Articles: intubation.
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Anesthesia and analgesia · Jul 1991
Randomized Controlled Trial Clinical TrialHemodynamic responses to endotracheal extubation after coronary artery bypass grafting.
After coronary artery bypass grafting (CABG) surgery, patients may remain at risk for myocardial ischemia and infarction and ventricular dysrhythmias. The hemodynamic responses to endotracheal extubation and the efficacy of intravenous lidocaine pretreatment were studied after CABG surgery and overnight mechanical ventilation. Twenty-five patients were divided into two groups: group 1 (n = 13) patients who had tracheal extubation after pretreatment with a placebo; group 2 patients who received lidocaine (1 mg/kg IV) before tracheal extubation. ⋯ Compared with the well-documented hemodynamic responses to tracheal intubation, we found that extubation of the trachea after CABG surgery was associated with less pronounced responses. This may be related to avoidance of laryngoscopy and possibly accommodation to the endo-tracheal tube. These modest hemodynamic responses of extubation of the trachea after CABG surgery were not modified by intravenous lidocaine.
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Acta Anaesthesiol Scand · Jul 1991
Randomized Controlled Trial Comparative Study Clinical TrialHemodynamic and catecholamine responses to laryngoscopy with vs. without endotracheal intubation.
To study the relationship between the intensity of the stimulus exerted against the base of the tongue during direct laryngoscopy and the magnitude of associated hemodynamic and catecholamine responses, a study was conducted in 40 ASA I or II patients. Laryngoscopy lasting 40 s was performed with a size 3 Macintosh blade connected to a force-displacement transducer. The intensity of the stimulus exerted during laryngoscopy is expressed by the product of its average force (N) and duration (s) and given as impulse in Ns. ⋯ The mechanisms of the responses to laryngoscopy and orotracheal intubation are proposed to be by somato-visceral reflexes. Stimulation of proprioceptors at the base of the tongue during laryngoscopy induces impulse-dependent increases of systemic blood pressure, heart rate and plasma catecholamine concentrations. Subsequent orotracheal intubation recruits additional receptors that elicit augmented hemodynamic and epinephrine responses as well as some vagal inhibition of the heart.
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A miniaturized, infrared, solid-state, end-tidal CO2 detector was used to confirm emergency endotracheal tube (ETT) placement. ⋯ This hand-held infrared capnometer reliably confirms ETT placement under emergency conditions.
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Rev Esp Anestesiol Reanim · Jul 1991
Comparative Study Clinical Trial Controlled Clinical Trial[Effect of an intravenous nitroglycerin bolus on the hemodynamic impact of laryngoscopy and intubation].
The aim of this study was to evaluate the effectiveness of intravenous administration of a single dose of nitroglycerin in lessening the hemodynamic effects induced during laryngoscopy and tracheal intubation. In an initial subset of 8 patients we verified that the hemodynamic changes after an intravenous dose of 2, 5, or 10 micrograms/kg of nitroglycerin were comparable. The study included 30 patients with a good clinical condition who were anesthetized with fentanyl, thiopental sodium and succinylcholine. ⋯ Increase in diastolic blood pressure was also lower in nitroglycerin treated patients but this difference was only present during laryngoscopy. There were no significant heart rate differences among the two groups of patients. It is concluded that a single intravenous dose of 2 micrograms/kg of nitroglycerin was able to lessen the increase in blood pressure induced by laryngoscopy and tracheal intubation without deleterious effects.
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Randomized Controlled Trial Clinical Trial
[Effects of clonidine premedication upon hemodynamic changes associated with laryngoscopy and tracheal intubation].
The authors studied 30 patients undergoing general anesthesia in order to evaluate whether oral clonidine premedication could attenuate the hemodynamic changes associated with laryngoscopy and tracheal intubation. Patients were randomly assigned to one of two groups; clonidine group (n = 15) who received oral clonidine of approximately 5 micrograms.kg-1, or control group (n = 15) who received no clonidine. ⋯ However, no significant difference was noted between the two groups in the heart rate responses to laryngoscopy and tracheal intubation. It is concluded that oral clonidine of 5 micrograms.kg-1 as a preanesthetic medication could attenuate the pressor responses associated with laryngoscopy and tracheal intubation.