Journal of clinical anesthesia
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A 13-year-old girl with Goltz's (Goltz-Gorlin) syndrome (focal dermal hypoplasia) and cloacal exstrophy underwent day surgery cystoscopy. During the administration of inhalation anesthesia by mask, persistent partial upper airway obstruction was noted. ⋯ The patient later returned for a complete endoscopic examination, followed by cup forcep and laser excision of these verrucous and pedunculated lesions, and remained intubated in the intensive care unit (ICU) for 48 hours following this procedure. Airway management and pathology specific to this rare disorder are discussed.
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Comparative Study
A comparison of thromboelastogram and template bleeding time in the evaluation of platelet function after aspirin ingestion.
To compare template bleeding time (TBT) with thromboelastography (TEG) in human subjects after aspirin ingestion. ⋯ TEG results may not identify patients who have an increased bleeding time as a result of aspirin ingestion.
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To determine whether the anesthetic cardiac arrest rate decreased following the introduction of enhanced respiratory monitoring and increased safety awareness during the past decade. ⋯ The results support the hypothesis that improved respiratory monitoring was effective in decreasing anesthetic morbidity.
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Case Reports
Total airway obstruction with neck extension: airway management of a patient with pharyngeal tumor.
Airway obstruction with the induction of anesthesia in children is common. Normally, neck extension with jaw thrust improves the airway. Flexion typically completes the obstruction. ⋯ We present a case of complete airway obstruction with neck extension in the presence of a nasopharyngeal tumor. Flexion rather than extension of the neck relieved this airway obstruction. We highly recommend radiologic studies with neck extension and flexion in such cases.