1/5. lingual nerve injury after use of a cuffed oropharyngeal airway.The cuffed oropharyngeal airway is a modified Guedel airway and is recommended for anaesthesia in spontaneously breathing patients. To our knowledge this is the first report of transient unilateral lingual nerve palsy after the use of a cuffed oropharyngeal airway to maintain anaesthesia during arthroscopy of an ankle. The aetiology of lingual nerve damage is multifactorial. The possible mechanisms involved include anterior displacement of the mandible during insertion of the cuffed oropharyngeal airway (as in the jaw thrust manoeuvre), compression of the nerve against the mandible, or stretching of the nerve over the hyoglossus by the cuff of the cuffed oropharyngeal airway. We recommend gentle airway manipulation with the use of the cuffed oropharyngeal airway, avoidance of excessive cuff inflation and early recognition of such a complication if it occurs.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
2/5. Intra-oral traumatic implantation: a case report.A case of traumatic implantation of a broken piece of a ball point pen in the pterygomandibular region in a 13-year-old male patient is presented. Removal of the pen shaft was done by blunt dissection and careful manipulation under local anaesthesia. The possible complications of similar cases are enumerated.- - - - - - - - - - ranking = 0.5keywords = anaesthesia (Clic here for more details about this article) |
3/5. External and internal rigid fixation.A 25-year-old labourer sustained submandibular and intra-oral injuries in an unusual industrial site accident. He fell from above onto steel reinforcing rods which were set in concrete and projecting two metres above the concrete floor. He was impaled by a rod which entered the mouth beneath the right side of the mandible and exited from the mouth passing upwards in front of the nose. The management of this patient is discussed with particular emphasis on the method of obtaining an airway for surgery. Due to the proximity of the rigidly embedded reinforcing rod to the nose, mouth and midline of the neck, an awake tracheostomy under local anaesthesia was conducted. The alternatives to this approach with their potential complications are discussed. In addition possible pre-, peri- and post-operative surgical complications for this case are outlined.- - - - - - - - - - ranking = 0.5keywords = anaesthesia (Clic here for more details about this article) |
4/5. jaw dislocation during general anaesthesia.A case is reported of jaw dislocation on placement of an oral airway and nasogastric tube during an otherwise unremarkable exploratory laparotomy under general anaesthesia. The pathophysiology, diagnosis and treatment of jaw dislocation are described.- - - - - - - - - - ranking = 2.5keywords = anaesthesia (Clic here for more details about this article) |
5/5. Occurrence of malignant hyperpyrexia in a patient with osteogenesis imperfecta.Probable malignant hyperpyrexia (MH) developed and was successfully treated in a 20-yr-old man during anaesthesia for reduction of a fractured mandible. The sister of this patient had died after an anaesthetic at the age of 14 yr, but malignant hyperpyrexia was not suspected. Subsequent enquiries revealed that the patient and his sister both had osteogenesis imperfecta. This case illustrates the infrequently reported association of malignant hyperpyrexia with osteogenesis imperfecta, and the difficulties in obtaining an adequate personal and family history of previous anaesthetics.- - - - - - - - - - ranking = 0.5keywords = anaesthesia (Clic here for more details about this article) |