Articles: intubation.
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Norcuron has been used for intubation and short-term relaxation in 21 cases and for maintaining neuromuscular blockade during major operations of 48 patients suffering from severe clinical conditions. The drug assured in all cases relaxation for the required period and longer operations could also be performed, if required, with the repetition of doses. According to the observations Norcuron proved to be a muscle relaxant of medium duration of action which may be combined with drugs commonly used for premedication, as well as with narcotics introducing and maintaining anaesthesia. The special advantage of the drug is that virtually it does not influence the circulatory parameters and its action may be reliably antagonized.
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[Search for early indications for reintubation after mechanical ventilation weaning of the newborn].
Early predictive factors for successful extubation were investigated, in order to determine the best moment for respiratory weaning of the newborn, and the risk of subsequent reintubation. PaO2/FiO2 ratio, PCO2 and respiratory rate were measured 2 h after extubation in 100 newborn infants. There was no statistically significant difference for the PaO2/FiO2 ratio and PCO2 between infants who were successfully extubated (group 1) and those who required subsequent reintubation (group 2). By contrast, the respiratory rate 2 h after extubation was significantly higher in group 2, and a respiratory rate greater than 70/min appears to be the earliest ventilatory modification predictive of the need for further mechanical ventilation before the occurrence of hypoxemia and respiratory acidosis.
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The PCV (Piquet-Crinquette-Vilette) laryngoscope has been designed for use in difficult endotracheal intubation in the adult. Its blade, 170 mm long, is curved, narrow (12 mm internal diameter) and semicircular in cross-section, like a closed C. An 8 mm endotracheal tube can be pushed through this blade. ⋯ Of 115 patients with a predicted difficult endotracheal intubation, fifty were intubated with the PCV without any failures. Also, twenty-five patients, out of thirty, were successfully intubated with the PCV after an attempt with a MacIntosh blade had failed. Of these five failures, one was never intubated by any technique whatsoever, two were intubated by fibroscopy and two by the ENT surgeon.
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Ann Fr Anesth Reanim · Jan 1991
Letter Case Reports[Sublingual hematoma after difficult intubation].
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The laryngoscopic conditions of 62 diabetic patients who underwent renal transplantation or vitrectomy were studied. Anaesthesia was induced with fentanyl and a sleep dose of thiopentone. Conditions for direct laryngoscopy after 0.1 mg/kg vecuronium were scored from 0 to 3 (easy-very difficult). ⋯ The correlation coefficient between these two factors was r = 0.6 (p less than 0.001). Our study shows that joint rigidity possibly caused by tissue glycosylation may also involve laryngeal and cervical areas resulting in a strenuous laryngoscopy. A defective palm print is a warning sign for difficult laryngoscopy.