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Submucous dissection of the nasopharynx complicating nasotracheal intubation
Item type: Journal Article • Journal: Southern African Journal of Anaesthesia and Analgesia • Authors: BO Bolaji --- Departments of Anaesthesia, Nigeria IK Kolawole --- Departments of Anaesthesia, Nigeria AAG Abdulrahman --- Departments of Surgery, NigeriaWe present the case of a 60-year old woman, who had an unusual complication of nasotracheal intubation, which was carried out to relieve post-thyroidectomy respiratory distress at the University of Ilorin Teaching Hospital (UITH). She presented with a huge malignant... -
LMA CTrach™—Results of our first experience with the fiberoptic intubating laryngeal mask airway in 80 patients
Item type: Journal Article • Journal: Southern African Journal of Anaesthesia and Analgesia • Authors: P Hilbert --- Department of Anesthesiology, Intensive Care and Emergency Medicine, Germany M Birkmeier --- Department of Anesthesiology, Intensive Care and Emergency Medicine, Germany R Stuttmann --- Department of Anesthesiology, Intensive Care and Emergency Medicine, GermanyWe report on our initial clinical experience with the new LMA CTrach™. The intention was to evaluate its suitability in the routine anaesthetic working environment. Method: After inducing general anesthesia and muscle relaxation, the CTrach™ was used in elective patients,... -
Rigid endoscope-assisted tracheal intubation in a case of epiglottic cyst
Item type: Journal Article • Journal: Southern African Journal of Anaesthesia and Analgesia • Authors: G Ramanathan --- Department of Anaesthesiology, G Shalini --- Department of Anaesthesiology, MD Karunanithi --- Department of Anaesthesiology, PK Purushottaman --- Department of Anaesthesiology, K Ratnam --- SRM Hospital and Research Centre, R Umadevi --- SRM Hospital and Research Centre,Epiglottic cysts are of particular interest to both surgeons and anaesthetists because of the way in which they encroach on the airway. An epiglottic cyst in a 29-year-old woman was scheduled for endoscopic excision. It was located at the vallecula,... -
Case study: Anaesthetic management of an achondroplastic dwarf undergoing radical nephrectomy
Item type: Journal Article • Journal: Southern African Journal of Anaesthesia and Analgesia • Authors: A Jain --- Department of Anaesthesia and Intensive Care, India K Jain --- Department of Anaesthesia and Intensive Care, India JK Makkar --- Department of Anaesthesia and Intensive Care, India K Mangal --- Department of Anaesthesia and Intensive Care, IndiaA three feet two inch (96 cm) tall achondroplastic patient with urothelial cell carcinoma involving renal pelvis was scheduled for a radical nephrectomy. Radial artery cannulation and central venous access were secured in the pre-induction period. After induction, the airway... -
Video laryngoscopy in paediatric anaesthesia in South Africa
Item type: Journal Article • Journal: Southern African Journal of Anaesthesia and Analgesia • Authors: LN Nienaber --- Department of Paediatric Anaesthesia Steve Biko Academic Hospital,This article provides a summary of the types of video laryngoscopes available in South Africa, and highlights some interesting paediatric cases in which video laryngoscopes were used at the Steve Biko Academic Hospital, Pretoria. -
Cuffed endotracheal tubes in paediatrics
Item type: Journal Article • Journal: Southern African Journal of Anaesthesia and Analgesia • Authors: MJ Motiang --- Department of Anaesthesia and Critical Care,The basic function of a tracheal tube is to provide a reliable connection between the patient's airway and the anaesthetic circuit (bag or ventilator). Ideally, this connection should allow a leak at 15–20 cmH2O to prevent pressure-related mucosal perfusion, which... -
Airway management in an infant with congenital trismus: the role of retrograde intubation
Item type: Journal Article • Journal: Southern African Journal of Anaesthesia and Analgesia • Authors: R Krishna --- Department of Anesthesiology and Critical Care, India TV Shenoy --- Department of Anesthesiology and Critical Care, India U Goneppanavar --- Department of Anesthesiology and Critical Care, IndiaCongenital trismus is a serious anomaly, and establishment of an airway for surgical correction is a challenge. In the case of limited mouth opening, the nasal route is the only available option to secure the airway via the supraglottic route... -
Comparison of the air-Q ILA™ and the LMA-Fastrach™ in airway management during general anaesthesia
Item type: Journal Article • Journal: Southern African Journal of Anaesthesia and Analgesia • Authors: EU Neoh --- Department of Anaesthesiology and Intensive Care, Malaysia YC Choy --- Department of Anaesthesiology and Intensive Care, MalaysiaOne hundred and sixty patients aged between 20–60 years with ASA physical status I-II, undergoing elective surgery under general anaesthesia, were enrolled into this prospective, randomised, double-blinded study to compare the success rate of tracheal intubation between the air-Q™ intubating... -
Evaluation of three adjusting manoeuvres and type of endotracheal tube in the success of air-Q™ aided tracheal intubation
