Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Mar 1999
Randomized Controlled Trial Clinical TrialThe effect on intraocular pressure of endotracheal intubation or laryngeal mask use during TIVA without the use of muscle relaxants.
Depolarizing and non-depolarizing muscle relaxants possess many untoward side effects. In most patients endotracheal intubation may be performed with a propofol and alfentanil combination. The purpose of this study was to compare the effect on intraocular pressure (IOP) and haemodynamics of endotracheal (ET) intubation or laryngeal mask (LMA) insertion during total intravenous anaesthesia (TIVA) without the use of muscle relaxants. ⋯ During TIVA without the use of muscle relaxants neither LMA insertion nor ET intubation increased the IOP, but ET extubation did.
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Acta Anaesthesiol Scand · Mar 1999
Influence of temperature on tracheal tube cuff pressure during cardiac surgery.
Lateral wall pressure may cause tracheal injury by affecting tracheal capillary blood flow. Damage to the trachea is less severe when lateral wall pressure exerted by the endotracheal tube cuff does not exceed the mean capillary perfusion pressure of the mucosa. The purpose of this study was to determine the effects of hypothermic and normothermic cardiopulmonary bypass (CPB) on tracheal tube cuff pressure dynamics. ⋯ We conclude that the ITCP is higher in normothermic CPB than in hypothermic CPB; however, the clinical significance of this observation needs further investigation.
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Acta Anaesthesiol Scand · Mar 1999
A simplified method for separate measurements of lung and chest wall mechanics in ventilator-treated patients.
Airway pressure measurements above the endotracheal tube will be distorted because of endotracheal tube resistance. To separate lung and chest wall compliance, esophageal pressure is conventionally measured with an air-filled balloon catheter, which is difficult to insert in unconscious patients. We have developed a methodology with fluid-filled catheters for intratracheal and esophageal pressure measurements. ⋯ Y-piece pressures are not representative of intratracheal pressures, which can be measured by inserting a fluid-filled pressure line through the tube. Esophageal pressure is easily recorded with a fluid-filled Salem double-lumen catheter. Large changes in lung compliance may pass unnoticed when only total compliance is monitored. Monitoring of lung compliance may offer an improved basis for decisions about ventilator settings.