Articles: intubation.
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Limited data are available on the efficacy of a common endotracheal suctioning intervention to prevent postsuctioning decreases in arterial oxygenation (PaO2). This study evaluated the effect on Pao2 of five hyperinflation (tidal volume 1.5 times normal) and hyperoxygenation breaths, administered before and after each of two consecutive endotracheal suctioning passes, with use of a manual resuscitation bag (PMR-2 model). The convenience sample consisted of 32 patients with endotracheal tubes who were observed within 24 hours of coronary artery bypass surgery. ⋯ In addition, a clinical measure of alveolar-capillary gas exchange (PaO2/PAO2 ratio) was found to be a significant predictor of PaO2 after suctioning, accounting for 38% of the variance. The data from this study support the efficacy of administering five hyperinflation and hyperoxygenation breaths, with use of a manual resuscitation bag, before and after endotracheal suctioning in stable patients after coronary artery bypass surgery. Further study is necessary to determine the efficacy of this suctioning intervention in patients with other respiratory problems.
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The influence of tube size, cuff inflation, and pharyngeal packing on development of sore throat after nasotracheal intubation was studied. Pharyngeal packing was found to be the most significant factor, followed by tube size and inflation of the cuff.
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J Cardiothorac Anesth · Oct 1988
Randomized Controlled TrialInfluence of beta-blockers on vecuronium/sufentanil or pancuronium/sufentanil combinations for rapid induction and intubation of cardiac surgical patients.
Use of pancuronium or vecuronium with the priming principle was evaluated in regards to hemodynamic changes and adequacy of relaxation for a rapid induction-endotracheal intubation sequence with sufentanil in 24 ASA Class III-IV patients undergoing cardiac surgery. Twelve patients taking beta-blockers (groups B-P and B-V) were compared with 12 patients not receiving beta-blockers (groups NB-P and NB-V). Patients randomly received vecuronium or pancuronium (15 microg/kg), followed in 4 minutes by sufentanil 5 microg/kg and another 85 microg/kg of the appropriate relaxant through a central vein. ⋯ Chronic beta-blocker therapy was able to attenuate the tachycardia from pancuronium and was not associated with bradycardia when used with vecuronium. In patients with cardiac disease not on beta-blockers, pancuronium was associated with tachycardia. Therefore, vecuronium appears to be more suitable for these patients.
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Middle East J Anaesthesiol · Oct 1988
A simple method for preventing obstruction of the endotracheal tube during palatal surgery.
In this paper we describe a simple method for avoiding the obstruction of the Mallinckrodt R. A. E. (Ring, Adair and Elwin) preformed endotracheal tube which we use during cleft palate surgery, palatal lengthening and pharyngoplasty in patients who have well developed lower incisor teeth.