Middle East journal of anaesthesiology
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Middle East J Anaesthesiol · Jun 2010
Case ReportsThe awake Glidescope intubation: an additional alternative to the difficult intubation.
The incidence of difficult intubations has consistently remained between 8 and 9%. We found a novel approach to the difficult intubation using a Glidescope in the awake spontaneously breathing patient. ⋯ This case report confirms that while not applicable to every patient, the awake Glidescope intubation does add to the previous existing armamentarium in this clinically challenging situation.
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Middle East J Anaesthesiol · Jun 2010
Case ReportsIntraoperative airway obstruction related to tracheostomy tube malposition in a patient with achondroplasia and Jeune's syndrome.
A 14 year-old adolescent with achondroplasia and Jeune's syndrome (asphyxiating thoracic dystrophy) presented for cervical spine surgery in the prone position. Due to the need for home mechanical ventilation at night, the patient had a tracheostomy in place. With the first surgical procedure, the cuffed tracheostomy tube was left in place during prone positioning. ⋯ There are currently no guidelines in the medical literature regarding perioperative management of patients with a tracheostomy requiring prone positioning for surgery. The management of such patients is reviewed and possible problems with tracheostomy positioning during prone positioning are explored. Given such issues, we would suggest removal of the tracheostomy tube and placement of an armored endotracheal tube through the stoma during surgical procedures in the prone position.
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Middle East J Anaesthesiol · Jun 2010
Case ReportsRadiation induced hypopharyngeal stenosis masquerading as the larynx: a case report.
Radiation to the head and neck is commonly used in the treatment of cancers. A side effect in some patients is the development of pharyngeal and or esophageal strictures. Hypopharyngeal strictures can resemble edematous larynges. ⋯ This report points out the development of hypopharyngeal stenosis following radiation. The location and appearance of hypopharyngeal stenosis during laryngoscopy are illustrated. The report points out the deficiencies of newer supraglotic laryngoscopes in this situation and underscores the benefits of flexible fiberoptic devices.
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Middle East J Anaesthesiol · Feb 2010
Randomized Controlled TrialThe effect of addition of low dose atracurium to local anesthetic in retrobulbar block for cataract surgery.
Addition of some neuromuscular blockers to local anesthetics proved to be effective in improving the quality of anesthesia in different regional techniques. This study was carried out to determine whether the addition of low-dose atracurium to a local anesthetic has any effect on the onset and duration of akinesia in retrobulbar block. ⋯ This study demonstrated that atracurium had a local action on the extraocular muscles. It shortened the onset period of retrobulbar block, prolonged its duration, and provided excellent surgical conditions without any specific complications.