Articles: intubation.
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Comparative Study Clinical Trial Controlled Clinical Trial
Rate of onset of good intubating conditions, respiratory depression and hand muscle paralysis after vecuronium.
The development of neuromuscular blockade of the adductor pollicis muscle following vecuronium 0.1, 0.15 and 0.2 mg kg-1, was compared with the development of intubating conditions and respiratory paralysis. From this relationship, the optimal time after injection required for ideal tracheal intubation was calculated for the three doses of vecuronium. The effects of these doses of vecuronium on the onset, the duration of action and rate of recovery were studied. ⋯ Suxamethonium 1.5 mg kg-1 (preceded by gallamine 20 mg 2 min earlier), produced excellent conditions in under 1 min. Hypopnoea occurred when the peripheral neuromuscular blockade was about 20-40% established with vecuronium or 50% established with pancuronium. Increasing the dose of vecuronium from 0.1 mg kg-1 to 0.2 mg kg-1 prolonged significantly the duration of action (from 21 to 48 min) but did not shorten significantly the onset time nor prolong the rate of recovery.
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Maintaining an unobstructed airway and providing adequate oxygenation and CO2 elimination, by artificial means if necessary, are among the highest priorities in all life-threatening circumstances. How this goal can best be met in the prehospital setting has become a controversial issue. The esophageal obturator airway (EOA) frequently is used in the prehospital setting, but its use and effectiveness recently have been criticized. ⋯ Many perceived EOA problems are due to poor mask fit and can be rectified. Although endotracheal intubation is the accepted standard for airway management in the apneic patient, its limitations in the prehospital setting are many. These utilization problems and complications remain undefined and must be addressed.
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Randomized Controlled Trial Comparative Study Clinical Trial
Reducing the haemodynamic responses to laryngoscopy and intubation. A comparison of alfentanil with fentanyl.
The effects of alfentanil and fentanyl on controlling the haemodynamic responses to laryngoscopy and intubation have been compared. Five groups of ten patients were studied. Induction was with thiopentone 4 mg/kg. ⋯ In those given 15 and 30 micrograms/kg alfentanil it was 11 and 12 minutes respectively. In those given 5 micrograms/kg fentanyl it was greater than 15 minutes. Alfentanil is shown to reduce the cardiovascular responses to laryngoscopy and intubation and the effect appears to have a shorter duration than that of fentanyl.
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J. Am. Vet. Med. Assoc. · Sep 1984
Case ReportsComplications associated with the use of the cuffless endotracheal tube in the horse.
Complications following the use of the cuffless large animal endotracheal tube during general anesthesia in 2 horses are reported. One horse developed laryngeal edema during recovery. ⋯ The second horse had a swollen tongue and had difficulty eating for 3 days after anesthesia. The condition resolved without treatment. this report is a reminder of the potential damage which can occur from endotracheal intubation.
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The volume and pressure of a tracheal tube cuff inflated with air increases during nitrous oxide anaesthesia. The study was designed to investigate the changes of tracheal tube cuff pressure during nitrous oxide anaesthesia following inflation of the cuff with air or saline in 10 mongrel dogs who were anaesthetised with nitrous oxide and their lungs artificially ventilated. ⋯ On microscopic examination of the trachea, only the air group had glandular inflammation, dilatation and destruction. Therefore, it appears that if saline is used to inflate tracheal tube cuffs, there will not be an increase in cuff volume and pressure during nitrous oxide anaesthesia.