Middle East journal of anaesthesiology
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Middle East J Anaesthesiol · Jun 1998
ReviewAdverse effects of neuromuscular blockers and their antagonists.
Among all the drugs used for general anesthesia, neuromuscular blockers appear to play a prominent role in the incidence of severe adverse reactions. It now seems likely that most serious adverse drug reactions occurring during anesthesia are immunological in type. The frequency of life-threatening anaphylactic or anaphylactoid reactions occurring during anesthesia has been estimated to be between 1 in 1000 and 1 in 25,000 anesthetic procedures, with the neuromuscular blockers being involved in 80% of cases. ⋯ In addition, nondepolarising neuromuscular blockers have been implicated in causing generalised weakness following their long term administration to patients on an intensive care unit. The problem with these adverse drug reactions is their upredictable nature. Therefore, prompt recognition with appropriate therapy can help to improve the outcome.
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Middle East J Anaesthesiol · Jun 1998
Aspirated air capnography with esophageal detector device to confirm tracheal intubation in rapid sequence induction.
Verification of the proper placement of a tracheal tube by capnography in rapid sequence induction can lead to aspiration if the patient is ventilated with the tube in the esophagus. In this study we have associated the capnography with the esophageal detector device as modified by Nunn. In 49 patients, two endotracheal tubes were introduced, one in the esophagus and the other in the trachea. ⋯ Two types of reinflation were seen with the tracheal tube: slow (6 cases), all were obese, and instant (43 cases) in the remaining patients. The air aspirated from the respiratory tract by the bulb was analyzed by the capnograph; CO2 was detected from all the tracheal tubes but not from the esophageal ones. We concluded that the esophageal detector device and capnography used as described in our study is a simple reliable test to confirm the proper placement of a tracheal tube before starting ventilation in rapid sequence induction.