Articles: intubation.
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Randomized Controlled Trial Comparative Study Clinical Trial
Cardiovascular and catecholamine responses to laryngoscopy with and without tracheal intubation.
The catecholamine and cardiovascular responses to laryngoscopy alone have been compared with those following laryngoscopy and intubation in 24 patients allocated randomly to each group. Following induction with fentanyl and thiopentone, atracurium was administered and artificial ventilation undertaken via a face mask for 2 min with 67% nitrous oxide in oxygen. Following laryngoscopy, the vocal cords were visualized for 10 s. ⋯ Arterial pressure, heart rate and plasma noradrenaline and adrenaline concentrations were measured before and after induction and at 1, 3 and 5 min after laryngoscopy. There were significant and similar increases in arterial pressure and circulating catecholamine concentrations following laryngoscopy with or without intubation. Intubation, however, was associated with significant increases in heart rate which did not occur in the laryngoscopy-only group.
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Intubation of a patient with an obstructive friable tumor mass in the hypopharynx can be difficult. A technique for solving our most difficult cases evolved after all current methods had been tried. This technique combines the use of a tubular laryngoscope and a hollow wand (or guide), through which O2 can be delivered into the trachea as the endotracheal tube is advanced past the obstructing lesion. Existing techniques are also discussed.
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Randomized Controlled Trial Comparative Study Clinical Trial
Magill versus Mallinckrodt tracheal tubes. A comparative study of postoperative sore throat.
An attempt to assess the relative merits of Magill and Mallinckrodt tracheal tubes is described. One hundred patients scheduled for routine gynaecological operations were randomly allocated to one of two groups of 50; in one, Magill red rubber tubes were used and in the other, Mallinckrodt tubes. ⋯ Fifty percent of those intubated with Magill tubes suffered sore throats, compared with 28% with Mallinckrodt (p less than 0.05). In both groups, sore throat was more frequent in younger patients undergoing short operations: smokers intubated with Magill tubes had significantly more sore throat than smokers in whom Mallinckrodt tubes were used.
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Comparative Study
Evaluation of two methods used to stabilize oral endotracheal tubes.
This study examined the effects of using an oral endotracheal tube holder versus conventional taping for stabilization of oral endotracheal tubes. Twenty-five patients were studied for 4 days, while 5 remained in the study 3 days. Each of the 30 patients had each of the two methods of stabilization in place for at least 1 day. ⋯ Skin breakdown was also observed less frequently with the tube holder. Overall, nursing staff had a higher level of acceptance of the tube holder as the method of choice for stabilization of an oral endotracheal tube. Patient perceptions of the system were not evaluated because of the degree of illness of the patients.