AANA journal
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Tumors of and trauma to the trachea and bronchi can result in loss of integrity of the airway and death. Once treated primarily with thoracic surgery, these conditions are increasingly being managed with interventional pulmonary procedures outside the operating room but requiring the assistance of anesthetists. ⋯ In addition, anesthetists may care for patients undergoing nonpulmonary surgery who have an existing bronchial or tracheal stent or patients requiring correction of displaced stents. A discussion on the preferred methods for caring for patients in these situations is included.
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Diastrophic dwarfism is an autosomal recessive disease that predominantly occurs in the Finnish population (1 in 33,000) but has been known to occur worldwide. Affected patients present with multiple cartilaginous anomalies and early degeneration of weight-bearing joints. Once past infancy, life expectancy is favorable and patients may undergo multiple surgical procedures throughout their lifetime to repair .or replace affected joints. The characteristic short trunk of these patients in addition to scoliosis, cervical kyphosis, and involvement of articular cartilages can create unique ventilation and airway challenges for anesthesia providers involved in their care.
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Local anesthetic toxicity remains a clinical concern when performing regional anesthesia. Because signs and symptoms of toxicity may not appear for 20 to 30 minutes after administration of local anesthetic, vigilance is crucial. ⋯ The number of case reports demonstrating successful use of lipid emulsions is growing. Continued research remains pivotal to improve understanding of the theory of lipid emulsion pharmacology and application to clinical practice.