Articles: intubation.
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Randomized Controlled Trial Clinical Trial
Attenuation of hypertensive response to tracheal intubation with nitroglycerin.
To evaluate the efficacy and safety of intravenous (IV) nitroglycerin in attenuating the hypertensive response to laryngoscopy and intubation as a new application of the drug. ⋯ A single, rapid IV dose of nitroglycerin is a simple, practical, effective, and safe method to attenuate the hypertensive response to laryngoscopy and tracheal intubation.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of intubating conditions after administration of Org 9246 (rocuronium) and suxamethonium.
We have assessed intubating conditions after administration of Org 9426 (rocuronium) 600 micrograms kg-1 at 60 or 90 s in groups of 20 patients anaesthetized with thiopentone, nitrous oxide in oxygen and small doses of fentanyl, and compared the data with those obtained after suxamethonium 1 mg kg-1 in similar groups of patients. The influence of prior suxamethonium administration on the potency of Org 9426 was studied also by constructing a dose-response curve. ⋯ The average time for the onset of block following Org 9426 at this dose was 89 s (which is shorter than with any of the currently available non-depolarizing neuromuscular blocking drugs); the duration of clinical relaxation (25% recovery of twitch height) 30 min. Prior administration of suxamethonium did not appear to influence the potency of Org 9426.
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Randomized Controlled Trial Comparative Study Clinical Trial
The esophageal detector device: a rapid and accurate method for assessing tracheal versus esophageal intubation in a porcine model.
To assess time and accuracy of the esophageal detector device (EDD), disposable end-tidal CO2 monitor (ETCO2), and standard clinical methods for detection of endotracheal tube placement. ⋯ In this porcine model, the EDD and ETCO2 were more accurate than clinical methods in determining endotracheal tube placement. The EDD demonstrated a significant time advantage over both ETCO2 and clinical methods. Prior ventilation of the esophageal tube does not interfere with the accuracy of the EDD.
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Randomized Controlled Trial Clinical Trial
Blind oral intubation: the development and efficacy of a new approach.
To develop an approach to blind oral intubation. With the aid of a fiberoptic laryngoscope and stylet within an endotracheal tube, a video camera, a monitor, and a recorder to correlate the effects of various manipulations of the airway on access to the trachea, a suitable approach was devised. We then evaluated its efficacy. ⋯ Blind oral tracheal intubation can be successfully performed in a safe and effective manner after appropriate teaching of the technique.
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Comparative Study
Catecholamine response to laryngoscopy and intubation. The influence of three different drug combinations commonly used for induction of anaesthesia.
The haemodynamic response and changes in plasma catecholamine concentrations associated with laryngoscopy and tracheal intubation were compared during anaesthesia employing three strictly standardised techniques with commonly used drug combinations. Thirty-six patients were investigated consecutively resulting in 12 patients in each of three study groups. Anaesthesia was induced with thiopentone 5 mg.kg-1 (group 1), fentanyl 6 micrograms.kg-1 with thiopentone 5 mg.kg-1 (group 2), or midazolam 0.2 mg.kg-1 with fentanyl 6 micrograms.kg-1 (group 3). ⋯ Noradrenaline concentration increased by a maximum of 147%. The addition of fentanyl (groups 2 and 3) attenuated the adverse haemodynamic response and elevation of plasma catecholamine concentrations; heart rate and mean arterial pressure did not differ from pre-intubation values and plasma catecholamine concentrations decreased steadily. Substitution of thiopentone by midazolam in combination with fentanyl abolished the adverse haemodynamic response and modified the increase in plasma catecholamine concentrations. 'High-dose' opioid anaesthesia is not necessary to produce optimal conditions during laryngoscopy and intubation.