[Spanish Society of Anaesthesia (SEDAR) guidelines for pre-anaesthesia checking procedures]. / Directrices de procedimientos de comprobación y validación («chequeo¼) previos a la anestesia de la Sociedad Española de Anestesiología.

We present this document as a guide to preparing a specific institutional pre-anaesthesia checklist, as recommended in the Helsinki declaration on patient safety in anaesthesiology. Also, the recently recommended WHO "safe surgery check-list" includes a check-list for anaesthesia. A working group was established in accordance with the charter of the Spanish Society of Anaesthesiology and Resuscitation (Sociedad Española de Anestesiología y Reanimación [SEDAR]). The new patient safety culture introduced into medicine, and the recommendations of European anaesthesia societies has led us to design and update protocols in order to improve results in this important part of our speciality. We have prepared these recommendations or guidelines using, as examples, updates of pre-anaesthesia check-lists by other American (ASA), British, or Canadian societies of anaesthesia. With that aim, we enlisted the help of anaesthesia ventilator experts and the participation and advice of experienced anaesthesiologists from all parts of Spain. After various corrections and modifications, the document was available at www.sedar.es, so that any anaesthesiologist could propose any correction, or give their opinion. Finally, these guidelines have been approved by the SEDAR Board of Directors, before it was sent for publication in this journal. The aims of this document are to provide: a guideline applicable to all anaesthesia machines, a descriptive pre-anaesthesia check-list that include everything necessary for the anaesthesia procedure, and a resumed check-list to be available in all the anaesthesia machines or other equivalent, but prepared for each institution, which should include anaesthetic equipment and drugs. So, in order to ensure the aims and requirements of the European Board of Anaesthesiology, the European Society of Anaesthesiology, and the WHO are met, each institution should have a protocol for checking equipment and drugs. These guidelines are applicable to any anaesthesia equipment, enabling every institution to develop their own checking protocols, adapted to their anaesthesia machines and their procedures. With the consent of the SEDAR, this group will collaborate with anaesthesia machines providers in order to develop specific checklists for each of their models that will be available at www.sedar.es.

[The laryngeal tube]. / El tubo laríngeo.

The laryngeal tube (VBM Medizintechnic GmbH, Sulz, Germany) is a supraglottic device designed for airway management in spontaneous or positive-pressure ventilation during anesthesia or in cardiopulmonary resuscitation. Currently, the tube is available in 4 versions: the standard laryngeal tube, the disposable tube (LT-D), the dual-lumen tube (with a tube for suction) (LTS II), and the disposable LTS (LTS-D). The design of the tube has been modified several times. It is easy to insert and the airway seal is more effective than that of the laryngeal mask. The incidence of complications is similar for both devices, though use of the laryngeal tube requires more adjustments. The standard tube is somewhat less effective than the ProSeal laryngeal mask, though the new LTS II has been improved considerably. The laryngeal tube is effective as an aid to management of the difficult airway. We reviewed the literature indexed on MEDLINE through December 2006 using the search terms laryngeal tube, anesthesia, equipment, and airway.

El tubo laríngeo / The laryngeal tube

El tubo laríngeo (TL) (VBM Medizintechnik GMBH,Sulz, Alemania) es un dispositivo supraglótico diseñadopara el manejo de la vía aérea en ventilación espontáneao controlada durante la anestesia o en resucitación cardiopulmonar.En la actualidad existen cuatro variantesdel TL: el TL estándar, el TL de un solo uso (TL-D), eltubo laríngeo succión II (TLS II) y el TLS desechable(TLS-D). El diseño del TL ha sido revisado en diferentesocasiones. Su inserción se realiza con facilidad. El selladode la vía aérea con el TL es más eficaz que con lamascarilla laríngea (ML). La incidencia de complicacioneses similar en los dos dispositivos, aunque el TLrequiere de más reajustes para su utilización. El TLestándar es algo menos efectivo que la ML Proseal, aunqueel nuevo TLS II ha sido mejorado significativamente.Es un dispositivo eficaz como ayuda en la resolucióndel manejo de la vía aérea difícil. Hemos revisado la literaturamédica existente hasta diciembre 2006 mediantebúsqueda en MEDLINE, utilizando los términos “laryngealtube”, “anaesthesia”, “equipment” and “airway” (AU)

The laryngeal tube (VBM Medizintechnic GmbH, Sulz,Germany) is a supraglottic device designed for airwaymanagement in spontaneous or positive-pressureventilation during anesthesia or in cardiopulmonaryresuscitation. Currently, the tube is available in 4versions: the standard laryngeal tube, the disposable tube(LT-D), the dual-lumen tube (with a tube for suction)(LTS II), and the disposable LTS (LTS-D). The design ofthe tube has been modified several times. It is easy toinsert and the airway seal is more effective than that ofthe laryngeal mask. The incidence of complications issimilar for both devices, though use of the laryngeal tuberequires more adjustments. The standard tube issomewhat less effective than the ProSeal laryngeal mask,though the new LTS II has been improved considerably.The laryngeal tube is effective as an aid to management ofthe difficult airway. We reviewed the literature indexed onMEDLINE through December 2006 using the searchterms laryngeal tube, anesthesia, equipment, and airway (AU)

Anaphylactic reaction after atropine.

A 38-year-old woman developed symptoms of anaphylactic shock after intravenous atropine and required adrenaline to maintain perfusion pressure. A strongly positive response was obtained on intradermal testing. The Prausnitz-Kuestner test was also positive, which indicated the presence of drug specific IgE antibodies. No response was obtained after hyoscine.