Mridula Goswami; Vashi Narula; Ramanandvignesh Pandiyan
Volume 12, Issue 4 , October 2024, , Pages 202-206
Abstract
Dental injury is a common anesthesia-related adverse event, with a high incidence of damage to teeth and surrounding tissues during oro-endotracheal intubation. Poor oral hygiene, compromised periodontium, faulty or loose prosthesis, proclined maxillary incisors along with increased difficulty level ...
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Dental injury is a common anesthesia-related adverse event, with a high incidence of damage to teeth and surrounding tissues during oro-endotracheal intubation. Poor oral hygiene, compromised periodontium, faulty or loose prosthesis, proclined maxillary incisors along with increased difficulty level of airway management, improper use of laryngoscope, and use of maxillary anterior teeth as a fulcrum for achieving accessibility to the airway are all risk factors for iatrogenic dental injury. This type of injury provides additional physical and psychological trauma to patients who have already undergone medical surgical procedures. The consequences of such mishaps might potentially result in medico-legal suits and financial claims.The present case series described three cases of managing iatrogenic dental lesions during oro-endotracheal intubation, after obtaining written informed consent, as well as methods for preventing such accidental injuries. This study emphasized the importance of collaboration between medical and dental professionals in preventing and successfully managing accidental dental injuries.
Omid Aghadavoudi; Hamidreza Shetabi; Hamid Saryazdi; Susan Babayi
Volume 10, Issue 2 , April 2022, , Pages 77-82
Abstract
Objective: To investigate the neck features for laryngeal mask airway (LMA) size selection. Methods: This cross-sectional study was conducted on 160 patients referred for elective surgeries to Feiz Hospital affiliated with Isfahan University of Medical Sciences, Isfahan, Iran (April 2016 to September ...
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Objective: To investigate the neck features for laryngeal mask airway (LMA) size selection. Methods: This cross-sectional study was conducted on 160 patients referred for elective surgeries to Feiz Hospital affiliated with Isfahan University of Medical Sciences, Isfahan, Iran (April 2016 to September 2018). Patients underwent ventilation using LMA whose size was determined through a weighted-based approach. All of the patients’ neck characteristics including circumference, thyromental distance, and opening mouth were measured. Ventilation factors were recorded including numbers of attempts for successful LMA insertion, quality of ventilation, and sealing. Results: Neck circumference and thyromental distance were significantly different with the size of LMA (p 0.05 for all comparisons). However, the thyromental distance was significantly different with the quality ventilation status (p <0.0001). The total assessment of insertion attempts, ventilation efficacy and sealing was significantly different with the neck circumference (p <0.001), but thyromental distance did not show a significant difference (p>0.05). Conclusion: Findings demonstrated that neck circumference might be considered as an appropriate indicator for the selection of LMA size but neither the thyromental distance nor mouth opening. Further studies with a larger sample size are strongly recommended.
Arash Farbood; Saeed Khademi; Ramin Tajvidi; Minoo Hooshangi; Saeed Salari; Mandana Ghani; Sakineh Tahmasebi; Hamid Jamali
Volume 8, Issue 2 , April 2020, , Pages 77-82
Abstract
Objective: To investigate the effect of intravenous regional anesthesia with single-cuff forearm tourniquet and hematoma block on intraoperative and postoperative pain intensity of patients with distal radial bone fracture. Methods: In this randomized clinical trial, a total number of 52 patients with ...
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Objective: To investigate the effect of intravenous regional anesthesia with single-cuff forearm tourniquet and hematoma block on intraoperative and postoperative pain intensity of patients with distal radial bone fracture. Methods: In this randomized clinical trial, a total number of 52 patients with distal radius fractures were randomly assigned to receive either a traditional Bier block with 3 mg.kg-1 lidocaine (D group) or a single-cuff forearm tourniquet intravenous regional anesthesia with 1.5 mg.kg-1 lidocaine and a hematoma block with 10 mL 0.5% bupivacaine (S group). Pain intensity score of numerical rating scale (NRS) was measured hourly for 6 hours, then every two hours till 12th hour and every 4 hours until 24th postoperative hour. Total morphine consumption in the first 24 hours after surgery, its side effects and the patients’ global satisfaction were assessed in each group. Results: Mean total morphine consumption during the first 24 hours after surgery was 11.68±7.88 mg in group D and 7.12±4.42 mg in group S (p=0.13). Pain intensity score of NRS both during recovery room and surgical ward stay was less in S group compared to D group (0.016 and 0.02, respectively). Conclusion: Intravenous regional anesthesia with single cuff forearm tourniquet and hematoma block compared to the traditional Bier block reduced intraoperative and postoperative pain intensity more effectively in patients with distal fracture of the radius bone and also reduced morphine consumption during the first 24 hours after surgery. Clinical Trial Registry: IRCT201604223213N4
Masoud Hashemi; Payman Dadkhah; Mehrdad Taheri; Sirous Momenzadeh; Tahereh Parsa; Behnam Hosseini; Mohammadreza Abbasian
Volume 7, Issue 2 , April 2019, , Pages 150-155
Abstract
Objective: To compare the efficacy of parasagittal interlaminar (PIL) and midline interlaminar (MIL) approaches for epidural block in patients with lower limb orthopedic surgery. Methods: This double-blind randomized clinical trial was performed on 40 patients undergoing tibial shaft fracture surgery. ...
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Objective: To compare the efficacy of parasagittal interlaminar (PIL) and midline interlaminar (MIL) approaches for epidural block in patients with lower limb orthopedic surgery. Methods: This double-blind randomized clinical trial was performed on 40 patients undergoing tibial shaft fracture surgery. In PIL group, an 18-gauge, 3.5 inch, Tuohy needle was placed at the level of L2-3 or L3-4 intervertebral spaces and pushed forward in a posteroanterior (PA) direction vertical to the body surface. After determining the most lateral place for needle arrival in an anteroposterior (AP) view, needle was pushed forward into the epidural space. For the MIL group, needle was pushed forward from the midline interspinous space with the same method. After confirmation of needle position, 1 mL of contrast was injected to confirm the epidural space distribution and then 15 ml lidocaine 2% was injected. The sensory and motor block level, onset, duration, heart rate (HR), mean arterial pressure (MAP), and arterial oxygen saturation (SPO2), and success rate were recorded.Results: Mean patients’ baseline characteristics showed no statistically significant difference between the two groups. (p>0.05). Outcome measures were statistically different and significantly higher in PIL group (p-values for sensory block level
