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Bürlukkara S, Kabalak AA, Ateş A, Baran Ö, Aykaç A, Özok HU. Comparative analysis of combined spinal-epidural anesthesia and general anesthesia in percutaneous nephrolithotomy: a prospective study on surgical team and operating room personnel satisfaction. World J Urol 2024; 42:262. [PMID: 38668757 PMCID: PMC11052852 DOI: 10.1007/s00345-024-04977-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 04/05/2024] [Indexed: 04/29/2024] Open
Abstract
OBJECTIVE We aimed to investigate the efficacy and complications of combined spinalepidural anesthesia and general anesthesia in percutaneous stone surgery prospectively. MATERIALS AND METHODS The study prospectively included patients who underwent percutaneous nephrolithotomy with general anesthesia (Group.1) or combined spinal-epidural anesthesia (Group.2) at the Department of Urology, Training and Research Hospital, Karabuk University. between December 2018 and December 2019. The effect of the anesthesia technique on the comfort and satisfaction of the operating room personnel, surgeon and anesthesia team were prospectively evaluated and recorded. RESULTS During the postoperative period, the spinal anesthesia group had a significantly lower visual analog score than the general anesthesia group. No patient in either group required narcotic analgesics during the postoperative period. In terms of overall satisfaction scores, the surgeon performing the surgical procedure had a significantly higher satisfaction score in the general anesthesia group than in the CSEA group. The score was considered good in the general anesthesia group and moderate in the CSEA group. Personnel satisfaction was higher in the patient group that underwent CSEA. In the general anesthesia group, the score was considered to be average. In the CSEA group, the satisfaction score was considered good, with a statistically significant difference (p < 0.05). The anesthesia team's satisfaction score was moderate, with no significant difference between the CSEA and general anesthesia groups (p > 0.05). CONCLUSION PCNL under CSEA can be performed safely in certain individuals. Different anesthetic techniques may have varied levels of satisfaction among the surgical team.
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Affiliation(s)
- Salih Bürlukkara
- Department of Urology, Karabuk University Medikal Faculty, Karabuk, Turkey.
| | - Afife Ayla Kabalak
- Department of Anesthesiology, Karabuk University Medikal Faculty, Karabuk, Turkey
| | - Alpay Ateş
- Department of Anesthesiology, Karabuk University Medikal Faculty, Karabuk, Turkey
| | - Özer Baran
- Department of Urology, Karabuk University Medikal Faculty, Karabuk, Turkey
| | - Aykut Aykaç
- Department of Urology, Eskişehir City Hospital, Eskişehir, Turkey
| | - Hakkı Uğur Özok
- Department of Urology, Karabuk University Medikal Faculty, Karabuk, Turkey
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Mirani KK, Ather MH, Kazmi Z, Aziz W. Access and Fluoroscopy Time Difference in Patients Undergoing Prone Percutaneous Nephrolithotomy (PCNL) With Ureteric Catheter Placement in Supine Versus Lithotomy Position. Cureus 2022; 14:e26220. [PMID: 35911369 PMCID: PMC9312847 DOI: 10.7759/cureus.26220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2022] [Indexed: 11/30/2022] Open
Abstract
Objective: To compare the operative and fluoroscopy time in two different methods of ureteral stent insertion before prone percutaneous nephrolithotomy (PCNL). Materials and method: Over 12 months, 124 patients with urolithiasis who went through prone PCNL were included in our study. All the patients had kidney stones and were divided into two groups based on the method of ureteral catheter insertion. This was done with the help of flexible or rigid cystoscopy in to group A and group B, respectively. Both groups had an equal number of patients, i.e., 62. The main outcome variables assessed were access time (from intubation to placement of access sheath) and fluoroscopy time during access. Results: The categorical variables (age, gender, site of the stone) between the two groups were comparable. The access time in groups A and B were 48±4.30 and 77±10 minutes, respectively. The fluoroscopy times in groups A and B were 52±14.63 and 116±47.77 seconds, respectively. A statistically significant difference (p-value < 0.05) was observed for both the access and fluoroscopy time. None of the patients in either of the groups had a misplaced ureteral catheter requiring repositioning. Conclusion: Flexible cystoscope-assisted insertion of ureteral catheter prior to PCNL significantly reduces operative time, fluoroscopy time, and consequently radiation exposure during PCNL.
