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Awake intubation

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https://www.readbyqxmd.com/read/29649032/airway-management-practice-in-adults-with-an-unstable-cervical-spine-the-harborview-medical-center-experience
#1
Michael G Holmes, Armagan Dagal, Bryan A Feinstein, Aaron M Joffe
BACKGROUND: Airway management in the presence of acute cervical spine injury (CSI) is challenging. Because it limits cervical spine motion during tracheal intubation and allows for neurological examination after the procedure, awake fiberoptic bronchoscopy (FOB) has traditionally been recommended. However, with the widespread availability of video laryngoscopy (VL), its use has declined dramatically. Our aim was to describe the frequency of airway management techniques used in patients with CSI at our level I trauma center and report the incidence of neurological injury attributable to airway management...
April 11, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29628546/hemodynamic-responses-and-safety-of-sedation-following-premedication-with-dexmedetomidine-and-fentanyl-during-fiberoptic-assisted-intubation-in-patients-with-predicted-difficult-airway
#2
Sunil Rajan, Rittick Talukdar, Pulak Tosh, Jerry Paul, Bindu K Vasu, Lakshmi Kumar
Background: Awake fiberoptic intubation (AFOI) is the gold standard for the management of predicted difficult airway, and inappropriate sedation is a major cause leading to its failure. Aims: The primary objective was to compare the heart rate (HR) changes that accompany AFOI following sedation with dexmedetomidine and fentanyl. Secondary objectives included comparison of changes in blood pressure, patient comfort, ease of intubation, and degree of sedation. Settings and Designs: This prospective double-blinded randomized study was conducted in a tertiary care institution...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29619784/comparison-between-lignocaine-nebulization-and-airway-nerve-block-for-awake-fiberoptic-bronchoscopy-guided-nasotracheal-intubation-a-single-blind-randomized-prospective-study
#3
Pooja Rawat Mathur, Neena Jain, Aji Kumar, Beena Thada, Veena Mathur, Deepak Garg
BACKGROUND: The preferred management strategy for difficult airways is awake fiberoptic bronchoscopy-guided intubation, which requires effective airway anesthesia to ensure patient comfort and acceptance. This randomized single-blind prospective study was conducted to compare lignocaine nebulization and airway nerve block for airway anesthesia prior to awake fiberoptic bronchoscopy-guided intubation. METHODS: Sixty adult patients scheduled for surgical procedures under general anesthesia were randomly allocated to two groups...
April 2018: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29559790/the-use-of-the-c-mac-videolaryngoscope-for-awake-intubation-in-patients-with-a-predicted-extremely-difficult-airway-case-series
#4
Tomasz Gaszyński
The C-MAC videolaryngoscope was evaluated for intubation in patients with predicted extremely difficult airway. The presented cases are patients with neoplasm tumors in larynx. In all cases, awake intubation using C-MAC videolaryngoscope was performed in patients breathing spontaneously, under local anaesthesia, with oxygen administered via nasal catheter. All intubations were successful and uneventful. The pre-surgery examination (CT scans and fiberscope laryngeal examination) was compared with view of larynx obtained during laryngoscopy...
2018: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/29544366/naloxone-reversal-of-clonidine-toxicity-dose-dose-dose
#5
Donna L Seger, Justin K Loden
CONTEXT: Following clonidine ingestion, naloxone is seldom administered as it is considered ineffective in reversing somnolence, bradycardia, or hypotension. However, this conclusion has been based on administration of small doses (2 mg or less) of naloxone. The somnolence is frequently treated with endotracheal intubation (ETI), a procedure with significant morbidity. OBJECTIVE: We aimed to determine if naloxone administration reversed the effects of clonidine or caused any adverse effects...
March 16, 2018: Clinical Toxicology
https://www.readbyqxmd.com/read/29527552/perioperative-airway-management-for-aortic-valve-replacement-in-an-adult-with-mucopolysaccharidosis-type-ii-hunter-syndrome
#6
Kazuchika Suzuki, Hiroaki Sakai, Kenji Takahashi
We herein report anesthetic management during aortic valve replacement for aortic valve regurgitation in a patient with adult mucopolysaccharidosis type II (MPS type 2) (Hunter syndrome). This disorder is rare and related to the accumulation of a mucopolysaccharide in lysosomes. It affects various organs, including the airways, heart, and central nerves. In children with MPS type 2, the risk of airway obstruction during anesthesia/sedation is high, and the degree of difficulty increases with aging. The patient described herein was a 33-year-old male without mental retardation...
2018: JA Clinical Reports
https://www.readbyqxmd.com/read/29521305/tracheal-intubation-awake-or-under-anesthesia-for-potential-difficult-airway-look-before-you-leap
#7
Fu-Shan Xue, Qian-Jin Liu
No abstract text is available yet for this article.
