Articles: intubation.
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Randomized Controlled Trial Clinical Trial
Cardiovascular response to intubation. A comparative study of thiopentone and midazolam.
The cardiovascular response evoked by tracheal intubation was observed in 20 patients undergoing elective abdominal surgery in whom anaesthesia was induced with either midazolam 0.3 mg/kg or thiopentone 4.5 mg/kg followed by pancuronium 0.1 mg/kg. In the thiopentone group, intubation caused a mean rise in systolic arterial pressure from 141 to 193 mmHg (p less than 0.0005) and in the heart rate-systolic pressure product from 11101 to 21763 (p less than 0.05); 5 minutes later the mean values were still 173 mmHg and 19030 respectively. In the midazolam group systolic arterial pressure and the rate pressure product increased from 138 to 151 mmHg and 10960 to 14267 respectively in response to intubation. These values were significantly lower than the thiopentone group (p less than 0.005 in each case) and were relatively transient and returned to control values within 5 minutes.
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Laryngeal injury secondary to prolonged intubation has been extensively discussed in the literature. Little however, has been reported regarding laryngeal injury from short-term intubation. ⋯ Our study indicates a small but significant number of patients will exhibit an injury after elective short-term intubation. This is most likely a result of intubation technique and recovery is generally prompt with conservative observation.
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Ann Oto Rhinol Laryn · Jul 1983
Clinical TrialVenturi jet ventilation through the metal endotracheal tube: a nonflammable system.
In an effort to design a fireproof and reliable method of ventilation during CO2 laser laryngoscopies, a new Venturi jet endotracheal tube coupler has been designed. This allows microdirect laryngoscopy. Its design features are described. ⋯ No complications or adverse effects were noted. The Venturi jet endotracheal tube coupler allows for jet ventilation through a metal endotracheal tube with reliable ventilation. This is an alternate, reliable, and fire-safe method during laser use.
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Ann Oto Rhinol Laryn · Jul 1983
Case ReportsDifficult laryngoscopy/intubation: the child with mandibular hypoplasia.
The child with mandibular hypoplasia (Treacher Collins syndrome, Pierre Robin sequence, hemifacial microsomia, etc) presents the otolaryngologist and anesthesiologist with considerable problems when direct laryngoscopy and/or endotracheal intubation is attempted. In addition to the small mandible, several other features of these patients contribute to the difficult laryngoscopy: macroglossia, glossoptosis, trismus related to temporomandibular joint abnormalities, and prominent maxilla or maxillary incisors. Most of the techniques that have been described for laryngoscopy/intubation in problem cases are difficult or impossible to use in infants and young children with mandibular hypoplasia. We present a modification of the standard direct laryngoscopic procedure, utilizing the 9-cm anterior commissure laryngoscope and an optical stylet in the task of exposing and intubating the larynx of a child with mandibular hypoplasia.