Scholars@Duke
Chakib Ayoub

Chakib Ayoub

Professor of Anesthesiology
Anesthesiology, General, Vascular, High Risk Transplant & Critical Care
chakib.ayoub@duke.edu
Duke University School of Medi, 2301 Erwin Road, 5673 Hapf, Durham, NC 27710

Selected Publications

General anesthesia and/or deep hypnotic state in propofol-based conscious sedation for endoscopy

Journal Article iGIE · June 1, 2024 Background and Aims: Although moderate sedation (defined as a depression of consciousness with the retention of the ability to respond purposefully to verbal commands) is the goal in endoscopy, the exact depth of sedation reached in practice has not been w ... Full text Cite

“I Can’t Ventilate!” Intraoperative Anesthesia Safety Events and Airway Management

Chapter · January 1, 2024 Management of the difficult airway is guided by expert algorithms and consensus. Maintenance of adequate patient oxygenation is the first priority. The best indicator that a patient may be easily ventilated or intubated is a history of prior success. In th ... Full text Cite

The Role of Sleep Apnea in Postoperative Neurocognitive Disorders among Older Noncardiac Surgery Patients: A Cohort Study

Journal Article Anesthesia and Analgesia · January 1, 2024 BACKGROUND: Obstructive sleep apnea is associated with increased dementia risk, yet its role in postoperative neurocognitive disorders is unclear. Here, we studied whether the severity of untreated obstructive sleep apnea is associated with the severity of ... Full text Cite

Randomized controlled trial of procedural sequence for same-day bidirectional endoscopy under monitored anesthesia care (RECoVER Trial)

Journal Article iGIE · September 1, 2023 Background and Aims: Evidence regarding the ideal endoscopy sequence is inconclusive in patients undergoing same-day bidirectional endoscopy (BDE). Methods: Adults undergoing endoscopy with moderate sedation were randomized to either colonoscopy first (C-E ... Full text Open Access Cite

Awake spinal anesthesia facilitates spine surgery in poor surgical candidates: A case series.

Journal Article Neurochirurgie · May 2023 BACKGROUND: Annually, hundreds of thousands of patients undergo surgery for degenerative spine disease (DSD). This represents only a fraction of patients that present for surgical consideration. Procedures are often avoided due to comorbidities that make p ... Full text Open Access Link to item Cite

The "In-Parallel" Technique for Awake, Bilateral Simultaneous Minimally Invasive Transforaminal Lumbar Interbody Fusion and Multilevel Lumbar Decompression.

Journal Article Oper Neurosurg (Hagerstown) · March 1, 2023 BACKGROUND: Minimally invasive transforaminal lumbar interbody fusion (MIS TLIF) and MIS lumbar decompression have been successfully undertaken in the absence of general anesthesia in well-selected patients. By leveraging spinal anesthesia, surgeons may sa ... Full text Link to item Cite

Novel Merging of CT and MRI to Allow for Safe Navigation into Kambin's Triangle for Percutaneous Lumbar Interbody Fusion-Initial Case Series Investigating Safety and Efficacy.

Journal Article Oper Neurosurg (Hagerstown) · March 1, 2023 BACKGROUND: For percutaneous lumbar fusion (percLIF), magnetic resonance imaging and computed tomography are critical to defining surgical corridors. Currently, these scans are performed separately, and surgeons then use fluoroscopy or neuromonitoring to g ... Full text Open Access Link to item Cite

Microendoscopic Ultrasound-Guided Percutaneous Tracheostomy (MUGPT): A Case Series Describing a Novel Technique for Performing Percutaneous Tracheostomy.

Journal Article Case Rep Crit Care · 2023 A percutaneous tracheostomy is a common surgical procedure done in intensive care. Several different techniques have been described. Recently, the addition of bronchoscopy or ultrasound has been advocated to decrease the risks and complications associated ... Full text Open Access Link to item Cite

Mesenteric Malperfusion Syndromes in Type A Aortic Dissection: Current Management Strategies.

Journal Article J Cardiothorac Vasc Anesth · December 2021 Acute type A aortic dissection is a surgical emergency associated with high mortality and morbidity. When complicated with mesenteric malperfusion, its management carries a very high mortality. Many innovations in the field of vascular and cardiothoracic s ... Full text Link to item Cite

Comparison of the Oxygenation Factor and the Oxygenation Ratio in Subjects With ARDS.

