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https://www.readbyqxmd.com/read/28639059/safety-of-flexible-endoscopic-biopsy-of-the-pharynx-and-larynx-under-topical-anesthesia
#1
David J Wellenstein, Joey K de Witt, Henrieke W Schutte, Jimmie Honings, Frank J A van den Hoogen, Henri A M Marres, Robert P Takes, Guido B van den Broek
Recent advancements in transnasal endoscopy enable a shift in diagnostic workup of lesions in the pharynx and larynx, from an examination with biopsy under general anesthesia to an office-based examination with flexible endoscopic biopsy under topical anesthesia. Procedural complications were evaluated to assess the safety of office-based flexible endoscopic biopsy in patients with benign and malignant laryngopharyngeal lesions. Patients who underwent flexible endoscopic biopsy from 2012 to 2016 were evaluated retrospectively...
June 21, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28621297/endoscopic-ultrasound-with-or-without-fine-needle-aspiration-has-a-meaningful-impact-on-clinical-care-in-the-pediatric-population
#2
Amit Raina, Maire A Conrad, Benjamin Sahn, Alireza Sedarat, Gregory G Ginsberg, Nuzhat A Ahmad, Vinay Chandrasekhara, Petar Mamula, Michael L Kochman
BACKGROUND AND OBJECTIVES: The safety and utility of endoscopic ultrasound (EUS) for the evaluation and management of gastrointestinal (GI) tract disorders among adults has been established. The literature on safety and efficacy in a pediatric referral population (under 21 years of age) is limited. We hypothesized that EUS is safe and useful in the pediatric population. We reviewed the pediatric EUS experience at a single tertiary-care system. We describe the indications, findings, safety, technical success rate, and impact on clinical outcomes...
May 2017: Endoscopic Ultrasound
https://www.readbyqxmd.com/read/28515519/desflurane-for-ambulatory-anaesthesia-a-comparison-with-sevoflurane-for-recovery-profile-and-airway-responses
#3
Kajal Sachin Dalal, Meghana Vijay Choudhary, Adit Jagdish Palsania, Pratibha Vinayak Toal
BACKGROUND AND AIMS: Desflurane and sevoflurane have low blood gas solubility co-efficients, allowing a rapid awakening from anaesthesia. However, desfluraneis pungent and may cause airway irritability. We compared desflurane and sevoflurane with respect to recovery and occurrence of adverse airway responses in spontaneously breathing patients while using the ProSeal™ laryngeal mask airway (LMA). METHODS: Ninety-four adult patients undergoing hysteroscopic procedures were divided into sevoflurane (S) group or desflurane (D) group...
April 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28488002/experience-with-the-use-of-propofol-for-radiologic-imaging-in-infants-younger-than-6-months-of-age
#4
Elan Jenkins, Kiran B Hebbar, Katie K Karaga, Daniel A Hirsh, James D Fortenberry, Courtney E McCracken, Stephen F Simoneaux, Michael D Mallory, Pradip P Kamat
BACKGROUND: There is an increased risk associated with procedural sedation of infants younger than 6 months of age. The use of propofol for radiologic imaging of this age group is not well studied. OBJECTIVE: We hypothesize that adverse events are higher in the infant population receiving propofol for radiologic imaging. MATERIALS AND METHODS: A retrospective chart review was undertaken of 304 infants younger than 6 months old who received propofol for procedural sedation from October 2012 to February 2015...
May 9, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28465842/postoperative-airway-obstruction-by-a-bone-fragment
#5
Patrick Schober, K Hakki Karagozoglu, Stephan A Loer, Lothar A Schwarte
Postoperative airway obstructions are potentially life-threatening complications. These obstructions may be classified as functional (sagging tongue, laryngospasm, or bronchospasm), pathoanatomical (airway swelling or hematoma within the airways), or foreign body-related. Various cases of airway obstruction by foreign bodies have previously been reported, for example, by broken teeth or damaged airway instruments. Here we present the exceptional case of a postoperative airway obstruction due to a large fragment of the patient's maxillary bone, left accidentally in situ after transoral surgical tumor resection...
