Articles: intubation.
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Rev Laryngol Otol Rhinol (Bord) · Jan 1992
[Laryngeal and tracheal complications of prolonged intubation].
Based on a retrospective study of 595 patients having undergone prolonged intubation, the authors present the main complications encountered and, in particular, the mucous ulceration which appears to be systematic and is itself at the origin of secondary stenosizing or granulomatous sequelae. Research is still needed concerning the follow-up of the intubated patients in order to limit the pressures exerted between the cordal mucosa or the tracheal mucosa in contact with the endotracheal tube. A systematic check upon removal of the tube decreases the secondary sequelae by starting adapted antacid, anti-inflammatory and antibiotic treatments, as well as certain acts of laryngeal microsurgery and, in some cases, laryngeal rehabilitation for both the voice and deglutition.
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Laser surgery can be performed using either endotracheal intubation, apnoea or jet ventilation. For operations performed under endotracheal intubation the same technical rules apply as for any other type of anaesthesia. To facilitate intubation a special laser tube is required. ⋯ For monitoring purposes during jet ventilation or procedures under apnoea, transcutaneous oximetry, ECG recording as well as non-invasive blood pressure measurements at short intervals is mandatory. In addition video monitoring is desirable to allow visual anaesthesiological surveillance of the larynx. The jet ventilator must meet established standards; the option must be available to survey inspiratory peak pressure and end-exspiratory pressure as well as the setting of appropriate alarm limits.
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Randomized Controlled Trial Clinical Trial
Attenuation of the pressor response to tracheal intubation by magnesium sulphate with and without alfentanil in hypertensive proteinuric patients undergoing caesarean section.
The pressor response to tracheal intubation is known to be exaggerated in patients with gestational proteinuric hypertension (GPH). We have studied the effect of pretreatment with magnesium sulphate 40 mg kg-1 or 30 mg kg-1 with alfentanil 7.5 micrograms kg-1 on this pressor response in 38 patients with moderate to severe GPH. ⋯ There was no significant difference in fetal outcome between groups. Both pretreatment methods produced satisfactory control of catecholamine release.