Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jan 2005
Case ReportsIsolated bilateral paralysis of the hypoglossal and recurrent laryngeal nerves (Bilateral Tapia's syndrome) after transoral intubation for general anesthesia.
Tapia's syndrome is due to extracranial involvement of the hypoglossal nerve and the recurrent laryngeal branch of the vagal nerve. The injury of these nerves is a rare complication of anesthetic airway management. ⋯ Forty-eight hours later, the movements of the vocal cords started to recover and full recovery was achieved by the fourth day. Within 3 days, tongue mobility was gradually improved and the patient's symptoms resolved completely by 4 weeks.
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Acta Anaesthesiol Scand · Jan 2005
Clinical TrialThe relationship between bispectral index and targeted propofol concentration is biphasic in patients with major burns.
Many pathophysiologic alterations in major burns can cause changes in the distribution of, and perhaps response to, drugs commonly used in anesthesia practice. This study was conducted to assess changes in bispectral index (BIS) caused by increasing the target propofol effect-site concentration during a target-controlled infusion (TCI) in major burns. ⋯ In major burns, the final biphasic BIS responses appeared to be determined by numerous other variables such as BIS algorithm, TCI performance, and altered propofol pharmacokinetics and pharmacodynamics. According to our results the importance of an individually tailored approach, including careful anesthetic titration, based upon the patient's clinical condition and responses can not be overemphasized.
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Acta Anaesthesiol Scand · Jan 2005
Case ReportsGuided tactile probing: a modified blind orotracheal intubation technique for the problem-oriented difficult airway.
We present 'tactile probing', a guided approach to blind orotracheal intubation to secure a problem-oriented anticipated difficult airway in a 55-year-old male patient scheduled for elective surgical tracheostomy for a postradiotherapy translaryngeal carcinoma. Standard techniques to gain the airway were inapplicable in this case and awake flexible fiberoscopy-aided intubation had already failed.
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Acta Anaesthesiol Scand · Jan 2005
Randomized Controlled Trial Comparative Study Clinical TrialCerebral blood flow velocity increases when propofol is changed to desflurane, but not when isoflurane is changed to desflurane in children.
Children may exhibit delayed emergence following maintenance of anesthesia with propofol or isoflurane. Desflurane is often used towards the end of procedures to facilitate emergence. This study evaluated the effect on middle cerebral artery blood flow velocity (Vmca) in anesthetized children when propofol or isoflurane was substituted with desflurane. ⋯ When propofol is changed to desflurane, cerebral blood flow velocity increases significantly in normal children. This cerebral vasodilatory effect may have important implications in the neurosurgical setting.