Vía aérea

Manejo de la vía aérea y respuesta hemodinámica a la laringoscopía e intubación en posición supina y lateral izquierda. AIRWAY MANAGEMENT AND HEMODYNAMIC RESPONSE TO LARYNGOSCOPY AND INTUBATION IN SUPINE AND LEFT LATERAL POSITIONS Muhamad Faisal Khan, Fawzia Anis Khan, and Fawzia Nasim Minai M.E.J. ANESTH 20 (6), 2010 Abstract Introduction: Intubation in the lateral position is desirable in several conditions. We compared the technical ease and hemodynamic response to laryngoscopy and intubation in the lateral (group L) and supine (group S) positions in 120 patients with normal airway in a prospective randomized controlled study. Methods: This was a randomized, controlled observational study. All intubations were performed by a single investigator experienced in lateral intubation. Ventilation score with bag and mask ventilation, laryngoscopy duration and attempts, application of external pressure and Cormac & Lehane grade were measured. Blood pressure and heart rate were observed before and after induction of anesthesia, after laryngoscopy/intubation and then at one minute interval for 6 minutes. Results: 90% of patients in group S were ventilated by a single operator compared to 17% in group L. Duration of laryngoscopy was significantly longer in group L (32 seconds) compared to group S (12 seconds) [p<0.001]. 78% of the patients in group S had Cormack and Lehane grade 1 versus nil in group L. External pressure was required in 58% patients in group L and 5% in group S. In intra-group comparison at specified time lines no difference was observed in HR but the changes in BP were significantly higher in the lateral position (P-value <0.001). Conclusion: Ventilation and intubation in lateral position was more difficult technically than in the suprine position, and the BP response was exaggerated in the lateral position. Keywords: Laryngoscopy; intubation; supine; lateral; hemodynamic response. http://www.meja.aub.edu.lb/downloads/20_6/795.pdf   Colocación de Mascarilla Laríngea en Prono Dr. Sergio Granados-Tinajero, Dr. John Domínguez, Víctor M. Whizar-Lugo Anestesia en México 2009;21:139-142. Resumen Los pacientes en posición prona son un reto para el aseguramiento de la vía aérea durante cirugía. Se describe el caso de una mujer de 38 años de edad a la cual se le terminó el efecto de la anestesia raquídea cuando estaba en posición prona. Su vía aérea se aseguró insertándole una mascarilla laríngea sin cambiarla de posición y terminando la cirugía con anestesia general. Palabras clave: Mascarilla laríngea, posición prono. Abstract Patients in the prone position are a challenge for airway management during surgery. We report the case of a 38 year old female in whom spinal anesthesia wore off during surgery in the prone position. The airway was protected through the insertion of a laryngeal mask without changing her position, and surgery proceeded  under general anesthesia. Key words: Laryngeal mask, prone position. http://www.anestesiaenmexico.org/RAM9/RAM2009-21-2/011es.pdf

Atentamente Anestesiología y Medicina del Dolor www.anestesia-dolor.org