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Grensemann J, Möhlenkamp E, Breitfeld P, Tariparast PA, Peters T, Punke MA, Kluge S, Petzoldt M. Tracheal Tube-Mounted Camera Assisted Intubation vs. Videolaryngoscopy in Expected Difficult Airway: A Prospective, Randomized Trial (VivaOP Trial). Front Med (Lausanne) 2022; 8:767182. [PMID: 34977071 PMCID: PMC8714897 DOI: 10.3389/fmed.2021.767182] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 11/16/2021] [Indexed: 01/09/2023] Open
Abstract
Background: Tracheal intubation in patients with an expected difficult airway may be facilitated by videolaryngoscopy (VL). The VL viewing axis angle is specified by the blade shape and visualization of the larynx may fail if the angle does not meet anatomy of the patient. A tube with an integrated camera at its tip (VST, VivaSight-SL) may be advantageous due to its adjustable viewing axis by means of angulating an included stylet. Methods: With ethics approval, we studied the VST vs. VL in a prospective non-inferiority trial using end-tidal oxygen fractions (etO2) after intubation, first-attempt success rates (FAS), visualization assessed by the percentage of glottis opening (POGO) scale, and time to intubation (TTI) as outcome parameters. Results: In this study, 48 patients with a predicted difficult airway were randomized 1:1 to intubation with VST or VL. Concerning oxygenation, the VST was non-inferior to VL with etO2 of 0.79 ± 0.08 (95% CIs: 0.75–0.82) vs. 0.81 ± 0.06 (0.79–0.84) for the VL group, mean difference 0.02 (−0.07 to 0.02), p = 0.234. FAS was 79% for VST and 88% for VL (p = 0.449). POGO was 89 ± 21% in the VST-group and 60 ± 36% in the VL group, p = 0.002. TTI was 100 ± 57 s in the VST group and 68 ± 65 s in the VL group (p = 0.079). TTI with one attempt was 84 ± 31 s vs. 49 ± 14 s, p < 0.001. Conclusion: In patients with difficult airways, tracheal intubation with the VST is feasible without negative impact on oxygenation, improves visualization but prolongs intubation. The VST deserves further study to identify patients that might benefit from intubation with VST.
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Affiliation(s)
- Jörn Grensemann
- Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Emma Möhlenkamp
- Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Philipp Breitfeld
- Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Pischtaz A Tariparast
- Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Tanja Peters
- Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Mark A Punke
- Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Stefan Kluge
- Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martin Petzoldt
- Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Dar MA, Malik SA, Dar YA, Wani PM, Wani MS, Hamid A, Khawaja AR, Sofi KP. Comparison of percutaneous nephrolithotomy under epidural anesthesia versus general anesthesia: A randomized prospective study. Urol Ann 2021; 13:210-214. [PMID: 34421253 PMCID: PMC8343281 DOI: 10.4103/ua.ua_82_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 12/30/2020] [Indexed: 11/24/2022] Open
Abstract
Introduction: PCNL has revolutionized the treatment of renal calculi putting almost an end to the era of open stone surgery. The procedure can safely be carried out under general anesthesia (GA) or regional anesthesia viz. spinal anesthesia (SA), epidural anesthesia (EA) or combined spinal and epidural anesthesia (CSE). Aims and Objectives: We evaluated the surgical outcome after PCNL in two groups of patients randomly divided to undergo procedure under GA or EA. Patients and Methods: Two hundred and thirty patients with American Society of Anesthesiologists (ASA) score <3 were randomly divided into two groups according to the type of anesthesia: i.e. GA (n=110) or EA (n=120). All patients underwent PCNL in prone position. Puncture was done using Bulls eye technique under fluoroscopic guidance and tract dilated using serial dilators up to 24Fr-28 Fr. Demographics, perioperative and postoperative parameters were noted and data analysed. Results: The two groups were comparable in terms of mean age, distribution of stone location, and stone burden. The stone free rate was 90.9% in GA group and 89.2% in EA group and the difference was statistically insignificant (P= 0.659). The requirement for auxiliary procedures was similar between the two groups. A significant difference in pain score was seen in favor of EA group during early post-operative period (P< 0.05). Conclusion: It seems that PCNL can be performed safely and effectively under regional epidural anesthesia with results comparable to general anesthesia with the added advantage of less immediate postoperative pain and analgesic requirement.