Journal Article Respir Care · December 2020 BACKGROUND: The oxygenation ratio (ie, [Formula: see text]/[Formula: see text]) remains the most commonly used index for assessing oxygenation and disease severity in patients with acute ARDS. However, the oxygenation ratio does not account for mechanical ... Full text Link to item Cite

Clinical Manual and Review of Transesophageal Echocardiography, 3/e

Book · January 9, 2019 Features: • Addresses all the important clinical and technical issues and major exam topics • Valuable appendices detailing normal chamber dimensions and volumes; wall motion and coronary perfusion; diastolic function; native valve ... ... Cite

Perioperative Management of Pancreaticoduodenectomy: Avoiding Admission to the Intensive Care Unit

Journal Article Gastrointestinal Tumors · 2019 <b><i>Introduction:</i></b> With the advancement in surgical expertise at high-volume centers and advances in perioperative management, pancreaticoduodenectomy is becoming safer and remains the gold standard for treating per ... Full text Cite

Anesthesia care in maxillofacial surgery

Chapter · January 1, 2018 Maxillofacial surgery requires specifically tailored anesthetic care. Working in close proximity to the airway warrants continuous communication between the teams. The advent of the videolaryngoscope and many other modalities for airway management over the ... Full text Cite

Improving pain management in maxillofacial cosmetic surgical procedures

Chapter · December 28, 2017 Pain still ranks among the highest patient as well as surgeon concerns for unwanted surgical outcomes. Thus, pain management plays a major role in patient satisfaction and improving our patients' safety. This chapter will review the pathogenesis of pain. S ... Full text Cite

Patient assessment and evaluation

Chapter · December 28, 2017 The invaluable preoperative visit remains the most important aspect of the proper patient evaluation prior to surgery. The physician's interview should attempt to gather as much information as possible around the patient's medical and surgical history. The ... Full text Cite

Injection laryngoplasty through a transoral approach using the Guedel oral airway.

Journal Article Acta Otorhinolaryngol Ital · October 2017 Injection laryngoplasty has gained popularity as a treatment modality for glottal insufficiency. Several approaches have been described, specifically transcutaneous, transoral and transnasal. The authors describe a novel technique performed successfully on ... Full text Open Access Link to item Cite

Spontaneous and recurrent subdural hematomas: Probable Panax Ginseng intake

Journal Article Chirurgia (Turin) · October 1, 2017 Panax ginseng is known for its medicinal effects and features and it can be found in different forms. We report three cases of spontaneous nontraumatic recurrent subdural hematoma in postmenopausal women who were throughout the case on a highly concentrate ... Full text Cite

Nondepolarizing muscle relaxant improves direct laryngoscopy view with no effect on face mask ventilation

Journal Article Brazilian Journal of Anesthesiology (English Edition) · July 2017 Full text Cite

[Nondepolarizing muscle relaxant improves direct laryngoscopy view with no effect on face mask ventilation].

Journal Article Rev Bras Anestesiol · 2017 BACKGROUND: Difficult or impossible face mask ventilation complicated with difficult tracheal intubation during anesthesia induction occurs in 0.4% of adult anesthesia cases, possibly leading to life-threatening complications. Because of such catastrophes, ... Full text Link to item Cite

Automated Sedation using propofol and midazolam based on Bispectral Index for ICU patients

Conference 2016 IEEE International Multidisciplinary Conference on Engineering Technology, IMCET 2016 · December 7, 2016 In this paper we present an automated sedation system for ICU setting. The system is based on objective sedation assessment using the bispectral index and takes into account the patient's hemodynamics i.e. heart rate and blood pressure to ensure that the t ... Full text Cite

Spontaneous intracranial hypotension syndrome treated with fludrocortisone.

Journal Article A A Case Rep · January 1, 2015 Spontaneous intracranial hypotension is a rare syndrome characterized by orthostatic headache not associated with trauma or dural puncture. In most cases, it is caused by a spontaneous spinal cerebrospinal fluid leakage as demonstrated by neuroradiological ... Full text Link to item Cite

Use of noninvasive positive pressure ventilation in emergency departments of public and private hospitals in Lebanon.

Journal Article Eur J Emerg Med · June 2014 Noninvasive positive pressure ventilation is increasingly being used in emergency departments across Europe and North America. To our knowledge, no similar data are available from other countries. The aim of this study is to describe the current use of non ... Full text Link to item Cite

Anesthesia for contouring body in post-bariatric surgery patient

Chapter · December 1, 2012 Obesity is a major health problem throughout the world. Its management by bariatric surgical interventions is associated with a good success rate, leading to a necessary removal of excess skin after weight loss. The popularity of bariatric surgery has crea ... Full text Cite

Natural orifice transluminal endoscopic surgery (NOTES): assessment of peritoneal bacterial load after intraperitoneal antimicrobial wash and evaluation of hemodynamic changes in a porcine model.