2017: Case Reports in Anesthesiology
https://www.readbyqxmd.com/read/28464295/obstructive-apnea-due-to-laryngospasm-links-ictal-to-postictal-events-in-sudep-cases-and-offers-practical-biomarkers-for-review-of-past-cases-and-prevention-of-new-ones
#6
Mark Stewart, Richard Kollmar, Ko Nakase, Joshua Silverman, Krishnamurthi Sundaram, Rena Orman, Jason Lazar
Seizure spread into autonomic and respiratory brainstem regions is thought to play an important role in sudden unexpected death in epilepsy (SUDEP). As the clinical dataset of cases of definite SUDEP available for study grows, evidence points to a sequence of events that includes postictal apnea, bradycardia, and asystole as critical events that can lead to death. One possible link between the precipitating seizure and the critical postictal sequence is seizure-driven laryngospasm sufficient to completely obstruct the airway for an extended period, but ictal laryngospasm is difficult to fully assess...
June 2017: Epilepsia
https://www.readbyqxmd.com/read/28416836/-comparison-between-flexible-laryngeal-mask-airway-and-reinforced-tracheal-tube-used-for-lumbar-vertebral-surgery-in-prone-position
#7
Y L Zheng, W F Song, D X Wang
OBJECTIVE: To estimate the safety and feasibility of flexible laryngeal mask airway (FLMA) for lumbar vertebral surgery in prone position. METHODS: In the study, 120 adult patients scheduled for lumbar vertebral surgery under intravenous general anesthesia were divided into group FLMA and reinforced tracheal tube (RTT) group at random. Heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were recorded at the beginning of anesthesia induction (T0) and on the time of artificial airway intubation (T1), 1 min after intubation (T2), extubation (T3), 1 min after extubation (T4) as well...
April 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28370856/validation-of-adapted-dartmouth-operative-conditions-scale-for-sedation-during-pediatric-esophagogastroduodenoscopy
#8
Vanmathi Chandran, Barath Jagadisan, Barani Ganth
AIMS: Pediatric esophagogastroduodenoscopy requires deep sedation as it involves stimulation of the airway. Frequency of adverse events is higher with esophagogastroduodenoscopy. Hence, monitoring needs sedation scales like the Dartmouth Operative Condition Scale that identifies safe states of sedation. This study aims at validating the Adapted Dartmouth Operative Condition Scale for sedation rating by pediatricians during pediatric esophagogastroduodenoscopy. METHODS: Items in the Dartmouth Operating Conditions Scale were adapted for pediatric esophagogastroduodenoscopy...
June 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28356076/dexmedetomidine-s-inhibitory-effects-on-acetylcholine-release-from-cholinergic-nerves-in-guinea-pig-trachea-a-mechanism-that-accounts-for-its-clinical-benefit-during-airway-irritation
#9
Maya Mikami, Yi Zhang, Benjamin Kim, Tilla S Worgall, Harald Groeben, Charles W Emala
BACKGROUND: Airway instrumentation can evoke upper airway reflexes including bronchoconstriction and cough which can cause serious complications including airway trauma, laryngospasm or bronchospasm which may in turn lead to difficulty with ventilation and hypoxemia. These airway events are mediated in part by irritant-induced neuronal modulation of airway tone and cough responses. We investigated whether the commonly used anesthetic agents dexmedetomidine, lidocaine or remifentanil attenuated neuronal and airway smooth muscle responses in the upper airways of guinea pigs...
March 29, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28298788/effects-of-lignocaine-administered-intravenously-or-intratracheally-on-airway-and-hemodynamic-responses-during-emergence-and-extubation-in-patients-undergoing-elective-craniotomies-in-supine-position
#10
Tabasum Shabnum, Zulfiqar Ali, Imtiaz Ahmad Naqash, Aabid Hussain Mir, Khan Azhar, Syed Amer Zahoor, Abdul Waheed Mir
INTRODUCTION: Sympathoadrenergic responses during emergence and extubation can lead to an increase in heart rate (HR) and blood pressure whereas increased airway responses may lead to coughing and laryngospasm. The aim of our study was to compare the effects of lignocaine administered intravenously (IV) or intratracheally on airway and hemodynamic responses during emergence and extubation in patients undergoing elective craniotomies. METHODOLOGY: Sixty patients with physical status American Society of Anaesthesiologists Classes I and II aged 18-70 years, scheduled to undergo elective craniotomies were included...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28224648/impacts-of-disease-severity-on-postoperative-complications-in-children-with-sleep-disordered-breathing
#11
Kun-Tai Kang, I-Sheng Chang, Chia-Chen Tseng, Wen-Chin Weng, Tzu-Yu Hsiao, Pei-Lin Lee, Wei-Chung Hsu
OBJECTIVES/HYPOTHESIS: To investigate the effects of diseases severity on postoperative complications following adenotonsillectomy (T&A) in children with sleep-disordered breathing (SDB). STUDY DESIGN: Retrospective study. METHODS: Children aged <18 years were enrolled and underwent T&A for treating SDB. Polysomnography was used to classify the disease severity: primary snoring (apnea-hypopnea index [AHI] <1), mild (AHI = 1-5), moderate (AHI = 5-10), and severe obstructive sleep apnea [OSA] (AHI ≥10)...
