Comprendre les réactions hémodynamiques à l’intubation endotrachéale

Effect of Dexmedetomidine on the Corrected QT and Tp-e Intervals during Spinal Anesthesia

“…Although the mechanism is still unclear, prolongation of the QTc interval may be attributed to sympathetic stimulation rather than the drug itself for regional anesthesia 12,13. It is well recognized that sympathetic activation provokes changes in cardiac repolarization14 and repolarization abnormalities 15. Therefore, the agents including opioids or β-adrenergic blockers, which can reduce the sympathetic stimulation, are considered for patients who are vulnerable to QTc interval prolongation 16,17.…”

Extubation and Reintubation of the Difficult Airway

“…The specific strategies needed to attenuate these usually transient changes are dictated by the clinical context. The strategies, which are not universally effective, include the use of intracuff, [63][64][65] intratracheal, 66 or intravenous lidocaine 61,67,68 ; beta-blockers 60,[69][70][71] ; dexmedetomidine 72,73 ; and nitrates.…”

On smooth extubation without coughing and bucking

“…To the Editor: Having just received the Journal and read Dr. Orlando Hung's editorial 1 and Dr. Michael Stix et al 's article 2 about trying to achieve smooth emergence from anesthesia and extubation (by intra-tracheal lidocaine and exchanging an endotracheal tube (ETT) for a laryngeal mask prior to emergence), I would like to suggest another relatively simple way of achieving such goals. Whenever I want to extubate a patient quite awake at the conclusion of anesthesia without all the coughing and bucking, I prepare an ETT that will allow me to instil 2% lidocaine into the trachea prior to extubation.…”