Journal of clinical anesthesia
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The purpose of this study was to analyze previously reported airway risk factors in the performance of Miller laryngoscopy and orotracheal intubation. ⋯ The Miller blade is highly successful in the performance of direct laryngoscopy for orotracheal intubation. These findings suggest that different sets of airway risk factors affect the process of laryngoscopy and orotracheal intubation.
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Observational Study
Time-dependent changes in epidural catheter aspirate after injection of a local anesthetic.
A glucose check is used for investigation of a suspected accidental dural puncture in epidural anesthesia. However, glucose-positive clear fluid is sometimes aspirated from an epidural catheter in cases without clinical evidence of puncture. The goal of the study was to investigate time-dependent changes in the aspirate composition after injection of a local anesthetic into the epidural space. ⋯ A glucose check may increase the risk of a false-positive finding for accidental dural puncture with increasing time after local anesthetic injection. Conversely, detection of glucose at the time of epidural catheter placement may provide useful information for detection of accidental dural puncture.
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Case Reports
Reversal of profound neuromuscular blockade with sugammadex in an infant after bronchial foreign body removal.
Sugammadex is a selective chemical agent that can reverse neuromuscular blockade induced by vecuronium and rocuronium. The aim of this report is to discuss the effectiveness of sugammadex in the reversal of neuromuscular blockade in children younger than 2 years. A 16-month-old boy, weighing 10 kg, was admitted to the pediatric emergency department due to choking, cyanosis, and severe respiratory distress that occurred while he was eating peanuts. ⋯ Clinical use of sugammadex in children younger than 2 years is not recommended because of the lack of clinical studies. In this case report, the profound neuromuscular blockade was successfully reversed with a dose of 2 mg/kg sugammadex in a 16-month-old boy. However, more prospective clinical studies are required for the safe use of this agent in children.
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This study aimed to characterize the current practice patterns with cuffed tracheal tubes (CTT) in neonates, infants, and children among members of the Society of Pediatric Anesthesia (SPA). ⋯ A majority of SPA members routinely use CTT in neonates, infants and children.
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An 18-month-old male patient, classified as American Society of Anesthesiologists I, with bilateral inguinal hernia was scheduled for operation. Preanesthetic evaluation revealed history of completed medical treatment of acute bronchitis 10 days ago, and his respiratory examination was recorded as normal. He was successfully operated under general anesthesia with a laryngeal mask. ⋯ The patient's hemodynamic and respiratory parameters recovered quickly after foreign body removal, and the patient was transferred to intensive care unit. His parents were questioned for persistent respiratory symptoms and they gave information about repeating respiratory tract infections in the last 3 months. We predict that displaced foreign body in lobar bronchus due to mechanical ventilation can cause this condition.