Articles: intubation.
-
Randomized Controlled Trial Clinical Trial
Alfentanil obtunds the cardiovascular and sympathoadrenal responses to suxamethonium-facilitated laryngoscopy and intubation.
Alfentanil 75 micrograms kg-1 or saline (control group) was given 1 min before induction of anaesthesia in 20 healthy patients premedicated with diazepam 0.14 mg kg-1 and pethidine 1 mg kg-1. Anaesthesia was induced with a sleep dose of thiopentone preceded by glycopyrrolate. Suxamethonium 1 mg kg-1 was used to facilitate laryngoscopy (which lasted 10 s) and tracheal intubation. ⋯ All these changes were attenuated in patients pretreated with alfentanil (n = 10), but four patients had chest wall rigidity. Changes in the QT interval correlated directly with the changes in plasma noradrenaline concentration (r = 0.67). Plasma adrenaline concentrations decreased during induction of anaesthesia in both groups.
-
Suctioning of secretions from the left endobronchial tree is frequently necessary but often difficult in intubated patients. We examined the effectiveness of a catheter designed expressly for this purpose. Special curved tip (Bronchitrac-L) suction catheters were fitted with thin, radiopaque tubing to facilitate x-ray visualization. ⋯ There were no catheter-induced complications in this study. The curved tip catheter is an effective means of suctioning the left bronchial tree in patients with tracheostomy tubes. Its reliability in patients with oral endotracheal tubes is reduced but more effective than current methods.
-
The Christiansen-Douglas-Haldane effect describes the reduced CO2 binding capacity of oxygenated as compared to deoxygenated hemoglobin on the basis of its increased acidity. This study describes the development of the above effect during the first 2 min of hyperoxic intubation apnea. METHODS. ⋯ During early hyperoxic apnea, venoarterial pH and pCO2 reversal can be observed due to the Christiansen-Douglas-Haldane effect. pH reversal starts earlier than pCO2 reversal. Reversal time is dependent on arterial-mixed-venous pCO2 difference (avDpCO2) before apnea, arterial-mixed-venous O2 saturation difference (avDsO2) and cardiac output. The amount of reversal is dependent on avDsO2, i.e. the pH difference of arterial and m
-
A patient (ASA class I) scheduled for an elective gynecological operation, could not be intubated by conventional means, as no part of the glottis could be seen on direct laryngoscopy. Endotracheal intubation was successful on the first attempt using a lighted intubation stylet (Tube-Stat, Concept Corporation, Clearwater, Florida, USA). Transillumination of the neck tissues acted as a guide for correct placement of the endotracheal tube. ⋯ We employed the Tube-Stat light-wand in a series of routine surgical cases with encouraging results. Our case report documents our first patient intubated with the light-wand after failure of conventional larnygoscopy. The first lighted stylet was described some 30 years ago, and the method of transillumination as an aid in difficult intubation developed over the following years.(ABSTRACT TRUNCATED AT 250 WORDS)