Articles: intubation.
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The changes in EMG evoked by train-of-four (TOF) stimulation of ulnar nerve were recorded to determine proper single bolus dose of vecuronium for endotracheal intubation in surgical patients. Onset and duration of neuromuscular block were judged by percent depression of EMG. Mean time intervals for 90% depression in TOF seen in 0.10 mg.kg-1 vecuronium group (n = 10), 0.15 mg.kg-1 vecuronium group (n = 10) and 0.20 mg.kg-1 vecuronium group (n = 10), were 181.1 sec, 135.0 sec and 120.0 sec, respectively. ⋯ No statistically significant difference was observed in recovery time between 0.10 mg.kg-1 and 0.15 mg.kg-1 group. These results indicate that the appropriate dose of vecuronium for rapid intubation is considered to be 0.15 mg.kg-1. This dose is allowable for surgical procedures of short duration.
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Neuromuscular blocking agents (NMBs) are frequently used to facilitate intubations in the hospital. The 1987 membership of the Association of Air Medical Services (AAMS) was surveyed to determine the frequency of NMB use by flight programs both before and after definitive airway control. Out of 141 programs, 101 returned completed survey forms. ⋯ The presence of a physician on the flight crew was associated with the use of succinylcholine prior to definitive airway control. Reported complications included three deaths attributed to use of NMBs in the preceding two years. We conclude that NMBs are commonly used following intubation, and that NMBs are used before intubation by some flight programs, especially those that have physician crew members.
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Anatomical features of the oral fissure and pharynx of rabbits make orotracheal intubation a difficult task with a high failure rate. We have developed a versatile technique for retrograde intubation of rabbits which consists of the following steps: (1) assessment of the trachea through a cervicotomy (2) insertion of a guidewire into its lumen, (3) delivery of the guide through the mouth, and (4) introduction of the orotracheal tube over the guide. ⋯ No complications related to this technique were observed during a follow-up period of 5-14 days. The described technique is a simple and safe method to access the airways of rabbits and can be useful in chronic experiments.
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J. Clin. Gastroenterol. · Jan 1992
Case ReportsSengstaken-Blakemore tube for control of massive bleeding from gastric varices in hiatal hernia.
Hemorrhage from varices in a hiatal hernia sac was controlled by a Sengstaken-Blakemore tube. There is little data available regarding the safety and effectiveness of balloon tamponade in patients with hiatal hernia. Therefore we review the available literature and discuss balloon tamponade in patients with a hiatal hernia.