Articles: intubation.
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Anesthesiologists may encounter particularly challenging airway management problems and anesthetic requirements for any surgical procedure. However, this is frequently the case with ENT surgery and its patient population. ⋯ Special ENT procedures require special skills. Anesthesiologists may be required to secure an airway in an unconventional manner in these patients, as well as use special ventilation methodology and challenging anesthesia techniques.
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A case is reported of rapidly resolving pulmonary oedema following post-extubation laryngospasm in a 23 year-old healthy man who underwent emergency resection of a rectal polyp. The laryngospasm occurred immediately after extubation and resolved after administration of curare. The patient was reintubated and auscultation disclosed bilateral coarse and moist rales. ⋯ In addition, this increased negative intra-alveolar pressure was responsible for significant changes in cardiovascular function: right ventricular blood volume, right ventricular ejection fraction and left ventricular after-load increased, while left ventricular ejection fraction decreased. These changes favoured a rise in left atrial and pulmonary blood volumes, with transudation of fluid from the capillaries into the alveoli. Because of the severe consequences of respiratory failure, any patient who suffers acute upper airway obstruction should be observed in the recovery room for at least 3 h in order not to miss this rarely developing, but fortunately rapidly reversible, syndrome.
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Randomized Controlled Trial Clinical Trial
Benzydamine for the prevention of pharyngo-laryngeal pathology following tracheal intubation.
A clinical study was carried out to assess the antiinflammatory effectiveness and related properties of this drug. It was performed double-blind in 40 adult patients (ASA I, and II) undergoing major otorhinolaryngological surgical procedures with tracheal intubation. ⋯ The following parameters were considered: physical examination, sensations referred from patient, cytologic examination, glottographic examination, and spectrographic examination. The results suggest that benzydamine applied locally at a concentration of 0.3% has therapeutic efficacy without local or systemic side-effects.