Propofol/Fentanyl/Rocuronium or Sevoflurane Inhalational Induction for Intubation?

ABSTRACT Ear, nose and throat (ENT) emergency procedures demand significant anesthetic challenges. Variety of emergency conditions like deep neck space infections (Ludwig's angina, retropharyngeal, parapharyngeal abscess), acute onset of stridor, epiglottitis, laryngotracheobronchitis, inhaled foreign bodies, facial injuries, etc. are a challenge to both the surgeon and the anesthesiologist and communication and cooperation is vital. Priority in emergency is to clear and secure the airway and consider requirement of ‘shared airway’. Preferred anesthesia and airway technique include awake flexible fiberoptic (FOB) guided intubation in cooperative patients’ and an inhalational induction in uncooperative patient or tracheostomy. Anticipation, vigilance, readiness for difficult intubation, emergency tracheostomy and team work is essential while managing ENT emergency procedures. How to cite this article Harde M, Bawankar T, Bhadade R. Ear, Nose and Throat Emergencies and Anesthesia. Int J Otorhinolaryngol Clin 2015;7(1):28-34.

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A portable inhalational induction device provides co-operative induction of anaesthesia in preanaesthetic area for children

Korean Journal of Anesthesiology ◽

10.4097/kjae.2010.58.6.521 ◽

2010 ◽

Vol 58 (6) ◽

pp. 521

Author(s):

Mi-Ja Yun ◽

Hyo-Seok Na ◽

Young Duck Shin ◽

Jun-Sung Han ◽

Jung-Won Hwang ◽

...

Keyword(s):

Inhalational Induction ◽

Induction Of Anaesthesia

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Optimum End Tidal Sevoflurane Concentration Required for Intravenous Cannulation in Children

QJM ◽

10.1093/qjmed/hcab086.095 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Bassel Mohamed Essam Noureldin ◽

Eman Mohamed Kamal Abo Seif ◽

Omar Mohamed Mohamed Eltawansy ◽

Mohamed Mohamed Abdel Fattah Ghoneim

Keyword(s):

Clinical Trial ◽

Pediatric Patients ◽

Pediatric Anesthesia ◽

Healthy Children ◽

Intravenous Access ◽

Inhalational Induction ◽

Sevoflurane Concentration ◽

Untoward Event ◽

Inhalation Agent ◽

End Tidal

Abstract Background Inhalation mask induction is a cornerstone of pediatric anesthesia. Because of their natural aversion to needles, healthy children are usually anesthetized by mask prior to intravenous insertion. The early insertion of an intravenous access provides a means for administering fluids and drugs if an untoward event occurs during inhalational induction. Sevoflurane is the inhalation agent most commonly used for mask inductions in pediatric anesthesia, having largely replaced halothane for this purpose. Objectives The aim of the study was to evaluate the optimum end tidal concentration of Sevoflurane at which an intravenous cannulation can be successfully attempted without movement in pediatric patients. Patients and Methods In this clinical trial, pediatric subjects of either sex aged 2-5 years, weighing 10-20 kg were included. Results Showed that an end tidal sevoflurane of 1.46% has 50% probability for successful intravenous cannulation without movement in children. Conclusion We conclude that an end tidal sevoflurane of 1.46% has 50% probability for successful intravenous cannulation in un- premedicated children aged between 2 and 5 years.

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Pediatrics: Congenital Diaphragmatic Hernia

Anesthesiology Applied Exam Board Review ◽

10.1093/med/9780190852474.003.0019 ◽

2018 ◽

pp. 127-134

Author(s):

Peggy Wingard

Keyword(s):

Patient Outcome ◽

Pulmonary Hypertension ◽

Airway Management ◽

Congenital Diaphragmatic Hernia ◽

Diaphragmatic Hernia ◽

Main Topic ◽

Inhalational Induction ◽

Respiratory Management ◽

Intraoperative Management

In this chapter the essential aspects of anesthesia for congenital diaphragmatic hernia (CDH) are discussed. Subtopics include respiratory management of CDH patients, airway management, and postoperative considerations of CDH patients. The chapter is divided into preoperative, intraoperative, and postoperative sections with important subtopics related to the main topic in each section. Preoperative topics addressed are assessment of respiratory and circulatory findings, including pulmonary hypertension. Discussion of intraoperative management includes monitoring, induction using inhalational induction, intubation, and maintenance of the patient, airway management, goals for ventilation, treating possible pneumothorax, and fluids used, such as glucose. Postoperative concerns addressed are decompensation and patient outcome.

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Novel technique of inhalational induction of an infant with a large nasal mass

Saudi Journal of Anaesthesia ◽

10.4103/1658-354x.146338 ◽

2015 ◽

Vol 9 (1) ◽

pp. 106

Author(s):

Anuj Jain ◽

Yashwant Dhanwale

Keyword(s):

Nasal Mass ◽

Inhalational Induction ◽

Novel Technique

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A Comparison of Sevoflurane with Halothane for Paediatric Day Case Surgery

Anaesthesia and Intensive Care ◽

10.1177/0310057x9702500609 ◽

1997 ◽

Vol 25 (6) ◽

pp. 643-649 ◽

Cited By ~ 44

Author(s):

S. M. Walker ◽

R. D. Haugen ◽

A. Richards

Keyword(s):

Randomized Study ◽

Phase Iii ◽

Breath Holding ◽

Day Case ◽

Open Label ◽

Day Case Surgery ◽

Inhalational Induction ◽

Rapid Induction ◽

Respiratory Events ◽

Case Surgery

A phase III, open label, randomized study was conducted in 50 patients comparing halothane and sevoflurane for paediatric day case surgery. A graded inhalational induction resulted in only slightly more rapid induction with sevoflurane (3.34±0.92 versus 3.85±1.02 minutes; P>0.05). In children receiving sevoflurane, systolic blood pressure decreased to a lesser extent during induction (14.3±19.2 versus 26.9±10.9 percent decrease from resting values; P<0.01) and heart rate was maintained. Respiratory events (coughing, breath-holding, bronchospasm, laryngospasm) were more common during induction with halothane, and excitement more common in children receiving sevoflurane. Emergence times were significantly more rapid in children who had received sevoflurane (21.4±10.9 versus 33.1 ±13.7 minutes; P<0.01). Objective pain/discomfort scores were higher in patients receiving sevoflurane at 10, 20, 30 and 40 minutes after arrival in the recovery room, and the incidence of excitement during emergence was higher in this group. It is concluded that sevoflurane is well tolerated for inhalational induction and has an improved cardiovascular profile compared to halothane. Emergence was significantly more rapid following sevoflurane.

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