Awake fiberoptic intubation (AFOI) is mandatory to manage difficult airways. Superior laryngeal nerve block (SLNB) could reduce risks and improve patient comfort. The aim of this study is to assess the procedural comfort of SLNB during AFOI in a population of patients undergoing upper airway oncological surgery. Forty patients were randomized into two groups and were treated with continuous infusion of remifentanil, topic anesthesia and intercricoid block. In the study group (=20), SLNB was performed with lidocaine (L-SLNB); in the control group (n=20) SLNB was performed using saline (S-SLNB). AFOI was more comfortable in the L-SLNB group compared to S-SLNB patients [FOICS ≤ 1 in 18 patients (90%) L-SLNB; 2 (10%) S-SLNB (P <0.001)]. Intubation was faster in L-SLNB (47.45 ±15.38 sec) than S-SLNB (80.15 ±37.91 sec) (p <0.001). The SLNB procedure during AFOI is a safe and comfortable procedure in a population of patients undergoing upper airways surgery. Time to intubation was shorter in L-SLNB than in S-SLNB.
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http://dx.doi.org/10.7417/CT.2020.2236 | DOI Listing |
BMC Anesthesiol
January 2025
Department of Anesthesiology, Pharmacology, Intensive Care and Emergency Medicine, University Hospitals of Geneva, Geneva, 1205, Switzerland.
Background: In resource-limited settings, advanced airway management tools like fiberoptic bronchoscopes are often unavailable, creating challenges for managing difficult airways. We present the case of a 25-year-old male with post-burn contractures of the face, neck, and thorax in Nigeria, who had been repeatedly denied surgery due to the high risk of airway management complications. This case highlights how an awake intubation was safely performed using an Airtraq laryngoscope, the only device available, as fiberoptic intubation was not an option.
View Article and Find Full Text PDFJ Anaesthesiol Clin Pharmacol
March 2024
Anaesthesia Department, AIIMS, Bathinda, Punjab, India.
Case Rep Anesthesiol
December 2024
Department of Anaesthesiology, Aga Khan University Hospital, Karachi, Pakistan.
Arteriovenous malformations (AVMs) in the head and neck present significant challenges due to airway management complexities and hemorrhage risks. This case report describes a 15-year-old female with a congenital facial AVM causing dyspnea and obstructive symptoms. The patient required angioembolization of the AVM, but many hospitals deferred the procedure due to the anticipated difficult airway and severe bleeding risks.
View Article and Find Full Text PDFCureus
November 2024
Anesthesiology, Unidade Local de Saúde de Coimbra, Coimbra, PRT.
Hiatal hernias are common in the elderly and in most cases asymptomatic and no intervention is needed. Hiatal hernias can range from asymptomatic to an intrathoracic stomach, a rare but potentially life-threatening condition, characterized by the migration of the stomach into the thoracic cavity. Its need for urgent intervention presents a major concern for the anesthesiologist because it is associated with a high risk of aspiration.
View Article and Find Full Text PDFCureus
November 2024
Neuroanesthesia, Unidade Local de Saúde de Santo António, Porto, PRT.
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