[Anesthesia techniques in epidermolysis bullosa]. / Técnicas anestésicas en la epidermólisis ampollosa.

Epidermolysis bullosa encompasses a group of rare clinical profiles marked by the formation of bullae on the skin and mucosa as the result of slight mechanical trauma. The anesthesiologist must take certain safety measures to monitor the airway and must expect difficult venous access in patients with this disease. We report our experience in providing anesthesia by various techniques for plastic and maxillofacial surgery. Most anesthetic techniques can be considered safe if they are performed with care and attention to detail.

[Inflation of the endotracheal tube cuff as an aid for blind nasotracheal intubation in patients with predicted difficult laryngoscopy]. / El inflado del neumotaponamiento como ayuda para la intubación nasotraqueal a ciegas en pacientes con predicción de laringoscopia difícil.

HYPOTHESIS AND OBJECTIVES: Inflation of the tracheal tube cuff to facilitate blind nasal intubation as described by Gobarck in 1987 has been shown to be effective for increasing the rate of successful intubation from 45 to 95% in patients with no airway alterations. We aimed to assess the usefulness of this technique in patients with anatomical alterations of the airway, in whom difficult intubation was predicted. PATIENTS AND METHODS: We enrolled 25 patients with airway alterations that made laryngoscopy likely to be difficult and who were scheduled for neoplastic maxillofacial surgery. RESULTS: Twelve patients (48%) were intubated on the first try, 5 (20%) on the second try and 6 (24%) on the third try. We were unable to intubate 2 patients (8%) after three tries, and therefore opted to intubate with a fiberoptic endoscope. CONCLUSIONS: Inflation of the tracheal tube cuff is useful for facilitating nasotracheal intubation in the awake patient.