Item type: Journal Article • Journal: Southern African Journal of Anaesthesia and Analgesia • Authors: RM Khan --- Department of Anaesthesia and Intensive Care Unit, National Trauma Centre, Sultanate of Oman NK Kaul --- Department of Anaesthesia and Intensive Care Unit, National Trauma Centre, Sultanate of Oman PH Neelakanthan --- Department of Anaesthesia and Intensive Care Unit, National Trauma Centre, Sultanate of Oman PK Sharma --- Sultan Qaboos University Hospital, Sultanate of OmanBackground: The present study observed whether the use of three different adjusting manoeuvres and use of an armoured tracheal tube would increase the success rate of tracheal intubation, aided by the air-Q™ intubating laryngeal airway (air-Q™ ILA). -
Haemodynamic and anaesthetic advantages of dexmedetomidine
Item type: Journal Article • Journal: Southern African Journal of Anaesthesia and Analgesia • Authors: SH Rao --- Department of Anaesthesia and Critical Care, India B Sudhakar --- Department of Anaesthesia and Critical Care, India PK Subramanyam --- Department of Anaesthesia and Critical Care, IndiaObjectives: The aim of this study was to describe the effect of dexmedetomidine on haemodynamic stability in the intraoperative period, as well as on the pressor response to intubation and extubation and the requirement of inhalation anaesthetics and recovery. -
The LMA Classic™ as a conduit for tracheal intubation in adult patients: a review and practical guide
Item type: Journal Article • Journal: Southern African Journal of Anaesthesia and Analgesia • Authors: ANJ Alberts --- Clinical Unit, Department of Anaesthesiology and Critical Care Kalafong Hospital; Faculty of Health Sciences,Unexpected difficulty in maintaining an open airway following induction of anaesthesia remains an ever-present hazard. Repetitive attempts at direct laryngoscopy and intubation are generally acknowledged to be inappropriate. The LMA ClassicTM is recognised as a rescue ventilation device in failed... -
A study to evaluate fibreoptic-guided intubation through the i-gel™
Item type: Journal Article • Journal: Southern African Journal of Anaesthesia and Analgesia • Authors: S Taxak --- Department of Anaesthesiology and Critical Care, India K Vashisht --- Department of Anaesthesiology and Critical Care, India KP Kaur --- Department of Anaesthesiology and Critical Care, India G Ahlawat --- Department of Anaesthesiology and Critical Care, India M Bhardwaj --- Department of Anaesthesiology and Critical Care, IndiaObjective: The i-gel™ superglottic airway (Intersurgical, Berkshire, UK) has been reported to function as an airway rescue device and as a conduit for fibre-optic intubation in predicted difficult airways. The wider and shorter stem of the i-gel™ and the absence... -
Intubation and mechanical ventilation: knowledge of medical officers at a South African secondary hospital
Item type: Journal Article • Journal: South African Family Practice • Authors: Linda van Deventer --- Department of Critical Care, South AfricaBackground: Medical officers frequently need to initiate the management of critically ill patients requiring endotracheal intubation and mechanical ventilation. The knowledge of hospital-based medical officers at a South African secondary hospital was evaluated on indications for endotracheal intubation and the... -
Intubation of a neonate with glossopalatine ankylosis using a paraglossal approach and a laryngoscope with a straight blade
Item type: Journal Article • Journal: Southern African Journal of Anaesthesia and Analgesia • Authors: S Mukharjee --- Department of Anaesthesiology, India D Mitra --- Department of Anaesthesiology, India A Sen --- Department of Anaesthesiology, India A Chattopadhyay --- Department of Paediatric Surgery, India S Kajal --- Department of Anaesthesiology, India M Dhankhar --- Department of Anaesthesiology, IndiaGlossopalatine ankylosis presents a challenge to the anaesthesiologist because of its intraoral attachment which obstructs the view of the oral cavity. When preoperative assessment by direct laryngoscopy is possible, a paraglossal approach using a straight blade can be used in... -
A new option in airway management: evaluation of the TotalTrack® video laryngeal mask
Item type: Journal Article • Journal: Southern African Journal of Anaesthesia and Analgesia • Authors: JO Choonoo --- Faculty of Health Sciences, Department of Anaesthesia, South Africa R Hofmeyr --- Faculty of Health Sciences, Department of Anaesthesia, South Africa NR Evans --- ZA Health, South Africa MF James --- Faculty of Health Sciences, Department of Anaesthesia, South Africa N Meyersfeld --- Southern Anaesthetics, South AfricaBackground: The TotalTrack® Video Laryngeal Mask (VLM) is a novel airway management device consisting of a disposable laryngeal mask paired with a reusable video display. Prior to the commencement of this study, there was no published literature on the performance... -
Intraoperative management of ETT and LMA cuff pressures: a survey of anaesthetists’ knowledge, attitude and current practice
