Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0010200 (cough)
 23,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Three cases of left recurrent laryngeal nerve palsy following heart-lung transplantation are described. In each case, within twelve hours of extubation, the left vocal cord was injected with Teflon, and the paralyzed vocal cord thus displaced to the midline. Effective closure of the glottis was then possible, permitting an adequate cough, adequate clearing of the bronchial tree and minimising the risk of aspiration. Augmentation under general anaesthesia as soon as possible after discovery of vocal cord dysfunction is advocated. Suitable materials for injection are discussed. To our knowledge, this is the first reported series of vocal cord augmentation in the acute phase following heart-lung transplantation.
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PMID:Recurrent laryngeal nerve palsy following heart-lung transplantation: three cases of vocal cord augmentation in the acute phase. 258 60

Sedation for fibreoptic bronchoscopy should produce optimal conditions for the operator, patient comfort and rapid recovery allowing early discharge home. We have compared a regimen producing 'light' sedation with a more traditional regimen producing 'deep' sedation. Seventy-six patients undergoing fibreoptic bronchoscopy under topical anaesthesia were randomized to receive either light sedation with the short acting opiate, alfentanil (median dose 1.1 mg, range 0.5-2.6 mg) or deep sedation with a combination of papaveretum (median dose 10 mg, range 5-15 mg) and diazepam (median dose 8 mg, range 0-20 mg). Both techniques gave equally good operating conditions, although patients given alfentanil coughed less than those given papaveretum and diazepam (U = 2.814 P less than 0.01). Patients recorded their degree of apprehension on a visual analogue scale prior to sedation and the actual degree of comfort experienced after recovery. There was no significant difference between apprehension or comfort between the groups. This was despite a higher degree of amnesia for an irrelevant object shown during the bronchoscopy in the deeply sedated group (chi 2 = 21.084 P less than 0.001). Patients given alfentanil performed significantly better in a modified Romberg test (chi 2 = 4.357 P less than 0.05) and a visualisation test (t = 3.035 P less than 0.01) two hours after the bronchoscopy. Alfentanil produced good operating conditions, patient comfort, less cough and a more rapid recovery, compared to the deep sedation regimen, and is an ideal sedative for fibreoptic bronchoscopy.
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PMID:Sedation for fibreoptic bronchoscopy: comparison of alfentanil with papaveretum and diazepam. 259 39

The antitussive Libexin was synthesized in the Research Laboratory of CHINOIN Pharmaceutical and Chemical Works Ltd., Budapest. Observations of the drug in different disease groups have been surveyed on the basis of data published over more than twenty years. According to the unanimous opinion of the authors the drug does not depress respiration, it rather improves the values of the respiratory function. The majority of the examining physicians are on the opinion that it does not hinder expectoration. The drug proved to be of high value in alleviating nocturnal coughing controlling spastic bronchitis in children, as a pretreatment before bronchological examinations and their anaesthesia. It may successfully be used in both acute and chronic bronchitises in preoperative and postoperative cases, in cardiology, otorhinolaryngology and paediatrics.
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PMID:Fifteen years of experience on the use of Libexin tablets. 266 94

Ninety unpremedicated patients undergoing mask anaesthesia were assigned to one of three groups according to the volatile anaesthetic and the acute intravenous premedication administered. Group I received saline placebo as premedication and halothane by inhalation. Group II received saline placebo and isoflurane by inhalation. Group III received nalbuphine 0.1 mg.kg-1 IV as premedication and isoflurance by inhalation. Mean time to loss of consciousness (71 sec) did not differ among groups. The dosage of thiopentone required to induce loss of consciousness was decreased by 15 per cent (from 3.9 to 3.3 mg.kg-1) by nalbuphine premedication (P less than 0.05), and time to induction of surgical anaesthesia using isoflurane was decreased by 15 per cent (P less than 0.05). The incidence of reflex actions (coughing, laryngospasm, breath holding, hiccoughs and movement) during induction was no different in the saline-premedicated halothane or isoflurane groups. Acute intravenous nalbuphine premedication decreased significantly the incidence of reflex actions during induction of isoflurane anaesthesia from 77 per cent to 37 per cent (P less than 0.02). Desaturation episodes (SaO2 less than 90 per cent) were more frequent with isoflurane inductions compared with halothane (55 per cent vs 17 per cent, P less than 0.01). Apnoeic episodes accounted for the majority of desaturations associated with nalbuphine premedication, while excitatory reflexes (coughing and laryngospasm) accounted for more desaturations with isoflurane alone.
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PMID:Induction reflex actions with intravenous nalbuphine as an adjunct to isoflurane. 266 79

Peak expiratory flow rate (PEFR) was measured in 19 mothers during elective Caesarean section under unsupplemented extradural anaesthesia. In 18 mothers, serial measurements of peak expiratory flow rate indicated adequate expiratory reserve and residual abdominal muscle power consistent with an effective cough. In one mother, with severe respiratory disease, PEFR decreased to a value indicative of inadequate cough. Data for one other mother who came for emergency Caesarean section after 4 h of an extradural infusion also indicated an inability to cough.
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PMID:Serial peak expiratory flow rates in mothers during caesarean section under extradural anaesthesia. 270 77

