Journal of clinical anesthesia
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Review Comparative Study
Obstructive sleep apnea as a risk factor associated with difficult airway management - A narrative review.
The association between obstructive sleep apnea (OSA) and difficult airway had been studied in various clinical trials but the relationship between the two conditions has not been clearly established. The objective of this narrative review is to determine if OSA is a risk factor associated with difficult airway. ⋯ OSA was found to be a risk factor associated with difficult tracheal intubation and difficult mask ventilation. There was no association between OSA and difficult SGA use.
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Review Meta Analysis Comparative Study
Diagnostic accuracy of radiology (CT, X-ray, US) for predicting difficult intubation in adults: A meta-analysis.
The aim of this study was to evaluate the overall accuracy of radiological measurements in prediction of difficult airway and compare the diagnostic value between the radiological measurements and the modified Mallampati score through a meta-analysis of published studies. ⋯ The results indicated that the diagnostic value of CT, X-ray and US was much better than that of modified Mallampati score. Ultrasound had diagnostic indices and the area under curve similar to those of CT and X-ray in predicting difficult airway. Considering being easy, readily availability, low cost, and free from radiological hazards, it can be considered as prior diagnostic strategy in this condition.
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Anesthetic management of obese pediatric patients is challenging. With increasing prevalence of childhood obesity, more severely obese children with comorbidities present for surgery every day. The purpose of this review is to provide an up-to-date comprehensive narrative review on the impact of pathophysiological changes imposed by pediatric obesity on the perioperative management of obese children, especially drug dosing. This knowledge is necessary to provide safe delivery of anesthesia for severely obese children. ⋯ Optimal and safe anesthetic management of an obese child requires thoughtful pre-procedure assessment and meticulous perioperative management tailored to associated comorbidities, with heightened awareness of potential perioperative complications. There remains a need for improved guidelines for risk stratification, drug dosing and postoperative disposition in this patient population.