Journal of clinical anesthesia
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Ehlers-Danlos syndrome (EDS) is an inherited disease characterized by defects in various collagens or their post translational modification, with an incidence estimated at 1 in 5000. Performance of peripheral nerve block in patients with EDS is controversial, due to easy bruising and hematoma formation after injections as well as reports of reduced block efficacy. The objective of this study was to review the charts of EDS patients who had received peripheral nerve block for any evidence of complications or reduced efficacy. ⋯ This series fails to show an increased risk of complications of peripheral nerve blockade in patients with hypermobility-type EDS.
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We describe a novel technique of real-time ultrasound-guided superior laryngeal nerve and translaryngeal blocks in 4 patients with anticipated difficult airways. All patients had altered neck anatomy, and 1 had a prior unsuccessful awake fiberoptic bronchoscopic intubation. For block performance, an 11-mm broadband curved array transducer with a scanning frequency between 8 and 5 MHz (Sonosite, Bothell, WA) was used for anatomical structure identification, needle guidance toward each superior laryngeal nerve and through the cricothyroid membrane, and deposition of local anesthetic in the appropriate location. This was followed by successful awake fiberoptic bronchoscopic endotracheal intubation in all cases.
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The green color in urine may suggest the presence of a severe pathology needing treatment. Many different potential causes of green urine have previously been reported. In our case, after ruling out other potential causes of green urine, it was suggested that the surgical manipulation of the paralytic ileum might have induced the reabsorption of the methylene blue which had been retained in the bowel (bezoar effect), even 96 hours after the nasogastric administration.
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To examine postoperative sore throat resulting from tracheal intubation stylet removal. ⋯ Postoperative sore throat was significantly related to increased extraction force during stylet removal.
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To determine the incidence of postoperative airway complications in infants <5kg in weight undergoing cardiac surgery intubated with Microcuff (Kimberley-Clark, Roswell, GA) endotracheal tubes (ETTs). ⋯ Microcuff ETTs in infants <5.0 kg in weight undergoing cardiac surgery are associated with a low incidence of severe postextubation stridor. Because cuffed ETTs allow for improved control of ventilation/oxygenation and decreased risk of aspiration, they should be considered for use in this high-risk population. Larger studies are needed to confirm these results.