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Rao C, Huang G, Mu F, Tan Z, Yuan J. Anesthetic management of patients with difficult intubation due to temporomandibular joint osteoarthritis: A case report. Medicine (Baltimore) 2024; 103:e36956. [PMID: 38215095 PMCID: PMC10783316 DOI: 10.1097/md.0000000000036956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 12/21/2023] [Indexed: 01/14/2024] Open
Abstract
INTRODUCTION Temporomandibular joint osteoarthritis (TMJOA) affects 8% to 16% of the global population, yet TMJOA remains relatively underappreciated clinically. To anesthesiologists, who is concerned about patient safety, adequate preoperative evaluation and preparation, as well as individualized anesthetic management of patients, are necessary. Therefore, the anesthesiologist should be alert for difficult airways due to TMJOA, have a full and comprehensive understanding of the disease, and possess the appropriate expertise for difficult airway intubation. CASE PRESENTATION A 52-year-old female patient was scheduled for laparoscopic operation of uterine adnexa under general anesthesia. The patient preoperative evaluation showed only 1 finger width of mouth opening, and the computed tomography scan showed bilateral temporomandibular arthritis, which was evident on the right side. Intraoperatively, the expected airway difficulties occurred, and the anesthesiologist opted to use lightwand intubation, which was ultimately successful in 1 pass without any complications. CONCLUSION Intubation using a lightwand for patients with difficult intubation due to TMJOA is a very effective intubation modality.
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Affiliation(s)
- Changle Rao
- Department of Anesthesiology, The Third Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Guihua Huang
- Department of Anesthesiology, The Third Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Fangfang Mu
- Department of Anesthesiology, The Third Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Zhengquan Tan
- Department of Anesthesiology, The Third Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Jie Yuan
- Department of Anesthesiology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
- Department of Pain Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, China
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SORBELLO M, ZDRAVKOVIC I, CORTESE G. The myth of Atlas and the basic principles of airway management: devil is in details. Minerva Anestesiol 2022; 88:760-763. [DOI: 10.23736/s0375-9393.22.16745-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Chau A, El-Boghdadly K. Analysis of paralysis: understanding the role of vocal cords in facemask ventilation. Anaesthesia 2022; 77:949-952. [PMID: 35727639 DOI: 10.1111/anae.15787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2022] [Indexed: 11/26/2022]
Affiliation(s)
- A Chau
- Department of Anesthesiology, Pharmacology and Therapeutics, The University of British Columbia, Vancouver, BC, Canada.,Department of Anesthesia, BC Women's Hospital, Vancouver, BC, Canada.,Department of Anesthesia, St. Paul's Hospital, Vancouver, BC, Canada
| | - K El-Boghdadly
- Department of Anaesthesia and Peri-Operative Medicine, Guy's and St Thomas' NHS Foundation Trust, London, UK.,King's College London, London, UK
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Jarvis JL, Lyng JW, Miller BL, Perlmutter MC, Abraham H, Sahni R. Prehospital Drug Assisted Airway Management: An NAEMSP Position Statement and Resource Document. PREHOSP EMERG CARE 2022; 26:42-53. [PMID: 35001829 DOI: 10.1080/10903127.2021.1990447] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Airway management is a critical intervention for patients with airway compromise, respiratory failure, and cardiac arrest. Many EMS agencies use drug-assisted airway management (DAAM) - the administration of sedatives alone or in combination with neuromuscular blockers - to facilitate advanced airway placement in patients with airway compromise or impending respiratory failure who also have altered mental status, agitation, or intact protective airway reflexes. While DAAM provides several benefits including improving laryngoscopy and making insertion of endotracheal tubes and supraglottic airways easier, DAAM also carries important risks. NAEMSP recommends:DAAM is an appropriate tool for EMS clinicians in systems with clear guidelines, sufficient training, and close EMS physician oversight. DAAM should not be used in settings without adequate resources.EMS physicians should develop clinical guidelines informed by evidence and oversee the training and credentialing for safe and effective DAAM.DAAM programs should include best practices of airway management including patient selection, assessmenct and positioning, preoxygenation strategies including apneic oxygenation, monitoring and management of physiologic abnormalities, selection of medications, post-intubation analgesia and sedation, equipment selection, airway confirmation and monitoring, and rescue airway techniques.Post-DAAM airway placement must be confirmed and continually monitored with waveform capnography.EMS clinicians must have the necessary equipment and training to manage patients with failed DAAM, including bag mask ventilation, supraglottic airway devices and surgical airway approaches.Continuous quality improvement for DAAM must include assessment of individual and aggregate performance metrics. Where available for review, continuous physiologic recordings (vital signs, pulse oximetry, and capnography), audio and video recordings, and assessment of patient outcomes should be part of DAAM continuous quality improvement.
