Paediatric anaesthesia
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Paediatric anaesthesia · Jan 2008
Case ReportsAwake tracheal intubation through the laryngeal mask in neonates with upper airway obstruction.
Neonates with Pierre Robin or Treacher-Collins syndrome are at risk of upper airway obstruction and may require surgical fixation of the tongue to the mandible. Such neonates are at high risk of hypoxia during induction of anesthesia and thus awake fiberoptic intubation would be required. We experienced neonates in whom awake fiberoptic intubation could not be carried out, because of severe hypoxia. ⋯ No hypoxia occurred after insertion of the laryngeal mask. In a further two neonates with Treacher-Collins syndrome and in one neonate with Pierre Robin syndrome, awake fiberoptic intubation through the laryngeal mask was also successful. We believe that in neonates with predicted difficult intubation, who are at risk of upper airway obstruction and awake fiberoptic intubation could aggregate hypoxia, awake insertion of the laryngeal mask can be useful in facilitating oxygenation (by relieving upper airway obstruction) and in facilitating fiberoptic intubation.
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Paediatric anaesthesia · Jan 2008
Comment Letter Comparative StudyRegarding sevoflurane and emergence agitation...again!
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Paediatric anaesthesia · Jan 2008
Comment Letter Comparative StudyIsoflurane vs sevoflurane in emergence delirium: a misleading conclusion.