Articles: intubation.
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Eur J Anaesthesiol Suppl · Jan 1991
Endotracheal intubation through the Laryngeal Mask--helpful when laryngoscopy is difficult or dangerous.
The correctly placed Laryngeal Mask will act as a guide to endotracheal intubation in over 90% of adult patients. Although the size of tube is limited to a 6-mm-internal-diameter cuffed oral or nasal pattern tube the technique is easy to learn and can provide a rapid solution when endotracheal intubation is necessary but conventional laryngoscopy is unexpectedly difficult or dental restorations are at risk. Application of cricoid pressure reduces the success rate of the technique; therefore, if this manoeuvre is indicated to reduce the risks of regurgitation, anaesthetists are advised to arrange for its momentary relaxation during the final stages of placement of the Laryngeal Mask and of the endotracheal tube.
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This study analyses 126 cases of dental injuries occurring during endotracheal intubation, reported to the service of litigations of the hospitals in Lyon over a ten-year period, and giving rise to a complaint. The overall rate was 1 out of 4,000 cases of intubation. The true incidence may be greater. ⋯ This device was tested in 108 patients. Intubation was easy with the device in place in 73.2% of patients; mouth opening was reduced by a mean of 4.2 +/- 0.5 mm. The device made intubation more difficult, and even impossible, in patients whose mouth opened no more than 3.5 cm.(ABSTRACT TRUNCATED AT 250 WORDS)
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Case Reports
Fiber-optic bronchoscopic guidance for intubating a neonate with Pierre-Robin syndrome.
The Pierre-Robin anomalad features micrognathia, glossoptosis, and frequently a cleft palate. Tracheal intubation may be challenging and sometimes impossible. ⋯ The bronchoscope was then removed, and an endotracheal tube was threaded over the wire. The technique is safe and allows rapid endotracheal intubation in pediatric patients with difficult upper airways.
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Acta Anaesthesiol Scand · Jan 1991
Randomized Controlled Trial Clinical TrialInjection pain, intubating conditions and cardiovascular changes following induction of anaesthesia with propofol alone or in combination with alfentanil.
In a double-blind study, propofol (P) 2-2.5 mg.kg-1 preceded by saline (Sal) or alfentanil (A) 20-30 micrograms.kg-1 was used for anaesthetic induction in 59 young patients of ASA physical class I or II, premedicated with oxycodone 0.1 mg.kg-1 and atropine 0.01 mg.kg-1 i.m. The patients were randomly allocated to one of the four groups: Group 1 Sal + P2.5, Group 2 A20 + P2.5, Group 3 A30 + P2.5 and Group 4 A30 + P2. Pain on injection of propofol occurred in 67, 36 and 7% of the patients in the Sal + P2.5, A20 + P2.5 and A30 + P2 groups, respectively, but not at all in the A30 + P2.5 group. ⋯ The other groups did not differ significantly from the Sal + P2.5 group. After injection of propofol, both systolic and diastolic arterial pressures decreased significantly in all other groups, with the exception of diastolic pressure in the Sal + P2.5 group, whereas heart rate did not differ from the control level. After intubation, systolic arterial pressure increased statistically significantly in the Sal + P2.5 and A30 + P2 groups and diastolic arterial pressure in all other groups with the exception of the A30 + P2.5 group when compared with the corresponding preceding values.(ABSTRACT TRUNCATED AT 250 WORDS)