Biomedical subjects

J G Poulos

Publications and source records attributed to J G Poulos.

6 recordsLinked to original sources

PubMedDate not supplied

The laryngeal lift: a method to facilitate endotracheal intubation.

STUDY OBJECTIVE: To assess the efficacy of the "laryngeal lift" maneuver in improving laryngoscopic visualization to facilitate endotracheal intubation. DESIGN: Blinded study. SETTING: Operating room at Meridia Huron Hospital. PATIENTS: 305 patients receiving general anesthesia for elective surgery requiring intubation. (Five patients were eliminated from the study because we elected to intubate these patients awake and sedated.) INTERVENTIONS: Following induction of anesthesia and paralysis with muscle relaxants, laryngoscopic views of each patient were evaluated by the laryngoscopist before and after the laryngeal lift was performed by an anesthesiologist assisting the laryngoscopist. Each patient served as his or her own control group. The anesthesiologist was blinded to the results obtained by the laryngoscopist. All Grade I laryngoscopic views were eliminated (198 patients). Five patients were eliminated on the basis of obesity or atlantoaxial subluxation. The laryngeal lift was performed on the remaining 102 patients, representing Grade II to Grade V laryngoscopic views. MEASUREMENTS AND MAIN RESULTS: A modification of the original classification of laryngoscopic views by Cormack and Lehane was used: Grade I = full view of glottis; Grade II = only posterior commissure visible; Grade III = arytenoids visible; Grade IV = epiglottis visible; Grade V = no glottic structure visible. In 98 of 102 cases (96%), the maneuver improved visualization by at least 1 grade. There was no evidence of change in the 4 remaining cases. CONCLUSIONS: The laryngeal lift should be part of the anesthesiologists' armamentarium in helping the laryngoscopist who is faced with Grades II, III, IV, and V laryngoscopic views to enhance visualization of the larynx and thus facilitate endotracheal intubation.

Anesthesia, General↗

PubMedDate not supplied

Uvular necrosis following endotracheal intubation.

Uvular necrosis as a potential source of infection is a poorly detected complication that should be considered as part of the differential diagnosis of postoperative sore throat. We report a unique case of uvular necrosis following endotracheal intubation. The patient complained of a severe sore throat and foreign body sensation 48 hours following surgery.

Adolescent↗

PubMedDate not supplied

Risks of infection from short-term epidural catheter use.

The risks of infection from the short-term use of epidural catheters were studied in 200 patients. The incidence of infection observed was found to be insignificant, which supports the continued use of an epidural catheter over several days.

Adult↗

PubMedDate not supplied

The incidence of neurovascular complications following axillary brachial plexus block using a transarterial approach. A prospective study of 1,000 consecutive patients.

BACKGROUND AND OBJECTIVES: The present study was performed at the Crystal Clinic Surgery Center, an outpatient free-standing surgicenter specializing in orthopedic surgery, to determine the incidence of both neurologic and vascular sequelae associated with exclusive use of a transarterial approach to axillary brachial plexus block in order to assess the technique's safety and efficacy. METHODS: The prospective consecutive study involved 1,000 adult patients scheduled for surgery using axillary brachial plexus block. The transarterial approach was performed on all patients using a medium-bevel 24-gauge Jelco 1-5-inch needle. Data tabulated included the incidence of neurovascular complications and the outcome of successful axillary brachial plexus anesthesia. RESULTS: Two patients presented with a sensory paresthesia (0.2%) in the distribution of the ulnar nerve and the musculocutaneous nerve that most likely occurred during supplementation of an incomplete block. Three patients presented with upper-arm myalgias (0.3%) related to tourniquet injury. After the operation, two patients developed reflex sympathetic dystrophy, which responded to stellate ganglion blocks. Vascular complications, including transient arterial spasm in 10 of 996 (1%), unintentional intravascular injection in 2 of 996 (0.2%), and small (0-2 cm) hematoma formation in 2 of 996 (0.2%), were recognized but did not require any intervention other than close observation. The study revealed a complete block in 88.8% of cases, an incomplete block requiring supplemental local anesthesia in 10% of cases, and a complete block failure in 1.2%. CONCLUSIONS: This study demonstrated the safety and efficacy of the transarterial technique in achieving brachial plexus block.

Adult↗

PubMedDate not supplied

Curing lights: changes in intensity output with use over time.

Intensity output of curing lights affects cure depth and time needed for complete polymerization of resin composites. In this study, changes in intensity output of Max Curing Lights (L.D. Caulk Co., Milford, DE) were compared over time. With a Demetron Model 100 Curing Radiometer (Demetron Research Corp., Danbury, CT), 201 curing lights (from 1 to 3 years old) were tested. The 1- and 2-year-old lights had mean outputs of 423 mW/cm2; the 3-year-old lights had a mean output of 376 mW/cm2. An analysis of variance (ANOVA) and post-hoc Scheffe test demonstrated a significant effect of use over time on intensity output of these lights.

Analysis of Variance↗

PubMedDate not supplied

Disinfection of impressions. Methods and effects on accuracy.

An understanding of the methods and mechanics of sterilization and disinfection is necessary to prevent bacterial cross-contamination. Since sterilization of impressions is not possible, because of the high temperature and time needed, disinfection is the method of choice. The most effective means of disinfecting impressions is to immerse them in disinfectant solution for 30 minutes. Most hydrophobic impression materials exhibit minimal distortion when disinfected in this manner. Irreversible hydrocolloid (alginate) and hydrophilic silicones distort when immersed and can be disinfected by spraying and placing in a sealed plastic bag for manufacturer's recommended time. Internal disinfection (replacing water with disinfectant before impression taking) is the method of choice for alginate, since it allows immediate pouring of the impression after removal from the oral cavity.

Aerosols↗