• Title/Summary/Keyword: Difficult intubation

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USE OF LARYNGEAL MASK AIRWAY (LMA) FOR DENTAL TREATMENT IN MENTALLY RETARD PATIENT WITH DIFFICULT AIRWAY -A CASE REPORT- (기도 유지가 어려운 정신지체 환자에서 후두마스크 삽입 하 치과치료)

  • Yi, Young-Eun;Seo, Kwang-Suk;Kim, Hyun-Jeong;Shin, Teo-Jeon
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.4 no.2
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    • pp.88-91
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    • 2008
  • A female patient (14 years-old) with mental retardation was scheduled for ambulatory general anesthesia to treat peri-apical abscess and multiple dental caries. She had got cleft palate plasty at 5 years, but there was no past history of difficulty airway during general anesthesia or airway obstruction. Following induction of anesthesia using an inhalational anesthetic technique, conventional naso-tracheal intubation was tried. However, with conventional intubation technique we could not insert tube. And following several trial of intubation with laryngoscope, she developed an upper airway obstruction. Her lungs could not be ventilated using a facial mask and oxygen saturation was decreased. A #3 laryngeal mask airway (LMA) was inserted immediately, which allowed us to ventilate her lungs and restore the oxygen saturation. And dental treatment was carried out under LMA insertion successfully.

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A simple method of intraoperative intubation tube change

  • Cho, Jin Yong;Kim, Hyeon Min;Ryu, Jae Young
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.40 no.5
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    • pp.250-252
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    • 2014
  • Nasotracheal intubation should be performed in patients with jaw fractures because maxillomandibular fixation is required. However, when there are concomitant fractures of the nose and facial bones, an intubation tube positioned at the nose makes it difficult to perform an intricate surgery. In order to overcome these problems, a variety of ways to change the position of the tube have been introduced. We describe a simple technique of switching the tube from a nasal to oral position, which was easily executed in a patient with concomitant nasal and mandibular fractures, accompanied by a literature review.

Aspiration Pneumonia after General Anesthesia Using Laryngeal Mask Airway -A case report- (후두 마스크를 이용한 전신 마취 후 발생된 흡인성 폐렴)

  • Lee, Deok-Hee;Park, Ki-Ho
    • Journal of Yeungnam Medical Science
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    • v.21 no.1
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    • pp.127-131
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    • 2004
  • A laryngeal mask airway (LMA) has many advantages in the management of airway emergencies or the treatment of patients in whom intubation is difficult, but the use of LMA during positive ventilation may seem inappropriate to protect the airway because of the risk of pulmonary aspiration of regurgitated gastric contents. We experienced aspiration pneumonia after general anesthesia using LMA in patient who suffered from panperitonitis. It is considered that the main reason for aspiration pneumonia was a leakage of gastric content through the space surrounding the nasogastric tube while under high airway inflation pressure. We concluded that when LMA or the Proseal laryngeal mask airway (PLMA) is chosen for the use in difficult intubations, careful patient-suitability selection and the correct knowledge of LMA and PLMA are needed to protect the airway against aspiration.

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Comparison of Endotracheal Intubation to Transfer - A Study of Simulation Using the SALT - (이송 중 기관내 삽관의 효율성 비교 - SALT를 이용한 시뮬레이션 연구 -)

  • Yun, Seong-Woo;Jung, Jun-Ho;Lee, Hyo-Ju;Choi, Mi-Young
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2022.10a
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    • pp.300-302
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    • 2022
  • The purpose of this study is to compare the speed, confidence, and ease of endotracheal intubation in a transfer posture by using the SALT(Supraglottic Airway Laryngopharyngeal Tube), and a direct laryngoscope to improve the ability to implement professional airway management. The subject of the study was an experimental study by a randomized crossover design, targeting 28 first-class emergency medical technicians working in J-do fire station, and the SPSS 20.0 version was used for data analysis. The endotracheal intubation by using SALT showed a significant difference in speed compared to endotracheal intubation by using a direct laryngoscope(p<.001), and also showed a significant difference in confidence and ease(p<.001). If it is transfer to endotracheal intubation by direct laryngoscope, or in the case of transfer patients, if SALT is used, safe and rapid intubation will be possible.

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Successful difficult airway management using GlideScope video laryngoscope in a child with Cornelia de Lange Syndrome

  • Park, Sang-Jin;Choi, Eun Kyung;Park, Suyong;Bae, Kunjin;Lee, Deokhee
    • Journal of Yeungnam Medical Science
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    • v.35 no.2
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    • pp.219-221
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    • 2018
  • Management of airway in a child with Cornelia de Lange Syndrome (CdLS) should be given due consideration because most of them have the problems related to difficult airway. The GlideScope video laryngoscope can be attempted during routine intubation, however it is mostly used in case of difficulty. With adequate preoperative airway assessment, we used the pediatric video laryngoscope as useful alternative airway device in a child with CdLS and orotracheal intubation proceeded uneventfully.

