Nitroglycerin relieves laryngospasm

Sibai, A. N.; Yamout, Imad

doi:10.1034/j.1399-6576.1999.431020.x

Cited by 19 publications

(18 citation statements)

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“…Because laryngospasm is an emergency that requires an immediate management, the policies and procedures (P&P) committee of the anesthesiology department in our institute required the technique to be fixed over a period of time and not changed from case to case. The cases were, thus, studied in a sequential manner with laryngospasms occurring in the first 2 years managed with the standard technique [6,7] (Standard-Practice Group) and laryngospasms developing in the next 2 years managed with the chest compression technique (Chest-Compression Group). Both study groups were managed by the same researchers.…”

Section: Methodsmentioning

confidence: 99%

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Gentle chest compression relieves extubation laryngospasm in children

2010

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Section: Methodsmentioning

confidence: 99%

“…The standard management is maintaining a clear airway while using 100% oxygen with continuous positive airway pressure (CPAP) via a tight face mask [6,7]. If this is ineffective, then succinylcholine is advised followed by subsequent manual ventilation with or without intubation [8,9].…”

Section: Introductionmentioning

confidence: 99%

Gentle chest compression relieves extubation laryngospasm in children

2010

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“…In 2 von Sibai u.Yamout [33] beschriebenen Fällen lös-te die intravenöse Gabe von Nitroglyzerin (4 mg/kg) innerhalb von 1 min nachhaltig einen Laryngospasmus. Da Nitroglyzerin jedoch nicht in jedem Fall unmittelbar verfügbar ist, dürften in der täglichen Routine Empfehlungen, wie Verwendung des Esmarch-Handgriffs, Oberkörperhochlagerung, Gabe von 100%igem Sauerstoff, Vertiefung der Narkose ggf.…”

Section: Therapieunclassified

Verzögert auftretendes, postobstruktives Lungenödem

Kulka¹,

Issel²,

Wiebalck³

et al. 2003

Der Anaesthesist

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A young athletic male adult (smoker) developed a pulmonary edema 30 min after the end of anaesthesia. Extubation was complicated by a laryngospasm. After artificial ventilation for 12 h the patient recovered completely.A negative pressure pulmonary edema (NPPE) develops after deep inspiratory efforts with an occluded airway. Such a maneuver leads to negative intrapleural pressures of -50 to -100 mmHg. This pressure gradient causes damage to the pulmonary capillaries, a transcapillary volume shift into the interstitium,and hemodynamic changes that increase the intrapulmonary blood volume. As a NPPE may occur with a delay of up to 1 h it is crucial to provide adequate monitoring for patients at risk. Symptomatic therapy usually leads to complete recovery within several hours.

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“…7,8 NTG sublingual spray is simple and easy to use formulation mainly aimed for treatment of acute anginal episodes. It is also marketed to treat acute hypertensive crisis and also to treat diabetic neuropathic pain with local application.…”

Section: Introductionmentioning

confidence: 99%

The Effects of Nitroglycerine (Ntg) Sublingual Spray to Blunt the Haemodynamic Response to Endotracheal Extubation in Lumbar Disc Surgery

Singh¹,

Sundrani²,

Tagalpallewar³

et al. 2015

jemds

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OBJECTIVE:The aim of this study was to evaluate the effects of nitroglycerine (NTG) Sublingual Spray on prevention of haemodynamic responses to tracheal extubation in patients undergoing lumbar disc surgery. METHODS: With approval from the institutional ethical Committee, written consent, 30 patients between 20-60 years of age undergoing elective lumbar disc surgery were randomly placed in either the Group A (n=30) or the Group B Control (n=30).Anaesthesia was induced with 2mg kg-1 propofol, 0.5mg kg-1pentazocin, and 0.1mg kg-1 vecuronium bromide iv, and was maintained with 0.8-1 MAC isoflurane in oxygen-nitrous mixture (40:60). After dressing of the surgical wound, all anaesthetic agents were discontinued and the patients were ventilated with 100% oxygen. Two sublingual NTG sprays (0.8mg) was given to Group A (n=30), after regain of spontaneous respiratory attempts, while no drug given to Group B. Hemodynamic variables were noted before administering study drug, during extubation then at 1, 3, 5, 10, 15 and 20 min after the extubation. RESULTS: In the sublingual NTG group, mean arterial pressures decreased significantly after sublingual NTG Spray and were significantly lower than in the control group at exubation and 1,3 and 5min after extubation (p<0.05).The heart rate and Rate pressure product (RPP) were comparable in both groups (p>0.050). CONCLUSION: We concluded that 0.8mg (Two sprays) sublingual NTG before extubation can prevent hypertension caused by extubation in patients undergoing elective lumbar disc surgery without much affecting heart rate and RPP . KEYWORDS: Nitroglycerine (NTG), Subligual, Extubation, Lumbar disc surgery. INTRODUCTION:Recovery from general anesthesia and extubation is a period of intense physiological stress for patients. There are several physiological responses to postoperative stress, including increases in oxygen consumption, catecholamine blood levels, blood pressure and heart rate. In most cases blood pressure and heart rate increases gradually as patient awakens. Tracheal extubation causes additional transient increase by 10-30% in arterial pressure and heart rate lasting 5-15 min. 1 it is more hazardous in patients with hypertension, myocardial insufficiency or cerebral vascular diseases. Patient with coronary artery disease experience a 40-50% decrease in ejection fraction. 2 Therefore, attenuation of haemodynamic responses to tracheal extubation such as hypertension, tachycardia and arrhythmias is important for an anesthesiologist. In order to control haemodynamic changes during tracheal intubation and extubation, local anaesthetics, opioids, beta-blocking agents, and calcium channel blockers have been used with varying success rates. 3-6 all of them require time for preparation and administration.Nitroglycerine generates NO (Nitric oxide) in vascular smooth muscles which produce vasodilatation leading to decrease in blood pressure.

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Nitroglycerin relieves laryngospasm

Cited by 19 publications

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Gentle chest compression relieves extubation laryngospasm in children

Gentle chest compression relieves extubation laryngospasm in children

Verzögert auftretendes, postobstruktives Lungenödem

The Effects of Nitroglycerine (Ntg) Sublingual Spray to Blunt the Haemodynamic Response to Endotracheal Extubation in Lumbar Disc Surgery

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