Journal of clinical anesthesia
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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.
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Stereotactic neurosurgery is a procedure that usually requires monitored sedation or general anesthesia. The authors report a case in which stereotactic irrigation of a brain cyst was temporally associated with respiratory distress. Additionally, the stereotactic apparatus limits the anesthesiologist's access to the airway.
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Randomized Controlled Trial Comparative Study Clinical Trial
Uptake and biotransformation of sevoflurane in humans: a comparative study of sevoflurane with halothane, enflurane, and isoflurane.
To compare the volatile anesthetic sevoflurane with halothane, enflurane, and isoflurane on the uptake and biotransformation in humans. ⋯ Accurate determinations of uptake and degradation rate for sevoflurane and three other volatile anesthetics in Japanese patients were obtained. These findings have established that, despite its relatively large MAC (1.71%), sevoflurane has a small uptake due to its low solubility. However, the degradation rate was shown to be as high as 3.3%, resulting in a higher serum fluoride concentration than seen after administration of isoflurane, halothane, and (possibly) enflurane.