Editor's key points † This study investigates the risk factors for reintubation in post-anaesthetic care units related to anaesthetic processes. † Risk factors were age ,1 yr, chronic pulmonary disease, preoperative hypoalbuminaemia and renal insufficiency, head and neck surgery, airway surgery, cardiothoracic surgery, cardiac catheterization, emergency case, duration of operation more than 3 h, ASA physical status III, and the use of certain neuromuscular blocking agents. Background. Risk factors for reintubation in post-anaesthetic care units related to anaesthetic processes have not previously been reported. Our goal was to identify risk factors for reintubation in general surgical patients. Methods. A time-matched, case-control study was conducted on anaesthetic patients between 2001 and 2011. One hundred and sixty-four reintubated patients were compared with 656 randomly selected controls. Results. Independent risk factors for reintubation were age ,1 yr vs age 30-49 yr [odds ratio (OR)¼16.4, 95% confidence interval (CI)¼5.7-47.7], chronic pulmonary disease (OR¼2.1, CI¼1.1-4.0), preoperative hypoalbuminaemia (OR¼4.9, CI¼2.4 -10), creatinine clearance ,24 vs .60 (OR¼4.1, CI¼1.2-13.4), emergency case (OR¼1.8, CI¼1.0-3.1), operative time .3 vs ,1 h (OR¼3.0, CI¼1.5 -6.2), airway surgery (OR¼32.2, CI¼13.6 -76), head and neck surgery (OR¼3.4, CI¼1.8 -6.2), cardiac surgery (OR¼3.8, CI¼1.1 -13.4), thoracic surgery (OR¼6.3, CI¼1.9-21.2), cardiac catheterization (OR¼2.5, CI¼1.1 -5.5), ASA physical status III (OR¼3.8, CI¼1.4-10), and the use of certain types of neuromuscular blocking agent (P,0.001). Conclusions. Age ,1 yr, chronic pulmonary disease, preoperative hypoalbuminaemia, and renal insufficiency were patient factors for reintubation. Emergency case, head and neck, cardiothoracic and airway surgery, and operative time .3 h were operative factors, while certain neuromuscular blocking agents and ASA physical status III were anaesthetic factors for reintubation. ParticipantsThe anaesthetic database included all patients who were serviced by anaesthetists either inside or outside the operating theatres. The database consisted of two parts. The first part contained preoperative data and intraoperative data which were entered into the database upon admission to the PACU by the anaesthetists involved in the patient's intraoperative care. The second part consisted of postoperative

We present two cases of transient lingual nerve injury that were associated with the use of a laryngeal mask airway Supreme™ (The Laryngeal Mask Company, Singapore) during lumbar discectomy in a 43-year-old female and i-gel™ (Intersurgical, Berkshire, UK) during ovum pick up in a 33-year-old female. They presented with numbness at the tip of their tongues and spontaneously and fully recovered 2 weeks after their operations.

Background. Tracheal intubation is a potentially life-saving procedure. This skill is taught to many anesthetic healthcare professionals, including nurse anesthetists. Our goal was to evaluate the learning ability of nurse anesthetist trainees in their performance of orotracheal intubation with the Macintosh laryngoscope. Methods. Eleven nurse anesthetist trainees were enrolled in the study during the first three months of their training. All trainees attended formal lectures and practice sessions with manikins at least one time on performing successful tracheal intubation under supervision of anesthesiology staff. Learning curves for each nurse anesthetist trainee were constructed with the standard cumulative summation (cusum) methods. Results. Tracheal intubation was attempted on 388 patients. Three hundred and six patients (78.9%) were successfully intubated on the trainees' first attempt and 17 patients (4.4%) on the second attempt. The mean ± SD number of orotracheal intubations per trainee was 35.5 ± 5.1 (range 30–47). Ten (90.9%) of 11 trainees crossed the 20% acceptable failure rate line. A median of 22 procedures was required to achieve an 80% orotracheal intubations success rate. Conclusion. At least 22 procedures were required to reach an 80% success rate for orotracheal intubation using Macintosh laryngoscope in nonexperienced nurse anesthetist trainees.

Intraoperative intensive glycaemic treatment significantly increased the risk of hypoglycaemia, but its effect on post-operative infection by clinical assessment could not be determined. Anaesthetic duration, pre-operative and post-operative IL-6 levels can independently predict post-operative infection.