Item type: Journal Article • Journal: Southern African Journal of Anaesthesia and Analgesia • Authors: A de Castro --- Discipline of Anaesthesiology & Critical Care, South Africa PD Gopalan --- Discipline of Anaesthesiology & Critical Care, South AfricaBackground: Endotracheal tubes and laryngeal mask airway devices are routinely used during anaesthesia. Inappropriate inflation of cuffs has been shown to cause postoperative airway morbidity, and limiting the pressure decreases the incidence of pharyngo-laryngeal complications. Subjective measurements of cuff pressures... -
Evaluation of the Intubating Laryngeal Mask Airway (ILMA) as an intubation conduit in patients with a cervical collar simulating fixed cervical spine
Item type: Journal Article • Journal: Southern African Journal of Anaesthesia and Analgesia • Authors: S Saini --- Department of Anaesthesiology & Critical Care, India R Bala --- Department of Anaesthesiology & Critical Care, India R Singh --- Department of Orthopaedics Paraplegia and Rehabilitation, IndiaBackground: Cervical spine immobilisation with a semi-rigid cervical collar imposes difficulty in tracheal intubation. There is increasing use of the Intubating Laryngeal Mask Airway (LMA- FastrachTM) for intubation in patients with difficult airways. The present study was conducted to assess... -
Errors and clinical supervision of intubation attempts by the inexperienced
Item type: Journal Article • Journal: Southern African Journal of Anaesthesia and Analgesia • Authors: VM Satyapal --- Department of Anaesthetics, Nelson R Mandela School of Clinical Medicine, South Africa CC Rout --- Department of Anaesthetics, Nelson R Mandela School of Clinical Medicine, South Africa TE Sommerville --- Department of Anaesthetics, Nelson R Mandela School of Clinical Medicine, South AfricaBackground: Tracheal intubation is an essential skill for anaesthetists and other disciplines that require emergency establishment of a secure airway. Early attempts in patients often meet with failure. Existing publications focus mainly on trainees in emergency settings and highlight the... -
Anaesthetic challenges in a patient with Klippel–Feil syndrome scheduled for panendoscopy and biopsy
Item type: Journal Article • Journal: Southern African Journal of Anaesthesia and Analgesia • Authors: A Chitnis --- Department of Anaesthesia and Intensive Care Medicine, United Kingdom KO Enohumah --- Department of Anaesthesia and Intensive Care Medicine, United KingdomKlippel–Feil syndrome is one of the congenital causes of difficult airway. It is characterised by a classic triad of a short neck, restricted cervical spine movement, and a low posterior hairline, which can pose a significant challenge to the anaesthetist... -
Unplanned extubations in a level one trauma ICU
Item type: Journal Article • Journal: Southern African Journal of Anaesthesia and Analgesia • Authors: KM Köhne --- Department of Anaesthesiology, South Africa T Hardcastle --- Trauma Service, Inkosi Albert Luthuli Central Hospital and Department of Surgery, University of KwaZulu-Natal, South AfricaBackground: Unplanned endotracheal extubation (UE) is the most common airway adverse event in ICU. This study aimed to determine the incidence, characteristics, complications and outcomes of UE in patients in a level one trauma ICU. -
Paraglossal straight blade intubation in syndromic children
Item type: Journal Article • Journal: Southern African Journal of Anaesthesia and Analgesia • Authors: Michiel A du Toit --- Department of Anaesthesiology and Perioperative Medicine, South Africa Rebecca M Gray --- Department of Anaesthesiology and Perioperative Medicine, South AfricaSyndromic children have an increased association with difficult airways, which may lead to difficulties and dangers even when anticipated and planned for. Hypoxia, with its risk of brain injury, cardiac arrest and even death, may follow induction of anaesthesia with... -
Anaesthetic considerations in a child with fibrodysplasia ossificans progressiva
Item type: Journal Article • Journal: Southern African Journal of Anaesthesia and Analgesia • Authors: Thomas Kleyenstüber --- Department of Anaesthesia, Rahima Moosa Mother and Child Hospital, South AfricaFibrodysplasia ossificans progressiva (FOP) is an extremely rare genetic disorder characterised by extraskeletal ossification of connective tissue. Affected individuals often become completely immobilised by their third decade of life. Amongst numerous anaesthetic concerns, the airway management of patients with FOP... -
Why them? A systematic review on common factors among youth who receive compulsory treatment for anorexia nervosa
Item type: Journal Article • Journal: Journal of Child & Adolescent Mental Health • Authors: Tim M Offringa --- Leiden University Medical Center, The Netherlands Laura A Nooteboom --- Leiden University Medical Center, The Netherlands Benjamin K Versluijs --- University Medical Center Utrecht, The Netherlands Robert R.J.M. Vermeiren --- Leiden University Medical Center, The NetherlandsBackground: Compulsory interventions, including compulsory nasogastric tube feeding, are sometimes necessary for youth with life-threatening anorexia nervosa. However, these interventions are also potentially traumatic for patients and clinicians alike.