Journal of clinical anesthesia
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Case Reports
Management of a suspected and unsuspected difficult laryngoscopy with the laryngeal mask airway.
The laryngeal mask airway (LMA) is a new development in airway control. Presented here are two cases of difficult airway management--one anticipated, the other not anticipated--during which the LMA was used effectively.
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The laryngeal mask airway (LMA) is a new concept in airway management. A miniature inflatable mask is positioned in the hypopharynx, forming a low-pressure seal around the laryngeal inlet. The mask is attached via a tube to the breathing circuit. ⋯ It is now widely used in the United Kingdom; however, it is not yet available for sale in the U. S. It has already had a major effect on practice in Britain and has the potential to do the same in the United States.
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Randomized Controlled Trial Comparative Study Clinical Trial
Propofol versus thiamylal-enflurane anesthesia for outpatient laparoscopy.
To determine whether propofol anesthesia differs from thiamylal-enflurane anesthesia in induction characteristics, intraoperative hemodynamics, postoperative side effects, and postoperative psychomotor function recovery. ⋯ Induction and maintenance of anesthesia with propofol were comparable to those with thiamylal-enflurane, except patients experienced more pain on injection after propofol. Both immediate and intermediate recovery were more rapid after propofol anesthesia compared with enflurane-based anesthesia.
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Comparative Study
Frequency and severity of desaturation events during general anesthesia in children with and without upper respiratory infections.
To determine whether anesthesia in the presence of a mild upper respiratory infection (URI) was associated with episodes of desaturation or reactive airway problems. ⋯ Children with a mild URI have an increased frequency of minor desaturation episodes, and intubated patients with a URI have an increased frequency of bronchospasm. It appears that children with a mild URI may be safely anesthetized, since the problems encountered are generally easily treated and without long-term sequelae.
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The perioperative management and dissemination of critical information regarding a patient with an unexpected difficult intubation, including successful application of a difficult airway algorithm (Figure 1), are described. Documentation and dissemination of critical information include entry of patient data into an in-hospital computerized Difficult Airway/Intubation Registry, simultaneous application of a highly visible Difficult Airway/Intubation Patient Wrist Band (coded for access to computer registry), summary reports distributed to health care providers, and enrollment of the patient in the Medic Alert Foundation International's newly established category difficult airway/intubation for 24-hour access. We postulate that the widespread use of the procedures described in this report may reduce the contribution of unexpected difficult airway/intubation to anesthetic morbidity and mortality.