British journal of anaesthesia
-
Randomized Controlled Trial Clinical Trial
Haemodynamic effects of remifentanil in children with and without intravenous atropine. An echocardiographic study.
Remifentanil is known to cause bradycardia and hypotension. We aimed to characterize the haemodynamic profile of remifentanil during sevoflurane anaesthesia in children with or without atropine. ⋯ Remifentanil produced a fall in blood pressure and cardiac index, mainly as a result of a fall in heart rate. Although atropine was able to reduce the fall in heart rate, it did not completely prevent the reduction in cardiac index.
-
A 61-yr-old woman presented with severe tetanus. Her intensive care management was complicated by severe generalized tetanic spasms despite the use of propofol, midazolam, alfentanil, magnesium sulphate, and atracurium. We describe the management of this problem with a variable dose remifentanil infusion.
-
The aim of this study was to evaluate the appropriateness of intubation depth marks on the new Microcuff paediatric tracheal tube. ⋯ The insertion depth marks of the new Microcuff paediatric tracheal tube allow adequate placing of the tracheal tube with a cuff-free subglottic zone and without the risk for endobronchial intubation in children from birth to adolescence.
-
Case Reports
Fluoroscope-aided retrograde placement of guide wire for tracheal intubation in patients with limited mouth opening.
Passing a retrograde catheter/wire into the pharynx through a cricothyroid puncture can facilitate tracheal intubation in difficult situations where either a flexible fibre-optic bronchoscope or an expert user of such a device is not available. Some mouth opening is essential for the oral and/or nasal retrieval of the catheter/wire from the pharynx. ⋯ Because we did not have a flexible fibre-optic bronchoscope, we performed fluoroscopy-assisted nasal retrieval of the guide wire passed up through a cricothyroid puncture and subsequently accomplished wire-guided naso-tracheal intubation. In the absence of a flexible fibre-optic bronchoscope, this technique is a very useful aid to intubation in patients with limited mouth opening.
-
Our aim was to assess the occurrence, aetiology, and clinical significance of a platelet count greater than 600 x 10(3)/mm(3) in trauma patients. ⋯ Reactive thrombocytosis is a common finding after severe trauma and was found to be associated with a better survival than predicted by severity of illness score. Unless additional risk factors are present, reactive thrombocytosis is not associated with an increased risk of thromboembolic events.