Articles: general-anesthesia.
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The laryngeal mask airway (LMA) was recently introduced in pediatric anesthesia as an alternative to the face mask or tracheal intubation for airway maintenance. The authors report their experience with LMA on 120 consecutively treated children who underwent elective inguinal herniorrhaphy or orchidopexy. The patients were monitored with electrocardiograms, noninvasive blood pressure determinations, pulse oxymetry, and capnometry. ⋯ In five patients, LMA was successfully inserted on the third attempt. The ease of insertion was not significantly different between the groups. Anesthesia was maintained by halothane (mean, 1.34%; range, 0.8% to 2.54%) for an average of time of 39.2 minutes (range, 15 to 90 minutes).(ABSTRACT TRUNCATED AT 250 WORDS)
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A cuffed nasopharyngeal airway was used in five cases of difficult intubation, initially to maintain anaesthesia, and subsequently to act as a landmark for the passage of a fibreoptic laryngoscope loaded with a tracheal tube. In all cases, airway patency was well preserved with the device and there were no significant problems with its use. The notion of a 'dedicated airway' for difficult intubation cases is developed. A trouble-free airway will permit time to consider solutions for difficult cases and time for the novice to learn fibreoptic laryngoscopy technique.
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A 51 year-old female with spinocerebrellar degeneration was anesthetized with O2-N2O-isoflurane for abdominal total hysterectomy. After monitoring of both orbicularis oculi and adductor pollicis twitches in the response to train-of-four stimulation of the facial and ulnar nerves had been prepared, vecuronium was administered as a bolus. ⋯ The onset with the adductor pollicis did not indicate good intubating conditions. In patients with spinocerebrellar degeneration, the twitch response of the orbicularis oculi should be monitored to determine accurately the degree of neuromuscular blockade when neuromuscular blocking drugs are administered.
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Anaesthesiol Reanim · Jan 1994
Randomized Controlled Trial Comparative Study Clinical Trial[Mechanomyographic and electromyographic studies of endotracheal intubation with 2 different rocuronium dosages].
Rocuronium is a new, intermediate-acting, nondepolarizing relaxant with rapid onset of action leading to both good and very good intubation conditions. It was the aim of our study to investigate the onset of action, the intubation conditions and the course of relaxation using two different dosage regimes. Thirty consenting ASA 1 and 2 patients received either 0.6 mg/kg (2 x ED 95; group 1) or 0.06 mg/kg as priming dose followed by an intubating dose of 0.24 mg/kg rocuronium (group 2) four min later. ⋯ The clinical duration of action was significantly longer in group 1 (28.4 +/- 8.0 min) than in group 2 (14.8 +/- 2.5 min). It can be concluded that rocuronium which has shorter intubation times than atracurium and vecuronium is very useful for endotracheal intubation in both dosage regimes in long and very long lasting operations. Using the "priming principle" the patient has to be carefully controlled during priming time.