Masui. The Japanese journal of anesthesiology
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The Pentax-AWS equipped with a new thinner blade (Introck-T) is an intubation device that provides a non-line-of sight view of the glottis. A non-line-of sight view is expected to cause less movement of the cervical spine during laryngeal visualization. We measured the degree of cervical spine movement during laryngoscopy with the device. ⋯ Laryngeal visualization using the Pentax-AWS with the new thinner Introck-T produces the anterior movement and extension of the cervical spine.
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In most cases, an endotracheal tube (ETT) enters the right bronchus due to anatomical features of the trachea. The Parker Flex-Tip Tube (Parker tube) has a centered and tapered tip with a posterior facing bevel. Here, we report a case of accidental left bronchial intubation that may be associated with the tip design of the Parker tube. ⋯ To test this hypothesis, we conducted a simulation study using a standard airway mannequin. Intubation with a standard left-beveled ETT resulted in right bronchial intubation in all 20 trials, while 4 of the 20 Parker tubes entered the left mainstem bronchus. This investigation suggests that unintentional left bronchus intubation of the Parker tube may occur in the ordinary clinical setting if the tube is advanced beyond the carina.
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Case Reports
[A child with Klippel-Feil syndrome in whom GlideScope was effective for tracheal intubation].
GlideScope videolaryngoscope (GlideScope, herein-after referred to as "GS", Verathon Medical, Bothell, WA, USA), with a high-resolution camera positioned on a blade, enables operators to confirm the position of the larynx and a tube through clear view, thereby conducting intubation safely in a patient whose neck is difficult to be bent back. As the blade is slim, GS is indicated for use in children whose oral cavity is narrow. We herein report safe and smooth intubation with GS in a child with Klippel-Feil syndrome in whom difficult intubation was predicted.
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Meta Analysis Comparative Study
[Efficacy of Pentax-AWS in difficult airways: a meta-analysis of randomized controlled trials].
Increased evidence indicates that the Pentax-AWS (AWS) is useful for difficult airways. The aim of this meta-analysis was to assess the efficacy of the AWS in difficult airways, comparing that of Macintosh laryngoscopy. ⋯ There is considerable evidence that AWS has an advantage over Macintosh laryngoscope in difficult airways.
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A 46-year-old man was diagnosed with descending colon cancer and was planned to undergo left hemicolectomy under general anesthesia. His body mass index was 42.6 and due to his small mouth and jaw, we anticipated difficult mask ventilation and tracheal intubation. ⋯ Then, we replaced the air-Q with an outside diameter 8.5 mm tracheal tube. This case was a successful use of the air-Q under moderate sedation for airway management in the setting of anticipated difficult mask ventilation and tracheal intubation.