanyl and chlorpheniramine may be a preferable sedation choice for bronchoscopy procedures

Étude des stratégies linguistiques de locuteurs de français L1 et d'apprenants étrangers lors de la prise de notes en français : perspectives en didactique des langues

Cette thèse se propose d’étudier les différents types de traitement utilisés par des locuteurs de français L1 et des apprenants étrangers de français lors de la prise de notes dans cette langue, à partir du discours oral magistral. Ce travail qui s’inscrit dans une perspective psycholinguistique vise à analyser la conformité et la fidélité sémantique et formelle des textes-cibles (les productions) par rapport au texte-source (le discours émis). Le cadre théorique de la thèse analyse différentes approches et taxinomies relatives aux stratégies communicatives en langue étrangère, notamment celle de Kellerman, dans le but de dégager une typologie des stratégies de traitement à étudier dans les données empiriques relevées. Afin d’étudier l’efficacité des prises de notes des participants à l’enquête observés, nous avons conçu une grille d’analyse intitulée une « grille de matrices » permettant d’analyser d’une part, le discours professoral (par la méthode de l’analyse discursive de Van Dijk) et d’identifier et de quantifier différents procédés audiographiques déployés par les noteurs observés. A l’issue d’analyses portant sur la forme et le fond des textes recueillis, nous avons dégagé des résultats détaillés relatifs à l’efficacité de la prise de notes des participants observés. Au terme des analyses, des propositions didactiques en matière de prise de notes en langue maternelle et étrangère sont formulées.This thesis intends to study different types of treatments used by speakers of French L1 and foreign learners of French for note-taking during an oral lecture in that language. From a psycholinguistic perspective, this assignment aims to analyze compliance and definite semantic fidelity of targets-texts (productions) in comparison with the source-text (the issued speech). The theoretical context of the thesis analyzes different approaches and taxonomies relating to conversational strategies in a foreign language notably that of Kellerman, with the intention of identifying a typology of treatment strategies to be studied in gathered empirical data. To study the effectiveness of the participants’ note-taking, we conceived an analysis grid called “matrix grid” allowing to analyze, on one hand, professorial speech (through the method of the discursive analysis of Van Dijk) and on the other hand, to identify and quantify different audiographique techniques used by examined note takers. After analyzing the form and semantic content of the gathered texts, we formulated detailed results relating to the effectiveness of the examined participants’ note-taking. As a consequence of these analyses, didactic proposals in note-taking in a native or foreign language were formulated

Étude des stratégies linguistiques de locuteurs de français L1 et d'apprenants étrangers lors de la prise de notes en français (perspectives en didactique des langues)

Cette thèse se propose d étudier les différents types de traitement utilisés par des locuteurs de français L1 et des apprenants étrangers de français lors de la prise de notes dans cette langue, à partir du discours oral magistral. Ce travail qui s inscrit dans une perspective psycholinguistique vise à analyser la conformité et la fidélité sémantique et formelle des textes-cibles (les productions) par rapport au texte-source (le discours émis). Le cadre théorique de la thèse analyse différentes approches et taxinomies relatives aux stratégies communicatives en langue étrangère, notamment celle de Kellerman, dans le but de dégager une typologie des stratégies de traitement à étudier dans les données empiriques relevées. Afin d étudier l efficacité des prises de notes des participants à l enquête observés, nous avons conçu une grille d analyse intitulée une grille de matrices permettant d analyser d une part, le discours professoral (par la méthode de l analyse discursive de Van Dijk) et d identifier et de quantifier différents procédés audiographiques déployés par les noteurs observés. A l issue d analyses portant sur la forme et le fond des textes recueillis, nous avons dégagé des résultats détaillés relatifs à l efficacité de la prise de notes des participants observés. Au terme des analyses, des propositions didactiques en matière de prise de notes en langue maternelle et étrangère sont formulées.This thesis intends to study different types of treatments used by speakers of French L1 and foreign learners of French for note-taking during an oral lecture in that language. From a psycholinguistic perspective, this assignment aims to analyze compliance and definite semantic fidelity of targets-texts (productions) in comparison with the source-text (the issued speech). The theoretical context of the thesis analyzes different approaches and taxonomies relating to conversational strategies in a foreign language notably that of Kellerman, with the intention of identifying a typology of treatment strategies to be studied in gathered empirical data. To study the effectiveness of the participants note-taking, we conceived an analysis grid called matrix grid allowing to analyze, on one hand, professorial speech (through the method of the discursive analysis of Van Dijk) and on the other hand, to identify and quantify different audiographique techniques used by examined note takers. After analyzing the form and semantic content of the gathered texts, we formulated detailed results relating to the effectiveness of the examined participants note-taking. As a consequence of these analyses, didactic proposals in note-taking in a native or foreign language were formulated.AIX-MARSEILLE1-Bib.electronique (130559902) / SudocSudocFranceF

Inadvertent intrathecal injection of large dose magnesium sulfate

The case is a 35-year-old man who underwent spinal anesthesia for emergency strangulated inguinal hernia repair. About five minutes after 3 ml intrathecal drug injection, the patient suffered respiratory distress, bradycardia, hypotension and loss of consciousness. The patient was rapidly intubated and crystalloid infusion and epinephrine drip were established. Thereafter, he was admitted in intensive care unit. Search for the cause revealed us that 3 ml of magnesium sulfate (50%) was injected mistakenly for spinal anesthesia. Two days later, he was extubated and on the fifth day, he was discharged from the hospital without an obvious evidence of complication