Background With the popularisation of video laryngoscopy, the difficulty of tracheal intubation has greatly reduced. This study explored the suitability of traditional airway assessment methods for tracheal intubation using video laryngoscopy. Methods A total of 1047 patients undergoing general anaesthesia were enrolled. Before anaesthesia, body mass index (BMI) was measured. Traditional airway assessment methods such as the modified Mallampati classification (MMC), upper lip bite test (ULBT), thyromental distance (TMD), mouth opening (MO), and neck movement (NM) been rigorously evaluated. During tracheal intubation, the grading of glottis exposure (Cormack-Lehane) was recorded, along with the intubation duration and one-time intubation success rate. Additionally, the use of other improvement methods, such as applying pressure to the laryngeal node or utilising alternative intubation positions, was observed. Results The proportion of Cormack-Lehane ≤ 2 in MMC with 1 or 2, ULBT with 1, TMD with 1, and NM with 1 were much higher than that of Cormack-Lehane ≥ 3 (P < 0.05). However, there were no significant differences in MO or BMI between different glottic exposure grades (P > 0.05). Multiple logistic regression analysis showed that MMC, ULBT, TMD, and NM were independent risk factors for glottic exposure grading (P < 0.05). With the increase in variable grading, the intubation duration prolonged, and there were significant differences in MMC with 1 or 2 vs. 3 or 4, ULBT with 1 vs. 2 or 3, TMD with 1 vs. 2 or 3, MO with 1 vs. 2 or 3, and NM with 1 vs. 2 (P < 0.05). Conclusion Traditional airway assessment indicators continue to provide guidance for tracheal intubation under video laryngoscopy, and there is currently no necessity to develop new methods for airway evaluation. Trial registration Chinese Clinical Trial Register: ChiCTR2200057603) on 15 March 2022.

目的 观察湿化高流量鼻导管通气(humidified high flow nasal cannula,HFNC)在肝硬化患者胃镜治疗中的临床效果.方法 肝硬化患者择期行无痛胃镜下食管-胃底曲张静脉治疗40例,所有患者术前均无活动性上消化道出血,随机分为气管插管组(I组)和HFNC组(H组),每组20例.所有患者均采用全凭静脉麻醉,I组围术期行机械通气,H组保留自主呼吸.记录两组患者麻醉药用量、苏醒时间、麻醉相关并发症发生情况及患者满意度.结果 与I组相比,H组丙泊酚、芬太尼用量明显减少,术后苏醒时间缩短,围术期低血压及鼻出血的发生率较低,但轻度低氧血症发生率较高(P<0.05).两组患者围术期其他并发症发生情况及满意度的比较差异无统计学意义(P>0.05).结论 采用HFNC可减少肝硬化患者胃镜治疗期间全麻药用量,缩短术后苏醒时间,降低低血压及鼻出血发生率,但围术期需加强气道管理.

With the development of minimally invasive spine concepts and the introduction of new minimally invasive instruments, minimally invasive spine technology, represented by foraminoscopy, has flourished, and percutaneous foraminoscopy has become one of the most reliable minimally invasive procedures for the treatment of lumbar disc herniation. Percutaneous foraminoscopy is a safe and effective minimally invasive spinal endoscopic surgical technique. It fully protects the paravertebral muscles and soft tissues as well as the posterior column structure of the spine, provides precise treatment of the target nucleus pulposus tissue, with the advantages of less surgical trauma, fewer postoperative complications, and rapid postoperative recovery, and is widely promoted and used in clinical practice. In this paper, we can view the location, morphology, structure, alignment, and adjacency relationships by performing coronary, CT, and diagonal reconstruction along the attachment of the yellow ligaments and performing 3D reconstruction or processing techniques after performing CT scans. This allows clinicians to observe the laminoplasty and the stenosis of the vertebral canal in a more intuitive and overall manner. It has clinical significance for the display of the sublaminar spine as well as the physician's judgment of the disease and the choice of surgery.

It was reported that prolonging the injection time or diluting administration can reduce the incidence of opioid-induced cough. However, the incidence of sufentanil-induced cough (SIC) via a standardized infusion rate is unclear. A mechanical dropper is an infusion filtering device commonly used for intravenous degassing; it can also be used to administer special drugs due to its temporary storage and dilution effect. This study assesses the effectiveness of administration via mechanical dropper on SIC.

Background With the development of painless diagnosis and treatment, remifentanil, a synthetic opioid agonist, is increasingly used in gastroscopy for its rapid, short-term, and potent analgesic effect. However, the dosage of remifentanil used in endoscopy is unclear. Index of consciousness (IOC) is a new anesthesia depth-monitoring indicator that can be divided into index of consciousness 1 (IOC 1 ) and index of consciousness 2 (IOC 2 ); IOC 1 is used for estimating a patient’s sedation state, whereas IOC 2 reflects analgesic depth. We hypothesized that combining with IOC 1 and IOC 2 monitoring may be helpful to identify an optimal remifentanil dosage in gastroscopic polypectomy. Methods One hundred twenty patients scheduled for gastroscopic polypectomy were enrolled and were randomly assigned to remifentanil 2 ng/mL (group R2), 4 ng/mL (group R4), or 6 ng/mL (group R6), and 40 cases were in each group. During the anesthesia period, remifentanil was kept at the initial given concentration but propofol was adjusted according to IOC 1 . The primary outcomes were the dosage of propofol and remifentanil. The secondary outcomes were the variety of IOC 1 and IOC 2 , patients’ awakening time, and peri-operative adverse reactions such as hypotension, hypertension, bradycardia, tachycardia, body movements, hypoxemia, therapy interruption, nausea, vomiting, aspiration, and intra-operative awareness. Results With the increasing dosage of remifentanil, the propofol dosage and patients’ awakening time decreased significantly, the morbidity of hypertension and body movements also declined, but the incidence of hypotension, bradycardia, and hypoxemia rose. In group R2, the value of IOC 2 remained above 50 during the treatment. However, IOC 2 dropped to below 30 at the beginning of the gastroscopy in group R6, and there was statistical difference in hypoxemia between groups R2 and R6 ( P <0.05). Conclusions With the help of IOC monitoring, we found that a target concentration of remifentanil 4 ng/mL is comparatively ideal in patients under gastroscopic polypectomy. Trial registration Chinese Clinical Trial Register: ChiCTR-OOD-16009489 , on October 19, 2016.