Tracheal bronchus is a congenital anatomical variant of patients with accessory bronchus in the right upper lobe deriving directly from the supracarinal trachea. Pre-operative consultation with the anesthesiologist is important for patient safety and can avoid adverse effects induced by endotracheal intubation. In this report, we described a case of tracheal bronchus in which general anesthesia was performed for video-assisted thoracoscopic surgery. We discussed some of the issues surrounding to complications in tracheal bronchus.
Atropine and glycopyrrolate were compared in a mixture with neostigmine for reversal of neuromuscular blockade in patients undergoing open heart surgery. In patients not receiving beta-blocking drugs, glycopyrrolate was shown to possess advantages over atropine in terms of a lower initial increase in heart rate, better protection against the muscarinic effects of neostigmine, and smaller increases in rate-pressure product. The concomitant administration of beta-adrenergic blocking therapy significantly attenuated the effect of reversal on heart rate and the differences between atropine and glycopyrrolate were not significant. There was no difference in the incidence of arrhythmias between patients who received beta-blocking drugs and those who did not.
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