The Difficult Airway
Airway management is a cornerstone of anesthetic practice, and difficulty with airway management has potentially grave implications —failure to secure a patent airway can result in hypoxic brain injury or death in a matter of minutes. The difficult airway in otolaryngologic surgery requires careful planning and close communication between the anesthesiologist and ENT or head and neck surgeon. Knowledge of predictive factors an d a detailed preoperative evaluation can be used to predict which airway strategies are likely to be successful and which are likely to fail.
Conclusionsinstrumental measurements highlight that SLMA offers the advantage of less resistance to the airflow, allowing to keep lower oropharyngeal leak pressure during mechanical ventilation. Despite the differences reported, we observed only a few minor complications in both groups.
Purpose of review The difficult airway remains an ongoing concern in daily anesthesia practice, with awake intubation being an important component of its management. Classically, fiberoptic bronchoscope-assisted tracheal intubation was the method of choice in the awake patient. The development of new generation videolaryngoscopes has revolutionized the approach to tracheal intubation in the anesthetized patient. The question whether videolaryngoscopes have a place in the intubation of the difficult airway in the awake patient is currently being addressed. Recent findings Randomized controlled trials and their meta-ana...
CONCLUSION The Spritztube was as effective as the LMA-S in maintaining the airway with all patients being successfully ventilated without difficulty. The success rate of achieving a patent airway was comparable between the groups, with a similar occurrence of complications. TRIAL REGISTRATION NCT03443219.
BACKGROUND Good visibility is essential for successful laryngeal surgery. A Tritube with outer diameter 4.4 mm, combined with flow-controlled ventilation (FCV), enables ventilation by active expiration with a sealed trachea and may improve laryngeal visibility. OBJECTIVES We hypothesised that a Tritube with FCV would provide better laryngeal visibility and surgical conditions for laryngeal surgery than a conventional microlaryngeal tube (MLT) with volume-controlled ventilation (VCV). DESIGN Randomised, controlled trial. SETTING University Medical Centre. PATIENTS A total of 55 consecutive patients (>18 y...
Publication date: Available online 1 November 2019Source: Operative Techniques in Otolaryngology-Head and Neck SurgeryAuthor(s): Verghese T. Cherian, Sonia J. VaidaAirway management and anesthesia for laryngeal surgery poses many challenges. A preoperative endoscopic airway examination and discussion with the otolaryngologist helps in planning the anesthetic management. Although, securing the airway using specialized endotracheal tubes is possible in the majority of cases, the surgeon may occasionally request a “tubeless” field. This can be achieved by ventilating the lungs using jet ventilation or high flow na...
Conclusions: The study outlined in this protocol will explore the possibility of ultrasound for predicting difficult airway in obstetric anesthesia. This may provide new insight into the practice of airway management. Trial registration: Chinese Clinical Trial Registry, ChiCTR1800018949.
This article outlines some of the specific difficulties faced by clinicians in ICU and attempts to provide some guidance as to how these may be overcome, or at least abated. Drug and equipment choices are discussed. A suggestion for a difficult airway algorithm for use in the ICU is put forward. The timing of tracheostomy is discussed. Finally, the importance of the team and the human factors that are at play are touched upon.
Abstract A 13-month-old infant was admitted to hospital approximately 3 weeks after ingestion of a button battery, which was lodged in the esophagus and had caused a tracheoesophageal fistula requiring mechanical ventilation. Since the battery had partially penetrated into the tracheal lumen just above the carina and also was in direct contact with the pulmonary artery, extensive considerations regarding airway and circulatory management were required preoperatively, which are presented and discussed in this case report. PMID: 31624891 [PubMed - as supplied by publisher]
Conclusion: Completeness of manual data recording in the electronic AIMS is poor after one year of implementation. First case of the day, second phase of study period, elective cases and trainee anaesthesiologist are associated with better completeness of manual data recording in the AIMS.
Arun Raja Thangavel, Sakthirajan Panneerselvam, Priya Rudingwa, Ranjith Kumar SivakumarIndian Journal of Anaesthesia 2019 63(10):862-863