ABSTRACT
The Macintosh laryngoscope has recently been used successfully as an airway clearance device during fibreoptic intubation in patients who presented difficult intubation, but it is not known whether this approach will increase the pressor response to intubation. The aim of this investigation was to compare the cardiovascular responses of this method of facilitating airway clearance with the lingual traction plus jaw thrust method. 40 ASA I or II adult patients were given a standardised general anaesthetic and were randomly allocated to receive either lingual traction with jaw thrust (lingual traction group) or direct laryngoscopy with a Macintosh laryngoscope (laryngoscopy group) as the airway clearance manoeuvre prior to fibreoptic orotracheal intubation. Following intubation there was a significant rise in arterial pressure above pre-induction levels in both groups (p < 0.05); however, the arterial pressure in the laryngoscopy group was significantly greater than that in the lingual traction group (systolic: p = 0.031, diastolic: p = 0.002). It appears therefore that the mechanical stimulus of the Macintosh laryngoscopy evokes a greater pressor response than that of lingual traction plus jaw thrust when these interventions are followed by fibreoptic intubation.
Subject(s)
Fiber Optic Technology , Intubation, Intratracheal/methods , Laryngoscopy/methods , Adolescent , Adult , Anesthesia, General , Blood Pressure , Female , Heart Rate , Humans , Jaw , Male , Middle Aged , TongueABSTRACT
We present a retrospective audit of radial fasciocutaneous vascularised free flaps performed over a decade. These have all been done with binocular loupe magnification, allowing comparison of free flap success with conventional microscope vessel anastomosis. The results are similar to other reported series.
Subject(s)
Face/surgery , Lenses , Mouth/surgery , Surgical Flaps , Anastomosis, Surgical , Carcinoma, Squamous Cell/surgery , Dental Audit , Fascia/transplantation , Graft Survival , Humans , Microsurgery , Mouth Neoplasms/surgery , Plastic Surgery Procedures , Retrospective Studies , Skin Transplantation , Surgical Flaps/blood supply , Treatment OutcomeSubject(s)
Carcinoma, Squamous Cell/surgery , Facial Neoplasms/surgery , Skin Transplantation , Splints , Acrylic Resins , Aged , Aged, 80 and over , Female , HumansSubject(s)
Carcinoma, Transitional Cell/secondary , Enophthalmos/etiology , Facial Pain/etiology , Maxillary Sinus Neoplasms/complications , Maxillary Sinus Neoplasms/secondary , Urinary Bladder Neoplasms/pathology , Aged , Breast Neoplasms/pathology , Carcinoma, Transitional Cell/complications , Fatal Outcome , Humans , Male , Maxillary Neoplasms/complications , Maxillary Neoplasms/secondary , Orbit/innervationABSTRACT
A case is reported in which an unexpected occlusal result arose following bimaxillary osteotomy for correction of a skeletal Class III discrepancy. In order to correct the occlusion, the mandible was protracted independently of the recently plated maxilla, by means of a fronto-sternal traction device.