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Min KJ, Rabinowitz AL, Hess CJ. Is It Time to Abandon Routine Mask Ventilation Before Intubation? Anesth Analg 2021; 133:1353-1357. [PMID: 34673727 DOI: 10.1213/ane.0000000000005723] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
| | | | - Cary J Hess
- Sidney Kimmel Medical College, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
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Pirlich N, Dutz M, Wittenmeier E, Kriege M, Didion N, Ott T, Piepho T. Current practice of German anesthesiologists in airway management : Results of a national online survey. Anaesthesist 2021; 71:190-197. [PMID: 34453552 DOI: 10.1007/s00101-021-01025-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 07/07/2021] [Accepted: 07/23/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND There is a worldwide consensus among experts that guidelines and algorithms on airway management contribute to improved patient safety in anesthesia. The present study aimed to determine the current practice of airway management of German anesthesiologists and assess the safety gap, defined as the difference between observed and recommended practice, amongst these practitioners. OBJECTIVE To determine the effect of implementing the guidelines on airway management practice in Germany amongst anesthesiologists and identify potential safety gaps. METHODS A survey was conducted in September 2019 by contacting all registered members of the German Society of Anaesthesiology and Intensive Care Medicine (DGAI) via email. The participants were asked about their personal and institutional background, adherence to recommendations of the current German S1 guidelines and availability of airway devices. RESULTS A total of 1862 DGAI members completed the questionnaire (response rate 17%). The main outcome was that anesthesiologists mostly adhered to the guidelines, yet certain recommendations, particularly pertaining to specifics of preoxygenation and training, showed a safety gap. More than 90% of participants had a video laryngoscope and half had performed more than 25 awake intubations using a flexible endoscope; however, only 81% had a video laryngoscope with a hyperangulated blade. An estimated 16% of all intubations were performed with a video laryngoscope, and 1 in 4 participants had performed awake intubation with it. Nearly all participants had cared for patients with suspected difficult airways. Half of the participants had already faced a "cannot intubate, cannot oxygenate" (CICO) situation and one in five had to perform an emergency front of neck access (eFONA) at least once. In this case, almost two thirds used puncture-based techniques and one third scalpel-based techniques. CONCLUSION Current practice of airway management showed overall adherence to the current German guidelines on airway management, yet certain areas need to be improved.
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Affiliation(s)
- Nina Pirlich
- Department of Anaesthesiology, Medical Centre of the Johannes Gutenberg-University, Mainz, Germany.
| | - Matthias Dutz
- Department of Anaesthesiology, Medical Centre of the Johannes Gutenberg-University, Mainz, Germany
| | - Eva Wittenmeier
- Department of Anaesthesiology, Medical Centre of the Johannes Gutenberg-University, Mainz, Germany
| | - Marc Kriege
- Department of Anaesthesiology, Medical Centre of the Johannes Gutenberg-University, Mainz, Germany
| | - Nicole Didion
- Department of Anaesthesiology, Medical Centre of the Johannes Gutenberg-University, Mainz, Germany
| | - Thomas Ott
- Department of Anaesthesiology, Medical Centre of the Johannes Gutenberg-University, Mainz, Germany
| | - Tim Piepho
- Department of Anaesthesiology and Intensive Care, Brothers of Mercy Hospital, Trier, Germany
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Canadian Airway Focus Group updated consensus-based recommendations for management of the difficult airway: part 2. Planning and implementing safe management of the patient with an anticipated difficult airway. Can J Anaesth 2021; 68:1405-1436. [PMID: 34105065 PMCID: PMC8186352 DOI: 10.1007/s12630-021-02008-z] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 03/11/2021] [Accepted: 03/14/2021] [Indexed: 01/15/2023] Open
Abstract
PURPOSE Since the last Canadian Airway Focus Group (CAFG) guidelines were published in 2013, the published airway management literature has expanded substantially. The CAFG therefore re-convened to examine this literature and update practice recommendations. This second of two articles addresses airway evaluation, decision-making, and safe implementation of an airway management strategy when difficulty is anticipated. SOURCE Canadian Airway Focus Group members, including anesthesia, emergency medicine, and critical care physicians were assigned topics to search. Searches were run in the Medline, EMBASE, Cochrane Central Register of Controlled Trials, and CINAHL databases. Results were presented to the group and discussed during video conferences every two weeks from April 2018 to July 2020. These CAFG recommendations are based on the best available published evidence. Where high-quality evidence is lacking, statements are based on group consensus. FINDINGS AND KEY RECOMMENDATIONS Prior to airway management, a documented strategy should be formulated for every patient, based on airway evaluation. Bedside examination should seek predictors of difficulty with face-mask ventilation (FMV), tracheal intubation using video- or direct laryngoscopy (VL or DL), supraglottic airway use, as well as emergency front of neck airway access. Patient physiology and contextual issues should also be assessed. Predicted difficulty should prompt careful decision-making on how most safely to proceed with airway management. Awake tracheal intubation may provide an extra margin of safety when impossible VL or DL is predicted, when difficulty is predicted with more than one mode of airway management (e.g., tracheal intubation and FMV), or when predicted difficulty coincides with significant physiologic or contextual issues. If managing the patient after the induction of general anesthesia despite predicted difficulty, team briefing should include triggers for moving from one technique to the next, expert assistance should be sourced, and required equipment should be present. Unanticipated difficulty with airway management can always occur, so the airway manager should have a strategy for difficulty occurring in every patient, and the institution must make difficult airway equipment readily available. Tracheal extubation of the at-risk patient must also be carefully planned, including assessment of the patient's tolerance for withdrawal of airway support and whether re-intubation might be difficult.
