European journal of anaesthesiology
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Randomized Controlled Trial
Magnesium sulphate: an adjuvant to tracheal intubation without muscle relaxation--a randomised study.
Tracheal intubation without administration of a neuromuscular blocking drug is used frequently in anaesthesia. Several techniques and adjuvants have been tried to improve intubating conditions. Magnesium sulphate is an agent with analgesic, anaesthetic and muscle relaxant effects. ⋯ Addition of magnesium sulphate to propofol and fentanyl at induction of anaesthesia significantly improved intubating conditions without administration of a neuromuscular blocking drug.
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The successful use of the laryngeal mask airway in children partly depends on the correct selection of size. Most anaesthesiologists rely on the weight-based table which is often difficult to remember. A simple method allowing an adequate choice of the correct size may be highly desirable. ⋯ Choosing the size of the laryngeal mask airway in children according to the size of the external ear was associated with a success rate of 93% which is comparable with that reported in the literature when the tables are used. This simple method may allow a rapid choice of the correct size of laryngeal mask airway and may eliminate the need to remember different tables or formulae.
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Although a life-threatening complication, pulmonary aspiration of gastric contents caused by vomiting or regurgitation during induction of anaesthesia cannot be prevented. It may be prevented if the mouth is placed more inferiorly than the larynx and tracheal bifurcation by the use of head-down tilt and head-neck positioning. ⋯ A head-down tilt equal to the mouth-arytenoid angle (levelling the mouth with the larynx) was necessary to completely prevent aspiration. This angle of tilt was within clinically relevant ranges only with the Sellick position.