Difficult airway management represents a major challenge, requiring a careful approach, advanced technical expertise, and accurate protocols. The task force of the Brazilian Society of Anesthesiology (SBA) presents a report with updated recommendations for the management of difficult airway in adults. These recommendations were developed based on the consensus of a group of expert anesthesiologists, aiming to provide strategies for managing difficulties during tracheal intubation. They are based on evidence published in international guidelines and opinions of experts. The report underlines the essential steps for proper difficult airway management, encompassing assessment, preparation, positioning, pre-oxygenation, minimizing trauma, and maintaining arterial oxygenation. Additional strategies for using advanced tools, such as video laryngoscopy, flexible bronchoscopy, and supraglottic devices, are discussed. The report considers recent advances in understanding crisis management, and the implementation seeks to further patient safety and improve clinical outcomes. The recommendations are outlined to be uncomplicated and easy to implement. The report underscores the importance of ongoing education, training in realistic simulations, and familiarity with the latest technologies available.
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http://dx.doi.org/10.1016/j.bjane.2023.12.001 | DOI Listing |
Cochrane Database Syst Rev
January 2025
Department of Otorhinolaryngology, Amsterdam University Medical Centre, Amsterdam, Netherlands.
Background: NSAID-exacerbated respiratory disease (N-ERD) is a hypersensitivity to non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin or ibuprofen, accompanied by chronic rhinosinusitis (with or without nasal polyps) or asthma. The prevalence of hypersensitivity to NSAIDs is estimated to be 2%. The first line of treatment is the avoidance of NSAIDs.
View Article and Find Full Text PDFAnesth Analg
November 2024
From the Department of Anesthesiology, Perioperative and Pain Medicine, Texas Children's Hospital, Houston, Texas.
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 Clin Med
December 2024
Department of Anesthesiology and Pain Medicine, Bern University Hospital, Inselspital, 3010 Bern, Switzerland.
During the COVID-19 pandemic, reducing aerosol-generating procedures became fundamental, particularly in ophthalmic surgeries traditionally performed under general anesthesia (GA). Regional anesthesia, such as sub-Tenon's block (STB), is widely used in vitreoretinal surgeries, offering a safer alternative by avoiding airway manipulation. However, the altered orbital anatomy in patients with previous scleral explant surgery creates unique challenges to STB application.
View Article and Find Full Text PDFBest Pract Res Clin Anaesthesiol
March 2024
Cardiothoracic Anesthesia, Anesthesiology Department, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; Cardiothoracic Anaesthesia Unit, Department of Anaesthesia, Surgical Intensive Care and Pain Medicine, College of Medicine, Mansoura University, Mansour, Egypt. Electronic address:
Innovations and challenges for lung separation or isolation have evolved during the last few years. In this chapter, we present the up-to-date, robust evidence available during the previous five years supporting the positions of the different devices, techniques, and tricks for their use in adult and pediatric patients undergoing various thoracic surgical interventions. Additionally, we presented an update on lung isolation in patients with airway difficulty and the suggested training level to master these techniques.
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