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Saito T, Asai T. A new scoring system to predict failed facemask ventilation: a reply to the letter of Professor Priebe. J Anesth 2020; 34:636-637. [DOI: 10.1007/s00540-020-02794-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 05/09/2020] [Indexed: 11/28/2022]
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Yamanaka H, Tsukamoto M, Hitosugi T, Yokoyama T. Mask Induction for an Intellectually Disabled Patient With Congenital Infiltrating Lipomatosis of the Face. Anesth Prog 2020; 67:98-102. [PMID: 32633775 DOI: 10.2344/anpr-67-01-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 09/23/2019] [Indexed: 11/11/2022] Open
Abstract
Airway management for patients with craniofacial disorders poses many challenges. Congenital infiltrating lipomatosis of the face (CILF) is an extremely rare disorder in which mature lipocytes invade adjacent tissues in the head and neck. The manifestations are typically unilateral, often with associated hypertrophy of both the hard and soft tissues of the face. This is a case report regarding the anesthetic management for a 5-year-old intellectually disabled female with CILF involving the right side of her face who underwent a successful intubated general anesthetic for dental treatment. Awake fiber-optic intubations are recommended and routinely used for patients with suspected or confirmed difficult airways. In this case, substantial distortion of the normal facial anatomy was observed clinically with noted hypertrophy of the right maxilla, mandible, and right side of the tongue. Further complicating matters was the patient's inability to fully cooperate because of her intellectual disability, precluding the option of an awake fiber-optic intubation. To secure the airway following mask induction of anesthesia, spontaneous ventilation was carefully maintained using sevoflurane, nitrous oxide, and oxygen combined with the application of a nasopharyngeal airway. Despite compression of the oral cavity and upper pharyngeal space by the hypertrophic tissues due to CILF, the space in and around the glottis was preserved. Intubation was completed easily with the use of a fiber-optic scope without any serious complications.
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Affiliation(s)
- Hitoshi Yamanaka
- Department of Dental Anesthesiology, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Masanori Tsukamoto
- Department of Dental Anesthesiology, Kyushu University Hospital, Fukuoka, Japan
| | - Takashi Hitosugi
- Department of Dental Anesthesiology, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Takeshi Yokoyama
- Department of Dental Anesthesiology, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
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Can a new scoring system reliably predict failed facemask ventilation? J Anesth 2020; 34:635. [PMID: 32440801 PMCID: PMC8187195 DOI: 10.1007/s00540-020-02793-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 05/09/2020] [Indexed: 01/07/2023]
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Gupta A, Gupta N, Kamal G, Girdhar KK. Videolaryngoscopy Bails us out of Difficult Intubation Scenarios in Syndromic Children: A Case Series. Turk J Anaesthesiol Reanim 2020; 49:78-82. [PMID: 33718912 PMCID: PMC7932707 DOI: 10.5152/tjar.2020.00947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 08/18/2019] [Indexed: 11/22/2022] Open
Abstract
Airway management in children with craniofacial anomalies can be complicated and may require multiple attempts with conventional direct laryngoscopy (DL). Videolaryngoscopes (VLs) have a well-established role in difficult airway management in adults; however, their role remains to be fully elucidated in paediatric age group. There is a relative paucity in the literature regarding the role of VLs in cases of syndromic children, and it is not clear whether they should be used as an initial option or as a rescue device. Herein, we report a series of cases of children with Pierre Robin sequence, Beckwith–Wiedemann syndrome, and Hurler’s syndrome wherein VLs proved beneficial after multiple failed DL attempts. Following initial failed attempts to intubate using DL, these children were subsequently intubated using VLs. Therefore, VLs should be used for initial intubation attempts in syndromic children with potential difficult airways.