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Affiliation(s)
- Manzoor Ahmad Dar
- Department of Urology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Sajad Ahmad Malik
- Department of Urology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Yaser Ahmed Dar
- Department of Urology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Prince Muzafer Wani
- Department of Urology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Mohammad Saleem Wani
- Department of Urology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Arif Hamid
- Department of Urology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Abdul Rouf Khawaja
- Department of Urology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Khalid Parvez Sofi
- Department of Anaesthesia, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
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Madziala A, Cieciel M, Konski R, Madziala M. An endotracheal tube mounted camera for intubation during cardiopulmonary resuscitation. Preliminary data. Am J Emerg Med 2018; 36:1897-1898. [PMID: 29396324 DOI: 10.1016/j.ajem.2018.01.091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 01/25/2018] [Accepted: 01/27/2018] [Indexed: 11/26/2022] Open
Affiliation(s)
- Agnieszka Madziala
- International Institute of Rescue Research and Education, Warsaw, Poland
| | - Michal Cieciel
- Emergency Medicine Student Scientific Circle at Department of Emergency Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Roman Konski
- Emergency Medicine Student Scientific Circle at Department of Emergency Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Marcin Madziala
- International Institute of Rescue Research and Education, Warsaw, Poland; Department of Emergency Medicine, Medical University of Warsaw, Poland.
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Herway ST, Benumof JL. The Tracheal Accordion and the Position of the Endotracheal Tube. Anaesth Intensive Care 2017; 45:177-188. [DOI: 10.1177/0310057x1704500207] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The purpose of this review is to, first, determine the static factors that affect the length of the human trachea across different populations and, second, to investigate whether or not there are dynamic factors that cause the length of the human trachea to vary within the same individual. We also investigated whether these changes in tracheal length within the same individual are significant enough to increase the risk of endobronchial intubation or accidental extubation. A PubMed/MEDLINE and a Web of Science database English-language literature search was conducted in May 2016 with relevant keywords and MeSH terms when available. We found that gender, extremes of age, patient height, postsurgical changes and co-existing disease are static patient factors that affect the length of the human trachea. Dynamic clinical changes that occur under anaesthesia, including Trendelenburg position, head and neck flexion and extension, paralysis of the diaphragm and pneumoperitoneum, cause the trachea to act as an accordion, decreasing and increasing its length. The length of the human trachea in both awake and anaesthetised and paralysed patients is a critical consideration in preventing both endobronchial intubation and tracheal extubation. It is clear from the literature that tracheal length varies widely across populations and, additionally, with the dynamic clinical changes that occur under anaesthesia, the trachea acts as an accordion decreasing and increasing its length within the same individual. Knowledge of the magnitude of the change in tracheal dimensions in response to these factors is an important clinical consideration.
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Affiliation(s)
- S. T. Herway
- Department of Anesthesiology, University of California San Diego, CA, USA
| | - J. L. Benumof
- Department of Anesthesiology, University of California San Diego, CA, USA
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Truszewski Z, Krajewski P, Fudalej M, Smereka J, Frass M, Robak O, Nguyen B, Ruetzler K, Szarpak L. A comparison of a traditional endotracheal tube versus ETView SL in endotracheal intubation during different emergency conditions: A randomized, crossover cadaver trial. Medicine (Baltimore) 2016; 95:e5170. [PMID: 27858851 PMCID: PMC5591099 DOI: 10.1097/md.0000000000005170] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Airway management is a crucial skill essential to paramedics and personnel working in Emergency Medical Services and Emergency Departments: Lack of practice, a difficult airway, or a trauma situation may limit the ability of paramedics to perform direct laryngoscopy during cardiopulmonary resuscitation. Videoscope devices are alternatives for airway management in these situations. The ETView VivaSight SL (ETView; ETView Ltd., Misgav, Israel) is a new, single-lumen airway tube with an integrated high-resolution imaging camera. To assess if the ETView VivaSight SL can be a superior alternative to a standard endotracheal tube for intubation in an adult cadaver model, both during and without simulated CPR. METHODS ETView VivaSight SL tube was investigated via an interventional, randomized, crossover, cadaver study. A total of 52 paramedics participated in the intubation of human cadavers in three different scenarios: a normal airway at rest without concomitant chest compression (CC) (scenario A), a normal airway with uninterrupted CC (scenario B) and manual in-line stabilization (scenario C). Time and rate of success for intubation, the glottic view scale, and ease-of-use of ETView vs. sETT intubation were assessed for each emergency scenario. RESULTS The median time to intubation using ETView vs. sETT was compared for each of the aforementioned scenarios. For scenario A, time to first ventilation was achieved fastest for ETView, 19.5 [IQR, 16.5-22] sec, when compared to that of sETT at 21.5 [IQR, 20-25] sec (p = .013). In scenario B, the time for intubation using ETView was 21 [IQR, 18.5-24.5] sec (p < .001) and sETT was 27 [IQR, 24.5-31.5] sec. Time to first ventilation for scenario C was 23.5 [IQR, 19-25.5] sec for the ETView and 42.5 [IQR, 35-49.5] sec for sETT. CONCLUSIONS In normal airways and situations with continuous chest compressions, the success rate for intubation of cadavers and the time to ventilation were improved with the ETView. The time to glottis view, tube insertion, and cuff block were all found to be shorter with the ETView. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT02733536.
