C. Philip Larson

Role of the Laryngeal Mask Airway in Airway Management

There are multiple ways that a laryngeal mask airway (LMA) can be used to facilitate airway management. The types of LMAs available and their advantages are discussed. Circumstances where LMA’s are useful are detailed.

Meperidine: A Forgotten Jewel

Meperidine was the first opioid to be synthesized in the laboratory. Its use in anesthesia has declined in recent years for reasons unrelated to its clinical value. Examples of its use in surgical anesthesia are provided.

An Incendiary Issue: Avoiding Operating Room Fires

Operating room fires continue to occur despite publications and media attention. Two typical cases of fires during surgery and how they could have been prevented are provided. The fire triad is reviewed, and recommendations for avoiding operating room fires and advisories for what to do if a fire does occur are provided.

Cricothyrotomy: A Lesson to Be Learned

Occasionally a cricothyrotomy is the only technique that will correct an obstructed airway. Anesthesia providers must know how to perform a cricothyrotomy quickly, effectively and safely. The technique using a knife is described and case examples of when it should be used are cited.

The Bariatric Challenge

Obesity is a common condition and surgery is often the only recourse to correct the problem. Obesity presents the anesthesia provider with special problems including establishment of an airway and potential complications from positioning.

Nitrous Oxide: Yea or Nay

Nitrous oxide has been used for surgical anesthesia for more than 125 years. It is an excellent supplement to other anesthetic drugs because of its low solubility, rapid induction and recovery, and minimal complications. Circumstances where it is of questionable use are cited.

Laryngospasm: The Silent Menace

Laryngospasm may occur during induction or emergence from general anesthesia, or following irritation of the upper airway from any cause in semiconscious patients. There is no reliable prevention, so treatment is the only recourse. The consequences of ineffective treatment are pulmonary edema and occasionally death. The standard treatment techniques such as positive pressure ventilation with oxygen are rarely effective. The ideal treatment is described and illustrated.

Tips on Blood-Gas Analysis

Interpretation of arterial or venous blood gas values requires understanding of the normal values breathing air and oxygen.

Induction of General Anesthesia

General anesthesia can be induced either by intravenous injection or inhalation of anesthetic drugs. The advantages and disadvantages of each are considered, and an effective technique for inhalation induction is described.

Epidural Anesthesia: The Best Technique

Epidural anesthesia is an excellent technique for many surgical procedures. Clinicians use several methods for performing the block, but the best method utilizes continuous pressure on the syringe as the needle is advanced.