Articles: intubation.
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Four different techniques of retrograde tracheal intubation were studied in 77 cadavers (patients who had died less than 4 h before). None had any laryngeal disease or a previous intubation. Following techniques were evaluated: cricothyroid membrane puncture; infracricoid puncture; catheter guide inserted through the endotracheal tube; catheter guide only inserted through the distal lateral eye (Murphy eye) of the endotracheal tube. ⋯ All 20 attempts were successful when infracricoid puncture was used and the guide passed through the distal lateral eye of the endotracheal tube. The different techniques and equipment needed are discussed in the light of the available literature. Retrograde tracheal intubation seems to be an easy and useful technique, which all anaesthetists should know, in case of difficult intubation.
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Randomized Controlled Trial Comparative Study Clinical Trial
[Frequency and severity of throat complaints following general anesthesia with the insertion of various endotracheal tubes].
Laryngeal and pharyngeal complaints following general anaesthesia are well-known problems. The frequency, extent, and intensity reported in several studies are at variance. Such transient postoperative problems should not be considered equivalent to traumatic airway injuries caused by endotracheal intubation. ⋯ The patients of groups A-D underwent oral intubation using lidocaine gel 2%; adequate cuff inflation was determined just after intubation. The patients were questioned every 24 h for 2 days postoperatively using an analogue scale and "open" and "closed" questions. The single groups were comparable in age, sex, height, weight, number of smokers, duration of operation (only groups A-D), and preoperative diseases of the upper airways.(ABSTRACT TRUNCATED AT 250 WORDS)
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A recommended approach to postextubation infant subglottic stenosis secondary to subglottic edema employs the recently described anterior cricoid split (ACS) procedure. This technique provides an expanded subglottic airway with minimal paratracheal dissection and does not require concomitant tracheotomy. We applied this procedure in managing extubation difficulty in pediatric as well as neonatal patients. ⋯ Relief of stridor and avoidance of tracheotomy were accomplished in nine of ten patients. One patient in whom mechanical ventilation was reinstituted developed an interesting complication. In properly selected infants with subglottic airway compromise, the ACS appears to be an effective adjunct in facilitating extubation.