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Affiliation(s)
| | - Paweł Krajewski
- Department of Forensic Medicine, Medical University of Warsaw, Warsaw
| | - Marcin Fudalej
- Department of Forensic Medicine, Medical University of Warsaw, Warsaw
| | - Jacek Smereka
- Department of Emergency Medical Service, Wroclaw Medical University, Wroclaw, Poland
| | - Michael Frass
- Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria
| | - Oliver Robak
- Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria
| | | | - Kurt Ruetzler
- Departments of Outcomes Research and General Anesthesiology, Cleveland Clinic, Cleveland, OH
| | - Lukasz Szarpak
- Department of Emergency Medicine
- Correspondence: Lukasz Szarpak, Department of Emergency Medicine, Medical University of Warsaw, Lidleya 4 Str., 02-005 Warsaw, Polamd (e-mail: )
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8
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Abstract
PURPOSE OF THE REVIEW To highlight the progressive evolution of the issue of patient positioning for percutaneous nephrolithotomy (PNL), explain the history of the prone and supine positions, report respective advantages and drawbacks, critically interpret the past and current literature supporting such arguments, identify the best candidates for each position, and reflect on the future evolution of the two approaches. RECENT FINDINGS Positioning for PNL has become a matter of debate during the last decade. The traditional prone PNL position - most widely performed with good success and few complications, and exhibiting essentially no limits except for the treatment of pelvic kidneys - is nowadays flanked mainly by the supine and supine-modified positions, equally effective and probably safer from an anesthesiological point of view. Of course, both approaches have a number of advantages and drawbacks, accurately reported and critically sieved. SUMMARY The current challenge for endourologists is to be able to perform PNL in both prone and supine positions to perfectly tailor the procedure on any patient with any stone burden, including increasingly challenging cases and medically high-risk patients, according to the patient's best interest. Intensive training and experience is especially needed for supine PNL, still less popular and underperformed worldwide. VIDEO ABSTRACT http://links.lww.com/COU/A8.
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Saracoglu A, Saracoglu KT. VivaSight: a new era in the evolution of tracheal tubes. J Clin Anesth 2016; 33:442-9. [PMID: 27555208 DOI: 10.1016/j.jclinane.2016.04.034] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 04/14/2016] [Accepted: 04/24/2016] [Indexed: 11/30/2022]
Abstract
STUDY OBJECTIVE To evaluate the available data describing the use of single and double lumen VivaSight tubes. DESIGN Systematic review. SETTING The use of VivaSight tubes for elective surgeries including advantages, disadvantages, and possible complications. PATIENTS Systematic review of randomized controlled trials from databases including Medline, Web of Knowledge, Google Scholar, and Cochrane Central Register of Controlled Trials. INTERVENTIONS Comparison of VivaSight single and double-lumen tubes with conventional tubes during normal airway and expected difficult airway management. The effectiveness of the devices was also evaluated during 1-lung ventilation for patients undergoing thoracic surgery. MEASUREMENTS Intubation time, success rate, the requirement for fiberoptic bronchoscope, and the rate of complications. MAIN RESULTS Following a VivaSight double-lumen tube, a flexible bronchoscope is still needed. It is difficult to agree that VivaSight tube reduces the need or use of a bronchoscope. According to the current literature, it is unclear if there is any advantage of the VivaSight compared with using flexible bronchoscopy to direct a blocker into the correct lung. The cost may be another issue. Studies comparing VivaSight tubes with standard double lumen tubes reported faster tracheal intubation rate and higher success rate at first attempt for VivaSight. However, VivaSight tubes may cause soft tissue trauma such as bleeding, hematoma, edema, and erythema. Sore throat and dysphonia are other reported complications. Due to the outer thickness, smaller-sized double-lumen tube may be necessary. It has been reported to have the disadvantages, such as melting due to the heat of light source before insertion and sudden shutdown without warning. CONCLUSIONS Problems such as overheating and melting on the distal end of the tube due to the light source and potential breakdowns of the cable should be solved by the manufacturer. This will probably require a redesign and necessitate further studies.
