scholarly journals GAMBARAN LAMA KERJA ROKURONIUM PADA PASIEN YANG MENJALANI ANESTESIA UMUM DI INSTALASI BEDAH SENTRAL RSUP. PROF. DR. R. D. KANDOU MANADO

e-CliniC ◽  
2014 ◽  
Vol 2 (2) ◽  
Author(s):  
Ni Wayan Ira L. Dewi ◽  
Harold Tambajong ◽  
Diana Ch. Lalenoh
Keyword(s):  
Endotracheal Tube ◽  
Endotracheal Intubation ◽  
Muscle Relaxant ◽  
Muscle Relaxation ◽  
Muscle Paralysis ◽  
Tube Insertion ◽  
Common Procedure ◽  
Duration Of Action ◽  
Muscle Relaxant Drug ◽  
Descriptive Method

Abstrak: Intubasi endotrakeal merupakan salah satu tindakan yang sering dilakukan, khususnya pada pasien yang menjalani operasi dengan anestesia umum. Intubasi endotrakeal dilakukan dengan memasukan pipa endotrakeal ke dalam trakea. Keberhasilan pemasangan pipa endotrakeal tergantung beberapa hal seperti relaksasi otot, kedalaman anestesia, dan keterampilan operator. Penggunaan obat pelumpuh otot khusunya pelumpuh otot non-depolarisasi lebih sering digunakan karena menghasilkan kondisi intubasi yang cepat dengan efek samping yang lebih minimal. Rokuronium merupakan salah satu obat pelumpuh otot yang banyak digunakan di Indonesia. Lama kerja obat perlu diketahui dengan pasti agar relaksasi otot cukup optimal untuk dilakukannya pembedahan dan derajat kelumpuhan otot dapat dipertahankan dengan melakukan penambahan dosis obat. Penelitian ini bertujuan untuk mengetahui lama kerja dari obat pelumpuh otot rokuronium agar dapat menentukan waktu penambahan dosis obat yang tepat. Penelitian ini menggunakan metode deskriptif dengan sampel sebanyak 10 orang. Hasil penelitian didapatkan lama kerja rokuronium yaitu 34,90 menit. Lama kerja pada laki-laki lebih lama daripada perempuan. Kelompok berat badan 66-75 kg dan kelompok umur 41-47 tahun memiliki lama kerja yang paling panjang. Kata kunci: Lama kerja, rokuronium.     Abstract: Endotracheal intubation is one of the most common procedure, especially on a patient undergoing surgery with general anesthesia. Endotracheal intubation is done by inserting endotracheal tube into trachea. The success of endotracheal tube insertion depends on several things such as muscle relaxation, the depth of anesthesia, and the operator’s skill. The use of muscle relaxant drugs especially non-depolarization muscle relaxant is more frequently because it produces rapid intubation conditions with minimal side effect. Rocuronium is a muscle relaxant drug that is widely used in Indonesia. Duration of action of drugs need to be known for certain so the optimal muscle relaxation sufficient to do the surgery and the degree of muscle paralysis can be maintained by adding a dose of the drug. This study aims to determine the duration of action of rocuronium in order to determine the time to administer proper dose addition. This study used a descriptive method with a sample of 10 people. The results showed that the duration of action of rocuronium is 34,90 minutes. The duration of action on men is longer than women. Longest duration of action occurs on 66-75 Kg weight group and 41-47 age group Keyword: Duration of action, rocuronium.

Premedication for Endotracheal Intubation in the Neonate

2018 ◽  
Vol 37 (4) ◽  
pp. 238-247
Author(s):  
Christopher McPherson
Keyword(s):  
Adverse Effects ◽  
Endotracheal Intubation ◽  
Muscle Relaxant ◽  
Neonatal Intensive Care ◽  
Safety Data ◽  
Pharmacokinetic Profile ◽  
Preterm Neonates ◽  
Pharmacokinetic Data ◽  
Common Procedure ◽  
Duration Of Action

