Anesthesia and analgesia
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Anesthesia and analgesia · Apr 1992
Comparative StudyComparison of the endotracheal tube and laryngeal mask in airway management by paramedical personnel.
An evaluation of the laryngeal mask airway (LMA) as a means of airway support when used by paramedical personnel was performed. Forty medical and paramedical students attempted to intubate the tracheas of 40 healthy anesthetized adults with the LMA and a cuffed endotracheal tube (ETT). The number of attempts to achieve correct placement and the time taken to adequately ventilate the lungs were recorded for both devices. ⋯ Five students were unable to intubate the trachea after three attempts with the ETT, but all positioned the LMA satisfactorily on their first try in a mean time of 40 s. We conclude that unskilled operators with minimal training can safely and successfully ventilate unconscious patients more rapidly using the LMA than the ETT. These results suggest the LMA should be available in all areas where resuscitation is performed.
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Anesthesia and analgesia · Apr 1992
Enhancement of bupivacaine sensory blockade of rat sciatic nerve by combination with phenol.
We sought to determine whether the addition of phenol would enhance a bupivacaine nerve block. The effects on nerve conduction of bupivacaine (0.125%) and phenol (0.5%), singly and combined, were evaluated in vivo on the rat sciatic nerve. Three groups of 10 animals each were used. ⋯ The analgesia score derived from the hot-plate test was more and persisted longer for the combination treatment than for either 0.125% bupivacaine or 0.5% phenol given singly; e.g., the average sensory block score after 150 min for the combination treatment was 1.0 compared with 0.1 for either bupivacaine or phenol given alone (P = 0.003). Analysis of the areas under the sensory score-time curves also demonstrated enhanced blockade from the combination treatment, which would be consistent with a synergism of the separate Na(+)-channel blocking effects of charged and uncharged local anesthetics. These findings may suggest other candidates for clinically useful combinations of amine and neutral local anesthetics.