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Nasotracheal intubation

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https://www.readbyqxmd.com/read/28921537/nasotracheal-intubation-over-a-bougie-vs-non-bougie-intubation-a-prospective-randomised-controlled-trial-in-older-children-and-adults-using-videolaryngoscopy
#1
R O Abrons, M B Zimmerman, Y M S El-Hattab
Conventionally, nasotracheal intubation has consisted of blind nasal passage and external manipulation of the tube through the glottis ('conventional technique'), a technique associated with a high incidence of nasal trauma. We evaluated a novel technique for routine asleep (i.e. post-induction) nasotracheal intubation using a bougie ('bougie technique'), which uses a nasopharyngeal airway to guide a paediatric bougie nasotracheally for use as a Seldinger tracheal intubation guide. Two hundred and fifty-seven older children (> 8 years) and adults were randomly assigned to videolaryngoscopy-assisted nasotracheal intubation using either the conventional or the bougie technique...
September 15, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28879342/anesthetic-management-of-a-patient-with-chromosome-6p-duplication-a-case-report
#2
Saori Morinaga, Masanori Tsukamoto, Takeshi Yokoyama
Chromosome 6p duplication is very rare and clinically characterized by short stature, mental retardation, and congenital heart diseases. Patients with mental retardation may present with poor oral health conditions. Dental treatment may need to be performed under general anesthesia in such patients. Our case report deals with induction of general anesthesia to a patient with chromosome 6p duplication, for dental treatment. The selection of a nasotracheal tube of an appropriate size, because of the patient's short stature, was especially important for airway management...
June 2017: J Dent Anesth Pain Med
https://www.readbyqxmd.com/read/28879330/flexible-laryngeal-mask-airway-management-for-dental-treatment-cases-associated-with-difficult-intubation
#3
Masanori Tsukamoto, Takashi Hitosugi, Takeshi Yokoyama
Nasotracheal intubation is generally a useful maxillofacial surgery that provides good surgical access for intraoral procedures. When nasotracheal intubation is difficult, laryngeal mask airway (LMA) insertion can be performed, and the flexible LMA™ (FLMA) is also useful for anesthetic management. However, the FLMA provides limited access to the mouth, which restricts the insertion of instrumentation and confines the surgical field available. Here, we present our experience using the FLMA airway management for dental treatment cases involving difficulty with intubation...
March 2017: J Dent Anesth Pain Med
https://www.readbyqxmd.com/read/28879322/difficult-airway-management-in-a-patient-with-a-thin-mandible
#4
Hong-Seok Choi, Jong-Shik Oh, Eun-Jung Kim, Ji-Young Yoon, Ji-Uk Yoon, Cheul-Hong Kim
A 47-year-old woman was referred for surgical treatment of osteomyelitis of the mandible. She had already undergone three previous surgeries. Pre-anesthetic airway evaluation predicted a difficult airway, due to the thin, retro-positioned mandible, tongue, and atrophic changes in the lips and soft tissue. We inserted packing gauzes in the buccal mucosa for easier mask fitting and ventilation. During direct laryngoscopic intubation with a nasotracheal tube (NTT), fracture of a thin mandible can easily occur...
December 2016: J Dent Anesth Pain Med
https://www.readbyqxmd.com/read/28879320/pharyngeal-flap-damage-caused-by-nasotracheal-intubation-in-a-patient-who-underwent-palatoplasty-and-pharyngoplasty
#5
Jong-Shik Oh, Hong-Seok Choi, Eun-Jung Kim, Cheul-Hong Kim, Ji-Uk Yoon, Ji-Young Yoon
Patients with cleft lip and palate (CLP) must undergo corrective surgeries during infancy and early childhood. Many patients with CLP undergo orthognathic surgery during their childhood for correction of skeletal asymmetries or pharyngoplasty with a pharyngeal flap to improve the quality of speech and velopharyngeal function. During orthognathic surgeries, nasotracheal intubation is performed under general anesthesia. In our case report, the patient had undergone palatoplasty and pharygoplasty previously. During the orthognathic surgery, a flexible fiberoptic bronchoscope-guided nasotracheal tube was inserted through the pharyngeal flap ostium; however, active bleeding occurred in the nasopharynx...
