Masui. The Japanese journal of anesthesiology
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Although preoperative airway assessment is important for airway management, preoperative predictive factors influencing successful fiberoptic oral intubation (FOI) have not been well investigated. Here, we assessed the factors for successful FOI. ⋯ We require additional airway procedures and assistance to succeed in FOI in patients who snore.
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Patients with Klippel-Feil syndrome (KFS) frequently encounter difficult airway management due to skeletal abnormalities, including fusion of two or more vertebrae and short neck. We report successful tracheal intubation using the air-Q supraglottic airway device (air-Q). A 46-year-old woman (height, 149 cm; weight, 62 kg) with KFS was scheduled to undergo vertebral arch plasty for cervical spondylotic myelopathy. ⋯ Using a size 2.5 air-Q, sufficient ventilation was finally achieved. We performed fiberoptic tracheal intubation through the air-Q using a tube with an internal diameter of 6.0-mm. We then exchanged the 6.0-mm tracheal tube with a 7.0-mm spiral tube using a 10 Fr tracheal tube introducer.
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Case Reports
[Successful tracheal intubation using the GlideScope AVL in a pediatric patient with Pierre Robin syndrome].
We report a successful use of GlideScope AVL in a pediatric patient with Pierre Robin syndrome. A 36-day-old boy weighing 2.8 kg with Pierre Robin syndrome presented for tracheostomy after several weeks of trial airway management in prone position, who had failed to relieve his obstructive apnea. ⋯ A tracheal tube (2.5 mm ID) with 90 degrees angled stylet, however, did not advance into the glottic opening, colliding with the anterior wall of the larynx and/or the laryngeal ventricle. Bending the tip of the stylet in a direction opposite to the inherent memory of the tube facilitated the placement of the tube into the trachea
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It is reported that hypotension during general anesthesia is associated with adverse outcomes in patients having both noncardiac and cardiac surgery. The present retrospective study was undertaken to evaluate the incidence and the predictors of hypotension after induction of general anesthesia (GA) until the start of operation. ⋯ The result in this study indicated that the age was a significant predictor for hypotension from tracheal intubation to start of operation.
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A 27-year-old parturient (height, 130 cm; weight, 43 kg) with achondroplasia, which is characterized by rhizomeric short stature, large head and frontal bossing, was scheduled for elective caesarean section (C/S) because of her contracted pelvis. Her first delivery had been performed by C/S under general anesthesia at a regional hospital 6 years before. Preoperative airway assessment showed normal mouth opening and mobile cervical spine. ⋯ The patient and baby had an uneventful perioperative course. Underdevelopment of bone formation results in characteristic craniofacial and vertebral abnormalities in patients with achondroplasia. Anesthetic management of achondroplastic parturients should be specified to individual basis based on careful preoperative assessment of craniofacial and vertebral deformities.