Endotracheal intubation, a common procedure in neonatal intensive care, results in distress and disturbs physiologic homeostasis in the newborn. Analgesics, sedatives, vagolytics, and/or muscle relaxants have the potential to blunt these adverse effects, reduce the duration of the procedure, and minimize the number of attempts necessary to intubate the neonate. The medical care team must understand efficacy, safety, and pharmacokinetic data for individual medications to select the optimal cocktail for each clinical situation. Although many units utilize morphine for analgesia, remifentanil has a superior pharmacokinetic profile and efficacy data. Because of hypotensive effects in preterm neonates, sedation with midazolam should be restricted to near-term and term neonates. A vagolytic, generally atropine, blunts bradycardia induced by vagal stimulation. A muscle relaxant improves procedural success when utilized by experienced practitioners; succinylcholine has an optimal pharmacokinetic profile, but potentially concerning adverse effects; rocuronium may be the agent of choice based on more robust safety data despite a relatively prolonged duration of action. In the absence of an absolute contraindication, neonates should receive analgesia with consideration of sedation, a vagolytic, and a muscle relaxant before endotracheal intubation. Neonatal units must develop protocols for premedication and optimize logistics to ensure safe and timely administration of appropriate agents.

scholarly journals Treatment of Iatrogenic Subglottic Stenosis by Therapeutic Fibreoptic Bronchoscopy

2019 ◽  
Vol 13 (2) ◽  
pp. 64-68
Author(s):  
Nurun Nahar Fatema Begum ◽  
Jesmin Sultana ◽  
Md Ferdousur Rahman Sarker ◽  
Sabina Yasmeen ◽  
Maj Bijoy Kumar Das ◽  
...  
Keyword(s):  
Endotracheal Tube ◽  
Endotracheal Intubation ◽  
Young Infant ◽  
Invasive Procedure ◽  
Armed Forces ◽  
Subglottic Stenosis ◽  
Fibreoptic Bronchoscopy ◽  
Tracheal Mucosa ◽  
Common Procedure ◽  
Cuffed Endotracheal Tube

Endotracheal intubation is a common procedure in intensive care unit. It still qualifies as an invasive procedure. Prolonged endotracheal intubation or intubation with cuffed endotracheal tube in a newborn or young infant is a risk factor for the development of subglottic stenosis. It usually presents with stridor in childhood.  The most likely mechanism of subglottic stenosis is an injury of tracheal mucosa, with secondary scar healing that consequently leads to the development of some degree of subglottic stenosis. Depending on the degree of subglottic stenosis, patients may be asymptomatic for a long time or symptoms can occur within several weeks. The incidence of stenosis is very low if intubation lasts less than a week. Sometimes the patient may develop severe subglottic stenosis after short-term endotracheal intubation. Intubation with cuffed endotracheal tube in newborn results in pressure necrosis and sloughing followed by subglottic stenosis. This article presents a case of a patient (Baby A) who had intubation with cuffed tube which landed to airway problem and stenosis and was managed successfully by taking help from an expert pediatric pulmonologist of a neighbouring country. Journal of Armed Forces Medical College Bangladesh Vol.13(2) 2017: 64-68

scholarly journals Penerapan Terapi Relaksasi Otot Progresif Untuk Menurunkan Hipertensi Di Desa Glandang Bantarbolang

2021 ◽  
Vol 1 ◽  
pp. 1501-1508
Author(s):  
Hema Agustian ◽  
Wiwiek Natalya ◽  
I Isytiaroh
Keyword(s):  
Blood Pressure ◽  
Muscle Relaxant ◽  
Muscle Relaxation ◽  
Progressive Muscle Relaxation ◽  
Lower Blood Pressure ◽  
Relaxation Therapy ◽  
Hypertensive Patients ◽  
Lower Blood ◽  
Health Field ◽  
Descriptive Method

