Journal of clinical anesthesia
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To evaluate the hemodynamic and respiratory effects of percutaneous transtracheal high-frequency jet ventilation (HFJV) during difficult intubation using fiberoptic bronchoscopy under general anesthesia. ⋯ Transtracheal HFJV under general anesthesia with etomidate, alfentanil, and vecuronium provided satisfactory hemodynamic conditions and pulmonary gas exchange. Percutaneous transtracheal HFJV can be used safely to manage patients with a difficult airway under general anesthesia using fiberoptic bronchoscopy.
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Halogenated inhalational anesthetics have been implicated in hepatotoxicity. Halothane hepatitis results from the biotransformation of the drug to a metabolite that binds to liver proteins, which creates a hapten, which, in turn, causes an immunologic response in the liver. Case reports of hepatic injury resulting from isoflurane, which has a decreased biotransformation compared with that of halothane, have received much criticism. We describe a patient who had elevated liver enzymes and a positive trifluoroacetyl antibody titer following an anesthetic regimen that included isoflurane.
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This report describes complete airway obstruction following anterior cervical fusion caused by extreme, fixed flexion of the neck in a halo device. The causes and treatment of such an airway complication are reviewed.