An appropriate tracheal intubation requires the patient who goes under this procedure to allow the manipulation of cervical, maxillofacial and laryngeal pharynx in order to be able to visualize the glotis.1 The use of neuromuscular relaxants is quite helpful when trying to attain this objective.2 Its use has become so widely applied that it is basically now the only technique known and taught t...

The pharmacological effects of suxamethonium and pancuronium on the cardiovascular system may vary and therefore alter the haemodynamic response to intubation. The arterial blood pressure, the heart rate and the rate pressure product were measured as parameters of haemodynamic change in forty adult ASA. I and II patients undergoing laryngoscopy and endotracheal intubation in a randomised contro...

AIM To determine the optimal composition o f the pre-hospital medical response team (MERT) and the value of pre-hospital critical care interventions in a military setting, and specifically to determine both the benefit of including a doctor in the pre-hospital response team and the relevance of the time and distance to definitive care. METHOD A comprehensive review of the literature incorpora...

This article presents a case in which an air medical flight crew encountered a potentially difficult airway when a trauma patient deteriorated in-flight. The crew elected to sedate and paralyze the patient and place a laryngeal mask airway without a prior attempt at direct laryngoscopy and endotracheal intubation. The term Rapid Sequence Airway (RSA) is coined for this novel approach. This arti...

The effect of tubocurarine and gallamine pretreatments on suxamethonium relaxation was measured in 81 patients. The blocking effect of a constant infusion of suxamethonium (0.58 mg/sec) on the recorded thumb adduction in response to supramaximal ulnar nerve stimulation was reproducible in 18 control subjects: infusion time for 50% block was 37.7 (+/- SEM 1.02) sec. Tubocurarine 3 mg and 6 mg in...

Herein we present a report of four cases of severe type II respiratory failure that had contraindications both to conventional non-invasive ventilation and to endotracheal intubation. In all four cases, we successfully used a high-flow nasal oxygen device as a rescue device, with very reassuring outcomes.

In a controlled, randomized study, we evaluated duration of neuromuscular block in 80 patients undergoing routine abdominal surgery. Forty patients were aged 18-50 yr (control group) and 40 patients were more than 65 yr (elderly group). All patients had normal plasma creatinine concentrations. After induction of anaesthesia, patients were allocated randomly to receive either atracurium 0.5 mg k...

The addition of tracheal tubes to the respiratory system contributes an extra mechanical burden in terms of pressure necessary to overcome its own resistance. On the basis of experimental data from the literature and on a previously reported mathematical model of the inspirogram, we wished to study predictions of pressures, volume, flow and work of breathing during the use of tracheal tubes. Th...

The purpose of this double-blind randomized work was to study the effect of alfentanil and esmolol and their half-dose combination on the increases of heart rate and arterial pressure and on the prolongation of the QTc interval of the ECG occurring during anaesthetic induction. Sixty ASA class I-II patient with mean age ranging from 26 to 32 yr among the groups. Patients were allocated to one o...

Difficult intubation has been classified into four grades, according to the view obtainable at laryngoscopy. Frequency analysis suggests that, in obstetrics, the main cause of trouble is grade 3, in which the epiglottis can be seen, but not the cords. This group is fairly rare so that a proportion of anaesthetists will not meet the problem in their first few years and may thus be unprepared for...