Articles: intubation.
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Anesthesia and analgesia · Aug 1982
Randomized Controlled Trial Clinical TrialLow-dose fentanyl blunts circulatory responses to tracheal intubation.
The effect of fentanyl, 8 micrograms/kg, used as an adjunct to thiopental for induction of anesthesia, on the circulatory response to tracheal intubation was investigated in 36 patients undergoing major vascular surgery. Patients were randomly assigned to receive either thiopental, 6 mg/kg, alone (N = 18), or thiopental, 3 mg/kg, along with fentanyl, 8 micrograms/kg (N = 18), for induction of anesthesia. ⋯ Increases in systolic blood pressure, diastolic blood pressure, and pulmonary capillary wedge pressure with intubation were also significantly greater following administration of thiopental than following fentanyl-thiopental. Doses of fentanyl that are low enough to cause little postoperative respiratory depression significantly blunt postintubation hypertension when used as an adjunct to thiopental.
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Randomized Controlled Trial Comparative Study Clinical Trial
Tracheal damage after endotracheal intubation: comparison of two types of endotracheal tubes.
Twenty-eight patients who required endotracheal intubation for open-heart surgery were randomly allocated to one of two types of endotracheal tube. The tracheal mucosa was examined with a fibreoptic bronchoscope at the time of extubation, usually 24 hours after operation. The degree of oedema, inflammation, and ulceration was scored by the bronchoscopist, who also photographed the whole length of the trachea. ⋯ Both observers found significantly less mucosal damage with the low-pressure, high-volume type of cuff than with the traditional high-pressure, low-volume type. This difference may be related to the differences in lateral wall pressures exerted by the two types of cuff. The low-pressure type of cuff may be preferable in patients requiring prolonged endotracheal intubation.
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Randomized Controlled Trial Clinical Trial
Postoperative sore throat related to tracheal tube cuff design.
Recent reports of the incidence of postoperative sore throat following anaesthesia with tracheal intubation have claimed that low volume high pressure cuffs are preferable to those with high volume and low pressure. In this study similar methods were used for evaluating postoperative sore throat. Randomly selected tracheal tubes were used in 56 patients undergoing elective abdominal surgery, followed by direct questioning about sore throat on the first postoperative day. ⋯ Therefore the validity of this method for evaluating the influence of cuff design must be questioned. Postoperative sore throat is a symptom caused by many factors, such as the intubation procedure and the use of stylets or lubricants. The incidence of postoperative sore throat does not necessarily reflect damage caused by the tracheal tube cuff.
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Acta Anaesthesiol Scand · Jun 1982
Randomized Controlled Trial Clinical TrialAttenuation of the circulatory response to laryngoscopy and intubation by fentanyl.
The effects of fentanyl on arterial pressure and heart rate increases during laryngoscopy and intubation were studied in 45 normotensive, surgical patients, who were randomly allocated to three groups receiving 2 or 6 micrograms/kg of fentanyl or saline in a double-blind fashion before anaesthetic induction with thiopental. Fentanyl supplementation with 2 micrograms/kg significantly attenuated the arterial pressure and heart rate increases during laryngoscopy and intubation, and fentanyl, 6 micrograms/kg, completely abolished these responses. Moreover, fentanyl given during the induction decreased the amount of fentanyl needed during the operation. Respiratory depression was not observed during recovery.
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Randomized Controlled Trial Clinical Trial
Topical analgesia of the upper airway with lignocaine. Absorption and its relationship to toxic and anti-arrhythmic levels.
After routine topical application of lignocaine to the upper airway before passage of an endotracheal tube during general anaesthesia, plasma lignocaine levels were assayed in 20 artificially ventilated and 21 spontaneously ventilating patients. Systemic absorption was found to be rapid but very variable. Mean peak level were attained 15 minutes before spraying and were well below the convulsive threshold for anaesthetized patients, while reputedly anti-arrhythmic levels were achieved by 5 minutes and maintained until 40 minutes. Levels in the ventilated group were significantly higher 20 minutes after administration.