We have examined cerebral pressure autoregulation while awake, and during 0.5 and 1.5 MAC of sevoflurane anaesthesia in 10 patients undergoing non-intracranial neurosurgical procedures. All patients received a standardized anaesthetic comprising premedication with temazepam 20 mg orally, a sleep dose of propofol, fentanyl 1 microgram kg-1 and vecuronium 0.1 mg kg-1. After tracheal intubation, t...

BACKGROUND Tracheal extubations may be performed before or after awakening from anaesthesia. The advantage of extubation during anaesthesia may avoid all the unpleasant effects of fully awake extubation such as severe hypertension and tachycardia, malignant dysrhythmias, myocardial ischemia laryngospasm, and cough induced high intraocular and intracranial pressure. AIM To show the current pra...

BACKGROUND Tracheomalacia is a feared complication of goitre surgery, but considered rare in the Western World. This study aimed to estimate the risk of tracheomalacia in a contemporary series of patients with goitres causing significant tracheal compression. METHODS A retrospective review was conducted of thyroidectomies performed in a UK tertiary referral centre over a 30 month period. Anae...

The ProSealTM laryngeal mask airway (PLMA) insertion using a gum-elastic bougie placed in the oesophagus as a guide has a high first-attempt success rate ( 99%) and a potential role in difficult airway management [1]. On those occasions when it fails, the aetiology is usually laryngospasm, severe epiglottic downfolding, glottic/supraglottic compression or cuff infolding [2]. Most of these probl...

Purpose: To describe the evolution of aspiration risk identification and prophylactic management during general anaesthesia as presented in the United Kingdom (UI 0 anaesthesia textbooks published 1900t998. Methods: The Cumulated Index Medicus, 1900 1997, was searched under the headings: anaesthesia, aspiration, and pneumonia for relevant articles. A classification of features was created using...

PURPOSE Prediction of difficult tracheal intubation is not always reliable and management with fibreoptic intubation is not always successful. We describe two cases in which blind intubation through the intubating laryngeal mask airway (ILMA FasTrach) succeeded after fibreoptic intubation failed. CLINICAL FEATURES The first patient, a 50 yr old man, was scheduled for elective craniotomy for i...

BACKGROUND In this prospective study we aimed at examining the effects of pneumatic tourniquet on intraocular pressure during elective knee surgery. METHOD Twenty patients undergoing elective knee surgery under general anesthesia with tracheal intubation were inluded the study. Anesthesia was induced with pentothal, rocuronium and fentanyl, then maintained with sevoflurane and nitrous oxide i...

Intubation of patients with a supraglottic mass causing obstruction of the glottis remains a difficult problem for the experienced anesthesiologist. Awake fiberscopic endotracheal intubation is the recommended approach in such cases; however, use of a video laryngoscope for awake intubation can be an alternative to a fiberscope. Here we present two cases of awake intubation using a King Vision™...

provided the original work is properly cited. CC Klippel-Feil syndrome (KFS) is a congenital anomaly of the cervical vertebral segments presenting three characteristics: an extremely short neck, low hairline, and significantly restricted range of motion of the neck. KFS is one of the congenital causes of difficult airway management because of these characteristic features, and patients with KFS...