Journal of clinical anesthesia
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Comparative Study
Vecuronium neuromuscular blockade at the cricothyroid and posterior cricoarytenoid muscles of the larynx and at the adductor pollicis muscle in humans.
To compare the sensitivity to vecuronium in the cricothyroid (CT) and posterior cricoarytenoid (PCA) muscles of the larynx and the adductor pollicis muscles. ⋯ The laryngeal (CT and PCA) muscles are more resistant to vecuronium than is the adductor pollicis, and the PCA muscle is more resistant to vecuronium than is the CT muscle. This finding suggests that partially paralyzed patients are able to maintain laryngeal patency despite the apparent impaired neuromuscular transmission in the adductor pollicis muscle.
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Randomized Controlled Trial Clinical Trial
Respiratory effects of sevoflurane used in combination with nitrous oxide and surgical stimulation.
To evaluate the respiratory effects of sevoflurane anesthesia with and without nitrous oxide (N2O) during surgical stimulation. ⋯ Sevoflurane administered at an appropriate anesthetic depth maintained spontaneous respiration at acceptable levels during surgical stimulation, especially when combined with N2O.
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To determine the efficacy and safety of administering low-dose analgesic infusions through cervical epidural catheters. ⋯ Patients with chronic persistent cervical radiculopathy pain were effectively treated with infusion of analgesics through epidural catheters for 2 to 17 days while they were at home.
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Case Reports
Nasotracheal intubation in a child with Treacher Collins syndrome using the Bullard intubating laryngoscope.
Tracheal intubation may be difficult or impossible in children with Treacher Collins syndrome. Nasotracheal intubation may be required for appropriate repair of cleft palate in these patients. This report describes the use of the Bullard intubating laryngoscope to facilitate nasotracheal intubation in a child with severe mandibulofacial dysplasia.
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The LMA has been commercially available since 1988, and in the United States since 1992. The device combines several advantages of endotracheal tubes and face masks and may be used in many situations where either device was previously used routinely. ⋯ Although not suitable for all patients and procedures, the LMA has become widely used in all other countries where it is available. Many of the surgical procedures for which the LMA is most suited are performed in outpatients, and we expect this device will soon become popular in carefully selected cases in this country.