Anesthesia Progress Volume 69: Issue 3

Objective:

Postoperative sore throat is relatively frequent complication after orotracheal intubation. However, there are few reports about postoperative sore throat in nasotracheal intubation. In this retrospective study, we investigated the risk factors of postoperative sore throat in nasotracheal intubation.

Methods:

Anesthesia records of patients 16 to 80 years of age who underwent nasotracheal intubation were included. Patients underwent oral and maxillofacial surgery from February 2015 until September 2018. Airway device (Macintosh laryngoscope, Pentax-AWS, or McGRATH video laryngoscope, or fiberoptic scope), sex, age, height, weight, American Society of Anesthesiologists classification, intubation attempts, duration of intubation, intubation time, tube size, and fentanyl and remifentanil dose were investigated. Fisher exact test, Wilcoxon rank sum test, Welch t test, and Steel-Dwass multiple test were used, and a multivariable analysis was performed using stepwise logistic regression to determine the risk factors of postoperative sore throat.

Results:

A total of 169 cases were analyzed, and 126 patients (74.6%) had a postoperative sore throat. Based on the univariate analysis of the data, 12 factors were determined to be potentially related to the occurrence of a postoperative sore throat. However, after evaluation using stepwise logistic regression analysis, the 2 remaining variables that correlated with postoperative sore throat were airway device (P < .05) and intubation attempts (P = .04). In the model using logistic regression analysis, the fiberoptic scope had the strongest influence on the incidence of sore throat with reference to Pentax-AWS (odds ratio = 5.25; 95% CI = 1.54–17.92; P < .05).

Conclusion:

Use of a fiberoptic scope was identified as an independent risk factor for postoperative throat discomfort. Compared with direct laryngoscopy and other video laryngoscopes, the use of a fiberoptic scope had a significantly higher incidence of sore throat.

Objective:

Mask ventilation can be difficult in elderly edentulous patients. Various solutions have been proposed to address this challenge. This study assessed the use of a new airway-securing device called the Tulip Airway and investigated its application in simulated edentulous patients.

Methods:

This pilot study utilized a modified edentulous airway training mannequin and a high-performance simulator. Participants attempted to ventilate the edentulous mannequin using a Guedel oropharyngeal airway and face mask (M method) or the Tulip Airway (T method). Successful inflation of the mannequin model lung was confirmed visually. The time required for the insertion of the Tulip Airway was also assessed. A high-performance simulator was then used to compare ventilation volumes achieved using the M and T methods, and data subsequently analyzed.

Results:

In the edentulous mannequin, lung inflation was not achieved by any participants using the M method, but all were successful using the T method. Insertion time for the Tulip Airway was ∼8 seconds. Median ventilation volumes achieved using the high-performance simulator were higher for the T method (308 mL) compared with the M method (192 mL; P < .05).

Conclusion:

The results of this pilot study indicate that the Tulip Airway is an effective airway device for use in edentulous patients with difficult mask ventilation.

Objective:

Dental fear screening is an important part of providing a positive pediatric dental experience. To improve efficiency, the development of a single-item dental fear assessment tool for children has been desired. In this psychometric analysis, the reliability and validity of the Dental Anxiety Question (DAQ) is studied when used in children aged 7 to 18 years.

Methods:

Participants completed the DAQ (pre-tx-DAQ), the Children's Fear Survey Schedule–Dental Subscale (CFSS-DS), and a demographic information questionnaire before treatment. Participants repeated the DAQ after treatment (post-tx-DAQ) and once more at least 2 weeks later (follow-up-DAQ). Stability reliability within the DAQ scores and criterion validity with the CFSS-DS were evaluated.

Results:

Stability reliability analyses between pre-tx-DAQ/post-tx-DAQ and post-tx-DAQ/follow-up-DAQ demonstrated significant positive correlations: Spearman rank correlation coefficient (rs) = 0.420, rs ² = 0.18, P < .001, and rs = 0.563, rs ² = 0.32, P < .001, respectively. Criterion validity analysis between the pre-tx-DAQ and CFSS-DS also demonstrated a significant correlation: Pearson correlation coefficient (r) = 0.584, r ² = 0.34, P < .001.