December 2016: J Dent Anesth Pain Med
https://www.readbyqxmd.com/read/28868789/the-phenylephrine-concentration-response-relationship-for-blood-pressure-after-nasal-delivery-in-children
#6
Brian J Anderson, Lisa K Christensen, Valerie E Armstead, David P Bilyeu, Kenneth E Johnson, Robert H Friesen
BACKGROUND: Intranasal phenylephrine is commonly used to vasoconstrict the nasal mucosa, reducing bleeding associated with nasotracheal intubation or endoscopic sinus surgery. There are few data quantifying either absorption pharmacokinetics or phenylephrine concentration effect on blood pressure in children. METHODS: Published observations of plasma concentration and blood pressure changes after phenylephrine nasal administration (0.1 mL kg(-1) , 0.25% or 0.5%) in children (n = 52, 2-12 years, 10-40 kg) were pooled with those in adults (23-81 years) given phenylephrine 2...
September 4, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28846537/a-comparison-of-the-video-laryngoscopes-with-macintosh-laryngoscope-for-nasotracheal-intubation
#7
Kuang-Yi Tseng, I-Cheng Lu, Ya-Chun Shen, Chia-Heng Lin, Po-Nien Chen, Kuang-I Cheng
Nasotracheal intubation (NTI) is usually required in patients undergoing maxillofacial surgery. Though video-scopes have been demonstrated to perform well in oral endotracheal intubation, limited information is available concerning NTI. The aim of the study is to compare the efficiency of video-scopes and the traditional direct laryngoscopy in NTI. One hundred and eight patients scheduled for elective oro-maxillofacial surgery under nasotracheal intubation general anesthesia were randomly allocated into one of 3 groups of GlideScope, Pentax AirWay Scope, or Macintosh laryngoscope respectively...
March 2017: Asian J Anesthesiol
https://www.readbyqxmd.com/read/28757852/use-of-stylet-in-armored-tube-for-nasotracheal-intubation-why-not
#8
Pooja Bihani, Pradeep Kumar Bhatia, Sadik Mohhammad, Priyanka Sethi
No abstract text is available yet for this article.
July 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28642187/cheiloplasty-associated-to-a-palatal-obturator-in-a-preterm-infant-with-a-cleft-lip-and-palate
#9
H Bénateau, A-S Trentesaux, A Chatellier, J Laurent, A Bellot, A Veyssiere
INTRODUCTION: Preterm infants are commonly treated by non-invasive ventilation (NIV) and nasal continuous positive airway pressure (CPAP), which are associated with fewer complications than nasotracheal intubation. In preterm infants with a cleft lip and palate, this method of respiratory management is difficult or impossible to perform because of air leakage through the cleft defect. CASE: We report a male infant who was born at 29 weeks of gestation with a left complete unilateral cleft lip and palate...
June 19, 2017: Journal of Stomatology, Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28523090/penetrating-craniomaxillofacial-injury-caused-by-a-pneumatic-nail-gun
#10
Kevin Jae Choi, Marisa Ann Ryan, Tracy Cheng, David Powers
Craniomaxillofacial injuries can be complex, requiring a multidisciplinary approach. The primary survey is always the first step in trauma management prior to proceeding with further evaluation and treatment. A 26-year-old man presented with a penetrating nail gun injury through the oral and nasal cavities. He did not present in extremis but required elective endotracheal intubation for intraoperative assessment and treatment. Airway management was enhanced by the use of lingual nerve and inferior alveolar nerve blocks via the Vazirani-Akinosi technique to maintain spontaneous respiration while the tongue was distracted from the palate...