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Affiliation(s)
- Ayten Saracoglu
- Department of Anesthesiology and Reanimation, Istanbul Bilim University Medical School, Istanbul, Turkey.
| | - Kemal T Saracoglu
- Department of Anesthesiology and Reanimation, Istanbul Bilim University Medical School, Istanbul, Turkey
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Fiorelli AF, Ferraro FF, Milione RM, Scarumuzzi RS, Imitazione PI, Marulli LM, Orsini AO, Santini MS. Percutaneous dilatational tracheostomy using a tracheoscopic ventilation tube in an experimental ex vivo animal model. Anaesth Intensive Care 2016; 44:371-5. [PMID: 27246937 DOI: 10.1177/0310057x1604400303] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The ETView(®) tube is a standard endotracheal tube with an embedded miniature video camera that permits real-time video imaging of the tracheal lumen. We evaluated its use when performing percutaneous dilatational tracheostomy (PDT) in an ex vivo animal model. The model consisted of a pig larynyx and trachea. The ETView tube was used as an alternative to bronchoscopy, to see all manoeuvres of PDT in real time. At the end of the PDT, operative time and any complications such as trauma to the cricoid cartilage, tracheal wall or tube cuff were assessed. Nine PDT procedures were performed by two experienced operators. The mean operative time was 7.1 ± 0.9 minutes. No complications were observed. Our study supports the use of the ETView tube as a suitable alternative to bronchoscopy when performing PDT, although clinical studies are required to confirm our experimental results. .
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Affiliation(s)
- A F Fiorelli
- Thoracic surgeon, Thoracic Surgery Unit, Second University of Naples, Naples, Italy
| | - F F Ferraro
- Anesthesiology and Intensive Care Unit, Second University of Naples, Naples, Italy
| | - R M Milione
- Thoracic surgeon, Thoracic Surgery Unit, Second University of Naples, Naples, Italy
| | - R S Scarumuzzi
- Thoracic surgeon, Thoracic Surgery Unit, Second University of Naples, Naples, Italy
| | - P I Imitazione
- Anesthesist, Anesthesiology and Intensive Care Unit, Second University of Naples, Naples, Italy
| | - L M Marulli
- Anesthesist, Anesthesiology and Intensive Care Unit, Second University of Naples, Naples, Italy
| | - A O Orsini
- Anesthesist, Anesthesiology and Intensive Care Unit, Second University of Naples, Naples, Italy
| | - M S Santini
- Thoracic surgeon, Thoracic Surgery Unit, Second University of Naples, Naples, Italy
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Umutoglu T, Bakan M, Topuz U, Yilmaz S, Idin K, Alver S, Ozturk E, Salihoglu Z. Comparison of EtView™ tracheoscopic ventilation tube and video-assisted fiberoptic bronchoscopy during percutaneous dilatational tracheostomy. J Clin Monit Comput 2016; 31:507-512. [PMID: 27130402 DOI: 10.1007/s10877-016-9885-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 04/26/2016] [Indexed: 11/26/2022]
Abstract
Fiberoptic bronchoscopy (FOB) via endotracheal tube (ETT) is the most frequent utilized technique for monitoring of percutaneous dilatational tracheostomy (PDT) procedure while maintaining mechanical ventilation. Endoscopic guidance has increased the safety of this procedure; nevertheless, the use of a bronchoscope via ETT potentially may deteriorate ventilation and lead to hypercarbia and/or hypoxia. EtView tracheoscopic ventilation tube (EtView TVT) is a standard endotracheal tube with a camera and light source embedded at the tip. The objectives of this study are to introduce EtView TVT as a monitoring tool during PDT and to compare it with video assisted FOB via ETT. We hypothesized that using EtView TVT during PDT may obtain similar visualization; also may have advantages regarding better mechanical ventilation conditions when compared with video-assisted FOB via ETT. Patients, 18-75 years of age requiring mechanical ventilation scheduled for PDT were randomly allocated into two groups for airway monitorization to guide PDT procedure either with FOB via ETT (Group FOB, n = 12) or EtView TVT (Group EtView, n = 12). After standard anesthesia protocol, alveolar recruitment maneuver was applied and all patients were mechanically ventilated at pressure-controlled ventilation mode with same pressure levels. The primary outcome variable was the reduction in arterial oxygen partial pressure (PaO2) values during the procedure. Other respiratory variables and the effectiveness (the visualization and identification of relevant airway structures) of two techniques were the secondary outcome variables. Patients in both groups were comparable with respect to demographic characteristics and initial respiratory variables. Visualization and identification of relevant airway structures in any steps of the PDT procedure were also comparable. The decrease in minute ventilation in Group FOB was higher when compared with Group EtView (51 ± 4 % vs. 12 ± 7.3 %, p < 0.05). The decrease in PaO2 from initial levels during (34 ± 21 % vs. 5 ± 7 % decrease) and after (26 ± 27 % vs. 2.8 ± 16 % decrease) the procedure was higher in Group FOB when compared with Group EtView (p < 0.05). Considering comparable features in monitorization and advantageous features over mechanical ventilation when compared with video bronchoscopy; EtView TVT would be a good alternative for airway monitorization during PDT especially for patients with poor pulmonary reserve.
