• Title/Summary/Keyword: airway management

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Advantages, Disadvantages, Indications, Contraindications and Surgical Technique of Laryngeal Airway Mask

  • Anubhav, Jannu;Ashim, Shekar;Ramdas, Balakrishna;Sudarshan, H.;Veena, G.C.;Bhuvaneshwari, S.
    • Archives of Craniofacial Surgery
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    • v.18 no.4
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    • pp.223-229
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    • 2017
  • The beauty of the laryngeal mask is that it forms an air tight seal enclosing the larynx rather than plugging the pharynx, and avoid airway obstruction in the oropharynx. The goal of its development was to create an intermediate form of airway management face mask and endotracheal tube. Indication for its use includes any procedure that would normally involve the use of a face mask. The laryngeal mask airway was designed as a new concept in airway management and has been gaining a firm position in anesthetic practice. Despite wide spread use the definitive role of the laryngeal mask airway is yet to be established. In some situations, such as after failed tracheal intubation or in oral surgery its use is controversial. There are several unresolved issues, for example the effect of the laryngeal mask on regurgitation and whether or not cricoids pressure prevents placement of mask. We review the techniques of insertion, details of misplacement, and complications associated with use of the laryngeal mask. We then attempt to clarify the role of laryngeal mask in air way management during anesthesia, discussing the advantages and disadvantages as well as indications and contraindications of its use in oral and maxillofacial surgery.

Anesthetic management of a patient with branchio-oto-renal syndrome

  • Tsukamoto, Masanori;Yokoyama, Takeshi
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.17 no.3
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    • pp.215-217
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    • 2017
  • Branchio-oto-renal syndrome (BOR) is a rare autosomal dominant disorder. The features include branchial cysts, hearing loss, ear malformation, preauricular pits, retrognathia, congenital heart disease, and renal abnormalities. However, anesthetic management of these patients has seldom been reported. We report a case in which general anesthesia was performed for dental treatment in a patient with BOR. Airway management, renal function, and hemodynamic changes can be of critical concern during anesthetic management. A 13-year-old girl diagnosed with BOR had severe right hearing loss, right external ear malformation, renal abnormalities, and postoperative patent ductus arteriosus (PDA). Dental extraction under general anesthesia was scheduled for a supernumerary tooth. The procedure was completed with sufficient urine volume, adequate airway management, and stable hemodynamics.

A Development and Effects of Simulation-based Education Program on Emergency Airway Management (시뮬레이션 기반 응급기도관리 교육 프로그램 개발 및 효과)

  • Lee, Hyun Ah;Kim, Sung Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.11
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    • pp.282-293
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    • 2019
  • Purpose: After developing and imparting knowledge of a simulation-based emergency airway management education program for nursing students, this study identified the effects of the education by evaluating emergency airway management knowledge, Clinical Performance Ability, self-efficacy, and critical thinking disposition. Method: The participants were 30 nursing students. Data were collected from October 14 to November 11, 2017, and analyzed using IBM SPSS Version 22.0. Results: The simulation-based nursing education program was developed and applied based on the ADDIE model involving five stages: analysis, design, development, implementation and evaluation. Comparing the pre-and post-education results, we observed statistically significant improvement when considering emergency airway management knowledge (t=-9.98, p<0.001), Clinical Performance Ability (t=-23.90, p<0.001), self-efficacy (t=-16.77, p<0.001), and critical thinking disposition (t=-5.04, p<0.001). Conclusions: Simulation-based emergency airway management training program is an effective educational program that enhances the emergency airway management knowledge, Clinical Performance Ability, self-efficacy, and critical thinking disposition of nursing students. We believe that the program developed in this study contributes towards improvement of patient nursing quality by enhancing the ability of nursing students to cope with emergencies in practice. Furthermore, it can be applied for educating new nursing students, and contribute to the development of nursing practices.

Airway management during general anesthesia in an intellectually disabled patient with undiagnosed tracheomalacia

  • Shin, Sooil;Kim, Seungoh
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.18 no.2
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    • pp.119-123
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    • 2018
  • In cases of intellectually disabled patients, there is sometimes difficult to obtain sufficient information due to the intellectual disorder, even though the patient has significant medical problems. Herein, we report a case of decreased oxygen saturation and inadequate air exchange during general anesthesia in an intellectually disabled patient. We also describe the subsequent management, including the diagnosis of tracheomalacia (TM) using bronchoscopy, and the management of airway compromise with manual and/or controlled respiration, which led to the prevention of complications.