Conclusion:

The stability reliability and criterion validity of the DAQ was proved among children.

Wylie NP, Beale L, Westley I.Consistency of remifentanil concentrations in propofol–remifentanil infusions. A laboratory-based study. Pediatr Anesth . 2022;32:727–731. doi: 10.1111/pan.14427

Remifentanil has been shown to be poorly soluble when added to propofol in high concentrations; however, the physiochemical properties of these admixtures have not been studied in clinically relevant concentrations or settings. This study examined remifentanil-propofol admixtures in commonly used concentrations while subjecting them to delivery through an extension line driven by a syringe pump. A solution of propofol 10 mg/mL combined with remifentanil 5 mcg/mL was run using a Paedfusor propofol target-controlled infusion model for 10- and 20-kg

Difficulty Controlling Sedation Level Using Processed Electroencephalography Monitoring in a Patient With Intellectual Disability, Fontan Circulation, and a Severe Gag Reflex

Riko UmemotoDDS,

Satoshi TachikawaDDS, PhD,

Daisuke KikuchiDDS,

Aoi OoshioDDS,

Risa KajiwaraDDS, PhD,

Rie NishidaDDS, PhD,

Asuka TaguchiDDS, PhD,

Takehiko IijimaDDS, DMSc, and

Rikuo MasudaDDS, PhD

Did We Lose Something Along the Way?

Risk Factors for Postoperative Sore Throat After Nasotracheal Intubation

Objective:

Methods:

Results:

Conclusion:

Usefulness of Tulip Airway in Edentulous Elderly Patients

Objective:

Methods:

Results:

Conclusion:

Reliability and Validity of the Dental Anxiety Question Used With Children

Objective:

Methods:

Results:

Conclusion:

Coronary Spasm During Postoperative Sedation With Dexmedetomidine

Methemoglobinemia Induced by Prilocaine in a Child With Noonan Syndrome

ACE-Inhibitor or ARB-Induced Refractory Hypotension Treated With Vasopressin in Patients Undergoing General Anesthesia for Dentistry: Two Case Reports

Anesthetic Management Using a Laryngeal Mask Airway for a Patient With Ankylosing Spondylitis: A Case Report

Anesthesia Management of a Patient With Familial Cold Autoinflammatory Syndrome: A Case Report

Perioperative Management of Oral Antithrombotics in Dentistry and Oral Surgery: Part 1

A Review of Current Literature of Interest to the Office-Based Anesthesiologist

Wylie NP, Beale L, Westley I.Consistency of remifentanil concentrations in propofol–remifentanil infusions. A laboratory-based study. Pediatr Anesth . 2022;32:727–731. doi: 10.1111/pan.14427

Difficulty Controlling Sedation Level Using Processed Electroencephalography Monitoring in a Patient With Intellectual Disability, Fontan Circulation, and a Severe Gag Reflex

Comparison of the Length and Shape of Various Preformed Nasotracheal Tubes

A Review of Current Literature of Interest to the Office-Based Anesthesiologist

General Anesthesia for a Child With a Living Donor Liver Transplant After Hepatoblastoma and Metastatic Lung Tumor Resection

Effect of Thermomechanical Stimulation on Pain During IANB Injections

Mistaken Endobronchial Placement of a Nasogastric Tube During Mandibular Fracture Surgery

The Effect of Intraoral Suction on Oxygen-Enriched Surgical Environments: A Mechanism for Reducing the Risk of Surgical Fires

Letter to the Editor

Monheim LM. Analgesia in dentistry now and in the future. Anesth Prog. 1971;18(5):100–106 and J Am Analg Soc. 1971:9:1(abstract).

A Review of Current Literature of Interest to the Office-Based Anesthesiologist