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Awake intubation

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https://www.readbyqxmd.com/read/29432361/single-port-thoracoscopic-pericardial-window-under-local-anesthesia
#1
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...
February 9, 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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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...
January 19, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29349354/awake-intubation-in-a-patient-with-huge-orocutaneous-fistula-a-case-report
#8
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
#9
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
#10
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
https://www.readbyqxmd.com/read/29313710/long-term-outcomes-after-protocolized-sedation-vs-usual-care-in-ventilated-pediatric-patients
#11
R Scott Watson, Lisa A Asaro, James H Hertzog, Lauren R Sorce, Alicia G Kachmar, Leslie A Dervan, Derek C Angus, David Wypij, Martha A Q Curley
RATIONALE: Whether a nurse-implemented goal-directed sedation protocol resulting in more awake yet calm intubated children affects post-discharge functional status, health-related quality of life, or risk for post-traumatic stress disorder is unknown. OBJECTIVES: To compare post-discharge outcomes in children with acute respiratory failure cluster randomized to a sedation protocol or usual care. METHODS: A stratified random sample of 1360 patients from 31 centers in the Randomized Evaluation of Sedation Titration for Respiratory Failure trial was assessed by mail, electronically, and/or telephone six months after intensive care unit discharge...
January 9, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29284884/airway-considerations-in-case-of-a-large-multinodular-goiter
#12
Harpreet Kaur, Amar Parkash Kataria, Magila Muthuramalingapandian, Harjinder Kaur
Patients with large goiters pose a great challenge to the anesthesiologist regarding securing the airway without compromising the safety of the patient. The technique of intubation depends on the choice and expertise of anesthesiologist. Awake fiberoptic intubation (AFOI) is the preferred technique. We present the case of large multinodular goiter with difficult airway in which AFOI was successfully used to secure the airway. Proper assessment, planning, and preparation for airway management should be done preoperatively to ensure patient safety...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29284863/evaluation-of-effectiveness-of-dexmedetomidine-and-fentanyl-midazolam-combination-on-sedation-and-safety-during-awake-fiberoptic-intubation-a-randomized-comparative-study
#13
Abida Yousuf, Basharat Ahad, Aabid Hussain Mir, Abdul Waheed Mir, Juvera Gul Wani, Sheikh Quyoom Hussain
Background: Awake fiberoptic intubation (AFOI) is a recommended technique for anticipated difficult airway. An ideal regime should provide patient comfort, cooperation, amnesia, hemodynamic stability, and blunt airway reflexes and maintain a patent airway with spontaneous ventilation. The aim of our study was to compare intubation conditions between dexmedetomidine and fentanyl-midazolam combination during AFOI. Methods: This prospective, randomized study was conducted on a total of sixty patients of the American Society of Anesthesiologists physical status I and II of either sex, in the age group of 18-60 years having predicted difficult intubation undergoing elective surgeries and the patients were allocated to two groups of thirty patients each...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29275577/-study-of-sevoflurane-remifentanil-coadministration-on-improving-emergence-and-recovery-characteristics-of-patients-following-general-anaesthesia-with-sevoflurane
#14
H T Sun, M Xu, G L Chen, J He
Objective: To investigate the effects of remifentanil infusion on emergence and recovery characteristics of patients with thoracoscopic lobectomy following general anaesthesia with sevoflurane. Methods: One hundred patients, who were aged 37 to 65 years with American Society of Anesthesiologists (ASA) physical status 1-2, and scheduled for elective thoracoscopic lobectomy under general anaesthesia in National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, from February 2016 to August 2016, were allocated to receive sevoflurane maintenance regimen(group S, n=50)or sevoflurane/remifentanil maintenance regimen(group SR, n=50)by random digital table...
