Acta anaesthesiologica Sinica
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The tussive effect of fentanyl, in sharp contrast to the antitussive effect that common opioids have, is not rarely seen in clinical anesthesia. Pretreatment with beta 2 agonist inhalation could dramatically suppress fentanyl-induced coughing. We hypothesized that airway hyperresponsiveness might exist in large proportion of the subjects who had experienced fentanyl-induced coughing during previous anesthesia. ⋯ From the analysis of the present study, we cannot prove that there is a direct correlation between fentanyl-induced coughing and airway hyperresponsiveness.
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Acta Anaesthesiol. Sin. · Dec 2002
Personnel exposure to waste sevoflurane and nitrous oxide during general anesthesia with cuffed endotracheal tube.
Waste anesthetic gases may have adverse effects on the health of operating room personnel. To reduce the risk of exposure, the United States National Institute of Occupational Safety and Health (US-NIOSH) recommends a time-weighted average (TWA) of 25 ppm (part-per-million) for nitrous oxide (N2O) and a ceiling of 2 ppm for sevoflurane (SEV). This study investigated the concentrations of these two gases in the atmosphere of operating room to which the working personnel (anesthetists) were exposed during anesthetic practice. ⋯ To decrease the exposure of the operating personnel to waste anesthetics, minimization of the use of N2O is recommended. Besides, the three extraordinary conditions as disclosed in this study were tubing flushing, illy managed endotracheal tube cuff and disconnection of scarvenging system, the first of which sometimes is unavoidable but the last two of which should be avoided.
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Acta Anaesthesiol. Sin. · Dec 2002
Randomized Controlled Trial Comparative Study Clinical TrialTracheal intubation condition--a comparison between one minute after rocuronium alone, one minute after rocuronium combined with atracurium and one minute after atracurium with rocuronium at one minute priming interval.
Rocuronium, a monoquaternary steroid analogue of vecuronium, is designed to provide a rapid onset of action. Experimentally, it has been shown that two non-depolarizing neuromuscular relaxants administered together can produce either a neuromuscular block of a size expected to be the sum of the individual doses (additive effect) or a larger neuromuscular block (synergistic effect). Experimental observations have suggested that during onset rocuronium acts synergistically with other nondepolarizing agents, but that at a steady state the combined action is additive. ⋯ Statistically, rocuronium alone, mixture of equipotent atracurium and rocuronium, and using rocuronium to prime atracurium all provided similar onset for satisfactory intubation.
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Acta Anaesthesiol. Sin. · Dec 2002
Case ReportsEndotracheal tube fire induced by electrocautery during tracheostomy--a case report.
Airway fire resulting from ignition of the endotracheal tube (ETT) caused by electrocautery during tracheostomy is a severe and possibly fatal event, and should be avoided. An 88-year-old male because of respiratory failure received elective tracheostomy for ventilatory support on which prolonged dependence was anticipated. Unfortunately, flame was noted to jet out from the trachea incision just after a single burst of electrocautery to coagulate a bleeder in the trachea tissue nearby the incision. ⋯ The patient stood this ordeal of fire well without related sequelae and was returned from the intensive care unit (ICU) to the general ward two weeks later. From this accident, we recommend that, besides emphasis on lowering of the inspired oxygen concentration (FiO2) and careful use of electrocautery during the tracheostomy procedure, special attention should be paid to the integrality of ETT cuff. It serves as a barrier to prevent oxygen leaking out from the trachea to be exposed to the sparks of electrocautery while the surgical procedure is under way, and thus it plays a significant role in the avoidance of airway fire induced by electrocautery.
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Acta Anaesthesiol. Sin. · Dec 2002
The analgesic effect of nalbuphine and its long-acting prodrug, nalbuphine pivalate, in rats.
Nalbuphine is an opioid-analgesic with agonist-antagonist properties. Recently, we have synthesized a nalbuphine prodrug, nalbuphine pivalate. The aim of the present study was to evaluate the analgesic effect and the analgesic duration of this prodrug. ⋯ Nalbuphine pivalate has a very long duration of analgesic action. This fascinating finding is worth further evaluation.