Difficult intubation and brain-stem anaesthesia
| Autor: | A. F. D. Cole, Chidambaram Ananthanarayan, Martin S. Kazdan |
|---|---|
| Rok vydání: | 1997 |
| Předmět: |
Male
medicine.medical_specialty genetic structures Lidocaine medicine.medical_treatment Sedation Retrobulbar block Cataract Extraction Laryngeal mask airway Intubation Intratracheal medicine Humans Intubation Aged Aged 80 and over Bupivacaine business.industry Tracheal intubation Nerve Block General Medicine Surgery Anesthesiology and Pain Medicine Anesthesia medicine.symptom Airway business Brain Stem medicine.drug |
| Zdroj: | Canadian Journal of Anaesthesia. 44:658-661 |
| ISSN: | 1496-8975 0832-610X |
| DOI: | 10.1007/bf03015451 |
| Popis: | To present a case of difficult intubation with brainstem anaesthesia after retrobulbar block with bupivacaine and lidocaine and sedation with midazolam and to point out that dose monitoring and timely treatment is important in preventing an unfavourable outcome. An 82-yr-old man with treated hypertension and stable angina was scheduled for cataract extraction. Physical examination revealed a class 2 airway. He had a retrobulbar block after topical tetracaine drops, with bupivacaine 0.5% and lidocaine 2% with hyaluronidase under sedation with 1 mg midazolam. Five minutes after the block, respiration slowed, he became unresponsive and oxygen saturation decreased to 80%. Immediate ventilation with mask without additional oxygen improved saturation. Attempted tracheal intubation failed: the epiglottis could not be visualized despite flaccid jaw and extremeties. A laryngeal mask airway was placed which was leaking and adequate ventilation could not be achieved but a second laryngeal mask airway was placed successfully. This case emphasizes the need for dose monitoring and personnel capable of managing the difficult airway when intra-orbital anaesthesia is used. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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