Anaesthesia and intensive care
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Anaesth Intensive Care · Nov 2011
Case ReportsJet ventilation for the excision of vocal cord polyps in a pregnant patient.
The anaesthetic management of patients presenting with laryngeal tumours and airway obstruction is difficult. We present the case of a pregnant woman at 30 weeks gestation who underwent surgical removal of two vocal cord polyps under general anaesthesia using jet ventilation
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Anaesth Intensive Care · Nov 2011
Case ReportsNasogastric medication for perioperative Parkinson's rigidity during anaesthesia emergence.
We present a case of severe rigidity during emergence from general anaesthesia in a 64-year-old man who had suffered from Parkinson's disease for nine years. Controversy still exists over how to optimally manage these patients perioperatively. We successfully managed his Parkinsonism with administration of crushed Sinemet" and amantadine via a nasogastric tube. This case report serves as a reminder of the importance that patients receive their anti-Parkinsonian medications perioperatively, and highlights the potential benefits of inserting a gastric tube to continue anti-Parkinson's medication dosing during prolonged surgery.
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Anaesth Intensive Care · Nov 2011
ReviewLaryngeal mask airway for airway control during percutaneous dilatational tracheostomy.
Percutaneous dilatational tracheostomy is a common bedside procedure in critical care for patients requiring prolonged mechanical ventilation. The traditional technique requires withdrawal of the endotracheal tube to a proximal position to facilitate tracheostomy insertion, but this carries the risk of inadvertent extubation and does not prevent cuff rupture. ⋯ We found reasonable evidence to show improved ventilation and bronchoscopic visualisation with the laryngeal mask airway, but this has not been translated into improved outcome. There is currently insufficient evidence to draw conclusions about the safety of the laryngeal mask airway during percutaneous dilatational tracheostomy.