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Affiliation(s)
- Anju Gupta
- Department of Anaesthesiology, Pain Medicine and Critical Care, AIIMS, New Delhi, India
| | - Nishkarsh Gupta
- Department of Onco-Anaesthesiology and Palliative Medicine, DRBRAIRCH, AIIMS, New Delhi, India
| | - Geeta Kamal
- Department of Anaesthesiology, Chacha Nehru Bal Chikitsalya, New Delhi, India
| | - Kiran Kumar Girdhar
- Department of Anaesthesiology, Pain Medicine and Critical Care, AIIMS, New Delhi, India
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de la Varga O, Galve AI, Romera A. Perioperative anesthetic management of reductive glossoplasty in a patient with Beckwith-Wiedemann syndrome. ACTA ACUST UNITED AC 2020; 68:156-160. [PMID: 32417109 DOI: 10.1016/j.redar.2020.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Revised: 02/06/2020] [Accepted: 02/18/2020] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Postoperative management of patients with the congenital growth disorder Beckwith-Wiedemann syndrome (BWS) can be complicated. The main clinical manifestations of the syndrome are macroglossia - which may hamper airway management -, prematurity, hemihypertrophy, omphalocele, embryonal tumours and episodes of neonatal hypoglycaemia. OBJECTIVE Our main objective is to describe the perioperative management and potential anaesthetic complications in paediatric patients with BWS undergoing glossectomy. METHODS Case report and literature review. RESULTS We describe the case of an 11-month-old patient diagnosed with BWS who underwent reduction glossoplasty. We performed a comprehensive preoperative evaluation, taking into account potential anaesthetic complications derived from both macroglossia and prematurity, and the risk of hypoglycaemia. The procedure was performed under general anaesthesia. Intubation - performed according to difficult airway management algorithms - was uneventful and the patient was successfully extubated in the operating room. The patient remained stable during the postoperative period, with good respiratory dynamics, SatO2>96% and good glycaemic control. Oral intake was started 4hours after surgery, and she was discharged to the ward at 24hours. CONCLUSION BWS patients require a multimodal approach that includes detailed preoperative planning and knowledge of potential airway-related and systemic complications.
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Affiliation(s)
- O de la Varga
- Servicio de Anestesiología y Reanimación, Hospital Clínico Universitario de Valladolid, Valladolid, España.
| | - A I Galve
- Servicio de Anestesiología y Reanimación, Hospital Gregorio Marañón, Madrid, España
| | - A Romera
- Servicio de Anestesiología y Reanimación, Hospital Gregorio Marañón, Madrid, España
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Tsukamoto M, Taura S, Hitosugi T, Yokoyama T. Comparison of the Performance of Mask Ventilation Between Face Masks With and Without Air Cushion. J Oral Maxillofac Surg 2019; 77:2465.e1-2465.e5. [PMID: 31574262 DOI: 10.1016/j.joms.2019.08.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 08/29/2019] [Accepted: 08/29/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE Mask ventilation is a basic technique for induction of anesthesia. In head and neck surgery, we have encountered difficulty in ventilation owing to facial deformities. Recently, a new type of face mask without an air cushion, the QuadraLite face mask (Intersurgical, Berkshire, UK), was developed. The aim of this study was to compare the performance of cases with predicted difficult mask ventilation between the new type of face mask and a traditional face mask. PATIENTS AND METHODS This study was a crossover prospective study. The participants were patients (aged > 18 years) who underwent oral-maxillofacial surgery under general anesthesia. The risk factors for a difficult airway were assessed. Patients were divided into 3 risk groups: low risk, 0 or 1 risk factor for predicted difficult mask ventilation; medium risk, 2 or 3 risk factors; and high risk, 4 or more risk factors. An air cushion face mask (Koo Medical, Shanghai, China) and the QuadraLite face mask were applied in turn under the setting of pressure-controlled ventilation. The expiratory tidal volumes were compared between these face masks. RESULTS A total of 48 patients were included: 16 in the low-risk group, 16 in the medium-risk group, and 16 in the high-risk group. Higher expiratory tidal volumes were observed with the QuadraLite face mask than with the air cushion face mask, although the differences did not reach the statistically significant level: 574.3 ± 62.7 mL versus 553.1 ± 60.6 mL in the low-risk group (P = .44), 553.1 ± 112.9 mL versus 536.4 ± 114.2 mL in the medium-risk group (P = .38), and 560.0 ± 98.6 mL versus 548.2 ± 07.1 mL in the high-risk group (P = .22). In all cases, a sufficient ventilation volume was obtained by the QuadraLite face mask. CONCLUSIONS The QuadraLite face mask is compact because there is no air cushion, and it can provide sufficient mask ventilation as well as a traditional face mask with an air cushion even in patients with a difficult airway.