November 28, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29245289/perioperative-management-of-a-patient-with-coffin-lowry-syndrome-complicated-by-severe-obesity-a-case-report-and-literature-review
#15
Mikako Hirakawa, Tasuku Nishihara, Kazuo Nakanishi, Sakiko Kitamura, Sonoko Fujii, Keizo Ikemune, Kentaro Dote, Yasushi Takasaki, Toshihiro Yorozuya
RATIONALE: Coffin-Lowry syndrome (CLS) is a rare inherited disease with specific clinical features, such as mental retardation, facial dysmorphism, and cardiac abnormality. In particular, the characteristic facial features of CLS, including retrognathia and large tongue, are associated with difficult ventilation and/or intubation, which is a serious problem of anesthesia management. However, case reports on anesthesia management of CLS are very limited as there are only two published English reports till date...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29242653/awake-orotracheal-fibre-optic-intubation-comparison-of-two-different-doses-of-dexmedetomidine-on-intubation-conditions-in-patients-undergoing-cervical-spine-surgery
#16
Jaya Sharma, Shobha Purohit, Sonali Bhatia, Poonam Kalra, Mamta Sharma, Reema Meena
Background and Aims: Awake fibre-optic intubation (AFOI) is an integral part of anaesthetic management of difficult airways. Conscious sedation is essential to assist AFOI. This study compared two different doses of dexmedetomidine in combination with topical spray and airway blocks for awake orotracheal fibre-optic intubation in patients undergoing elective cervical spine surgery with rigid cervical collar in situ. Methods: A randomized, prospective, comparative study design was conducted in sixty patients divided into two groups: Group (L) (n = 30) patients received low dose of dexmedetomidine (0...
October 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29174197/comparison-of-cardiac-measurements-by-multi-detector-computed-tomography-angiography-and-transthoracic-echocardiography-in-english-bulldogs
#17
E T Hostnik, B A Scansen, A M Habing, G A Chiappone, R R Layman, R D White
INTRODUCTION: Transthoracic echocardiography (TTE) is the primary tool for the assessment of cardiac structure and function in dogs but is challenging in English bulldogs due to dorsoventral compression of the thorax, obesity, and narrow intercostal spaces. Multi-detector computed tomography angiography (CTA) may overcome the conformational obstacles of cardiac imaging in this breed. ANIMALS: Eleven client-owned English bulldogs. MATERIALS AND METHODS: Prospective clinical trial with paired analysis of TTE and CTA studies...
December 2017: Journal of Veterinary Cardiology: the Official Journal of the European Society of Veterinary Cardiology
https://www.readbyqxmd.com/read/29149007/awake-bronchoscopic-intubation-with-a-noninvasive-positive-pressure-support-in-critically-ill-patients
#18
Fu-Shan Xue, Gui-Zhen Yang, Chao Wen
No abstract text is available yet for this article.
December 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29119207/anesthesia-in-a%C3%A2-child-with-suspected-peroxisomal-disorder
#19
J S Englbrecht, M Maas
We present the case of an 8‑year-old female child with suspected peroxisomal disorder requiring general anesthesia for adenotomy, paracentesis and brainstem-evoked response audiometry. Peroxisomes are small intracellular organelles that catalyse key metabolic reactions. Peroxisomal disorders are a heterogeneous group of rare genetic diseases. Anesthesia can be challenging as adrenal insufficiency, mental retardation, muscle weakness, risk of pulmonary aspiration, airway complications, seizure disorders and altered pharmacokinetics and pharmacodynamics can occur in these patients but guidelines for anesthesia do not exist due to the heterogeneity and rarity of these diseases and case reports are rare...
December 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/29109646/ludwig-s-angina-in-children-anesthesiologist-s-nightmare-case-series-and-review-of-literature
#20
Maitree Pandey, Manpreet Kaur, Manoj Sanwal, Aruna Jain, Sunil K Sinha
Ludwig's angina is potentially lethal, rapidly spreading cellulitis of the floor of mouth and neck. The anticipated difficult airway becomes even more challenging when it occurs in children. In children, the larynx is positioned relatively higher in the neck, and one does not have the option for blind nasal intubation or awake fiberoptic, which otherwise is the technique of choice in adult patients. We present the clinical course of 16 children and highlight various problems encountered during the anesthetic management of six children who required emergency surgical drainage under general anesthesia...
July 2017: Journal of Anaesthesiology, Clinical Pharmacology
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