Articles: intubation.
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A case of respiratory obstruction caused by an armoured silicone rubber tracheal tube is reported and the literature reviewed. New silicone tubes have shown defects in design and manufacture formerly associated with those made of latex rubber. The authors found disposable polyvinyl chloride tubes to be more reliable.
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Twenty patients, ASA grades 1 and 2, aged 18-65 years were admitted to an open study to investigate the ease of tracheal intubation after induction of anaesthesia with propofol without the use of muscle relaxants after the chance observation that propofol 2.5 mg/kg allowed easy laryngoscopy and tracheal intubation. Satisfactory intubation conditions were achieved in 19 patients.
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Randomized Controlled Trial Clinical Trial
[Suppression of blood pressure increases during intubation: lidocaine or fentanyl?].
The hypertensive response to anesthetic induction with endotracheal intubation may be harmful in patients with cardiovascular disease, increased intracranial pressure, or anomalies of the cerebral vessels. Recommendations for attenuating the reflex hypertension and tachycardia elicited by upper airway irritation are therefore manifold. Besides minimizing the cardiovascular response, anesthesia induction for patients at risk must also satisfy the following requirements: it must be applicable regardless of patient collaboration, prevent impairment of cerebral blood flow, and avoid arousal of the patient; it should neither be time-consuming nor affect the duration or modality of the ensuing anesthesia. ⋯ The two equally simple induction procedures were compared to anesthesia induction with thiopental alone. In both patient groups no significant effect of lidocaine on the pressure response could be observed. Fentanyl lowered the pressure response slightly though significantly in brain-tumor patients only (p less than 0.05), but showed a significant pressure-lowering action persisting over the whole observation period in all patients.(ABSTRACT TRUNCATED AT 250 WORDS)