Articles: anesthesiology.
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Randomized Controlled Trial Clinical Trial
Teaching fibreoptic intubation in anaesthetised patients.
One hundred ASA grade 1 and 2 patients requiring orotracheal intubation for various general surgical procedures were randomly assigned to receive either expert rigid laryngoscopic or novice fibreoptic orotracheal intubation under total intravenous anaesthesia. Five anaesthesia residents in the 4th year, with no prior experience in fibreoptic laryngoscopy, participated in a fibreoptic training course, viewing two instructional videos and practising on the intubation manikin. Each resident intubated 20 patients in a randomised fashion either as an expert laryngoscopist or as a fibreoptic novice. ⋯ The haemodynamic profile was similar for fibreoptically intubated and conventionally intubated patients and there was no difference between the first two or the last two fibreoptic or rigid intubations. The study was designed to detect a difference of 10% in means (assuming alpha = 0.05 and beta < or = 0.2). The incidence of postoperative sore throat, dysphagia or hoarseness was similar in both groups.(ABSTRACT TRUNCATED AT 250 WORDS)
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Randomized Controlled Trial Comparative Study Clinical Trial
Head extension and laryngeal view during laryngoscopy with cervical spine stabilization maneuvers.
Direct laryngoscopy frequently is modified in patients with known or suspected cervical spine injury. The goals of this study were to measure the degrees of head extension required to expose the arytenoid cartilages and glottis if neck flexion were not possible and to determine whether in-line stabilization maneuvers alter the amount of head extension. ⋯ Head immobilization reduced head extension necessary for laryngoscopy. If head extension is construed to be potentially dangerous in patients with cervical spine injuries, head immobilization without traction might be the preferable stabilization technique.
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Randomized Controlled Trial Clinical Trial
Teaching fibreoptic intubation. Effect of alfentanil on the haemodynamic response.
A technique for teaching fibreoptic orotracheal intubation in patients under general anaesthesia is described and evaluated. A standard general anaesthetic was administered to 60 patients presenting for elective gynaecological surgery. Patients were randomly assigned to receive either alfentanil 10 micrograms.kg-1 or a placebo, and to be intubated either by a consultant experienced in the use of the fibreoptic bronchoscope or by an inexperienced trainee under instruction. ⋯ The hypertensive response to fibreoptic intubation was suppressed in those patients who received alfentanil (p < 0.001). The increase in heart rate was not suppressed, but was attenuated when these patients were compared with those who had received the placebo (p < 0.001). Alfentanil 10 micrograms.kg-1 minimises the haemodynamic response when teaching fibreoptic orotracheal intubation under general anaesthesia.
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Acta Anaesthesiol Belg · Jan 1994
Randomized Controlled Trial Comparative Study Clinical TrialDouble-blind comparison between inverse sequence induction with atracurium and rapid sequence induction with succinylcholine.
In this double-blind randomized study of 60 patients, a new rapid sequence induction technique (RSI), the so-called inverse sequence induction technique (ISI), is compared to the standard RSI using succinylcholine (SUX). All patients were premedicated with midazolam 0.07 mg.kg-1 and morphine 5 mg im. The patients in the ISI group received atracurium 0.6 mg.kg-1 followed after 1 min by thiopental 5 mg.kg-1. ⋯ In both groups all patients were able to cough forcefully at the time of thiopental injection. These data emphasize the reliability and safety of ISI as an alternative for RSI when succinylcholine is contraindicated. However, the unpleasantness of awake partial curarization may limit its acceptance.
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Randomized Controlled Trial Comparative Study Clinical Trial
A split laryngeal mask as an aid to training in fibreoptic tracheal intubation. A comparison with the Berman II intubating airway.
Thirty patients were randomly allocated to one of two groups in order to compare the use of a split laryngeal mask airway with the Berman II airway as aids to training in fibreoptic laryngoscopy. In both groups anaesthesia was induced with propofol and maintained with isoflurane in N2O/O2 (FIO2 = 0.5). ⋯ Two min after intubation mean heart rate was significantly greater in group 1 (101 beat.min-1) than in group 2 (84 beat.min-1) (P < 0.05). The split laryngeal mask is a useful aid to training in fibreoptic intubation and may allow better airway control than the Berman II intubating airway.