Articles: intubation.
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Randomized Controlled Trial Comparative Study Clinical Trial
Intubation with propofol augmented with intravenous lignocaine.
Sixty patients of ASA grade 1 and aged 18 to 55 years were admitted to a double-blind study. Anaesthesia was induced with propofol 2.5 mg/kg after intravenous pretreatment with lignocaine 1.5 mg/kg or a similar volume of isotonic saline. The quality of subsequent tracheal intubation was graded and the pressor response to tracheal intubation assessed. There were no significant differences between treatment groups.
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The tracheas of 140 adult patients were intubated with either TFX or Portex tracheal tubes. Guide marks were printed at variable distances proximal to the tube cuffs, and during intubation the guide mark was positioned at the level of the vocal cords. The distance between the bevel end of the tube and the carina was determined with a fibreoptic bronchoscope. ⋯ The tip of the tracheal tube approaches the carina by a mean distance of 0.5 cm when the head is moved from the extended position to the neutral position. It is recommended that a guide mark be placed 2.5 cm from the proximal end of the cuff in tubes used for adult males and 2.25 cm in tubes used for adult females. The use of guide marks is a simple, safe and reliable method for correct tracheal tube placement.
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Randomized Controlled Trial Comparative Study Clinical Trial
Tracheal extubation in children: halothane versus isoflurane, anesthetized versus awake.
The authors compared the incidence of respiratory complications and arterial hemoglobin desaturation during emergence from anesthesia in children whose tracheas were extubated while they were anesthetized or after they were awake and to whom halothane or isoflurane had been administered. One hundred children 1-4 yr of age undergoing minor urologic surgery were studied. After a standard induction technique, patients were randomized to receive either isoflurane or halothane. ⋯ When tracheal extubation occurred in deeply anesthetized patients, no differences were found between the two volatile agents. When tracheal extubation of awake patients was performed, the use of isoflurane was associated with more episodes of coughing and airway obstruction than was halothane (P less than 0.05). Awake tracheal extubation following either agent was associated with significantly more episodes of hemoglobin desaturation than was tracheal extubation while anesthetized.
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Critical care medicine · Apr 1991
Validity of a disposable end-tidal carbon dioxide detector in verifying endotracheal tube position in piglets.
the most reliable methods for confirming endotracheal tube placement are direct visualization of passage through the vocal cords and documentation of CO2 in the expired gas. We evaluated the use of a disposable colorimetric CO2 detector for verifying endotracheal tube position in small animals. The end-tidal CO2 (Petco2) detector was tested in 11 piglets with the endotracheal tube sequentially in the trachea, the esophagus, the esophagus with a carbonated beverage in the stomach, the esophagus after bag-mask ventilation. Endotracheal tube position was confirmed in all cases by direct visualization and capnometry. ⋯ This disposable Petco2 detector is highly sensitive and specific for verifying endotracheal tube placement in this nonarrest piglet model.
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Randomized Controlled Trial Clinical Trial
Intravenous lignocaine and sympathoadrenal responses to laryngoscopy and intubation. The effect of varying time of injection.
We have studied the effect of varying the timing of a prior dose of intravenous lignocaine 1.5 mg/kg on the cardiovascular and catecholamine responses to tracheal intubation. Forty healthy patients were given an intravenous injection of either placebo or lignocaine 2, 3 or 4 minutes before tracheal intubation. There was a significant increase in heart rate of 21-26% in all groups. There was no significant increase in mean arterial pressure in response to intubation in any group of patients given lignocaine before intubation, but in the placebo group, mean arterial pressure increased by 19.1% compared to baseline values (p less than 0.05).