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Affiliation(s)
- Tarik Umutoglu
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Bezmialem Vakif University, Vatan caddesi, Fatih, 34093, Istanbul, Turkey
| | - Mefkur Bakan
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Bezmialem Vakif University, Vatan caddesi, Fatih, 34093, Istanbul, Turkey.
| | - Ufuk Topuz
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Bezmialem Vakif University, Vatan caddesi, Fatih, 34093, Istanbul, Turkey
| | - Sinan Yilmaz
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Bezmialem Vakif University, Vatan caddesi, Fatih, 34093, Istanbul, Turkey
| | - Kadir Idin
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Bezmialem Vakif University, Vatan caddesi, Fatih, 34093, Istanbul, Turkey
| | - Selcuk Alver
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Bezmialem Vakif University, Vatan caddesi, Fatih, 34093, Istanbul, Turkey
| | - Erdogan Ozturk
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Bezmialem Vakif University, Vatan caddesi, Fatih, 34093, Istanbul, Turkey
| | - Ziya Salihoglu
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Bezmialem Vakif University, Vatan caddesi, Fatih, 34093, Istanbul, Turkey
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12
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One-lung ventilation after rapid-sequence intubation: a novel approach using an ETView tracheoscopic ventilation tube for placement of an EZ-Blocker without bronchoscopy. J Clin Anesth 2016; 29:48-9. [DOI: 10.1016/j.jclinane.2015.10.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 10/13/2015] [Indexed: 12/23/2022]
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13
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Massot J, Dumand-Nizard V, Fischler M, Le Guen M. Evaluation of the Double-Lumen Tube Vivasight-DL (DLT-ETView): A Prospective Single-Center Study. J Cardiothorac Vasc Anesth 2015; 29:1544-9. [DOI: 10.1053/j.jvca.2015.04.031] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Indexed: 11/11/2022]
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Truszewski Z, Szarpak L, Czyzewski L, Evrin T, Kurowski A, Majer J, Karczewska K. A comparison of the ETView VivaSight SL against a fiberoptic bronchoscope for nasotracheal intubation of multitrauma patients during resuscitation. A randomized, crossover, manikin study. Am J Emerg Med 2015; 33:1097-9. [DOI: 10.1016/j.ajem.2015.04.078] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Revised: 04/23/2015] [Accepted: 04/24/2015] [Indexed: 11/27/2022] Open
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15
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Kurowski A, Szarpak L, Truszewski Z, Czyzewski L. Can the ETView VivaSight SL Rival Conventional Intubation Using the Macintosh Laryngoscope During Adult Resuscitation by Novice Physicians?: A Randomized Crossover Manikin Study. Medicine (Baltimore) 2015; 94:e850. [PMID: 26020389 PMCID: PMC4616410 DOI: 10.1097/md.0000000000000850] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
UNLABELLED The aim of this study was to assess the performance of the ETView VivaSight SL (ETView) single-lumen airway tube with an integrated high-resolution imaging camera in a manikin-simulated cardiopulmonary resuscitation scenario with and without chest compression. This was a randomized crossover manikin trial. Following a brief training session, 107 volunteer novice physicians who were inexperienced with airway management attempted to intubate a manikin using a Macintosh laryngoscope (MAC) and an ETView, with and without chest compressions. The participants were instructed to make 3 attempts in each scenario. In this trial, we compared intubation time, intubation success rates, and glottic visibility using a Cormack & Lehane Grade. Dental compression and ease of use of each device were also assessed. Median intubation times for the ETView and MAC without chest compressions were 17 (IQR, 15-19) s and 27 (IQR, 25-33) s, respectively (P < 0.001). The ETView proved more successful on the first intubation attempt than the MAC, regardless of compressions. Continuation of compressions caused an increase in intubation times for both the ETView (P = 0.27) and the MAC (P < 0.005). The ETView VivaSight SL is an effective tool for endotracheal intubation when used by novice physicians in a manikin-simulated cardiac arrest, both with and without chest compressions. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT02295618.
