Silent regurgitation during general anesthesia

Regurgitation of acidic gastric fluid and subsequent pulmonary injury still remain a major cause of morbidity and mortality in clinical anesthesia. In this case report we describe our experience with a 39-year-old Indian woman who developed silent regurgitation [SR] during induction of general anesthesia for an emergency surgery. SR was manifested by hypoxaemia [SaO2 90%] and bronchospasm. Her chest x-ray revealed collapse and consolidation of the right upper lobe of the lung. She was treated with corticosteroids, aminophylline, antibiotics and fibreoptic bronchoscopic lavage and ultimately recovered without any long-term sequelae

Awake fibreoptic nasotracheal intubation in a patient with limited mouth opening

Awake fibreoptic nasal intubation was used in the management of a 35 years old woman with severe limitation in mouth opening. intubation, using this technique, facilitated examination of the oral cavity under general anesthesia to delineate the cause of the defect and later on the definitive surgical correction of the oral abnormalities. Patient cooperation, sedation and local analgesia are needed for optimal. results. Inherent limitations of the technique limits its use in patients with difficult intubation under general anesthesia. Adequate pre-intubation oxygenation, for a minimum of 3 minutes, and experience of the operator are essential factors to limit the intubation time and hence, avoid hypoxia