Articles: intubation.
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Clinical Trial Controlled Clinical Trial
Esmolol for control of increases in heart rate and blood pressure during tracheal intubation after thiopentone and succinylcholine.
Esmolol, an ultra-short-acting cardioselective beta-adrenergic blocker, was investigated in a double-blind prospective protocol for its ability to control haemodynamic responses associated with tracheal intubation after thiopentone and succinylcholine. Thirty ASA physical status I patients received a 12-minute infusion of esmolol (500 micrograms X kg-1 X min-1 for four minutes, then 300 micrograms X kg-1 X min-1 for 8 minutes) or saline. Five minutes after the start of the drug/placebo infusion, anaesthesia was induced with 4 mg X kg-1 thiopentone followed by succinylcholine for tracheal intubation. ⋯ Increases in HR, SAP and RPP after intubation were approximately 50 per cent less in patients given esmolol compared to patients given placebo. There were highly significant differences in HR (p less than 0.0001), and RPP (p less than 0.0005) and significant differences in SAP (p less than 0.05) when the maximal esmolol post-intubation response was compared to the maximal placebo response. Infusion of esmolol in the dose utilized in this study significantly attenuated but did not completely eliminate cardiovascular responses to intubation.
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Historical Article
[The history of endotracheal anesthesia, with special regard to the development of the endotracheal tube].
Endotracheal anaesthesia is today the form of general anaesthesia most often applied. It represents more than 80% of the total in hospitals with different surgical specialties. ⋯ At the beginning of our century all preconditions had been given for a widespread and safe performance of endotracheal anaesthesia. The most important stages in the development of this form of anaesthesia are as follows: 1869: First endotracheal anaesthesia in human by use of a tracheotomy cannula by Friedrich Trendelenburg. 1880: First orotracheal intubation anaesthesia by William Macewen. 1894: Positive pressure ventilation following morphine intoxication by George Fell and Joseph O'Dwyer. 1895: Description of direct laryngoscopy by Alfred Kirstein. 1901: Franz Kuhn "Die perorale Intubation".