Journal Article Minim Invasive Ther Allied Technol · July 2012 AIMS: Natural orifice transluminal endoscopic surgery (NOTES) is a promising newly developed procedure; however, it is associated with many complications. The main aim of our study is to assess whether peritoneal wash with antibiotics decreases the bacteri ... Full text Link to item Cite

Subpleural block is less effective than thoracic epidural analgesia for post-thoracotomy pain: a randomised controlled study.

Journal Article Eur J Anaesthesiol · April 2012 CONTEXT: Thoracic epidural and paravertebral blocks provide adequate analgesia for postoperative thoracotomy pain. Both procedures are usually performed percutaneously with considerable failure rates. A subpleural catheter placed in the space posterior to ... Full text Link to item Cite

Low back pain as perceived by the pain specialist.

Journal Article Middle East J Anaesthesiol · February 2012 Link to item Cite

Weaning from mechanical ventilation.

Journal Article Curr Opin Anaesthesiol · February 2012 PURPOSE OF REVIEW: Liberation from mechanical ventilation is a defining moment for intubated patients, and thus a critical clinical decision. Extubating the patient too early exposes the patient to extubation failure and reintubation. Waiting too long incr ... Full text Link to item Cite

Posterior lingual lidocaine: a novel method to improve tolerance in upper gastrointestinal endoscopy.

Journal Article World J Gastroenterol · December 21, 2011 AIM: To evaluate the effect of posterior lingual lidocaine swab on patient tolerance to esophagogastroduodenoscopy, the ease of performance of the procedure, and to determine if such use will reduce the need for intravenous sedation. METHODS: Eighty patien ... Full text Link to item Cite

Effect of weight gain during pregnancy on heart rate variability and hypotension during caesarean section under spinal anaesthesia.

Journal Article Anaesthesia · December 2011 The purpose of this study was to assess the effect of antenatal weight gain on baseline heart rate variability and incidence of hypotension in singleton parturients with a normal pre-pregnancy body mass index, presenting at term for elective caesarean sect ... Full text Link to item Cite

Low back pain as perceived by the pain specialist.

Journal Article Middle East J Anaesthesiol · June 2011 Link to item Cite

Amiodarone and reperfusion ventricular fibrillation.

Journal Article J Cardiothorac Vasc Anesth · February 2011 Full text Link to item Cite

Effect of Age and Lordotic Angle on the Level of Lumbar Disc Herniation

Journal Article Advances in Orthopedics · 2011 It has been previously suggested in the literature that with aging, degenerative changes as well as disc herniation start at the lower lumbar segments, with higher disc involvement observed in an ascending fashion in older age groups. We conducted ... Full text Cite

Fertility drugs and the risk of breast cancer: a meta-analysis and review.

Journal Article Breast Cancer Res Treat · November 2010 The risk of breast cancer has been associated with reproductive history. The purpose of this study was to determine the relationship between fertility drugs used in assisted reproductive procedures and the risk of breast cancer. We performed a literature s ... Full text Link to item Cite

Tracheal intubation following training with the GlideScope compared to direct laryngoscopy.

Journal Article Anaesthesia · July 2010 Tracheal intubation using direct laryngoscopy has a high failure rate when performed by untrained medical personnel. This study compares tracheal intubation following direct laryngoscopy by inexperienced medical students when initially trained by using eit ... Full text Link to item Cite

Critical care clinicians' knowledge of evidence-based guidelines for preventing ventilator-associated pneumonia.

Journal Article Am J Crit Care · May 2010 BACKGROUND: Ventilator-associated pneumonia is the most common hospital-acquired infection among patients receiving mechanical ventilation in an intensive care unit. Different initiatives for the prevention of ventilator-associated pneumonia have been deve ... Full text Link to item Cite

Clinical Manual and Review of Transesophageal Echocardiography, Second Edition

Book · March 2, 2010 Ongoing competence requires performance of at least 30 examinations and reviews of at least 50 recorded exams every year. Completion of the PTEeXAM or ... Cahalan MK, Foster E. Training in transesophageal echocar- diography: in the lab ... ... Cite

Significance and cost-effectiveness of somatosensory evoked potential monitoring in cervical spine surgery.

Journal Article Neurol India · 2010 BACKGROUND: Intraoperative somatosensory evoked potential (SSEP) monitoring during cervical spine surgery is not a universally accepted standard of care. Our retrospective study evaluated the efficacy and cost-effectiveness of intraoperative SSEP in a sing ... Full text Link to item Cite

A comparison of a silicone wire-reinforced tube with the Parker and polyvinyl chloride tubes for tracheal intubation through an intubating laryngeal mask airway in patients with normal airways undergoing general anesthesia.

