Journal of clinical anesthesia
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Case Reports
Fiber-optic bronchoscopic guidance for intubating a neonate with Pierre-Robin syndrome.
The Pierre-Robin anomalad features micrognathia, glossoptosis, and frequently a cleft palate. Tracheal intubation may be challenging and sometimes impossible. ⋯ The bronchoscope was then removed, and an endotracheal tube was threaded over the wire. The technique is safe and allows rapid endotracheal intubation in pediatric patients with difficult upper airways.
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To describe a current method of teaching flexible fiber-optic laryngoscopy. ⋯ Oral flexible fiber-optic laryngoscopy and intubation may be taught safely using thiopental sodium and succinylcholine by adhering to the guidelines outlined in this paper.
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While malformations of the upper airway are rare, they present challenging management problems and have a potentially devastating impact during anesthesia. This case report describes the management of a patient with a massive supraglottic venous malformation as he underwent transvenous embolization.
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Anesthetic experience with three cases of the resection of glucagonoma, a rare tumor of alpha cells of pancreatic islets, is presented. Marked increases of blood glucagon and glucose levels, with the potential for clinically significant metabolic and myocardial dysfunction, did not occur during anesthesia and surgery. Associated tumors of other endocrine cell types also were absent in the three study patients. Strategies for anticipating and managing other perioperative problems associated with glucagonoma also are discussed.