Biomedical subjects

Ronald B George

Publications and source records attributed to Ronald B George.

3 recordsLinked to original sources

PubMed2006

Laryngoscopic evaluation with the Airway Cam.

PURPOSE: The Airway Cam is a head-mounted direct laryngoscopy video system which uses a prismatic sighting system that aligns with the operator's line of sight. This study evaluated intra- and inter-observer consistency in laryngoscopy grading comparing direct laryngoscopy to the laryngoscopy grade obtained with the Airway Cam. METHODS: Twenty-seven patients receiving a general anesthetic for elective surgery had laryngoscopy performed by an anesthesiologist wearing the Airway Cam. Each video was duplicated, then randomized and reviewed in a blinded fashion by the original laryngoscopist and a second anesthesiologist. Intra- and inter-observer correlations were identified. RESULTS: There was good intra-observer agreement of the Cormack-Lehane scale between direct laryngoscopy and laryngoscopy recorded with the Airway Cam (kappa = 0.63). The corresponding intra-observer correlation of the percentage of glottic opening score was strong at r = 0.83. There was good inter-observer agreement of the Cormack-Lehane scale between direct laryngoscopy and that observed by the second anesthesiologist during Airway Cam video review (kappa = 0.70). There was moderate correlation of the inter-observer percentage of glottic opening scores (r = 0.73). CONCLUSION: This study validates that the view recorded by the Airway Cam reflects the view of the laryngoscopist. The Airway Cam may introduce an additional level of objectivity into airway management research and teaching.

Adult↗

PubMed2005

Bilateral hearing loss following a retrobulbar block.

PURPOSE: Regional anesthesia is the most commonly used ophthalmological anesthetic technique in Canada and the United States. Brainstem anesthesia is not an uncommon complication of retrobulbar blocks. Anesthesiologists are a prominent element in the ophthalmology suite, in part due to the complications possible with regional anesthesia. This is the first reported case of complete bilateral hearing loss following a retrobulbar block. CLINICAL FEATURES: A 46-yr-old male with type 1 diabetes mellitus presenting for ophthalmological surgery had a retrobulbar block performed by the ophthalmologist. Local anesthetic was injected through a 25 G, 1.5 inch needle, entering the orbit inferiorly on the temporal third of the lower lid. Shortly after the block was completed the patient experienced sudden hearing loss. On examination the hearing loss appeared to be complete and bilateral. The patient was alert and oriented; the remainder of the cranial nerve exam was normal. The patient's hearing loss gradually improved and three hours after the block his hearing had subjectively returned to normal. CONCLUSION: Brainstem anesthesia is not a rare complication of regional anesthesia for ophthalmological surgery. Symptoms include confusion, mental agitation, dizziness, blurred vision or blindness, ophthalmoplegia, deafness, tinnitus, dysphagia, dysarthria, respiratory depression to apnea, and/or limb paralysis. A connection between the subdural and subarachnoid spaces and the optic sheath exists. The effect on the central nervous system depends upon the amount of local anesthetic injected and the area to which it spreads.

Anesthesia, Conduction↗

PubMedDate not supplied

Suppurative mediastinitis secondary to Burkholderia cepacia in a patient with cystic fibrosis.

Burkholderia cepacia is an important opportunistic pathogen among patients with cystic fibrosis (CF); it is associated with deterioration of lung function, poor outcome following lung transplantation and increased mortality. Fever, an elevated white blood cell count, weight loss and an often fatal deterioration in pulmonary function characterize a particular clinical course, termed "Cepacia syndrome". The present case report describes a 40-year-old man with CF who developed Cepacia syndrome complicated by suppurative mediastinitis, from which B cepacia was isolated. Despite optimal medical and surgical therapy, this patient succumbed to his illness. Those caring for patients with CF should be aware of this potentially catastrophic complication of B cepacia infection, especially in the setting of Cepacia syndrome.

Adult↗