Journal Article Anesth Analg · September 2008 BACKGROUND: The intubating laryngeal mask airway (ILMA) is used in the management of difficult intubation. Usually, a silicone wire-reinforced tube is inserted for tracheal intubation. Because the silicone wire-reinforced tube is expensive, alternatives, s ... Full text Link to item Cite

Fertility drugs and risk of ovarian cancer: dispelling the myth.

Journal Article Curr Opin Obstet Gynecol · June 2008 PURPOSE OF REVIEW: Worldwide 50-80 million people suffer from infertility. Assisted reproductive technology has provided a way of overcoming infertility and childlessness. The current article will focus on data linking infertility and its treatment to ovar ... Full text Link to item Cite

Laryngospasm: review of different prevention and treatment modalities.

Journal Article Paediatr Anaesth · April 2008 Laryngospasm is a common complication in pediatric anesthesia. In the majority of cases, laryngospasm is self-limiting. However, sometimes laryngospasm persists and if not appropriately treated, it may result in serious complications that may be life-threa ... Full text Link to item Cite

Changes in resistances of endotracheal tubes with reductions in the cross-sectional area.

Journal Article Eur J Anaesthesiol · April 2008 BACKGROUND AND OBJECTIVES: Partial obstruction of endotracheal tubes due to accumulation of secretions and mucus plugs can increase the tube resistance and subsequently impose increased resistive load on the patient. This study was performed to determine t ... Full text Link to item Cite

Lidocaine lollipop as single-agent anesthesia in upper GI endoscopy.

Journal Article Gastrointest Endosc · October 2007 BACKGROUND: Conscious sedation is usually achieved during EGD by a combination of intravenous benzodiazepines and opiates; however, these have potential serious adverse effects. The addition of topical oropharyngeal anesthetics such as lidocaine may be use ... Full text Link to item Cite

Lidocaine Lollipop as Single Agent Anesthesia in Upper Gastrointestinal Endoscopy

Journal Article American Journal of Gastroenterology · September 2006 Full text Cite

Mitral valve repair or replacement in elderly people.

Journal Article Curr Opin Anaesthesiol · February 2006 PURPOSE OF REVIEW: Much has been published so far to describe and praise the benefits of mitral valve repair, and to compare it with valve replacement. Now, with mitral valve surgery in elderly people gaining greater acceptance worldwide, repair or replace ... Full text Link to item Cite

Music and ambient operating room noise in patients undergoing spinal anesthesia.

Journal Article Anesth Analg · May 2005 Previous studies have indicated that music decreases intraoperative sedative requirements in patients undergoing surgical procedures under regional anesthesia. In this study we sought to determine whether this decrease in sedative requirements results from ... Full text Link to item Cite

Prophylactic methylene blue in a patient with congenital methemoglobinemia.

Journal Article Can J Anaesth · March 2005 PURPOSE: To report the beneficial effect of prophylactic methylene blue administration before induction of anesthesia in a patient with congenital methemoglobinemia. CLINICAL FEATURES: A 26-yr-old male patient known to have congenital methemoglobinemia was ... Full text Link to item Cite

Intraperitoneal and intravenous routes for pain relief in laparoscopic cholecystectomy.

Journal Article JSLS · 2005 BACKGROUND: Postoperative abdominal and shoulder pain are the most common complaints after elective laparoscopic cholecystectomy. Postoperative pain is multifactorial in origin, and therefore multimodal therapy may be needed to optimize pain relief. METHOD ... Link to item Cite

Clinical Manual and Review of Transesophageal Echocardiography

Book · 2005 Prospective evaluation of the risk of bacteremia associated with transesophageal echocardiography . Circulation 1991 ; 84 : 177 . 5. Nikutta P , Mantey - Stiers F , Becht I , et al . Risk of bacteremia induced by transesophageal ... ... Cite

Aintree intubating bougie.

Journal Article Anesth Analg · May 2004 Full text Link to item Cite

Pharmacological therapy for myocardial reperfusion injury.

Journal Article Curr Opin Pharmacol · April 2004 In the ischemic myocardium, reperfusion is necessary for the salvage of cells and cardiac function. However, reperfusion itself causes 'reperfusion injury', leading to the damage of myocardial cells. This is reduced by several interventions, as measured by ... Full text Link to item Cite

Difficult airway management.

Journal Article Middle East J Anaesthesiol · February 2004 Link to item Cite

Dueling fiberoptic bronchoscope techniques.

