Masui. The Japanese journal of anesthesiology
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Case Reports
[A case of a patient with Forestier's disease--intubation by Airway Scope and bronchofiberscope].
Forestier's disease accompanies difficult airway management with the ossification of the anterior longitudinal ligament of the spine. The abnormalities include limited cervical mobility, constrained epiglottic elevation, exclusion of the part of aryepiglottic, recurrent nerve paralysis and thinning of respiratory tract mucosa. ⋯ We could intubate an enforced tube (internal diameter 7.5 mm) with the bronchofiberscope guidance without any complications. This procedure seems to be safe for intubation in a Forestier's disease patient.
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A 71-year-old female developed upper airway obstruction due to flexed cervical position after posterior occipito-cervical fusion. After the operation, she was re-intubated with the air-Q intubating laryngeal airway. ⋯ From the retrospective radiographic analysis, we suggest that the decrease of 18 degrees in the O-C2 angle causes the upper airway obstruction. On the extubation after occipito-cervical fusion, we should take care of the possibility of re-intubation and its difficulty based on the O-C2 angle.
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The aim of this case series was to evaluate the performance of GlideScope AVL single-use video laryngoscope for the visualization of the glottis and endotracheal intubations. ⋯ GlideScope AVL single-use video laryngoscope could be an effective aid for airway management in surgical patients.
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We describe the clinical use of a new video-laryngoscope (McGRATH MAC, McG) in patients with a difficult airway and morbid obesity. In a patient, case no. 2, with a difficult airway, showing a Cormack-Lehane grade III view with Macintosh direct laryngoscope, the glottis opening (Cormack-Lehane grade I) was visualized with McG. McG also provided a good view of glottis opening in a patient with morbid obesity. McG will have a profound impact on the management of the difficult airway.
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Case Reports
[Helicopter transportation of a sedated, mechanically ventilated patient with cervical cord injury].
We report helicopter transportation of a sedated, mechanically ventilated patient with cervical cord injury. A 20-year-old male sustained traumatic injury to the cervical spinal cord during extracurricular activities in a college. On arrival at the hospital, a halo vest was placed on the patient and tracheostomy was performed. ⋯ In consideration for patient's psychological stress, he was sedated with propofol. RSS (Ramsay sedation scale) scores were recorded to evaluate whether the patient was adequately sedated during helicopter transportation. Prior to transport, we rehearsed the sedation using bispectral index monitoring (BIS) in the hospital to further ensure the patient's safety during the transport.