June 2017: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/28506413/nasotracheal-prolonged-safe-extubation-in-acute-respiratory-failure-post-thyroidectomy-an-efficacious-technique-to-avoid-tracheotomy-a-retrospective-analysis-of-a-large-case-series
#11
F Ferraro, C Gambardella, D Testa, L Santini, R Marfella, P Fusco, C P Lombardi, A Polistena, A Sanguinetti, N Avenia, G Conzo
BACKGROUND: Acute respiratory failure is a rare life threatening complication following thyroid surgery and its incidence is reported as high as 0.9%. Clinical presentation of severe acute respiratory failure is characterized by dyspnea, inspiratory airways distress, hypoxia and its standard current management is the orotracheal intubation and safe extubation. In case of persistent distress, tracheotomy is mandatory. The Authors, analysing a large acute respiratory failure clinical series, describe an innovative treatment of this severe condition: the nasotracheal prolonged safe extubation...
May 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28504321/hemodynamic-responses-and-plasma-phenylephrine-concentrations-associated-with-intranasal-phenylephrine-in-children
#12
Lisa K Christensen, Valerie E Armstead, David P Bilyeu, Kenneth E Johnson, Robert H Friesen
INTRODUCTION: Intranasal phenylephrine, an alpha-1 adrenergic agonist, causes vasoconstriction of the nasal mucosa and is used to reduce bleeding associated with nasotracheal intubation or endoscopic sinus surgery. The purpose of this study was to describe the hemodynamic effects associated with plasma phenylephrine concentrations following topical intranasal administration of 0.25% and 0.5% phenylephrine in children. METHODS: After Institutional Review Board and parental approval, 77 children between the ages of 2 and 12 years were studied in a prospective, double-blind manner and randomized into three groups...
July 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28494884/less-postoperative-sore-throat-after-nasotracheal-intubation-using-a-fiberoptic-bronchoscope-than-using-a-macintosh-laryngoscope-a-double-blind-randomized-controlled-study
#13
Nobuko Tachibana, Yukitoshi Niiyama, Michiaki Yamakage
STUDY OBJECTIVE: To evaluate whether nasotracheal intubation using a fiberoptic bronchoscope reduces postoperative sore throat. DESIGN: Prospective, double-blinded, randomized, and controlled study. SETTING: Postoperative areas and surgical ward of a university hospital. PATIENTS: Seventy-four patients with American Society of Anesthesiologists physical status I-II who were scheduled for elective general anesthesia requiring nasotracheal intubation...
June 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28439444/airway-management-of-patients-undergoing-oral-cancer-surgery-a-retrospective-analysis-of-156-patients
#14
Sapna Annaji Nikhar, Ashima Sharma, Mahesh Ramdaspally, Ramachandran Gopinath
OBJECTIVE: Oral cancer patients have a potentially difficult airway, but if managed properly during the perioperative period, morbidity and mortality can be reduced or avoided. METHODS: The medical records of 156 patients who were operated for oral cancers were reviewed for airway management during the perioperative period. RESULTS: The surgical procedures ranged from excisions, wide local excisions with split skin graftings, hemiglossectomies and radical neck nodes dissections to pectoralis major myocutaneous or free fibular flaps...
April 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/28422874/consort-the-effect-of-intraoperative-dexmedetomidine-on-hemodynamic-responses-during-emergence-from-nasotracheal-intubation-after-oral-surgery
#15
RANDOMIZED CONTROLLED TRIAL
Youn Yi Jo, Hong Soon Kim, Kyung Cheon Lee, Young Jin Chang, Youseok Shin, Hyun Jeong Kwak
BACKGROUND: Dexmedetomidine provides smooth emergence with reduced agitation. The authors hypothesized low-dose dexmedetomidine infusion might contribute to hemodynamic stability during and after nasotracheal tube extubation. METHODS: Ninety-three adult patients scheduled for oral and maxillofacial surgery were enrolled in this prospective study. Patients were randomly assigned to receive normal saline (control group, n = 31), dexmedetomidine at 0.2 μg/kg/h (DEX0...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28405043/anaesthetic-management-of-a-child-with-stone-man-syndrome-look-before-you-leap
#16
Geeta Kamal, Anju Gupta, Sapna Batla, Nishkarsh Gupta
Stone Man syndrome or fibrodysplasia ossificans progressiva (FOP) is an extremely rare (1 in 2 million) genetic disorder characterised by ectopic ossification of the skeletal and connective tissues leading to progressive fusion of axial and appendicular skeleton. Surgery and anaesthesia-induced trauma can lead to disease flare-up if due precautions are not taken and disable the patient further. However, rarity of the disease may lead to its common misdiagnosis and anaesthesiologist may be caught unaware. There is relative paucity of literature regarding anaesthetic management of children with FOP...