Journal Article Anesth Analg · January 2004 Full text Link to item Cite

Anesthetic management of a patient having a carcinoid syndrome.

Journal Article Middle East J Anaesthesiol · October 2003 Link to item Cite

Amniotic fluid embolus: Can we affect the outcome?

Journal Article Current Opinion in Anaesthesiology · June 1, 2003 Purpose of review: Amniotic fluid embolism is a rare catastrophe unique to pregnancy. Its mortality rate remains high despite efforts at prompt and aggressive management protocols, highlighting the need to maintain a high index of suspicion. Recent finding ... Full text Cite

Advancing the tracheal tube over a flexible fiberoptic bronchoscope by a sleeve mounted on the insertion cord.

Journal Article Anesth Analg · January 2003 UNLABELLED: The advancement of an endotracheal tube (ETT) over a flexible fiberoptic bronchoscope (FOB) is often impeded at the glottis. This is attributed to the creation of a cleft by the difference in the outer diameter of the fiberscope and the interna ... Full text Link to item Cite

A peripheral nerve stimulator for nerve location controlled by the scrubbed anaesthetist.

Journal Article Anaesthesia · October 2002 This newly designed peripheral nerve stimulator allows the scrubbed anaesthetist performing a nerve block to adjust the electrical current output needed for localisation of the target nerve without the need for an assistant. ... Full text Link to item Cite

Pump activated by a foot switch pedal for controlled administration of local anaesthetic drugs.

Journal Article Anaesthesia · April 2002 We describe a newly designed syringe pump which is electrically controlled by a dual foot switch pedal. The device enables the scrubbed anaesthetist performing the regional block to aspirate, as well as to inject, the local anaesthetic without the need for ... Full text Link to item Cite

The pregnant cardiac woman

Journal Article Current Opinion in Anaesthesiology · January 1, 2002 Cardiac diseases are present in 0.5-4% of pregnancies, and they remain a frequent cause of death during pregnancy. Pregnancy per se imposes significant hemodynamic changes, placing a major burden on the cardiovascular system. The early recognition and clos ... Full text Cite

A new cut-off point of thyromental distance for prediction of difficult airway.

Journal Article Middle East J Anaesthesiol · October 2000 BACKGROUND: Difficult intubation, often unexpected, remains a primary concern for the anesthesiologist. None of the bedside tests have proven to be efficacious and highly predictive. The prupose of this study was to correlate the full range of thyromental ... Link to item Cite

Attenuation of the preoperative stress response with midazolam: effects on postoperative outcomes.

Journal Article Anesthesiology · July 2000 BACKGROUND: Previously, effects of preoperative sedatives were assessed mainly with respect to preoperative outcomes such as anxiety and compliance. The purpose of this investigation was to evaluate the effects of preoperative sedatives on postoperative ps ... Full text Link to item Cite

A modified Guedel airway for continuous oxygenation and suctioning during fibreoptic bronchoscopy.

Journal Article Anaesthesia · May 2000 We describe a modification to the Guedel airway that improves suction and oxygenation during fibreoptic bronchoscopy. The entire roof of a Guedel airway was removed. Two 2.5-mm internal diameter tracheal tubes were inserted into the modified airway to allo ... Full text Link to item Cite

Magnesium therapy for refractory ventricular fibrillation.

Journal Article J Cardiothorac Vasc Anesth · April 2000 Full text Link to item Cite

Evaluation of hemostasis by the Clot Signature Analyzer: a potentially valuable device for the anesthesiologist.

Journal Article J Clin Monit Comput · February 1999 Rapid detection of hemostatic defects presents a challenge for the anesthesiologist who must balance anesthetic and surgical considerations for maintaining adequate platelet and coagulant factors, while keeping allogenic blood exposure to a minimum. The Cl ... Full text Link to item Cite

Electromyographic assessment of ulnar nerve motor block induced by lidocaine.

Journal Article J Clin Anesth · December 1998 STUDY OBJECTIVE: To determine the differences in the onset time and duration of motor block produced by lidocaine 1% and lidocaine 2% via a quantitative and objective method, the measurement of compound muscle action potentials (CMAPs). STUDY DESIGN: Prosp ... Full text Link to item Cite

The sedative and analgesic sparing effect of music.

Journal Article Anesthesiology · August 1998 BACKGROUND: To determine whether music influences intraoperative sedative and analgesic requirements, two randomized controlled trials were performed. METHODS: In phase 1, 35 adults undergoing urologic procedures with spinal anesthesia and patient-controll ... Full text Link to item Cite