Abstract:
BACKGROUND:Topical anesthesia is a crucial step in awake endotracheal intubation for providing favorable intubation conditions. The standard of care technique for awake intubation at our institution, which consists of oropharyngeal tetracaine spray, can result in inadequate mucosal anesthesia. Therefore, we sought to compare the effectiveness of dyclonine hydrochloride mucilage to the standard of care tetracaine in achieving anesthesia of the upper airways for awake endotracheal intubation. METHODS:This is a randomized, assessor-blinded, prospective study. From Jun. 1st, 2019 to Aug. 1st, 2019, patients scheduled for either endoscopic submucosal dissection or peroral endoscopic myotomy were enrolled and randomly allocated into two groups after obtaining written informed consent: patients allocated to novel awake intubation care (Group N-AIC) received a single administration of oral dyclonine hydrochloride mucilage, whereas patients allocated to standard awake intubation care (Group S-AIC) received three oropharyngeal tetracaine sprays before transcricoid tetracaine injection before awake intubation. Mean arterial pressure (MAP), which was the primary outcome of this study, as well as heart rate (HR) were recorded throughout the procedure and compared between the two groups. Feeling of numbness, nausea, and intubation conditions after topical anesthesia were also assessed. RESULTS:Sixty patients were enrolled and completed the study. Baseline MAP and HR were similar between the two groups. However, hemodynamic responses to intubation and gastrointestinal endoscopy, especially MAP, were significantly less elevated in Group N-AIC. The degree of numbness of the oropharyngeal mucosa after topical anesthesia did not differ between the two groups, neither did the feeling of nausea during laryngoscopy. The amount of pharyngeal secretions before intubation was less in Group N-AIC. Total intubation time was significantly shorter in Group N-AIC when compared to Group S-AIC (18.4 ± 2.86 vs. 22.3 ± 6.47, P < 0.05). Extubation bucking was significantly less frequent in Group N-AIC (13.3% vs. 76.7%). Patients received in Group N-AIC had a lower rate of post-extubation sore throat compared to Group S-AIC (6.7% vs. 43.3%). No adverse side effects attributable to either tetracaine or dyclonine were observed in this study. CONCLUSIONS:In awake endotracheal intubation, novel care using oral dyclonine hydrochloride mucilage can provide more favorable mucosal anesthesia and better intubation conditions compared to standard of care practice using oropharyngeal tetracaine spray. TRIAL REGISTRATION:ChiCTR1900023151 . Date of registration: May 14th, 2019.
journal_name
BMC Anesthesioljournal_title
BMC anesthesiologyauthors
Han C,Li P,Guo Z,Guo Y,Sun L,Chen G,Qiu X,Mi W,Zhang C,Berra Ldoi
10.1186/s12871-020-01210-8subject
Has Abstractpub_date
2020-12-14 00:00:00pages
301issue
1issn
1471-2253pii
10.1186/s12871-020-01210-8journal_volume
20pub_type
杂志文章abstract:BACKGROUND:Low-flow sevoflurane anesthesia has been shown to influence renal function in rats, but not in adult humans. Presently, no study has assessed the effects of sevoflurane on renal function in low birth weight infants. Our aim was to study the renal function in low birth weight infants undergoing surgery with l...
journal_title:BMC anesthesiology
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doi:10.1186/1471-2253-15-6
更新日期:2015-01-21 00:00:00
abstract:BACKGROUND:Spinal block is a common procedure for lower limbs surgery. Fentanyl, a synthetic opioid and dexmedetomidine, a selective α2 agonist have been used as adjuvants in spinal anesthesia to prolong intraoperative and postoperative analgesia. The aim of current study is to compare the efficacy of dexmedetomidine a...
journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12871-018-0531-7
更新日期:2018-06-06 00:00:00
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abstract:BACKGROUND:Enhanced recovery after surgery programs (ERAS) using thoracic epidural anesthesia and perioperative patient conditioning with omega-3 fatty acids (n3FA), glucose control (GC) and on-demand fluid therapy, respectively, showed beneficial effects. In the MOFA- study these components were used together in patie...
journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12871-019-0823-6
更新日期:2019-08-17 00:00:00
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pub_type: 杂志文章,随机对照试验
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abstract::BACKGROUND: We report a case of a patient with apparent resistance to local anesthetics. While similar cases of failure of regional anesthetics are often attributed to technical failure, the overall clinical presentation and history of this patient suggests a true resistance to local anesthetics. CASE PRESENTATION: Th...
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更新日期:2004-01-16 00:00:00
abstract:BACKGROUND:Increase of pulmonary vascular resistance (PVR) is an efficient method of modulating pulmonary and systemic blood flows (Qp/Qs) for patients with left-to-right (L-R) shunt, and is also closely associated with insufficient oxygen exchange for pulmonary hypoperfusion. So that it might be a preferred regime of ...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-019-0852-1
更新日期:2019-10-09 00:00:00
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journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12871-016-0209-y
更新日期:2016-07-30 00:00:00
abstract:BACKGROUND:Carbohydrate-rich liquid drinks (CRLDs) have been recommended to attenuate insulin resistance by shortening the preoperative fasting interval. The aim of our study the effect of preoperative oral administration of CRLDs on the well-being and clinical status of patients. METHODS:A randomized, double blind, p...
journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
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更新日期:2014-10-17 00:00:00
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journal_title:BMC anesthesiology
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pub_type: 杂志文章
doi:10.1186/1471-2253-9-1
更新日期:2009-02-03 00:00:00
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doi:10.1186/s12871-018-0616-3
更新日期:2018-10-20 00:00:00
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pub_type: 临床试验,杂志文章
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pub_type: 杂志文章
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更新日期:2016-08-03 00:00:00
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journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
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更新日期:2019-10-10 00:00:00
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pub_type: 杂志文章
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更新日期:2012-09-18 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2018-11-06 00:00:00
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journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
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更新日期:2019-12-19 00:00:00
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更新日期:2019-10-31 00:00:00
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更新日期:2019-07-04 00:00:00
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journal_title:BMC anesthesiology
pub_type: 杂志文章
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更新日期:2018-04-05 00:00:00
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journal_title:BMC anesthesiology
pub_type: 杂志文章
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journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-020-01087-7
更新日期:2020-07-17 00:00:00