Articles: intubation.
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Aichi Gakuin Daigaku Shigakkai Shi · Jun 1989
[Effects of intravenous injections of lidocaine on hemodynamics and catecholamine levels during endotracheal intubation in infants and children].
It is known that during anesthesia, administering medication and endotracheal intubation often cause stress for the patient which induces sthenia of the endocrinal system as well as changes in hemodynamics, sometimes leading to further systemic complications. Various changes in hemodynamics caused by endotracheal intubation in infants and children were studied, including tachycardia and increased blood pressure. Changes in catecholamine levels in blood plasma and in cardiovascular parameters were observed, with patients divided into two groups for comparison. ⋯ The results also indicate that systemic complications during the induction of general anesthesia may be due to an increased secretion of endogenous catecholamines. These results further suggest that an intravenous injection of lidocaine is not effective in suppressing the increase of catecholamines in the plasma during endotracheal intubation. The intravenous injection of lidocaine, however, inhibits tachycardia and also inhibits the increase in blood pressure often caused by endotracheal intubation, and also serves to reduce the general oxygen demand in the cardiac tissue.
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We evaluated the use of an inexpensive trans-illuminating light wand for tracheal intubation. Expertise in its use was acquired quickly, thereby providing successful per-oral intubation in all patients who were able to open the mouth, irrespective of the view obtained of the epiglottis and larynx.
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A newly designed nasal bridle and rationale for its clinical use are described. Previous nasal bridles have been shown to reduce the 40 to 60% incidence of dislodgement of nasoenteral feeding tubes. ⋯ The newly designed nasal bridle described herein has the advantages of easy and rapid placement. Use of this bridle can promote safer and more effective enteral feeding while avoiding the complications and cost of parenteral nutritional and gastrostomies.
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This study compares some physical characteristics of a selection of cuffed endotracheal tubes with large-volume, low-pressure cuffs currently used in the United Kingdom. Six types of endotracheal tubes of Sizes 7, 8 and 9 were studied. There was considerable variation in physical characteristics of endotracheal tubes and cuffs from different manufacturers and even from the same manufacturer.