February 22, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28184275/postoperative-negative-pressure-pulmonary-edema-following-repetitive-laryngospasm-even-after-reversal-of-neuromuscular-blockade-by-sugammadex-a-case-report
#12
Ji Hyeon Lee, Jae Ho Lee, Min Hyun Lee, Hyun Oh Cho, Soon Eun Park
Laryngospasm, an occlusion of the glottis, can occur at any time during anesthesia, and is associated with serious perioperative complications such as hypoxia, hypercabia, aspiration, bronchospasm, arrhythmia, prolonged recovery, cardiac collapse, and eventually catastrophic death. Importantly, postoperative negative pressure pulmonary edema (NPPE) is a rare, but well described life-threatening complication related to acute and chronic upper airway obstruction. Sugammadex well known for affirmatively reducing the postoperative pulmonary complications associated with residual neuromuscular blockade may have an indirect role in triggering the negative intrathoracic pressure by raising a rapid and efficacious respiratory muscle strength in acute upper airway obstruction...
February 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28183554/comparison-of-laryngeal-mask-airway-vs-tracheal-intubation-a-systematic-review-on-airway-complications
#13
REVIEW
Babette F van Esch, Inge Stegeman, Adriana L Smit
To determine whether the laryngeal mask airway (LMA) has advantages over the tracheal tube (TT) in terms of incidence of cough, sore throat, laryngospasm, dysphagia, dysphonia, and blood staining. This is a systematic literature review performed at the Universtity Medical Center of Utrecht. The online databases PubMed, Embase, and the Cochrane Library were searched for relevant randomized controlled trials. Two independent reviewers selected relevant articles after title, abstract, and full text screening. Articles were assessed on risk of bias in accordance with the Cochrane risk of bias tool...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28181336/impact-of-high-concentrations-of-sevoflurane-on-laryngeal-reflex-responses
#14
Thomas O Erb, Britta S von Ungern-Sternberg, Jens Moll, Franz J Frei
BACKGROUND: Exaggerated defensive upper airway reflexes, particularly laryngospasm, may cause hypoxemic damage, especially in children. General clinical experience suggests that laryngeal reflex responses are more common under light levels of anesthesia, and previous clinical studies have shown an inverse correlation between laryngeal responsiveness and depth of hypnosis. However, this seems to be less obvious in children anesthetized with sevoflurane. The aim of this study was to assess the impact of high concentrations of sevoflurane on laryngeal and respiratory reflex responses in spontaneously breathing children...
March 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28128660/cardiac-failure-in-a-trisomy-9-patient-undergoing-anesthesia-a-case-report
#15
Cara J Riley, Timothy Moore, Lauren Eagelston, Dale Burkett, Scott Auerbach, Richard J Ing
A 27-year-old female with Trisomy 9 mosaicism presented to Children's Hospital Colorado for outpatient dental surgery under general anesthesia. The patient's past medical history was also significant for premature birth, gastroesophageal reflux, scoliosis and kyphosis, obesity, and developmental delay. Per her mother's report, the patient had no cardiac issues. She had undergone multiple previous general anesthetics, some of which documented respiratory complications such as laryngospasm, bronchospasm, and possible aspiration...