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Affiliation(s)
- Andrzej Kurowski
- From the Department of Anesthesiology and Critical Care, Cardinal Wyszynski National Institute of Cardiology, Warsaw, Poland (AK); Department of Anesthesiology and Critical Care, Cardinal Wyszynski National Institute of Cardiology, Warsaw, Poland and Department of Emergency Medicine, Medical University of Warsaw, Warsaw, Poland (LS); Department of Emergency Medicine, Medical University of Warsaw, Warsaw, Poland (ZT) and Department of Anesthesiology, Cardinal Wyszynski National Institute of Cardiology, Warsaw, Poland and Department of Nephrologic Nursing, Medical University of Warsaw, Medical University of Warsaw, Warsaw, Poland (LC)
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16
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Koopman EM, Barak M, Weber E, Valk MJA, de Schepper RTI, Bouwman RA, Huitink JM. Evaluation of a new double-lumen endobronchial tube with an integrated camera (VivaSight-DL™): a prospective multicentre observational study. Anaesthesia 2015; 70:962-8. [DOI: 10.1111/anae.13068] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2015] [Indexed: 12/01/2022]
Affiliation(s)
- E. M. Koopman
- Department of Anesthesiology; VU University Medical Center; Amsterdam The Netherlands
| | - M. Barak
- Department of Anesthesiology; Rambam Health Care Campus; Haifa Israel
| | - E. Weber
- Department of Anesthesiology; Catharina Hospital; Eindhoven The Netherlands
| | - M. J. A. Valk
- Department of Anesthesiology; VU University Medical Center; Amsterdam The Netherlands
| | | | - R. A. Bouwman
- Department of Anesthesiology; Catharina Hospital; Eindhoven The Netherlands
| | - J. M. Huitink
- Department of Anesthesiology; VU University Medical Center; Amsterdam The Netherlands
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17
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Kim SS, Lee JW, Yu JH, Sung LH, Chung JY, Noh CH. Percutaneous nephrolithotomy: comparison of the efficacies and feasibilities of regional and general anesthesia. Korean J Urol 2013; 54:846-50. [PMID: 24363866 PMCID: PMC3866288 DOI: 10.4111/kju.2013.54.12.846] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2013] [Accepted: 07/29/2013] [Indexed: 11/18/2022] Open
Abstract
Purpose To compare surgical outcomes and complications after percutaneous nephrolithotomy (PCNL) under regional or general anesthesia. Materials and Methods One hundred and one patients who underwent PCNL as a first-line treatment for kidney calculi between June 2004 and June 2013 were enrolled in this retrospective study. Patients were classified into two groups by anesthetic method: 77 were allocated to the regional anesthesia group and 24 to the general anesthesia group. Patient general characteristics, stone features, surgical outcomes, and complications were compared between the two groups. Results The two groups were similar in terms of mean age and stone size, number, and type. Furthermore, they did not differ significantly in terms of general characteristics, treatment outcomes, or complications excluding postoperative fever. However, mean hospital stay was significantly shorter in the regional anesthesia group than in the general anesthesia group (8.9±3.2 days vs. 11.5±6.9 days, respectively, p=0.025). Also, the postoperative fever rate was significantly higher in the general anesthesia group (53.2% vs. 83.3%, respectively, p=0.007). Conclusions Regional anesthesia is as effective as general anesthesia during percutaneous nephrolithotomy and is associated with shorter hospital stays and lower rates of postoperative fever.
