European journal of anaesthesiology
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The cuff ballotability method was used in 120 adult patients to confirm the correct depth of insertion of the endotracheal tube after tracheal intubation. The correct tube position was assumed when the cuff of the endotracheal tube could be felt to distend over the suprasternal notch when the pilot balloon was squeezed and the pilot balloon was felt to distend when pressure was applied over the suprasternal notch. ⋯ In all patients the tip of the endotracheal tube was found to be in the desired position, i.e. 3-7 cm from the carina--the level of T3-T4 vertebrae. We concluded this technique to be a simple and reproducible way to confirm the correct depth of insertion of endotracheal tubes.
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Comparative Study
The effects of fenoldopam on renal blood flow and tubular function during aortic cross-clamping in anaesthetized dogs.
Postoperative renal impairment is a recognized complication of infrarenal aortic cross-clamping. Fenoldopam, a selective dopamine agonist, may increase renal blood flow and decrease tubular oxygen consumption. The objective of this study was to quantify the effects of fenoldopam (0.1 microg kg-1 min-1) on renal blood flow and renal tubular function in anaesthetized dogs that have undergone aortic cross clamping. ⋯ The most striking abnormalities observed by electron microscopy were marked disruption of the microvillus brush border in proximal tubules, vacuolation and separation of epithelial cells on basolateral infolds. The changes were similar in the two groups. In conclusion fenoldopam (0.1 microg kg-1 min-1) may have renoprotective effects which persist during infrarenal aortic cross clamping.
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This study investigated the changes in the hypnotic component of anaesthesia, estimated by the bispectral index of the electroencephalogram, during normothermic cardiopulmonary bypass. Twenty-six patients (20 men, 6 women), aged 61 +/- 11 years (Mean +/- SD) scheduled for cardiac surgery were premedicated with hydroxyzine and meperidine. Anaesthesia was induced and maintained with a computer-controlled continuous infusion (not adjusted for haemodilution) of sufentanil (effect site concentration 0.4-0.6 ng mL-1) and a manually adjusted continuous infusion of propofol (4.4 +/- 1.8 mg kg-1 h-1). ⋯ Bispectral index values were 48 +/- 8 before cardiopulmonary bypass onset, 50 +/- 10 before, and 48 +/- 8 after end of cardiopulmonary bypass (P = NS). No patient had increases in bispectral index values during cardiopulmonary bypass consistent with awakening. We conclude that with the anaesthetic regimen presented in this study bispectral index values do not change during normothermic cardiopulmonary bypass.