Canadian journal of anaesthesia = Journal canadien d'anesthésie
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The literature describing the pulmonary mechanisms of increased PA-PaO2 during general anaesthesia was examined to define the role of airway closure and sub-radiological atelectasis. ⋯ Airway closure and atelectasis contribute equally to the increased ventilation: perfusion mismatching that occurs during general anaesthesia.
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Airway management in neurosurgical patients presents unique challenges to the anaesthetist. This review will consider specific approaches to numerous problems in airway management related to logistical, physiological and anatomical concerns. The goal is to provide a clinically oriented and practical discussion regarding issues of airway management in neurosurgical patients. ⋯ The demands for airway management in neuroanaesthesia require expertise in the various modes of securing the airway while considering the patient's physiological requirements as well as the unique surgical demands.
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Sleep apnoea syndrome (SAS) is a relatively common, potentially fatal, disorder. Patients with SAS exhibit repetitive, often prolonged episodes of apnoea during sleep, with serious nocturnal and diurnal physiologic derangements. Several anecdotal reports and clinical studies have documented anaesthetic-related occurrence of fatal and near-fatal respiratory complications in these patients. The purpose of this article is to outline the potential problems encountered in anaesthetic management of adult SAS patients, and to suggest a practical approach for anaesthesia both for incidental and specific procedures. ⋯ Perioperative risks attending SAS patients emphasize the importance of their detection, perioperative evaluation and planning.