Articles: intubation.
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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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Anasth Intensivther Notfallmed · Oct 1988
Biography Historical Article[Joseph O'Dwyer--a pioneer in endotracheal intubation and pressure respiration].
The oro- and nasotracheal intubation has been developed into one of the most important techniques in anaesthesiology. Originally, intubations were carried out for overcoming acute diphteric airway obstruction in children. As late as the end of the 19 century, the only life saving chance was to perform tracheotomy. ⋯ Working together with the surgeon George Fell, O'Dwyer designed an apparatus, for artificial respiration. As Fell-O'Dwyer Apparatus it was widely used in cases of asphyxia, - even in those caused by overdosage of anaesthetics. Further developments of the apparatus permitted positive pressure ventilation and the combination with a funnel for narcotics increased the repertory of anaesthesiological possibilities.
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Am. J. Obstet. Gynecol. · Sep 1988
Randomized Controlled Trial Clinical TrialThe use of labetalol for attenuation of the hypertensive response to endotracheal intubation in preeclampsia.
Twenty-five women with preeclampsia who were scheduled to undergo cesarean section under general anesthesia were randomly assigned to either a labetalol pretreatment group (n = 15) or a control group (n = 10) who did not receive any antihypertensive therapy before the induction of anesthesia. Patients in the labetalol group received 20 mg of labetalol intravenously followed by 10 mg increments up to a total dose of 1 mg/kg, which resulted in moderate reductions in the maternal mean arterial pressure and heart rate with attenuation of the hypertensive and tachycardiac responses to laryngoscopy and endotracheal intubation. ⋯ The neonatal Apgar scores and umbilical arterial and venous pH and blood gas values were similar in the two groups. Side effects such as hypotension, bradycardia, and hypoglycemia were not seen in the neonates in the labetalol treatment group.
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Stenosis of the larynx and trachea is an unfortunate sequel to many thermal injuries. Numerous surgical techniques have been developed for correction of such problems, many involving use of a tracheal T-tube. We report a serious complication attributed to the use of such a tube. Factors contributing to this complication are analyzed and methods for avoiding similar near-catastrophes discussed.