Articles: intubation.
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Anesthesia and analgesia · May 1990
Randomized Controlled Trial Comparative Study Clinical TrialPostoperative sore throat: effect of oropharyngeal airway in orotracheally intubated patients.
The incidence of postoperative sore throat was evaluated prospectively in 203 orotracheally intubated patients undergoing general anesthesia for surgical procedures. Patients were randomly assigned to have either a plastic oropharyngeal airway or a gauze bite-block in place during the operation and were evaluated for the occurrence of postoperative sore throat by questionnaire the day after surgery. The incidence of postoperative sore throat was 35.2% in the oropharyngeal airway group and 42.5% in the gauze bite-block group, not a statistically significant difference (P greater than 0.05). ⋯ The data from this study indicate that the intraoperative use of hard plastic oropharyngeal airways, compared with the use of soft gauze bite-blocks, does not increase the incidence of postoperative sore throat. These data also suggest that pharyngeal trauma may contribute significantly to the development of postoperative sore throat. We suggest that aggressive oropharyngeal suctioning may contribute to this pharyngeal trauma.
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Anaesth Intensive Care · May 1990
Steroids in croup: do they increase the incidence of successful extubation?
Between January 1983 and July 1988, 2623 patients with croup were admitted to the Royal Children's Hospital, Melbourne. A total of 416 patients (16%) were admitted to the Intensive Care Unit and 176 of these patients required intubation. Of these patients 117 patients were successfully extubated at the first attempt and 59 needed reintubation. ⋯ Only one patient who had received steroids failed extubation. Of those who did not receive steroids 59% required reintubation. In patients with croup who fail the first extubation the results of this study suggest that steroids significantly increase the success of subsequent extubations.
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Tracheal intubation is a skill that should be considered supplementary to other aspects of airway management which are of vital importance in resuscitation. Doctors involved in resuscitation should develop and retain such skills, and be aware of potential dangers.