March 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28338519/incidence-of-sinusitis-in-burn-victims-and-association-with-inhalational-injury
#17
Nicole M Melchior, Eric M Melchior, Linwood R Haith
The purpose of this study is to determine the incidence of sinusitis in mechanically ventilated burn victims and to examine if the presence of inhalational injury increases the likelihood of developing sinusitis. The authors hypothesize that the incidence of sinusitis will be increased in burn victims who have concomitant inhalational injury. A retrospective chart analysis was performed on all patients who were admitted to the Nathan Speare Regional Burn Treatment Center over a 24-month time frame. Patients who were mechanically ventilated for greater than 24 hours were then selected, resulting in a total of 137 patients for analysis...
March 22, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28288578/case-report-of-pierre-robin-sequence-with-severe-upper-airway-obstruction-who-was-rescued-by-fiberoptic-nasotracheal-intubation
#18
Satoru Takeshita, Hiroko Ueda, Tatenobu Goto, Daisuke Muto, Hiroki Kakita, Kazuo Oshima, Takahisa Tainaka, Takayuki Ono, Yoshiaki Kazaoka, Yasumasa Yamada
BACKGROUND: Pierre Robin sequence (PRS) refers to the association of micrognathia, glossoptosis, and airway obstruction. Cases with severe dyspnea due to upper airway obstruction immediately after birth are very rare. We here report two cases with PRS who developed severe dyspnea due to morphological abnormality immediately after birth and were rescued by fiberoptic nasotracheal intubation. CASE PRESENTATION: The patient in case 1 had micrognathia and cleft palate, and his tongue protruded into the nasal cavity via a cleft palate...
March 14, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28110989/emergency-department-airway-management-of%C3%A2-severe-angioedema-a-video-review-of-45%C3%A2-intubations
#19
Brian E Driver, John W McGill
STUDY OBJECTIVE: Angioedema is an uncommon but important cause of airway obstruction. Emergency airway management of angioedema is difficult. We seek to describe the course and outcomes of emergency airway management for severe angioedema in our institution. METHODS: We performed a retrospective, observational study of all intubations for angioedema performed in an urban academic emergency department (ED) between November 2007 and June 2015. We performed a structured review of video recordings of each intubation...
May 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28078544/epistaxis-during-nasotracheal-intubation-a-randomized-trial-of-the-parker-flex-tip%C3%A2-nasal-endotracheal-tube-with-a-posterior-facing-bevel-versus-a-standard-nasal-rae-endotracheal-tube
#20
RANDOMIZED CONTROLLED TRIAL
Rosie Earle, Enda Shanahan, Himat Vaghadia, Andrew Sawka, Raymond Tang
PURPOSE: Nasotracheal intubation is a widely performed technique to facilitate anesthesia induction during oral, dental, and maxillofacial surgeries. The technique poses several risks not encountered with oropharyngeal intubation, most commonly epistaxis due to nasal mucosal abrasion. The purpose of this study was to test whether the use of the Parker Flex-Tip™ (PFT) nasal endotracheal tube (ETT) with a posterior facing bevel reduces epistaxis when compared with the standard nasal RAE ETT with a leftward facing bevel...
April 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
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