Journal of clinical anesthesia
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We present the case report of a 49-year-old gentleman with a history of adenoid cystic carcinoma of the left nare status post curative bifrontal craniotomy, left lateral rhinotomy and medial maxillectomy, adjuvant radiotherapy, and orbital exenteration for optic neuropathy, complicated by medial wall dehiscence. His course was also complicated by severe radiation trismus, for which he was scheduled to undergo bilateral mandibular coronoidectomies. ⋯ Because of concerns of traumatizing his nare, we utilized a flexible fiberoptic bronchoscope to perform asleep transorbital intubation. Airway management in patients with severe trismus may require ingenuity.
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To determine risk factors associated with reintubations in adult patients with soft tissue infections. ⋯ Soft tissue patients who have received rocuronium are at increased risk for reintubation, particularly those with renal failure. In addition, this article supports the use of neuromuscular blockade reversals, even in patients with a strong train of four ratio.
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This study aims to determine trends and predictors of acute stroke among total joint arthroplasty (TJA) patients using nationally representative data. ⋯ Despite a decline in the rate of stroke and stroke-related mortality after TJA, stroke still seems to be a major cause of in-hospital mortality. The present study outlines some risk factors for stroke after TJA. Recognition of these factors and identification of the at-risk patients may allow for appropriate allocation of resources and ability to minimize this complication after TJA.