Articles: intubation.
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Randomized Controlled Trial Clinical Trial
Bolus doses of esmolol for the prevention of perioperative hypertension and tachycardia.
The effectiveness of esmolol, an ultra short-acting cardioselective beta blocker, in the prevention and treatment of post-intubation haemodynamic perturbations, was investigated. Forty-eight ASA physical status I and II patients undergoing hysterectomy were randomly assigned to receive a single intravenous bolus of placebo, esmolol 100 mg, or esmolol 200 mg in a double-blind fashion. This was administered over 15 sec, and immediately followed by thiopentone 3-5 mg.kg-1, succinylcholine 1.5 mg.kg-1, and tracheal intubation 90 sec later. ⋯ The systolic blood pressure post-induction was lower in the esmolol 200 mg group (P less than 0.05); following intubation, however, no significant differences were seen among groups in systolic, diastolic, or mean blood pressures. Following tracheal intubation, the incidence of ventricular arrhythmias was lower in the esmolol groups (P less than 0.05). In summary, esmolol in 100 mg and 200 mg doses was effective in mitigating the haemodynamic response following tracheal intubation.
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Comment Letter Case Reports
The length of the blade is more important than its design in difficult tracheal intubation.
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Aspiration of gastric contents continues to be one of the most serious complications of general anesthesia. Laryngeal competence may be reduced immediately following endotracheal extubation, which may increase the risk of aspiration. ⋯ Evaluation of radiographs from both groups revealed that no aspirate of barium was detected in the tracheobronchial trees of any of the dogs. This study establishes that there is no difference in the risk of aspiration following endotracheal extubation using the canine model regardless of the clinical technique employed.