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2 "Laryngeal mask airway"
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General Anesthesia for a Patient with GNE Myopathy: a case report
Christine Kang, Ji-hye An, Jae-Young Kwon, Boo-Young Hwang
Kosin Med J. 2020;35(1):64-68.   Published online June 30, 2020
DOI: https://doi.org/10.7180/kmj.2020.35.1.64
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Abstract PDFPubReader   ePub   

GNE, or bifunctional UDP-N-acetylglucosamine 2-epimerase/N-acetylmannosamine kinase, myopathy presents with symptoms of foot drop, followed by lower and upper extremity muscle weaknesses and sparing of the quadriceps. Myopathies usually increase the risks of complications related to general anesthesia. The anesthetic management of patients with GNEmyopathy has not been previously reported. Herein, we report a case of GNEmyopathy in a 37-year-old woman and discuss anesthetic considerations for elective laparoscopic hysterectomy and bilateral salpingectomy, focusing on the postoperative airway management. We avoided administering neuromuscular-blocking agents and instead used a laryngeal mask airway.

The anesthetic management combining the use of a laryngeal mask airway and desflurane without neuromuscular-blocking agents provided sufficient abdominal and diaphragmatic muscle relaxations for sustaining the pneumoperitoneum for laparoscopic surgery.

Use of laryngeal mask after repeated endotracheal intubation failure in a patient with tracheobronchopathia osteochondroplastica: case report
Sang Gyun Kim, Hyun Kim, Jong Chul Son, Ji-Hyang Lee, Jihyun An, Eunju Kim
Kosin Med J. 2018;33(2):252-256.   Published online December 31, 2018
DOI: https://doi.org/10.7180/kmj.2018.33.2.252
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Abstract PDFPubReader   ePub   

We report a case of difficult endotracheal intubation in a patient with tracheobronchopathia osteochondroplastica. A 65-year-old man was scheduled to undergo ulnar nerve decompression and ganglion excisional biopsy under general anesthesia. During induction of general anesthesia, an endotracheal tube could not be advanced through the vocal cords due to resistance. A large number of nodules were identified below the vocal cords using a GlidescopeĀ® video-laryngoscopy, and fiberoptic bronchoscopy revealed irregular nodules on the surface of the entire trachea and the main bronchus below the vocal cords. Use of a small endotracheal tube was attempted and failed. a laryngeal mask airway (LMA Supreme ā„¢) rather than further intubation was successfully used to maintain the airway.


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