Articles: intubation.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Heart rate and arterial pressure changes during fibreoptic tracheal intubation under general anaesthesia.
The cardiovascular responses to fibreoptic orotracheal intubation under general anaesthesia were compared with those in a control group in whom tracheal intubation was effected with a Macintosh laryngoscope. The patients received a standard anaesthetic and were allocated randomly to either group immediately before intubation. Fibreoptic intubation took significantly longer to perform. ⋯ The tachycardia in the fibreoptic group was significantly greater than that in the control group during the second minute after intubation, and the increase in systolic pressure was sustained for a longer period in the fibreoptic group. The maximum increases in systolic and diastolic pressures above pre-intubation values were significantly greater in the fibreoptic group. The cardiovascular responses associated with fibreoptic intubation under general anaesthesia appear to be more severe than those which follow intubation effected with a Macintosh laryngoscope.
-
Randomized Controlled Trial Clinical Trial
Learning fibreoptic intubation: use of simulators v. traditional teaching.
This study compared a graduated training programme with that of a traditional teaching method to facilitate the learning of the technique of fibreoptic nasotracheal intubation. Thirty-two anaesthesia trainees were randomly assigned to two groups. ⋯ Nasotracheal intubation was accomplished significantly more often by the trainees in the graduated programme (86 out of 96 (89.6%) v. 64 out of 96 (66.5%) (P less than 0.01). The results demonstrate that trainees who undergo a graduated training programme using simulators are initially more successful at awake fibreoptic nasotracheal intubation than those who have learned in the traditional manner, and that the conditions of the investigation were acceptable to the trainees and patients.
-
The amount of larynx seen at intubation was assessed in 633 adult patients undergoing routine surgery. Various measurements of the head and neck were made in an attempt to discover which features were associated with difficulty with laryngoscopy (defined as the inability to see even the arytenoids). ⋯ A simple predictive rule was developed and tested on a prospective set of 778 patients, in 1.5% of whom laryngoscopy was found to be difficult. Depending on the threshold chosen, the rule allowed the detection of, for example, 75% of the "difficult" laryngoscopies at a cost of falsely identifying 12% of the "not difficult" patients.
-
Anaesth Intensive Care · Aug 1988
A method of detecting oesophageal intubation or confirming tracheal intubation.
A method of testing the location of an endotracheal tube, in the trachea or oesophagus, was subjected to trial. The test involves drawing back on the plunger of a 50 ml syringe connected with airtight fittings to the endotracheal tube connector, with the endotracheal tube cuff deflated. ⋯ The method was 100% accurate in fifty intubations, 25 tracheal and 25 oesophageal. The technique has been in routine use by one author for several years without giving an incorrect answer and enthusiastic use by other authors is producing the same result.