March 20, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29521283/effectiveness-and-safety-of-a-novel-approach-for-management-of-patients-with-potential-difficult-mask-ventilation-and-tracheal-intubation-a-multi-center-randomized-trial
#8
Ji-Ming Wang, Er-Li Ma, Qing-Ping Wu, Ming Tian, Yan-Yan Sun, Jing Lin, Liang Peng, Qiang Xu, Wei Wei, Hong Tan, Cen Yang, Xiao-Qiang Li, Yun-Xia Zuo, Jin Liu
Background: Patients with potential difficult mask ventilation (DV) and difficult intubation (DI) are often managed with awake intubation, which can be stressful for patients and anesthesiologists. This prospective randomized study evaluated a new approach, fast difficult airway evaluation (FDAE). We hypothesized that the FDAE approach would reduce the need for awake intubation. Methods: After obtaining informed consent, 302 patients with potential DV/DI undergoing elective surgeries were randomly assigned to the FDAE group (Group E) and the control group (Group C)...
March 20, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29502065/-application-of-sevoflurane-and-laryngeal-mask-in-cesarean-section-in-women-with-heart-disease
#9
Zhi-Peng Wang, Jue Ma, Sheng Wang, Li-Na Yu, Jin-Feng Wei, Jin-Dong Xu
OBJECTIVE: To compare the safety of sevoflurane anesthesia with laryngeal mask and tracheal intubation in cesarean section in women with heart disease. METHODS: Fifty-two pregnant women with heart diseases undergoing cesarean section were randomized into laryngeal mask (LAM) group and tracheal intubation group. In LAM group, 6% sevoflurane was given at the rate of 6 L/min for induction with a maintenance sevoflurane concentration of 3%. In the intubation group, 1...
February 20, 2018: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
https://www.readbyqxmd.com/read/29465200/-the-choice-of-tracheal-intubation-method-in-reconstructive-maxillo-facial-surgery-with-difficult-airways
#10
A Yu Zaytcev, K V Dubrovin, V A Svetlov
BACKGROUND: The development of modern video - and endoscopic equipment allows for revision and adjust to modern protocols for maintaining patency of the difficult airway, especially in maxillofacial or ENT -surgery. THE PURPOSE OF THE STUDY: Comparison the efficacy ofvarious methods of maintaining the airway patency in the practice of reconstructive maxillofacial surgery. MATERIALS AND METHODS: 89 patients, who were divided into 4 groups, were examined...
September 2017: Anesteziologiia i Reanimatologiia
https://www.readbyqxmd.com/read/29432361/single-port-thoracoscopic-pericardial-window-under-local-anesthesia
#11
Chang Y Park, Niall C McGonigle
There are numerous surgical approaches for the treatment of pericardial effusions but no clear consensus of best management. We present a 44-year-old woman with metastatic breast cancer presenting with a new 2-cm pericardial effusion on ultrasound. In light of the patient's palliative condition and the urgent need for chemotherapy, careful consideration was made for her surgical drainage of the pericardial effusion. Because of the patient's medical comorbidities, a general anesthetic was deemed not to be in the patient's best interest...
January 2018: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29432293/is-spinal-anaesthesia-in-young-infants-really-safer-and-better-than-general-anaesthesia
#12
Nicola Disma, Natasha Clunies-Ross, George A Chalkiadis
PURPOSE OF REVIEW: Concerns regarding the potential neurotoxic effects of general anaesthesia have seen resurgence in awake spinal anaesthesia in neonates and infants. This review includes recently published data from a large prospective randomized controlled trial with view to determining if spinal anaesthesia is safer and better than general anaesthesia in this population. RECENT FINDINGS: Compared with general anaesthesia, spinal anaesthesia results in less haemodynamic instability and fewer early (<30 min) apnoeic episodes in neonates and infants undergoing inguinal herniorraphy; the overall incidence of apnoeas in the first 12 h postoperatively was similar...
February 9, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29429553/intubation-in-two-patients-with-difficult-airway-management-and-tracheal-stenosis-after-tracheostomy-in-thoracic-surgery
#13
M Granell Gil, P Solís Albamonte, C Córdova Hernández, I Cobo, R Guijarro, J A de Andrés Ibañez
Lung isolation in thoracic surgery is a challenge, this is even more complex in the presence of unknown tracheal stenosis (TS). We report two cases of unknown TS and its airway management. TS appears most frequently after long term intubation close to the endotracheal tube cuff or in the stoma of tracheostomy that appears as a consequence of the granulation tissue after the surgical opening of the trachea. Clinical history, physical examination, difficult intubating predictors and imaging tests (CT scans) are crucial, however most of tracheal stenosis may be unnoticed and symptoms depend on the degree of obstruction...
