Revista española de anestesiología y reanimación
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Many congenital and acquired diseases, including trauma, may result in cervical spine instability. Given that airway management is closely related to the movement of the cervical spine, it is important that the anesthesiologist has detailed knowledge of the anatomy, the mechanisms of cervical spine instability, and of the effects that the different airway maneuvers have on the cervical spine. We first review the normal anatomy and biomechanics of the cervical spine in the context of airway management and the concept of cervical spine instability. In the second part, we review the protocols for the management of cervical spine instability in trauma victims and some of the airway management options for these patients.
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Rev Esp Anestesiol Reanim · Mar 2014
Health worker exposure risk during inhalation sedation with sevoflurane using the (AnaConDa®) anaesthetic conserving device.
Occupational exposure to sevoflurane should not exceed 2 ppm. During inhalation sedation with sevoflurane using the anaesthetic conserving device (AnaConDa(®)) in the post-anaesthesia care unit, waste gases can be reduced by gas extraction systems or scavenging devices such as CONTRAfluran™. However, the efficacy of these methods has not been clearly established. To determine the safest scenario for healthcare workers during inhalation sedation with sevoflurane in the post-surgical intensive care unit. ⋯ Administration of sevoflurane through the AnaConDa(®) system during inhalation sedation in post-surgical intensive care units is safe for healthcare workers, but gas extraction systems or scavenging systems, such as CONTRAfluran™ should be used to reduce occupational exposure as much as possible.
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Rev Esp Anestesiol Reanim · Mar 2014
Case Reports[Rare problem with the insertion of a Supreme™ laryngeal mask airway device. Case of the trimester].
A breast tumor was resected under general anesthesia. After induction, the airway was managed with a Supreme™ laryngeal mask airway device. The insertion of the laryngeal mask airway device, the insertion of the orogastric tube through the drain tube, as well as the mechanical ventilation, were very difficult from the beginning. ⋯ It was later found out that the laryngeal mask airway device, as well as the whole manufacturing batch, had suffered a design modification: the cuff was constructed with a softer material without reinforcement in the tip, and the drain tube had a heat-sealing defect that facilitated the break. The incident was reported to the local supplier and the manufacturer, and the defective batch of laryngeal mask airway devices was recalled. The incident was also reported to other hospitals via SENSAR, to warn other users of the potential dangers of the design modification in the Supreme™ laryngeal mask airway.