Journal of clinical anesthesia
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Pneumothorax may be a medical emergency. Iatrogenic pneumothorax is more common than all other forms of spontaneous pneumothorax, and surgical procedures involving the breast are a frequent setting for this. A 32-year-old, 60 kg, woman without any significant medical history underwent a bilateral breast augmentation and rhinoplasty. ⋯ The patient immediately returned to hemodynamic stability. This case report discusses iatrogenic pneumothoraces as well their most likely causes; which in this specific case was the injection of local anesthetic. Suggestions for prevention and treatment of the unusual complication are discussed.
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Case Reports
Anesthetic management of a patient with obstructive sleep apnea syndrome and difficult airway access.
Patients with the obstructive sleep apnea syndrome (OSAS) are predisposed to respiratory complications under the influence of sedative and anesthetic drugs because of these drugs' alternation of respiratory control with a tendency for upper airway collapse. Additional difficulties for airway management during anesthesia may arise if fixed anatomic obstacles block the upper airway. We present a case of a patient with OSAS scheduled for general anesthesia for nasal polypectomy and correction of a deviated septum. ⋯ An individualized strategy of airway management based on published standards was developed and successfully applied. It involved fiberoptic guided intubation through a laryngeal mask airway. This case illustrates the management of patients with OSAS and additional conditions that reduce upper airway patency.
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To determine whether saline soaked pledgets would protect the cuffs of polyvinylchloride (PVC) endotracheal tubes from carbon dioxide (CO2) laser-induced combustion. ⋯ Under the conditions of this experiment, saline soaked pledgets protected PVC endotracheal tube cuffs from the CO2 laser.