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Affiliation(s)
- Sung Soo Kim
- Department of Urology, Inje University Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Jeong Woo Lee
- Department of Urology, Inje University Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Ji Hyoung Yu
- Department of Urology, Inje University Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Luck Hee Sung
- Department of Urology, Inje University Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Jae Yong Chung
- Department of Urology, Inje University Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Choong Hee Noh
- Department of Urology, Inje University Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
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Nouralizadeh A, Ziaee SAM, Hosseini Sharifi SH, Basiri A, Tabibi A, Sharifiaghdas F, Kilani H, Gharaei B, Roodneshin F, Soltani MH. Comparison of Percutaneous Nephrolithotomy Under Spinal Versus General Anesthesia: A Randomized Clinical Trial. J Endourol 2013; 27:974-8. [DOI: 10.1089/end.2013.0145] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Akbar Nouralizadeh
- Shahid Labbafinejad Medical Center, Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, I.R. Iran
| | - Seyed Amir Mohsen Ziaee
- Shahid Labbafinejad Medical Center, Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, I.R. Iran
| | - Seyed Hossein Hosseini Sharifi
- Shahid Labbafinejad Medical Center, Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, I.R. Iran
| | - Abbas Basiri
- Shahid Labbafinejad Medical Center, Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, I.R. Iran
| | - Ali Tabibi
- Shahid Labbafinejad Medical Center, Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, I.R. Iran
| | - Farzaneh Sharifiaghdas
- Shahid Labbafinejad Medical Center, Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, I.R. Iran
| | - Hossein Kilani
- Shahid Labbafinejad Medical Center, Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, I.R. Iran
| | - Babak Gharaei
- Anesthesiology Department of Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, I.R. Iran
| | - Fatemeh Roodneshin
- Anesthesiology Department of Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, I.R. Iran
| | - Mohammad Hossein Soltani
- Shahid Labbafinejad Medical Center, Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, I.R. Iran
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Gaitini LA, Yanovski B, Mustafa S, Hagberg CA, Mora PC, Vaida SJ. A Feasibility Study Using the VivaSight Single Lumen™ to Intubate the Trachea Through the Fastrach Laryngeal Mask Airway. Anesth Analg 2013; 116:604-8. [DOI: 10.1213/ane.0b013e31827b278f] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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20
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Huitink JM, Koopman EM, Bouwman RA, Craenen A, Verwoert M, Krage R, Visser IE, Erwteman M, van Groeningen D, Tijink R, Schauer A. Tracheal intubation with a camera embedded in the tube tip (Vivasight™). Anaesthesia 2012; 68:74-8. [DOI: 10.1111/anae.12065] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2012] [Indexed: 12/16/2022]
Affiliation(s)
- J. M. Huitink
- Department of Anaesthesiology; VU University Medical Center; Amsterdam; the Netherlands
| | - E. M. Koopman
- Department of Anaesthesiology; VU University Medical Center; Amsterdam; the Netherlands
| | - R. A. Bouwman
- Department of Anaesthesiology; VU University Medical Center; Amsterdam; the Netherlands
| | - A. Craenen
- Department of Anaesthesiology; VU University Medical Center; Amsterdam; the Netherlands
| | - M. Verwoert
- Biomedical Sciences; VU University; Amsterdam; the Netherlands
| | - R. Krage
- Department of Anaesthesiology; VU University Medical Center; Amsterdam; the Netherlands
| | - I. E. Visser
- Department of Anaesthesiology; VU University Medical Center; Amsterdam; the Netherlands
| | - M. Erwteman
- Department of Anaesthesiology; VU University Medical Center; Amsterdam; the Netherlands
| | - D. van Groeningen
- Department of Anaesthesiology; VU University Medical Center; Amsterdam; the Netherlands
| | - R. Tijink
- Department of Anaesthesiology; VU University Medical Center; Amsterdam; the Netherlands
| | - A. Schauer
- Department of Anaesthesiology; VU University Medical Center; Amsterdam; the Netherlands
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ECIRS (Endoscopic Combined Intrarenal Surgery) in the Galdakao-modified supine Valdivia position: a new life for percutaneous surgery? World J Urol 2011; 29:821-7. [PMID: 22057344 DOI: 10.1007/s00345-011-0790-0] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2011] [Accepted: 10/18/2011] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Percutaneous nephrolithotomy (PNL) is still the gold-standard treatment for large and/or complex renal stones. Evolution in the endoscopic instrumentation and innovation in the surgical skills improved its success rate and reduced perioperative morbidity. ECIRS (Endoscopic Combined IntraRenal Surgery) is a new way of affording PNL in a modified supine position, approaching antero-retrogradely to the renal cavities, and exploiting the full array of endourologic equipment. ECIRS summarizes the main issues recently debated about PNL. METHODS The recent literature regarding supine PNL and ECIRS has been reviewed, namely about patient positioning, synergy between operators, procedures, instrumentation, accessories and diagnostic tools, step-by-step standardization along with versatility of the surgical sequence, minimization of radiation exposure, broadening to particular and/or complex patients, limitation of post-operative renal damage. RESULTS Supine PNL and ECIRS are not superior to prone PNL in terms of urological results, but guarantee undeniable anesthesiological and management advantages for both patient and operators. In particular, ECIRS requires from the surgeon a permanent mental attitude to synergy, standardized surgical steps, versatility and adherence to the ongoing clinical requirements. ECIRS can be performed also in particular cases, irrespective to age or body habitus. The use of flexible endoscopes during ECIRS contributes to minimizing radiation exposure, hemorrhagic risk and post-PNL renal damage. CONCLUSIONS ECIRS may be considered an evolution of the PNL procedure. Its proposal has the merit of having triggered the critical analysis of the various PNL steps and of patient positioning, and of having transformed the old static PNL into an updated approach.
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