Pulmonary alveolar proteinosis is characterized by an amorphous lipoproteinaceous material filling the acini of the lung, resulting in hypoxemia. At present, the most effective treatment for alveolar proteinosis is lung lavage. Here, we report the first case in Taiwan treated with this method. A 38-year-old male with a 6-month history of cough and increasing breathlessness was transferred from another hospital. On admission, his arterial oxygen tension was 51 mmHg when breathing room air. Chest X-ray films showed diffuse infiltration of both lung fields. Transbronchoscopic lung biopsy was consistent with alveolar proteinosis, therefore the patient was submitted to pulmonary lavage. Under general anesthesia, the patient was intubated with a left-sided double lumen endotracheal tube, and lavage of the right lung was repeated with 0.9% saline until the washing became clear. At the end of the procedure, the patient was extubated after making strong respiratory efforts. Several days later, the left lung was lavaged using the same technique. The mechanical washing of amorphous material from alveoli by pulmonary lavage is of great benefit in relieving hypoxemia. Judicious use of lung lavage is effective and safe for patient with alveolar proteinosis.
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PMID:[Pulmonary lavage for alveolar proteinosis. A case report]. 272 86

The authors examined and followed 104 patients who had undergone surgery under endotracheal anesthesia in order to recognize the lesions of the oropharynx and the larynx resulting from intubation and other manipulations within the oral cavity and the pharynx. Laryngoscopic examination disclosed: a hematoma of true vocal cords in 5 patients, hematoma of the aditus ad laryngem and soft palate in 1 patient, edema in 4 patients, and in 8 patients hematoma of the oropharyngeal mucosa. The patients reported the following post-extubation discomforts: sore throat, hoarseness, dysphagia, a feeling of burning, clenching or foreign body in the throat, rough throat, irritation to hacking cough, and pains in the cervical musculature. Laryngitis was singled out as a disorder found in an increased percentage in the study group, as compared to the literature data, for which an explanation is given.
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PMID:[Intubation lesions of the oropharynx, larynx and trachea]. 273 96

The authors determined the thiopental dose needed for satisfactory induction in ten neonates, 0-14 days of age, and 20 infants, 1-6 months of age. A single iv bolus of thiopental was given. Thirty seconds after injection the anesthesia mask was applied and the response was observed during the following 30 s while the patient breathed oxygen. Induction was considered satisfactory if there were no gross movements or coughing. The dose required for satisfactory induction in 50% of patients, ED50 (+/- SE), was 3.4 +/- 0.2 mg/kg in neonates and 6.3 +/- 0.7 mg/kg in infants (P less than 0.001). It is concluded that the thiopental dose needed for satisfactory induction is less in neonates than in infants.
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PMID:Thiopental requirements for induction of anesthesia in neonates and in infants one to six months of age. 277 60

Postoperative psychomotor and cognitive recovery were assessed after anaesthesia induced by either propofol or thiopentone, and maintained with nitrous oxide and halothane in 40 unpremedicated dental patients. Performance was shown to be impaired one hour postoperatively for the whole sample in hand-eye coordination (p less than 0.001), reaction time (p less than 0.001) and digit span (p less than 0.05). There was evidence of impairment at 3 hours postoperatively in reaction time (p less than 0.05) and ataxia (p less than 0.01). Performance also deteriorated in the dexterity and aiming tasks. Patients reported significantly less clumsiness by 24 hours in blurred vision and shivering (p less than 0.05) and by 48 hours less coughing (p less than 0.05). However, there was no significant difference between groups. No evidence showed that recovery in the propofol group was faster, so it was concluded that induction with propofol offered no advantage when anaesthesia is maintained with nitrous oxide and halothane for the periods of time reported in this study.
Anaesthesia 1989 Mar
PMID:Propofol-induced anaesthesia. Double-blind comparison of recovery after anaesthesia induced by propofol or thiopentone. 278 49

The onset of neuromuscular blockade following the i.v. injection of vecuronium and pancuronium 0.05, 0.08 or 0.1 mg/kg and suxamethonium 0.5 or 1.0 mg/kg was studied in 304 patients during induction of anaesthesia by means of the compound action potential derived from the adductor pollicis muscle, which was indirectly stimulated via the ulnar nerve. The intubation conditions 1-5 min after injection were assessed using a scoring system related to ease of laryngoscopy, movement of vocal cords and coughing, and reflex movements of extremities. Development of motor blockade was time- and dose-dependent. After administration of 0.1 mg/kg vecuronium, the actual maximum effect (more than 90% block) was established within 4 min; after 0.1 mg/kg pancuronium within 6 min and after 1.0 mg/kg suxamethonium within 2 min. Intubation conditions improved with time. After 0.1 mg/kg vecuronium atraumatic intubation was possible within 2 min and after 0.1 mg/kg pancuronium within 4 min. Following 1.0 mg/kg suxamethonium, optimum intubation conditions were achieved within 1 min. Although suxamethonium acts the fastest and tracheal intubation can be achieved within 0.5-1.0 min, its use involves certain side effects and disadvantages. Vecuronium acts considerably faster than pancuronium and good or excellent intubation conditions are present within 2 min. Suxamethonium is no longer the muscle relaxant of choice for intubation except for crash intubation, e.g., in patients with a full stomach.
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PMID:[Vecuronium: onset of effect and intubation conditions in comparison to pancuronium and suxamethonium]. 286 13


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