Two cases of femorofemoral cardiopulmonary bypass prior to induction of anaesthesia in the management of tracheal obstruction by thyroid cancer (기도 폐쇄로 인한 삽관불능이 갑상선 암환자엣 심장폐우회 마취에 의한 치험 2예)

  • 왕수건;김기태;이병주;권재영;김영대;이강대
    • Korean Journal of Bronchoesophagology
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    • v.9 no.1
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    • pp.101-104
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    • 2003
  • One of major problem in endotracheal intubation for general anesthesia is intrathoracic tracheal obstruction induced by tumor such as, intrathoracic goiter and malignant lymphoma etc. Small amount of secretion or hemorrhage and mild tracheal edema may cause aggravation of tracheal obstruction during endotracheal intubation. Also, it is too difficult to perform the emergency tracheostomy in middle tracheal obstruction. We tried to perform femorofemoral cardiopulmonary bypass without endotracheal intubation for induction of general anesthesia in case of middle tracheal obstruction and We reported with review of literature.

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Dexamethasone treatment for bilateral lingual nerve injury following orotracheal intubation

  • Kim, Saeyoung;Chung, Seung-Yeon;Youn, Si-Jeong;Jeon, Younghoon
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.18 no.2
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    • pp.115-117
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    • 2018
  • Lingual nerve injury is a rare complication of general anesthesia. The causes of lingual nerve injury following general anesthesia are multifactorial; possible mechanisms may include difficult laryngoscopy, prolonged anterior mandibular displacement, improper placement of the oropharyngeal airway, macroglossia and tongue compression. In this report, we have described a case of bilateral lingual nerve injury that was associated with orotracheal intubation for open reduction and internal fixation of the left distal radius fracture in a 61-year-old woman. In this case, early treatment with dexamethasone effectively aided the recovery of the injured lingual nerve.

Anesthetic management of a large mandibular odontogenic myxoma in a child - a case report

  • Koovakattil Akhil Kuttan;Sri Rama Ananta Nagabhushanam Padala;Anagha P Vina;Kuruba Aravind;Molli Kiran
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.24 no.3
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    • pp.213-217
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    • 2024
  • Numerous neoplastic lesions can arise in the orofacial region in the pediatric populations. Odontogenic tumors typically affect the mandible more than the maxilla. Airway management can be challenging in pediatric oral tumors because of the distorted anatomy and physiological variations. Conventional awake fiberoptic intubation is not always possible owing to limited cooperation from the pediatric populations. Herein, we report the case of a 1-year-old child with odontogenic myxoma of the mandible and an anticipated difficult airway. Given the expected difficulties in the airway, video laryngoscope-assisted orotracheal intubation under general anesthesia with maintenance of spontaneous breathing was scheduled. Proper planning and thorough examinations are vital for successful airway management in pediatric patients.

Comparison of Educational Effects of Difficult Endotracheal Intubation in the 119 Rescue Service (119구급대의 어려운 기관내삽관 교육 전·후 비교)

  • Yun, Hyeong-Wan;Yu, Eun-Yeong;Yun, Young-Hyun
    • The Journal of the Korea Contents Association
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    • v.11 no.1
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    • pp.254-265
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    • 2011
  • The purpose of this study was to examine the effect of difficult endotracheal intubation education in the 119 rescue services. The subjects in this study were 60 members of the 119 rescue services that was under the umbrella of the Fire Service Headquarters of J province. A SPSS 14.0 program was utilized to find out the effect of tough tracheal intubation education on their relevant knowledge, self-confidence, academic self-efficacy and technical Performance in consideration of general characteristics. The findings of the study were as follows: 1. They showed a significant improvement in all the knowledge, self-confidence, academic self-efficacy and technical Performance after they received that education. 2. As for connections between general characteristics and knowledge before and after that education, there were significant differences in their knowledge according to gender and career of working in the hospital, and their rank and career of working in the hospital made a significant differences to their self-confidence. Their academic self-efficacy significantly differed with rank, career of working in the hospital and academic credential. There were significant gaps among them technical Performance Case 1 according to career of working in the 119 rescue services, and technical Performance Case 2 significantly varied with age and academic credential. There were significant gaps in technical Performance Case 3 according to career of working in the 119 rescue services and career of working in the hospital after that education was provided, and technical Performance Case 4 significantly varied with age and rank before and after the education was conducted. In conclusion, the kind of education programs that aim at stirring up the interest of the 119 rescue services in advanced airway and helping the members learn about tracheal intubation accurately with confidence is urgently required.

Awake fiberoptic nasotracheal intubation for patients with difficult airway

  • Tsukamoto, Masanori;Hitosugi, Takashi;Yokoyama, Takeshi
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.18 no.5
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    • pp.301-304
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    • 2018
  • Awake fiberoptic nasotracheal intubation is a useful technique, especially in patients with airway obstruction. It must not only provide sufficient anesthesia, but also maintain spontaneous breathing. We introduce a method to achieve this using a small dose of fentanyl and midazolam in combination with topical anesthesia. The cases of 2 patients (1 male, 1 female) who underwent oral maxillofacial surgery are reported. They received $50{\mu}g$ of fentanyl 2-3 times (total $2.2-2.3{\mu}g/kg$) at intervals of approximately 2 min. Oxygen was administered via a mask at 6 L/min, and 0.5 mg of midazolam was administered 1-4 times (total 0.02-0.05 mg/kg) at intervals of approximately 2 min. A tracheal tube was inserted through the nasal cavity after topical anesthesia was applied to the epiglottis, vocal cords, and into the trachea through the fiberscope channel. All patients were successfully intubated. This is a useful and safe method for awake fiberoptic nasotracheal intubation.