The anaesthetic requirements for microsurgery of the larynx are described and techniques in frequent use reviewed. A method involving the Coplans nasotracheal cuffed tube and using controlled ventilation is described and its advantages detailed. The illustrations and blood gas measurements support the authors' view that this technique is the most satisfactory at present available.

BACKGROUND Formulas based on age and height often fail to reliably predict the proper endotracheal tube (ETT) size in pediatric patients. We, thus, tested the hypothesis that subglottic diameter, as determined by ultrasonography, better predicts optimal ETT size than existing methods. METHODS A total of 192 patients, aged 1 month to 6 yr, who were scheduled for surgery and undergoing general ...

Objective To determine the risk factors associated with stridor, with special attention to the role of the cuffed orotracheal cannula. Methods Prospective analysis of all the intubated patients submitted to mechanical ventilator support from January 2008 to April 2011. The relevant factors for stridor collected were age, weight, size and type of airway tube, diagnosis, and duration of mechanica...

High vertical laryngeal position (VLP), pharyngeal constriction, and laryngeal compression are common features associated with hyperfunctional voice disorders. The present study aimed to observe the effect on these variables of different semioccluded vocal tract postures in 20 subjects diagnosed with hyperfunctional dysphonia. During observation with flexible endoscope, each participant was ask...

 Confirmed decrease in tube exchange rate from in some studies 25% to 2%. (2) The advantages of this include, time saving, possible cost saving and less trauma and intubation stress.  Reduced environmental pollution has been shown with levels of volatile and nitrous in the operating theatre significantly reduced. (2) (Not to mention keeping the greenies happy).  Low flow anaesthesia is possi...

Ventilator-associated pneumonia (VAP) is a major healthcare-associated complication with considerable attributable morbidity, mortality and cost. Inherent design flaws in the standard high-volume low-pressure cuffed tracheal tubes form a major part of the pathogenic mechanism causing VAP. The formation of folds in the inflated cuff leads to microaspiration of pooled oropharyngeal secretions int...

(Kimberly-Clark, Roswell, GA) endotracheal tube (ETT) in neonates. They reported that on three neonates who after being intubated with these cuffed ETTs, each had significant postoperative stridor. Most interesting to me was that in each of the cases, no attempt was made to establish whether there was a functional leak at ventilation pressures above 20 cm H2O after intubation. In two of these c...

Rusli Arshad Anaesthesiology Department Faculty of Medicine Universiti Kebangsaan Malaysia Kuala Lumpur Anaesthesia was induced with halothane, the trachea was intubated by a Registrar with a size 3 non-cuffed Portex tube nasally and the lungs ventilated with a mixture of nitrous oxide and oxygen in a ratio of 2:1 using Ayre's T-piece. No relaX:ant was given as breathing was easily controlled m...

OBJECTIVE To simultaneously record tracheal and oesophageal pH in mechanically ventilated children to determine: (1) the feasibility and safety of the method; (2) the incidence of gastro-oesophageal reflux (GOR) and pulmonary contamination; and (3) their associated risk factors. DESIGN Prospective study. SETTING Paediatric intensive care unit in a university hospital. PATIENTS Twenty mech...

ON WE~Y ~A~E OCCASIONS it may be necessary to ventilate each lung separately in association with major injuries to the trachea. A double lumen tube (e.g. Carlens tube) may be unsatisfactory ff the defect in the trachea is of such a location and magnitude as to allow an air leak when the tracheal cuff is inflated. The following is a ease report describing the management of the airway of a patien...