Journal of clinical anesthesia
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Case Reports
A two-person technique for fiberscope-aided tracheal extubation/reintubation in intensive care unit (ICU) patients.
The technique of fiberoptic-aided intubation for management of a difficult airway is often limited in the presence of blood or secretions and conditions in which the passage of a fiberoptic bronchoscope ("fiberscope") beneath the epiglottis and into the glottic opening may prove difficult. Direct laryngoscopy can be utilized in combination with the fiberscope as a two-person technique to overcome these challenges. We report the usefulness of a two-person technique using the flexible fiberscope in combination with direct laryngoscopy for extubation/reintubation in two intensive care unit patients with known difficult airways.
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Many anesthesiologists have called for the abandonment of the epidural test dose in the obstetric patient, citing its lack of sensitivity and specificity. A test dose of lidocaine 1.5% with epinephrine 1:200,000, in combination with aspiration, is highly effective in detecting incorrect placement of an epidural catheter. ⋯ It should not be administered during uterine contraction, as labor pain may trigger a tachycardic response. This test dose has been extensively studied and is safe both for both mother and fetus.
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Letter Case Reports
Myoclonus after prolonged infusion of etomidate treated with dantrolene.