Anesthesia for Intranasal Surgery: A Comparison Between Tracheal Intubation and the Flexible Reinforced Laryngeal Mask Airway

WEBSTER, ANTHONY C.; Morley‐Forster, Patricia; Janzen, Victor; Watson, James T.; Dain, Steven; Taves, Donald H.; Dantzer, Dale

doi:10.1097/00132586-199910000-00063

Cited by 22 publications

(32 citation statements)

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“…The use of LMA has also been evaluated and found to decrease cough during the postoperative period. [54][55][56][57] Additional studies on the English bulldog by Kirchner 58 demonstrated that a more muscular pharynx will produce higher than normal airway pressures and supraglottic collapse during inspiration. Bulldogs are known to have a high risk of pulmonary edema, presumably owing to their overall body habitus and pharyngeal anatomy.…”

Section: Laryngospasm and Upper Airway Obstructionmentioning

confidence: 99%

Negative-Pressure Pulmonary Edema After Routine Septorhinoplasty

Westreich

Sampson

Shaari

et al. 2006

Archives of Facial Plastic Surgery

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Section: Laryngospasm and Upper Airway Obstructionmentioning

confidence: 99%

Negative-Pressure Pulmonary Edema After Routine Septorhinoplasty

Westreich

Sampson

Shaari

et al. 2006

Archives of Facial Plastic Surgery

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“…The success of tracheal extubation during the patient's emergence from general anesthesia is critical. The extubation response can elicit undesirable cardiovascular and airway reflexes (Hartley and Vaughan, 1993;Kim and Bishop, 1998) and increases the rate of serious complications including laryngospasm, negative-pressure pulmonary edema and bleeding at the surgical site (Mendel et al, 1995;Nishina et al, 1995;Koga et al, 1998;Tagaito et al, 1998;Webster et al, 1999;Diachun et al, 2001;Soltani and Aghadavoudi, 2002). Furthermore, the open state of the mouth in maxillary and mandibular surgery may prevent successful re-intubation.…”

Section: Introductionmentioning

confidence: 99%

Ropivacaine via trans-cricothyroid membrane injection inhibits the extubation response in patients undergoing surgery for maxillary and mandibular fractures

Gao

et al. 2014

Genet. Mol. Res.

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ABSTRACT. Extubation response can lead to cardiovascular and respiratory complications. Here, we aimed to evaluate the effect of ropivacaine injected via the trans-cricothyroid membrane on the extubation response. This prospective, double-blind, randomized study included 70 patients classified as American Society of Anesthesiologists status I-II, who required general anesthesia with nasotracheal intubation for maxillary and mandibular fracture surgery; patients were divided into the ropivacaine (20 mg) and dicaine (20 mg) groups. Both groups were injected via the trans-cricothyroid membrane. Mean arterial pressure (MAP), heart rate (HR), and incidence and severity of cough were recorded during intubation and extubation. During intubation, there was no significant intergroup difference in MAP or HR and no occurrence of coughing (P > 0.05). During extubation, MAP and HR were significantly lower in the ropivacaine group than the dicaine group (P < 0.05). The proportion of patients with no reports of cough was significantly higher in the ropivacaine group than in dicaine group (P < 0.05). The number of patients with grade 1 or 2 cough was significantly higher in the dicaine group than that in the ropivacaine group (P < 0.05). There was no significant intergroup difference in the rate of postoperative complications (P > 0.05). These results suggest that the administration of ropivacaine via trans-cricothyroid membrane injection can effectively inhibit the extubation response.

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“…However, different modes of ventilation are electively used by anesthesiologists during FESS, which may potentially affect surgical bleeding and operating conditions independently, through the carbon dioxide (CO 2 )-mediated effect on nasal vasculature. Although most published studies appear to favor normocapnia by using intermittent positive pressure ventilation (3,4,6,9), others allow patients undergoing FESS to breathe spontaneously, either through the endotracheal tube or laryngeal mask airway (10,11). Yet, maintaining a patient's spontaneous ventilation is not routinely recommended during most otolaryngological procedures, for fear that rapidly ensuing hypercapnia will promote microvascular and mucosal bleeding due to the CO 2 -induced peripheral vasodilation (12,13), a situation particularly undesirable during FESS.…”

mentioning

confidence: 99%