We have studied intubating conditions in 64 healthy children, aged 3-10 yr, undergoing adenotonsillectomy, in a double-blind, randomized study. Intubation was performed 150 s after induction using either 8% sevoflurane in nitrous oxide and oxygen or propofol 3-4 mg kg-1 with succinylcholine 2 mg kg-1. An anaesthetist blinded to the technique performed intubation and scored intubating conditions using Krieg and Copenhagen Consensus Conference (CCC) scores. The trachea was intubated successfully at the first attempt in all patients under clinically acceptable conditions, although scores were significantly better with propofol and succinylcholine. The sevoflurane technique cost 3.62 +/- 0.55 Pounds to completion of tracheal intubation, significantly more (P < 0.001) than the cost of propofol-succinylcholine and isoflurane (2.04 +/- 0.54 Pounds) when based on actual amount of drug used. This cost increased to 4.38 +/- 0.05 Pounds when based on whole ampoules, which is significantly more than the cost of sevoflurane (P < 0.001).
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http://dx.doi.org/10.1093/bja/83.3.410 | DOI Listing |
Ann Emerg Med
January 2025
Department of Emergency Medicine, Kaiser Permanente San Diego Medical Center, San Diego, CA.
Study Objective: This study analyzes emergency medicine airway management trends and outcomes among community emergency departments.
Methods: A multicenter, retrospective chart review was conducted on 11,475 intubations from 15 different community emergency departments between January 1, 2015, and December 31, 2022. Data collected included patient's age, sex, rapid sequence intubation medications, use of cricoid pressure, method of intubation, number of attempts, admission diagnosis, and all-cause mortality rates.
J ECT
December 2024
Department of Psychiatry, Nowon Eulji Medical Center, Uijeongbu Eulji Medical Center, Eulji University, Seoul, Korea.
Electroconvulsive therapy (ECT) is a therapeutic intervention that induces generalized seizures under general anesthesia. This case report compares the efficacy of dexmedetomidine (DEX) and nitrous oxide (N2O) to that of propofol during ECT procedures. A 33-year-old woman with a 15-year history of schizophrenia and recurrent psychotic episodes underwent ECT.
View Article and Find Full Text PDFJ Perioper Pract
November 2024
Department of Immunology & Molecular Medicine, Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Srinagar, India.
Patients with allergy to multiple drugs who have experienced anaphylaxis multiple times present a significant challenge in perioperative management. This report presents a 27-year-old female patient diagnosed with cholelithiasis scheduled for cholecystectomy. The patient has a history of adverse reaction to multiple drugs, including Amoxicillin/Clavulanic acid, Cefpodoxime, Levofloxacin and two additional drugs (one analgesic and the other multivitamin) each resulting in symptoms suggestive of anaphylaxis on separate occasions.
View Article and Find Full Text PDFCureus
September 2024
Anesthesiology, Augusta University Medical College of Georgia, Augusta, USA.
This case report describes a 27-year-old healthy female patient undergoing bilateral salpingectomy for sterilization who experienced sudden bradycardia following induction with propofol (2, 6 diisopropylphenol) and succinylcholine. Despite lacking prior cardiac issues, the patient's heart rate dropped precipitously, necessitating intervention with glycopyrrolate. This case report highlights the importance of premedication with anticholinergics to prevent bradycardia in similar scenarios, underscoring the need for vigilance and preparedness to manage adverse cardiac events during anesthesia induction, even in patients without evident risk factors.
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