{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T10:17:38Z","timestamp":1783160258459,"version":"3.54.6"},"reference-count":10,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,6,5]],"date-time":"2020-06-05T00:00:00Z","timestamp":1591315200000},"content-version":"vor","delay-in-days":156,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["associationofanaesthetists-publications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Anaesthesia Reports"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>A transgender female patient, who had previously undergone gender\u2010confirming feminisation surgery to the face and larynx, was scheduled for thoracic surgery requiring one\u2010lung ventilation. We encountered unexpected difficult airway management and difficulty inserting an appropriately\u2010sized double\u2010lumen tube. A size 41Fr double\u2010lumen tube, which is selected commonly for biological males, was used eventually for lung isolation and subsequently exchanged for a size 6.5 single\u2010lumen tracheal tube at the end of the case, before successful extubation with a staged extubation set. It is important to highlight the challenges faced, as the care of transgender patients is likely to be unfamiliar to most anaesthetists, despite the increase in the number of gender\u2010confirming procedures performed. Many of these procedures involve the face and airway and can result in significant challenges for airway management, including appropriate sizing of tracheal tubes and their correct placement. It is also possible that patients may not volunteer a history of these procedures and it should be enquired about specifically as part of the anaesthetic pre\u2010assessment.<\/jats:p>","DOI":"10.1002\/anr3.12042","type":"journal-article","created":{"date-parts":[[2020,6,5]],"date-time":"2020-06-05T06:58:28Z","timestamp":1591340308000},"page":"36-39","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Unexpected difficult airway management in a transgender female patient"],"prefix":"10.1002","volume":"8","author":[{"given":"B. J.","family":"Vowles","sequence":"first","affiliation":[{"name":"Department of Anaesthesia Guy's and St Thomas\u2019 NHS Fountdation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia Guy's and St Thomas\u2019 NHS Fountdation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Christodoulides","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia Guy's and St Thomas\u2019 NHS Fountdation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,6,5]]},"reference":[{"key":"e_1_2_5_2_1","first-page":"609","article-title":"Temporal trends in gender\u2010affirming surgery among transgender patients in the United States","volume":"153","author":"Canner JK","year":"2018","journal-title":"Journal of the American Medical Association: Surgery"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000003371"},{"key":"e_1_2_5_4_1","unstructured":"Government Equalities Office.Trans People in the UK 2018.https:\/\/assets.publishing.service.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/721642\/GEO-LGBT-factsheet.pdf(accessed 21\/01\/2020)."},{"key":"e_1_2_5_5_1","unstructured":"Royal College of Anaesthetists.Curriculum for a CCT in Anaesthetics 2010; Edition 2 (August).https:\/\/www.rcoa.ac.uk\/system\/files\/TRG-CU-CCT-ANAES2010_1.pdf(accessed 21\/01\/2020)"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.4103\/ija.IJA_640_18"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599817697050"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26692"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000002171"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000005391"},{"key":"e_1_2_5_11_1","unstructured":"World Professional Association for Transgender Health. Standards of Care for the Health of Transsexual Transgender and Gender\u2010Nonconforming People 2012.https:\/\/www.wpath.org\/media\/cms\/Documents\/SOC%20v7\/Standards%20of%20Care_V7%20Full%20Book_English.pdf(accessed 26\/01\/2020)."}],"container-title":["Anaesthesia Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/anr3.12042","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/anr3.12042","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/anr3.12042","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T11:37:58Z","timestamp":1759923478000},"score":1,"resource":{"primary":{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/10.1002\/anr3.12042"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1]]},"references-count":10,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,1]]}},"alternative-id":["10.1002\/anr3.12042"],"URL":"https:\/\/doi.org\/10.1002\/anr3.12042","archive":["Portico"],"relation":{},"ISSN":["2637-3726","2637-3726"],"issn-type":[{"value":"2637-3726","type":"print"},{"value":"2637-3726","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,1]]},"assertion":[{"value":"2020-04-13","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-06-05","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}