In this chapter, we scope the importance of functional anatomy and physiology of the upper airway. The upper airway has an important role in transporting air to the lungs. Both the anatomical structure of the airways and the functional properties of the mucosa, cartilages, and neural and lymphatic tissues influence the characteristics of the air that is inhaled. The airway changes in size, shape, and position throughout its development from the neonate to the adults. Knowledge of the functional anatomy of the airway in these forms the basis of understanding the pathological conditions that may occur. The upper airway extends from the mouth to the trachea. It includes the mouth, the nose, the palate, the uvula, the pharynx, and the larynx. This section also describes the functional physiology of this airway. Managing the airway of a patient with craniofacial disorders poses many challenges to the anesthesiologist. Anatomical abnormalities may affect only intubation, only airway management, or both. This section also focuses on the abnormal airways in obesity, pregnancy, children and neonate, and patients with abnormal facial defects.

Because intubation becomes a long procedure as potential, arterial oxygen (O2) desatu-ration should be taken into account during the intubation. Since oxygen reserves are not always sufficient to meet the duration of intubation, preoxygenation should be routine before anesthetic induction and tracheal intubation. Surveys show that maximal preoxygenation increases oxygen reserves in the body and significantly delays arterial hemoglobin desaturation and hypoxia. In cases of respiratory insufficiency oxygenation can be improved by positive end expiratory pressure (PEEP) or pressure support. Effective technique and FeO2 monitoring can increase the effectiveness of preoxygenation and thus increase the safety margin. Preoxygenation failures have to be identified and alternative oxygenation methods must be readily available in order to be applied quickly and easily. Although genetic and environmental factors play a role in diseases such as heart attack, stroke and cancer, which have become the cause of the worst death in the twenty-first century, the underlying problem in the development of these pathological conditions is hypoxia. Better understanding of hypoxic areas in ischemic tissues or growing tumors as well as increased knowledge of hypoxia cellular and molecular responses will allow possible applications in the treatment of major diseases associated with tissue hypoxia.

Amaç: Bu çalışmanın amacı; mavi kod uygulamasının önemi, etkinlik ve güvenilirliğine dikkat çekmek, işleyişteki aksaklıklar, sorunlar ve bunlarla ilgili çözüm önerilerini paylaşmaktır. Gereç ve Yöntemler: 2018-2022 yıllarında Mavi Kod Bildirim Formları (MKBF) retrospektif olarak incelendi. Yaş, cinsiyet, çağrının verildiği birim, çağrının verildiği saat ve zaman dilimi, ekibin ulaşma zamanı, olası nedenler ve uygulama sonuçları değerlendirildi Bulgular: Kayıtlara geçen 192 mavi kod çağrısının (MKÇ) 86’sı (%44,8) kadın, 106’sı (%55,2) erkek, yaş ortalaması 53,23 olarak saptandı. Müdahale yeri oranlarına bakıldığında en büyük oranın hastane koridorları ve bekleme salonları olduğu görüldü. Öğleden önce ve öğleden sonra olan çağrılarda sayısal açıdan istatistiksel olarak anlamlı bir fark görülmedi. Ekiplerin %70 oranında 1 dakikadan kısa sürede çağrı noktasına ulaştığı gözlendi. Olay yerinde konan ön tanılara bakıldığında senkop ilk sırada yer aldı. Çağrıların ileri yaşam desteği gerektiren durumlarına bakıldığında; 51 çağrının resüsitasyon gerektirdiği, diğer çağrıların basit tıbbi müdahale ile yönetilebilir olduğu görüldü. Müdahale yerlerinde MKÇ’nin gerçek olması ve resüsitasyon ihtiyacı ilişkisine bakıldığında işlem ünitelerindeki çağrıların mavi kod olma olasılığının belirgin yüksek olduğu (p

Aims: This study was designed to compare the efficacy and safety of erector spinae plane block and serratus anterior plane block in VATS (video assisted thoracoscopic surgery) patients. Methods: This prospective, single-blinded, randomized controlled trial included fifty patients aged 18 to 70 years, classified as American Society of Anesthesiologists (ASA) physical status I-III, who were scheduled to undergo elective video-assisted thoracoscopic surgery (VATS) between February 2022 and February 2023. Patients were randomly assigned to receive either an erector spinae plane block (ESPB) or a serratus anterior plane block (SAPB). In the ESPB group, a catheter was inserted at the T5 vertebral level, and 30 ml of 0.25% bupivacaine was administered. In the SAPB group, the catheter was placed into the superficial fascia overlying the serratus anterior muscle at the level of the fifth rib, and the same volume and concentration of local anesthetic was used. Postoperatively, when the Numeric Rating Scale (NRS) pain score was ≥3, a patient-controlled analgesia (PCA) device delivering 0.125% bupivacaine was connected to the catheter, and continuous infusion was initiated. Intraoperative fentanyl consumption, time to PCA connection, NRS scores, and postoperative morphine use were recorded. Data were analyzed using R version 4.0.0. Appropriate parametric or non-parametric tests were used based on data distribution. Repeated measures were evaluated with the Friedman test, and a p-value

Background/Objectives: High thoracic erector spinae plane block (ESPB) is a novel technique for managing chronic radicular and sympathetically mediated pain. Although physiological changes, such as increased skin temperature, perfusion index (PI), and optic nerve sheath diameter (ONSD), are known to reflect ESPB-induced sympatholysis, their predictive value for analgesic success remains unclear. In this context, the objective of this study is to investigate whether these objective indicators of sympathetic blockade are associated with the clinical success of high thoracic ESPB. Methods: The sample of this prospective, observational study consisted of 35 adult patients with chronic radicular pain undergoing a high thoracic ESPB procedure. Pre- and post-procedure assessments included bilateral skin temperature, PI, ONSD measurements, and administration of a visual analog scale (VAS). Patients with a greater than 50% decrease in VAS score were deemed responders to the procedure. Results: Of the 35 patients, 29 (82.9%) were responders. The patients’ post-procedure ipsilateral skin temperature (p < 0.001), PI (p = 0.002), and ONSD (p < 0.001) values were significantly higher than their pre-procedure values. However, none of these parameters differed significantly between responders and non-responders (p > 0.05). There was also no significant correlation between VAS score and changes in PI, ONSD, or skin temperature (p > 0.05). Conclusions: In conclusion, although high thoracic ESPB resulted in measurable physiological changes suggestive of sympathetic blockade, these changes did not predict clinical analgesic success.