Introduction. This study compared streamlined liner of the pharynx airway (SLIPA) and I-gel noninflatable, single-use, supraglottic airway device (SAD) performance in anesthetized, paralyzed adults. Methods. Eighty adults (ASA physical statuses I–III) who were undergoing elective procedures under general anesthesia with an SAD were enrolled in this prospective, randomized, single-blind study. Subjects were randomly and evenly assigned to the SLIPA or I-gel group for intraoperative airway management. Ease and number of insertions, insertion time, oropharyngeal sealing pressure, hemodynamic response, oxygen saturation (SpO2), end-tidal CO2 (EtCO2), and peri- and postoperative complications were examined. Results. The SLIPA and I-gel devices were successfully inserted in 100% and 95% of subjects, respectively. In two I-gel subjects (5%), ventilation was not possible after two attempts, but a size 55 SLIPA was successfully inserted in both cases. Forty-two and 38 patients were ultimately included in the SLIPA and I-gel groups, respectively. Insertion time was significantly shorter with the SLIPA (11.19 ± 3.03 s) than with the I-gel (15.05 ± 6.37 s, P = 0.003). Oropharyngeal sealing pressure was significantly higher in SLIPA (28.76 ± 3.11 cmH2O) than in I-gel (25.9 ± 3.65 cmH2O) subjects (P = 0.001). Blood staining occurred more frequently in SLIPA (n = 8, 19.0%) than in I-gel (n = 5, 13.2%) patients (P < 0.01). Heart rate, mean arterial blood pressure, SpO2, and EtCO2 were not significantly different between groups. Conclusion. Although blood staining incidence was higher, SLIPA insertion was easier and faster than I-gel insertion. The SLIPA provided better airway sealing pressure. Both devices had similar mechanical ventilation and oxygenation characteristics and comparable hemodynamic stability. Both noninflatable SADs are useful, but SLIPA rapid insertion and good airway sealing make it an effective alternative to the I-gel.

COVID-19 is a highly infectious contagious virus. One of the major concerns is crossinfection of healthcare staff and other patients without COVID-19 in the hospitals. This is a major problem for patients with COVID-19 who require a surgical or interventional procedure, especially pregnant women. In our successful experience, we have adopted a ''closed circuit'' model for those patients by the proper utilization of the burns unit at our center. Accordingly, no cases of cross-infection were reported.

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Background Intraoperative awareness is the second most common complication of surgeries, and it negatively affects patients and healthcare professionals. Based on the limited previous studies, there is a wide variation in the incidence of intraoperative awareness and in the practices and attitudes toward depth of anesthesia (DoA) monitoring among healthcare systems and anesthesiologists. This study aimed to evaluate the Jordanian anesthesiologists’ practice and attitudes toward DoA monitoring and estimate the event rate of intraoperative awareness among the participating anesthesiologists. Methods A descriptive cross-sectional survey of Jordanian anesthesiologists working in public, private, and university hospitals was utilized using a questionnaire developed based on previous studies. Practice and attitude in using DoA monitors were evaluated. Anesthesiologists were asked to best estimate the number of anesthesia procedures and frequency of intraoperative awareness events in the year before. Percentages and 95% Confidence Intervals (95%CI) were reported and compared between groups using chi-square tests. Results A total of 107 anesthesiologists responded and completed the survey. About one-third of the respondents (34.6%; 95% CI 26.1–44.2) had never used a DoA monitor and only 6.5% (95% CI 3.1–13.2) reported using it as a “daily practice”. The use of a DoA monitor was associated with experience and type of health sector. However, 81.3% (95% CI 66.5–83.5) believed that currently available DoA monitors are effective for DoA monitoring and only 4.7% (95%CI 1.9–10.8) reported it as being “invalid”. Most respondents reported that the main purpose of using a DoA monitor was to prevent awareness (86.0%; 95%CI 77.9–91.4), guide the delivery of anesthetics (63.6%; 95%CI 53.9–72.2), and reduce recovery time (57%; 95%CI 47.4–66.1). The event rate of intraoperative awareness was estimated at 0.4% among participating anesthesiologists. Most Jordanian hospitals lacked policy intending to prevent intraoperative awareness. Conclusions Most anesthesiologists believed in the role of DoA monitors in preventing intraoperative awareness, however, their attitudes and knowledge are inadequate, and few use DoA monitors in routine practices. In Jordan, large efforts are needed to regulate the use of DoA monitoring and reduce the incidence of intraoperative awareness.