The Ambu aScope 3 Slim required more time to intubate than the conventional reusable FOB. It requires more rigidity, similar to the conventional FOB for management of the difficult airway.

Anaesthetists possibly contribute to the spread of infections during anaesthesia. The adenosine triphosphate (ATP) bioluminescence assay is an easy-to-perform, on-the-spot assay that provides objective data; therefore, using the LuciPac ® Pen and the Lumitester PD-20 ® System, we assessed contamination of the working environment of anaesthetists before and after surgery as well as their hands at the time of each procedure during induction and extubation. Similarly, cleanliness of the operating room was evaluated using this assay to determine whether it is useful to assess the effectiveness of the routine cleaning protocols followed after surgery. ATP concentrations in the working environment of anaesthetists and their hands increased during surgery. In addition, ATP concentrations within the working environment decreased after routine cleaning with ethanol or accelerated hydrogen peroxide; however, there were no differences in the number of sites with ATP concentrations >500 relative light units before and after cleaning. This method is useful to evaluate contamination of the working environment of anaesthetists; nevertheless, it is prudent to evaluate the effectiveness of routine cleaning protocols because ATP bioluminescence assays are influenced by the use of various disinfectants at varying concentrations.

No abstract

The Masimo Radical-7 monitor provides better detection of apnea in volunteers than the Nellcor™ PM-1000N.

IntroductionRegional oxygen saturation (rSO2) reflects tissue perfusion. This observational study aimed to examine the change in the forehead and lower thigh rSO2 associated with intraoperative posture, anesthesia regimen, or mean arterial pressure (mAP) at heart and external auditory meatus (ear) levels. MethodsPatients undergoing robot-assisted laparoscopic radical prostatectomy in the Trendelenburg position at 30°w ith pneumoperitoneum (TPP) or arthroscopic shoulder surgery in the beach chair position at 70° (BCP) under desflurane-remifentanil (D/R) or propofol-remifentanil (P/R) anesthesia were examined. Bilateral forehead and lower thigh rSO2 values and mean radial artery pressure were measured simultaneously at heart and ear levels. ResultsIn TPP, there were no differences under anesthesia regimens in the forehead or lower thigh rSO2 change, although one patient with an absolute lower thigh rSO2 of ≤50% in the lithotomy position complained of transient limb pain. No correlation was observed between rSO2 and mAP. In BCP, forehead rSO2 decreased and lower thigh rSO2 increased under either of the anesthesia regimens. The coefficient of correlation between forehead rSO2 and heart-level and ear-level mAP was 0.341 and 0.236, respectively. ConclusionsThere were no differences under anesthesia regimens in the changes of forehead rSO2 and lower thigh rSO2. In TPP, significant changes in forehead rSO2 and lower thigh rSO2 were not observed. Monitoring lower thigh rSO2 might be useful for preventing lower extremity pain. In BCP, forehead rSO2 decreased and lower thigh rSO2 increased from the supine position to the BCP. To prevent brain damage, anesthesiologists should pay attention to heart-and ear-level mAP.