Secrets to a successful awake fibreoptic intubation (AFOI) on a patient with odentogenous abscess

Teah, Ming Kai; Liew, Esther Huey Ring; Wong, Melvin Teck Fui; Yeap, Tat Boon

doi:10.1136/bcr-2020-238600

Cited by 10 publications

(3 citation statements)

References 11 publications

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“…In addition, good sedation in patients at risk of seizure following alcohol withdrawal and allow precise Glasgow Coma Scale (GCS) assessment. In our patient, we chose dexmedetomidine as it possesses excellent anxiolytic and sedative properties [ 12 , 13 ]. Chronic alcohol consumption leads to thiamine deficiency by way of decreased absorption of thiamine from the gastrointestinal tract (GIT) and impaired cellular utilisation [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Ketoacidosis can Be alcohol in origin: A case report

Soe

Ching

Teah

et al. 2022

Annals of Medicine &Amp; Surgery

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Section: Discussionmentioning

confidence: 99%

Ketoacidosis can Be alcohol in origin: A case report

Soe

Ching

Teah

et al. 2022

Annals of Medicine &Amp; Surgery

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“…Our patient did not exhibit cardiovascular or respiratory compromise and had no preference for any posture. This, however, did not preclude the possibility of an anaesthetic disaster as demonstrated by Yeap et al [ 11 , 12 ]. We opted for AFOI since this directly enabled us to visualise the airways.…”

Section: Discussionmentioning

confidence: 99%

Case report: A rare occurrence of a huge mediastinal mass from disseminated prostate carcinoma

Teah

Bong

Mudin

et al. 2021

Annals of Medicine and Surgery

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Background Prostatic carcinoma is the commonest malignancy among men. It usually metastasizes to the spine and regional lymph nodes. However, it is extremely rare for it to metastasize to the mediastinum. Case presentation An elderly man presented to us with progressive onset of bilateral lower limb weakness which was associated with thoracic radiculopathy and urinary incontinence. An urgent magnetic resonance imaging (MRI) of the spine showed severe cord compression with enlarged prostate and superior mediastinal mass. A computed tomography (CT) guided biopsy of the mediastinal mass was suggestive of prostatic malignancy. An emergency posterior instrumentation and fusion (PSIF) in prone position was successfully done. Histopathological examination of the spine showed malignant glandular tissues, suggestive of prostate. Discussion A huge mediastinal mass can compromise the cardiorespiratory system and is very challenging for the anaesthetist to safely secure the airway for surgical procedures. Androgen deprivation therapy (ADT) for patients with metastatic prostatic carcinoma can be achieved either by medical castration or with bilateral orchidectomy. Conclusion It is extremely uncommon for a prostatic carcinoma to metastasize to the mediastinum. Patients with a huge mediastinal mass possess risks of cardiorespiratory collapse perioperatively. Chemoradiotherapy and androgen deprivation therapy (ADT) can be utilized for metastatic prostatic carcinoma with good outcomes.

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“…In addition, good topical anaesthesia often leads to successful AFOI. The technique of thyrocricocentesis is useful, but it has disadvantages among subjects with tumors and neck infection [10]. Therefore, there is need for a modified technique or method that involves the application of an epidural catheter on the suction channel of the fibreoptic bronchoscope.…”

Section: Introductionmentioning

confidence: 99%

Benefits of probiotics in rheumatoid arthritis patients: A systematic review and meta analysis

Wen¹,

Li²,

Xiao³

et al. 2023

Trop. J. Pharm Res

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Purpose: To evaluate the safety and efficacy of propofol and dexmedetomidine as sedatives in patients with anticipated difficult airways, used as a modified topical preparation.Methods: A total of 432 patients were enrolled in this study. They were classified as ASA I and ASA II. The patients were equally divided into group A (propofol group) and group B (dexmedetomidine group). A modified Awake Fiberoptic Intubation (AFOI) was carried out for these patients, followed by airway assessment and evaluation of clinical outcome based on intubation scores, adverse events, and postoperative data.Results: Patients in both groups had successful intubation at the first attempt. There was no significant difference in baseline characteristics between the two groups. The SARI scores which characterized the overall score for tracheal intubation were 4.6 and 4.2 for groups A and B, respectively. With respect to rescue infusion and consciousness, 11 patients (5.09 %) in group A required rescue, as against 5 patients (2.31 %) in group B. Seven (7) patients (3.24 %) in group A (propofol group) had severe airway obstruction, while only 4 patients (1.85) in group B had the same adverse reaction. Patients in group B had more satisfactory and favourable outcomes than those in group A who were treated with modified AFOI.Conclusion: The use of dexmedetomidine based on modified topical anaesthesia is safe and comfortable in terms of patient convenience and difficult airway management. Thus, dexmedetomidine is a safe, feasible and effective method for managing difficult airway when applied using the modified AFOI.

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Secrets to a successful awake fibreoptic intubation (AFOI) on a patient with odentogenous abscess

Cited by 10 publications

References 11 publications

Ketoacidosis can Be alcohol in origin: A case report

Ketoacidosis can Be alcohol in origin: A case report

Case report: A rare occurrence of a huge mediastinal mass from disseminated prostate carcinoma

Benefits of probiotics in rheumatoid arthritis patients: A systematic review and meta analysis

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