The recent finding of terbutaline as the treatment of choice to manage intraoperative penile tumescence with the patient under anesthesia (general and regional) has prompted us to use this beta-2 agonist (5 mg. orally) for persistent penile erection and priapism resulting from injection of pharmacological agents, such as phentolamine, phenoxybenzamine and papavarine, into the penis for erectile impotence. The drug also has been used successfully (0.25 to 0.5 mg. intravenously or subcutaneously) to treat priapism developing despite a cavernosum-spongiosum shunt procedure. This and other pure beta 2 agonists will have an important role in the treatment of undesirable and painful penile erection, alone or in association with other invasive and noninvasive intervention.
The applied anatomy of the cricothyroid and cricotracheal region of the neck and a retrograde method of tracheal intubation using the subcricoid region are described. This approach has several advantages, including absence of bleeding complications, as there are no major blood vessels on the cricotracheal membrane, and reduction in the possible development of subglottic oedema and stenosis.
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