Objectives: To estimate the accuracy and rapidity of bed-side upper airway ultrasonography (UA-US) versus standard auscultation (SA) for confirmation of endotracheal tube (ETT) position. Patients and methods:107 patients underwent tracheal intubation for maintenance of general anesthesia. Position of ETT was confirmed by chest auscultation for the presence of breath sounds on both sides, and by UA-US using 9-12 MHz linear US transducer that was placed transversely on the neck anteriorly and superior to the suprasternal notch to visualize the ETT in the tracheal transverse and longitudinal views. The data obtained were compared to findings on using waveform capnography (WC). Time to define ETT position was determined. Study outcomes included determination of ETT position; tracheal or esophageal, accuracy of diagnosis and time taken till confirming the diagnosis. Results:With comparison to WC findings, UA-US revealed sensitivity, specificity and accuracy rates of 97%, 71.4% and 95.3% while that for SA were 93.6%, 53.9% and 88.8%, respectively with significantly higher specificity and accuracy rates for UA-WC versus SA. Time required for confirmation of ETT position was significantly shorter with WC (9.16 ± 0.69 sec.) compared to SA and UA-US with significant difference in favor of UA-US (11.14 ± 1.3 vs. 13.5 ± 2.15 sec). Conclusion:Confirmation of ETT position using UA-US or WC is very important because of the high false result depending on SA alone. UA-US using bed-side equipment is a simple, accurate and fast method than SA compared to WC as a gold standard, so it is recommended to be one of the important theater equipments whenever possible

Sevoflurane is an inhaled anesthetic widely used for pediatric anesthesia, but emergence agitation (EA) or emergence delirium (ED) is a common sevoflurane anesthesia recovery-associated problem.1 Emergence agitation is associated with increased risk of injury in children and parents' dissatisfaction with anesthesia care.2 In a web-based survey of pediatric anesthesiologists in Canadian Pediatric Anesthesia Society, 42% felt that EA was a significant problem and 45% of them were giving medication before or during anesthesia to prevent its development.

Background and Objectives: To evaluate outcome of pain management after modified radical mastectomy (MRM) using US-guided combined pectoral and serratus anterior (PEC1/SAB) block versus thoracic paravertebral block (PVB).Methodology: Ninety women were categorized into control group received no block, PVB group received PVB and PEC1/SAB group received PEC1 and SAB immediately after surgical wound closure using levobupivacaine. Postoperative (PO) pain was monitored for 24-hr PO; using 11-points numeric rating scale (NRS) and at NRS score ≥4, IV morphine (0.05 mg/kg) was given. Primary outcome was reduction of 24-hr amount of morphine consumption by 20% with regional block in relation to no block. Results were analyzed using paired t-test, One-way ANOVA Test and Chi square test.Results: PVB and PEC1/SAB blocks significantly reduced PO morphine consumption by 40.4% and 49.2%, respectively and PEC1/SAB block significantly reduced the amount used by 14.8% of the dose received with PVB block. Duration of PO analgesia was significantly longer, and number of morphine requests and collective 24-hr NRS scores were significantly lower in with blocks than no block with non-significant differences between both types of block. Morphine-induced side effects were more manifest in control patients. Conclusion:PVB or PEC1/SAB blocks allowed reduction of PO morphine consumption by >40% than no block with significantly longer duration of PO analgesia and lower number of requests of additional analgesia in comparison to no block. PEC1/SAB block significantly reduced amount of morphine consumption than PVB.