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V Dimitriou

Publications and source records attributed to V Dimitriou.

34 records · Page 2Linked to original sources
PubMed1999

Light-guided tracheal intubation using a prototype illuminated flexible catheter through the intubating laryngeal mask.

We evaluated the efficacy of a newly developed prototype illuminated flexible catheter to facilitate tracheal intubation through the intubating laryngeal mask and compared this light-guided technique with the conventional blind tracheal intubation through the intubating laryngeal mask. The illuminated flexible catheter consists of a completely flexible thin plastic catheter, a bulb attached to its distal end, a 15-mm concentric adapter at its proximal end connected with a battery and a power switch. The device is placed into a silicone tracheal tube in such a way that the bulb protrudes from the distal end of the tracheal tube. One hundred adult patients, ASA I-III, scheduled to undergo propofol/fentanyl/atracurium anaesthesia for elective surgery were studied. All participants underwent a randomized double comparative cross over trial with respect to the tracheal intubation technique through the intubating laryngeal mask. The light guided tracheal intubation was performed as follows; the tracheal tube preloaded with the illuminated flexible catheter was inserted through the intubating laryngeal mask and by observing the glow in the neck was advanced into the trachea. Whenever resistance was felt during insertion, appropriate adjusting manoeuvres were performed. The intubating laryngeal mask was inserted successfully in all patients. The success rate for the blind and light-guided technique was 91% and 100%, respectively (P = 0.003). The mean (+/- SD) duration including appropriate intubating laryngeal mask placement and tracheal intubation, was significantly lower in the light-guided tracheal intubation technique, than with the blind tracheal intubation (31 +/- 8 s vs. 43 +/- 18 s; P < 0.0001). We conclude that the use of an illuminated flexible catheter carries advantages either in optimizing the intubating laryngeal mask position in the laryngopharynx or in achieving a quick and safe light-guided advancement from laryngopharynx into the trachea.

Adult↗
PubMed1999

Comparison between two different propofol dosage regimens for insertion of cuffed oro-pharyngeal airway.

Conditions for insertion of the cuffed oropharyngeal airway (COPA) were assessed following two different dosage regimens of propofol: group I (n = 40): 1.5 mg.kg-1; group II (n = 40): 2.5 mg.kg-1. The insertion conditions were evaluated by using a scoring system (-, + and +2) of gag and cough reflexes. The necessary use of additional dosage of propofol and the duration of post-induction apnea were also recorded. There were no significant differences between the two groups in the incidence of coughing, gagging and the additional usage of induction agent. The mean (+/- SD) duration of apnea was significantly longer in the high dose group: 9 +/- 6 min vs 5 +/- 7 min (p = 0.007). Low dose of propofol combines efficient insertion conditions with decreased length of post-induction apnea.

Adult↗
PubMed1998

Value of oropharyngeal Mallampati classification in predicting difficult laryngoscopy among obese patients.

The prediction of difficult intubation in obese patients was investigated by co-estimating the degree of visibility of oropharyngeal structures in conjunction with the respective body mass index. Data were collected prospectively in a series of 1833 consecutive adult patients. Body mass index (BMI) in kg m-2 was used as a measure of obesity (morbid: > 40, moderate: 30-40, no obesity: < 30). The oropharyngeal class findings were assessed using the original methodology as well as by a modification requiring the tongue to be pulled forward by the examiner. Difficult intubation was defined as inadequate exposure of the glottis by direct laryngoscopy. Both oropharyngeal class methodologies were of equal sensitivity, whereas the modified technique presented a significantly higher positive predictive value (50.0% vs. 37.2%, P < 0.01). Statistical analysis revealed an increased risk of difficult laryngoscopy among obese patients compared with subjects with normal body mass index (20.2% vs. 7.6%, P < 0.001). When obesity is estimated with respect to oropharyngeal class the positive predictive value is greatly improved (66.7% vs. 20.2%, P < 0.001). We conclude that obesity which is associated with a disproportionately large base of the tongue, is a predisposing factor for difficult laryngoscopy.

Adult↗
PubMed1993

Double-blind comparison between doxapram and pethidine in the treatment of postanaesthetic shivering.

Sixty patients who shivered after routine surgery under general anaesthesia were allocated randomly to receive normal saline (n = 20), doxapram 1.5 mg kg-1 (n = 20) or pethidine 0.33 mg kg-1 (n = 20). Both doxapram and pethidine were effective in treating postoperative shivering 2-3 min after i.v. administration. In the group who received normal saline, 15 patients were still shivering 10 min after treatment, whilst in the doxapram group only three patients were shivering at that time. In the pethidine group, all patients had stopped shivering by 7 min after treatment. We conclude that both doxapram and pethidine were effective in the treatment of postoperative shivering.

Adolescent↗
PubMedDate not supplied

Lipid kinetics in obese patients undergoing laparoscopy. The impact of cortisol inhibition by etomidate.

The aim of this study was to investigate the response of cortisol, insulin and lipid parameters [serum Lipoprotein Lipase activity, choleseryl-ester transfer protein, triglycerides, total Cholesterol, High Density Lipoprotein, Free Fatty Acids] during the perioperative period in obese patients undergoing laparoscopic cholecystectomy. Twenty obese patients were included and divided in two groups. In group A (n=10) patients were anaesthetized with propofol and group B (n=10) with etomidate. Blood samples were collected before induction in anaesthesia, just after the end of the operation and at one, two and three hours postoperatively. According to our results, in both groups serum LPL activity showed a significant decrease whereas serum Free Fatty Acids a potent increase over time. Likewise, both groups did not demonstrate significant changes over time in choleseryl-ester transfer protein activity, total cholesterol, triglycerides, High Density Lipoprotein or insulin concentrations in serum. Furthermore, cortisol release was significantly inhibited in the etomidate group while substantially enhanced in propofol group. Additionally, apart of triglycerides, no difference was found between the two groups in all the lipid parameters and insulin concentrations. In conclusion, serum Free Fatty Acids levels and Lipoprotein Lipase activity demonstrated significant alterations in obese patients underwent laparoscopic cholecystectomy and this result did not seem to be related with the anaesthetic agent used for induction in anaesthesia.

Aged↗