Journal of clinical anesthesia
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Case Reports
Pseudocholinesterase hyperactivity with succinylcholine resistance: an unusual cause of difficult intubation.
We describe a case of difficult intubation, possibly due to marked pseudocholinesterase hyperactivity that caused rapid inactivation of succinycholine. Possible causes of difficult intubation and pseudocholinesterase hyperactivity are discussed. ⋯ It is concluded that pseudocholinesterase hyperactivity may be a rare cause of difficult intubation. We recommend that pseudocholinesterase activity should be determined in all patients who appear to be resistant to the action of normal doses of succinylcholine or mivacurium.
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Randomized Controlled Trial Comparative Study Clinical Trial
Rocuronium versus succinylcholine for rapid-sequence induction using a variation of the timing principle.
To determine if, using a variation of the "timing" principle, 0.6 mg/kg of rocuronium can achieve an onset time and intubating conditions similar to those achieved with succinylcholine. ⋯ Rocuronium given 20 seconds prior to thiopental provides intubating conditions equivalent to thiopental-succinylcholine for rapid-sequence inductions, circumventing rocuronium's longer onset time to 95% neuromuscular blockade.
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Randomized Controlled Trial Clinical Trial
Is intravenous lidocaine an effective adjuvant for endotracheal intubation in children undergoing induction of anesthesia with halothane-nitrous oxide?
To evaluate the efficacy of intravenous (i.v.) lidocaine in suppressing the cough reflex and increases in intraocular pressure (IOP), heart rate (HR), and mean arterial pressure (MAP) elicited by endotracheal intubation. ⋯ In healthy premedicated children, aged 2 to 6 years, who are undergoing induction of anesthesia with halothane-N2O, 2 mg/kg of lidocaine given 90 seconds prior to laryngoscopy effectively suppresses the cough reflex and increase in IOP secondary to endotracheal intubation and attenuates increases in HR and MAP.
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Comparative Study Clinical Trial
Intrathecal morphine for postoperative analgesia following repair of frontal encephaloceles in children: comparison with intermittent, on-demand dosing of nalbuphine.
To determine the efficacy of lumbar intrathecal (i.t.) morphine in a dose of 0.02 mg/kg in providing analgesia following repair of frontal encephaloceles. ⋯ Lumbar IT morphine provides effective analgesia following repair of frontal encephaloceles in children and adolescents.
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To examine factors contributing to successful lightwand (lighted stylet) intubation of infants and children. ⋯ Lightwand intubation in children uses both tactile and visual cues regarding the location of the endotracheal tube tip. Attention to detail results in a high level of success among novice users of the pediatric lightwand. Endoscopic and external videotaping gave us a means of monitoring the progress of mechanical skills among novice users.