Articles: intubation.
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To determine the optimal interval between the administration of the priming dose and the intubating dose, atracurium was given to 44 patients either in a single dose of 0.5 mg X kg-1 or in an initial dose of 0.06 mg X kg-1 followed two, three or five minutes later with 0.44 mg X kg-1. When atracurium was given as a single bolus of 0.5 mg X kg-1 the time to 100 per cent twitch suppression (onset time) was 90.9 +/- 36 (mean +/- SD) seconds. When the priming interval was two minutes, the onset time of the intubating dose was 76.6 +/- 42.2 seconds (p = NS). ⋯ Waiting for five minutes after the administration of the priming dose did not improve the intubating conditions. It is concluded that three minutes appears to be the optimal time interval for the administration of atracurium in divided doses. When a priming dose of atracurium is given three minutes before the intubating dose, it can provide an alternative to succinylcholine for rapid endotracheal intubation.
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Ann Oto Rhinol Laryn · Mar 1986
Current modifications of the salivary bypass tube and tracheal T-tube.
Recent changes in the salivary bypass tube and the silicone tracheal T-tube (Montgomery Safe-T-Tube) are reported. The esophageal tube, a precursor of the salivary bypass tube, was introduced as a device to bridge the gap between the pharyngostome and esophagostome following laryngoesophagectomy and the first stage reconstruction of the cervical esophagus. It has continued to serve this function as well as others and has been modified a number of times. ⋯ Although this complication has been rare in 21 years of usage, it can be fatal. Ridges and grooves have been constructed on the extraluminal portion of the T-tube so that a ring can be attached to prevent posterior displacement. Drainage grooves have also been added along the long axis to aid in the drainage of secretions and to differentiate the T-tube from the silicone tracheal cannula on which there is only one longitudinal groove.