AbstractHypertension is the increase of blood pressure which is higher than or equal to 140 mmHg at systolic blood pressure and higher or equal to 90 mmHg at diastolic blood pressure. The purpose of this study is to implement actions of progressive muscle relaxant therapy to lower blood pressure on hypertensive patients. This research uses descriptive method and tye subjects of this research are two hypertension clients with blood pressure higher than 140/100 mmHg at Glandang Village, Bantarbolang. Intervention is done by giving progressive muscle relaxation therapy for six days and is done once a day. The result of the study shows a drop in blood pressure on both clients, for client 1 to drop blood pressure from 160/100mmhg to 130/90mmhg and for the second client to drop in blood pressure from 170/100mmhg to 130/100mmhg. The study of the case indicates that progressive muscle relaxation therapy reduces blood pressure on hypertensive people. It is recommended for nurses or people working in health field to provide therapy in order to lower blood pressure in the form of progressive muscle relaxation therapy in hypertensive people.Keywords: Progressive Muscle Relaxation, Hypertension AbstrakHipertensi merupakan penyakit the silent killer yang menyebabkan 1 dari 3 orang dewasa terkena penyakit hipertensi dan diperkirakan 7,5 juta kematian didunia ini akibat hipertensi. Pada umumnya penyakit hipertensi ini tidak disadari oleh penderitanya, 50% penderita hipertensi tidak memperlihatkan pertanda yang pasti, terutama apabila sedang dalam taraf awal. Tujuan studi kasus ini adalah untuk mengaplikasikan tindakan terapi relaksasi otot progresif untuk menurunkan tekanan darah pada penderita hipertensi. Rancangan Karya Tulis Ilmiah ini menggunakan metode studi kasus deskriptif dengan subyek dua klien hipertensi yang mengalami tekanan darah tinggi diatas 140/100mmHg di Desa Glandang Bantarbolang. Intervensi yang dilakukan adalah pemberian terapi relaksasi otot progresif selama enam hari dan dilakukan satu kali sehari. Hasil studi ini menunjukan adanya penurunan tekanan darah pada kedua klien, untuk klien 1 mengalami penurunan tekanan darah dari 160/100mmHg menjadi 130/90mmHg dan untuk klien kedua mengalami penurunan tekanan darah dari 170/100mmHg menjadi 130/90mmHg jadi rata-rata penurunan tekanan darah dari kedua klien adalah untuk tekanan darah sistolik sebanyak 30-40mmHg dan untuk tekanan diastolik sebanyak 10mmHg. Simpulan studi kasus ini menunjukan bahwa terapi relaksasi otot progresif mampu menurunkan tekanan darah pada penderita hipertensi. Saran bagi tenaga kesehatan diharapkan dapat memberikaan tindakan terapi untuk menurunkan tekanan darah yang berupa terapi relaksasi otot progresif pada penderita hipertensi.Kata kunci: Relaksasi Otot Progresif, Hipertensi

scholarly journals Computer Controlled Muscle Relaxation: A Comparison of Four Muscle Relaxants in the Sheep

1976 ◽  
Vol 4 (1) ◽  
pp. 16-22 ◽  
Author(s):  
N. M. Cass ◽  
D. G. Lampard ◽  
W. A. Brown ◽  
J. R. Coles
Keyword(s):  
Clinical Practice ◽  
Muscle Relaxant ◽  
Muscle Relaxation ◽  
Computer Control ◽  
Muscle Relaxants ◽  
Muscle Paralysis ◽  
Precise Control ◽  
Integrated Electromyogram ◽  
Computer Controlled

Computer control of anaesthesia has been extended to include muscle relaxant drugs. Injection of d-tubocurarine, gallamine, alcuronium or pancuronium was controlled by computer to reduce the integrated electromyogram to a preset level (40 per cent of control) for one hour. A programmed level of muscle paralysis is therefore possible for use in physiological and pharmacological experiments, and in clinical practice where precise control of the degree of paralysis together with minimal dosage is advantageous.

scholarly journals Estimation of length of endotracheal tube insertion by foot length in newborns

2018 ◽  
Vol 5 (3) ◽  
pp. 958
Author(s):  
Nabeela Hannan ◽  
Prema . ◽  
Surabhi H. S.
Keyword(s):  
Endotracheal Tube ◽  
Cross Sectional Study ◽  
Normal Weight ◽  
Tube Length ◽  
Strong Positive Correlation ◽  
Tube Insertion ◽  
Common Procedure ◽  
Cross Sectional ◽  
Optimal Depth ◽  
Foot Length

