Journal of perioperative practice
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Ludwig's angina is defined as a potentially lethal, rapidly spreading cellulitis, involving the sublingual and submandibular spaces, and is manifested by a brawny suprahyoid induration, tender swelling in the floor of the mouth, and elevation and posterior displacement of the tongue. During a life-threatening infection such as Ludwig's angina, the mother and foetus are vulnerable to septicemia and asphyxia. We describe a case of decompression of Ludwig's angina in a 28 weeks pregnant patient under bilateral superficial cervical plexus block. The block, coupled with bilateral mandibular nerve block, provided ample anaesthesia to perform a thorough incision and drainage, including transection of mylohyoid with lowering of the floor of mouth and rapid relief of respiratory obstruction.
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Comparative Study
Should the Glidescope video laryngoscope be used first line for all oral intubations or only in those with a difficult airway? A review of current literature.
The purpose of this study was to review literature that looked into the efficacy of the Glidescope video laryngoscope versus the Macintosh laryngoscope in oral endotracheal intubations. We aimed to answer the question 'Should the Glidescope video laryngoscope laryngoscopes be used as first line intubation aids or only in the difficult airway?' A systematic search of electronic databases was made. The inclusion criteria included: Glidescope, video laryngoscope, and Macintosh laryngoscope in human studies. ⋯ Overall time to intubate showed no significant differences between the Glidescope video laryngoscope and the Macintosh laryngoscope although it was identified that with increased training and experience with the Glidescope video laryngoscope, intubation time was reduced. Glidescope video laryngoscopes show advantages over the Macintosh laryngoscopes in obtaining better glottic views in those with difficult airways. However its use is not supported in all routine intubations.