February 8, 2018: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/29422029/ultrasound-guided-identification-of-the-cricothyroid-membrane-in-a-patient-with-a-difficult-airway-a-case-report
#14
Hiromu Okano, Kohji Uzawa, Kunitaro Watanabe, Akira Motoyasu, Joho Tokumine, Alan Kawarai Lefor, Tomoko Yorozu
BACKGROUND: Surgical cricothyroidotomy is considered to be the last resort for management of the difficult airway. A major point for a successful surgical cricothyroidotomy is to identify the location of the cricothyroid membrane. CASE PRESENTATION: We encountered a patient with progressive respiratory distress who was anticipated to have a difficult airway due to a large neck abscess. We prepared for both awake intubation and surgical cricothyroidotomy. The cricothyroid membrane could not be identified by palpation, but was readily identified using ultrasound...
February 8, 2018: BMC Emergency Medicine
https://www.readbyqxmd.com/read/29416263/fiberoptic-guided-intubation-after-awake-insertion-of-the-i-gel%C3%A2-supraglottic-device-in-a-patient-with-predicted-difficult-airway
#15
Julian Arevalo Ludena, Jose Juan Arcas Bellas, Rafael Alvarez-Rementeria, Luis Enrique Munoz
No abstract text is available yet for this article.
October 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29416257/awake-fiber-optic-intubation-stop-and-think-before-you-act
#16
Manoj Bhardwaj, Shagun Bhatia Shah, Ajay Kumar Bhargava
No abstract text is available yet for this article.
October 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29352365/-anesthesia-problem-cards-indispensable-yet-problematic-nationwide-survey-on-experiences-from-clinical-practice
#17
M Schieren, A Böhmer, W Golbeck, J Defosse, F Wappler, H E Marcus
BACKGROUND: Anesthetic procedures may lead to severe and potentially life-threatening complications (e. g. difficult airway, allergic reactions, malignant hyperthermia). Most complications can be avoided in future anesthetic procedures with adequate preparation (e. g. awake intubation, trigger-free anesthesia). In Germany, anesthesia problem cards were introduced two decades ago to identify patients at risk and to increase patient safety by creating a standardized documentation system for anesthesia-related complications...
April 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29349354/awake-intubation-in-a-patient-with-huge-orocutaneous-fistula-a-case-report
#18
Hye-Jin Kim, So-Hyun Kim, Tae-Heung Kim, Ji-Young Yoon, Cheul-Hong Kim, Eun-Jung Kim
Mask ventilation, the first step in airway management, is a rescue technique when endotracheal intubation fails. Therefore, ordinary airway management for the induction of general anesthesia cannot be conducted in the situation of difficult mask ventilation (DMV). Here, we report a case of awake intubation in a patient with a huge orocutaneous fistula. A 58-year-old woman was scheduled to undergo a wide excision, reconstruction with a reconstruction plate, and supraomohyoid neck dissection on the left side and an anterolateral thigh flap due to a huge orocutaneous fistula that occurred after a previous mandibulectomy and flap surgery...
December 2017: Journal of Dental Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29349352/learning-fiberoptic-intubation-for-awake-nasotracheal-intubation
#19
Hyuk Kim, Eunsun So, Myong-Hwan Karm, Hyun Jeong Kim, Kwang-Suk Seo
Background: Fiberoptic nasotracheal intubation (FNI) is performed if it is difficult to open the mouth or if intubation using laryngoscope is expected to be difficult. However, training is necessary because intubation performed by inexperienced operators leads to complications. Methods: Every resident performed intubation in 40 patients. Success of FNI was evaluated as the time of FNI. First intubation time was restricted to 2 min 30 s. If the second attempt was unsuccessful, it was considered a failed case, and a specialist performed nasotracheal intubation...
December 2017: Journal of Dental Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29328000/conscious-sedation-with-dexmedetomidine-compared-with-asleep-awake-asleep-craniotomies-in-glioma-surgery-an-analysis-of-180-patients
#20
Eric Suero Molina, Stephanie Schipmann, Isabelle Mueller, Johannes Wölfer, Christian Ewelt, Matthias Maas, Benjamin Brokinkel, Walter Stummer
OBJECTIVE Awake craniotomies have become a feasible tool over time to treat brain tumors located in eloquent regions. Different techniques have been applied in neurooncology centers. Both "asleep-awake-asleep" (asleep) and "conscious sedation" were used subsequently at the authors' neurosurgical department. Since 2013, the authors have only performed conscious sedation surgeries, predominantly using the α2-receptor agonist dexmedetomidine as the anesthetic drug. The aim of this study was to compare both mentioned techniques and evaluate the clinical use of dexmedetomidine in the setting of awake craniotomies for glioma surgery...
January 12, 2018: Journal of Neurosurgery
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