However, actual needle insertion in the pre-puncture ultrasound-assisted technique remains a ��blind�� procedure. We describe two patients with an abnormal spinal anatomy in whom ultrasound-assisted spinal anesthesia was unsuccessful. Successful dural puncture was subsequently achieved using a technique of real-time ultrasound-guided spinal anesthesia. This may be a useful option in patients in whom landmark-guided and ultrasound-assisted techniques have failed. ""Background: Tracheal intubation may http://www.selleckchem.com/
be more difficult in morbidly obese (MO) patients than in the non-obese. The aim of this study was to evaluate clinically if the use of the Video Intubation Unit (VIU), a video-optical intubation stylet, could improve the laryngoscopic view compared with the standard Macintosh laryngoscope in this specific population. Methods: We studied 40 MO patients (body mass index >35?kg/m2) scheduled for bariatric surgery. Each patient had a conventional laryngoscopy and a VIU inspection. The laryngoscopic grades (LG) using the Cormack and Lehane scoring system were noted and compared. Thereafter, the patients were randomised to be intubated with one of the two techniques. In one group, the patients were intubated Imatinib
with the help of the VIU and in the control group, tracheal intubation was performed conventionally. The duration of intubation, as well as the minimal SpO2 achieved during the procedure, were measured. Results: Patient characteristics were similar in both groups. Seventeen patients had a direct LG of 2 or 3 (no patient had a grade of 4). Out of these 17 patients, the LG systematically improved with the VIU and always attained grade 1 (P<0.0001). The intubation time was shorter <a href="http://www.selleckchem.com/products/SP600125.html
">selleck within the VIU group, but did not attain significance. There was no difference in the SpO2 post-intubation. Conclusion: In MO patients, the use of the VIU significantly improves the visualisation of the larynx, thereby improving the intubation conditions. ""Background: Work place pollution during filling of anaesthetic vaporisers has been a matter of concern. We studied personnel breathing zone ambient air sevoflurane concentrations during filling of sevoflurane with three different filling systems: Quik-Fil? for Abbott and Dr?ger Fill? resp. Easy-Fil? adapters for Baxter sevoflurane bottles, referred to as ��Abbott and Baxter filling systems��. Method: Sequential filling of three vaporisers was performed for a 15-min period, once with each of Abbott and Baxter filling systems, by four nurses. Ambient-air sevoflurane p.p.m. concentration in the breathing zone was continuously measured using a Miran 1a device during filling, and the mean 15?min sevoflurane concentration was calculated.