Background: Intubation is a common procedure for neonates. This study was designed to determine whether the foot length (FL) can predict the depth of endotracheal (ET) tube insertion in newborns.Methods: This one year prospective cross-sectional study was done on 50 neonates admitted to NICU under the Department of Paediatrics, Rajarajeswari Medical College and Hospital, Bangalore from January 2016 to June 2017. The FL was measured and compared with the optimal depth of ET tube insertion. The data was analysed using SPSS version 20.0.Results: The mean FL was 7.42±0.75cms and mean optimal ET tube length was 7.70±0.71cm. The correlation between optimal ET tube length and foot length was noted in 70% of the babies and significant strong positive correlation was noted between optimal ET tube length and FL (r=0.780; p<0.001; R2=0.607). Significant differences were noted in mean FL and mean optimal depth of ET tube in term newborns (p=0.013) and those with normal weight (p=0.016).Conclusions: Foot length could be used as a simple and easy predictor in the estimation of endotracheal tube length in newborns.

Facilitating Submental Endotracheal Intubation with an Endotracheal Tube Exchanger

2000 ◽  
Vol 90 (1) ◽  
pp. 222-223 ◽  
Author(s):  
Pierre Drolet ◽  
Michel Girard ◽  
Jean Poirier ◽  
Yvan Grenier
Keyword(s):  
Endotracheal Tube ◽  
Endotracheal Intubation

scholarly journals Is there an optimal place to hold the endotracheal tube during direct laryngoscopy? Protocol for a Randomised Controlled Trial

2021 ◽  
Author(s):  
Manisha Sahoo ◽  
Swagata Tripathy ◽  
Nitasha Mishra
Keyword(s):  
Endotracheal Tube ◽  
Endotracheal Intubation ◽  
Controlled Trial ◽  
Scientific Evidence ◽  
Intubation Difficulty ◽  
The Mean ◽  
Randomised Controlled ◽  
Difficulty Score ◽  
Clinical Trials Registry ◽  
Rate Of Success

Abstract Background: Laryngoscopic endotracheal intubation (LEI) is a widely performed lifesaving technique. There are evidence and guidelines to help decide the optimal sized endotracheal tube (ET), laryngoscope, depth of insertion, and patient position for successful endotracheal intubation. We hypothesize that after glottic visualization, the point at which the ET is held will affect the time, ease, and success of the technique due to a difference in visualization and torque. We aim to compare two sites of holding the ET after optimal laryngeal-inlet visualization: time to intubation, rate of success of first pass intubation, intubation difficulty and complications.Methods: Supervised intubations on ASA 1-2 patients (>18 years) posted for surgery under general anesthesia performed by anesthesia trainees (experience <18 months) will be included. Patients with an anticipated difficult airway or unanticipated difficulty - CL grade > three or requiring the use of airway adjuncts will be excluded. A computer-generated numbers list will randomize patients; allocation concealed with opaque sealed envelopes. ET marked at the selected site will be handed to the intubator by the theatre-technician once she/he confirms the optimum laryngoscopic view. The entire procedure will be video recorded. Two blinded assessors will independently review the videos to document the time to intubation (TTI defined as the time from holding the ET to the removal of laryngoscope from the mouth after successful intubation) and intubation difficulty score. Postoperative sore throat and hoarseness will be recorded.Sample size: 54 experienced anesthetists were video-recorded during intubating. The site of holding ET and TTI were analyzed. The mean site was 3 SD 2.5 cm from the tip, yielding two sites for the study- 19 cm (Gr 1) and 24 cm (Gr 2). To detect a 20% difference in intubation time between groups, the confidence of 95%, and power 85%, we will need 298 patients: 180 per group after accounting for data loss.Discussion: This will be the first study to assess whether holding the tube at a particular site has any impact on the ease and time taken for intubation. This study's findings will provide the first scientific evidence for an appropriate place for holding the ET during LEI, which we feel will help trainees improve their LEI technique.Trial registration: CTRI/2019/09/021201, Clinical Trials Registry India. http://ctri.nic.in/Clinicaltrials/advsearch.php. Registered 12th September 2019,

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