No abstract

Background: Intubation is an optimal method for opening the airway and effective ventilation to the patient. There are some problems during intubation. It is important to identify devices like videolaryngoscopes and guides for shorten the procedure. This study addresses the use of a Truflex Articulating Stylet (TAS) verses Rapid position intubating Stylet (RPIS) using D -blade video laryngoscopy with manual inline stabilization during cervical spine surgeries. Subjects and Methods: It was single blinded, prospective, randomized, interventional study. Sixty patients between 18 and 60 years of age belonging to either sex undergoing tracheal intubation under uniform general anesthetic technique will be randomly divided into Rapid position intubating Stylet (RPIS) group and Truflex articulating stylet group during cervical spine surgeries. For comparison of intubation times and the Intubation Difficulty Score, ANOVA will be used. Mallampati grading (MPG), mouth opening (MO), thyromental distance (TMD), sternomental distance (SMD), Cormack Lehane's grading (CLG) were recorded. Student t test, Fisher's exact test, Mann-Whitney U test and Chi square test were used where appropriate. A p value of less than 0.05 was considered statistically significant. Results: Intubation using a video laryngoscope with a Truflex articulating stylet was more effective than that using a standard intubation stylet with the same laryngoscope. There were no complications observed during the procedure with either of the stylets. There was no significant difference between the two groups with respect to total intubation time. Conclusion: The results suggest that the patients intubated using Truflex articulating stylet and RPIS stylet has no difference in terms of successful or failed intubation. The patients intubated using Truflex articulating stylet has lesser endotracheal tube negotiation time compared to the patients intubated with RPIS and without much significant difference in number of attempts, total intubation time, glotticoscopy time and any complications in any stylets.

In spite of the relative common occurrence of spinal injuries, spinal epidural hematomas (SEHs) are rare lesions. Depending on the onset, site, size, and presence of neurological deficits, they can be treated conservatively or surgically. In the presented article, we report an uncommon case of posttraumatic dorsolumbar SEH and discuss the characteristic magnetic resonance imaging (MRI) imaging findings of epidural fat in the cases of traumatic spinal hematomas.

No abstract

Epidural anaesthesia is being regularly practised in many clinical settings and there are many documented complications. Here we report the successful management of accidental migration of epidural catheter into the subarachnoid space causing near collapse in a patient. Key words: Epidural anaesthesia, Catheter migration, Subarachnoid space