Articles: intubation.
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Randomized Controlled Trial Clinical Trial
The effect of an intermediate dose of labetalol on heart rate and blood pressure responses to laryngoscopy and intubation.
To evaluate the efficacy of an intermediate dose of labetalol (0.4 mg/kg) for attenuation of heart rate (HR) and blood pressure (BP) responses to laryngoscopy and intubation. ⋯ An intermediate dose of labetalol blunted the HR response to laryngoscopy and intubation during rapid-sequence induction in healthy patients but had a minimal effect on BP.
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Acta Anaesthesiol Scand · Jan 1992
Randomized Controlled Trial Clinical TrialAttenuating the hypertensive response to laryngoscopy and endotracheal intubation using awake fibreoptic intubation.
Blood pressure and pulse rate measurements were recorded in 35 patients undergoing endotracheal intubation during general anaesthesia (Group A), and 35 patients who had an awake fibreoptic intubation under local anaesthesia (Group B). The mean arterial pressure in Group A rose by a mean of 35 mmHg immediately after intubation, compared with a mean fall of 9 mmHg in Group B. The mean pulse rate in Group A rose by 24 beats per minute (b.p.m.) immediately after intubation, compared with a rise of 3 b.p.m. in Group B. ⋯ There was a statistically higher mean score in relation to nose discomfort in Group B (P less than 0.002). Awake fibreoptic intubation successfully reduces the pressor response to endotracheal intubation in normotensive adults. It is suitable for use in those patients who are at risk from the pressor response.
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Randomized Controlled Trial Comparative Study Clinical Trial
Effect of verapamil on the cardiovascular responses to tracheal intubation.
We have studied the efficacy of verapamil in attenuating the cardiovascular responses to tracheal intubation in three groups of ASA grade I patients given verapamil 0.05 mg kg-1 or 0.1 mg kg-1 or saline 45 s before the start of laryngoscopy. Anaesthesia was induced with thiopentone 5 mg kg-1 i.v. and tracheal intubation was facilitated with vecuronium 0.2 mg kg-1. ⋯ In patients who received saline, there was a significant increase in mean arterial pressure and rate-pressure product associated with tracheal intubation. The increases were significantly less in verapamil-treated patients compared with those in the control group, although verapamil failed to prevent tachycardia caused by laryngoscopy and intubation.
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Intensive care medicine · Jan 1992
Randomized Controlled Trial Clinical TrialPrevention of nosocomial pneumonia in intubated patients: respective role of mechanical subglottic secretions drainage and stress ulcer prophylaxis.
Chronic microaspiration through a tracheal cuff is the main culprit in the penetration and colonization of the lower respiratory tract. A total of 145 patients intubated for more than 3 days were randomly assigned to a double nosocomial pneumonia (NP) prevention: 1--Prevention of aspiration by hourly subglottic secretion drainage (SSD) with a specific endotracheal tube (HI-LO Evac tube, Mallinckrodt); 2--Prevention of gastric colonization using either sucralfate or antacids. ⋯ Subglottic secretion drainage treatment was associated with: a) a twice lower incidence of NP (no-SSD: 29.1%, SSD: 13%); b) a prolonged time of onset of NP (no-SSD: 8.3 +/- 5 days, SSD: 16.2 +/- 11 days); c) a decrease in the colonization rate from admission to end-point day in tracheal aspirates (no-SSD: +21.3%, SSD: +6.6%) and in subglottic secretions (no-SSD: +33.4%, SSD: +2.1%). Sucralfate was not associated with a significantly lower incidence of NP (antacids: 23.6%, sucralfate: 17.8%), but with a lower increase in the colonization rate in subglottic and gastric aspirates, from admission to end-point day.