Journal of anesthesia
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Journal of anesthesia · Jun 2012
Case ReportsAnesthetic management of a child with both Marfan syndrome and Turner syndrome.
Marfan syndrome is an autosomal dominant heritable disorder of the connective tissue that involves primarily the skeletal, ocular, and cardiovascular systems. Turner syndrome is a genetic disorder resulting from partial or complete X chromosome monosomy. We report the anesthetic management of a case of Marfan-Turner syndrome, which is the first such case to appear in the literature to our knowledge. ⋯ Special care should be given to syndromic patients. Prior medical evaluations and any prior anesthetic history can help to focus preoperative evaluations and planning. Preoperatively targeting relevant organ systems, any anatomic or laboratory abnormalities that can be optimized, and perioperative airway management are all key to a successful outcome.
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Journal of anesthesia · Jun 2012
Initial experience of the i-gel supraglottic airway by the residents in pediatric patients.
Insertion of a laryngeal mask airway (LMA) is occasionally difficult in children because of their anatomical features and variations. A new single-use supraglottic airway device, the i-gel airway, was recently introduced. The objective of this study was to show the initial experience of the i-gel airway device by the residents for pediatric patients. ⋯ These results show that the i-gel airway is a safe and effective device for use by residents who do not have experience with insertion of a pediatric LMA. However, using size 1.5, special caution should be taken to protect the infant airway, similar to what has been previously reported for other airway devices.
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Journal of anesthesia · Jun 2012
Case ReportsAnesthetic management of a neonatal lingual gastric duplication cyst: report of a rare case.
Gastrointestinal duplications can occur anywhere from the mouth to the anal cavity. The occurrence of a duplication cyst in the tongue of a neonate is very rare. ⋯ They usually present in the neonatal period and surgical excision is curative. We report a 10-day-old, 3-kg neonate with a gastric duplication cyst in the oral cavity with inability to close his mouth or breast feed for whom we performed subtotal excision of the cyst.
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Journal of anesthesia · Jun 2012
Case ReportsAnesthetic management during tracheotomy in a child with respiratory distress caused by severe intubation-induced glottic stenosis.
We provided anesthetic management during a tracheotomy procedure for a child who demonstrated labored respiration during inspiration because of severe glottic stenosis and bilateral vocal cord paralysis caused by tracheal intubation. A 4-year-old boy developed acute respiratory depression associated with influenza pneumonia and had been under respiratory management with mechanical ventilation with tracheal intubation for 3 days. ⋯ For anesthetic management, we used a combination of ketamine with low-concentration sevoflurane inhalation. The tracheotomy was performed safely without respiratory complications by employing manual-assisted ventilation, while spontaneous breathing was preserved by use of a face mask.
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Journal of anesthesia · Jun 2012
Experiences with epidural anesthesia of Japanese women who had childbirth in the United States.
Cultural views are purported to be critical barriers to the use of epidural anesthesia during childbirth in Japan, even though it is not routinely available. We sought to understand the importance of the asserted cultural barriers for Japanese women living in Michigan in the United States where access to epidural anesthesia is routine. ⋯ While Japanese women in this United States setting considered previously reported cultural barriers to epidural anesthesia for birth pain, many chose to have it during their labor. This finding implicates limited access as a barrier at least as important as cultural barriers to epidural anesthesia use in Japan.