Difficult airway management in a patient with a parapharyngeal tumor

  • Ji, Sung-Mi
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.15 no.3
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    • pp.153-156
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    • 2015
  • A 47-year-old man was referred to the operating room to treat a dentigenous cyst of the mandibular bone. Initial assessment of the airway was considered normal. However, after the induction of anesthesia, we could not intubate the patient due to severe distortion of the glottis. Fiberoptic bronchoscopy and video laryngoscopy were not effective. Intubation using a retrograde wire technique was successful. After the conclusion of surgery, the patient recovered without any complications. Subsequent magnetic resonance imaging of the patient's neck showed a $6{\times}4{\times}8.6cm$ heterogeneous T2 hyperintense, T1 isointense well-enhancing mass in the prestyloid parapharyngeal space. The patient was scheduled for excision of the mass. We planned awake intubation with fiberoptic bronchoscopy. The procedure was successful and the patient recovered without complications. Anesthetic induction can decrease the muscle tone of the airway and increase airway distortion. Therefore, careful airway assessment is necessary.

Study on Clinical Utility of the Laryngeal Mask Airway in Dogs (개에서 Laryngeal Mask Airway의 임상적 효용성에 관한 연구)

  • Kim Yong-hoon;Lee Joo-myoung;Cheong Jongtae
    • Journal of Veterinary Clinics
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    • v.22 no.3
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    • pp.214-219
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    • 2005
  • This experiment was conducted in order to identify the effect of the laryngeal mask airway and it's clinical utility on cardiovascular system, intraocular pressure and stress reaction at the time of anesthesia care. The heart rate, systolic arterial pressure, diastolic arterial pressure and intraocular pressure were significantly reduced in the experimental group to be compared with the control group. But, there were no significant differences in mean arterial pressure, central venous pressure and blood cortisol concentration between both groups. In view of the above results, it is thought that the airway management using the laryngeal mask airway will be useful to reduce the stress condition in the induction of anesthesia.

Position of the hyoid bone and its correlation with airway dimensions in different classes of skeletal malocclusion using cone-beam computed tomography

  • Shokri, Abbas;Mollabashi, Vahid;Zahedi, Foozie;Tapak, Leili
    • Imaging Science in Dentistry
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    • v.50 no.2
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    • pp.105-115
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    • 2020
  • Purpose: This study investigated the position of the hyoid bone and its relationship with airway dimensions in different skeletal malocclusion classes using cone-beam computed tomography (CBCT). Materials and Methods: CBCT scans of 180 participants were categorized based on the A point-nasion-B point angle into class I, class II, and class III malocclusions. Eight linear and 2 angular hyoid parameters(H-C3, H-EB, H-PNS, H-Me, H-X, H-Y, H-[C3-Me], C3-Me, H-S-Ba, and H-N-S) were measured. A 3-dimensional airway model was designed to measure the minimum cross-sectional area, volume, and total and upper airway length. The mean crosssectional area, morphology, and location of the airway were also evaluated. Data were analyzed using analysis of variance and the Pearson correlation test, with P values <0.05 indicating statistical significance. Results: The mean airway volume differed significantly among the malocclusion classes(P<0.05). The smallest and largest volumes were noted in class II (2107.8±844.7 ㎣) and class III (2826.6±2505.3 ㎣), respectively. The means of most hyoid parameters (C3-Me, C3-H, H-Eb, H-Me, H-S-Ba, H-N-S, and H-PNS) differed significantly among the malocclusion classes. In all classes, H-Eb was correlated with the minimum cross-sectional area and airway morphology, and H-PNS was correlated with total airway length. A significant correlation was also noted between H-Y and total airway length in class II and III malocclusions and between H-Y and upper airway length in class I malocclusions. Conclusion: The position of the hyoid bone was associated with airway dimensions and should be considered during orthognathic surgery due to the risk of airway obstruction.

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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