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Affiliation(s)
- Masanori Tsukamoto
- Assistant Professor, Department of Dental Anesthesiology, Kyushu University Hospital, Fukuoka, Japan.
| | - Shiori Taura
- Graduate Student, Department of Dental Anesthesiology, Graduate School of Dental Science, Kyushu University, Fukuoka, Japan
| | - Takashi Hitosugi
- Assistant Professor, Department of Dental Anesthesiology, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Takeshi Yokoyama
- Professor, Department of Dental Anesthesiology, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
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Saastamoinen M, Larsson J, Frykholm P. Checking mask ventilation before neuromuscular block: A nation-wide survey of anaesthetists' attitudes and thinking. Acta Anaesthesiol Scand 2019; 63:1178-1183. [PMID: 31359434 DOI: 10.1111/aas.13426] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 05/20/2019] [Accepted: 05/27/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND The value of checking mask ventilation before administering neuromuscular blocking drugs is still debated. METHOD We conducted a survey of the practice of anaesthetists in Sweden, first asking if they use a mask ventilation trial (MVT) as part of routine induction with intubation (not rapid sequence induction or expected difficult airway). We focused on the reasons for or against the MVT, probing the anaesthetists' attitudes in general but also in specific scenarios. RESULTS The response rate was 54%. We found that 65.1% routinely use a MVT, 21.4% sometimes do and 13.5% never do so. There was no effect for years of experience on the distribution. The most common reason for checking mask ventilation was "to gather information about the airway," while the reason for not using the MVT was mostly "that muscle relaxation often improves mask ventilation." CONCLUSION We found several interesting comments about airway management at both practical and theoretical levels. The survey highlights that routinely performing a MVT is a common practice in Sweden in spite of the lack of evidence for increased patient safety. Future airway guidelines may need to address this practice.
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Affiliation(s)
- Marcus Saastamoinen
- Department of Surgical Sciences, Section of Anaesthesiology and Intensive Care Medicine Uppsala University Uppsala Sweden
| | - Jan Larsson
- Department of Public Health and Caring Sciences Section of Health Services Research, Uppsala University Uppsala Sweden
| | - Peter Frykholm
- Department of Surgical Sciences, Section of Anaesthesiology and Intensive Care Medicine Uppsala University Uppsala Sweden
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Asai T. Progress in difficult airway management. J Anesth 2017; 31:483-486. [PMID: 28258332 DOI: 10.1007/s00540-017-2333-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 02/22/2017] [Indexed: 12/14/2022]
Affiliation(s)
- Takashi Asai
- Department of Anesthesiology, Dokkyo Medical University, Koshigaya Hospital, 2-1-50 Minamikoshigaya, Koshigaya, Saitama, 343-8555, Japan.
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Tsukamoto M, Hitosugi T, Yokoyama T. Perioperative airway management of a patient with Beckwith-Wiedemann syndrome. J Dent Anesth Pain Med 2016; 16:313-316. [PMID: 28879321 PMCID: PMC5564198 DOI: 10.17245/jdapm.2016.16.4.313] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 12/19/2016] [Accepted: 12/26/2016] [Indexed: 11/30/2022] Open
Abstract
Airway obstruction in pediatric patients always poses a challenge for anesthesiologists. Beckwith-Wiedemann syndrome causes various abnormalities such as macroglossia and omphalocele. Patients with these abnormalities often need corrective surgeries. Management of difficult airway caused by conditions such as macroglossia in patients with this syndrome could be challenging. We encountered a case of difficult airway in an infant with Beckwith-Wiedemann syndrome. It was predicted that macroglossia might cause difficult ventilation, intubation, and extubation. Preoperative assessment and preparations for difficult airway should be considered.
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Affiliation(s)
- Masanori Tsukamoto
- Department of Dental Anesthesiology, Kyushu University Hospital, Fukuoka, Japan
| | - Takashi Hitosugi
- Department of Dental Anesthesiology, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Takeshi Yokoyama
- Department of Dental Anesthesiology, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
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Lang SA. The Vortex Model of Emergency Airway Management and Human Factors. Br J Anaesth 2016. [DOI: 10.1093/bja/el_14119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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