2017: Anesthesia Progress
https://www.readbyqxmd.com/read/28120104/adjuncts-to-local-anaesthetics-in-tonsillectomy-a-systematic-review-and-meta-analysis
#16
REVIEW
R Vlok, T M Melhuish, C Chong, T Ryan, Leigh D White
The infiltration of local anaesthetic agents has been shown to reduce post-tonsillectomy pain. A number of recent studies have shown that the addition of agents such as clonidine and dexamethasone improve the efficacy of nerve blocks and spinal anaesthesia. The aim of this review was to determine whether additives to local anaesthetic agents improve post-tonsillectomy outcomes. Four major databases were systematically searched for all relevant studies published up to August 2016. All study designs with a control group receiving local anaesthetic infiltration and an intervention receiving the same infiltration with an added agent were included in this review...
January 24, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28108038/the-effect-of-endotracheal-tubes-versus-laryngeal-mask-airways-on-perioperative-respiratory-adverse-events-in-infants-a-randomised-controlled-trial
#17
Thomas F E Drake-Brockman, Anoop Ramgolam, Guicheng Zhang, Graham L Hall, Britta S von Ungern-Sternberg
BACKGROUND: Perioperative respiratory adverse events (PRAE) are the most common critical incidents in paediatric anaesthesia and occur more often in infants. Use of laryngeal mask airways (LMAs) is associated with reduced PRAE compared with endotracheal tubes in older children (>1 year). We aimed to evaluate the effect of these devices on the incidence of PRAE in infants. METHODS: We did a randomised controlled trial at the Princess Margaret Hospital for Children in Perth (WA, Australia) by recruiting infants (aged 0-12 months) undergoing general (with or without regional or local) anaesthesia with anticipated fentanyl dose 1 μg/kg or lower for minor elective surgery...
February 18, 2017: Lancet
https://www.readbyqxmd.com/read/27984222/succinylcholine-for-emergency-airway-rescue-in-class-b-ambulatory-facilities-the-society-for-ambulatory-anesthesia-position-statement
#18
Girish P Joshi, Meena S Desai, Steven Gayer, Hector Vila
Procedures in class B ambulatory facilities are performed exclusively with oral or IV sedative-hypnotics and/or analgesics. These facilities typically do not stock dantrolene because no known triggers of malignant hyperthermia (ie, inhaled anesthetics and succinylcholine) are available. This article argues that, in the absence of succinylcholine, the morbidity and mortality from laryngospasm can be significant, indeed, higher than the unlikely scenario of succinylcholine-triggered malignant hyperthermia. The Society for Ambulatory Anesthesia (SAMBA) position statement for the use of succinylcholine for emergency airway management is presented...
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27942052/critical-incidents-in-paediatric-anaesthesia-a-prospective-analysis-over-a-1-year-period
#19
Raylene Dias, Nandini Dave, Swapna Chiluveru, Madhu Garasia
BACKGROUND AND AIMS: Critical incident reporting helps to identify errors and formulate preventive strategies. Many countries have existing national reporting systems. Such a system is yet to be established in India. We aimed to study the incidence of critical events in the paediatric operation theatre (OT) of our institute. METHODS: We conducted a prospective observational study of all children receiving anaesthesia in paediatric OT over a period of 1 year. They were monitored intraoperatively as well as postoperatively, and critical incidents were noted in terms of date and time of incident, location (OT/post-anaesthesia care unit, clinical category, age of patient, degree of patient harm resulting from the incident, description of what happened and duration of surgery...
November 2016: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/27901329/comparing-incidence-of-emergence-delirium-between-sevoflurane-and-desflurane-in-children-following-routine-otolaryngology-procedures
#20
Jeremy N Driscoll, Brian M Bender, Carlos A Archilla, Carol M Klim, Md J Hossain, George Mychaskiw, Julie L Wei
BACKGROUND: Emergence delirium (ED) is a state of aggressive agitation that can occur temporarily in the process of emerging from anesthesia in children exposed to volatile or intravenous anesthetics. Emergence delirium is typically assessed using the published and validated Pediatric Emergence Delirium (PAED) Scale. Due to some variation in properties between sevoflurane and desflurane for maintenance of anesthesia after standard sevoflurane induction, we designed a prospective study to examine potential differences in emergence behavior and incidence of ED in children undergoing elective ear-nose-throat surgery...
April 2017: Minerva Anestesiologica
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