- General Anesthesia for Extracorporeal Shockwave Lithotripsyin Child with Lesch-Nyhan Syndrome.
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Sang Jin Park, Il chi Kwon, Won Ki Lee, Deok Hee Lee
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Yeungnam Univ J Med. 2008;25(1):78-83. Published online June 30, 2008
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DOI: https://doi.org/10.12701/yujm.2008.25.1.78
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 Abstract
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- Lesch-Nyhan syndrome is an inborn error of purine metabolism resulting from hypoxanthine-guanine-phosphoribosyltransferase (HGPRT) deficiency and leading to excess purine production and uric acid over-production. It is a very rare X-linked recessive disorder, characterized by movement disorder, cognitive deficits, and self-injurious behavior. However, because of the high incidence of calculi, patients may present for surgery of urinary tract, and have increased risk of difficult intubation, aspiration pneumonia, renal insufficiency or sudden death. We report the case of a 5-year-old boy with Lesch-Nyhan syndrome who underwent successive extracorporeal shockwave lithotripsy under general anesthesia.
- The Clinical Effectiveness of the Bonfils Intubation Fibrescope in Difficult Tracheal Intubation.
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Deok Hee Lee, Il Chi Kwon
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Yeungnam Univ J Med. 2007;24(2):154-161. Published online December 31, 2007
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DOI: https://doi.org/10.12701/yujm.2007.24.2.154
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Abstract
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- BACKGROUND
This study was undertaken to evaluate the effectiveness of the Bonfils intubation fibrescope for cases of difficult tracheal intubation. MATERIALS AND METHODS: For patients with an ASA physical status 1 or 2 betwen the ages of 20-90, direct laryngoscopy was performed and the layngoscopic view graded according to the Cormack and Lehane classification. Forty patients with Cormack and Lehane grade 3 or 4 were intubated using the Bonfils intubation fibrescope. During intubation, the success rates for tracheal intubation, overall time to intubation, number of attempts and adverse effects were recorded. The Thyromental and sternomental distances were recorded after the orotracheal intubation. RESULTS: The success rates were significantly higher in Cormack and Lehane grade 3 (96.9%) patients compared to grade 4 (50%) (P<0.01). The time to intubation was significantly faster in patients with grade 3 compared to grade 4 (20 (10-49[7-300]) sec vs. 180 (31-300[10-300]) sec, P=0.01). The number of cases with a SpO2<90% was significantly lower in patients with grade 3 (3.1%) compared to grade 4 (50%) (P<0.01). CONCLUSION: In patients with Cormack and Lehane grade 3, tracheal intubation using the Bonfils intubation fibrescope appears to be an effective technique for the management of a difficult intubation. However, the Bonfils intubation fibrescope can not always be used for the management of a difficult intubation in grade 4 patients; for these patients other effective instruments should be considered for difficult intubations.
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Yeungnam University College of Medicine
